Antimicrobial susceptibility testing and ESBLdetection from the bacteria in haemodialysis patients

To find out the antimicrobial sensitivity and extended spectrum beta-lactamase producing organisms among clinical isolates recovered from patients on haemodialysis. Extended spectrum beta-lactamase are enzymes produced from some strains of gram negative bacilli that mediate resistance to extended spectrum cephalosporin and aztreonam. They are most common in E.coli and Klebsiella species but are present in variety of enterobacteriacea. Experimental and observational study. This study was carried out in Microbiology Department of BMSI, JPMC, Karachi. This study was carried out from June 2005 to June 2006. A total of 250 cases irrespective of age and gender were included in this study. A total of 15 gram positive cocci [7.5%] and 175 [87.5%] gram negative organisms were recovered. In this study 66.66% E.coli and 33.33% Klebsiella species were ESBL producing. Antimicrobial sensitivity pattern in this study show that most of the organisms were sensitive to 2[nd] and 3[rd] generation cephalosporins and fluroquinolones i.e. ciprofloxacin. Table 1 shows isolation of ESBL producing organisms from 200 positive cases. Out of these 175 cases were from Enterobacteriaceae, among these 06 [3.42%] cases have been found to be ESBL producing organisms. The results of this study support the use of initial antimicrobial therapy to reduce the spread of infection and other complications. Currently ciprofloxacin is regarded as the drug of choice for the treatment of infection caused by both gram negative and gram positive bacteria in patients on hemodialysis

Resistant pattern of enterobacteriaceae isolates from surgical wards of tertiary care hospital

The objective of the study was to identify the species of enterobacteriaceae from the post operative patients and their susceptibility pattern. Rising antibiotic resistance rates among bacterial pathogens has resulted in increased morbidity and mortality. In Pakistan lack of infection control practice and non-existence of formal antibiotics policies has further augmented this problem. 200 postoperative wounds swabs were taken from different surgical and gynaeccolgy/obstetric wards of hospitals, specimens were then inoculated on Blood agar and MacConkey agar medium. The Enterobacteriaceac were identified by using battery of tests. Antimicrobial susceptibility was determined by Kirby Bauer disc diffusion method as per CLSI. E. coli isolates showed 100% resistance to ampicillin, while imepenem showed 94.3% sensitivity. Klebsiella species were found 100% resistant to ampicillin and 96.8% sensitive to imepenem. Enterobacteriaceae isolates show nearly the same type of multi-drug resistance even though some species showed 100% resistance to some antibiotics

Evaluation of sampling sites for detection of potential pathogenic bacteris in children with upper respiratory infections [URTIs]

URTIs are common cause of morbidity in children. Two sampling techniques, oropharynx [OP] and nasopharynx [NP] for detection of upper respiratory tract [URT] pathogenic bacteria were studied. To determine which sample site, NP or Op yields the highest rate of S. pneunoinae, H. influenze, M. catarrhalis, S. aureus and S. pyogenes isolates at different age group. The aim of present study was to evaluate as to which sample site yields the highest rates of bacterial isolates in children with upper respiratory tract infection [URTIs]. The prevalence of potential pathogenic bacteria [S. pneumoinae, H. influenzae, M. catarrhalis, S. aureus and S. pyogenes] from 150 infected children of various ages, >5, 6-10 and 11-15 years were compared in NP and OP samples having URTIs. S. pneumoinae was found equally in both NP and OP sites while H. influenzae, M. catarrhalis, S. aureus were more in OP sample while S. pyogenes was isolated in OP alone

Prevalence of upper respiratory bacterial pathogens in children

To determine the spectrum of potential pathogenic bacteria in the upper respiratory tract [URT1]. The study was conducted in the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi during the period of June 2004 to June 2005. A total of 600 subjects of 5-15 years of age were included. Swabs from nasopharyngeal and oropharyngeal were collected from Jinnah Postgraduate Medical Centre, National Institute of Child Health and other ENT clinics and processed according to Standard Laboratory Methods. The most common bacterial pathogens isolated were S. pneumoniae, S. aureus, H. influenzae and M. catarrhalis. This study included 600 cases and yielded 102 [17%] different strains of bacterial pathogens. Bacterial pathogens were commonly isolated from 5-10 years age children who developed upper respiratory tract infections

Detection of extended specturm beta lactamase [ESBL] producing organisms in enterobacteriaceae family like escherichia coli [E. coli] and klebsiella pneumoniae by double disc diffusion method [DDDM]

Extended spectrum beta lactamase [ESBL] producing organisms are extremely broad spectrum beta-lactamase enzymes found in a variety of enterobacteriaceae. Most strains producing these beta lactamases are Klebsiella pneumoniae and Escherchia coli [E. coli]. When producing these enzymes, organisms become highly effective at inactivating various beta lactam antibiotics. In addition, ESBL producing bacteria are frequently resistant to many classes of antibiotics, resulting in difficult to treat infections. Other problems due to ESBL producing bacteria are difficulty in detecting the presence of ESBLs limiting treatment options and detoriation impact on clinical outcomes. Hence it is very important that a doctor should be familiar with the clinical significance of these enzymes and potential strategies for dealing with this growing problem