ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY AND THYROID SCINTIGRAPHY IN EVALUATION OF SOLITARY THYROID NODULE; A COMPARATIVE STUDY

  • Ayesha Qaiser Combined Military Hospital, Rahim Yar Khan Cantonment, Pakistan
  • Muhammad Zubair Combined Military Hospital, Rahim Yar Khan Cantonment, Pakistan
  • Muhammad Sohail Babar Niazi Combined Military Hospital, Rahim Yar Khan Cantonment, Pakistan
  • Waqarul Hassan Zaidi Combined Military Hospital, Rahim Yar Khan Cantonment, Pakistan
  • Salma Gul Combined Military Hospital, Rahim Yar Khan Cantonment, Pakistan

Abstract

Objectives: Colistin has been increasingly used for the treating infections caused by carbapenem resistant bacteria. Resistance to colistin is increasingly being reported among carbapenemā€“resistant Enterobacteriaceae as well as Acinetobacter and Pseudomonas species. This study was undertaken to determine the frequency of colistin resistance among fermenter and non-fermenter Gram-negative rods in our setup.

Methods: The present study was conducted in the Microbiology section of Pathology Laboratory of Jinnah Burn and Reconstructive Surgery Centre, Lahore, Pakistan from April 2017 to August 2017. Gram-negative organisms, recovered from different specimens of hospitalized and follow-up burn patients resistant to all routinely used antimicrobial drug groups were included in the study. Colistin Minimum Inhibitory concentrations (MICs) were performed by E test for selected organisms.

Results: A total of 434 extremely-drug resistant Gram-negative bacteria, consisting of 244 Pseudomonas spp 126 Acinetobacter spp, 57 Klebsiella spp and 7 Escherichia spp were isolated during the present study. Among these Gram-negative bacteria, three Colistin resistant organisms were isolated. All three were non-fermenters. Two isolates were Pseudomonas aeruginosa and one was Acinetobacter baumnnii. The MIC results of Colistin as tested by E strip were 8 mg/ L for one Pseudomonas aeruginosa, 16 mg/L for the other Pseudomonas isolate and 12 mg/L for Acinetobacter species.

Conclusion: Our study highlights the emergence of Colistin resistance in non-fermenters. This is alarming, as it leaves almost no options for clinicians to treat infections caused by such organisms. It is the need of the hour to establish a policy for antimicrobial stewardship and to control antimicrobial resistanceĀ in our country.

Key words: Non-fermenters, Colistin, Carbapenem resistance.

Published
2018-06-11