PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ESBL PRODUCING GRAM NEGATIVE BACILLI IN 200 CASES OF URINARY TRACT INFECTIONS

Objective: Isolation and identification of Extended Spectrum Beta Lactamases from urinary isolates and to study their drug sensitivity pattern. Methods: The study was done on 200 patients with suspected urinary tract infection from Rajindra Hospital, Patiala. Urine samples were processed for significant bacteriuria. The antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method as per the CLSI recommendations. ESBL production was tested by using the double-disk approximation test and the combination disk method. Results: Out of the total of 200 urine samples, there were 84 (42%) culture positive cases, out of which 78 (92.9%) were found to be gram negative bacilli. E. coli was found to be the commonest uropathogen (60.3%). The percentage of ESBL producers was 69.2%. Maximum number of ESBLs were found among E. coli isolates ie. 80.9%. E. coli was found to be sensitive to imipenem (97.9%) followed by nitrofurantoin (91.5%), amikacin (76.6%), piperacillin-tazobactam (68%) and gentamicin (53.2%). It was relatively resistant to ampicillin. Ciprofloxacin showed sensitivity of 29.8% in E. coli. Conclusion: E. coli and other isolates were more sensitive to impaired. Nitrofurantoin and piperacillin-tazobactam compared to the other antibiotics tested and therefore these may be the drugs of choice for treatment of infections that are caused by ESBLs

A retrospective study of antimicrobial resistance pattern of Pseudomonas aeruginosa isolates from urine samples over last three years (2013-2015)

Background: Problem of antibiotic resistance is compounding day by day because of overuse and misuse of antibiotics. There is no systematic national surveillance of antibiotic resistance and insufficient data is available to quantify the problem in our country. This study aims at studying the changing pattern of antimicrobial resistance of Pseudomonas aeruginosa isolates from patients of urinary tract infections over last three years.Methods: A retrospective, record based study carried out based on the records of C/S (Culture sensitivity) reports of indoor patients, during past three years (2013 - 2015). The types of organisms causing urinary tract infections were noted and the drugs still effective for the Pseudomonas aeruginosa were noted.Results: Pseudomonas aeruginosa is inherently resistant to many antimicrobial agents. Analysis of the results year wise indicated that the lowest percentage of resistance manifested against imipenem was 14%, 24.48% and 20.99% for the years 2013-2015. Resistance for fluoroquinolones decreased over the three consective years from 84.67% (2013) to 78.27% (2015). Over the successive years, the resistance to ceftriaxone tends to increase from 80% (2013) to 92.59% (2015). C/S reports showed on an average 69% were resistant to aminoglycosides. Multi drug resistant pseudomonas percentage resistant to fluoroquinolones, third generation cephalosporines and aminoglycosides were 78% (2013), 78.33% and 80.33% (2015) over the consective years.Conclusions: The antimicrobial resistance patterns are constantly evolving and vary from region to region it has become a necessity to do constant antimicrobial sensitivity surveillance. This will help clinicians to provide safe and effective empirical therapies

Colposcopic and microbiological correlation in patients with vaginal infections: a prospective study

Background: Objective of the study was to evaluate the association of abnormal vaginal flora with pathological colposcopic and microbiological findings.Methods: The present study was conducted in outpatient’s department of Obstetrics and Gynaecology, Government Medical College, Patiala. We studied 300 cases with symptoms and signs of vaginal infections in reproductive age group (15-49 years). After taking detailed history and examination, samples of vaginal discharge were collected for microbiological analysis and patients were subjected to colposcopy. Recorded data was analysed to find out any association of abnormal vaginal flora with pathological colposcopic and microbiological analysis.Results: The prevalence rate of vaginal infections was 31% among patients who reported to us with symptoms and signs of vaginal infections. The most common micro-organism detected was B. vaginosis (BV) in 14%, C. albicans (C) in 12% and T. vaginalis (T) in 3.33%. The normal colposcopic findings were observed in 81.33% and abnormal colposcopic findings were noted in 18.67% of the patients which were vaginal hyperaemia in 9%, chronic cervicitis in 5.33%, small iodine negative area in 2.33%, keratosis in 1.33% and cervical polyp in 0.67% of the patients.Conclusions: We concluded that vaginal discharge is a common gynaecological complaint and vaginal infections are an important cause of the vaginal discharge thus leading to significant proportion of female morbidity in reproductive age group. So, vaginitis and vaginal discharge highlights the importance of microbiological investigations to find out the causative organisms and the specific findings due to particular micro-organism can be correlated colposcopically and specific treatment can be provided

Evaluation of efficacy and tolerability of nitrofurantoin versus ciprofloxacin in patients of urinary tract infection: a comparative study

Background: UTIs are one of the most common infectious diseases encountered in out-patient departments on day to day basis. Nitrofurantoin and Ciprofloxacin are most commonly used antibiotics in the treatment of UTI. The present study was done to compare the efficacy and tolerability of nitrofurantoin and ciprofloxacin in patients of urinary tract infection.Methods: This prospective, open, randomized, parallel group, comparative study was conducted on 60 patients presenting with acute/uncomplicated or recurrent urinary tract infection in the outpatient Department of Urology, Rajindra Hospital attached to Govt. Medical College, Patiala, Punjab. They were divided into two groups, Group I and Group II of 30 cases each. Group I patients were put on Nitrofurantoin and Group II patients were put on Ciprofloxacin. Initially 100 patients were enrolled but only those who showed growth of uropathogens on baseline urine culture or those who completed the treatment were included in the study. The primary outcome measure was microbiological eradication on post treatment urine culture.Results: The age range of the patients in Group I and Group II was 19 to 68 years (43.40±14.58 years) and 20-60 years (39.77±13.49 years) respectively. The total no. of males and females who participated in this study were 32 (53.33%) and 28 (46.66%) respectively. The most common uropathogen associated with uncomplicated UTI was E. coli (80%), other organisms detected were Klebsiella species (16.67%), Staphylococcus aureus (3.33%) and Providencia (3.33%). Post treatment urine culture results showed significant difference between two groups, 5 patients (16.67 %) in case of Group I and 14 patients (46.67%) in case of Group II showed growth of micro-organisms post treatment. P-value comes out to be 0.017 which is significant.Conclusions: In this era of super bugs, nitrofurantoin is more efficacious than ciprofloxacin in the treatment of UTI. E. coli was found to be major organism causing UTI. Ciprofloxacin is less effective due to increasing antibiotic resistance among uropathogens. Both the drugs were well tolerated, no major significant adverse effects were encountered

OSMOTIC PUMP DRUG DELIVERY SYSTEM: A NOVAL APPROACH

Conventional drug delivery systems have little control over their drug release and almost no control over the effective concentration at the target site. The major problem associated with conventional drug delivery system is unpredictable plasma concentrations. Controlled drug delivery systems offer spatial control over the drug release. Osmotic pumps are most promising systems for controlled drug delivery. These systems are used for both oral administration and implantation. The present review is concerned with the study of drug release systems which are tablets coated with walls of controlled porosity. . Osmotic pump uses the basic principle of osmosis for release of drug(s). Osmotic pumps consist of an inner core containing drug and osmogens, coated with a semi permeable membrane. As the core absorbs water, it expands in volume, which pushes the drug solution out through the delivery ports. Osmotic pumps release drug at a rate that is independent of the pH and hydrodynamics of the dissolution medium. Various patents available for osmotic drug delivery system like Rose-Nelson pump, Higuchi-leeper pump, higuchi-theeuwes pump and elementary osmotic pump. In this paper, various types of osmotic pump and the basic components of  osmotic system tablets have been discussed briefly. Keywords: Osmosis, component of osmotic system, Osmotic pum

OSMOTIC PUMP DRUG DELIVERY SYSTEM: A NOVAL APPROACH

Conventional drug delivery systems have little control over their drug release and almost no control over the effective concentration at the target site. The major problem associated with conventional drug delivery system is unpredictable plasma concentrations. Controlled drug delivery systems offer spatial control over the drug release. Osmotic pumps are most promising systems for controlled drug delivery. These systems are used for both oral administration and implantation. The present review is concerned with the study of drug release systems which are tablets coated with walls of controlled porosity. . Osmotic pump uses the basic principle of osmosis for release of drug(s). Osmotic pumps consist of an inner core containing drug and osmogens, coated with a semi permeable membrane. As the core absorbs water, it expands in volume, which pushes the drug solution out through the delivery ports. Osmotic pumps release drug at a rate that is independent of the pH and hydrodynamics of the dissolution medium. Various patents available for osmotic drug delivery system like Rose-Nelson pump, Higuchi-leeper pump, higuchi-theeuwes pump and elementary osmotic pump. In this paper, various types of osmotic pump and the basic components of  osmotic system tablets have been discussed briefly. Keywords: Osmosis, component of osmotic system, Osmotic pum

What are we drinking? Assessment of water quality in an urban city of Punjab, India

Introduction: Ground water is the ultimate and most suitable fresh water resource for human consumption in the urban areas of India. Studies regarding ground water quality have shown that the higher rate of exploration as compared to the rate of recharging, inappropriate dumping of solid, as well as liquid waste, lack of strict enforcement of law has led to the deterioration of ground water quality. The present study was thus, carried out to evaluate physicochemical, as well as a microbiological profile of tap water, and filtered water in urban areas of Patiala, Punjab. Materials and Methods: The three zones under Municipal Corporation and two areas under Public Health Department were chosen according to the simple random sampling from Patiala city. From each area, 10 houses were chosen according to the systematic random sampling technique (n = 50). Water was taken from two sources, tap water, and from the water filter. Two samples were taken from each source one for the physicochemical analysis and another for bacteriological analysis. The samples which were sent for bacteriological assessment were collected in a sterile container. Results: The number of water samples found to be within desirable limits with respect to physicochemical parameters were significantly more with the filter water sample than the tap water samples. Suspicious/unsatisfactory microbiological quality of water was observed in 28% and 4% of tap and filter water samples, respectively. Conclusion: The results indicate that certain chemical parameters such as hardness, chloride, and fluoride levels were beyond the permissible limits. Therefore, we recommend that home filters should be installed, serviced appropriately, and their water quality should be checked routinely. Also, any leak from sewage pipes should be promptly repaired to prevent contamination of drinking water