Browsing by Subject "UTI"
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Item Different Types of Vaginitis and the Association Between Bacterial Vaginosis and Urinary Tract Infection among Suspected Pregnant Women(Department of Microbiology, 2011) Lamichhane, PramilaVaginitis is the inflammation and infection of the vagina most oftenly caused by bacteria, fungi and parasites. This cross-sectional descriptive study was carried out to describe the prevalence and distribution factors of different types of vaginitis and the association between bacterial vaginosis and urinary tract infection among suspected pregnant women visiting Thapathali Maternity and Women’s Hospital, Kathmandu during the period of June 2010 to December2010. Duplicate high vaginal swabs (HVS) were taken for whiff test, wet mount, p Hdetermination, gram stain and culture. Similarly midstream urine of those patients was taken and culture was done for determination of urinary tract infection(UTI). Among 230 pregnant women, 40.0% had vaginitis, and the prevalence of bacterial vaginosis(BV), vulvo vaginal candidiasis (VVC) and trichomoniasis was found to be 27.8%, 24.3% and0.4% respectively. The infection rate was higher in inpatients (26.9%),rural (30.8%), housewife(28.6%) and illiterate (22.6%) women compared to outpatients (13.0%), urban (9.1%), employed(11.3%), and literate women (17.4%) respectively. The infection rate was higher in age group 20to 29 (44.7%) while least infected age group was 40 and above (20.0%). Pregnant women in third trimester were more infected (42.5%) followed by second (39.4%) and first trimester(28.0%). BV was found more common among women who smoke (56.0%) than nonsmoker(20.0%) (P<0.05). Infection rate was higher in symptomatic cases (54.7%) as compared to asymptomatic women (24.8%). Among 64 BV positive cases, 23.4% had UTI while only 10.2%of pregnant women without BV had UTI (P<0.05).E. coli was the most predominant bacteria isolated from both HVS (53.1%)and urine (43.8%).E. coli isolated from HVS and urine was52.9% and 57.1% multidrug resistance respectively. Hence, the prevalence of vaginitis was higher among pregnant women and BV was associated with UTI during pregnancy. Also the higher percentage of the isolated bacteria was found to be multidrug resistance.Key words:vaginitis, pregnancy, BV, UTI, MDRItem Incidence of Urinary Tract Infection in cancerpatients Underchemotherapyand the Prevalence of Multidrug Resistants trains among The isolated Bacterial Pathogens(Central Department of Microbiology, 2010) Manandhar, SunilaCancer and its treatment causes both direct and indirect effect on a patient's immunesystem which increases the susceptibility of immunosuppressed cancer patients toinfections.UTI is the common bacterial infectiongenerally detected in cancer patientsspecially in those who are on chemotherapy. UTI in cancer patients should beconsidered complicated when it occurs asa result of suppressed immunity. This study was conducted in OMHospital and Research Center, Kathmandu amongcancer patients underchemotherapy fromFebruary2009 toJuly 2009.The aim of thisstudy was to investigate the incidence of UTI in these patients, establish an antibioticsusceptibility profile of the isolated organisms and determine the prevalence of MDRstrains.This study was also carried out with anobjective to find the possibleassociationbetween the blood cell count and occurrence of UTIamong these patients. Altogether, 127 mid-stream urine samples from cancer patients under chemotherapywere investigated by conventional semi-quantitative culture technique, pus cell count,and albumin test for detection of UTI. Meanwhileblood samples were also collectedfrom all the patients to determine their totalWBCcount and absolute neutrophil count. Out of 127 urine samples, 26 (20.5%) samples showed significant bacterial growth.Status ofsignificantbacteriuria was found higher in females(65.4%) than in males(34.6%).However, association between significant bacteriuria and gender of the patients was found tobe statistically insignificant (P>0.05).The highest number of growth positive samplesbelonged to the age group 70-80(38.5%).Maximumoccurrenceof UTI (n=13,50%)were found in thosepatients who had received 6-8 chemotherapy cycles followed bythose who had received 4-6 cycles (n=10,38.5%). No significant association was foundbetween the total WBC count and the occurrence of UTI (P>0.05).Similarly, nosignificantassociationcould be established betweenUTIand theconditionwhenANC<1500(P>0.05). Out of the 26 bacterial isolates, 25 were gram negatives and the remaining one isolatewas a gram positivecocci.Escherichia coli was found to be themost predominantisolate (73%). Other bacterial isolates which were found in the study wereCitrobacterfruendii (7.7%), Klebsiella oxytoca (7.7%), P. aeruginosa(3.9%), Acinetobacterspp.(3.9%) andS.aureus(3.9%). Among theGram negative organisms, Amikacin was found to be the most effectiveantibioticfollowed by Ceftazidime and Nitrofurantoin.Fluoroquinolones were found tobe highly resistant towards the majority of gram negative isolates. The only isolate ofS.aureuswas found susceptibletowards Amikacin and Novobiocin. Multidrug resistance (MDR) was observed in88.5% (23/26)of the total bacterial isolates.Among the19E. coli isolates, 16 (84.2%) were MDR-strains.All the other batcerialisolates were alsofound to bemulti-drug resistant. Key words: UTI, cancer, chemotherapy, MDR, Total WBC count and ANCItem Urinary Tract Infection in Pregnant Women and Antibiotic Susceptibility Pattern of Bacterial Isolates with Reference to Extended Spectrum Beta Lactamase Producing Strains(Department of Microbiology, 2011) Thapa, RekhaThe objective of this study was to determine the prevalence of urinary tract infection among the pregnant women and antibiotic susceptibility pattern of bacterial isolates with reference to extended spectrum β-lactamase producing strains. This cross sectional study was conducted at Paropakar Maternity and Women’s Hospital,Thapathali, Kathmandu from June to December 2010 among 1720 pregnant women attending their antenatal checkup. Information regarding various characteristics was obtained and urinespecimen was processed for isolation of bacteria, performing antibiotic susceptibility test byKirby-bauer disc diffusion method and ESBL test by Double Disc Synergy Test (DDST) method. The prevalence of UTI was found to be 30.5%. Majority of the pregnant women were fromoutpatient department of hospital (65.7%), urban areas of the country (52.3%), age group 21-30years (74.3%), unemployed (73.3%), literate (88.0%), primiparous (54.3%) and second trimesterof pregnancy (48.3%). Parity, education status, occupation of pregnant women, times of bathing,history of UTI, presence of pus cells and RBC in urine was found to be the risk factors of UTIfrom both univariate and multivariate analysis. E. coli (52.0%) was found to be the mostpredominant isolate and Pseudomonas aeruginosa (0.7%) was least one. Gentamicin andamikacin were found to be the most effective antibiotics. About 72.0% of the isolates were foundto be multidrug resistant with higher rate in hospitalized patients (84.0%). About 20.0% ofE.coli and 36.4% of the Klebsiella pneumoniae were found to be the ESBL producers. There is a great need to follow strictly the hospital antimicrobial policy in order to prevent the emergence and dissemination of MDR and ESBL producing microorganisms as they are associated with the treatment failure of UTI. KEY WORDS: Pregnant women, UTI, multi drug resistant, ESBL