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Mycobacterium tuberculosis associated morbidity, mortality and drug resistance is a global health issue. The Gene Xpert is used for early diagnosis of TB and simultaneous detection of Rifampicin (RIF) resistance. We aimed to determine situation analysis of clinical TB in tertiary care hospitals of Faisalabad and to find out frequency of TB and drug resistance pattern by Gene Xpert. A total of 220 samples from suspected patients of TB were included in this study and 214 samples were detected as positive by Gene Xpert. Samples were classified on the basis of gender, age group (<30, 30-50 and >50 years), type of sample (sputum and pleural) and number of M. tuberculosis by ct value (cycle threshold). The results of present study showed high positive frequency of TB in male patients and in 30-50 years of age groups by Gene Xpert. High number of M. tuberculosis was found in low and medium category in TB patients. Out of 214 positive TB patients, rifampicin resistance was detected in 16 patients. In conclusion, our study identified that Gene Xpert is an effective approach for diagnosing TB by detection of M. tuberculosis and rifampicin resistance in <2 hours for rapid diagnosis and management of TB. [ABSTRACT FROM AUTHOR]

Sepsis is a leading cause of neonatal deaths across the world. Gram-negative rods such as Klebsiella and E. coli are major cause of sepsis in neonates. With a mortality rate of 1-4 deaths per thousand live births, sepsis is the second most important cause of neonatal deaths in the developing countries. The present study was designed to determine the occurrence of Gram-negative bacteria in neonatal sepsis and to find antibiotic susceptibility of isolated microbes. Blood samples of 100 neonates (1-89 days old) were sub cultured on MacConkey's and Blood agar for isolation of Gram-negative bacteria. A total of four bacterial species were isolated including Klebsiella (35.71%), E. coli (28.57%), Acinetobacter (21.42%) and Proteus (14.28%). Gram-negative bacteria were isolated more commonly from EOS (early onset sepsis) as compared to LOS (late onset sepsis). Klebsiella isolates from neonates showed sensitivity to imipenem (70%) followed by ceftazidime (40%) and cefotaxime (40%) and high resistance was shown by sulfamethoxazole (80%) and amikacin (70%). E. coli associated with neonatal sepsis were sensitive to imipenem (63%) while highly resistant to cefotaxime (75%) and ciprofloxacin (62%). For Acinetobacter high sensitivity was found for ceftazidime (50%) and resistance was shown to ciprofloxacin and sulfamethoxazole (100%). Proteus showed high sensitivity to amikacin (75%) and high resistance to imipenem and ciprofloxacin (75%). In conclusion, Gram-negative associated neonatal sepsis was found in the studied subjects and drug resistance was observed to clinically used antibiotics. [ABSTRACT FROM AUTHOR]

Presence of multiple drug resistant pathogens in hospital waste is a serious public health concern, because it may ultimately be disseminated to the human. Current study was designed with the objective to estimate the occurrence of ESBL-producing K. pneumoniae in hospital settings and waste. For this purpose, cross sectional study for a period of one year was designed and non-probability sampling techniques was used to collect total n= 112 samples from various sample sources of hospital waste including ward waste, operation theatre waste, wastewater and hospital sludge. Isolation of the K. pneumoniae was done by using selective agar, biochemical identification of the isolates was done through API 20E kit (bioMérieux, France). Molecular identification of the isolates was done by amplifying 16SrDNA with PCR. According to CLSI guidelines disc diffusion assay was performed for antibiotic susceptibility profiling. PCR of MDR isolates was done for the molecular detection of various ESBL genes. Results of the study showed 17 (15%) percentage prevalence of MDR K. pneumoniae from all 112 collected samples. Among various sample sources wastewater showed the highest percentage (23%) prevalence of MDR K. pneumoniae. In 17 confirmed isolates blaCTX-M and blaCTX-M1 were found in 13 (76%) and 12 (71%) respectively which showed the highest prevalence as compared to all other investigated genes. While blaTEM, blaSHV, blaNDM-1 and blaOXA-48 were found with percentage prevalence 9 (53%), 1 (6%), 9 (53%) and 6 (35%) respectively. Whereas blaKPC, blaIMP, blaVIM and blaGIM were not detected in any of the isolate. Taking together, strict rules and regulations should be adopted at public as well as hospital level to restrict the dissemination of antibiotic resistance from hospital environment to humans. [ABSTRACT FROM AUTHOR]

The present study aimed to decipher the bacterial infections in diabetic foot human patients in Pakistan and the anti-microbial susceptibility for clinical relevance. A total of 30 samples were collected from hospitalized type 2 diabetic patients (men and women) having foot ulcers. The collected samples were cultured on mannitol salt agar, Blood agar and MacConkey's agar and cetrimide agar. Gram staining and specific biochemical tests were performed to identify the invading bacteria. Antibiotic sensitivity and resistance pattern was performed for isolated bacteria by Kirby-Bauer disc diffusion method. In diabetic foot ulcers, most prevalent bacteria were S. aureus with percent positivity of 83% followed by E. coli (66%), K. pneumoniae (40%) and P. aeruginosa (16%). The infected ulcer with poly-microorganisms was 83.4% and the infected ulcer with single isolates was 16.6%. Imipenem was found to be most sensitive antibiotic against Gram positive as well as Gram negative bacterial isolates from diabetic foot ulcer human patients. Gram negative isolates from diabetic foot showed resistance to ampicillin, sulfamethoxazole/trimethoprim, cefotaxime/clavulanate, metronidazole. The diabetic foot ulcers of human patients revealed high prevalence of S. aureus followed by E. coli, K. pneumoniae and P. aeruginosa respectively. Imipenem was found to be the most sensitive antibiotic for all the bacterial isolates from foot ulcers of type 2 diabetic patients. This study suggests imipenem as effective antibiotic for treatment of diabetic foot ulcers against bacteria.