Frequency of group d streptococci isolated from UTI cases among hospitalized patients and their antibiotic sensitivity pattern

Objective: To determine the frequency and antibiotic susceptibility pattern of Enterococci obtained from UTI patients

Methods: A total of 2653 urine samples have been received for culture and sensitivity during the study period, 1387 were culture positive and 117 urine specimens have recovered Enterococci. The repeated urine cultures recovering Enterococci from the same patient and with mix growth were excluded from the study. The patients were asked to wash the perineal area with clean tap water. Females patients were instructed to apart the labia majora and minora to wash the area before collecting sample to avoid vaginal contamination.. Sterile plastic, wide mouthed containers were used to collect early morning, clean catch, mid-stream urine samples, and the samples were processed as soon as possible within 30 min. In case of delay, the samples were refrigerated. The urine samples were inoculated on Cysteine Lactose Electrolyte Deficient [CLED] media [Oxoid, England] and incubated at 37 degree C for 24 hours. Bacterial growth was taken significant as per count [single species count > 105 organisms]. The growth appeared was identified by colonial morphology, Grams Staining, Catalase Test, Bile Esculin test and growth in nutrient broth with 6.5 % NaCl. The antibiotic sensitivity pattern was determined by modified Kirby Bauer disc diffusion method

Results: The eighty six [73.50%] samples showed salt tolerance as growth appeared and turned out as Group D Enterococci whereas 31 [26.50%] did not show salt tolerance as no growth was observed and labelled as group D non Enterococci. The antibiotic sensitivity of the Group D Enterococci by Kirby bauer disk diffusion mehod with Penicillin 81[82.65%], Ampicillin 73[74.49%], Gentamicin 61[62.24%], Vancomycin 90 [91.84%], Linezolid 98[100%], Ciprofloxacin and Levofloxacin 55 [56.12%] and 57 [58.16%], Nitrofurantoin and Fosfomycin is 42 [42.86%] and 34 [34.69%]. While antibiotic sensitivity of Group D non Enterococci with Penicillin 18[68.71%], Ampicillin 9[47.36%], Gentamicin 10[52.63%], Vancomycin 19 [100%], Linezolid 19 [100%], Ciprofloxacin and Levofloxacin is 9 [47.36%] and 9 [47.36%], Nitrofurantoin and Fosfomycin is 11 [57.89%] and 14 [73.68%]

Conclusion: The frequency of the Group D Enterococci is 86 [73.50%] while that of Group D non Enterococci is 31 [26.50%]. The Enterococci are most susceptible to Linezolid, Vancomycin, Penicillin, Ampicillin, Nitrofurantoin, Levofloxacin, Ciprofloxacin, Gentamicin and Fosfomycin in descending order while the non Enterococci are most susceptible to Linezolid, Vancomycin, Fosfomycin, Penicillin, Nitrofurantoin, Gentamicin, Ciprofloxacin and Levofloxacin in descending order

Antibiotic sensitivity pattern of acinetobacter species isolated from clinical specimens in a tertiary care hospital

Acinetobacter, once considered as opportunistic pathogen has recently been emerged as an important nosocomial pathogen world over, mostly involving patients with impaired host defense[1]. It is rapidly evolving toward multi drug resistance against commonly prescribed antimicrobials and is becoming major challenges for physicians[2]. The aim of present study was to find sensitivity and resistance pattern of Acinetobacter species in our set up. It is a descriptive study, that was carried out in the Pathology Department, Post Graduate Medical Institute Lahore from June 2011 to May 2012. This descriptive study was conducted in the department of Pathology, Post Graduate Medical Institute Lahore from June 2011 to May 2012. Total 6185 clinical specimens were inoculated. All isolations obtained were further processed and Acinetobacter species was isolated by the routine microbiological and biochemical tests. Antibiotic sensitivity test was done by modified Kirby - Bauer disc diffusion method according to the Clinical and Laboratory Standards Institutes guidelines 2011. During the study period from June 2011 to May 2012 a total of 6185 specimen were received from Lahore General Hospital. Out of 6185 clinical samples processed 2180 [35%] were culture positive and 4005 [65%] showed no growth. Acinetobacter species isolated was 90 [4.2%] in 12 months from 2180 positive cultures. In the present study the susceptibility pattern of Acinetobacter species recovered from different clinical specimens against various types of antibiotics was maximum with Cefepime 70%, Meropenem 66%, Pipercillin / Tazobactam 66%, Amikacin 66% followed by Ampicillin - Salbactum 59%, Gentamycin 50%, Ciprofloxacin 50%, Ceftriaxone 44%, Ceftazidime 40%, Tetracycline 31% and Trimethoprime - sulfamethoxazole 22%. Acinetobacter species isolated was 90 [4.2%] in 12 months from 2180 positive cultures. Acinetobacter species are becoming difficult to treat day by day due to increasing resistant isolates. These drug resistant infections can be minimise to some extend by judicial use of antibiotics and adopting strict infection control methods

Prevalence of HBV and HCV infection in Faisalabad

Blood-borne pathogens like hepatitis B virus [HBV] and hepatitis C virus [HCV] are considered major but preventable public health problems in the developing world. Routes of transmission include unsafe injections, blood, sex and transmission from infected mothers to their babies and many other unusual routes like through barbers, dentists and beauty parlors. In Pakistan, national efforts have been made to reduce potential transmission of HBV and HCV, e.g. HBV vaccination programmes, public health education programmes on safe sex, blood and injection practices and legislation to standardise and ensure safety in blood banks. A common element of these programmes and initiatives is a baseline situation analysis using routine surveillance data, or data from surveys or studies, typically followed by a repeat analysis to determine if any change has occurred as a result of an intervention. Given the paucity of surveillance data in Pakistan, high risk areas are an excellent sites for sentinel surveillance of blood-borne pathogens to determine trends in prevalence and disease distribution defined on social, demographical, geographical, and biological variables. We therefore conducted a baseline analysis of residents in Faisalabad city which is a high risk area as part of a pilot phase to develop a sentinel surveillance system for HBV and HCV infections. Similar analysis are expected to follow data in subsequent years to allow comparisons based on time, place and person to determine trends and evaluate interventions. A total of 193 blood samples were collected from Faisalabad. Blood samples safely reached Laboratory and were tested for HBV and HCV by ELISA technique. Results showed that 4.5% blood samples were reactive for HBV and 22% blood samples were reactive for HCV. In HBV reactive cases co-infection is 22% and in HCV reactive cases co-infection is 4.6%

Management of dental waste in a dental hospital of lahore

It is a descriptive study based on personal observations at Punjab Dental Hospital, Lahore carried out over a period of two weeks. A structured checklist was made to collect the data regarding the management of Dental hospital waste and filled in by observation. Final analysis was made with the help of Epi info 2002 statistical package. There was no categorization and segregation of infectious waste at the point of origin. Bags and containers for infectious waste were not marked with Biohazard symbol. White bags were not available for the general waste. There is no incinerator, storage site and landfill sights in the dental hospital. Transportation of waste within the hospital is through open baskets. Dental Hospital sends its infectious waste to the Children Hospital Lahore for incineration twice a week. Amalgam/mercury, X-ray developer and fixer waste were drained through main sewage system. Sanitary workers are not provided with the protective clothing, gloves, masks and shoes. Waste management at Punjab Dental Hospital is not satisfactory. Interest and motivation in hospital waste management is lacking. The administration is required to play its role