RESUMO
Blood stream infections [BSI] remain a major cause of debility and death around the world. BSI accounts for 10-20% of all Nosocomial infections. Empirical antimicrobials are based on the susceptibility pattern of the pathogens isolated in a specific institute from time to time. We have conducted this study only on cardiac Patients over two and half years of study duration
Study design: cross sectional study
Settings: microbiology Department, Allama Iqbal Medical College/Jinnah Hospital, Lahore
Study Period: January 2013 to July 2015
Materials and Methods: a total of 5411 blood culture specimens were collected from cardiac patients including patients admitted to cardiology ward, coronary care unit [CCU], pre-operative and post-operative cardiac surgery patients. The bottles containing BHI broth were incubated and were subcultured after 24 hours, 72 hours, 120 hours, and 168 hours on blood and MacConkey agars. Isolates were further identified with the help of Gram staining, biochemical reactions and rapid tests like catalase, oxidase, coagulase, Analytical Profile Index [API] 20E and API 20NE. Antimicrobial susceptibility of the isolate was carried out on Mueller-Hinton agar by Modified Kirby Bauer disc diffusion technique according to the isolate as per recommendations of Clinical and Laboratory Standards Institute [CLSI] guidelines 2013
Results: out of total 5411 patients, 3958[73.14%] were male, 1453[26.85%] were females. Out of total 5411 Specimens, only 486 [8.98%] were positive for bacterial growth. Out of total 486 positive blood cultures, 261 [53.71%] were Gram positive isolates and 225 [46.29%] were Gram negative isolates. Out 486 positive blood cultures, 96 [19.75%] were from cardiology ward, 67 [13.78%] were from CCU, 113 [23.25%] were from pre operative cardiac surgery ward, 210 [43.20%] were from post operative cardiac surgery ward. Among Gram positives, Staphylococcus Species were most common organism isolated from 246 [50.61%] blood culture specimens. Among Gram negatives, Pseudomonas aeruginosa and E.coli were predominant organisms, isolated from 81[16.66%] and 72[14.81%] blood culture specimens respectively
Conclusion: gram Positive isolates were more common as compared to Gram negative isolates. Vancomycin and Linezolid were the most effective drugs among Gram positive isolates. Piperacillin-Tazobactam was most potent antimicrobial against Pseudomonas aeruginosa. For coli forms Tigecycline was most effective drug
RESUMO
1] To observe and analyze the different aspects of homicidal deaths in Sargodha in terms of age, sex, weapon involved and seasonal variation. 2]]. To compare it with other studies conducted in Pakistan and all over the world. Non-interventional descriptive study. The study was done on autopsies conducted at mortuary, District Headquarter Teaching Hospital Sargodha from January 2012 to December 2012 [one year]. 82 cases of homicidal deaths which were brought by police for autopsy examination at DHQ Teaching Hospital Sargodha from Jan. 2012 to Dec. 2012. These cases include both sexes of all age groups. Manner of death was decided on the basis of police inquest and autopsy report. The relevant data was collected on prescribed performa and statistically analyzed. On analysis of recorded data, the homicidal rate in Sargodha, Pakistan is 7.59 /100,000 populations per year. Homicide manner of death was observed 51.25% of total autopsies. 39% of the victims were in the third decade of life. Males predominated females by a ratio of 2.28:01 Firearm was used in most of homicidal deaths i.e. 67%. A rise in homicidal cases was observed in the months of summer i.e. June to September 2012 and a fall was observed in the months of winter i.e. November, December, January and February, 2012. Homicide rate is high as compared to other manners of death in Sargodha. Firearm is the major weapon used for committing homicide