RESUMEN
The aim of the study was to compare the effectiveness of Cefoxitin with that of Methicillin/Oxacillin in the determination of mecAgene in Methicillin resistant Coagulase-negative staphylococci(CoNS). We assessed 57 CoNS isolates for mecA gene via PCR, which were subsequently subjected to Methicillin/Oxacillin and Cefoxitin disc diffusion test. These methods are simple, inexpensive and easily available compared to PCR despite less specificity. Out of 41 mecApositive species, 33 (80.5%) were resistant to Methicillin/Oxacillin. Cefoxitin-resistance was seen in all 41 (100%) mecApositive samples. Two (12.5%) mecAnegative isolates of S.saprophyticuswere Methicillin/Oxacillin resistant, but were Cefoxitin sensitive. Four (9.7%) isolates of S.saprophyticus, three (7.3%) of S.epidermidisspecies, and one (2.4%) S.haemolyticusthat were mecApositive were sensitive to Methicillin/Oxacillin but resistant to Cefoxitin. Cefoxitin resistance provides a more accurate picture of mecAgene positivity as compared to Methicillin and Oxacillin.
Asunto(s)
Antibacterianos/farmacología , Cefoxitina/farmacología , Resistencia a la Meticilina/genética , Meticilina/farmacología , Oxacilina/farmacología , Infecciones Estafilocócicas/microbiología , Staphylococcus/efectos de los fármacos , Staphylococcus/aislamiento & purificación , Proteínas Bacterianas/efectos de los fármacos , Proteínas Bacterianas/genética , Proteínas Bacterianas/aislamiento & purificación , Coagulasa/metabolismo , Farmacorresistencia Bacteriana , Genes Bacterianos/genética , Humanos , Pruebas de Sensibilidad Microbiana , Proteínas de Unión a las Penicilinas/efectos de los fármacos , Proteínas de Unión a las Penicilinas/genética , Proteínas de Unión a las Penicilinas/aislamiento & purificación , Reacción en Cadena de la Polimerasa , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Infecciones Estafilocócicas/tratamiento farmacológicoRESUMEN
Percutaneous endoscopic gastrostomy (PEG) tube placement serves as a well-tolerated and efficacious technique for long-term enteral access in patients with medical conditions precluding oral food intake. The nutritional optimisation of patients with oral cancer is mostly achieved via PEG tube placement. However, certain special situations, such as pregnancy and the immediate post-partum period, may render the placement of PEG tubes to be a challenge. A 28-year-old pregnant female patient presented to us with the diagnosis of squamous cell carcinoma of the tongue during her third trimester. Definitive surgical resection was planned post-delivery along with simultaneous PEG tube placement. Immediately following delivery via an elective Caesarean section, she successfully underwent laparoscopic-assisted PEG tube placement. A gravid uterus or an immediately post-partum distended uterus poses significant difficulties whilst attempting PEG insertion. However, laparoscopic-assisted PEG insertion in a controlled setting may make the process safer to perform.
Asunto(s)
Carcinoma de Células Escamosas/terapia , Gastrostomía , Intubación Gastrointestinal , Laparoscopía , Complicaciones Neoplásicas del Embarazo/terapia , Neoplasias de la Lengua/terapia , Adulto , Carcinoma de Células Escamosas/patología , Femenino , Humanos , Embarazo , Complicaciones Neoplásicas del Embarazo/patología , Neoplasias de la Lengua/patologíaRESUMEN
The case of a 38-year old female, victim of a road traffic accident who presented with a near complete aortic transection is presented. An emergent repair employing cardiopulmonary bypass was attempted in the operating room. Anticipating a high-risk of compromise to cerebral perfusion from air micro-emboli, the bypass was attempted with an innovative approach involving the successful cannulation of the pulmonary artery and descending aorta. The patient survived and was found to be doing well on subsequent post-operative visits.
Asunto(s)
Aorta Torácica/lesiones , Aorta Torácica/cirugía , Puente Cardiopulmonar/métodos , Accidentes de Tránsito , Adulto , Femenino , Humanos , Traumatismo Múltiple , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: The aim of this study was to evaluate the antibiotic resistance pattern of Psedomonas aeruginosa and its prevalence in patients with urinary tract infections (UTI) for effective treatment in a developing country like Pakistan. METHODS: This is an observational study conducted for a period of ten months which ended on December 2013 at the Dr. Essa Laboratory and Diagnostic Centre in Karachi. A total of 4668 urine samples of UTI patients were collected and standard microbiological techniques were performed to identify the organisms in urine cultures. Antibiotic susceptibility testing was performed by Kirby-Bauer technique for twenty five commonly used antimicrobials and then analyzed on SPSS version 17. RESULTS: P. aeruginosa was isolated in 254 cultures (5.4%). The most resistant drugs included Ceclor(100%) and Cefizox (100%) followed by Amoxil/Ampicillin (99.6%), Ceflixime (99.6%), Doxycycline (99.6%), Cefuroxime (99.2%), Cephradine (99.2%), Cotrimoxazole (99.2%), Nalidixic acid (98.8%), Pipemidic acid (98.6%) and Augmentin (97.6%). CONCLUSION: Emerging resistant strains of Pseudomonas aeruginosa are potentially linked to injudicious use of drugs leading to ineffective empirical therapy and in turn, appearance of even more resistant strains of the bacterium. Therefore, we recommend culture and sensitivity testing to determine the presence of P.aeruginosa prior to specific antimicrobial therapy.
