Background: Bloodstream infections (BSIs) are an important frequent health problem in terms of their high incidence and lethal outcomes. The bacteria that frequently cause bacteremia are Staphylococcus, Streptococcus, Enterococcus, Escherichia coli, Klebsiella, Enterobacter, Pseudomonas, Neisseria and Haemophilus. Gram negative rods constitute a significant bulk in BSIs. The bloodstream infections due to multidrug resistant pathogens are on the rise globally making treatment more challenging. Aim: To identify the gram negative organisms causing blood stream infections and assess their susceptibility pattern so as to provide guidance for the empirical treatment hoping for better clinical outcome. Methodology: A retrospective, cross-sectional descriptive study carried out in Pathology Laboratory of Sharif City Hospital, Lahore. All the blood culture samples received in Microbiology laboratory between June 2017 to June 2019 were included in the study by non-probability consecutive sampling. Blood cultures were proceeded by subculturing on 1st and 5th day on MacConkey and Blood agar. The colonies obtained were identified through gram staining and biochemical profile. API20E was used for Enterobacteriaceae. Antibiotic susceptibility testing of the pathogens was by Kirby Bauer disc diffusion method. Results: In the current study 663 blood cultures were analyzed. Only 11.9% exhibited positive microbial growth. 55.7% of the positive cultures revealed gram negative bacteria. Among the pathogens isolated, E.coli was found to be responsible for BSIs in 22.7% cases, followed by Salmonella Typhi 20.4% and Klebsiella pneumoniae 18.1%.The gram negative rods exhibited a very high resistance for penicillins, cephalosporins and fluoroquinolones. The efficacy of aminoglycosides and results for carbapenems susceptibility were hopeful. Conclusion: The study shows that the Gram negative bacteria causing BSIs have shown unsatisfactory susceptibility to most of the commonly prescribed antimicrobials. The rising drug resistance has a major impact on the selection and prescription of antibiotics and calls for judicious use of antibiotics. Keywords: Gram Negative Organisms, Blood Culture, Antimicrobial Susceptibility Pattern
Aim: To Isolate Non fermenting Gram negative bacteria (NFGNB) from clinical specimens of infected patients in a tertiary care hospital and then determine the antimicrobial susceptibility of these isolates to Carbapenems Methodology: It was a Retrospective Cross-Sectional study conducted in the department of Pathology, of a tertiary care hospital, Lahore from December 2020-November 2021. The study included 4320 specimens received in Microbiology lab, for culture and sensitivity and consisted of urine, sputum, bronchial washings, pus, wound swabs, ETT, Folly’s catheter tip, HVS, body fluids, blood etc. All other specimens were inoculated on Blood agar (Oxoid UK), Mac Conkey agar (Oxoid UK), and urine was inoculated on CLED (Oxoid UK). The culture plates were incubated overnight at 37°C. Bacterial identification was achieved by gram staining, and biochemical profile. Analytical profile index API-20NE (Biomerieux, France) was used for non fermenting gram negative bacteria (NFGNB). Results: Four thousand three hundred and twenty specimens were processed and Gram negative bacteria were isolated in 651 cases constituting 15.1%. Out of these GNR, 130(19.97%) NFGNB were isolated. Maximum number of NFGNB were obtained from patients admitted in Surgery ward constituting 46 cases followed by Medical ward consisting of 38 cases, 15 cases each from ICU and OPD. Pus/wound swabs yielded majority of NFGNB 58(44.6%), followed by urine 33(25.3%), sputum 15(11.5%), and HVS 14(10.7%). Pseudomonas aeruginosa exhibited 35.29% and 32.35% resistance to meropenem (MEM) and imepenem (IPM) respectively. Conclusion: NFGNB are emerging pathogens responsible for variety of infections. These resilient pathogens have developed alarming resistance against the previously considered last therapeutic resort, carbapenems. Keywords: NFGNB, Carbapenems, Kirby Bauer disc diffusion method, CLSI, meropenem, imepenem,
Background: There is an emerging trend of pseudomonas infections in immune-compromised patients, specifically in hospital settings. The flagship member of this family is Pseudomonas aeruginosa, which is a major infectious agent. This study assessed the distribution and susceptibility patterns of Pseudomonas species isolated from various specimens as a part of surveillance program, in order to devise antibiograms. Aim: To determine frequency & antimicrobial sensitivities of Pseudomonas species in a tertiary care hospital from Lahore. Study design: Retrospective, descriptive, cross sectional study Place & duration of study: Conducted in a tertiary care hospital in Lahore, from January 2021 to January 2022. Methods: Thirty two isolates of Pseudomonas species from different clinical specimens were isolated in microbiology section of a tertiary care hospital during a period of 13 months. MacConkey and blood agar were utilized for culturing of organisms. Gram staining, oxidase, and catalase testwere utilized for phenotypic characterization. Antibiotic susceptibility testing against anti-pseudomonal drugs was performed according to the Clinical and Laboratory Standards Institute guidelines (CLSI) 2021. Results: The inference drawn at the end of study was that, out of thirty two isolates of Pseudomonas species received and pus was the most common specimen (46.8%), followed by 18.75% from urine specimens. 62.5% of the pseudomonas species were obtained from male patients. The most affected age group was 40-60 years, followed by 1-20 years. The most sensitive options turned out to be Imipenem (65.6%) and Pipericillintazobactam (62.5%), followed by 59.3% sensitivity in Amikacin. The least sensitive options in the study isolates were Aztreonam (15.6%) and Ticarcillin clavulanic acid (25%). In 18% of pseudomonas species isolated from urine cultures, fosfomycin was 83.3%, whereas nitrofurantoin turned out to be 50% sensitive. Conclusions: The steadily rising resistance in Pseudomonas species againstavailable antibiotics optionsnecessitates their use inlife-threatening and hospital acquiredinfections. Keywords: Peudomonas, Flouroquinolones, Carbapenem
Aim: To explore the differences in the levels of self-esteem and social Intelligent in visually and non-visually impaired adolescents Study design: Cross sectional Place and duration: December, 2018 to February, 2020 in special education center private and government school of city Lahore Method: There were 122 people in total in the sample. There were 56 visually impaired volunteers and 66 non-visually impaired persons.Boys and girls aged 14 to 19 from private and public special education schools took part in the study. Two scales were used; Self-esteem Scale for Children (SESC), and Social Intelligence Scale (SIS) used along with a demographic Performa Results: Analysis revealed that being visually impaired and having low level of social facilitation is found to be a negative predictor of low self-esteem. There was no significant difference found on three factors of self-esteem and social intelligence. Overall visually impaired tend to have lower level of self-esteem. Conclusion: Adolescence is a vital period in a person's life when he or she faces a number of psychological obstacles. If he had any type of handicap at this teenage time, he would have a lot of problems in his life. According to this study, if a person has any handicap throughout the teenage stage, it affects their degree of self-esteem and social intelligence. Key words: Self-esteem, Social Intelligence Visually Impaired, Non-Visually Impaired, Adolescents
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