Objective: To identify antimicrobial susceptibility pattern of multidrug resistant bacteria causing secondary infections in COVID-19 patients in ICU’ sofa tertiary care hospital. Study Design: Cross–sectional study. Place and Duration of Study: Department of Microbiology, Pak Emirates Military Hospital, Rawalpindi, from Apr to Jul 2020. Methodology: This study included blood samples and endotracheal aspirates from 114 critically ill COVID-19 patients. Peripheral blood specimens were collected fromthe patients with secondary bacterial blood stream infections and endotracheal aspirates were collected from patients with ventilator associated pneumonia for culture and sensitivity. The results were interpreted according to Clinical & Laboratory Standard Institute (CLSI) 2020. Results: A total of 114 COVID-19 patients were admitted in ICU during that time period. Fourteen (12.28%) were female and 100 (87.71%) were male, age distribution was between 36-82 years. Sixty six paired blood samples were sent to the microbiology lab out of which 51 (77.2%) showed bacterial growth while 15 (22.7%) samples were negative. Out of 50 endotracheal aspirates, 42 showed bacterial growth (84%) and 8 samples did not show any significant bacterial growth (16%). Most of the endotracheal aspirates showed growth of >1 bacterial isolates. The most common gram-negative organisms were Acinetobacter baumannii (n=54) and Klebsiella pneumonia (n=26) and most common gram-positive organism isolated was Enterococcus faecium (n=9). All isolated organisms were multidrug resistant. Conclusion: Poor antimicrobial stewardship particularly in critical care units resulted in secondary bacterial infections in COVID-19 patients. The pathogens isolated were multidrug resistant including Acinetobacter baumannii, Klebsiella pneumonia and Enterococcus faecium.
The COVID-19 pandemic has witnessed the rapid development of vaccines produced simultaneously form various countries. However, these vaccines were shrouded by a set of myths ranging from serious effects to change of human DNA. Pakistan was one of the countries to start vaccination early and the front-line workers were first to be vaccinated. We undertook to study the vaccinated health care workers for the post effects of vaccines they received. The methodology adopted was through a structured questionnaire comprising 12 questions covering almost all the possible post effects. This was circulated among health care workers of Pak-Emirates Military hospital and Army Medical College/ National University of Medical Sciences, Rawalpindi, Pakistan. Fever was the most frequently encountered post effect, followed closely by pain at site of injection, headache and fatigue. There was a strong association between age and post effects of vaccination. No life threatening or serious side effects were experienced by health are workers indicating that benefits of vaccine outweigh its adverse effects especially with emergence of new variants. No participant required hospitalization following immunization. Therefore, vaccination against SARS-CoV-2 should be carried out on priority basis in order to avoid severe COVID-19 infection.<br /><br />
Objective: To determine the reasons for hesitancy against the COVID-19 vaccine in the Rawalpindi/Islamabadregion of Pakistan.Study Design: Cross-sectional study.Place and Duration of Study: The study was conducted at the Department of Microbiology, Army MedicalCollege, Rawalpindi, Pakistan, from 1 June 2021 to 1 July 2021.Materials and Methods: A questionnaire of socio-demographic variables and factors leading to vaccinationhesitancy was administered to the participants after obtaining informed consent. Data were analyzed by usingSPSS version 27.0.Results: Out of total of 1067 participants, 41 % declined vaccination. The main reason for refusal of the vaccinewas fear of death 25.6% followed by fear of infertility 16.5%. Social media also played a major role in leading tovaccine hesitancy as 46.3 % of the study population expressed distrust in vaccines because of social mediainfluence, followed by 44.5% having concerns about the safety and efficacy of vaccines.Conclusion: The vaccine acceptance rate was sub-optimal among participants. As almost 41 % of theparticipants were hesitant. The success of any vaccination program largely depends on the public willingness toaccept the vaccine therefore policy makers and stake holders should try to address the apprehensions of thegeneral public.
Introduction Members of Enterobacterales are very common pathogens, which continue to show resistance to many antibiotics. Carbapenem performed well for some time. Colistin was the final hope for the carbapenem-resistant Enterobacterales, but resistance against it has virtually tied the clinician’s hands, especially when it comes to treating critically ill patients. Purpose Detection of colistin resistance by the agar method as well as by the polymerase chain reaction (mobilized colistin resistance-1 gene) in carbapenem-resistant Enterobacterales. Materials and Methods A cross-sectional study from Dec 2019 to Dec 2020 was conducted at the Department of Microbiology, Army Medical College, National University of Medical Sciences Rawalpindi Pakistan. Antimicrobial susceptibility of Enterobacterales was determined according to the Kirby–Bauer disc diffusion method except for colistin. Colistin agar was used, in concentrations of 2 µg/mL and 4 µg/mL. Results were interpreted according to Clinical and Laboratory Standards Institute guidelines 2020. Mobilized colistin-resistant-1 gene in the carbapenem resistant Enterobacterales was detected by performing real-time polymerase chain reaction assay. Results Among the 172 carbapenem-resistant Enterobacterales 18 isolates were resistant using the colistin agar test. Whereas by molecular method colistin resistance was detected among 10 isolates that carried mobilized colistin resistance 1 gene, making the frequency of the MCR-1 gene 5.81%. Seventy percent of isolates were from paired blood samples. Eight patients, from whom the colistin resistant gene was isolated expired. Conclusion Colistin resistance is a very serious issue and should not be missed in a clinical microbiology laboratory. The phenotypic agar test method is an excellent option for routine use, as it combines ease of performance with affordable cost. However, molecular methods are essential for the detection of mobilized colistin resistance gene (1–9) for epidemiological purposes.
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