Sero-prevalence of HCV and associated infections with HIV and HBV among prisoners in Lahore

Hepatitis C Virus [HCV] infection and its co-infection with HIV or HBV is associated with an accelerated course of the disease and may result in more rapid progression of either or both, but knowledge on these dynamics in the imprisoned is scarce particularly in the developing world. Hence in this study we evaluated the prevalence of HCV infection and its associated co-infections with HBV or HIV in the prison population of Lahore. This was a descriptive cross-sectional study aimed to estimate the prevalence of HCV infection in prisons of Lahore [Pakistan] between May and November 2009. In this study, 4915 prisoners participated; 91.5% of them were males, and 8.5% females. Median age of prisoners was 28 years. Jail inmates were tested for serological markers-HBsAg, HCV antibodies and HIV antibodies-by chromatographic immunoassay. Initially reactive sera were retested for HBV and HCV with ELISA and for HIV with another rapid method. In total, 783 [15.93%] prisoners were positive for HCV and 105 [2.13%] of all prisoners were registered having co-infection with HIV, HBV or both. Among 783 HCV positive prisoners 72 [9.19%] had HIV co-infection, HCV/HBV co-infection was observed in 30 cases [3.83%] and triple co-infection [HCV/HBV/HIV] in three cases [0.38%]. The prevalence rate of HCV infection is quite high in the prison population of Pakistan and is mainly complicated with HIV co-infection. It is imperative that HCV, HIV and HBV prevention strategies be intensified in this community

Antibiobitc susceptibility pattern of bacterial isolates from patients admitted to a tertiary care hospital in Lahore

To determine the antimicrobial sensitivity pattern of bacterial isolates from patients admitted in a tertiary care hospital of Lahore. The study was carried out in Department of Pathology, Postgraduate Medical Institute, Lahore from January 2010 to June 2010. The samples from the hospital were sent to microbiology laboratory for bacteriological examination. They were cultured onto Blood and MacConkey agar plates; organisms were identified by their colonial morphology, Gram Staining and appropriate biochemical tests using standard recommended protocol. Antimicrobial susceptibility pattern of the bacterial isolates recovered from different clinical specimens against penicillins,, cephalosporins, fluoroquinolones, carbapenems, aminoglycosides and trimethoprim sulphmethoxazole was determined using modified Kirby Bauer method. Among the 925 different clinical samples, 379 organisms were isolated. Escherichia coli and Klebsiella species were the most prevalent isolates followed by Pseudomonas and Staphylococcus spp. High degree of resistance was observed among gram negative organisms to all groups of antibiotics. Resistance to amikacin ranged from 12- 18% among different species of Gram negative isolates whereas the range of carbapenem resistance was 1.4 - 9.5%. The percentage of oxacillin resistance among staphylococcal isolates was 33.1%, but all were sensitive to vancomycin. High frequency of resistance observed in the present study indicates that antibiotic resistance among nosocomial isolates is a serious problem. There is a continuous need of surveillance of sensitivity patterns of antimicrobial agents in our set up to know about the trend of this problem

Association of blood group types to Hepatitis B and Hepatitis C virus infection

Frequency of Hepatitis B Surface Antigen [HBsAg] and Hepatitis C Virus Antibodies [Anti-HCV] among blood donors of Lahore and their association with blood group types. To study the frequency of Hepatitis B Surface Antigen [HBsAg] and Hepatitis C Virus Antibodies [Anti-HCV] in blood donors of Lahore and to assess the association with blood group types. The design of study will be cross sectional descriptive study. It was held in the Pathology Department, Nawaz Sharif Social Security Hospital, Lahore, during the period January, 2006 to December, 2008. A total of 16695 blood donors were screened for HBsAg and Anti-HCV by rapid test devices based on immuno-chromatographic technique following the instruction given by the manufacturer. In the present study, devices manufactured by Acon, USA were used. The specimens reactive on screening by devices were confirmed on ELISA. The results were subjected to chi-square analysis for determination of statistical difference between the values among different categories. Among 16695 blood donors, 467 [2.79%] were positive for HBsAg and 1326 [7.94%] were positive for Anti-HCV. The frequency of HBsAg was seen to decrease significantly [p < 0.01] from 2006 to 2008 [4.23% to 2.31%]. However, frequency of anti-HCV was seen to rise significantly [< 0.01] from 2006 [6.69%] to 2008 [7.82%]. Comparison of HBsAg and anti-HCV positivity among RhD positive and RhD negative donors showed that there was no significant difference for HBsAg positivity [2.79% vs 2.85%]. However, significantly higher number of RhD positive donors had HCV infection as compared to RhD negative donors [8.25% vs 3.66%]. High frequency of HCV infection in blood donors need implementation of strict screening policy for donors and public awareness campaigns about preventive measure to reduce the spread of this infection as well as other transfusion transmissible infections. Association of HCV infection with blood group types needs more studies to get more knowledge about this aspect

Methicillin resistant staphylococcus aureus: a study in a tertiary care hospital

This study was carried out to find the frequency of Methicillin Resistant Staphylococcus aureus [MRSA] in a tertiary care hospital. This is a cross sectional descriptive study performed in Pathology Department, Nawaz Sharif Social Security Hospital, Multan Road, Lahore, during the period January, 2008 to December, 2008. Two hundred and thirty three consecutive, non-duplicate strains of Staphylococcus aureus were isolated from a variety of clinical specimens of pus/ pus swab, throat swab, sputum, urine, semen, ear swab, vaginal swab, blood, pleura/fluid and cerebrospinal fluid were studied for Methicillin resistance. Standard methodology using modfied Kirby- Baur disk diffusion method was adopted. Oxacillin [1 micro g disk] was used to detect Methicillin resistance. An inhibition zone of less than 10 mm was taken as indicative of MRSA. Out of 233 Staphylococcus aureus isolates, 81 [34.76%] were found to be Methicillin resistant. The yield of MRSA was highest from pus/ pus swab and sputum samples [40.0%], followed by throat swab [35.71%], urine, blood and pleural fluid [33.33%], semen [30.43%], vaginal swab [27.27%], ear swab [24.0%], and cerebrospinal fluid [20.0%]. The high prevalence of MRSA in our setup should not go without serious concern. Implementation of strict aseptic techniques and suitable antimicrobial policy may reduce the spread of MRSA in our environment

Bacterial pathogens responsible for blood stream infection [BSI] and pattern of drug resistance in a tertiary care hospital of Lahore

The present retrospective analysis was carried out to determine the pattern of bacterial agents responsible for blood stream infection [BSI] in a tertiary care hospital of Lahore and to get an updated knowledge about their antibiotic resistance pattern. It is a cross sectional descriptive study, carried out in the Microbiology Section, Department of Pathology, Services Institute of Medical Sciences [SIMS], Lahore during the period April, 2006 to December, 2006. Among the 1814 blood cultures 1382 [76%] were received from pediatrics/ neonatology wards and 432 [24%] from adult patients. In a total of 508 [27.9%] blood cultures, 465 yielded monomicrobial growth and 43 polymicrobial growth. A total of 454 [97.6%] of the monomicrobial growths were bacterial isolates and 11 [2.4%] were Candida Spp. Gram negative bacteria [Enterobacteriaceae + nonfermenter bacteria] comprised the majority of bacterial isolates. Amongst the gram-negative bacteria the most common organism was Klebsiella Spp. while amongst the gram-positive organisms Staph. aureus was the most common isolate. It was seen that 31.25% Staph. aureus isolates were resistant to Oxacillin, 93.7% of Klebsiella Spp. and E. coli isolates were resistant to 3rd generation Cephalosporins and 6.49% of Pseudomonas Spp. and Acinetobacter Spp. whereas resistant to Carbapenems in the present study. As BSI is an emergency, for appropriate management of these cases an updated knowledge about the causative agents and their susceptibility pattern to antibiotics is required to start appropriate empirical antibiotic therapy till the results of the microbiology report are available. The alarming finding is the high resistance seen amongst Enterobacteriaceae against 3rd generation cephalosporins [93.7%], oxacillin resistance among Staph aureus [31.25%] and increasing resistance against Carbepenems among Pseudomonas and Acinetobacter isolates [6.49%]. In conclusion there are grave implications of these findings for our already strained health care system as the presence of these multidrug resistant organisms leads to longer hospital stay, more expensive/ toxic drugs and higher mortality