ABSTRACT
To determine the current sensitivity and resistance profile of Salmonellae [S.] isolates in a laboratory setting. An observational study. Dr. Essa's Laboratory and Diagnostic Centre, Karachi, Pakistan, from November 2008 - October 2010. Isolates from blood culture specimens of 481 bacteraemic patients were identified using conventional biochemical tests. Salmonellae was confirmed with specific antisera and their antibiograms determined by Kirby-Bauer Disc Diffusion method using 12 relevant antibiotics. Inclusions of the study were bacteraemia documented in all blood samples positive for S. typhi, S. paratyphi-A and B. Exclusions were all samples other than blood and blood samples negative for S. typhi and S. paratyphi-A and B during the same period. Multidrug resistance [MDR] of isolates was defined as the isolates showing resistance to all conventional anti-typhoid medicines i.e., Chloramphenicol, Ampicillin and Co-trimoxazole. Specimens [n=217] yielded 131 Salmonellae typhi [60.36%], 71 S. paratyphi-A [32.71%], and 15 S. paratyphi-B [6.9%]; these were sensitive to the Quinolones [Enoxacin: 94.96% [n=91], Ciprofloxacin, 96.47% [n=182], Ofloxacin: 95.74% [n=203]], and Cephalosporins [Cefixime: 96.62% [n=202], Cefotaxime: 99.17% [n=206], Ceftriaxone: 98.79% [n=208]]. Resistance to Amoxicillin was 96.48% [n=128] and 29.91% [n=78] to Co-trimoxazole. About 62.64% [n=136] of the isolates were MDR strains. Ciprofloxacin is currently a suitable empirical choice in presumed enteric fever cases, but culture and sensitivity analysis should be encouraged and results incorporated in prescription strategy. Increasing frequency of S. paratyphi-A isolates possibly suggests incomplete coverage employing monovalent vaccine
ABSTRACT
This study attempts to document the current bacteriological profile from pertinent specimens of fire burn victims in our setting with respect to the time related variations in the isolation of microbial species, extent of their burn injury and their effect on mortality rate. During a three year period [Jan 2008 to Dec 2010], a prospective study was conducted on 477 fire burn victims at the Burns Centre of Civil Hospital, Karachi, with the exclusions of electrical, chemical and other forms of burn injury. Blood, pus, urine and wound biopsy samples were collected and cultured according to standard laboratory protocols. The data was analyzed according to the age, gender, time related changes, percentage of burn surface and the mortality rate. Total 477 patients were included in our study. Multiple specimens were collected [n=732] of which 649 [88.7%] cultures were positive for different organisms. Staphylococcus aureus was the commonest organism isolated in fire burn patients. During 1[st] week S. aureus was predominant [31.6%] followed by Pseudomonas. After 1[st] week S. aureus [24.6%] and Pseudomonas [25.5%] isolation rate became similar. Mortality rate due to infections was 18.9% in the subjects. S.aureus was the commonest cause of infection in fire burn patients in our setting followed by Pseudomonas. These suggests that hygiene should strictly be maintained around burn patients to avoid opportunistic infections