INCREASED C-REACTIVE PROTEIN AN ADVERSE PROGNOSTIC FACTOR IN MYELODYSPLASTIC SYNDROMES-EXPERIENCE FROM PAKISTAN

OBJECTIVE : To determine the bacterial causative agent and associated risk factors responsible for sudden increase in cases of acute diarrheal disease in Rawalpindi/Islamabad Pakistan and to find the antimicrobial susceptibility pattern of isolates. METHODOLOGY: A Cross-sectional observational study was carried out at Department of Microbiology, Army Medical College (National University of Medical Sciences) from 18th May 2022 to 30th July 2022. Case definition was defined and all stool specimens were processed according to Clinical Microbiology procedures hand book edition four. Bacterial growth was identified by biochemical reactions and was further confirmed by serology. Antimicrobial susceptibility testing was performed by Kirby Bauer disc diffusion method following Clinical and Laboratory Standards Institute M45-A-2 document. Risk factors like age, gender, socio economic determinants, provision of safe drinking water, availability of toilets and hygiene facilities. History was evaluated through structured questionnaire after obtaining informed consent. Data was analyzed using statistical package for social sciences version 26 and correlation was determined between different risk factors and presence of disease. RESULTS : A total of 51 patients were recruited in the study. The mean age of positive cases was 40.80 years. All isolates were identified as biotype Classical serotype Ogawa and had same antibiotic susceptibility pattern i.e. Ampicillin, Azithromycin, Chloramphenicol, Tetracycline, Doxycyline, Ciprofloxacin sensitive to except trimethoprim-sulfamethoxazole. CONCLUSION : The organism responsible for rise in cases of acute diarrhea was Vibrio Cholera. A rise in cholera cases was associated with significant hospitalizations and mortality. With the increase rising trend of cholera cases in our hospital and Pakistan, we determined antibiotic susceptibility patterns of the Vibrio Cholerae. To overcome this threat, provision of safe drinking water, testing facilities and proper sewage should be available. KEYWORDS : Cholera, Developing countries Outbreak, Risk factors