ABSTRACT
Objective: To scrutinize patterns of multi-drug-resistant uropathogenic Escherichia coli (UPEC) strains and particularly of fluoroquinolone-resistance this is an alternative choice for the treatment of urinary tract infections. Methods: Bacterial samples (n = 250) were collected from out-patients from August 2012 to August 2014 Islamabad. Antibiotic susceptibility profiling and determination of minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations were performed according to the guidelines of Clinical and Laboratory Standards Institute (CLSI, 2012). Genes, qnrA, qnrB and qnrS were identified by DNA amplification and sequencing. Results: The highest percentage of UPEC isolates were resistant to co-trimoxazole (82%) followed by cephalothin (80%), 2nd Gen, 3rd Gen and 4th Gen cephalosporins, respectively. Resistance against gentamicin, amikacin remained 29% and 4%. For other drugs including nitrofurantoin, tetracycline, carbapenem and beta-lactam inhibitors remained below 10%. Altogether, 59% of the isolates were resistant to at least three antibiotics including one fluoroquinolone. Overall, MICs for ciprofloxacin remained (MIC ≥ 256 μg/mL) and for levofloxacin (MIC ≥ 16 μg/mL and 32 μg/mL). No significant differences were observed regarding MIC values of extended spectrum β-lactamase (ESBL) and non-ESBL producers. For qnrS and qnrB positive isolates MICs remained above 32 μg/mL. Prevalence of UPEC was significantly higher among females and 40% of the isolates were ESBL producers. Conclusions: Higher percentages of ESBL producing UPEC were associated with urinary tract infections. Moreover, the majority of these isolates were multi-drug resistant and fluoroquinolone-resistant.
ABSTRACT
Objective To study the seroprevalence of hepatitis B virus (HBV) and hepatitis delta virus (HDV) infections in patients visiting outpatient department of a major tertiary care hospital in Khyber Pakhtunkhwa region of Pakistan. Methods Blood samples were collected from non-hospitalized patients. Serological analysis was done by ELISA and viral DNA was amplified by PCR. The amplified DNA was analyzed by agarose gel electrophoresis. Results Altogether, 946 blood samples were screened, overall percentage of HBsAg-positive patients remained 22.41% (prevalence: 224.10/1 000; CI: 0.197 5 ± 0.250 7) with the highest incidence rates among relatively younger age groups (20–29 years). The prevalence of HBV–HDV co-infection was found to be 46.75/1 000; CI: 0.031 8 ± 0.061 7. In HBsAg-positive patients, anti-HBc-total was detected in 86.79% while 25.00% were positive for anti-HBc-immunoglobulin M. Similarly, among these patients, HBV DNA was detected in 64.13% and 10.85% were co-infected with HDV. Different symptoms were associated with the prevailing infection, including malaise (62%), anorexia (66%) and fatigue (73%). The most commonly associated symptom was abdominal discomfort. Among these patients, certain risk factors, including surgery, visit to dentist and intravenus infusions were frequently associated with the infection (χ