ABSTRACT
P. aeruginosa accounts for a significant proportion of nosocomial infections. This study was conducted to assess the prevalence, levels of antimicrobial susceptibility and resistance mechanisms of Pseudomonas from various clinical samples. P. aeruginosa accounts for a significant proportion of nosocomial infections. This study was conducted to assess the prevalence, levels of antimicrobial susceptibility and resistance mechanisms of Pseudomonas from various clinical samples. Methods: The study was conducted in a tertiary care hospital, over a period of 1 year. After identification of genus Pseudomonas, the speciation was done by biochemical tests and by VITEK 2. Antibiotic susceptibility was determined by disc diffusion method. Extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) production were detected by the combined disc diffusion test. Results: They were predominantly isolated from pus (44.3%), followed by blood (24.05%), body fluids (13.92%) and sputum (12.03%). The highest number of isolates were pseudomonas aeruginosa (64.56%) followed by p. fluroscence 19.62%, p. putida 7.6%, p. stutzeri 1.9%, p. alcaligens 1.9%, burkhelderia cepacia complex (BCC) (previous designation: pseudomonas cepacia) 1.9% and 2.53% isolate of burkhelderia pseudomallei (previous designation: pseudomona spseudomallei). Conclusion: This study examined the prevalence of pseudomonl infections, and its susceptibility patterns to different antibiotics. The presence of antibiotic-resistant P. aeruginosa isolates could be attributed to β-lactamase production and the use of multiple drug resistance efflux pump. It therefore calls for a very judicious, rational treatment regimens prescription by the physicians to limit the further spread of antimicrobial resistance among the P. aeruginosa strains.
ABSTRACT
Introduction: Corticosteroids play a pivotal role in thetreatment of the asthma. They rapidly reduce the numberof eosinophils in the blood and tissues and inhibit theirdegranulation, suggesting that sputum eosinophilia could be agood predictor of response to inhaled corticosteroids. Chronicdiseases like asthma have significant effects on patients'health-related quality of life (HRQoL). HRQoL measuresadditional indices as compared to objective measurements likespirometry. Objective: To assess and compare disease-specificquality of life in asthma patients using St. George's RespiratoryQuestionnaire (SGRQ) receiving inhaled corticosteroids.Material and Methods: Patients were enquired for theirduration of illness, other co morbidities (if present), historyof smoking and familial history of the illness. Pattern ofasthma was duly assessed. For Health-related Quality oflife assessment, Saint George’s Respiratory Questionnaire(SGRQ) was used in the study after obtaining due permissionfrom the concerned authority at St George’s, University ofLondon.Results: Mean age of the study population was found tobe 36.17 ± 18.77 years. Mean duration of illness for theasthmatics was 10.19 ± 11.08 years. Majority i.e. 69% deniedof having any familial history of asthma, while 31% confirmedhaving the same. Smoking status was enquired among thestudy subjects, which revealed that 85% were non-smokers,while 9% were past smokers and 6% were current smokers.Pattern of asthma was found to be seasonal for 65% patientswhile perennial for 35% patients. Baseline symptoms scorewas 61.45± 15.78, which was reduced to 48.19±18.73 after 3months on inhaled corticosteroids therapy. Baseline activityscore was 49.67± 15.34, which was reduced to 41.51±18.52after 3 months on inhaled corticosteroids therapy. Baselineimpact score was 48.79± 16.85, which was reduced to38.69±18.14 after 3 months on inhaled corticosteroids therapy.Conclusion: There was evidence for an early QoLimprovement on inhaled corticosteroids in moderate andsevere persistent asthma.