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Respiratory Medicine 2016
October 17-18, 2016
Volume 6, Issue 5(Suppl) J Pulm Respir Med
ISSN: 2161-105X JPRM, an open access journal
conferenceseries .com
October 17-18, 2016 Chicago, USA
Respiratory and Pulmonary Medicine
2nd International Conference on
Treatment of community acquired pneumonia: Assessment of antibiotic prescription
Saad Ghaus
University of Birmingham, UK
Background: Community acquired pneumonia (CAP) affects 0.5-1% of UK adults annually, more than half of them are aged
over 84. Hospitalized patients have 5-14% mortality, with annual costs exceeding £400 million. The British Thoracic Society
(BTS) have devised guidelines for CAP management. This involves documentation of severity using CURB65 score, and
antibiotic prescription according to this score.
Aim: To assess compliance with BTS guidelines (2009) in the Elderly Care ward of the Queen Elizabeth Hospital.
Methods: Notes of geriatric patients treated for CAP during July, August and September were retrospectively studied for
CURB65 score, antibiotic treatment, treatment duration and time before IV medication changed to oral (if applicable). The
PICS online system was used as confirmation, and to identify if a prescribing note (for indication) had been issued. Data was
analyzed on Microsoft Excel.
Results: CURB65 recorded in 50% (24/48). Treatment was appropriate to the score in 54% of cases (no significant differences
between scores, p=0.2393). Prescription note compliance was 69% and the average treatment duration was 6.21 (±0.86) days.
Conclusions:CURB65was poorly documented inCAP.When documented, compliancewith guidelines was poor. Prescriptions
notes were absent in medical notes, and require improvement on PICS. Increased staff training for prescription notes and re-
audit has been planned.
J Pulm Respir Med 2016, 6:5(Suppl)
Characterization ofmutations causing rifampicin and isoniazid resistance of Mycobacterium tuberculosis
Maya Habous
Rashid Hospital-Dubai Health Authority, UAE
Objective: To characterize mutations causing rifampicin and isoniazid resistance of M. tuberculosis in Syria.
Methods: 69 rifampicin resistant (RIFr) and 72 isoniazid resistant (INHr) isolates were screened for point mutations in hot
spots of the rpoB, katG and inhA genes by DNA sequencing and real time PCR.
Results: Of the 69 RIFr isolates, 62 (90%) had mutations in the rifampin resistance determining region (RRDR) of the rpoB
gene, with codons 531 (61%), 526 (13%) and 516 (8.7%) being the most commonly mutated. We found two new mutations
(Asp516Thr and Ser531Gly) described for the first time in the rpoB-RRDR in association with rifampicin resistance. Only one
mutation (Ile572Phe) was found outside the rpoB-RRDR. Of 72 INHr strains, 30 (41.6%) had a mutation in katG codon 315
(with Ser315Thr being the predominant alteration), and 23 (32%) harbored the inhA−15C<T mutation. While the general
pattern of rpoB-RRDR and katG mutations reflected those found worldwide, the prevalence of the inhA−15C<T mutation was
above the value found in most other countries.
Conclusion: Emphasizing the great importance of testing the inhA−15C<T mutation for prediction of isoniazid resistance in
Syria. Sensitivity of a rapid test using real time PCR and 3’-minor groove binder (MGB) probes in detecting RIFr and INHr
isolates was 90% and 69.4%, respectively. This demonstrates that a small set of MGB-probes can be used in real time PCR in
order to detect most mutations causing resistance to Rifampicin and Isoniazid.