International Medical Publisher Journals (iMedPub)
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Characterization of resistance genes to macrolides, lincosamides and streptogramins (MLS) among clinical isolates of Staphylococcus aureus in North Lebanon
Get PDFBackground. – Staphylococcus aureus is one of the most significant pathogens causing significant morbidity and mortality. Moreover, the incidence of MLS-resistant Staphylococcus aureus infections continues to grow globally.Objective. – The aim of this study is to examine the expression of resistance of Staphylococcus aureus (S. aureus) isolates to MLS and the prevalence of genes involved in this resistance by PCR.Methods. – 38 strains of S. aureus MLS-resistant (resistant at least for one macrolide) were isolated in the sector of microbiology at Nini Hospital in North Lebanon. The disk diffusion method was used to determine the phenotype of the MLS resistance. The resistance genes involved were detected by PCR using specific gene primers for ermA, ermB, ermC, msrA, linA, mefA, vat and vgb genes.Results. – A total of 55.3% of the isolates were positive for inducible phenotype (iMLSB), 15.8% for the constitutive phenotype (cMLSB), 23.7% for MSB phenotype and 5.2% for L phenotype. The ermC gene was the most prevalent (52.6%), while ermA, ermB, msrA and linA genes were observed with lower prevalence. However, a combination of several of these genes was detected. The vgb, vat and mefA genes were not detected in any of the clinical isolates.Conclusion. – To our knowledge, this study is the first investigation regarding characterization of MLS resistance genes in clinical isolates of S. aureus in Lebanon. The study revealed a high prevalence of the inducible resistance to lincosamides (iMLSB phenotype) and the most prevalent resistance determinants was ermC
The mammalian efflux pump inhibitor Valspodar (PSC833) improves susceptibility of MRSA to antibiotics.
Get PDFAim: Inhibitors of mammalian efflux pumps are known to potentiate antibiotic susceptibility in bacteria by inhibiting bacterial efflux pumps as well. In this study the effect of 2nd generation mammalian efflux pump inhibitor PSC 833 on inhibition of efflux pumps in bacteria is tested.Methods: Disc diffusion assay for several antimicrobial agents such as cefoxitine, oxacillin, gentamicin, ticarcillin-clavulanate norfloxacin and ofloxacin was performed in the presence and absence of PSC 833 in culture media of Gram positive and Gram negative bacteria and zones of inhibition were compared. Accumulation of the universal efflux pump substrate ethidium bromide in test organisms was measured in the presence and absence of PSC 833.Results: PSC833 at concentrations starting from 62.5 µg/ml downwards till 3.12 µg/ml have significantly improved and restored the sensitivity of S.aureus and MRSA towards all tested antibiotics and resulted in highest accumulation of ethidium bromide within the cells, when compared to the other mammalian efflux inhibitors, verapamil and reserpine. However no effect was observed on the Gram negative P. aeruginosa and vancomycin resistant Enterococci (VRE).Conclusions: The results of this study indicate that PSC 833 represents a good candidate for use in combination with examined antibiotics to restore their clinical efficacy.Â
Human immunodeficiency virus infection and chemotherapy treatment in the Kingdom of Bahrain
Get PDFHuman immunodeficiency virus (HIV) is a lentivirus which that may progress to immunodeficiency syndrome (AIDS) and predispose for opportunistic infections and malignancies. According to recent reports, Â 1.5 million people died of AIDS in 2013 worldwide which is a 35% decrease since 2005. The number of deaths has decreased in part due to antiretroviral treatment (ART) wide spread use. In Bahrain, in 2011, a multidisciplinary team was established for HIV management involving major stakeholders: public health, infectious diseases, pharmacists, nursing and virologists. A retrospective descriptive study is done about HIV positive patient in Bahrain, their current treatment regimens and other blood parameters were collected, aiming to have a general idea about their health status in a way to help in their medical care. The data was collected retrospectively from the 2014 registry about all patients who are diagnosed to have HIV. Their ART regimen, CD 4 count and viral load were gathered and entered in Excel sheet.. A total of 208 patients were diagnosed to have HIV up to 2014. However, only 108 of them have their full data. In addition, a review of the frequency of admission of these patients over a 10 year period was done too. On reviewing the medical records of the patients admitted over the last ten years from 2004 till 2014, it was found that the total admission of HIV positive patients were 107. Hepatitis C was the most common co infection among those patients with a percentage of 24%. It was found that with better ART treatment and better structure of HIV team and program, we are getting more patients to be controlled. There is a clear increase in the number of patients with improving CD4 count. Based on the results of our study, the HIV multi-disciplinary management team is an essential part for the best management of these patients
Childhood Depression in Family Narratives
Get PDFBACKGROUND: The family narratives are true contextual cues in the representation of the experiences of illness of depressive child. The family members use healthcare services in an attempt to understand the disease so that describe the everyday practices in the living with the child. OBJECTIVE: This original article aims to present childhood depression with its various nuances and its many consequences in the family context. METHODS: The universe of this study involved 24 families in the age group ranging from 45 to 70 years who searched the care services at Children's Psychosocial Care Center (CAPSi). Through the records, a survey of the family members was performed, from case reports, in the course of medical and psychological consultations. This is a purposive sample, which was selected by approximation the inclusion criteria, a sample of 12 family members of both sexes. The attention focused on the use of narrative interview - which is recognized as a genre of sociolinguistic research - fully recorded. RESULTS: The family member has its convivial trajectory with the disease through a specific identity and enunciation with the child. The family narratives show up symbolic portraits to the rescue of the guiding elements of the depressive situation. The family narratives are shown as spaces of reinterpretation of pain and psychological distress. The disorder explained in the narratives of childhood depression inserted in understanding plays a crucial role in exposing the intensity of pain and psychological distress. CONCLUSION: It is fundamental important in clinical care the psychiatric practice inserted into the historical and social context of the family members who have their own living narrative with the disease
Mycobacterium tuberculosis complex: Detection and patterns of resistance to the first line anti-TB drugs at the King Abdulaziz University Hospital, Saudi Arabia
Get PDFTuberculosis (TB) remains a major cause of morbidity and mortality worldwide. Continued surveillance of drug susceptibility help determining treatment regimen by anti-tuberculous drugs. Gene Xpert PCR sensitivity was compared to the liquid culture media by Versa TREK for detecting Mycobacterium tuberculosis complex(MTBC). Rates, patterns and types of anti-tuberculosis drug- resistance atKing Abdulaziz University Hospital (KAUH), Jeddah, KSA were determined from January 2013 to June 2014.A total of 101 tuberculous patients were included, 43 Saudi tuberculous patients and 58 non-Saudi tuberculous patients. All resistances detected were primary resistances. PCR Sensitivities for detection of MTBC were 29.4%, 80%, 87.5%, 77.8% and 100% in AFB-negative samples and AFB +1,+2,+3 and +4 positive samples respectively. MTBC percentage detected by PCR was 88.1% in AFB-positive samples and 29.9% in AFB-negative ones. Versa Trek detection time was 15.01±7.32 days in AFB-positive samples and 26.63±6.7 days in AFB-negative ones. MTBC pyrazinamide resistance was (13.86%), followed by streptomycin (7.9%), rifampicin (3.96%) and isoniazid (3.96%). Mono-resistance percentages to pyrazinamide, rifampicin and isoniazid were 11.88%, 1.98% and 0.99% respectively. MDR-TB were 1.98% and anti-TB resistance percentage was 24.75%. There was no significant difference between Saudi and non-Saudi tuberculous patients regarding anti- tuberculous drugs resistance.Â
Scorpion venom as antimicrobial peptides (AMPs): A review article
Get PDFThe high level of reported multidrug resistant pathogens with the failure of most conventional antibiotic to kill many of them arise the global concern in the last decade to find alternatives urgently. Many researches are conducted on scorpion venom area and different antimicrobial peptides had been reported in literature also  many had been functionally characterized in the last decade. Here quick overview of all scorpion AMPs with antibacterial activity , their Structural determinants, classification types and their mode of action, in addition to their resistance mechanism and finally their therapeutics potentia
Prevalence of Legionella among pneumonia patients and environmental water samples in an Egyptian University Hospital
Get PDFAbstractObjectives: to diagnose Legionella infection in community- acquired pneumonia (CAP) cases admitted to chest department of Zagazig University Hospital and in hospital- acquired pneumonia (HAP) patients hospitalized in the emergency and surgery ICU, to determine incidence of these disease condition and to identify risk factors. Another objective was to determine the occurrence of Legionella genus in the water of these departments.Subjects and methods: one hundred pneumonic patients; 50 patients with CAP and 50 with HAP were the subject of this laboratory-based, comparative cross sectional study. Full clinical history and lower respiratory tract specimens were collected from each patient. Water samples were taken from 25 water outlets. DNA was extracted by QIAamp DNA Mini Kit, and real time PCR amplification of 16s r-RNA gene was used for diagnosis of Legionella genus. Risk factors were analyzed by logistic regression analysis.Results: Legionella genus was identified in eight out of 50 patients of CAP (16%), and ten out of 50 patients with HAP (20%). As regards CAP, Legionella was prevalent in old- age, smoker males, with diabetes mellitus (DM) and/or chronic obstructive pulmonary disease (COPD). Gastrointestinal tract (GIT) and neurological manifestations were the main presentations. Seventy-five percent needed ICU admission. Concerning HAP, hospitalization for more than ten days and having a stroke or head trauma were significant risk factors. Ten out of the 25 water samples tested were positive for Legionella genus; seven samples were from the chest department and three were from emergency ICU. No water-contamination with Legionella was found in the surgery ICU.Discussion: diagnosis of Legionella should be considered for both CAP and HAP in our locality. Periodic surveillance for detection of that genus with subsequent disinfection of water sources when indicated should be carried out
Impacto de la Artritis Reumatoide sobre la funcionalidad fÃsica y la calidad de vida relacionada con la salud: Metaanálisis 2003-2013
Get PDFIntroducción: La artritis reumatoide es una enfermedad que afecta la funcionalidad fÃsica y la calidad de vida relacionada con la salud (CVRS); en la literatura médica se presenta una elevada heterogeneidad sobre el impacto de la enfermedad en estos dominios.Objetivo: Evaluar el impacto de la artritis reumatoide sobre la funcionalidad fÃsica y la CVRS a partir de estudios publicados entre 2003 y 2013.Materiales y métodos: Revisión sistemática con metaanálisis. Se realizó una búsqueda en cuatro bases de datos multidsicplinarias con los términos de búsqueda “calidad de vida & artritis reumatoideâ€Â y sus homólogos en inglés y portugués. Se evaluó la calidad de los artÃculos por dos investigadores garantizando la exhaustividad y reproducibilidad. La funcionalidad fÃsica se evaluó con el HAQ-DI (Health Assesment Questionnaire Disability Index) y la CVRS con el MOSSF-36 (Medical Outcome Study Short Form 36). El análisis se basó en frecuencias, medidas de resumen, intervalos de confianza y prueba t Student para los análisis de heterogeneidad y sensibilidad.Resultados: Se incluyeron 48 investigaciones en 27 paÃses, en los cuales se evaluó la funcionalidad fÃsica en 24.237 pacientes y la calidad de vida en 46.725. Se obtuvo un promedio ponderado de 1,12±0,8 en el HAQ-DI y en el MOSSF-36 fue 35,2±6,3 para el componente fÃsico y 47,3±6,9 para el mental, lo que resulta menor a los puntajes establecidos para poblaciones sanas de 50 puntos.Conclusión: La artritis reumatoide impacta negativamente la CVRS, siendo mayor su efecto sobre el componente fÃsico, mientras que la funcionalidad fÃsica se afecta moderadamente; este conocimiento resulta útil para direccionar los lineamientos de intervención en el individuo con la enfermedad e investigación en esta área
Genetic heterogeneity of CTX-M type extended-spectrum ß-lactamase producing Escherichia coli strains from diverse sources in Saudi Arabia
Get PDFBackground: The rise of CTX-M extended spectrum β-lactamase (ESBLs)-producing E. coli in non-human sources is a growing concern of public health. Understanding the extent of public health risk attributed to CTX-M type ESBLs-producing strains from different sources is critical for effective control.Objective: This study focuses on detection and molecular typing of CTX-M type ESBL-producing E. coli isolated from various sources in Taif, Western Saudi Arabia. Material and Methods: A total of 24 E. coli ESBLs-producing isolates from multiple sources were assessed for the presence of CTX-M groups gene by PCR, and subsequently their clonal relatedness by random amplifid of polymorphic DNA (RAPD) analysis. Isolates were selected according to a resistance phenotype consistent with production of ESBL-type beta-lactamase using double disk diffusion method.Results: A CTX-M gene was detected in all 24 isolates. RAPD typing of E. coli isolates bearing CTX-M gene showed 24 patterns verifid into two major clusters (A, B) and three sub-clusters (A1 – A3). Phylogenetic analysis indicating a degree of similarity among clustering isolates from human, sheep and raw milk origins. Identical profie was observed between three isolates obtained from pet bird and chicken
Factors associated with the delay in seeking legal abortion for pregnancy resulting from rape
Get PDFAbstractBackground: about 7% of rape cases in Brazil result in pregnancy. Brazilian  women generally are unaware of the right to legal interruption of pregnancy  after rape and try to end abortion in an unsafe manner or last to request the  procedure. Objective: to analyse factors associated with the time of seeking  legal abortion after rape in a public hospital. Methods: this is an observational,  analytical, and cross-sectional study. Data are from medical records of 1,270  women who complained of rape and have requested legal abortion in a public  hospital in São Paulo between 1994 and 2013. The variables age, education,  race, marital status, religion, form of intimidation, vulnerable condition,  perpetrator of sexual violence, number of perpetrators, and police report were analysed in relation to gestational age, according to multiple multinomial logistic  regression models. Results: the delay in requesting abortion at intermediate  gestational age is associated to when a woman is vulnerable (p=0.015), late  gestational age is associated with the presence of a police report (p=0.029) and 48 marital status as ngle (p=0.05). Be a relative of the aggressor is associated with  both intermediate (p=0.016) and late gestational age (p=0.002). Conclusions:  women without partners, who suffered intimidation with threats, in a vulnerable  condition, who made a police report and, above all, who were raped by relatives,  composed the group who took longer to get the health service.Keywords: sexual violence; rape; unwanted pregnancy; legal abortio