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The present study showed that bla CTX-M-1 ESBL production is more prevalent in our clinical E. coli isolates. More often the ESBLs were resistant to commonly used antibiotics.
Objectives: To determine the frequency and characteristics of dengue patients.Study Design: Cross sectional observational study. Setting: Qazi Hussain Ahmed MedicalComplex Nowshera. Period: 5th July to 25th Sept 2017. Material and Methods: A total of72 cases were received for dengue serology. Relevant information’s were collected on a predesignedquestionnaire prepared in accordance with the objectives of the study. Results: Atotal of 117 patients were referred from fever clinic and emergency OPD for dengue serology.72(61.5%) were males and 45(38.5%) were females. 24(20.5%) cases were dengue positive.14(12%) were NSL1 positive, 8(8.8%) were IgM positive and 2 (1.7%) were IgM&IgG positive.We received patient in the range of 4 years to 60 years, Mean with SD was 27 +3 years. Out of14 NSL1 positive cases 8 were males and 6 females. 2 females were IgG positive. The spectrumof dengue in correlation with gender was significantly positive with p value .026. In two casesplatelet at first visit were 58000/cmm3 that were both IgM&IgG positive. Out of 24 positivedengue cases two cases were also positive for plasmodium vivax (ring tropozoites). 6 caseswere managed in hospital and discharged home with an average stay of 3 days and 4 casesreferred to Lady Reading Hospital Peshawar for repeated platelet transfusion. Mortality waszero in our cases. Conclusion: The suspicion rate of the clinician for dengue from fever clinicwas 1:7. The cause of poor rate can be contributed to the patient insist for doing the denguetest before they are screened for MP and FBC etc. NSL1 was positive in 6 cases that showsthat people reach the health care facility for screening well in time and patient are educatedabout the dengue. Females 50% positive cases were IGM and IGG positive that shows femalereceive the health care later than males as NSL1 positivity in female gender is less than males.The spectrum of dengue in correlation with gender was significantly positive with p value .025that shows mosquito has some affinity for specific gender, or dengue virus has it for differencein gender or the inside immunity of the both gender is involved that causes different mode ofpresentation and activation of antibodies.
Objectives: To evaluate extended spectrum betalactamase (ESBL) in E.coli andKlebsiella pneumoniae in bacterial cultures and its frequency at LRH. Study Design: Crosssectional analytical study. Setting: Lady Reading Hospital, Peshawar. Period: June 2013 toDecember 2013. Methodology: Total of 1037 bacterial isolates including 614 E.coli and 423 ofKlebsiellapneumoniae were evaluated. All cases were subjected to double disc diffusion methodfor ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin asall ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16. Results:Out of 1037 cases five ninety two (55%) were males and four fourty five (45%) were females. Ofthese, E. Coli were 614 (59.2%) and K. Pneumoniae were four twenty three (40.8%). Of these1037 isolates, four hundred & ninety five(47.7%) tested positive for ESBL enzyme. Frequencyof ESBL positivity in E.coli isolates was 264 (43%) and in Klebsiellapneumoniae isolates was231 (54.6%).Frequency of ESBL in pus was 34.3%(152/395),in urine, it was 31.8%(141/368),in blood it was 28.6%(127/233) and in sputum it was 5.1% (23/41). Unit wise frequency ofESBL was surgical & allied 24.6% (109/283), medical and allied 21.4%( 95/241), paediatrics18.5% (82/203), obstetrics & gynaecology 23.2%( 103/178) and outpatients 12.1 %(54/132).No significant correlation between ESBL positivity, gender, unit or specimen was found.Conclusion: ESBL positive isolates of E.coli and K.pneumoniaeshould be properly detected inroutine laboratory workflow to avoid unnecessary use of otherwise effective antibiotics.Theseresults indicate that such organisms are highly prevalent in our Hospital and need immediateinfection control measures to reduce their further spread.
This study was conducted from May 2018 to Oct 2019 to determine the culture and sensitivity pattern of Methicillin resistant Staphylococcus aureus (MRSA) and MRSA with Macrolide Lincosamide and Streptogramin-B (MLS-B) antibiotics in a tertiary care hospital of Nowshera. A total of 235 isolates were studies and 86 samples showed MRSA. The prevalence rate of MRSA was 89/235 (37.87%). Out of 86 isolates with MRSA, 19 (22.09%) were also resistant to MLS-B antibiotics.Regarding gender specification, 52 (60.5%) were females and 34 (39.5%) were males. The mean age with standard deviation of patients was 29 + 6.8 years. The sensitivity pattern to MRSA was; Vancomycin 100%, Linezolid 100%, Rifampicin 86.04%, Clindamycin, 73.25%, Fusidic acid 60.46%, Erythromycin 44.18%., Doxycyclin 32.55%, levofloxacin 16.27%, Gentamycin 13.95% and Ciprofloxacin 11. 62%. Sensitivity of Vancomycin & Linezolid was 100% in MRSA and MLS-B resistant isolates, and should be kept reserved for MRSA cases to avoid misuse of antibiotics and to reduce resistance.
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