In vitro activity of glycopeptides against clinical isolates of enterococci from a tertiary care hospital

The objective of this study was to establish the prevalence of glycopeptide [vancomycin and teicoplanin] resistance among clinical isolates of enterococci in Shaikh Zayed Hospital, Lahore, and comparison of antimicrobial sensitivities of vancomycin and teicoplanin among these isolates. A comparative analytical study. This study was conducted in the Department of Microbiology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore. 60 [Sixty] enterococci isolates were collected from clinical specimens received in the laboratory. Identification of these bacteria was done utilizing standard laboratory operating procedures. Their sensitivity to glycopeptide antibiotics was tested by disk diffusion method in accordance with the National Committee for Clinical Laboratory Standards [NCCLS] guidelines. Results show that all enterococci were sensitive to teicoplanin. However, among these isolates 1.7% resistance to vancomycin was detected. The results indicate that resistance to glycopeptide antibiotics in the test organisms is low in our hospital. The presence of vancomycin resistance in 1.7% clinical enterococcal isolates necessitates strict surveillance of these organisms, institution of effective infection control policies and judicious use of antibiotics

Prophylactic role of epidural saline injection for post dural puncture headache: a pilot study

This pilot study was designed to judge the prophylactic role of epidural saline injection for prevention of post dural puncture headache [PDPH] in patients with accidental dural puncture during the setting up of epidural anaesthesia. Ten patients who sustained accidental dural puncture during the setting up of epidural anaesthesia. Ten patients who sustained accidental dural puncture during routine epidural anaesthesia for various gynaecological and obstetrical surgical procedures carried out in Gynae Block of Services Hospital Lahore between 16-03-05 to 15-04-06 were included in the study. All patients had ASA I to ASA III status. The age range was 25 to 50 years and weight range was 45 to 70. Kg. A 16 gauge Touhy needle was used for epidural anaesthesia. In case of dural puncture, epidural anaesthesia was given one space above or below the site of puncture. The study was approved by hospital ethical committee. After completion of surgery, 30 ml of normal saline [0.9%] was injected in the epidural space. All patients were observed for three days for occurrence of post dural puncture headache. Two out of ten patients [20%] complained of post dural puncture headache. One patient had to undergo repeat surgery under general anaesthesia for a surgical complication but did not complain of post dural puncture headache. Prophylactic epidural saline injection is associated with low frequency of post dural puncture headache in patients with accidental dural puncture during setting up of epidural anaesthesia

Glycopeptide sensitivity patterns in staphylococci isolated from clinical specimens in a tertiary care hospital

Staphylococci are among the most important and common human pathogens worldwide. Their resistance to antibiotics is increasing. The glycopeptide antibiotics [vancomycin and teicoplanin] are the last resort to treat serious infections caused by these bacteria. During the last decade the strains of staphylococci have developed intermediate levels of resistance to teicoplanin and vancomycin. The objective of this study was to establish the prevalence glycopeptide resistance among clinical isolates of staphylococci in Shaikh Zayed Hospital, Lahore, and comparison of antimicrobial sensitivities of vancomycin and teicoplanin among these isolates. 75 [Seventy five] consecutive staphylococci isolated from clinical specimens received in the laboratory were collected and their sensitivity to antibiotics was tested by National Committee for Clinical Laboratory Standards [NCCLS] disk diffusion method. Results show that all staphylococci were sensitive to the glycopeptide antibiotics. This indicates that no high-level resistance to glycopeptide antibiotics in these organisms is present in our hospital. However, the emerging resistance in staphylococci against these drugs worldwide necessitates strict surveillance of these organisms, institution of effective infection control policies and judicious use of antibiotics

Epidemiology of meningitis: a Retrospective study of 1197 cases

The aim was to determine the extent of morbidity and mortality of Meningitis according to age, sex, season and to causative microorganisms. A retrospective study was conducted on 1197 cases diagnosed as meningitis in Mosul, Iraq between 1988 and 1995. The study found that meningitis was an important constituent of infectious diseases representing 18.4% of total admissions and 24.2% of total deaths. The study revealed a predominance of male cases with the highest attack rate and mortality among infants. About 50% of the cases have been becteriologically identified. The commonest three pathogens were M. meningitides, H. influnzae and S. pneumoniae. Viral infections were suspected in 23.3% and tuberculosis was the cause of 2.2% of meningitis cases. The disease was common in winter and spring, with the highest admission rate in1990. A total of 84.2% were cured, 9.7% died and 3.1% developed complications. The highest cure rate was observed in viral meningitis [97.8%] while the lowest was in tuberculous meningitis [38.5%]. The study pointed to the importance of meningitis as a common health problem. Doctors, particularly newly graduated, should be aware of the size of the problem and of criteria for early diagnosis and treatment