ABSTRACT
To determine antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus in a tertiary care setting. Descriptive study. Microbiology Department, Armed Forces Institute of Pathology, Rawalpindi from March 2011 to April 2012. Two hundred isolates of MRSA recovered from various clinical specimens sent to AFIP for culture and sensitivity were identified using standard microbiological techniques and the antimicrobial susceptibility was carried out employing Kirby-Bauer disc diffusion technique as recommended by Clinical and Laboratory Standards Institute. The Susceptibility pattern of isolates was recorded in percentages. Of the 200 MRSA isolated, all[100%] were susceptiblr to vancomycin and Linezolid followed by 88% to tigecycline, 81% to chloramphenicol, 66% to amikacin, 62.5% to clindamycin, 52.5% to doxycycline, 36% to trimethoprim-sulfamethoxazole, 29% to gentamicin, 28.5% to erythromycin and 26.5% to ciprofloxacin. The results show that linezolid and vacomycin hold excellent in vitro efficacy against MRSA whereas doxycyline, clindamycin, trimethoprim-sulfamethoxazole, gentamicin, erthromycin and ciprofloxacin have poor sensitivity.
Subject(s)
Microbial Sensitivity Tests , Tertiary Care CentersABSTRACT
To determine the spectrum and antimicrobial susceptibility pattern of pathogens isolated from bone marrow transplant centre and to examine the evolution of bacterial resistance to antibiotics in these patients. It was a retrospective study conducted in the department of Microbiology, Armed Forces institute of Pathology [AFIP] from January 2004 to December 2009. Isolation, identification and antimicrobial susceptibilities were performed by standard methods. Gram negative bacterie accounted for 50.4% of the total isolates and Gram positives 49.6%. Escherichia coli was the most common isolate among the gram negative rods followed by Pseudomonas spp and Acinetobacter spp. Amongst the Gram positive organisms staphylococcus aureus and coagulase negative staphylococci followed by enterococci were the predominant organisms. The susceptibility of methicillin resistant staphylococcus aureus remained 100% for Vancomycin and Linezolid, while those of minocycline, fusidic acid and doxycycline were at an acceptable level of above 60%. Imipenem remained the most effective antibiotic for Gram negative rods. Acinetobacter spp. was the most problematic organism as only 62% isolates were susceptible to imipenem. Linezolid, vancomycin and tigecycline were very effective for enterococci. Ciprofloxacin sensitivity has been reduced among most of the bacteria isolated. The spectrum of isolates from neutropenic patients in our population appears to be changing with a shift towards Gram-positive microorganisms. At the same time resistance to most of the commonly used antimicrobials is increasing. Continuous surveillance of their susceptibility patterns is essential for formulation of empiric therapeutic regimens for these patients
ABSTRACT
To determine the in vitro efficacy of Piperacillin/Sulbactam, Piperacillin/Tazobactam and Cefoperazone/Sulbactam against clinical isolates of Pseudomonas aeruginosa. Cross-sectional study Department of Microbiology, Armed Forces Institute of Pathology from January 2010 to September 2010. A total of 287 isolates of Pseudomonas aeruginosa recovered from various clinical specimens were taken under consideration. Routine microbiological methods were used to identify the organism. Susceptibility of the isolates was carried out by modified Kirby-Bauer disc diffusion method against piperacillin 100/sulbactam 30 [SPR130micro g], cefoperazone 75/sulbactam 30 [SCF105micro g] and piperacillin 100/tazobactam 10 [TZP110micro g], according to the guidelines provided by Clinical and Laboratory Standards Institute [CLSI]. The highest numbers of Pseudomonas aeruginosa isolates were found in pus swabs, followed by urine and endobronchial washings. Seventy five percent of clinical isolates of P. aeruginosa were susceptible to tazobactam/piperacillin, 71% to piperacillin/sulbactam and 70% to cefoperazone/sulbactam. The difference between the susceptibility of isolates to these three antimicrobials was statistically not significant [p>0.05]. We conclude that there was very little difference in the antimicrobial susceptibility of P. aeruginosa to the three beta-lactam/beta-lactamase inhibitor combination drugs studied. Periodic susceptibility testing should be carried out over a period of two to three years, to detect the current resistance trends. Moreover, a rational strategy on the limited and prudent use of anti-Pseudomonal agents is urgently required