Background
Opportunistic pathogens represent the type of pathogens which infects only those individuals
with impaired immune system and lead to diseases that can be severe, debilitating and difficult to
treat in immunocompromized host. These opportunistic pathogens include different bacteria,
viruses and fungi. This study was designed to identify the opportunistic bacterial pathogens
pseudomonas and Citrobecter in immunocompromized chronic liver disease (CLD) patients.
This study was performed to analyze sensitivity pattern of bacterial pathogens to commonly used
antibiotics quinolones, aminoglycosides, cephalosporin and co-trimoxazole and to evaluate the
synergistic efficacy of different combination s of antibiotics. The study was conducted on
different CLD patients admitted in different medical wards of Sir .ganga Ram Hospital Lahore.
Aim
By using blood and urine culturing technique and different biochemical tests opportunistic
pathogens Pseudomonas and Citrobecter in CLD immunocompromized patients belonging to
different age group were determined. Combination therapy of quinolones, aminoglycosides,
cephalosporin and sulpha drugs were effective against the bacterial pathogens Pseudomonas and
Citrobecter.
Material and Methods
Clinical sign and symptoms of all the CLD patients who were admitted in the hospital were
noted at the time of admission The patients who start showing sign and symptoms (Fever,
burning micturation, pain) of suspected infection on 2nd and 3rd day of their admission were
included in this study. Blood and urine samples were collected from infected CLD patients with
CHAPTER – 6
SUMMARY
suspected sign and symptoms by using all necessary aseptic precautions with the assistance of
trained professionals. The pathogens were isolated, identified and purified by selective culturing
methods, which were subjected to active growth, during which sensitivity to different antibiotics
was checked. Antibiotic sensitivity test was conducted on pure culture isolates employing the
Kirby Bauer disc diffusion method for the commonly used antibiotics. The diameters of growth
inhibition around the discs was measured and interpreted by using Clinical Laboratory Standards
Interpretations (CLSI).
Statistical Analysis
The collected data was analyzed by ANOVA and Chi-square test on SPSS software (16) .
Results
Pseudomonas and Citrobecter pathogens are now proved to be a multi resistant pathogens and
use of combinations of antibiotics against these pathogens found to be more effective. This study
was performed to evaluate the synergistic effect of different antibiotics combinations against
Pseudomonas and Citrobecter pathogens, so that the chances of recurrent infections among the
immunocompromized hospitalized patients were minimized. It will help to improve the quality
of life of immunocompromized patients through providing information about effective antibiotic
treatment. The effects of different combinations of antibiotics were also analyzed in CLD
patients through evaluating the improvement in infectious disease. It was found during study that
combination of ceftriaxone and amikacin prove to be more effective in clinical settings but in
vitro studies shows the combination of cephradine with gentamycin was 97% susceptible.