Biofilm Formation by Environmental Microbes Isolated from Hospitals in Karachi, Pakistan

The purpose of this study was to isolate and identify the microbes from hospital environmental samples and to evaluate the potential of biofilm formation by isolated microbes. For this, 125 surface swabs of different environmental samples were taken from PNS SHIFA hospital, Karachi, Pakistan. Bacteria and fungi were isolated and identified by culture plate method. Trypticase soy broth (TBS) media was used for biofilm development by microbes in plastic tubes. Developed biofilm in tubes was visualized with crystal violet staining method and then biofilm forming potential was estimated by measuring the optical density through spectrophotometer. Total 202 microbes including 126(62.38%) bacteria and 76(37.62%) fungi were isolated and identified. Among environmental samples, hospital ward curtains and medical trays were highly contaminated with bacteria and fungi (with 26% each of total assemblage respectively). Staphylococcus aureus was in highest abundance followed by Candida albicans with 28.7% and 15.8% of total assemblage of isolation respectively. Moreover; Staphylococcus aureus followed by Candida albicans also found to have highest potential to form biofilm with 30.25% and 23.52% of total assemblage of biofilm formation respectively which clearly indicates that  Staphylococcus aureus and Candida albicans may recognized as major agents of hospital acquired infection and can relate with enhanced potential of biofilm formation. Highest abundance and biofilm formation potential of bacteria and fungi in combination can also underline a direct extensive and striking interaction between prokaryotic and eukaryotic cells in biofilm

Diagnostic Accuracy of Modified Kenneth Jones Scoring Criteria as Screening Tool to Diagnose New Cases of Pulmonary Tuberculosis in Children

Objective: To evaluate the effectiveness of the Modified Kenneth Jones Scoring System as a screening tool for diagnosing pulmonary tuberculosis in children. Methodology: A cross sectional study was conductedto assess the symptoms of tuberculosis among 100 pediatric patients with male to female ratio was 67:33. through Modified Kenneth Jones Scoring System (MKJSC) at Gulab Devi Tertiary Care Hospital, Lahore from June-December, 2022. The study included symptoms based on gender, drug usage and microbial load. Patients diagnosed with TB were included in this study to assess the system's effectiveness in identifying specific symptoms and clinical manifestations of TB. This inclusion allowed for a comprehensive evaluation of the MKJSC's diagnostic accuracy and its potential utility in early detection and intervention in pediatric TB cases. The Data was analyzed using SPSS to identify specific symptoms. Results: The Modified Kenneth Jones Criteria diagnosed 65 patients out of 100 with one false positive. The sensitivity for TB detection was 84.2% (95% CI: 73.6% - 91.2%), specificity was 95.8% (95% CI: 76.8% - 99.7%), positive predictive value was 98.4% (95% CI: 90.5% - 99.9%), and negative predictive value was 65.7% (95% CI: 47.7% - 80.3%). Statistical analysis with 5% confidence interval revealed a medium of age of 73 months and a mode of 120 months among patients. While cough prevalence varied, all patients had a history of prolonged fever. Meningeal irritation was observed in 52% of participants and 77% had contact with TB patients. Other findings included malnutrition 50%, pneumonia 48% and BCG screening 24%. Conclusion: The Modified Kenneth Jones Scoring System demonstrated high sensitivity and specificity in detecting tuberculosis, outperforming previous methods. It proves to be an effective tool in resource-limited healthcare settings for diagnosing TB in children

Prevalence Of Rifampicin Resistance in New Cases Of Pulmonary Tuberculosis In Children

Objective: The research aims to determine the prevalence of rifampicin resistance in newly diagnosed pediatric pulmonary tuberculosis cases, investigating the frequency of resistance to this first-line antibiotic. By doing so, it seeks to provide insights into rifampicin's effectiveness as a treatment and contribute to understanding drug-resistant tuberculosis in children. Methods: The investigation employed a cross-sectional design to evaluate the presence of rifampicin resistance in newly diagnosed pediatric pulmonary tuberculosis cases. Executed in Lahore, Pakistan, it adopted a convenience sampling strategy with a sample size of 100. The research entailed screening children displaying symptoms of TB, acquiring written consent, and gathering demographic and clinical data, encompassing bacterial load and evidence of antibiotics. Sputum samples were processed employing the Xpert MTB/RIF assay. Statistical analyses, encompassing descriptive statistics and prevalence calculations, were executed utilizing the SPSS software. The investigation underscored the significance of resilient diagnostics, early identification, and tailored interventions for the management of drug-resistant TB in children. Results: The study provides valuable insights into rifampicin resistance among children with pulmonary tuberculosis. These findings highlight the importance of regular monitoring and appropriate treatment strategies to combat drug-resistant tuberculosis in pediatric populations. Further research and interventions are warranted to minimize the emergence and spread of drug-resistant strains in this vulnerable population. Conclusion: The study highlights the need for continuous monitoring of drug resistance patterns in children with tuberculosis, particularly concerning rifampicin, a crucial first-line antibiotic. The higher resistance rate suggests exploring alternative treatment options, optimising drug regimens, and developing interventions to prevent and manage drug-resistant tuberculosis effectively in children. Keywords: Antibiotics, Disease, Paeds, Resistance, Susceptibility, Tuberculosis

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous