Proportion of Hospitalization at a Respiratory Centre Under RNTCP.

Objective: To determine proportion of patients requiring hospitalization under RNCTP. Methodology:All area-patients registered for treatment under RNTCP at LRS Institute, New Delhi through 16 DOTS centre during the reference period (1st April 2006 to 31st Dec 2006) were listed and those patients requiring hospitalization (upto 31st Dec 2007) at LRS Institute were identified and interviewed by a single investigator using semi-structured proforma with certain inclusion and exclusion criteria’s. The data was entered into master sheet and analysis carried out using software statistical package by computing proportion (%) and chi-square test. Results: It was observed that there were 2,345 patients registered for treatment under RNTCP during the reference period, out of which, 4.22% (99) required hospitalization. The males outnumbered females in absolute numbers, however, gender related hospitalization was similar, 4.08% for males to 4.47% for females (p=0.647). Maximum case load (75.75%) was seen in economically productive age group (15-49 years). The proportion of hospitalization amongst 1- 14, 15-49, 50-60 and 61 years & above age group was 2.36%, 4.10%, 5.11% and 8.60% respectively (p=0.08); category II (7.61%) patient admissions was twice than category I (3.65%) patients (p<0.001). The proportion of hospitalization was 2.37% and 5.4% amongst patients with negative and positive sputum status respectively. Conclusion: The study was undertaken at a respiratory tertiary care centre in a metro city and within the study constraints it highlights disease severity, late presentation and minimum need for TB beds under prevailing socio-economic circumstances in the country.

Sputum concentration improves diagnosis of pulmonary tuberculosis cases in children at a tertiary care institution in Rwanda

Introduction: A great concern exists about the emergence of antibiotic resistant organisms. The goal of this study is to delineate antibiotic sensitivity patterns at King Faisal Hospital. Methods: A three years study; from Jan 2009 to Dec 2011 was conducted in the Microbiology unit; department of Laboratory; King Faisal hospital; Rwanda. All the specimens and antibiotic sensitivity were processed according to the standard guidelines. Microorganisms and their sensitivity data were reviewed and compiled by using hospital information system. Results: Over the 3-year period; several Enterobacteriaceae pathogens declined in susceptibility to various antimicrobial agents. A total of 2153 Enterobacteriaceae were isolated. Most common isolate was Escherichia coli check for this species in other resources (1413) followed by Klebsiella check for this species in other resources species (550); Enterobacter check for this species in other resources species (110); Proteus check for this species in other resources species (165); Citrobacter check for this species in other resources Species (79); Shigella check for this species in other resources species (110) and other species. Most notable were the decreased sensitivities to cefuroxime: E. coli (84 to 72); Klebsiella (78 to 33); Enterobacter (50 to 41) Proteus(67 to 59) and Shigella to ciprofloxacin (100 to 96). And also decreased sensitivities to Imipenem: E. coli (100 to 98) and Klebsiella species (100 to 94). Conclusion: These decreased antibiotic sensitivities reflect increased bacterial selection pressure as a result of widespread antibiotic use. A combined approach involving infection-control specialists; infectious disease physicians; and hospital administrators is necessary to address this increasingly difficult problem