Browsing by Subject "Mid-stream urine"
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Item Antibiotic Susceptibilty Pattern of Urinary Isolates with Reference to Extended Spectrum Β-Lactamase Producing Bacteria from Alka Hospital(Department of Microbiology, 2014) Tiwari, VijayAntibiotic resistance is now a global concern. The emergence and spread of antimicrobial resistance due to the production of β-lactamases represent a clinical threat because of their broad spectrum of activity. The present study was conducted at Alka Hospital from Ocotober 2011 to December 2012 with the objectives to study the emergence of extended spectrum β-lactamase production in common bacterial isolates from urine sample. During this period, 1699 mid-stream urine samples collected were investigated to determine UTI by conventional culture technique and microscopy. Only 16% (n=271) out of 1699 samples showed significant bacterial growth. The maximum number of growth was observed in age group 20-30 yrs (27.3%), followed by age group 30-40 (20.30%). The high culture positivity was seen among female 17.9% (n=193) than in males 12.4% (n=78). Altogether nine different species of bacteria were isolated among which Escherichia coli 67.50% (n=183) were found the most predominant organisms followed by Staphylococcus aureus 10.70% (n=29), Klebsiella pneumoniae 7% (n=19). Multidrug resistance (MDR) was observed in 70.11% (n=190) of total bacterial isolates. Seventy seven (28.4%) isolates were confirmed for ESBL production. ESBL production was found highest in E.coli 31.6% (n=183) followed by K. pneumoniae 31.50% (n=19), Pseudomonas aeruginosa 27.30% (n=11), Acinetobacter spp. 26.70% (n=15).Item Study of Bacteria Causing Urinary Tract Infection and Their Antimicrobial Resistance Trend at National Public Health Laboratory(Department of Microbiology, 2007) Shrestha, PadmaThepresent study was conducted at National Public Health Laboratory, Teku from May toSeptember 2006 with the objectives to isolate bacteria causingurinary tract infectionand todetermine their antimicrobial resistance trend. During this period, three hundred and fifty twomid-stream urine samples collected were investigated by conventional semi-quantitative culturetechnique, microscopy and antibiotic susceptibility test. Only 22.7% (80/352) of the samples showed significant bacterial growth. Status of bacteriuriawas found higher in females (29.8%) than in males (15.2%). Association of significant bacteriuriaand gender of patients was found to be statistically significant (P<0.05). Status of bacteriuria wasfoundhigher in age group 21-30 (21.6%) followed by 31-40 (18.8%). Altogether11 differentbacteria were isolated among whichEscherichia coli(48.8%) was foundthe most predominant organisms followed byKlebsiella pneumoniae(18.8%),Proteus mirabilis(7.5%),Proteus vulgaris(6.3%), Coagulase-negative Staphylococci (5.0%),K. oxytoca(3.8%),Enterobacterspp. (3.8%),Citrobacter freundii (2.5%),Acinetobacterspp. (1.3%),Alcaligenesspp. (1.3%) andStaphylococcus aureus(1.3%). Predictors concerning pus cell count (≥5/HPF) and RBC count (≥3/HPF) were analyzed todetermine the positive predictive value (PPV) in relation to the significant bacteriuria. Positivepredictive value for pus cell count was found to be higher (77.8%) than that of RBC count(39.6%). Gramnegative bacilli showed best susceptibility towards gentamicin (80.0%) followed byceftriazone (76.0%)whereas ampicillin was found out to be the least effective drug.Nitrofurantoin(100.0%)was found to bethe most effective against Grampositive bacteria. Multidrug resistance (MDR) was observed in 45.0% (36/80) of total bacterial isolates. Multidrugresistance was foundto be 51.3% (20/39) inE. coliand that inKlebsiella pneumoniaewas 33.3 %(5/15). Higherrateof MDR was found in males (57.7%, 15/26) than in females (38.8%,21/54).Among the MDRE. coli isolates, 100.0%, 90.0% and 65.0% were resistant to ampicillin,norfloxacinandcotrimoxazolerespectively.Among the MDRK. pneumoniae isolates, 100.0%were resistant to ampicillin, cotrimoxazole and norfloxacin. Key words:bacteriuria, urinary tract infection,mid-stream urine, pyuria, multidrug-resistanceItem Study on the Incidence of Urinary Tract Infection in Diabetic Patients and the Prevalence of Multidrug Resistant Strains among the Bacterial Pathogenic Isolates(Department of Microbiology, 2006) Puri, NishaDiabetes is a chronic disorder of carbohydrates, fat and protein metabolism due to insulin deficiency and /or insulin resistance. It has been noted that diabetic patients can have severe medical complications. Urinary tract infections (UTI) are very often encountered in patients with diabetes mellitus. They may present themselves as asymptomatic bacteriuria, but may also lead to more serious infection. Urinary tract infection is a common medical problem; sometimes, leading to the number of deaths either from acute infection or from chronic renal failure. Bacteriological examination of the urine is an important tool in the diagnosis of infection. This study was conducted in “OM” Hospital and Research Center, Kathmandu among diabetic patients suspected of UTI from March 24, 2006 to June 13, 2006. The aim of this study was to investigate the incidence of UTI in diabetic patients, etiology of UTI, antibiotic susceptibility profile, to isolate the multi-drug resistant strains (MDR-strains) and to compare the results with control patients. Altogether, 100 samples from diabetic patients as test and 100 samples from nondiabetic patients as control were included in this work, which were investigated by glucose oxidase test for blood sugar level, conventional semi-quantitative culture technique, pus cell count, red blood cell count, epithelial cell count and albumin test for detection of UTI. Out of 100 test urine samples, 22.0% showed significant growth while 4.0% samples showed mixed growth and 8.0% showed non significant growth. Out of 100 control urine samples, 12.0% showed significant growth while 1 sample showed mixed growth and 2.0% showed non significant growth. The highest number of growth positive samples from test 7 (31.8%) and from control patients 3 (25.0%) belonged to the same age group 51-60 years. Also, among the 22 isolates from test, 13 (59.5%) and among 12 isolates from control, 10 (83.3%) were from female patients. Escherichia coli was found to be the most predominant isolate (40.9%) followed by Citrobacter fruendii (27.2%) and Staphylococcus aureus (18.1%) in test and in control it was 83.3%. Out the total isolates, 20 (90.9%) in test and 9 (75.0%) in control patients were MDR. In case of test out of 9 E. coli isolates, 8 were MDR-strains while all the isolates of Citrobacter fruendii, Pseudomonas aeruginosa, Klebsiella pneumoniae and Proteus vulgaris and out of four S. aureus isolates, three were MDR strains. Nitrofurantoin was found to be the most effective drug for all Gram negative isolates followed by Ofloxacillin. Erythromycin was the drug of choice for Gram positive isolates. Microscopy for pyuria showed the sensitivity of 59.0% vs 66.6% and specificity of 93.5% vs 96.5% in diabetic and control patients respectively. Similarly albuminuria showed sensitivity of 59.0% vs 66.6% and specificity of 89.7% vs 92.0%. Higher proportion of positive cases seen among test patients was found to be statistically non significant (P>0.05) with control patients, whereas no significant association was found between MDR and non MDR strains and significant and non significant pyuria between test and control patients.