scholarly journals Urinary tract infections and antibiotic susceptibility among the patients attending B & D hospital of Lalitpur, Nepal

2016 ◽  
Vol 7 (5) ◽  
pp. 47-51 ◽  
Author(s):  
Yadav Prasad Joshi ◽  
Shreejeet Shrestha ◽  
Russell Kabir ◽  
Anita Thapa ◽  
Parbati Upreti ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Susceptibility ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Tract Infections

Background:Urinary tract infection is the most common bacterial infections in humans and serious health problem in many parts of the world. It has become more complicated in treatment due to different pathogens and increasing resistant to antimicrobial agents. This study aims to investigate the prevalence of urinary tract infection and antibiotic susceptibility patterns of pathogens among the patients attending in B & B hospital Nepal.Materials and Methods:A hospital based cross sectional study was conducted in between April 2010 to March 2011. Urine samples were collected from clinically suspected patients and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for isolated pathogen using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines.Results:Out of 1260 examined specimens 25.24 % were positive and majority 61.64% were females.  The most common pathogens isolated were Escherichia coli (66.67%), Enterococcus (7.55%) and Staphylococcus (6.60 %). The drug resistant among the positive cases were reported. The highest resistant of positive cases was found with Cefexime (87.88%) and Enterococcus with Ampicillin (66.67%) and Staphyllococcus with Cloxacillin (66.67%). The highest susceptibility was for Vancomycin and Ampicillin i.e. 33.33% in each.Conclusion:The findings showed that E. coli isolates were the predominant pathogen and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs. As drug resistance among bacterial pathogens is an evolving process and serious issue. Therefore, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs. Asian Journal of Medical Sciences Vol.7(5) 2016 47-51

scholarly journals Extended Spectrum Beta-Lactamase Production in Uropathogens Isolated from Hospitalized Patients with Chronic Pyelonephritis

2015 ◽  
Vol 8 (1) ◽  
pp. 71-75 ◽  
Author(s):  
Olga I Chub ◽  
Aleksandr V Bilchenko ◽  
Igor Khalin
Keyword(s):  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Chronic Pyelonephritis ◽  
Diffusion Method ◽  
Beta Lactamase ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Tract Infections

Background : Increased multidrug resistance of extended-spectrum beta-lactamases (ESBLs) compromises the efficacy of treatment of urinary tract infections. Objective : The objective of this study is to determine the prevalence of ESBL-producing uropathogens from hospitalized patients with chronic pyelonephritis and to identify the presence of genes involved in the resistance. Methods : A cross-sectional study of 105 patients with chronic pyelonephritis, treated in Kharkiv City Clinical Emergency Hospital, Ukraine was carried. Bacterial isolates were collected, antimicrobial susceptibility of isolates was determined by the Kirby Bauer disk diffusion method and screening for the presence of blaSHV, blaTEM, blaCTX-M ESBL genes was performed by polymerase chain reaction. Results : 84 (80%) patients had positive urine cultures. Eschеrichia coli wаs the most common microorganism isolated. Among them, 29 (25.2%) were found to be ESBL producers. Out of 53 E. coli isolates, 10 (18.9%), 4 (7.5%) and 6 (11.3%) were identified to carry bla(TEM), bla(SHV) and bla(CTX-M) beta-lactamase genes, respectively. The highest resistance was observed against ampicillin (75.9%), ciprofloxacin (48.3%), levofloxacin (41.4%) and gentamicin (41.4%). Beside this, only meropenem (96.6% susceptibility), nitroxolinum (86.2%) and fosfomycin (72.4%) exhibited a good enough activity against ESBLs-producing urinary strains. Conclusion : Isоlation and detеction of ESBL-prоducing strаins are еssential fоr the sеlection оf the mоst effеctive antibiоtic for the empiric trеatment.

scholarly journals The Prevalence of Bacterial Pathogens associated with Urinary Tract Infection (UTI) among Patients attending Kam Medical Consult Clinic, Uganda.

2021 ◽  
Author(s):  
◽  
Gerald Turyatunga
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Bacterial Pathogens ◽  
Clinical Signs ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Etiological Agents ◽  
Tract Infections

Background: A urinary tract infection (UTIs) is a common type of infection caused by bacteria that travel up the urethra to the bladder. Globally, it is reported that 150 million people are diagnosed with a UTI annually, costing the world economy over 6 million US dollars in treatment and work loss. Studies conducted in the in-patients pediatric ward of Muhimbili Hospital in Tanzania and Mulago National Referral Hospital in Uganda between five to ten years reported the prevalence of UTI to be 16.8% and 14.6% respectively. On average at Kam Medical Consult Clinic, patients who turn up in the laboratory are about 20%, and 50% of patients present with recurring UTIs clinically. Therefore,  there is a need to establish and investigate the prevalence of bacterial pathogens associated with UTI and multiple pathogens that are not known. Methodology: The cross-sectional study was carried out at Kam medical consult clinic (KMCC) located in Kafeero zone Mulago II Kawempe division. The study population was adults and children presenting with symptoms of urinary tract infection. 120 Midstream urine Samples were collected from patients presenting clinical signs of UTI. The diagnosis was done through macroscopy dry chemistry, microscopy, and culture. Results Among the sampled population, 33% of males had urinary tract infections while 67% of females had urinary tract infections.  88.5% were outpatients while 11.5 % were in-patients The overall prevalence of UTI among patients was 63.3% with children aged (1-10) having a prevalence of 5.8 %. Conclusion and recommendation: E.coli is an etiological agent causing UTIs in male and female patients presenting UTI at Kam Medical Consult Clinic. Other etiological agents included Klebsiella, Coliform, Enterococcus species, staphylococcus aureus, pseudomonas species, and candida species. There is a need to monitor the profile of etiological bacteria of UTI through culture and sensitivity regularly. 

scholarly journals Association between the frequency of disposable diaper changing and urinary tract infection in children

2013 ◽  
Vol 53 (2) ◽  
pp. 70
Author(s):  
Meirina Daulay ◽  
Rosmayanti Siregar ◽  
Oke Rina Ramayani ◽  
Supriatmo Supriatmo ◽  
Rafita Ramayati ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Bacterial Count ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Disposable Diaper ◽  
Disposable Diapers ◽  
Tract Infections

Background Urinary tract infection (UTI) is the most commoncause of fever in children. Less frequent disposable diaper changingis thought to be a cause ofUTI in children. While wearing a diapei;the perinea! area becomes damp with urine allowing bacteria tomigrate from the anus to the external urethral orifice.Objective To assess for an association between the frequencyof disposable diaper changing and urinary tract infections inchildren.Methods This cross-sectional study was conducted in thechildren's outpatient clinic of Haji Adam Malik Hospital fromApril to June 2010. Urine culture was performed in children withsuspected UTI who wore disposable diapers every day. Subjects'ages ranged from 2 months to 2 years 6 months, with samplesmatched and collected by consecutive sampling. Diagnosis ofUTIwas based on urine cultures with bacterial count 2:: 105/mL. Eightychildren were followed in this study and divided into two groups:positive (n=40) and negative (n=40) urine cultures. Chi squaretest was use d to analyze the association between the frequency ofdaily disposable diapers changing during a one week period andthe urine culture results.Results The frequency of daily disposable diapers changing in80 subjects was as follows: < 4 times (22.5%), 4-5 times (40%),and 2::6 times (37.5%) . The frequency of daily disposable diaperchanging in children with positive urine culture was as fo llows:< 4 times (1 8 out of 40), 4-5 times (22 out of 40), and 2::6 times(O out of 40); (P < 0.0001). The most common bacterial speciesfound in urine cultures was Escherichia coli.Conclusion Lower frequency of daily disposable diaper changingis significantly associated with higher UTI incidence in children.

Detection of Virulence Factors and Antimicrobial Resistance in Enterococci Isolated from Urinary Tract Infection

2018 ◽  
Vol 4 (2) ◽  
pp. 30-34 ◽  
Author(s):  
Surovi Era Suchi ◽  
SM Shamsuzzaman ◽  
Bhuiyan Mohammad Mahtab Uddin ◽  
Md Abdullah Yusuf
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Virulence Genes ◽  
Diffusion Method ◽  
Susceptibility Pattern ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Medical College

Background: The genus Enterococcus is of increasing significance as a cause of nosocomial infections and this trend is exacerbated by the development of antibiotic resistance.Objective: The aims of this study was to find out the susceptibility pattern and the prevalence of virulence genes in Enterococcus strains isolated from urinary tract infection in Bangladesh.Methodology: This cross-sectional study was conducted in the Department of Microbiology at Dhaka Medical College, Dhaka from January 2015 to December 2015 for a period of one (01) years. All the admitted patients in the Dhaka Medical College & Hospital, Dhaka and Banghabandhu Sheikh Mujib Medical University, Dhaka who were  presented with clinical features of urinary tract infection at any age with both sexes were included as study population. The antimicrobial susceptibility of the strains was determined using the disk diffusion method; vancomycin susceptibility pattern was detected by MIC method. PCR was performed for the detection of genus-species, vanA, vanB gene and potential virulence genes.Result: Out of 84 Enterococci, majority (71.42%) of the isolates were E. faecalis followed by 23.81% were E. faecium. Regarding antimicrobial susceptibility pattern, 100% isolated Enterococci were sensitive to vancomycin, linezolid and teicoplanin. Most of the Enterococci were resistant to ciprofloxacin and ceftriaxone (92.86%) followed by 88.10% to gentamicin and 85.71% to azithromycin and rifampicin. No VRE was identified and the range of MIC for vancomycin was 1-4 µg/ml. None of the Enterococci was positive for vanA and vanB genes. Out of total E. faecalis and E. faecium, 87.50% were positive for ebp and 77.5%, 72.5%, 55.0%, 45.0%, 40.0% and 10.0% of isolates were positive for gelE, esp, ace, cyl, asa and hyl respectively.Conclusion: Almost all the virulence genes were more prevalent in E. faecalis isolates.Bangladesh Journal of Infectious Diseases 2017;4(2):30-34

scholarly journals Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district

2019 ◽  
Author(s):  
Jacob Stanley Iramiot ◽  
Innocent B. Rwego ◽  
Catherine Kansiime ◽  
Benon B Asiimwe
Keyword(s):  
Vibrio Cholerae ◽  
Antibiotic Susceptibility ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Suspected Case ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Mueller Hinton Agar ◽  
Global Threat

Abstract Background Cholera has continued to be a global threat to public health and a key indicator of lack of social development in developing countries. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Materials and methods This was a descriptive cross-sectional study to describe the epidemiology of the 2017 cholera outbreak in Kasese district. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Results A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Antibiotic susceptibility using Kirby-Bauer disc diffusion method showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/sulfamethoxazole whereas gentamicin showed 100% susceptibility. The general trend also showed increased susceptibility to combination therapy as opposed to mono-therapy.

scholarly journals Prevalence of E. Coli in Urinary Tract Infection of Children Aged 1-15 Years in A Medical College of Eastern Nepal

2020 ◽  
Vol 58 (221) ◽  
Author(s):  
Arun Giri ◽  
Raju Kafle ◽  
Ganesh Kumar` Singh ◽  
Niraj Niraula
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Presenting Symptoms ◽  
Tract Infections

Introduction: Urinary tract infection is one of the commonest causes of childhood morbidity. Earlydiagnosis and appropriate choice of antimicrobials is essential. Hence, this study aims to identify theprevalence of Escherichia coli in childhood urinary tract infections. Methods: This was a hospital based descriptive cross-sectional study conducted in Nobel MedicalCollege, Biratnagar over a period of one year. A total of 163 cases aged 1-15 years were included andclinical profile, laboratory reports including bacterial isolates in urine cultures and their sensitivitypatterns were documented. Results: The prevalence of Escherichia coli is 45 (53.57%) C.I. Escherichia coli was the most commonorganism isolated in bacterial cultures followed by Klebsiella 12 (14.29%), Enterococcus 10 (11.90%).Urinary tract infection was common among females with male: female ratio of 1:2.3. Fever 152(93.2%) and abdominal pain 113 (69.3%) were the most common presenting symptoms. Escherichiacoli was found most sensitive to Nitrofurantoin 43 (95.5%) followed by Ciprofloxacin 41 (91.1%) andAmikacin 40 (88.8%). Conclusions: Urinary tract infections in childhood require prompt attention and treatment to preventsignificant morbidity and mortality. From this study it can be concluded that Escherichia coli is oneof the most common isolates in urine culture and Aminoglycosides and Fluoroquinolones can beaccepted as empirical treatment regimens for childhood Urinary tract infections.

scholarly journals Uropathogens and their antimicrobial susceptibility pattern: A retrospective study in a district level hospital in Western Nepal

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 375
Author(s):  
Manoj Ghimire ◽  
Sudeep Adhikari ◽  
Kalpana Ghimire ◽  
Bishal Tiwari ◽  
Soni Koju ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Cross Sectional Study ◽  
Causative Organism ◽  
Lower Sensitivity ◽  
Cross Sectional ◽  
Antimicrobial Susceptibility Pattern

Background: Urinary tract infection (UTI) is a common cause of hospital visits. There is an increasing trend of resistance of uropathogens to antibiotics worldwide. The aim of this study was to identify the common uropathogens, along with their antimicrobial susceptibility. Methods: This retrospective cross-sectional study was conducted from April 2018 to April 2020 at Beni hospital. All patients with urinary tract infection visiting Beni hospital during this time and who had urine culture sensitivity tests done were included in this study. Urine samples were first cultured on cystine lactose electrolyte-deficient agar by a semi-quantitative technique, and then incubated aerobically for 18–24 h at 37 °C. The identified bacterial isolates were tested for antimicrobial susceptibility by the Kirby–Bauer disc diffusion technique. Results: Of the 1173 samples, 164 (14%) samples showed significant growth. Escherichia coli (74%) was the most common causative organism. E. coli was sensitive in 113 cases (95%) out of 119. Amikacin was tested in 87 isolates that showed 99% sensitivity. Other commonly used antimicrobial agents had lower sensitivity rates: gentamicin (83%), ciprofloxacin (75%), ceftriaxone (59%), cefixime (56%), cotrimoxazole (55%), cefotaxime (41%), and ampicillin (38%). Conclusions: E.coli is the most common pathogen associated with urinary tract infection. Nitrofurantoin and amikacin can be good empirical agents for treating UTI in patients coming to Beni hospital.

scholarly journals Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district

2019 ◽  
Author(s):  
Jacob Stanley Iramiot ◽  
Innocent B. Rwego ◽  
Catherine Kansiime ◽  
Benon B Asiimwe
Keyword(s):  
Vibrio Cholerae ◽  
Antibiotic Susceptibility ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Suspected Case ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Mueller Hinton Agar ◽  
Global Threat

Abstract Background Cholera has continued to be a global threat to public health and a key indicator of lack of social development in developing countries. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Materials and methods This was a descriptive cross-sectional study to describe the epidemiology of the 2017 cholera outbreak in Kasese district. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Results A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Antibiotic susceptibility using Kirby-Bauer disc diffusion method showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/sulfamethoxazole whereas gentamicin showed 100% susceptibility. The general trend also showed increased susceptibility to combination therapy as opposed to mono-therapy.

scholarly journals Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria

2017 ◽  
Vol 11 (1) ◽  
pp. 292-300 ◽  
Author(s):  
Angus N. Oli ◽  
Vivian B. Akabueze ◽  
Chijioke E. Ezeudu ◽  
George U. Eleje ◽  
Obiora S. Ejiofor ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Susceptibility ◽  
Empirical Treatment ◽  
Urine Samples ◽  
Diffusion Method ◽  
P Value ◽  
Female Patients ◽  
Tract Infections

Background: Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment. Objective: This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria. Method: Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days’ antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby–bauer disc diffusion method. Results: Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients’ location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85). Conclusion: E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

scholarly journals Occurrence of urinary tract infection among children attending Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal

2013 ◽  
Vol 2 (3) ◽  
pp. 82-86 ◽  
Author(s):  
G Gautam ◽  
S Regmi ◽  
NT Magar ◽  
B Subedi ◽  
T Sharma ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Teaching Hospital ◽  
College Teaching ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Medical College ◽  
Tract Infections

INTRODUCTION: Urinary tract infection (UTI) is considered as the most common bacterial infectious disease seen among the pediatric patients. Most commonly, members of Enterobacteriaceae, particularly uropathogenic strains of E. coli and Enterobacter spp. are the primary causative pathogens of UTI in the different part of the world. Emergence of antimicrobial resistance rates among pathogens recovered from urinary tract infections is an increasing problem in the specific region. MATERIALS AND METHODS: Prevalence and anti microbial susceptibility pattern of the bacterial uropathogens isolated from the children attending Gandaki Medical College Teaching Hospital and Reserch Center (GMC) Nepal. A total of 155 children aged upto 15 years were included in this study. Urine cultures were carried out and the isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). RESULTS: In the present study 21.3 % of the sample size, showed significant bacterial growth. E. coli was the most frequently occurring pathogen (39.40%), followed by Proteus spp. 21.2%, Citrobacter spp. and Streptococcus faecalis (12.1%) Klebsiella spp. (9.1%), and Staphylococcus aureus and Enterobacter (3.0%). Susceptibility rate of E. coli were 69.2% to Gentamycin and Amikacin, 53.8% to Norfloxacin, 38.4% to Nalidixic acid and Norfloxacin. CONCLUSIONS: Pediatric urine culture isolates were becoming increasingly resistant to commonly used antibiotics. Finally, we suggest that empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organisms and antibiotic sensitivities rather than on universal guidelines. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8665   Int J Infect Microbiol 2013;2(3):82-86

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