Venous catheter tip infections in intensive care units of a tertiary care hospital

Objective: To determine the local and changing patterns of bacterial growth and antibiotic sensitivity for appropriate empiric treatment before culture results are available. Study Design: Retrospective observational study. Place and Duration of Study: This study was conducted at Khan Research Laboratories Hospital, Islamabad, Pakistan, from Jul 2014 to Dec 2016

Material and Methods: One hundred and seventy five patients having positive cultures of venous catheter tips performed after following standard protocol were included. Age, gender, common pathogens, their sensitivity and resistance to 27 antimicrobial drugs were taken into account. Statistical Package for Social Sciences [SPSS] version 20 was used for data analysis

Results: Total number of patients included were 175. 56.5% [n=99] were females while 43.4% [n=76] were males. Minimum age was 16 years while maximum age was 93 years. Mean age was 58.15 +/- 17.94 years. 175 patients having culture positive venous catheter tips, were available for analysis. Majority of the patients were admitted in Medical ICU, 78.3% [n=137]. Staphylococcus epidermidis [S. Epidermidis] was the most common isolate 24.6% [n=43] followed by Escherichia coli [E. coli] 21.7% [n=38], Staphylococcus aureus [S.aureus] 18.8% [n=33], Klebsiella pneumonia [K. pneumoniae] 14.3% [n=25], Acinetobacter baumannii [A.baumannii] 5.7% [n=10]. S. epidermidis showed maximum sensitivity to Linezolid i.e. 100% followed by Minocyclin, 88%, Vancomycin 86%. It was resistant to Ampicillin 93%. E. colishowed maximum sensitivity to Amikacin i.e. 95% followed by Imipenem 87%, while being resistant to Amoxicillin/clavulanic acid [97%] and Ciprofloxacin [92%]. Staphylococcus aureus showed maximum sensitivity to Linezolid i.e. 97% followed by Vancomycin [90%] while showing resistance to Ampicillin [100%], Ciprofloxacin [88%] and Levofloxacin [85%]. Klebsiella pneumoniae showed decreased sensitivity to Amikacin, Imipenem, Meropenem i.e. 64% while 100% resistant to Amicillin, Amoxicillin/clavulanic acid. Acinetobacter baumannii showed maximum sensitivity to Colistin i.e. 90%. Pseudomonas aeruginosa showed maximum sensitivity to Polymyxin B [100%] and Colistin [87%], while resistant to Ceftazidime and Quinolones [37%]

Conclusion: Antibiotic pool for catheter related infections is shrinking. Commonly used as well as reserved antibiotics are no longer effective as before

Obesity and hypertension in female medical students; frequency and risk factors

OBJECTIVE: To determine the frequency and risk factors of obesity and hypertension in female medical students

STUDY DESIGN: Descriptive cross sectional study

SETTING: Department of Medicine, Sir Syed College of Medical Sciences and Hospital Karachi

STUDY DURATION: 3 months [March 2014 to June 2014]

MATERIAL AND METHODS: Total 307 female medical students were included after ethical approval

Students with systemic illness, diabetes mellitus and taking corticosteroids were excluded

Demographic details obtained, followed by anthropometric measurements; height, weight, waist circumference and body mass index [BMI]. Students were classified as underweight, at risk, overweight, obesity grade I and obesity grade II as per WHO criteria for Asians. Blood pressure of each student was measured at two occasions. Outdoor activity time, screen time, sedentary time, dietary preferences, sleep hours and family history documented. Data analyzed via SPSS version 17 with significant p-value < 0.05

RESULTS: Among 307 students, obesity was found in 34% [25.4%obesity grade I and 8.8% obesity gradeII]. Hypertension was found in 4.88 %. There was significant association between hypertension and obesity [12 % obese hypertensiveversus 1.9 % non obese hypertensive students]

35 % students had higher waist circumference that was associated with hypertension. Excessive use of soft drinks, diet drinks, meat, dairy products, chocolates, oversleep on weekends and daily screen time >2 hours were found to be associated with obesity

CONCLUSION: Higher prevalence of obesity and obesity related hypertension in younger age group needs to be addressed. Those with obesity should be screened for the presence of hypertension at younger age. Waist circumference should be considered in addition to BMI while screening for obesity, and evaluation of its risk factors in Asians.Creating awareness and timely intervention in terms of dietary modification, adequate physical activity and sleep hours thus reducingthe screen time and sedentary time may help in controlling obesity and its complications among our young generation. Weight loss must be the first line of therapy in obesity related hypertension among younger obese population