ABSTRACT
Research training at higher education level for clinical and teaching staff is important and there are methods to introduce research culture in employees at clinical and teaching departmental level. Objectives: To recognize and quantify the research productivity status of teaching and clinical faculty of [DUHS] Dow University of Health Sciences Karachi before and after its establishment in 2003. Design: Non experimental cross sectional study. Period: 1st October 2012 to 1st February 2013.. Setting: Medical college Karachi. Subjects and method: Students of third semester were applied to sort out the ten years record from 1998 to 2008 of all researches conducted by faculty of Dow University of Health Sciences, published in international and national journals by using different online search engines. Research Output was measured in terms of the increase in the number of publications and quality of publications before and after the launch of Dow University. Data was entered in Microsoft office excel version 2007 and analyzed it in statistical package for social sciences [SPSS] version 17; person chi-square was applied to test the statistical significance at 95% confidence interval. Results: Data of total 594 researches was found out between the years1998 to 2008, 175[29.5%] researches were published before the foundation of Dow university of Health sciences Karachi [2003] while 419[70.5] researches were produced after 173[45.6%] research papers were published in indexed journals before, "whereas" 206[54.4%] were published in indexed journal after 2003. Original research articles were 152 [31%] before 2003, which rose to 339 [69%]. Publications of article types such as case reports, case series, and short communication, editorials and review articles also increased to 80 from 23 after establishment of Dow University. Conclusions: From a total of 594 faculty researches o published in indexed and non indexed journals between the years 1998 and 2008; there was a significant increase in production after establishment of Dow university of Health Sciences Hence it is confidently reported that due to establishment of research committees after the founding, there is a promotion and facilitation of research activities among faculty members.
ABSTRACT
The in vitro antimicrobial activity of Sea buckthorn [SBT] [Hippophaerhamnoides], Green tea [Camellia sinensis] and Dandasa [Juglansregia] on selected methicillin resistant Staphylococcus aureus [MRSA] isolates from clinical samples was tested. The in vitro antimicrobial activity of six antiseptics/disinfectants against MRSA isolated from environmental samples was also evaluated. Experimental Observational. This study was conducted in Immunology and Infectious Diseases Research Laboratory [IIDRL] Lab, University of Karachi from January 2011 to July 2011. Minimum Inhibitory Concentration [MICs] of plant extracts was determined by micro- broth dilution method and, susceptibility of MRSA isolates from environmental samples against antiseptics/ disinfectants was estimated by the agar disk diffusion and agar well diffusion methods. None of the plant extracts inhibited the isolates originating from blood samples. SBT offered comparatively more inhibitory zones and among the antiseptics/disinfectants, savion was the most effective. In view of the rising antibiotic resistance, exploring possible natural plant extracts for their antimicrobial action seems like an attractive substitute. The results showed some degree of susceptibility and can be suggested for use in vivo after standard clinical trials
ABSTRACT
To detect genes for enterotoxins, exfoliative and toxic shock syndrome toxins in Staphylococcus aureus [S. aureus] strains isolated from clinical specimens. Cross-sectional observational study. Department of Molecular Genetics, Dr. Ziauddin Hospital, Karachi, from January to December 2010. Two hundred and ninety eight S. aureus clinical isolates were obtained from various clinical samples received at Dr. Ziauddin Hospital, Karachi. Out of these, 115 were detected as methicillin resistant [MRSA] by cefoxitin disk diffusion test showing a prevalence rate of 38.6%. Detection of individual toxin genes was performed by Polymerase Chain Reaction [PCR] by using only one primer pair for each tube. Uniplex primers were preferred as multiplex primers are longer in base pairs and have the potential for cross reaction due to non-specific binding and increase in optimization time. The possession of a single gene or more than a single gene in MRSA isolates was found in 61.73% of clinical samples; the highest number was found in pus swab, followed by sputum, blood, urethral swab, and urine. The prevalence of toxin genes was higher in MRSA as compared to methicillin sensitive [MSSA] isolates [19.12%]. PCR detects strains possessing toxin genes independent of their expression. The possession of genes for super-antigens seems to be a frequent and habitual trait of S. aureus more so in MRSA
ABSTRACT
Methicillin-resistant Staphylococcus aureus [S. aureus] [MRSA] is an important pathogen in hospitals and communities. There is advance in technologies but infections by MRSA are difficult to diagnose. The current study was conducted to compare three phenotypic methods for with a genotypic method. Cross-sectional study. Methicillin resistance was tested in 450 isolates of S. aureus retrieved from various clinical samples received in Dr. Ziauddin Laboratory Department of Molecular Genetics [DMG], Karachi from January to October 2011. Methods used were, oxacillin disc diffusion, oxacillin screen agar, cefoxitin disc diffusion and Polymerase Chain Reaction [PCR] for mecA gene, which was taken as the gold standard. The Kirby Bauer disc diffusion, using cefoxitin discs 30microg, identified a total of 174 [38.6%] S. aureus isolates as methicillin resistant. With oxacillin disk diffusion test, 152 [33.77%] strains were MRSA with sensitivity of 87.35% and specificity of 100%. Oxacillin-agar screen detected 168 [37.33%] strains with sensitivity of 96.5% and specificity of 100%. PCR method detected mec A gene in 169 [37.55%] isolates with sensitivity of 97.12%, specificity of 100%. The cefoxitin disc diffusion, as suggested by the Clinical and Laboratory Standards Institute [CLSI], is a consistent method for MRSA diagnosis but must be augmented with other methods like oxacillin screen agar, so that no MRSA is overlooked. PCR although taken as the gold standard cannot be recommended as routine because of the high cost and time consumption
ABSTRACT
To determine the pattern of antibiotic resistance in the clinical isolates of Staphylococcus [S.] aureus, Methicillin Resistant S. aureus [MRSA] and define the possible emergence of Vancomycin resistant S. aureus [VRSA] in Karachi. An observational study. Essa Laboratories and Department of Molecular Genetics, Ziauddin Hospital, from January to December 2009. Staphylococcal isolates from different clinical specimens, pus, urine, blood, high vaginal swab and other secretions received at Ziauddun laboratories and Dr.Essa laboratories were collected. The specimens were inoculated on blood agar, MacConkey agar and Chrom agar. Antibiotic susceptibility to conventional antibiotics was done by disc diffusion, and E-test. Methicillin resistance was tested by using Oxacillin and Methicillin disks and confirmed by gold standard PCR for presence of mecA gene. All MRSA strains were subjected in addition to Vancomycin screen agar test. Out of the 450 S. aureus isolates 174 [38.6%] were found to be MRSA. In those isolates, high resistance was found to Cefixime [100%] Doxicycline [100%] Oxacillin [96.5%] Gentamicin, [96.3%], Timethoprim/Sulfametoxazole [95.6%] Chloramphenicol [93%] Tobramicin [81.03%], Ofloxacin [72.4%] and Ciprofloxacin [63.7%]. Low resistance was found to Ceftazidine [36%], Amoxicillin/Clavulanate [32.7%], Fosfomycin [31%], Cefroxime [24%], Amikacin [17.2%] and Meropenem [13%]. One isolate was found to be Vancomycin resistant [MIC 32 microg/ml]. Four isolates had intermediate resistance, with two strains having MIC of 16 microgram/ml and two having MIC of 8 microgramg/ml. These strains were also resistant to all the other tested antibiotics except Linezolid to which all isolates were susceptible. Antibiotic resistance to all the conventionally used antibiotics was high in the tested isolates. All the strains were susceptible to Linezolid which is an expensive alternative with adverse side effects. Judicious use of antibiotics focused on the compliance and formation of antibiotic policy guide lines is highly recommended
Subject(s)
Humans , Staphylococcus aureus/drug effects , Vancomycin Resistance , Microbial Sensitivity Tests , Drug Resistance, Multiple , DNA, Bacterial/analysisABSTRACT
Blood stream infections [BSI] [septicemias] require prompt empirical therapy based on awareness of the drug susceptibility profiles of locally prevalent pathogens isolated. Department of Pathology Dow University of Health Sciences, Karachi, in collaboration with Dr Essa's Diagnostic Centre, from July to November 2008. A cross-sectional prospective study. 324 consecutive blood cultures from patients coming to Civil Hospital Karachi were scrutinized for bacterial isolates and their antibiotic sensitivity profiles were done. A total of 100 [30.9%] specimens were found positive, of these 78% isolates were gram negative bacteria and 22% gram positive cocci. Salmonella typhi, seen less often in adults [20.5%], was the predominant pathogen in children [82.5%]. Escherichia coli, Staphylococcus aureus, Pseudomonas and Klebsiella were isolated in neonates, and Klebsiella, Pseudomonas, Enterobacter and Acinetobacter were identified among adult patients. While all S.typhi isolates were sensitive to cefixime, ceftriaxone and the fluoroquinolones and increasingly amenable to chloramphenicol, of significance was the percentage of other multidrug resistant bacterial isolates. Methicillin resistant Staphylococcu aureus was isolated from one case. The results were analysed by applying SPSS version 16 to derive p value. Amikacin, carbapenems, cefoperazone+sulbactam, fosfomycin and pipericillin+tazobactam are currently the only available drugs still active in-vitro on blood isolates, judicious use of antibiotics focused on the compliance and formation of antibiotic policy guide lines is highly recommended
Subject(s)
Humans , Aged , Child , Adolescent , Adult , Middle Aged , Infant, Newborn , Infant , Child, Preschool , Sepsis/drug therapy , Sepsis/diagnosis , Microbial Sensitivity Tests , Cross-Sectional Studies , Prospective StudiesABSTRACT
Chronic otitis media may cause permanent damage to the ear, mastoid pathologies and extra-cranial complications. Selection of an effective drug by culture analysis of discharge may reduce the risk of serious complications. In a multicentre study of 596 ear-swabs, Staphylococcus aureus and Pseudomonas were found in 40% and 29.6% respectively among 11 types of bacteria, Aspergillus [6.2%] and Candida [3.1%] were additional irritants. However, approximately 14.4% of swabs were culture-negative, suggesting a viral or non-infective etiology. The finding that Pseudomonas was increasingly implicated in recent years and that 37.9% of our Staphylococci isolates were betalactamase producers and Methicillin-resistant, necessitate the choice of 'enzyme-stable' antibiotics as first-line treatment. The high number of gram-negative aerobes isolated suggests faeco-aural route as a major contributor to this infective process which is consistent with our environmental conditions