Browsing by Author "Azeez, A"

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    Antibiotic Sensitivity Pattern of Uropathogenic Escherichia coli in Pediatric Patients in a Tertiary Care Center in Kerala
    (International Research Organization for Life & Health Sciences, 2023-03) Joseph, P; Azeez, A; Mathew, SM; Kumar, AS; Sheriff, R; Hashim, S
    Introduction: Urinary tract infections (UTI) are one of the most common but difficult to reliably diagnose clinically in children. The etiopathogenesis may range from urinary stasis due to improper toilet training or physical obstruction like phimosis to neural causes like neurogenic bladder or urogenital abnormalities. The most common uropathogen isolated is Escherichia coli. Prompt diagnosis and proper treatment as per the culture and sensitivity report are essential to avoid recurrent and chronic infections as well to prevent late complications like renal cortical scarring as a precedence to chronic renal failure. Materials and Methods: The study was carried out in samples received from January 2022 to June 2022 to assess the antibiotic sensitivity pattern of Uropathogenic E. coli in pediatric patients and also to ascertain the prevalence of extended spectrum beta lactamase (ESBL) in these infections. Four hundred and thirty-two clean catch midstream urine samples were collected from pediatric patients during the study period and after exclusions, 129 samples of monobacterial growth of more than 100,000 cfu/mL were selected for the study. Out of these 129 g negative bacterial isolates, 78 isolates were identified as E. coli., these were subjected to disc diffusion based antibiotic sensitivity testing using the Kirby Bauer method and CLSI 2021 guidelines. Accordingly antibiotics Ampicillin (10 ?g), Gentamicin (10 ?g), Ciprofloxacin (5 ?g), Levofloxacin (5 ?g), Cotrimoxazole (25/1.25 ?g), Amoxicillin-clavulanic acid (20/10 ?g), Piperacillin/Tazobactum (100/10 ?g), Norfloxacin (10 ?g), Amikacin (30 ?g), Ceftazidime (30 ?g), Ceftazidime + clavulanic acid (20/10 ?g), Cefuroxime (30 ?g), Cefotaxime (30 ?g), Imipenem (10 ?g), Aztreonam (30 ?g), Tetracycline (30 ?g), Nitrofurantoin (300 ?g), Tobramycin (10 ?g), Colistin (10 ?g), Etrapenem (10 ?g), Doripenem (10 ?g), and Meropenem (10 ?g) were tested. Screening of ESBL producing E. coli was done with combined disc diffusion method using ceftazidime and ceftazidime-clavulanic acid in combination. Results: Out of the 78 E. coli isolates, the screening for ESBL producers revealed that 50 isolates were ESBL positive. The antibiogram of 28 non-ESBL producers revealed that most isolates were resistant to Penicillins and cephalosporins. The non-ESBL producers showed sensitivity to Piperacillin-Tazobactum (100%), Carbapenems (100%), Nitrofurantoin (100%), Amikacin (96.4%), Ciprofloxacin (75%), Levofloxacin (78.5%), and Norfloxacin (75%). On the other hand, the ESBL producers were resistant to Penicillin, Beta lactams + inhibitors, Cephalosporins, Aminoglycosides, Tetracyclines, Folate pathway inhibitors, and Fluroquinolones. Conclusion: UTI is a common health problem in children and is an important cause of morbidity and mortality. The effect of ESBL producers is very much evident in the sensitivity pattern wherein the Amoxycillin-Clavulanic acid reduces from 71.4% to 0% among ESBL producers. In the same way, Piperacillin-Tazobactum reduces from 100% to 52%, Amikacin reduces from 96.4% to 64%, and cephalosporins become totally ineffective in the ESBL producing strains. Every healthcare institution must develop its own antimicrobial treatment policy based on the culture and sensitivity report prevailing in the past 6 months. As per the antimicrobial stewardship programs in health-care facilities in low-and middle-income countries advised by the World Corresponding Author: Dr. Riyaz Sheriff, Department of Microbiology, Azeezia Institute of Medical Sciences and Research, Kollam, Kerala, India. Print ISSN: 2321-6379 Online ISSN: 2321-595X Access this article online www.ijss-sn.com Month of Submission : 01-2023 Month of Peer Review : 02-2023 Month of Acceptance : 02-2023 Month of Publishing : 03-2023 Health Organization, these policies need to be reassessed at least once in 6 months to know the pattern of emerging resistance as well as to decide about the use of antibiotic recycling for the better usage of available antibiotics for the treatment of UTI.
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    Obstetric outcomes in pregnant women with low pregnancy-associated plasma protein-A (PAPP-A) levels
    (?Eldaghayes Publisher, 2024-12) Azeez, A; Nair, HS; Vasanthakumari, N; Jacob, JT; Fathima, S.
    Background: Pregnancy-associated plasma protein-A (PAPP-A) is traditionally one of the combined biochemical screening methods for aneuploidies. Though PAPP-A has been found in many human organs, including the colon, kidneys, breast, and bone marrow, it is found more in pregnant woman’s serum due to the production by syncyt- io-trophoblast of the placenta. Recent studies have explored the use of PAPP-A for the prediction of adverse pregnancy outcomes. This study focuses on the obstetric outcomes in pregnant women with low PAPP-A levels. Methods: This was a prospective cohort study conducted in the Department of Obstetrics & Gynaecology, SAT Hospital, Trivandrum among antenatal women of gestational age 11 to 14 weeks. They were followed up to see the difference in pregnancy outcomes between women with low PAPP-A and normal PAPP-A levels. Results: Women with low PAPP-A are at a significantly higher risk of complications as fetal growth restriction, preec- lampsia, preterm birth, low birth weight, and neonatal complications. Conclusion: The study supports the association between low PAPP-A levels and adverse obstetric outcomes. The findings underscore the importance of identifying and closely monitoring pregnant women with low PAPP-A. Future research should focus on elucidating the underlying mechanisms linking low PAPP-A levels with adverse outcomes and exploring potential interventions to mitigate the risks associated with low PAPP-A levels.