Molecular epidemiology of Shigella flexneri isolated from pediatrics in a diarrhea-endemic area of Khyber Pakhtunkhwa, Pakistan.

Shigella flexneri is considered as an important causative agent of Shigellosis causing diarrhea in the countries with a low socioeconomic status. No study has been carried out on the molecular prevalence of S. flexneri in Khyber Pakhtunkhwa, Pakistan. So this study was designed to evaluate the molecular prevalence of S. flexneri and their associated risk factors. A total of 2014 diarrheal stool samples were collected from January 2016 to May 2017 from pediatrics patients of Khyber Pakhtunkhwa followed by identification of S. flexneri through biochemical, serological, and molecular methods. The overall prevalence of Shigella species was found to be 7.9% (n = 160). The predominant Shigella specie was S. flexneri (n = 155, 96.8%) followed by S. boydii (n = 5, 3.1%). Interestingly, no sample was found positive for S. sonnei and S. dysenteriae. The majority of Shigellosis cases occurred from June to September. Potential risk factors related with Shigellosis were unhygienic latrine usage, bad hand washing, and consumption of unhygienic food and water, and pipe leakage in the sewage system. In this study, we have observed a high number of Shigellosis cases especially those caused by S. flexneri. It is suggested that effective health awareness programs should be organized by the regional health authorities to minimize the magnitude of pediatrics Shigellosis.

Multi drug resistant Pseudomonas aeruginosa: Pathogen burden and associated antibiogram in a tertiary care hospital of Pakistan.

Pseudomonas aeruginosa is an important pathogen of both community and hospital acquired infections, and a major threat to public health for continuous emergence of multi-drug resistance. Current prevalence and pattern of multidrug resistance in the clinical isolates of P. aeruginosa is reported here. Samples were collected from September 2013 to January 2014 tertiary care hospital, Peshawar. Samples were subjected to phenotypic and molecular based detection of P. aeruginosa and were further processed for multidrug resistance pattern. Out of 3700 samples, 102 were identified as MDR P. aeruginosa. Prevalence of MDR isolates were found in pus (34.3%), wounds (28.4%), urine (19.6%), blood (14.7%) and sputum (2.9%) respectively. Isolates were more resistant to Sulphamethoxazole/Trimethoprim (98.04%), Amoxycillin/Clavulanic acid, Doxycycline and Chloramphenicol (95.1%) each, while least resistant to Imipenem (43.1%), Cefoperazone/Sulbactam (50.98%) and Amikacin (53.9%). Extensive MDR pattern was observed in P. aeruginosa was found as (n = 17, 16.6%) isolates were resistant to all four classes of antibiotics. Increased burden of MDR P. aeruginosa was documented in the study. Moreover, some isolates were even resistant to four classes of antibiotics. Findings of the study will be helpful to devise an appropriate antibiotic treatment strategy against MDR P. aeruginosa to cope the chances of evolving resistant pathogens.

Molecular prevalence and antibiotics resistance pattern of class A bla CTX-M-1 and bla TEM-1 beta lactamases in uropathogenic Escherichia coli isolates from Pakistan.

BACKGROUND/AIM: Extended spectrum beta lactamase (ESBL) production among E. coli is one of the principal mechanisms that augment resistance to antibiotics. In the current study the molecular detection of class A beta lactamases among uropathogenic Escherichia coli was evaluated. MATERIALS AND METHODS: A total of 355 urine samples were collected from a tertiary care hospital in Peshawar. The ESBL production among E. coli isolates was detected by using the disc synergy diffusion method. Moreover, the molecular detection of bla TEM-1 and bla CTX-M-1 ESBLs, the antibiotic resistance pattern, and the minimum inhibitory concentrations (MICs) were also documented. RESULTS: Among the 355 urine samples, 157 isolates were E. coli, and 23.56% of the isolates were ESBL E. coli. Among phenotypic ESBL producers, bla CTX-M-1 and bla TEM-1 were found in 59.45% and 40.54% of the isolates, respectively. A high resistance rate was observed against aztreonam (97.29%), while the lowest resistance was observed against imipenem (2.7%). The MICs of ESBLs E. coli for ceftriaxone, ciprofloxacin, and gentamicin was >512 µg/mL, 4 µg/mL to 128 µg/mL, and 1 µg/mL to 14 µg/mL respectively. CONCLUSION: The present study showed that bla CTX-M-1 ESBL production is more prevalent in our clinical E. coli isolates. More often the ESBLs were resistant to commonly used antibiotics.