Neonatal sepsis: causative bacteria and their resistance to antibiotics

Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries. The objective of this study was to determine the causative bacteria and level of their resistance to commonly used antibiotics. This descriptive study was carried out at Ayub Teaching Hospital, Abbottabad from April 2009 to January 2010. All neonates of either gender admitted in neonatology unit with clinical sepsis and positive blood culture were included in the study. Neonatal period was defined as 28 days of life at term and up to 44 weeks of gestational age in preterm babies. One hundred and thirty neonates of either gender were studied during the period. Blood sample for culture was taken from a peripheral vein or an artery ensuring standard anti-septic measures. BACTEC technique was used for obtaining bacterial growth and drug sensitivity after incubation of 24-48 hours. Second blood culture was also performed in few cases which were not showing improvement after initial treatment. Male to female ratio was 1.3:1. Early and late onset sepsis was found in 29.2% and 70.8% respectively. Gram-negative bacteria were more frequent than grampositive bacteria with a frequency of 54.6% and 45.4% respectively. Gram-positive and gram-negative bacteria showed high resistance against commonly used antibiotics such as ampicillin, amoxicillin, cefotaxime, ceftriazone and gentamicin. Staph. aureus is the most common gram-positive bacterium and E. coli is the most common gram-negative bacterium causing neonatal sepsis. Grampositive and gram-negative bacteria are highly resistant against commonly used antibiotics such as ampicillin, amoxicillin, cefotaxime, ceftriazone and gentamicin, and are relatively more sensitive to less commonly used drugs like amikacin and ceftazidime

Haematological findings in relation to clinical findings of visceral leishmaniasis in Hazara division

Visceral Leishmaniasis [VL] has worldwide distribution including Pakistan. The disease is characterized by a spectrum of clinical features along with serious complications in untreated cases. This study describes the correlation between clinical manifestations with haematological changes of VL in Hazara Division. This cross sectional study was carried out in the children wards of Women and Children Hospital an Ayub Teaching Hospital Abbottabad. Seventy cases were included in this study, Sign, symptoms, complications and haematological parameters were recorded in detail and their comparison was carried out. Majority of the patients [98.57%] presented with fever followed by abdominal distension [47%] Pallor, [44%] weight loss [43%] diarrhoea [17%], vomiting [15%] and epitasis [8%] and hepatosplenomegaly was found in about 83% along with lymphadenopathy [20%] purpura [13%] and peripheral oedema [11%]. Laboratory findings revealed anaemia in all the cases followed by neutropenia 43%, lymphocytosis 86% with thrombocytopenia 79%. Bone marrow in most of these cases showed myeloid hyperplasia with increased megakaryocytosis. There exists a new focus of visceral leishmaniasis in Hazara Division. The disease mainly affects children below 5 years and is more common in males than in female children. Bone marrow examination provides a reliable and simple tool for diagnosis of visceral leishmaniasis and the condition can be affectively managed with Sodium stibogluconate or meglumine antimoniate