Changing pattern of resistant pathogens causing urinary tract infections in Karachi

INTRODUCTION: The study under view is based under the aim to investigate the prevalence and susceptibility pattern of pathogens, causing urinary tract infections (UTIs), to antibiotics commonly used in routine medication. MATERIALS AND METHODS: Over a period of 10 months 100 isolates were collected for the determination of their susceptibility to chosen antibiotics, from a laboratory (MedPath Laboratories) in urban area of Karachi. All Gramnegative and Gram-positive urinary tract pathogens were re-identified by their morphological and biochemical characteristics and the susceptibility to seven antibiotics was determined. RESULTS: Pathogens were found as, Escherichia coli, Pseudomona spp, Klebsiella species, Enterobacter spp., and Staphylococci spp. In recent study, more than half of the Escherichia coli isolates were resistant to one or more of the all antimicrobial drugs tested. Resistance was most common to amoxicillin/clavulanic acid and ofloxacin, cefixime, followed by gentamicin. Our results indicate that Escherichia coli and Pseudomonas spp. were the most common organisms causing UTI. Other organisms involved were Enterobacter spp., Staphylococcus spp., and Klebsiella spp. Increasing patterns of resistant to gentamicin, and ofloxacin were also observed. CONCLUSIONS: In conclusion, pattern of antibiotic susceptibility to first line antibiotics is changing hence antimicrobial susceptibility testing of all isolates is crucial for the treatment of UTI. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8069 Int J Infect Microbiol 2013;2(3):99-104

Assessment of bacterial load in broiler chicken meat from the retail meat shops in Chitwan, Nepal

INTRODUCTION: Keeping quality of meat and meat related food hazard relates to microbes present in the meat during processing or storage. The poultry slaughtered and dressed under Chitwan conditions carrying high initial contamination would be present in meat as inherent contamination in the finished products. MATERIALS AND METHODS: This cross-sectional study included 26 fresh broiler meat samples from registered retail shops. The samples were subjected to bacteriological analysis such as total viable count (TVC), total enterobacteriaceae count (TEC), total coliform count (TCC) and total staphylococcal count (TSC). Also, the samples were analyzed for the detection of Salmonella spp. and identified by different biochemical tests. RESULTS: The mean counts in log10±SE colony forming units per gram (cfu/g) for Bharatpur, Ratnanagar and Institute of Agriculture and Animal Science (IAAS) vicinity were obtained as 11.1±0.3, 11.5±0.3 and 12.2±0.5 TVC; 8.5±0.2, 9.2±0.3 and 10.2±0.4 TEC; 6.5±0.3, 7.6±0.3 and 8.4±0.5 TCC; 6.5±0.2, 6.8±0.3 and 7.7±0.4 TSC respectively. No samples were found to be within the permissible limits given by different agencies. Prevalence of Salmonella spp. in retail broiler meat in Chitwan was found 46.2%. CONCLUSION: The retail broiler meat samples from the locations contain high count of bacteria suggesting deplorable state of hygienic and sanitary practices. The presence of Salmonella and Staphyloccus aureus organisms over the permissible limits are of special concern because these account for potential food borne intoxication. So, the need for microbial assessment of fresh meats can be emphasized. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8671 Int J Infect Microbiol 2013;2(3):99-104

Prevalence of intestinal parasitic infection of kindergarten children

INTRODUCTION: Intestinal parasitic infections are the major public health problems of Nepal. Apart from causing mortality and morbidity, infection with intestinal parasites has been associated with stunting of linear growth, physical weakness and low educational achievement in school children. The drinking water is considered as the major cause for parasitic infection. This study aims to determine the prevalence of parasitic infection among the children visiting kindergarten of the Kathmandu, Khusibhu area. MATERIALS AND METHODS: Cross sectional study was done in randomly selected Kindergarten of Khusibhu area. A total of 101 samples were examined. The study was focused in isolating intestinal parasites using normal saline and iodine wet mount method. Both macroscopic and microscopic studies were performed. RESULTS: Among the samples 45.5% (n=46) showed parasitic infection in which the Giardia lambia infection was found the highest 56.5% (n=26) and infection with Ascaris lumbricoides was found lowest 8.7% (n=4). Infection rate was found to be high in children drinking filtered water than among those drinking boiled and filtered water. CONCLUSION: The prevalence of parasitic infection in children is mainly associated with hygiene and food habit of the children. Hence good education about the hygienic practice helps in the prevention of the infection. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8205 Int J Infect Microbiol 2013;2(3):111-113

Risk factors for bad obstetric history in Kirkuk women, Iraq

INTRODUCTION: Microbial agents such as Toxoplasma, rubella, CMV and HSV are important cause of infections during pregnancy, which mainly are asymptomatic. However, the infection during pregnancy may result in serious foetal side effects. Objective was to determine the risk factors that enhance the development of bad obstetric history (BOH) due to TORCH infections in Iraqi women. MATERIALS AND METHODS: A 538 women were included in the study, of them 293 (54.5%) were with BOH, and 245 (45.5%) were with normal pregnancy history. In the BOH group, 144 (49.1%) women were pregnant, while in the normal pregnancy group, 117 (47.7%) were pregnant. Logistic regression analysis was used to determine the risk factors that may play a role in development of BOH. RESULTS: Multifactorial analysis indicated that Toxoplasma gondi IgM, rubella IgM, rubella IgG, CMV IgM, HSV -2 IgG and animal exposure were risk factors that lead to BOH development. However, Toxoplasma IgG seropositivity had inverse correlation to BOH development. Mother education was a significant protective (OR=0.614, P=0.000) factor that reduce development of BOH. Residence, education, occupation and family size influenced the role of TORCH in induction of BOH. CONCLUSIONS: This study indicated that Toxoplasma gondi IgM, rubella IgM, rubella IgG, CMV IgM, HSV-2 IgG and animal exposure were risk factors that lead to BOH development. Mother education was a significant protective factor that reduce development of BOH. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8121 Int J Infect Microbiol 2013;2(3):70-77

Outbreak investigation of Cholera in Shantinagar VDC of Ilam District in Eastern Nepal

INTRODUCTION: In 2012 August, suspected cases of Cholera in increased number were reported to the district health office of Ilam by the in charge of Shantinagar health post asking for intervention to stop further occurrences. The aim of the investigation was to identify the possible source of infection, the causative agent and the application of local control measures for prevention of further recurrences. MATERIALS AND METHODS: Focus group discussion and Key informant survey were conducted to assess the sanitary hygiene and practices along with source of drinking water for probable cause of diarrhea. Similarly, face to face interview was done among the sick and healthy local residents to collect the demographic and clinical details. Ten stool and water samples were sent for analysis in Biratnagar, Dharan. RESULTS: 150 local residents had suffered from diarrhea with no deaths. People of all the age group were affected with children being more sufferers. Six of the stool analysis and eight of the water samples were positive for Vibrio Cholerae. It was also observed that sanitary hygiene and practices wasn’t adequate after nose and bottoms cleaning of the children and before preparing the meal. CONCLUSIONS: Lack of adequate cleanliness of the common water tank was found to be the culprit behind the incident and Vibrio Cholerae being the causative agent. Local residents and water management committee were demonstrated the technique of chlorination of water and proper hand washing practices to prevent further recurrences. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8666 Int J Infect Microbiol 2013;2(3):87-90

Comparison of hypertonic saline-sodium hydroxide method with modified Petroff’s method for the decontamination and concentration of sputum samples

INTRODUCTION: Tuberculosis is one of the major health problems particularly in developing countries. For definitive diagnosis of pulmonary tuberculosis identification of tubercle bacilli in sputum by microscopy and culture is essential. For decontamination and concentration of sputum, the commonly used method in the laboratory is Modified Petroff’s method but the Hypertonic saline–sodium hydroxide (HS-SH) method is known to be better for detection of Mycobacterium tuberculosis by culture. This study was aimed to compare a novel method for the improvement of decontamination and concentration of sputum samples. MATERIALS AND METHODS: A total of 50 confirmed smear positive sputum samples from pulmonary TB patients who visited at St. John’s Medical College and Hospital during 2009 to 2010, were processed for the decontamination process. Each sample was decontaminated by Modified Petroff’s and HS-SH method separately. Treated samples were cultured in Lowenstein-Jensen media in microbiology laboratory. RESULTS: The culture positive percents of Mycobacterium tuberculosis in the L-J medium treated with HS-SH and Modified Petroff’s method were 84.0% and 70.0%, respectively. A notable feature is that by HS-SH method more samples were positive by 4th week, statistically significant (Chi- square value-11.26 with p-value < 0.05) compare to Modified Petroff’s method. The difference for 3+ grades of L-J growths found slightly higher by Modified Petroff’s method but at lower grades of growths HS-SH method performed better. CONCLUSIONS: HS-SH method is better for the detection of Mycobacterium tuberculosis by culture when compared with the Modified Petroff’s method. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8664 Int J Infect Microbiol 2013;2(3):78-81

Occurrence of urinary tract infection among children attending Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal

INTRODUCTION: Urinary tract infection (UTI) is considered as the most common bacterial infectious disease seen among the pediatric patients. Most commonly, members of Enterobacteriaceae, particularly uropathogenic strains of E. coli and Enterobacter spp. are the primary causative pathogens of UTI in the different part of the world. Emergence of antimicrobial resistance rates among pathogens recovered from urinary tract infections is an increasing problem in the specific region. MATERIALS AND METHODS: Prevalence and anti microbial susceptibility pattern of the bacterial uropathogens isolated from the children attending Gandaki Medical College Teaching Hospital and Reserch Center (GMC) Nepal. A total of 155 children aged upto 15 years were included in this study. Urine cultures were carried out and the isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). RESULTS: In the present study 21.3 % of the sample size, showed significant bacterial growth. E. coli was the most frequently occurring pathogen (39.40%), followed by Proteus spp. 21.2%, Citrobacter spp. and Streptococcus faecalis (12.1%) Klebsiella spp. (9.1%), and Staphylococcus aureus and Enterobacter (3.0%). Susceptibility rate of E. coli were 69.2% to Gentamycin and Amikacin, 53.8% to Norfloxacin, 38.4% to Nalidixic acid and Norfloxacin. CONCLUSIONS: Pediatric urine culture isolates were becoming increasingly resistant to commonly used antibiotics. Finally, we suggest that empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organisms and antibiotic sensitivities rather than on universal guidelines. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8665 Int J Infect Microbiol 2013;2(3):82-86

A descriptive study of associated factors with HIV/AIDS among antiretroviral users of Eastern Nepal

INTRODUCTION: In Nepal, the firstcase of Human Immunodeficiency Virus (HIV) was reported in 1988, since then the epidemic is driven by sexual transmission and intravenous drug use. The aim of this research is to study various associated factors with HIV/AIDS patients. MATERIALS AND METHODS: A cross-sectional study was carried out from May 2009 – April 2010 at three Anti-retroviral treatment centers (B.P.K.I.H.S, Dharan, Koshi Zonal Hospital, Biratnagar and Mechi Zonal Hospital, Bhadrapur). A purposive sampling technique was applied to include all 234 seropositive patients who were under medication from these centers. RESULTS: Males represented 71% of the patients. More than 75%of the patients fell in the age group of 20-39 years. 35.9% of them had visited commercial sexual workers and similar proportion of them had shared needles during intravenous drug use. CONCLUSIONS: Unsafe high risk behavior with commercial sexual worker and needle sharing habit were found to be the associated with HIV/AIDS patients. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8667 Int J Infect Microbiol 2013;2(3):95-98

Smear negative pulmonary tuberculosis and infectivity

DOI: http://dx.doi.org/10.3126/ijim.v2i3.8663 Int J Infect Microbiol 2013;2(3):68-69

Prevalence of gastrointestinal zoonotic helminths in dogs of Kathmandu, Nepal

INTRODUCTION: Considering the close association of dog and human beings and increasing trend of pet rearing, it is important to know the status of zoonotic helminths of pet and stray dogs and awareness of owners about this in Kathmandu, Nepal. This study was carried out to determine the prevalence of gastrointestinal zoonotic helminth parasites in dogs and to assess the awareness about canine helminth zoonoses in pet owners. MATERIALS AND METHODS: This cross-sectional study was conducted from September- 2012 to December- 2013. A total of 210 fecal samples (105 each from pet and stray dogs) were collected perrectally and examined by using Formalin-Ether Concentration method. Questionnaire survey was carried out among dog owners. RESULTS: The prevalence of gastrointestinal helminths was 46.7% (98/210). Out of 98 positive samples five different parasite species observed were Ancylostoma spp. 52.0% (51/98), Toxocara canis 41.8% (41/98), Taenia/Echinococcus spp. 15/98 (15.3%), Dipylidium caninum, 9.2% (9/98), and Trichuris vulpis, 5.1% (5/98). Prevalence was higher in stray dogs (56.2% vs. 37.1%) (p<0.05); in females (51.6% vs. 39.8%) (p>0.05); in younger dogs up to 2 years of age (56.3% vs. 35.7%) (p<0.05); in non-dewormed dogs (72.7% vs. 33.0%) (p<0.05) and in dogs sharing rooms with owner (46.1% vs. 13.8%) (p<0.05). Only 11.4% of the owners surveyed were aware about canine helminth zoonoses. CONCLUSIONS: Due to potential risk of zoonotic helminths to human beings and low level of zoonoses awareness in pet owners, there is need of generating awareness to pet owners regarding periodic anthelminthic treatment of pet dogs and other prevention and control measures. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8211 Int J Infect Microbiol 2013;2(3):91-94