Extended-spectrum ß-lactamase production in Shigella flexneri.

Emergence of multidrug-resistant strains of Shigella is a growing concern across the globe. Third-generation cephalosporins are used for treating infections caused by multidrug-resistant Shigellae. However, resistance to these cephalosporin antibiotics due to extended-spectrum ß-lactamases, has emerged as a new problem. So far extended-spectrum ß-lactamases producing Shigella has not been reported from Pakistan. We report such a case in Shigella flexneri from an 8-year old girl with acute dysentery.

Vancomycin resistant enterococcal sepsis in an acute myeloid leukemic patient.

Neutropenic fever is an important cause of morbidity and mortality during therapy of acute myeloid leukemia. Patients with acute myeloid leukemia are at increased risk of acquiring vancomycin resistant enterococcal infection and its treatment remains problematic. Vancomycin therapy for more than 7 days is usually associated with inducible vancomycin-resistant enterococcal infections. We report a case of vancomycin resistant enterococcal sepsis in a patient of acute myeloid leukemia.

Efficacy of amikacin and ciprofloxacin against clinical isolates of Mycobacterium tuberculosis.

BACKGROUND: Tuberculosis was a leading cause of death at the turn of the 20th century and continues to be one of the medical scourges of mankind. Before the availability of antimicrobial drugs the cornerstone of treatment was rest in the open air in sanatoria. The major breakthrough in treatment of tuberculosis came with the discovery of Streptomycin. Later, INH, Ethambutol. Pyrazinamide, Rifampicin were added to the arsenal. Objective of this study was to determine the sensitivity of clinical isolates of Mycobacterium tuberculosis against two second-line anti-tuberculosis drugs, Amikacin and Ciprofloxacin. METHODS: This cross-sectional study was conducted at Department of Microbiology. Armed Forces Institute of Pathology (AFIP) Rawalpindi. All routine clinical samples received for acid fast bacilli (AFB) in the Department of Microbiology. AFIP, Rawalpindi were processed by modified Petroff's technique and inoculated on Lowenstein Jensen (LJ) medium and Bactec 460 Mycobacterium tuberculosis culture system. After identification of M. tuberculosis sensitivity was performed against first-line anti-tuberculosis drugs. Then susceptibility of M. tuberculosis isolates against Amikacin and Ciprofloxacin was performed on LJ medium. H37Rv was used as control strain. RESULTS: Results were interpreted using resistance ratio method. Out of 100 M. tuberculosis isolates, 98% were sensitive to Amikacin and 97% to Ciprofloxacin. CONCLUSION: Amikacin and Ciprofloxacin are very effective 2nd line anti-tuberculosis drugs against tuberculosis isolates in our set-up.

Comparison of effects of extract of Myristica fragrans and verapamil on the volume and acidity of carbachol induced gastric secretion in fasting rabbits.

BACKGROUND: Peptic ulcer is mostly produced due to the over production of gastric acid. This study was undertaken to find out the effects of extract from Myristica fragrans which contains documented natural Calcium channel blocker and Verapamil on volume and acidity of Carbacol induced gastric section. Their effects were also compared to find out any difference in their efficacy. METHODS: Thirty rabbits of local breed, weighing 1-1.5 kg were used. The animals were kept on fasting for 48 hours, after which the pylorus of each animal was ligated. Verapamil 10 mg/kg, Myristica fragrans 500 mg/kg and Carbachol 600 microg/kg body weight were administered intraperitoneally. RESULTS: It was found that extract from Myristica fragrans reduced the volume, free and total acidity of gastric secretion, which were statistically highly significant when compared with Carbachol (P<0.001). Verapamil had also the same effects. When the difference of mean for verapamil was compared with that of extract, all these differences were found statistically non significant indicating that extract has similar effect as that of Verapamil on all parameters included in study. CONCLUSION: The effect of Myristica fragrans is similar to Verapamil and therefore it can be used effectively in the treatment of peptic ulcer and all other conditions that require calcium channel blockers for the treatment of these disorders.