International Medical Publisher Journals (iMedPub)
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Antimicrobial susceptibility and virulence factors of Enterococci colonizing intestinal tract of infants
No full textAim: This study investigated distribution of enterococci colonizing intestinal tract of infants and  has determined their putative virulence factors and antimicrobial susceptibility patterns. Methods:  A total of 82/186 (44.1%) fecal enterococcal isolates were recovered from infants. All enterococci isolates were identified either E. faecalis or E. faecium using culture and PCR. Results: A significant higher intestinal colonization of enterococci was detected among non-hospitalized compared to hospitalized patients with a percentage of (72 % vs. 28%), respectively . E.faecalis was the predominant species in both groups (75.6%). It had also significantly higher virulence factors genes than E. faecium ,while E. faecium had higher rates of antimicrobial resistance than E.faecalis. Conclusion: This study shows significantly higher rate of intestinal colonization of  E.faecalis than E. faecium of hospitalized and non-hospitalized infants, and  E.faecalis carried significantly higher potential virulence genes than E. faecium. Key word: Fecal enterococci, Infants, Antimicrobial resistance, Virulence factorsShort title: Fecal ent
Aminoglycoside and chlorhexidine resistance genes in Staphylococcus aureus isolated from surgical wound infections.
Get PDFHamdia Askar1, Wafaa Badawy2  and Enas Hammad11Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Egypt2MD.MansouraUniversity Students'Hospital,Egypt. Background:  Staphylococcus aureus is a major human pathogen resistant to many antimicrobial agents especially the methicillin-resistant Staphylococcus aureus (MRSA). In surgical site infections, MRSA is known to be an important etiologic factor. Infections range from skin and soft-tissue infections to deep tissue infections such as osteomyelitis, bacteremia, and endocarditis that are much more common in hospital environment. In staphylococci the main mechanism of aminoglycoside resistance is the drug inactivation by aminoglycoside-modifying enzymes (AMEs) and reduced biocide susceptibility is associated with the acquisition of quaternary ammonium compound (qac) gene-encoding for Qac efflux proteins.Aim of the work: To investigate the prevalence of the aminoglycosides resistance genes aac(6′)aph(2″), aph(3′)-IIIa, Ant(4′)-Ia) and the biocide resistance genes (qacA/qacB, qacC) in S. aureus isolated from surgical site infections.Methods: Swabs from 280 infected surgical sites were sent to our laboratory from different surgical words at Mansoura University Hospitals between January 2014 and December 2014. Sixty- six staphylococcal strains were isolated and included in this study. Verification of the presence of methicillin resistance gene (mecA), chlorhexidine MIC and qac resistance genes (qacA/qacB, qacC) were detected by PCR. The presence of aminoglycoside resistance genes [(aac(6′)/aph (2″), ant (4′)-1a and aph(3′)-IIIa)] in S. aureus was also tested by PCR.Results:  Seventeen of the 66 S. aureus isolates (25.75 %) were phenotypically MRSA and mecA gene was detected in 19 S. aureus isolates (28.7 %) by PCR. Aminoglycoside resistant S. aureus were 21/66 (31.8%). AME genes were detected in all aminoglycoside-resistant S. aureus; aac(6′)/aph (2″) was the most frequently detected 11/21(52.4%) followed by aph(3′)-IIIa 6/21 (28.6%) and the least frequent was ant (4′)-1a 4/21(19%). Aminoglycoside resistance in 9 out of the 21 (42.9%) aminoglycoside resistance S. aureus isolates was solely plasmid mediated being lost after plasmid curing. A total of 14 out of the 21 aminoglycoside-resistant S. aureus isolates (66.7 %) carried the mecA gene. Among the 45 aminoglycoside-sensitive S. aureus isolates 5 (11.1%) were mecA positive. Nine of the 21 aminoglycoside-resistant S. aureus isolates (42.9%) were positive for qacA/qacB genes and in all of them mecA gene co-existed. Five aminoglycoside resistant S. aureus isolates were qacC positive (23.8%).  Conclusion: In the Staphylococcus aureus isolated from infected surgical wounds, quaternary ammonium compounds resistance genes were positive at a considerable ratio and co-existed with aminoglycosides and methicillin-resistance genes in S. aureus isolates. Â
Atenciones debidas a patologÃa reumatológica en el Servicio de Emergencias del Instituto Nacional de Salud del Niño (Lima, Perú) durante el periodo Enero 2012-Junio 2014
Get PDFObjetivos: Evaluar las causas más frecuentes de atenciones por patologÃa reumatológica en el servicio de emergencias de un hospital pediátrico peruano de tercer nivel.Pacientes y Métodos: Se llevó a cabo un estudio descriptivo, observacional y retrospectivo mediante la revisión de la base de datos y registros del servicio de emergencias del hospital, correspondientes al periodo comprendido entre enero 2012 y junio 2014, seleccionándose las atenciones debidas a patologÃa reumatológica. Los datos fueron procesados mediante el programa estadÃstico SPSS 16.0.Resultados: Durante el periodo evaluado el número total de atenciones en el servicio de emergencias fue de 133484, correspondiendo 835 casos (0,63%) a diagnósticos reumatológicos segúnla Clasificación Internacionalde Enfermedades 10° (CIE-10). La mayorÃa de los pacientes fueron hombres (450, 53,08%) y la distribución por grupos etáreos fue: 1-4 años 327 (39,16%), 5-9 años 251 (30,02%), 10-14 años 158 (18,98%), mayores de 15 años 68 (8,11%) y menores de un año 32 (3,77%). Las 5 primeras causas de atenciones reumatológicas, de acuerdo al CIE-10, durante este perÃodo fueron: artritis reactiva 173 casos (20,72%), dolor en articulación 168 (20,12%), púrpura de Schönlein-Henoch (púrpura alérgica) 107 (12,81%), artritis séptica (artritis piógena) 89 (10,67%) y mialgias 77 (9,22%). El número de atenciones por problemas reumatológicos se mantuvo estable a través del tiempo, siendo de325 a345 casos por año.Conclusiones: Las atenciones debidas a patologÃa reumatológica en el servicio de emergencias de un hospital pediátrico terciario como el nuestro son frecuentes y estables durante el transcurso del tiempo. Una adecuada evaluación inicial y un apropiado periodo de seguimiento aseguran un correcto diagnóstico y un tratamiento eficaz. Los pediatras que trabajan en el área de emergencias deberÃan estar capacitados en reumatologÃa pediátrica
Antimicrobial resistance of Staphylococcus aureus, fecal streptococci, Enterobacteriaceae and Pseudomonas aeruginosa isolated from the coastal water of the Gaza strip-Palestine
Get PDFObjectives: To document the occurrence and distribution of antibiotic resistance of clinically important bacteria in the seawater of Gaza strip-Palestine. Methods: Seawater samples were collected at 16 location distributed along the coast of the Gaza strip. Sampling was accomplished during 12 months, from March 2014 to June 2015. The microbial composition including Enterobacteriaceae, Staphylococcus aureus, fecal streptococci and Pseudomonas aeruginosa was recorded and tested for their resistance to specific antimicrobial agents according to CLSI using the disc diffusion method. Results: A total of 816 isolates of Enterobacteriaceae (377), S. aureus (29), fecal enterococci (FS) (369), and P. aeruginosa (29) were recovered and identified. Enterobacteriaceae, P. aeruginosa, FS and S. aureus isolates exhibited the highest rates of resistance against β-lactam drugs. The isolates also showed resistance to at least one antimicrobial in the range between 99.7 to 78%. Multiple resistance occurred in almost 85% of all isolates; 99.2% of Enterobacteriaceae, 96.6% of P. aeruginosa, 72.1% of FS and 61% of S.aureus. The incidence of multiple resistance of isolates from all sampling locations ranged from 69.2 to 94.1%. Antibiotic resistance indices were found to be highest in P. aeruginosa (0.57), followed by E. coli (0.53), FS (0.49), Enterobacter (0.41), S. marcescens (0.40), Klebsiella (0.39) and finally Proteus (0.28). Most of the isolates showed multiple antibiotic resistance (MAR) index value higher than 0.2. Conclusions: This study demonstrated that the seawater of the Gaza strip is highly contaminated with antibiotic resistant bacteria which can be transmitted to humans through recreational and other activities. Therefore, there is a need to apply appropriate and rationale use of antibiotic to minimize the occurrence of multiple antibiotic resistant bacteria in the marine environment. Proper treatment of sewage before it is discharged to the sea is highly recommended.Keywords: Multiple antimicrobial resistance, Gaza strip, seawater, fecal enterococci, P. aeruginosa, Enterobacteriaceae, S. aureus
Peels of Psidium guajava fruit possess antimicrobial properties
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Background: Psidium guajava (guava) leaf extracts have been extensively studied for their anti-microbial effect. Yet, very few studies investigated the antimicrobial effect of the ripe guava fruit. Aim: This study aims at examining aqueous extracts of ripe Psidium guajava fruit, bulb, seeds and peels (harvested in autumn at Jordan River valley). Materials and methods: Decreasing concentrations of water extracts of three parts of the fruit are tested against Gram positive and Gram negative bacteria as well as the fungus Saccharomyces cerevesea using the agar diffusion method. Clinical isolates of MRSA are also included. Results: Water extracts of Guava peels at concentrations ≥ 10% are inhibitory to coagulase positive S. aureus and MRSAs, and at ≥ 1% are inhibitory to coagulase negative Staphylococci. Water extracts of peels acted synergistically with cell wall synthesis inhibitor antibiotics towards S. aureus and MRSA strains used. HPLC-MS-MS analysis through ion trap and subsequent fragmentation of the isolated ions from peels water extracts allowed the clear identification of two well-known phenolic compounds that are known for their antimicrobial activity: Gallic acid (957.6 μg/mL) and Ferulic acid(13 μg/mL). Conclusion: The ripe fruit of Guava is a nutritionally rich fruit with an outer covering that possess antimicrobial propertie
Prevalence of Helicobacter pylori resistance to clarithromycin determined by 23S ribosomal RNA analysis in Jordan. Diab AF1, Diab FH2, Nassar SS3. Faculty of Medicine, University of Jordan1; Departments of Medicine2 and Laboratory Medicine3, Khaldi Medica
No full textBackground: Antimicrobial resistance is a growing problem in Helicobacter pylori treatment. This study was intended to evaluate the prevalence of clarithromycin resistance, using a polymerase chain reaction (PCR) technique on gastric specimens, from adult Jordanian patients with Helicobacter pylori infection.
Materials and Methods: Gastric biopsy specimens were taken from gastric antrum and body during routine upper gastrointestinal endoscopies, and were tested with Rapid Urea test for H. pylori. Only specimens that were positive for H. pylori by the rapid Urea test were included in the study. A total of 50 specimens tested positive for H. pylori, and were further tested using the Seeplex® ClaR-H. pylori ACE detection kit, a dual priming oligonucleotide (DPO) methodology from Seegene Inc., Seoul, Korea, to determine the frequency of point mutations in 23s rRNA gene, known to confer resistance to clarithromycin (A2142G and A2143G point mutations).
Results: Out of a total of 50 gastric specimens that tested positive for H. pylori by rapid urease test, 49 were confirmed positive for H. pylori by PCR technique. Point mutations were found in 11 specimens (8 had A2143G point mutation, and 3 had A2142G point mutation).
Conclusion: Prevalence of clarithromycin resistant strains of H. pylori in Jordan was 22.4%. A2143G was the most prevalent point mutation. This high rate of clarithromycin resistant strains should be taken into consideration when prescribing eradication regimens. This is the first study to investigate H. pylori resistance to clarithromycin in Jordan. 
Water-in-oil microemulsions exhibit antimicrobial activity
Get PDFObjectives: Previous research from this group has identified significant antimicrobial activity associated with oil-in-water (O/W) microemulsions. This activity has been exhibited against both bacteria and fungi (including yeasts) and bacterial biofilms and is dependent upon the position of the microemulsion within its stability zone. This novel work aims to identify antimicrobial activity of water-in-oil (W/O) microemulsions.
Materials & Methods: A simple, thermodynamically stable water-in-oil microemulsion was tested for its time-related antimicrobial activity against a selected panel of test microorganisms (i.e.: Pseudomonas aeruginosa ATCC 9027, Escherichia coli ATCC 8739, Candida albicans ATCC 10231 and Staphylococcus aureus ATCC 6538P) and its effectiveness as a self-preserving system against a similar panel (Pseudomonas aeruginosa ATCC 9027, Candida albicans ATCC 10231, Staphylococcus aureus ATCC 6538P and Aspergillus niger ATCC 16404).
Results: The microemulsion exhibited significant antimicrobial activity against all the selected microorganisms. Decreases in the viability of cultures (P. aeruginosa, C. albicans, E. coli and S. aureus) were observed over a short period of time after exposure to a known concentration of the first microemulsion. The results for the four samplings in the preservative effectiveness test according to the European Pharmacopeia requires a significant reduction in bacterial count, and this requirement was achieved in all samplings.
Conclusions: Thermodynamically stable water-in-oil microemulsions are antimicrobially active, self-preserving systems, as are their oil-in-water counterparts
Occurrence of potential virulence factors and antimicrobial resistance markers in fecal E. coli isolates from infants
Get PDFObjectives: E. coli is one of the first gram-negative organism colonizing the intestine of infants, and it’s commonly causes various communityacquired and nosocomial bacterial infection in infants. This study explores the relationship between the incidence of antimicrobial resistance profile and virulence factors genes of E. coli colonizing the intestine of infants.Methods: A total of 150 fecal E. coli isolates from infants aged less than one year, who were admitted to Pediatric Clinics at The Jordan University Hospital, Amman, Jordan, were investigated for their antimicrobial resistance profile and 11 common virulence factors using PCR. Results: A total of 134/150 (89.3%) were multidrug resistant (MDR) to at least 3 antibiotic classes. Hospitalized infants carried significantly more MDR E. coli than non-hospitalized. The majority of E. coli isolates carried the virulence factors; aerobactin (33.3%), type1 fimbriae (27.3%), S.fimbriae (20%), followed by P.fimbriae (18%), haemolysin (14.7%), papG class II (12.0%), and papG class III (7.3%), whereas all isolates were negative for capsular antigens K1 and K5 genes, papG adhesion `Class I and Dr haemagglutinin. Hospitalized infants carried significantly more MDR isolates than nonhospitalized infants, and the type of milk feeding was not significantly associated with MDR isolates in both groups. Conclusion: This study showed that increased presence of antimicrobial resistance markers (≥ 6) in E. coli isolates were significantly (P= 0.001) associated with less presence of potential virulence genes
Laboratory approach for detection of non-invasive fungal rhinosinusitis: A case-control study
Get PDFÂ Â Â Â Â Â Â Â Noninvasive fungal rhinosinustis is problematic being resistant to traditional medical treatment. Mycology laboratory work helps solving this issue. This case control study was designed to supplement the lacking information about the frequency of noninvasive fungal rhinosinusitis in our locality and identify fungal species responsible for this condition in Zagazig University Hospitals. In addition, to evaluate the role of microscopic examination, antigen detection and PCR in comparison to culture technique in diagnosis. Sinus material was collected from seventy eight cases represented clinically and radiologically with noninvasive fungal rhinosinusitis from June 2013 to September 2015. A control group 78 subjects with healthy sinuses from whom nasal smears were obtained. Samples were processed in Mycology Unit and examined microscopically in 10% KOH preparations. Lactophenol cotton blue slide preparations were examined for microscopic structures as hyphae and conidia. PCR amplification of the extracted DNA was performed using fungal universal primers for amplification of 28 S rDNA genes. Results: Microscopic examination revealed hyphae and fruiting bodies in 37 (47.4% of the cases). Culture diagnosed 36 FRS patients. Aspergillus fumigatus was the most frequently isolated from fungal rhino sinusitis (52.7 %) of cases, followed by Penicillium spp. in 22.2%. PCR amplification exhibits the same sensitivity and specificity as those demonstrated by microscopic examination (100% and 97.3% respectively). ELISA of Aspergillus galactomannan (GM) antigen lacked sensitivity (58.3%), with a higher specificity (100%). Conclusion: It is concluded that an experienced mycological confirmation especially, direct microscopic examination of clinically suspected noninvasive FRS cases is necessary for a final diagnosis. Key words: Rhinosinusitis; fungus; KOH; galactomannan; PCRRunning Title: Fungal rhinosinusitis mycology la
Clostridium difficile : Infection, diagnosis and treatment with antimicrobial drugs : A review article
Get PDFClostridium difï¬cile infection (CDI) is increasing problem in healthcare, associated with high incidence, mortality, and costs in hospitalized patients. Dramatic increases in the incidence and severity of healthcare-associated C. difficile infection have occurred since the last decade, including elderly population, young adults, pregnant females, infants and children. C. difï¬cile infections are mainly linked to the prolonged use of wide-spectrum antibiotics that disrupt the intestinal microbiota equilibrium. Toxigenic strains of C. difï¬cile commonly produce two clostridial toxins, toxins A (TcdA) and B (TcdB), to which disease symptoms are attributed. Few strains of C. difï¬cile may also produce another more powerful binary toxin associated with high fatality. The clinical manifestations of infection with toxin-producing strains of C. difï¬cile range from symptomless carriage, to mild or moderate watery-bloody diarrhea, and few percentage developed fulminant and sometimes fatal pseudomembranous colitis. Complications that have been associated with CDI include dehydration, electrolyte disturbances, toxic megacolon, bowel perforation, hypotension, renal failure, systemic inflammatory response syndrome, sepsis, and death. The most important step in treating CDI is immediately discontinuing use of offending antimicrobial drug. Both metronidazole and vancomycin are equally effective for the treatment of mild CDI, but vancomycin is superior for treating patients with severe C. difï¬cile disease. Recently, fidaxomicin proved to be superior to other drugs in treatment of patients who are at high risk for CDI relapse.Â