Antimicrobial susceptibility patterns among community and health care acquired carbapenem resistant Enterobacteriaceae, in a tertiary care hospital of Lahore.

OBJECTIVE: To compare the disk susceptibility pattern of healthcare acquired carbapenem-resistant enterobacteraceae with that of community-acquired isolates and their associated clinical presentations. METHODS: The cross-sectional study was conducted at the Department of Microbiology, Combined Military Hospital, and the Institute of Dentistry, Lahore, Pakistan, from November 2017 to July 2018. Patients with positive carbapenem-resistant enterobacteraceae cultures from clinical specimens were included. All the isolates were identified through conventional methods and standard biochemical tests. Antibiotic susceptibility testing was performed by Kirby Bauer Disk Diffusion method on Muller Hinton Agar plates. Data was analysed using SPSS 23. RESULTS: Of the 123 isolates identified, 97(79%) were healthcare acquired and 26(21%) were community-acquired. Statistically significant susceptibility patterns (p<0.001) of community acquired isolates were observed against cefoperazone-sulbactum and amikacin, while a low significance was observed with gentamycin (p<0.05). Significant results were obtained in case of colistin against both the groups (p<0.001). CONCLUSIONS: There was low antimicrobial resistance in community acquired carbapenem-resistant enterobacteraceae isolates.

Antibacterial activity of different plant extracts and antibiotics on pathogenic bacterial isolates from wheat field water.

The present work was carried out to study bacterial pathogens isolated from wheat field water and also effect of some plant extracts on these bacterial pathogens. Five bacterial strains were isolated from wheat field water. Different morphological and biochemical tests were performed to identify and characterize bacterial pathogens. Among isolated strains two belonged to genus Staphylococcus sp., other two were Pseudomonas spp. and one strain belonged to genus Salmonella sp. Effect of various parameters such as temperature, pH, antibiotics and heavy metals of these pathogens were also studied. Optimum temperature for all bacterial strains was 37oC and optimum pH was 7 except strain 3 which had pH 6. Different antibiotics with different potency were applied to check the resistance of bacterial strains against them. Among these antibiotics Cloxacillin and Teicoplanin were most potent while Oxacillin was as less potent antibiotic because three bacterial strains were resistant against it. While remaining antibiotics proved as potent. Seven heavy metals which were zinc (Zn+2), copper (Cu+2), Ferrous (Fe+2), mercury (Hg+2), Nickel (Ni+2), chromium (Cr+2) and cobalt (Co+2) with different concentrations were applied to bacterial strains. Minimum inhibitory concentration of heavy metals for all bacterial was different. Different plant extracts (Artemezia incise, Colebrookia oppositifolia, Rhynchosia pseudocajan) checked for their antibacterial activity against these pathogens. These plant extracts showed antibacterial activity against antibiotic and metal resistant bacterial isolates.