ABSTRACT
Abstract: Since the Physicians start use of antibiotics long ago with un-notice drug resistance. However actual problem was recognized about 85 years ago. Antibiotic resistant and Multi-drug resistant bacterial strains are at rise throughout the world. It is physicians and researchers to take scientific research based appropriate action to overcome this ever-spreading problem.. This study is designed to find out sensitive [S], resistant [R] and multi-drug resistant [MDR] Acinetobacter baumanii strain along with other isolates in the resident patients of Eastern Region of Saudi Arabia. Pseudomonas aeruginosa is excluded from other gram-negative organisms isolated from different sites as it will be dealt separately. This study is based in was retrospective observations designed to collect data of different stains of Acinetobacter baumanii with reference to their Sensitivity [S], Resistance [R], Multi-Drug Resistance [MDR] along with other Gram negative isolated from different sites [from 1st January 2004 to 31st December 2011] at King Abdulaziz Hospital located Eastern Region of Kingdom of Saudi Arabia [KSA]. All necessary techniques were used to culture and perform sensitivity of these isolates. There were 4532 isolates out of which 3018 [67%] were from patients. Out of Acinetobacter baumanii infected were 906 [20%] while other 3626 [80%] isolates were miscellaneous. Numbers of patients or cases were 480 [53%] out of 906 isolates and numbers of patients or cases in other organisms were 2538 [70%] out of 3626 isolates. Acinetobacter baumanii infected patients 221 [46%] were male and 259 [54%] were female and the male and female ratio of 1:1.2. In other organisms this male female ratio was almost same. There was steady rise in number of patients and the hence the isolates from 2004 to 2011. Majority of the bacterial strains were isolated as single organism but some were isolated as double or triple or quadruple or more organisms from different sites. Sensitive, Resistant and Multi-Drug Resistant Acinetobacter baumanii have been isolated from different sites. The other Gram negative isolates included Escherichia coli, Klebsiella pneumoniae, Proteus vulgaris, Klebsiella oxytoca, Serratia marcescens and Stenotrophomonas maltophilia. A significant rise in R and MDR but there is rise in R and MDR Acinetobacter baumanii Strains has been interceded other isolates. It is important to adopt proper and sustainable policies and guideline regarding antibiotics prescription and used. We should also check our infection control practices in our hospital or healthcare settings. We should start antibiotics stewardship in our hospital in order to reducing or overcoming antibiotics Resistant [R] and Multi-Drug Resistant [MDR] strains prevalence.
ABSTRACT
Mycotic aortic aneurysm is rare but life threatening disease. Endovascular aneurysm repair [EVAR] has become an established procedure for the treatment of many infrarenal aortic aneurysms
Although EVAR is obviously less invasive than open surgical repair but it is not without complications. Lower extremity ischemia is a known complication of endovascular abdominal aortic aneurysm repair [EVAR]. Limb occlusion, embolism or access related problems are the main causes. We hereby describe the first case of EVAR of infra renalmycotic aortic aneurysm in the history of Sultan Qaboos University Hospital Oman. A 67 years old lady known to have diabetes mellitus and hypertension admitted with fever and abdominal pain. On further evaluation found to have 4 cms infra-renal mycotic abdominal aortic aneurysm treated by EVAR but procedure was complicated by lower limb ischemia due to thrombosis at the puncture site which was successfully treated by aspirating thrombus and ischemia was relieved