ABSTRACT
Multidrug resistance (MDR) in gram-negative pathogens is the emerging threat to clinicians. The current study was designed to determine the prevalence and pattern of multidrug resistance in gram-negative clinical isolates. It was conducted at the COMSATS Institute of Information Technology, Islamabad, Pakistan, from June to October 2014. Of the 8, 300 samples collected, 729(8.8%) clinically important gram-negative pathogens were retrieved. These pathogens were subjected to phenotypic and biochemical detection and were further processed for multidrug resistance pattern. It was observed that gram-negative pathogens were simultaneously resistant to many antibiotics. The prevalence of extended spectrum b-lactamase phenomenon was 220(100%) in Klebsiella pneumoniae, 195(75%) in Escherichia coli. Resistance to carbapenem was 174(79%) in Klebsiella pneumoniae and 14(5.4%) in Escherichia coli. Resistance against fluoroquinolones also displayed an escalating trend. The current study found that resistance against antibiotics was displaying a drastic increase in chronic renal patients.
Subject(s)
Anti-Bacterial Agents/pharmacology , Drug Resistance, Multiple, Bacterial , Gram-Negative Bacteria/drug effects , Gram-Negative Bacteria/isolation & purification , Renal Insufficiency, Chronic/microbiology , Carbapenems/pharmacology , Cross-Sectional Studies , Escherichia coli/drug effects , Fluoroquinolones/pharmacology , Humans , Kidney Transplantation , Klebsiella pneumoniae/drug effects , Renal Insufficiency, Chronic/surgery , beta-Lactam ResistanceABSTRACT
OBJECTIVE: To determine Candida colonisation/infection in renal transplant patients and to determine the resistance pattern against antifungal drugs. METHODS: This prospective, observational study was conducted at Al-Sayyed Hospital, Rawalpindi, Pakistan, from January to October 2014, in collaboration with the Microbiology and Public Health Laboratory's, Islamabad campus..The clinical specimens investigated included respiratory tract secretions, blood, urine, high vaginal swab, skin scrapings, and plastic devices samples. RESULTS: Of the 7,850 samples, 164(2.08%) were positive for Candida. Candida albicans were most prevalent as they were found in 114(69%) samples. Besides, 56(34%) of the positive samples were resistant to one or more antifungal agents. Highest resistance was obtained against fluconazole. We found only 5(3.04%) positive samples of Candida glabrata; of them, 3(60%)were resistant. In case of Candida spp, 27(48%) resistance was observed. In Candida albicans, 23(41%) of the samples were found to be resistant. Most of the Candida isolates was recovered from bronchial alveolar lavage. CONCLUSIONS: Although Candida albicans remained the main responsible species for Candida infections, but non-albican Candida species are also emerging.
Subject(s)
Antifungal Agents/pharmacology , Candidiasis/epidemiology , Drug Resistance, Fungal , Kidney Failure, Chronic/surgery , Kidney Transplantation , Amphotericin B/pharmacology , Candida albicans/drug effects , Candida albicans/isolation & purification , Candida glabrata/drug effects , Candidiasis/microbiology , Cross-Sectional Studies , Fluconazole/pharmacology , Humans , Ketoconazole/pharmacology , Microbial Sensitivity Tests , Pakistan/epidemiology , Prevalence , Prospective Studies , Tertiary Care Centers , Voriconazole/pharmacologyABSTRACT
OBJECTIVE: To determine the prevalence of bacteraemia in patients with chronic kidney disease, particularly those on dialysis and those who had had renal transplant, and to evaluate resistance among the isolated strains. METHODS: The cross-sectional study was conducted at Kidney Centre, Al-Sayyed Hospital, Rawalpindi, Pakistan, from June to December 2014. Samples that displayed positive growth were separated from the rest. The isolates were then identified and screened for extended spectrum beta lactamases and metallo beta lactamases production and other resistance mechanisms by phenotypic method. RESULTS: Of the 1400 samples, only 46 samples (3.3%) displayed signal for positive growth. The prevalence of extended spectrum beta lactamase (ESBL) producing strains was recorded to be 37%.Carbapenem resistance was witnessed in 15% samples. Whereas, Methicillin-resistant staphylococcus aureus prevalence was detected to be 2%. CONCLUSIONS: Resistance in gram-negative microbes was rising, while it was declining in gram-positive microbes.