Causative Organisms of Urinary Tract Infection and Antibiotic Susceptibility Among Patients Attending in Tertiary Care Hospitals of Bangladesh

Background: Urinary tract infections (UTIs) are considered to be the chronic public health problem due to morbidity and financial cost as urological diseases causes the highest health care cost. UTI is known as one of the most common diseases today. UTI can occur in both men and women, but studies found that the incidence of UTI is more common in women especially among the sexually active women. Material & Methods:This study was a retrospective cross-sectional study which was conducted at the department of Medicine in Tairunnessa Memorial Medical College and Hospital, Gazipur, obstetrics and gynecology in Bikrampur Bhuiya Medical College and Hospital, Munshiganj and Medicine in City Medical College and Hospital, Gazipur. The study was conducted during the period of February 2018- January 2022. The total sample size for this study was 131.Results:Most of the respondents 56(42.7%) were aged from 26-35 years. Majority of them 117(89%) were female whereas only 14(11%) were male. Burning sensation of micturition was found in 115 patients where 46(40%) had burning for 0-3 days, 63(54.8%) for 4-7 days and 6(5.2%) for >7 days. In most cases causative organism was E. Coli in this study. According to sensitivity patterns of E. Coli Amoxiclav was used in 77(59%) cases and followed by Amikacin in 94(72%), Azithromycin in 120(92%), Cefixime in 130(99.2%), Ceftriaxone in 83(63.3%), Cefuroxime in 37(28.2%), Imipenem in 62(47%), Ciprofloxacine 64(49%), and Gentamicin in 38(29%) cases. In assessing the antibiotic resistance pattern of E. coli Ampicillin was used in 55(42%) cases and followed by Amoxycillin in 98(75%), Colchicine in 13(10%), Linezolid in 35(26.2%), Amoxiclav in 54(41.2%), Colistin in 16(12.2%), Imipenem in 69(53%) and Novobiocin in 62(47%) cases.Conclusions:Antibiotics are considered to be the only treatment for UTI. But antibiotic resistance is highly prevalent in bacterial isolates around the world, especially in developing countries.

Pneumonia in South-East Asia Region: Public health perspective.

Globally, pneumonia is the leading cause of death in young children and burden of disease is disproportionately high in South-East Asia Region of WHO. This review article presents the current status of pneumonia disease burden, risk factors and the ability of health infrastructure to deal with the situation. Literature survey was done for the last 20 years and data from country offices were also collected. The estimated incidence of pneumonia in under five children is 0.36 episodes per child, per year. Risk factors are malnutrition (40% in India), Indoor air pollution, non-breast feeding, chronic obstructive pulmonary disease, etc. Strengthening of health care delivery system for early detection and treatment and as well as minimization of preventable risk factors can avert a large proportion of death due to pneumonia.

The Clinical Profiles and Risk Factors and Outcome of CAPD Peritonitis : A Single Center Study / 대한신장학회잡지

Peritonitis remains the leading cause of the patient dropout in CAPD in many developing countries. In Korea, 71% of CAPD patients dropout is caused by peritonitis. To elucidate an adequate guideline for treating peritonitis in our country, we analyzed clinical and bacteriologic profiles of peritonitis(1995. 1. 1- 1999. 12. 31). Two hundred and twenty eight episodes of peritonitis were developed in 127/247 patients. The incidence of peritonitis was 0.41/patient-year in general, which was decreased to 0.24/patient-year in 1999. The incidence of causative organisms were as follows; 82(36.0%) by Gram positive organisms, 38 (16.2%) by gram negative organisms, 16 cases(7.0%) by mixed organsisms, and 5 cases(2.2%) by fungus. During study period, the incidence of peritonitis by gram positive organsism was decreased while the incidence of peritonitis by gram negative organism was not changed. Recurrent infection/relapse was noted in 58 patients(45%). Peritonitis were eradicated only in 66% of the cases by initial antibiotics(cefazolin+aminoglycoside); and another 17% responded by second line antibiotics. Peritoneal catheters were removed in 38 episodes(16.7%). Patients with exit infection were more frequent in removal of catheter. Risk factor analysis was performed in 146 patients, who were newly started CAPD. There were 60 initial episodes of peritonitis(mean duration of follow up was 16.7 patient months). Sixty-five percent were free of peritonitis at the end of first year, 54% at the end of second year and 45% at the end of third year (Kaplan-Meier). Factors such as age, sex, underlying DM, were not risk factor for CAPD peritonitis. In conclusion, we observed that the incidence of peritonitis decreased every year. It was revealed however that only 66% of peritonitis can be successfully treated by first line antibiotics. Second line antibiotics such as ceftazidime may need to be introduced in early phase of CAPD peritonitis. Up to one third of patients had recurrent infection/relapse, which raised the incidence of peritonitis. Continuing education as well as better exit care is needed to improve technical survival of CAPD patients in Korea.

Clinical Observation of Pyogenic Osteomyelitis / 대한정형외과학회잡지

Pyogenic osteomyelitis is a frequent and difficult disease in treatment in orthopedic surgery. The various manifestation of the disease related to the causative organisms, the sites of involvement, the pathogenesis and the clinical course tend to give a bad prognosis after treatment. This study consists of three hundred and twenty four cases of pyogenic osteomyelitis which are studied at the Department of Orthopedic Surgery, Yonsei University hospital for 7 years and 8 months from January 1973 to August 1979. The results are as follows: 1. The frequency of the disease was highest in 1977 but not significant. 2. Femur and tibia were most frequently involved. (65.4%). 3. Age distribution showed the highest incidence between 6 and 15 years of age. (60.6%) Sex ratio was 2(M):1(F) 4. The causative organism was mostly Staphylococcus. (80.5%) The coagulase(+) Staphylococcus showed the highest sensitivity to cefamezine (88.8%) and the highest resistance to penicillin. (89.7%) 5. The treatment had been carried out case by case with variable methods. Author considered the best method of treatment was early decompression and massive antibiotic therapy in acute osteomyelitis, and saucerization with closed irrigation system in chronic osteomyelitis.