Cutaneous leishmaniasis is a vector-borne infection caused by flagellated parasitic protozoans in the genus Leishmania. Promastigotes are the infective stage, which are transmitted by the bite of female sand flies of the genera Phlebotomus or Lutzomyia. Three clinical forms of Leishmania infection are recognized in humans, and they are caused by different Leishmania species. They are cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (ML), and visceral leishmaniasis (VL). Up to 2 million cases of leishmaniasis are reported annually worldwide. In Pakistan, CL is widely distributed in endemic areas. In the current study, a survey was conducted to investigate the occurrence of CL in an endemic area of the metropolitan city of Multan, Pakistan. The material for diagnosis of CL was obtained from 461 patients from 239 clinical laboratories and health care centers in Multan. Of these patients, 42.9% (198 of 461) having positive findings of amastigotes in Giemsa stained tissue impression smears. The distribution of CL skin lesions was highly variable. Most patients (76.2%) had a single lesion. Most CL lesions were found on a single hand (23.7%). The prevalence of two CL lesions per patient was 21.7%, while three or more positive CL lesions were observed in 2.0% of patients. The 198 CL-positive patients ranged in age 10-40 yr old, 101 were males, and 97 were females. Logistic regression analysis of leishmaniasis versus age and gender showed that both the age and gender had a significant (P < 0.05) effect on the occurrence of infection. Outbreaks of CL were reported in 14 of the 68 Union Councils of Multan.
Urinary Tract Infection is alarming problem worldwide due to the intensity of antimicrobial resistance. Escherichia coli is the most predominant organism in UTI. This study was planned to evaluate demographic parameters, the prevalence of E. coli, and antimicrobial resistance patterns among E. coli isolates from UTI patients in Nishtar Hospital of Multan from January to June 2018. A total of 350 mid-stream urine samples were collected from different patients having age group from 25 to 60 years and processed by standard laboratory procedures. Out of 350 samples, 100 samples were observed as critical bacteremia. Escherichia coli and Klebsiella pneumonia were the most persistent (47 % and 19 % individually) among the Gram-negative pathogens followed by S. aureus (14 %), Enterobacter spp. (11 %) and Candida (9 %) respectively. The incidence of UTI was found higher in 25-35 age groups. The prevalence of UTI with E. coli as an infectious agent was 72 % in females, and 28 % in males. The prevalence of E. coli was more in rural areas (70 %) than in urban areas (26 %). The antimicrobial testing against E. coli showed the highest resistance to amoxicillin (65.9 %) and ciprofloxacin (38.2 %), whereas highly sensitive rate observed against Fosfomycin (FOS) (95.7 %), Gentamicin (GEN) (89.3 %), and Nitrofurantoin (NIT) (85 %) respectively. The increased resistance against ampicillin and ciprofloxacin was observed in Multan have a great emerging problem so there is a need for effective prevention strategies for the E. coli drug resistance and successful surveillance required to be improved.
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