4.Bacterial profile and antimicrobial susceptibility patterns in primary surgical infections at Modilon Hospital, Papua New Guinea
J. M. Kuzma ; J. W. Hombhanje ; J. Pawiying ; M. V. Hombhanje
Papua New Guinea medical journal 2016;59(3-4):155-163
Primary surgical infections are the second most common cause of surgical admission and contribute considerably to morbidity and mortality of surgical patients in developing countries. This study aimed to determine a bacterial profile and antimicrobial susceptibility patterns in primary surgical infections. Methods: This was a prospective cross-sectional study including 150 patients diagnosed clinically as primary surgical infections. Antibiotic susceptibility testing was done on the isolates using the disc diffusion method. Results: Positive cultures were obtained from 122 patients; Gram-positive bacteria were responsible for 48% (n = 59), Gram-negative for 39% (n = 48), mixed flora for 10% (n = 12) and Candida for 2% (n = 3) of primary surgical infections. The alarming finding was that 78% of Staphylococcus aureus were resistant to oxacillin (MRSA) and 83% resistant to cephalosporins, whilst 3 isolates showed intermediate resistance to vancomycin. Gram-negative isolates also demonstrated antibiotic resistance. Conclusions: This study provides recent baseline data both on the bacterial profile and the antibiotic susceptibility patterns in primary surgical infections in the Papua New Guinean setting and it should guide therapeutic policies in the country. There is a growing need for surveillance of the local microbiological epidemiology and for antimicrobial stewardship to ensure that the empirical use of antibiotics is appropriate.
Bacterial diseases/Diagnosis
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Anti-infective agents/Therapeutic use
10. Multiple liver abscesses: an unusual case which demonstrates the importance of ultrasonography in the detection of liver pathology
Papua New Guinea medical journal 1998;41(2):77-82
A 48-year-old caucasian male was admitted to hospital with right-sided chest pain, pyrexia and cough. He had no history of dysentery. He was treated with erythromycin and cotrimoxazole for right lower lobe pneumonia but failed to respond. Tender hepatomegaly developed and ultrasound scan demonstrated multiple abscesses in the liver. Entamoeba histolytica was identified in his faeces. He was treated with intravenous metronidazole, chloramphenicol and gentamicin and then oral tinidazole, after which improvement was rapid. He was later transferred to Australia. Subsequent abdominal CAT scan and aspiration of abscesses confirmed the diagnosis of multiple amoebic liver abscesses with secondary bacterial infection. Final treatment was with oral ciprofloxacin and metronidazole for four weeks. Ultrasonography is a noninvasive technique which is invaluable in the diagnosis of abdominal and especially liver pathology. This technique should be available in larger centres in tropical countries. Anyone living in or visiting the tropics should be aware of possible exotic diseases presenting in unusual ways.
Anti-Bacterial Agents - therapeutic use
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Antitrichomonal Agents - therapeutic use
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Liver Function Tests
Result Analysis
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