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  1. Article ; Online: The Ever-Worsening Antimicrobial Resistance in Enterobacterales; A wakeup call

    Fatima Ali / Irfan Mirza / Hafsa Waseem / Humaira Zafar

    Pakistan Armed Forces Medical Journal, Vol 73, Iss

    2023  Volume 2

    Abstract: Objective: To determine the comprehensive antibiotic susceptibility profile of carbapenem-resistant Enterobacterales among clinical samples received at the Armed Forces Institute of Pathology (AFIP), Rawalpindi. Study Design: Cross-sectional study. Place ...

    Abstract Objective: To determine the comprehensive antibiotic susceptibility profile of carbapenem-resistant Enterobacterales among clinical samples received at the Armed Forces Institute of Pathology (AFIP), Rawalpindi. Study Design: Cross-sectional study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Apr to Sep 2020 Methodology: Over six months, 150 carbapenem-resistant Enterobacterales were isolated at the Armed Forces Institute ofPathology, Rawalpindi Pakistan. The antimicrobial susceptibility testing was performed using the Kirby-Bauer Disk-Diffusion technique, and their susceptibility was interpreted according to the CLSI 2020 and EUCAST 2020 guidelines. Results: Out of 150 clinical isolates resistant to Carbapenems, 99(66%) were identified as Klebsiella Pneumoniae, followed by Escherichia Coli 38(25.7%), Proteus Mirabilis 7(4.6%), Enterobacter Cloacae, Serratia Marcescens, Citrobacter Freundii, Providencia retgerii 1(0.6%) each. The isolates were highly resistant to the following categories of antibiotics tested. For Penicillins/Cephalosporins and their combinations, the resistance range was between 94 to 100%, and it was and >79% for Aminoglycosides, >97% for Fluoroquinolones and >48% for Tetracyclines. Isolates showed the highest susceptibility to Colistin, 94(92%) out of 102 then to Tigecycline 81(81%) out of 100, followed by Fosfomycin 60(78.9%) out of 76, Minocycline 41(52%) out of 79 and Doxycycline 33(50%) out of 66. Conclusion: Extensively drug-resistant Enterobacterales ‘Superbugs’ with ever-worsening antimicrobial resistance threaten the human race back to the pre-antibiotic era. This real menace cautions against the lack of antimicrobials for treating lethal and hazardous infections caused by such difficult-to-treat bacteria in times to come.
    Keywords Enterobacterales ; Carbapenems ; Klebsiella pneumonia ; Medicine ; R ; Medicine (General) ; R5-920
    Subject code 630
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Army Medical College Rawalpindi
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Diagnostic Accuracy of CHROMagar Orientation for Identification of Uropathogens

    Nayab Ali / Wajid Hussain / Irfan Mirza / Asima Niazi / Fatima Rubab / Saira Salim

    Pakistan Armed Forces Medical Journal, Vol 73, Iss

    2023  Volume 1

    Abstract: Objective: To determine the diagnostic accuracy of CHROMagar Orientation for its ability to support the growth and identification of uropathogens by keeping API 20E/20NE as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: ...

    Abstract Objective: To determine the diagnostic accuracy of CHROMagar Orientation for its ability to support the growth and identification of uropathogens by keeping API 20E/20NE as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Jun to Nov 2019. Methodology: A total of 470 midstream specimen of urine from patients suspected of UTIs were analyzed. Urine specimens were inoculated by 1µL calibrated sterilized loop each on CLED Agar, Blood agar and CHROMagar Orientation media plates.Culture plates were incubated at 35.00±2.00ºC for 18 to 24 hours. As per standard protocols, isolates were identified by colony morphology, Gram stain, catalase, oxidase, DNAase, coagulase, and API 20E/20NE. In addition, the appearance of microorganism on CHROMagar Orientation media were identified according to the manufacturer’s instructions. Results: Out of 470 samples, 211 showed no growth, 90 were classified as mix growth (polymicrobial), and 169 samples were positive (unimicrobial) for the growth of uropathogens. All the samples positive for bacterial growth on conventional media were also positive on CHROMagar orientation and vice versa. The sensitivity and specificity of CHROMagar Orientation for differentiation of uropathogens were 99% and 100%, respectively. Conclusion: The overall findings of our study suggested that CHROMagar supports the growth of all uropathogens. It provided the rapid identification of organisms based on their colour morphology, even in a mixed bacterial culture, growth within 24 hours easily.
    Keywords CHRO-Magar Orientation ; Polymicrobial growth ; Uropathogens ; Medicine ; R ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher Army Medical College Rawalpindi
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Unrelated donors in kidney transplantation

    Taqi F Toufeeq Khan / Irfan Mirza / Tahir Rashid / Nisar Anwar

    Saudi Journal of Kidney Diseases and Transplantation, Vol 31, Iss 2, Pp 563-

    Myths and the gruesome reality

    2020  Volume 567

    Keywords Medicine ; R
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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