Objective: The efficacy of fosfomycin against ESBL and/or carbapenem-resistant E. coli isolated from urine samples was determined. Methodology: Three hundred fifty (350) urine samples were collected from the patients having UTI visited to the department of Urology, JPMC, Karachi. The CLED agar was used for the primary isolation of uropathogens. Regular antimicrobial sensitivity testing was conducted in accordance with CLSI standards, and the minimum inhibitory concentration (MIC) of fosfomycin was assessed using E-strips. Results: Out of 350 urine samples 213 (60.85%) were E. coli. Patients with E. coli had an average age of 38.75 15.01 years. Females are more prone to have UTI 146(68.54%). E. coli was highest among uropathogens having frequency of 213(60.85%). E. coli manifest highest resistance to ampicillin 187(87.79%) and low resistance to meropenem 12(5.63%), imipenem 15(7.51%) and fosfomycin 21(9.85%). The overall carbapenem resistant E. coli was 9(6.4%) and majority of (61.5%) fosfomycin resistant E. coli, MIC value was >1024µg/ml. Isolates were categories in the non-MDR, MDR and XDR. Most of the isolates were MDR (53%), followed by the non-MDR (35%) and XDR (11%). Conclusion: In conclusion present study suggests that fosfomycin is still effective against E. coli. More than 50% E. coli isolates were MDR and it’s an alarming situation for urologist.
Objective: To determine the diagnostic accuracy of serologic (IgG) in the diagnosis of Helicobacter Pylori among patients of dyspepsia by taking Helicobacter pylori Stool Antigen (HpSA) as the gold standard. Material and methods: The study was conducted in Microbiology Department, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi with the collaboration of gastroenterology OPD. All the patients with a history of dyspepsia, above 25 years of age and of either gender were included. After taking informed consent the clinical samples of blood and stool from patients were taken. A 6 ml venous blood was taken from the antecubital vein for detecting IgG antibody to H. pylori. Stool samples were collected for detecting H. pylori antigen in a wide mouth, sterile, leak proof container properly labeled by serial number and stool samples were stored in a refrigerator at 4°C up to 72h. On the specimens containing H. pylori antibodies, a colored line appeared in the test line region consider a positive result. H. pylori antigen was detected in stool (HpSA) by rapid chromatographic immunoassay. During analysis, the specimen responds with an anti-H. pylori antibody-coated particle. By capillary action, the mixture migrates upward on the membrane, reacting with anti-H. pylori antibodies on the membrane to produce a colorful line. A positive result is indicated by the presence of this colored line in the test zone, whereas a negative result is indicated by its absence. All the data were obtained using a study proforma, and the data was analyzed using SPSS version 26. Results: A total of 210 patients presented with dyspepsia were studied, their mean age was 49.07±10.97 and females were in majority (71.9%). H. Pylori was positive among 137 cases, those who underwent serological test (IgG) and 127 were positive for stool antigen (HpSA). The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Conclusion: The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Key words: H. pylori, diagnosis, IgG, Stool antigen
Background: Magnesium deficiency is common in serious diseases and is often associated with mechanical ventilation, mortality, and long-term intensive care. Awareness of hypomagnesaemia is essential because little data is available and may have prognostic and therapeutic implications. Aim: This study was conducted to calculate the incidence of hypomagnesaemia at PICU admission and to relate it to length of PICU stay, duration of mechanical ventilation, and outcome of hospital stay or discharge. Place and Duration: In the Pediatric Intensive Care Unit (PICU), Abbasi Shaheed Hospital, Karachi for one-year duration from April 2020 to April 2021. Methods: This is a prospective observational study involving 200 children aged 1 month to 12 years admitted to the PICU. All qualified children underwent an interview and clinical examination. Blood was collected during admission to calculate serum magnesium level. The patients were grouped into three groups: normomagnesemia, hypomagnesaemia and hypermagnesemia, and the data were analyzed. Results: 200 children were included in the inclusion study. Males constituted 57.0%and females 43.0%. The ratio of men to women was 1.2: 1. Most of the respondents were 5 years old. Most of the respondents were in the ICU with neurological symptoms (36.5%), followed by respiratory diseases (27%). Of the 200 patients, 138 (69%) had a mean magnesium level of 1.9 mg / dL. 51(25.5%) patients had hypomagnesaemia. The average magnesium level was 1.3 mg / dL. 11 (5.5%) patients had hypermagnesemia with a mean magnesium content of 2.7 mg / dl. The lowest measured magnesium level was 1 mg / dl and the highest was 4.2 mg / dl. There was no statistically significant association between hypomagnesaemia and gender, age, disease acceptance category, and sepsis. ≤ 27.4% of children under 5 years of age had severe acute malnutrition in the hypomagnesaemia group. Among those with normal magnesium levels, 24% had severe acute malnutrition and 27.3% had severe acute malnutrition among those with hypermagnesemia. In the study, overall mortality was 25% (50 out of 200). Mortality among people with hypomagnesaemia was 29.40%. Among those with normal magnesium levels, 21.2% died and 18.2% in the hypermagnesemia group. Conclusion: Patients with hypomagnesaemia have prolonged PICU stay, other related electrolyte disturbances and increased mortality. Therefore, in severe ill patients, magnesium levels are monitored. Keywords: Children, Hypomagnesaemia, Intensive Care Unit, Mortality, Outcome, ICU
Objective: This study was designed to determine the frequency of Candida in clinically diagnosed cases of onychomycosis. Study Design: It was a cross-sectional study.Setting: It was conducted in the Department of Microbiology, BMSI, JPMC, Karachi, in a period of one year with the collaboration of the Department of Dermatology, JPMC, Karachi.Materials and Methods: A total of 328 clinical samples have been collected. The fungal isolates were identified according to standard microbiological procedures. Samples were processed for primary screening microscopic test by KOH 20% (potassium hydroxide solution) wet mount. Processing for mycological culture was done by using Sabouraud's dextrose agar (cycloheximide and chloramphenicol), without antibiotics and Dermatophytes test medium. Candida species identification will be achieved through the commercial test of the API ID 32C system.Results: Prevalence of fungal species that isolated from the 328 samples, 14.33% were dermatophytes, 6.40% were non-dermatophytes mould, 23.70% were Candida, 4.87% were mixed growth and 50.30% were negative for growth. Among the 16 mixed isolates, 15 were Candida species, accounting for a total of 28.4% Candida isolates. Out of 93, Candida albicans were 52.68%. Of the 47.32%, 26.88%, 11.82%, 4.30%, 2.15% and1.07%, Candida non albicans C. tropicalis C. parapsilosis, C. glabrata, C. krusei, C. guilliermondii, and Candida utilis respectively.Conclusion: A significant number of onychomycosis cases result from the Candida spp. and Candida albicans were the main species. However, Candida non-albicans species are emerging in onychomycosis. In this manner, legitimate conclusion of the pathogens of onychomycosis is vital for focused treatment.
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