Species identification and antibiotic susceptibilities of coagulase o negative staphylococci isolated from urinary tract infection specimens

Objective: To determine the incidence of Coagulase - negative S. aureus in urinary tract infections and sensitivities of these isolates to antimicrobial agents

Study Design: Cohort study

Place and Duration of Study: Dr. Essa Laboratory and Immunology and Infectious Disease Research Laboratory [IIDRL], Microbiology Department, University of Karachi, from January 2009 to January 2010

Methodology: Urine specimens, suggestive of urinary tract infection [UTI], were identified. Speciation of isolates was done using API-20 Staph. system. Screening of extracellular products was done using SDS-PAGE electrophoresis and Hemolysin on blood-agar plates. Minimum inhibitory concentration [MICs] of antibiotics was estimated by microtiter well plate method. Frequency and percentages were determined and chi-square test was used for comparing proportions with significance at p < 0.05

Results: Coagulase - negative S. aureus [CONS] were the cause of urinary tract infection in 56 out of 1866 outpatient [3%] and 164 of 1261 inpatient [13%], urinary tract infections [p < 0.001]. Two hundred and twenty CONS isolates were identified. The most common CONS identified was S. saprophyticus [31%, 68 strains]. The relative frequency of Coagulase - negative S. aureus was 6% [13 strains]. All isolates were sensitive to Vancomycin and Linezolid. Resistance was 69% to Ampicillin, 53% to Methicillin, and 37.5% to Ciprofloxacin

Conclusion: CONS are a potential uropathogens, with capability of slime production and resistance to common empirical prescriptions. This also warrants formulation of an appropriate antibiotic policy that covers CONS

Modification of Cabrol patch for control of aortic root bleeding

Rate of bleeding following aortic root replacement is reported in upto 24% of cases. Bleeding significant enough to require re-operation is reported in upto 4% of cases. We performed a modification of Cabrol patch to control bleeding from complicated aortic root replacement procedure. We used a perigraft - right-atrial fistula technique to control bleeding from aortic root area using a bovine pericardial patch. Patient had an uneventful hospital course and was discharged on postoperative day 14

Laparoscopic cyst-gastrostomy for pancreatic pseudocyst

Pancreatic pseudocyst Is a complication following resolution of pancreatitis. The optimum treatment for this condition has been under much debate. Laparoscopic surgery has changed the outlook of surgical management for the condition by reducing the operation related morbidity. The procedure has not been reported in local literature and is relatively new for the medical-surgical community. We report a case of pseudocyst gastrostomy and explain the procedure through laparoscopic approach

Complete androgen insensitivity syndrome

The incidence of Complete Androgen Insensitivity Syndrome [CAIS] is about 1 in 20.000. People with CAIS are normal appearing females, despite the presence of testes and a 46, XY chromosome constitution. We came across a case in which a 17 years old girl presented with the complaint of inguinal hernia and amenorrhea. Subsequent investigations were done revealing absence of female internal genitalia and the presence of abdominal mass, possibly testes. Syndrome has been linked to mutations in AR, the gene for the human Androgen Receptor, located at Xq11-12 leading to the insensitivity of the receptor to testosterone. Gonadectomy was performed and life long Hormone replacement therapy was advised