Microbiology Laboratory Research Articles

Prevalence of multidrug-resistant gram-negative bacilli (MDR-GNB) in hospital-acquired and ventilator-associated pneumonia: A comparative study from a tertiary care center, Gujarat

Antibiotic resistance poses a formidable challenge to global healthcare, with Gram-negative bacteria emerging as a primary concern. Multidrug-resistant Gram-negative bacilli (MDR-GNB) have become a significant cause of nosocomial infections, particularly pneumonia, complicate therapy, and have a detrimental impact on patients’ outcomes. This study aims to investigate the etiology, risk factors, and antibiotic resistance patterns associated with Gram-negative bacilli (GNB) isolated from nosocomial pneumonia cases.This prospective cross-sectional study was conducted at the Microbiology laboratory of a tertiary care Hospital in Gujarat. Patients hospitalized for >48 hours with new lung infiltrates and at least two of the following clinical features: fever, leukocytosis/leukopenia, purulent secretions, or decreased oxygenation were included. The study was initiated after the ethical approval. Patient demographic and clinical details were noted in the preformed questionnaire. A total of 64 specimens [Sputum (n= 28) and Endotracheal aspirate (ET, n=36)] were cultured on MacConkey’s agar and Blood agar and further species identification with Antimicrobial Susceptibility Pattern was done by automated Vitek-2 compact system. Ventilator-associated Pneumonia (VAP) was found in 14.6% of infected patients, with male predominance and common in the 30-50 years age group. Out of them, 72% were mainly associated with late-onset. Overall, the major isolates were (20/64, 31%), followed by (19/64, 29.6%) and (17/64, 26.5%) both as solitary and mixed infections.76% strains of and 85% of strains were resistant to carbapenems and 93.3% of were resistant to cephalosporins and carbapenems. strains were 100% resistant to carbapenems. The study recommends effective Infection control practices and strong antibiotic stewardship programs to reduce the morbidity and mortality of nosocomial pneumonia.

Evaluation of the double-zone hemolysis (DZH) test for the detection of livestock-associated methicillin-resistant Staphylococcus aureus.

This study evaluated a simple and reliable phenotypic test that can be very useful in the clinical microbiology laboratory to detect livestock-associated (LA) methicillin-resistant Staphylococcus aureus (MRSA) isolates and S. aureus of potential animal origin. The proposed double-zone hemolysis test has shown high positive and negative predictive values, sensitivity, and specificity to detect these LA-MRSA clones and S. aureus of potential animal origin. Most LA-MRSA clones exhibit resistance to different classes of antibiotics, with unique epidemiological characteristics, and their early detection has public health relevance and patient management.

Evaluation of Isolated Anti-HBc Positivity in Patients Considered for Hepatitis B Diagnosis: 8.5 Years of Data

Background: Hepatitis B virus (HBV) infection is a global health problem. Isolated anti-hepatitis B core (HBc) serologic pattern is the most common atypical serologic profile and is defined as positive anti-HBc and negative hepatitis B surface antigen (HBsAg) and anti-HBs. Objectives: This study aimed to determine the prevalence of isolated anti-HBc positivity in samples sent to the medical microbiology laboratory for the examination of hepatitis B indicators, to identify both anti-HBc IgM and HBV DNA positivity rates within this pattern, to examine the relationship of this atypical pattern with different clinics, and to contribute to the clinical data of our country. Methods: Between January 2015 and July 2023, the patients’ test results of HBsAg, anti-HBs, anti-HBc, anti-HBc IgM, and HBV DNA requested from blood samples were retrospectively scanned along with demographic data of these patients. Results: Isolated anti-HBc positivity was observed in 1941 (6.0%) patients. Hepatitis B virus DNA positivity was 8.4% and anti-HBc IgM positivity was 0.6% in patients with isolated anti-HBc positivity. In addition, isolated anti-HBc positivity increased by age, was more common in males, and in internal medicine units (gastroenterology, oncology, general internal medicine, etc.). Conclusions: Consequently, anti-HBc IgM and/or HBV DNA positivity within an isolated anti-HBc positive pattern shows the infectivity of the disease. For this reason, in the diagnosis of HBV, in addition to HBsAg and anti-HBs, anti-HBc also needs to be tested, and anti-HBc IgM and HBV DNA need to be checked in every patient with isolated anti-HBc positivity.

Physical, chemical, and microbiological parameters of soil under different tillage types.

Objective: To determine the effect on the chemical, physical and biological properties of soils under minimum tillage and conservation tillage in different locations in Sinaloa. Design/methodology/approach: The treatments were evaluated using a completely randomized experimental design, with a total of eight treatments or sampling sites, where five samples per site were collected at a depth of 30 cm. A total of 40 samples were obtained, which were preserved in a thermal box and were transferred to the microbiology laboratory of the Faculty of Agronomy (UAS). The variables evaluated included the quantification of bacteria on plates, where the number of total bacterial colonies (TB), phosphate solubilizing bacteria (PSB), nitrogen-fixing bacteria (NF) and indole-promoting bacteria (IPB) were determined. In addition, organic matter, electrical conductivity and pH were determined. Results: Soils under minimum tillage modality significantly promoted higher percentage of organic matter, a greater number of bacterial colonies and higher electrical conductivity compared to soils with conventional tillage modality. Limitations on study/implications: Findings/conclusions: Agricultural tillage intervenes in the physical, chemical and microbiological properties of soils, as the sampling sites where minimum tillage is practiced show a higher concentration of organic matter and therefore leads to greater microbiology and electrical conductivity in those evaluated soils.

Bartonella quintana Infection in Canada: A Retrospective Laboratory Study and Systematic Review of the Literature

Background:Bartonella quintana is a body-louse-borne bacterium. Canadian B. quintana disease has been reported primarily in populations experiencing homelessness and in Indigenous communities with limited access to water. We sought to understand the epidemiology of B. quintana in Canada. Methods: This study combined an analysis of laboratory data from Canada’s National Microbiology Laboratory (NML) with a systematic review of the literature. Laboratory data included quantitative polymerase chain reaction (qPCR) cycle threshold values and indirect immunofluorescent antibody titers with the year and province of the sample acquisition. For the systematic review, we searched PubMed, Scopus, Embase, and Web of Science for articles published before 15 July 2024, with terms related to B. quintana in Canada. Results: Thirty-three individuals with qPCR-positive B. quintana were documented in seven provinces and one territory. The number of cases increased over time (p-value = 0.005), with the greatest number of cases being reported in 2022 and 2023. The percent positivity for the B. quintana qPCR performed at the NML increased over time (p-value = 0.036). The median immunoglobulin G titer demonstrated a sustained increase starting in 2017. The systematic review identified fourteen individuals with qPCR-positive B. quintana (none had a qPCR performed at the NML) and seven probable cases of B. quintana disease. Four of these twenty-one individuals from the systematic review died (19%). All fatalities were attributed to endocarditis. Conclusions: The detection of B. quintana disease in seven provinces and one territory suggests that B. quintana has a national distribution. B. quintana disease is increasingly diagnosed in Canada, indicating ongoing transmission across geographic settings.

A rapid liquid chromatography-tandem mass spectrometry based method for the detection of Tet(X) resistance gene in Enterobacteriaceae

There is a major public health threat posed by antibiotic resistance around the world. Tigecycline overcomes the resistance mechanisms of traditional tetracyclines and is often seen as the final resort in combating infections caused by bacteria resistant to multiple drugs. However, the introduction of new mobile tet(X) tetracycline destructases is leading to a notable rise in tigecycline resistance. Therefore, a rapid detection method is needed to monitor the spread of tigecycline resistance. In this study, a novel liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to detect tet(X) in bacterial isolates was developed. This method utilized the analysis by LC-MS/MS of metabolite ratios to determine the presence of tet(X). Bacterial suspensions were co-incubated with tigecycline for 1 h, where tet(X) destructase inactivated tigecycline, making a particular metabolite with a 16-Da change in mass. The characterized quantitative ion pairing of tigecycline in the ESI positive mode was observed at 586.1 → 569.1 m/z. The oxygenated tigecycline detection was established at 602.2 → 529.1 m/z. A model was established using 35 tet(X)-positive and 15 tet(X)-negative Enterobacteriaceae strains in this study to optimize the cutoff value. Applying the model to analyze 70 bacterial isolates, the sensitivity of the LC-MS/MS test was 98.9% compared to polymerase chain reaction (PCR), and specificity was 100%. This method is rapid and easy to operate, providing results within 1 h, making it more suitable for routine use in clinical microbiology laboratories.

Pattern of rapidly growing mycobacteria (RGM) species isolated from clinical samples: A 10-year retrospective study in a tertiary care hospital of Bangladesh

PurposeInfections caused by rapidly growing mycobacteria (RGM) are increasing worldwide. The study was conducted in a microbiological laboratory of Bangladesh to determine the pattern of detection of RGM from clinical samples. MethodsAll laboratory culture records of RGM from 2012 to 2022 were collected retrospectively and analyzed. ResultsA total 62 RGM infected patients with surgical site infection (74.1 %), injection site and skin abscess (9.7 %), septicaemia (4.8 %) and UTI (1.6 %) were identified. The annual isolation frequency of RGM increased 4.8 %–29.1 % in between year 2012 and 2022. RGM infected patients (14.5 %) were mistakenly treated with first line anti tubercular drug before correct microbiological diagnosis (median, IQR; 3, 2–5 months). Out of 23 RGM isolates, 86.9 % were M. abscessus and rest 13.1 % were M. fortuitum. Most of them (≥95 %) were sensitive to amikacin, linezolid, clarithromycin where as 27.1 % to imipenem and ciprofloxacin, 40 % to cefoxitin, 35.3 % and 1.7 % to doxycycline and co-trimoxazole respectively. ConclusionMisdiagnosis or delay in diagnosis and erroneous treatment with first line anti tubercular drug may cause prolong morbidity and therapeutic failure to patients with RGM infection. So, early and appropriate diagnosis is crucial for successful outcome.

Phenotypic and molecular determination of biofilm formation and antibiotic resistance of coagulase negative staphylococci isolated from food samples of animal origin in Turkey.

Aim: This study aimed to investigate the antibiotic resistance and biofilm formation characteristics of the coagulase-negative Staphylococcus (CNS) isolated from various animal food samples (raw milk, cheese, chicken, meat). Methods: A total of 60 Staphylococcus isolates collected from various animal food samples (raw milk, cheese, chicken, meat) were obtained from the frozen culture collection of the Microbiology Laboratory of the XXX University. The isolates were assessed regarding antibiotic resistance, biofilm and s layer formation, and biofilm-associated genes. Results: In total, 22 CNS isolates were identified. The CNS isolates were highly resistant to fosfomycin (68.2%; 15/22), fusidic acid (63.6%, n=14/22), and tetracycline (59.1%, n=13/22). There was an intermediate resistance to other antibiotics as well. There was very strong slime production (54.5%, n=12/22) and S-layer production (40.9%, n=9/22). The biofilm formation of CNS isolates was better at 24 hours. Regarding the biofilm producing genes, 10 (45%) of 22 CNS isolates were positive for the icaA gene, and 4 (18%) isolates were positive for the icaD gene while all of the isolates were negative for the bap gene. Conclusion: The CNS existing in foods from animals may lead to public health problems with clinical implications as a result of being one of the important factors associated with antibiotic resistance. The bacteria that can gain antibiotic resistance and biofilm formation capabilities in the stages of production and consumption may be a critical healthcare issue for humans and animals.

Spatial analysis of environmental sanitation and stunting incidents

Environmental factors such as sanitation and hygiene, drinking water sources, quality of drinking water, and ownership of latrines are indirect factors causing stunting. This study aims to analyze the distribution of stunting and environmental sanitation factors that cause stunting in Dairi District, North Sumatra, Indonesia. The case-control design was carried out with 172 toddlers. The distribution pattern of stunting and the association of patient characteristics and environmental risk factors was carried out using the Geographic Information System. Data on healthy clean-living behavior was collected using a questionnaire, and microbiological laboratory tests measured water quality. The spatial analysis uses an average nearest-neighbor overlay. The association of characteristics and risk factors with the incidence of stunting was analyzed using chi-square and logistic regression. The average nearest neighbor analysis shows that the nearest neighbor index is 0.19 ( 0.05) are unrelated to stunting. The pattern of distribution of cases tended to be in clusters, and no relationship was found between population density and the incidence of stunting. The findings of this study provide a new understanding that health promotion to prevent stunting does not only focus on fulfilling nutrition but also on healthy clean-living behavior and water quality.

Rare case report: Perforation Gallbladder Peritonitis Caused by Enterococcus avium at Prof. Dr. I.G.N.G Ngoerah Hospital

Enterococcus is a gram-positive, catalase-negative, and non-spore-bearing bacteria that generally live in the digestive tract of humans and animals. Enterococcus avium has rarely been detected infecting humans. Enterococcus avium has low virulence and is an opportunistic pathogen in hosts with weakeness immune systems. The most frequently reported sites of entry are the biliary tract and stomach. Peritonitis caused by Enterococcus avium is rare. Infection generally occurs through bacterial colonization. We report the first case of a patient with Gallbladder perforation resulting in peritonitis caused by Enterococcus avium at Prof. dr.I.G.N.G Ngoerah Hospital. Case Presentation: A 67-year-old Balinese man with peritonitis due to gallbladder perforation caused by infection Enterococcus avium. Previously the patient complained of stomach pain, and the patient had a history of gallstone disease. Subsequently, surgery was performed on the patient. During the operation, pus and perforation of the gallbladder were found. The pus specimen was examined in the microbiology laboratory, and the Enterococcus avium bacteria was identified as a significant agent causing the infection. In this case, ampicillin was recommended as therapy. After 5 days of antibiotics, the patient’s condition improved. Conclusion: Enterococcus avium has low virulence and is an opportunistic pathogen in an immunocompromised host. The finding case will be beneficial to clinicians because it provides additional information about the lesser-known Enterococcus avium.

Ceftazidime-avibactam tolerance and persistence among difficult-to-treat KPC-producing Klebsiella pneumoniae clinical isolates from bloodstream infections.

Tolerance and persistence occur "silently" in bacteria categorized as susceptible by antimicrobial susceptibility testing in clinical microbiology laboratories. They are different from resistance phenomena, not well-studied, and often remain unnoticeable. We aimed to investigate and characterize ceftazidime-avibactam (CZA) tolerance/persistence in 80 Klebsiella pneumoniae isolates from bloodstream infections. We used the Tolerance Disk Test (TDtest) to detect CZA tolerance/persistence and investigate the avibactam (AVI) influence on them, and time-kill assays with minimal duration for killing (MDK) determination to characterize/differentiate CZA tolerance from persistence, for selected isolates. Whole genome sequencing was performed for 49/80 selected isolates to investigate genes related to beta-lactam tolerance/persistence and resistance as well as phylogeny studies. Tolerance/persistence to CZA was detected in 48/80 (60%) isolates, all extensively drug-resistant (XDR) or multidrug-resistant, carbapenem-resistant K. pneumoniae (CRKp), KPC producers, and previously categorized as susceptible (not resistant) to CZA. No heteroresistance was detected. CZA tolerance/persistence occurred due to ceftazidime tolerance/persistence and was not related to AVI in the CZA combination. 5/11 isolates were characterized as CZA-tolerant and 5/11 as CZA-persistent. The single (1/11) XDR and CRKp non-KPC producer was truly susceptible. All the CZA-tolerant/persistent isolates (ST11, ST258, ST340, ST437, ST16, ST17, and ST307) harbored the carbapenemase-encoding gene blaKPC-2. Mutation in only two genes (rpoS and degQ) related to beta-lactam tolerance/persistence was found in only 7/49 CZA-tolerant/persistent isolates, suggesting the presence of yet unknown beta-lactam tolerance/persistence genes. Among the K. pneumoniae bloodstream isolates studied, 60%, previously categorized as susceptible to CZA, were, actually, tolerant/persistent to this antibiotic, all these KPC producers.

Comparison of two automated urine cytometry systems: Sysmex® UF-1000i and Beckman Coulter® DxU 850 Iris

Background: Urinary tract infection, defined as the presence of bacteria or yeast in the urinary tract, is the most common community-acquired infection after respiratory infections. The cytobacteriological examination of urine (CBEU) remains the primary diagnostic test for urinary tract infections and is the most frequently conducted test in microbiology laboratories. Direct examination is a crucial step of CBEU, enabling the assessment of cytology, including leukocytes and red blood cells, as well as the identification of crystals, epithelial cells, and microorganisms when present in significant quantities. This examination also provides preliminary results that can guide clinical decision-making. While the standard method for urine cytology is a microscopic examination, automation offers several advantages, including standardized results with higher repeatability, improved reproducibility, increased sample throughput, and seamless data transfer to laboratory information systems. Objectives: This study aimed to compare the performance of two automated urine cytology systems: Sysmex UF-1000i and the Beckman Coulter DxU 850 Iris. Methods: We described the methodology and technology underlying each system and assessed their analytical performance. The UF-1000i uses flow cytometry for the objective characterization and identification of particles based on forward scattering, fluorescence, and adaptive typing analysis. In contrast, the DxU-850 Iris, a urine microscopy analyzer, employs proprietary digital flow morphology technology alongside automatic particle recognition software to isolate, identify, and characterize digital images of particles. Conclusion: Our comparison showed that both systems performed exceptionally well, delivering results that are comparable, and, in some cases, superior to, those obtained through the reference method of optical microscopy.

Case Report: Soft tissue infection with Burkholderia thailandensis capsular variant: case report from the Lao PDR

Background Burkholderia thailandensis is an environmental bacteria closely related to Burkholderia pseudomallei that rarely causes infection in humans. Some environmental isolates have shown to express a capsular polysaccharide known as B. thailandensis capsular variant (BTCV), but human infection has not previously been reported. Although B. thailandenisis has been identified in environmental samples in Laos before, there have not been any human cases reported. Case A 44-year-old man presented to a district hospital in Laos with a short history of fever and pain in his left foot. Physical examination identified a deep soft-tissue abscess in his left foot and an elevated white blood count. A deep pus sample was taken and melioidosis was suspected from preliminary laboratory tests. The patient was initially started on cloxacillin, ceftriaxone and metronidazole, and was then changed to ceftazidime treatment following local melioidosis treatment guidelines. Laboratory methods A deep pus sample was sent to Mahosot Hospital microbiology laboratory where a mixed infection was identified including Burkholderia sp. Conventional identification tests and API 20NE were inconclusive, and the B. pseudomallei-specific latex agglutination was positive. The isolate then underwent a Burkholderia species specific PCR which identified the isolate as B. thailandensis. The isolate was sent for sequencing on the Illumina NovaSeq 6000 system and multi-locus sequence typing analysis identified the isolate had the same sequence type (ST696) as B. thailandensis E555, a strain which expresses a B. pseudomallei-like capsular polysaccharide. Conclusion This is the first report of human infection with B. thailandensis in Laos, and the first report of any human infection with the B. thailandensis capsular variant. Due to the potential for laboratory tests to incorrectly identify this bacteria, staff in endemic areas for B. thailandensis and B. pseudomallei should be aware and ensure that appropriate confirmatory methods are used to differentiate between the species.

In vitro Evaluation of Antifungal Activities of Zingiber officinale (Ginger) and Allium sativum (Garlic) Extracts on Fungal Isolates from Tinea Capitis

In vitro Evaluation of Antifungal Activities of Zingiber officinale (Ginger) and Allium sativum (Garlic) Extracts on Fungal Isolates from Tinea Capitis

Evaluation of a Novel Smart Capsule Bacterial Detection System Device for Diagnosis of Small Intestinal Bacterial Overgrowth.

There is a large unmet need for alternative, non-invasive, and accurate diagnosis of small intestinal bacterial overgrowth (SIBO). The smart capsule bacterial detection system (SCBDS) device contains a targeted sampling technology and an onboard SCBDS assay to detect metabolically active bacteria in the small intestine. Here, we evaluated the agreement of SCBDS assay with duodenal aspiration/culture exvivo in a multicenter clinical study. Duodenal aspiration was performed in subjects with gastrointestinal symptoms suggestive of SIBO. Aspirated fluid was sent to local and central microbiology labs to evaluate the agreement for detecting bacteria with SCBDS assay compared to the total bacterial count (TBC) reference standard. The performance of SCBDS assay was evaluated using a receiver operator curve, sensitivities, and specificities. Aspirates from 66 patients were collected and analyzed for TBC and SCDBS assay. The overall agreement between the two assays was 82%-92% across 3 clinical sites. The SCBDS assay had a sensitivity of 67%-100% and a specificity of 90%-97% using either ≥ 103 or 105 CFU mL-1 cutoff. Additionally, there was a good correlation (r = 0.82) for the TBC culture between the local and central labs. The SCBDS assay showed a high level of agreement with TBC and improved performance compared to other non-invasive tests. These results demonstrate the potential utility of SCBDS device to aid SIBO diagnosis as a simple and non-invasive tool that merits further clinical validation.

Comparison of intra-assay and inter-assay reproducibility and positive detection times of two different (BacT/Alert 3D and Autobio BC) commercial blood culture systems

PurposeIn our study, we aimed to compare the performance of the BacT/Alert 3D (bioMerieux, France) system, which is currently used in our laboratory, and the Autobio BC (Autobio, China) system, which was newly introduced in our country, using standard and clinical isolates. MethodsBacterial suspension was prepared by two technicians on the same day and three consecutive days from five different standard strains with 0.5 McFarland turbidity, then serial dilution to a final concentration was adjusted and was simultaneously inoculated in aerobic blood culture bottles. The bacterial concentration was measured by making a quantitative counting plate. The same procedure was also performed for 55 clinical isolates belonging to eleven species. After simulated bacteremia with standard and clinical isolates, the growth results were confirmed by inoculation from positive blood culture bottles onto solid medium and identification was made in the next day with MALDI-TOF MS (bioMérieux). In each study, sterile saline and blood was inoculated into the bottles as a negative control to check contamination. Intra-assay and inter-assay reproducibility of recovery rates and detection times of standard strains; recovery rates and detection times of clinical isolates were compared for both systems. ResultsRecovery rates were 100 % in both systems, and when positive detection times were compared, it was found that there was no difference between the two devices in clinical isolates (p:0.262) but that Autobio BC gave significantly (p < 0.001) earlier results in standard strains. ConclusionsIn our simulated bloodstream infection study, Autobio BC was found to be comparable with BacT/Alert 3D, both recovery rates and growth detection time performance were found to be very good, and it can be used in routine microbiology laboratories.

Comparative evaluation of eravacycline susceptibility testing methods in 587 clinical carbapenem-resistant Acinetobacter baumannii isolates: broth microdilution, MIC test strip and disc diffusion.

The study aimed to evaluate the accuracy of different methods for determining carbapenem-resistant Acinetobacter baumannii (CRAB) susceptibility to eravacycline. We collected 587 CRAB strains from Huashan Hospital affiliated to Fudan University between 2019 and 2023. The broth microdilution (BMD) method served as the reference standard. The susceptibility results were evaluated using the clinical breakpoints established by the Chinese Committee on Antimicrobial Susceptibility Testing (ChinaCAST) (susceptible MIC, ≤ 1 mg/L; inhibition zone diameter, ≥ 15 mm). The study compared the reliability of the MIC test strip (MTS) and disc diffusion (DD) methods in detecting CRAB susceptibility to eravacycline. The MICs required to inhibit 50% and 90% of CRAB growth were as follows: BMD, 0.5/1 mg/L; MTS, 0.38/0.75 mg/L. According to the ChinaCAST breakpoints, the BMD method demonstrated a 98.13% (576/587) susceptibility rate, whereas the MTS and DD methods showed susceptibility rates of 97.96% (575/587) and 97.61% (573/587), respectively. The essential agreement rate between the MTS and BMD methods was 94.55%. Categorical agreement (CA) rates for the MTS and DD methods were 99.83% and 99.49%, respectively. The major error (ME) rate for MTS was 0.17%, with no very major errors (VMEs) observed. For the DD method, the ME rate was 0.51%, also with no VMEs. The MTS and DD methods demonstrated strong consistency with the BMD reference method, with CA, ME and VME rates meeting methodological evaluation criteria. Both MTS and DD methods are reliable alternatives for assessing the antibacterial activity of eravacycline in clinical microbiology laboratories.

Study of bacterial susceptibility to antibiotic and phage combinations: a literature review

The aim of the review is to describe existing laboratory methods for determining the sensitivity of bacteria to a combination of antibiotics and bacteriophages. However, more and more often there are scientific papers in which their combined action is described as synergism. The mechanisms of this phenomenon have not been fully studied, but it has been proven that not only virulent but also moderate phages can enter into synergy with antibiotics, allowing the minimum inhibitory concentration of the antibiotic to be reduced several times. Since synergy cannot yet be empirically predicted, microbiological laboratories use various in vitro methods, most of which are labor-intensive. The development of a new technique that can be introduced into the daily practice of microbiological laboratories is relevant.

Distribution and Antibiotic Sensitivity of Burn Wound Colonization in Referred Patients at the Burn Care Centre, PIMS, Islamabad, Pakistan

ABSTRACT Background: Burn injuries represent a significant health challenge worldwide due to their high mortality and disability rates. These wounds often become prone to infection due to compromised immunity and disrupted blood vessels at the injury site. Timely surgical excision, coupled with topical chemotherapy, has notably reduced mortality rates in burn patients. Objective: The objective of this study was to determine the prevalence of common bacterial infections among referred patients, with a minimum delay of one week, and to assess their bacteriological susceptibility at the Burn Care Centre, PIMS, Islamabad. Methods: This retrospective descriptive study was conducted between March 2021 and February 2023. We reviewed wound swab culture results spanning 24 months, primarily from referred patients. Wound specimens were collected using sterile swabs and standard techniques from registered patients, then analyzed at the microbiological laboratory based on patients' culture reports. Results: A total of 226 culture reports were assessed, comprising 95 (42.04%) male patients and 131 (57.96%) female patients, with a mean age of 21 years (range: 11 months to 65 years). Among these reports, 16 (7.08%) showed no growth. Pseudomonas aeruginosa was identified in 88 patients (38.93%), while Staphylococcus aureus (MRSA) was present in 57 (25.22%), Klebsiella pneumoniae in 36 (15.93%), and a combination of Klebsiella and Pseudomonas in 18 (7.96%) cases, as per the swab culture reports. Escherichia coli was detected in 3 (1.33%) cases and Enterobacter in 2 (0.88%) cases. Other bacteria were found in 6 (2.65%) swab culture reports. Pseudomonas and Klebsiella exhibited maximum susceptibility to Polymyxin B, at 67.04% and 61.11%, respectively, while MRSA showed the highest susceptibility to linezolid, at 89.47%. Conclusion: Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae were the most prevalent bacteria among patients referred to our Burn Care Center. Referred burn patients were found to be colonized with multi-drug resistant bacteria, compared to inpatient cases at our center.

Evaluating the Effectiveness of Rapid Test for HBsAg and Anti HCV in Swabi, KPK

ABSTRACT Background: Both HBV and HCV are associated with chronicity causing irreversible damage which later may result in cirrhosis and Hepatocellular Carcinoma. Conducting sizeable epidemiological studies in order to obtain a detailed and precise data of HBV and HCV infection will enable us to be well equipped with proper awareness about the prevention both in terms of vaccines and treatment options. Objective: To highlight the importance of dire need of implementing public health measures against the increasing seroprevalence of HBV and HCV in Pakistan. Setting: This descriptive cross sectional study was conducted over a period of 17 months, starting from 7th Nov, 2022 to 31st March, 2024 at Microbiology Laboratory MTI- GKMC/BKMC, Swabi. Material and methods: A total of 459 blood samples were collected from suspected cases of HBV and HCV infection as they showed a positive result on performing the on spot screening for Hepatitis B surface antigen (HBs Ag) and Anti HCV through rapid immunochromatography (ICT). The samples which showed positive results through ICT were subjected to confirmation by polymerase chain reaction (PCR). Demographic data was also recorded. Permission from IRB was duly seeked. Results: Out of a total of 459 (ICT positive) HBV and HCV samples received at Virology section, 117 were of HBV, whereas 342 were of HCV. Out of the total 117 ICT positive HBV cases 60 were males and 57 were females. On subjection to confirmation by PCR 36 males and 18 females were confirmed positive by PCR. Similarly, out of the total 342 ICT positive HCV samples, 145 were males, whereas 197 were females, which upon subjection to confirmation by PCR, showed 104 males and 86 females confirmed positive by PCR. Conclusion: The being reported burden of HBV and HCV, stresses upon the policy makers to prioritize steps for efficient and adequate therapeutic and preventive measures for the effective reduction in the burden of HBV and HCV in Pakistan. Key words: HBV, HCV, immunochromatography, PCR