Methicillin-resistant Staphylococcus aureus (S. aureus) (MRSA), resistant to all antibiotics including Vancomycin, has been reported in Japan, USA, Canada and Brazil. Hence, the main objective of this study was to evaluate the possible presence of Vancomycin resistant or intermediate S.aureus in Karachi. A total of 850 clinical isolates were collected from two civil hospitals in the city between February 2006 and January 2007. They were identified using standard bacteriological methods.Sensitivity to recommended antibiotics was determined by disc diffusion, agar dilution, and E-test quantitative minimum inhibitory concentration (MIC). Susceptibility to natural or semi-natural products was determined by the agar dilution method. Out of 850 isolates, 250 were MRSA, of which 22% were resistant to 4 µg/ml Vancomycin, 24% to 8 µg/ml, 15.2% to 16 µg/ml, 10% to 20 µg/ml, and 13.2% to 30 µg/ml; the remaining 15.6% were sensitive to all used concentrations. Although we did not detect any Vancomycin-resistant S. aureus (VRSA), we found that 13% of the strains were intermediates (VISA), i.e. resistant to 30 µg/ml of Vancomycin. Because of the continuously increasing prevalence of VISA, it is imperative to minimize the use of Vancomycin. Indeed, the drug should only be prescribed for the treatment of documented, culture-proven infections with MRSA that are not susceptible to routine or alternative agents. This should help avoid the consequences of the development of Vancomycin resistant S. aureus (VRSA) in our environment.

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Background: Antibiotics are believed to be safe drugs implying unawareness of people regarding implications of their unchecked overuse, health care professionals being no exception attributed to their attitude and differential practices. Objective was to assess knowledge, attitude and practices regarding antibiotic resistance among medical and non-medical students. Methods: Descriptive study was conducted in Lahore from March to August 2018. A total of 384 first and second year medical and bachelor students of Fatima Memorial medical college and Nur university were enrolled. Validated questionnaire adopted from WHO survey was used to interview students. Data was analyzed using SPSS version 23. Individual and institutional ethical considerations were fulfilled. Results: Mean age was 19.89±1.4. 94 medical (49%) and 77 (40.1%) non-medical students claimed to have taken antibiotics in the previous month, 63.6% using a prescription, 76% buying from medical store. Majority 91.7% (176) medical students were aware of the term “Antibiotic Resistance” compared to 64.1% (123) non-medical. Antibiotics becomes less effective once resistance develops leading to difficulty in treatment of infections; medical 145(76%) and nonmedical 137 (71.4%). Commonest treated diseases sore throat 102(53.1%) medical and fever 89(46.4%) non-medical students. Antibiotic resistance is a global issue; 77.6% (149) medical and 75% (144) non-medical students. Conclusion: Majority of students were aware of antibiotics and resistance developing against them with a minimal difference between medical and non-medical.

Objective: To know the spectrum of surgical site infections in general surgical patients so that specific strategies can be developed to decrease the morbidity caused by these infections.Material and Methods: All the patients who underwent general surgical operations on an emergency basis at the surgical unit of the District headquarters teaching hospital Rawalpindi from 01-01-2016 to 31-12-2017 were evaluated for surgical site infections. Surgical site infections suspected clinically were confirmed by culture and sensitivity. Involved flora and their sensitivity to various antibiotics were also determined.Results: Among 2202 emergency operated patients, two hundred and thirty-seven patients (10.76%) had surgical site infection confirmed on culture and sensitivity (C/S) report. About sixty-five percent of patients were male. Of two hundred and thirty-seven positive patients, the twenty-nine patient underwent laparotomy for penetrating and blunt abdominal trauma. Staph aureus was present in one hundred and forty-five (79.67%) patients. E.coli was the commonest Gram-ve micro-organism (70.95%). Forty-six patients (19.40%) were sensitive to Cefoperazone sodium followed by twenty patients (8.43%) to Piperacillin sodium and twenty-one (8.86%) each to Amikacin and Linezolid.Conclusion: Surgical site infection causes a significant rise in morbidity on the surgical floor. Most of the causative microorganisms are becoming resistant to routine antibiotics. Sensitivity to the broader spectrum of antibiotics like Cefoperazone and Linezolid is increasing.

Methicillin-resistant Staphylococcus aureus (S. aureus) (MRSA), resistant to all antibiotics including Vancomycin, has been reported in Japan, USA, Canada and Brazil. Hence, the main objective of this study was to evaluate the possible presence of Vancomycin resistant or intermediate S.aureus in Karachi. A total of 850 clinical isolates were collected from two civil hospitals in the city between February 2006 and January 2007. They were identified using standard bacteriological methods.Sensitivity to recommended antibiotics was determined by disc diffusion, agar dilution, and E-test quantitative minimum inhibitory concentration (MIC). Susceptibility to natural or semi-natural products was determined by the agar dilution method. Out of 850 isolates, 250 were MRSA, of which 22% were resistant to 4 µg/ml Vancomycin, 24% to 8 µg/ml, 15.2% to 16 µg/ml, 10% to 20 µg/ml, and 13.2% to 30 µg/ml; the remaining 15.6% were sensitive to all used concentrations. Although we did not detect any Vancomycin-resistant S. aureus (VRSA), we found that 13% of the strains were intermediates (VISA), i.e. resistant to 30 µg/ml of Vancomycin. Because of the continuously increasing prevalence of VISA, it is imperative to minimize the use of Vancomycin. Indeed, the drug should only be prescribed for the treatment of documented, culture-proven infections with MRSA that are not susceptible to routine or alternative agents. This should help avoid the consequences of the development of Vancomycin resistant S. aureus (VRSA) in our environment.