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Multidrug Resistance of Uropathogens at Governmental Hospitals in the Gaza Strip/Palestine 加沙地带/巴勒斯坦政府医院泌尿病原体耐多药情况
Pub Date : 2021-04-24 DOI: 10.3823/855
Sameh A. Alkhodari, A. Elmanama
Urinary tract infection is a public health problem worldwide. E. coli and klebsiella are among the main etiologic for UTI in Gaza Strip. The growing variations in resistance among uropathogens to antimicrobials is multifactorial and varies globally. It greatly reduces/limits or complicate treatment option. Aims: To determine the pattern of antimicrobial resistance and multidrug resistance among uropathogens at governmental hospitals. Methods: We analyzed the data of 11,890 urine samples processed in governmental hospitals in the Gaza Strip, Palestine during 2019. The percentage of resistance was calculated for uropathogens, and then multidrug resistance was calculated according to “CDC” definition. Results: Of 11,890 urine samples, 2910 (24.5%) showed significant growth.  Escherichia coli was isolated most frequently (1743; 59.9%), followed by Klebsiella spp. (725; 24.9%), Pseudomonas spp. (123; 4.2%), Streptococcus spp. (98; 3.4%), Staphylococcus aureus (41; 1.4%). Microorganisms resistance was high against Ampicillin (92.4%) and Amoxicillin (91.1%), Co-Trimoxazole (68.2%), Cefalexin (64.9%), Doxycycline (61.9%), Nalidixic acid (53.6%), Cefuroxime (53.0%), Ceftriaxone (48.9%), Ceftazidime (43.1%), Ciprofloxacin (36.9%), Gentamicin (25.8%), Amikacin (3.2%). The resistance of microorganisms in males is higher than females. Multidrug resistance was detected in 37% of E. coli and 53% in Klebsiella spp. Conclusion: Resistance is high and variable among uropathogens isolated from patients in Gaza strip. Both age and gender are risk factors in both infection and resistance pattern. The multidrug resistance percentage is growing remarkably in Gaza Strip. Keywords: Uropathogens, Resistance, Urinary tract infection, Multidrug resistance, Gaza strip, Palestine  
尿路感染是一个世界性的公共卫生问题。大肠杆菌和克雷伯菌是加沙地带尿路感染的主要病因。尿路病原体对抗菌素耐药性的变化是多因素的,在全球范围内也有所不同。它大大减少/限制或使治疗选择复杂化。目的:了解公立医院泌尿系病原菌抗菌药物耐药及多药耐药情况。方法:对2019年在巴勒斯坦加沙地带政府医院处理的11890份尿液样本进行分析。计算尿路病原菌的耐药百分比,然后根据“CDC”定义计算多药耐药。结果:11,890份尿样中,有2910份(24.5%)出现显著增长。大肠杆菌最常被分离(1743;59.9%),其次是克雷伯氏菌(725;24.9%),假单胞菌(123;4.2%),链球菌(98;3.4%),金黄色葡萄球菌(41%;1.4%)。微生物对氨苄西林(92.4%)、阿莫西林(91.1%)、复方新诺明(68.2%)、头孢氨苄(64.9%)、多西环素(61.9%)、那利地酸(53.6%)、头孢呋辛(53.0%)、头孢曲松(48.9%)、头孢他啶(43.1%)、环丙沙星(36.9%)、庆大霉素(25.8%)、阿米卡星(3.2%)耐药较高。男性对微生物的抗性高于女性。结论:从加沙地带患者身上分离出的尿路病原菌耐药程度高且具有多样性。年龄和性别都是感染和耐药模式的危险因素。加沙地带的多药耐药比例正在显著增长。关键词:尿路病原体耐药尿路感染多药耐药加沙地带巴勒斯坦
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引用次数: 3
Antibacterial activity of selected varieties of Malaysian honey against Escherichia coli: A comparative study 马来西亚蜂蜜对大肠杆菌抑菌活性的比较研究
Pub Date : 2021-03-28 DOI: 10.3823/854
Mohammad A Al-Kafaween, H. Al-Jamal, A. Hilmi
Background: The purpose of this study was to investigate the antibacterial activity of three varieties of Malaysian honeybees; Tualang honey (TH), Gelam honey (GH), and Acacia honey (AH) against Escherichia coli. Methods: The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the honey samples against E. coli were determined by the broth microdilution assay in the presence and absence of catalase enzyme. The mode of inhibition of honey samples against E. coli was investigated by the effect of time on viability. Impacts of the honey samples on the expression profiles of the selected genes of E. coli were examined using RT-qPCR analysis. Results: The results showed that TH and GH honey possessed lowest MIC and MBC values against E. coli with 20% and 25% (w/v) respectively. Highest MIC and MBC values were observed by AH honey against E. coli with 25% (w/v) and 50% (w/v) values, respectively. Among the tested honey samples, TH and GH exhibited the highest total antibacterial activity and the highest levels of peroxide-dependent activity. Time-kill curve demonstrated a bactericidal rather than a bacteriostatic effect; with a 2-log reduction estimated within 540 min. Viable cells were not recovered after 9 hours exposure to MIC of all honey-treated samples. The RT-qPCR analysis showed that all honey-treated cells share a similar overall pattern of gene expression, with a trend toward reduced expression of the virulence genes of interest. Antibacterial activity of selected varieties of Malaysian honey against Escherichia coli: A comparative study Mohammad A. Al-kafaween1, Hamid A. Nagi Al-Jamal1, Abu Bakar Mohd Hilmi1 1 Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Terengganu, Malaysia. Contact information: Hamid A. Nagi Al-Jamal, Mohammad A. Al-kafaween. mohammadalkafaween25@yahoo.com The InTernaTIonal arabIc Journal of anTImIcrobIal agenTs ISSN: 2174-9094 2021 Vol. 11 No. 1:3 doi: 10.3823/854 This article is available at: www.iajaa.org 2 Introduction Honeybees is one of the oldest traditional medicines that has been highly reputed and widely used for the treatment of several human diseases for thousands of years [1]. This reputation has continued up to the present day, leading to the emergence of a relatively new branch of alternative medicine, called "apitherapy", which focuses on medical applications of honey and other bee products [2-3]. Nowadays, different types of honey have been used in many countries as an alternative to pharmaceutical products for treating contaminated, infected, and burn wounds [4-5]. This is attributed to the effectiveness of these honeybees in inhibiting or killing a broad spectrum of bacteria [6-7]. E. coli is particularly interesting because it has been recognized as one of the most frequently isolated bacteria in nosocomial and surgical-site infections [8]. Although some studies have examined the effects of honeybees on bacterial structures [9, 10], the majority of thes
背景:本研究的目的是研究三种马来西亚蜜蜂的抗菌活性;土郎蜂蜜(TH), Gelam蜂蜜(GH)和金合欢蜂蜜(AH)对大肠杆菌的作用。方法:采用微量肉汤稀释法测定蜂蜜样品在存在和不存在过氧化氢酶的情况下对大肠杆菌的最低抑菌浓度(MIC)和最低杀菌浓度(MBC)。通过时间对活性的影响,探讨蜂蜜对大肠杆菌的抑制方式。采用RT-qPCR方法检测蜂蜜样品对大肠杆菌选定基因表达谱的影响。结果:TH和GH蜂蜜对大肠杆菌的MIC和MBC值最低,分别为20%和25% (w/v)。AH蜂蜜对大肠杆菌的MIC值和MBC值最高,分别为25% (w/v)和50% (w/v)。在蜂蜜样品中,TH和GH表现出最高的总抗菌活性和最高水平的过氧化物依赖活性。时间杀伤曲线显示出杀菌作用而非抑菌作用;在540分钟内估计减少了2对数。所有蜂蜜处理的样品在MIC暴露9小时后都没有恢复活细胞。RT-qPCR分析显示,所有经过蜂蜜处理的细胞具有相似的基因表达总体模式,并有降低感兴趣的毒力基因表达的趋势。精选品种马来西亚蜂蜜对大肠杆菌的抗菌活性:比较研究Mohammad A. Al-kafaween1, Hamid A. Nagi Al-Jamal1, Abu Bakar Mohd Hilmi1 1马来西亚登嘉努苏丹Zainal Abidin大学健康科学学院联系方式:Hamid A. Nagi Al-Jamal, Mohammad A. Al-kafaween。mohammadalkafaween25@yahoo.com国际阿拉伯抗菌剂杂志ISSN: 2174-9094 2021 Vol. 11 No. 1:3 doi: 10.3823/854本文可在:www.iajaa.org 2介绍蜜蜂是最古老的传统药物之一,数千年来一直备受赞誉并广泛用于治疗几种人类疾病[1]。这种声誉一直持续到今天,导致替代医学的一个相对较新的分支出现,称为“蜂疗”,其重点是蜂蜜和其他蜂产品的医疗应用[2-3]。如今,在许多国家,不同类型的蜂蜜已被用作药物产品的替代品,用于治疗污染、感染和烧伤伤口[4-5]。这归因于这些蜜蜂在抑制或杀死广泛的细菌方面的有效性[6-7]。大肠杆菌特别有趣,因为它已被认为是医院和手术部位感染中最常见的分离细菌之一[8]。虽然有一些研究考察了蜜蜂对细菌结构的影响[9,10],但这些研究大多是在一种蜂蜜上进行的,即麦卢卡蜂蜜,而且主要集中在铜绿假单胞菌和金黄色葡萄球菌上。蜂蜜的抗菌活性可能归因于几个因素,包括高渗透压、酸度,以及过氧化氢(H2O2)[11]和非过氧化氢成分,如甲基乙二醛[12]。除了发挥直接的抗菌作用外,一些蜂蜜品种还与细菌生存和毒力所必需的一些基因的差异表达有关,包括那些与毒力因子产生[13]、逆境耐受性[14]以及多细胞行为(如生物膜形成[15]和群体感应[16])有关的基因。蜂蜜的成分(及其抗菌活性)取决于采集原始花蜜的环境和地理位置[17]。这归因于不同地区植物来源和气候条件的自然差异[17]。几项研究涉及了马来西亚蜂蜜品种的不同方面,包括它们的理化性质、化学成分、抗菌和抗生物膜活性以及治疗用途[18-20]。然而,目前尚不清楚这些蜂蜜的抗生物膜活性,以及任何可能的抗群体感应和抗毒活性是否归因于细菌基因表达的改变。据我们所知,迄今为止只有三篇已发表的研究集中在蜂蜜诱导的大肠杆菌表达模式上[15- 17,21 -22]。因此,本研究的目的有三个:(a)评估三种马来西亚蜂蜜对大肠杆菌的直接抑菌活性;(b)
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引用次数: 2
Available COVID-19 vaccine platforms: A roadmap to eclipsing the SARS-CoV-2 viral saga 现有的COVID-19疫苗平台:超越SARS-CoV-2病毒传奇的路线图
Pub Date : 2021-02-06 DOI: 10.3823/853
Nancy K. El Beayni, G. Araj, A. Bizri, Najwa Khuri, A. Shehabi
The coronavirus disease 2019 (COVID-19) have devastated the globe and continues to be a protracted saga. In the absence of specific efficacious medical remedies, efforts to encounter and contain this emerging virus concentrated on vaccine production. A plethora of novel vaccines has been under development by major companies in different countries. To date, around 60 vaccines are in clinical trials with many other ones continuously added to the evolving pipeline. The variety in their corresponding designed platform and phases, warrants to tackle and understand what is being presented in the literature and launched in the market.  Thus, this study is intended to enlighten and educate the medical community by reviewing the different vaccine platforms, and briefly explaining their mechanism of action with an emphasis on those that reached most advanced stages.
2019冠状病毒病(COVID-19)肆虐全球,并将继续成为一场旷日持久的传奇。在缺乏具体有效的医疗补救措施的情况下,对付和遏制这种新出现病毒的努力集中在疫苗生产上。不同国家的大公司正在开发大量新型疫苗。迄今为止,大约有60种疫苗正在进行临床试验,还有许多其他疫苗不断加入到不断发展的管道中。在其相应的设计平台和阶段的多样性,保证处理和理解什么是在文献中提出的,并在市场上推出。因此,本研究旨在通过回顾不同的疫苗平台,并简要解释其作用机制,重点是那些达到最先进阶段的疫苗,来启发和教育医学界。
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引用次数: 1
Susceptibility of multidrug-resistant nosocomial pathogens for the new antimicrobial agents in Jordan 约旦多药耐药医院病原菌对新型抗菌药物的敏感性
Pub Date : 2021-01-18 DOI: 10.3823/852
Fidsa Jamal Ahmad Wadi Al Ramahi, M Said, Rasmieh Abu Kwaik, W. Jamal, Deema Al Jammal, Nisreen Al Radaidah, Amin A. Aqel
Background To study resistance rates of multidrug-resistant bacteria (MDR) for new Cephalosporines before their widespread use in Jordan. Methods During September 2019 - May 2020, MDR-bacteria were prospectively collected from microbiology laboratories of three hospitals, susceptibility of the extended-spectrum β-lactamases-producing Enterobacteriaceae (ESBL), K. pneumoniae-carbapenemases strains (KPC), carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant P. aeruginosa (CRPa), carbapenem-resistant A. baumannii (CRAb), and Methicillin-resistant Staphylococcus aureus (MRSA) were tested. Demographic details for patients were identified. Antimicrobials evaluated were ceftazidime-avibactam, ceftolozane-tazobactam, and ceftobiprole medocaril. Results Non-duplicate 263 MDR clinical isolates were collected from sterile sites; ESBL (128), P. aeruginosa (57), MRSA (37), KPC (22), A. baumannii (11), and CRE (n = 8). The age was dominated by the older age group (Age > 64, Pearson R = 0.985, R2 = 0.969, P = 0.000). Males were 143 and females 107 (P < 0.000). There were (194) isolate from the wards and (55) were from the ICUs. Sources were urine (96), blood (36), soft tissues (49), abdomen (24), URT (14), and osteo-skeletal (12). Clinical diagnoses were: UTI (90). Bacteremia (36), SSTI (45), IAI (23), pneumonia (17), URTI (13), osteomyelitis (11), and diabetic foot (6). The susceptibility of the ESBL-producing bacteria was 100% for meropenem, 99% for ceftazidime-avibactam, and 90% for ceftolozane/tazobactam. P. aeruginosa was, 73% for ceftazidime-avibactam, 62% susceptible to ceftolozane/tazobactam, 62% for meropenem, and 45% to ceftobiprole. CRE was 38% susceptible to ceftazidime-avibactam and KPC 15%, while ceftolozane-tazobactam susceptibility was zero, and 14% for CRE, and 0% for Ceftobiprole Medocaril. A. baumannii was 13% susceptible to ceftazidime-avibactam, meropenem 9%, and 2% for ceftolozane/tazobactam Conclusion Ceftazidime-avibactam and ceftolozane/tazobactam may be useful alternatives for the treatment of ESBL-producers and P. aeruginosa, though the MDR-bacteria demonstrated some resistance to the newly introduced agents before their widespread use in the country.
背景研究新型头孢菌素在约旦广泛应用前的耐多药菌(MDR)耐药率。方法2019年9月- 2020年5月,前瞻性采集3家医院微生物实验室耐多药菌,检测产β-内酰胺酶的广谱肠杆菌科(ESBL)、肺炎克雷伯菌-碳青霉烯酶菌株(KPC)、耐碳青霉烯类肠杆菌科(CRE)、耐碳青霉烯类铜绿假单胞菌(CRPa)、耐碳青霉烯类鲍曼假单胞菌(CRAb)和耐甲氧西林金黄色葡萄球菌(MRSA)的药敏。确定了患者的人口统计细节。评价的抗菌剂有头孢他啶-阿维巴坦、头孢奥唑烷-他唑巴坦和头孢双prole medocaril。结果无菌区临床分离得到非重复MDR菌株263株;ESBL(128例)、P. aeruginosa(57例)、MRSA(37例)、KPC(22例)、鲍曼a.p umannii(11例)、CRE(8例),年龄以年龄> 64岁年龄组为主,Pearson R = 0.985, R2 = 0.969, P = 0.000。男性143只,女性107只(P < 0.000)。其中病房分离194例,icu分离55例。来源为尿液(96)、血液(36)、软组织(49)、腹部(24)、上呼吸道(14)和骨-骨骼(12)。临床诊断为:尿路感染(90)。菌血症(36例)、SSTI(45例)、IAI(23例)、肺炎(17例)、尿路感染(13例)、骨髓炎(11例)、糖尿病足(6例)。产esbls细菌对美罗培南的敏感性为100%,对头孢他啶-阿维巴坦的敏感性为99%,对头孢氯氮唑/他唑巴坦的敏感性为90%。铜绿假单胞菌对头孢他啶-阿维巴坦的敏感性为73%,对头孢甲苯/他唑巴坦的敏感性为62%,对美罗培南的敏感性为62%,对头孢双普罗的敏感性为45%。CRE对头孢他啶-阿维巴坦的敏感性为38%,KPC为15%,而头孢奥唑坦的敏感性为零,CRE为14%,Ceftobiprole Medocaril为0%。结论头孢他啶-阿维巴坦和头孢托ozane/他唑巴坦可能是治疗esbls产生者和P. aeruginosa的有效替代药物,尽管耐多药细菌在国内广泛使用前对新引进的药物表现出一定的耐药性。
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引用次数: 1
Antimicrobial resistance of bacterial isolates from the clinical and hospital environment in Gaza Strip, Palestine: A review over 20-year 巴勒斯坦加沙地带临床和医院环境中分离细菌的抗菌素耐药性:20年来的回顾
Pub Date : 2021-01-01 DOI: 10.3823/859
A. Elmanama, Noor E. S. Abu Tayyem, Isabella Sjölander
Background: Antimicrobial resistance is a serious threatening problem worldwide, associated with high morbidity and mortality. The dissemination and spread of antibiotic-resistant bacteria is influenced by several factors like inappropriate and unwise use of antibiotics as well as the un-regulated discharge of these antibiotics to the environment. A critical high rates of pathogenic bacteria isolates in Palestine are showing multiple drug resistance patterns. This fact will complicate treatment of patients suffering from bacterial infections. Method: The study performed a review of most published articles on antibiotic resistant bacteria isolates from patients and hospital environment in Gaza strip/Palestine over the period 2002-2021 using Google scholar, Research gate, and PubMed search engines. Results: Out of the 51 articles screened, 29 studies were met the eligibility criteria to be included in this review. The overall results of these studies have shown a high rates of multidrug-resistant gramnegative bacteria especially E. coli, Enterobacter spp., Kebsiella spp., Acinetobacter spp. and Pseudomonas aerugineosa over the study period. Also, vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus were also commonly reported among Gram-positive bacteria. Conclusions: The high occurrence rates of multidrug resistant bacteria isolates from patients and hospital environment in Gaza/Palestine is alarming. Therefore, there is an urgent need to develop a local plan for containment of antimicrobial resistance by implement antimicrobial stewardship. Antimicrobial resistance of bacterial isolates from the clinical and hospital environment in Gaza Strip, Palestine: A review over 20-year Abdelraouf A. Elmanama1, Noor E. S. Abu Tayyem1, Isabella Sjölander2 1 Department of Medical Laboratory Sciences Faculty of Health Sciences Islamic University of Gaza, P.O. Box 108, Gaza Strip, Gaza, State of Palestine. 2 Uppsala University, Sweden. Contact information: Noor E. S. Abu Tayyem.  nooreabutayyem@gmail.com.
背景:抗菌素耐药性是世界范围内的一个严重威胁问题,与高发病率和死亡率有关。抗生素耐药细菌的传播和扩散受到几个因素的影响,例如不适当和不明智地使用抗生素以及不受管制地向环境排放这些抗生素。在巴勒斯坦,极高的致病菌分离率显示出多种耐药模式。这一事实将使细菌感染患者的治疗复杂化。方法:本研究使用Google scholar、Research gate和PubMed搜索引擎,对2002-2021年期间从加沙地带/巴勒斯坦患者和医院环境中分离出的抗生素耐药细菌发表的大多数文章进行了回顾。结果:在筛选的51篇文章中,29项研究符合纳入本综述的资格标准。这些研究的总体结果表明,在研究期间,多重耐药革兰氏阴性菌的比例很高,特别是大肠杆菌、肠杆菌、克伯氏菌、不动杆菌和铜绿假单胞菌。此外,在革兰氏阳性菌中也经常报道万古霉素耐药肠球菌和耐甲氧西林金黄色葡萄球菌。结论:加沙/巴勒斯坦患者和医院环境中分离出的耐多药细菌的高发生率令人震惊。因此,迫切需要制定一项地方计划,通过实施抗菌素管理来控制抗菌素耐药性。巴勒斯坦加沙地带临床和医院环境中分离的细菌的抗菌素耐药性:20年来的回顾Abdelraouf A. Elmanama1, Noor E. S. Abu Tayyem1, Isabella Sjölander2 1加沙伊斯兰大学医学化验系卫生科学学院,巴勒斯坦加沙地带,加沙地带。2乌普萨拉大学,瑞典。联系方式:Noor E. S. Abu Tayyem。nooreabutayyem@gmail.com。
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引用次数: 3
Emerging ceftazidime-avibactam resistance against carbapenem resistant Escherichia coli and Klebsiella pneumoniae in Lebanon 黎巴嫩对碳青霉烯类耐药大肠杆菌和肺炎克雷伯菌出现头孢他啶-阿维巴坦耐药性
Pub Date : 2021-01-01 DOI: 10.3823/858
Ghena M Sobh, Abdul Karim El Karaaoui, M. E. Chaar, G. Araj
Ceftazidime-avibactam (CZA) has been introduced as a novel drug to essentially combat the rising trends of carbapenem resistant Enterobacteriaceae. In the absence of in vitro data about the activity of this drug against carbapenem resistant (CR) Escherichia coli and Klebsiella pneumoniae in Lebanon, this study was warranted.
头孢他啶-阿维巴坦(CZA)是一种新型药物,主要用于对抗碳青霉烯耐药肠杆菌科的上升趋势。由于缺乏该药物在黎巴嫩抗碳青霉烯耐药(CR)大肠杆菌和肺炎克雷伯菌活性的体外数据,因此本研究是有必要的。
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引用次数: 0
Assessment of Urinalysis Reflex to Culture Criteria: Impact on Antimicrobial Usage 评估尿液分析对培养标准的反应:对抗菌药物使用的影响
Pub Date : 2020-10-31 DOI: 10.3823/851
Mohammad Ourani, N. Honda, W. MacDonald, Jill C. Roberts
Objectives: To assess the predictive value of the urinalysis (UA) reflex criteria’s parameters and to evaluate the criteria’s impact on antimicrobial usage Methods: A prospective study using laboratory data was conducted on inpatient urine samples with orders placed for Urinalysis Reflex Culture (UARC) in a 400-bed acute care hospital. A total of 4016 urine samples were collected and examined between February and April 2020. The UA results were then subjected to the laboratory UA reflex criteria for reflecting UA to culture.  Multivariable logistic regression was utilized in evaluating the effectiveness of the criteria’s parameters to predict positive urine cultures Results: The total number of the positive UA reflex samples was 1539, which accounted for 38.3% of all the UA samples. Moreover, those positive UA samples were reflexed to urine cultures. Among the urine samples that were cultured, 45.1% (n = 694) were negative urine cultures while 54.9% (n = 845) were positive urine cultures. The UA reflex criterion was associated with positive predictive values for positive urine cultures between 26.30% and 92.96%. Conclusions: The current Laboratory UA reflex criterion is not highly effective in predicting positive urine culture, thus potentially leading to the inappropriate antimicrobial usage.
目的:评估尿分析(UA)反射标准参数的预测价值,并评估该标准对抗菌药物使用的影响。方法:利用实验室数据对某400张床位的急诊科医院住院患者尿样进行尿分析反射培养(UARC)。在2020年2月至4月期间,共收集和检查了4016份尿液样本。然后将UA结果置于实验室UA反射标准以将UA反射到培养物中。采用多变量logistic回归评价标准参数预测尿培养阳性的有效性。结果:UA反射阳性样本总数为1539例,占全部UA样本的38.3%。此外,那些UA阳性的样本被反射到尿培养中。尿液培养样本中,阴性尿培养占45.1% (n = 694),阳性尿培养占54.9% (n = 845)。UA反射标准与阳性尿培养的阳性预测值在26.30%至92.96%之间相关。结论:目前的实验室UA反射标准在预测尿培养阳性方面不是很有效,因此可能导致不适当的抗菌药物使用。
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引用次数: 0
Evidence-Based Progressive Passage to Reopening American Societies Post COVID-19 以证据为基础的进步途径,重新开放美国社会后COVID-19
Pub Date : 2020-10-19 DOI: 10.3823/850
Z. Daoud, J. McLeod, O. Ikpatt, Magdalena Pérez, Mark G Atkins, Tracy SPeyer, D. Stockman
In the United States, the total number of confirmed reported cases of Covid-19 had reached  1.36 million with a total death of 80,574 and a total confirmed recoveries of 210,000 cases. Significant efforts have been invested to flatten the curve and control new cases appearing in the societies. Meanwhile, the governments has imposed a lockdown with the objective of controlling the transmission of the virus. The re-opening of societies is challenging and might involve threats, many of them remain unseen. We describe here a dynamic scenario to un-locking and re-opening societies using an evidence-based design, suggested by an algorithm of screening using RT-PCR and antibodies in a large population.
在美国,新冠肺炎确诊病例总数达到136万例,死亡80574例,确诊康复21万例。已经投入了巨大的努力,以使曲线趋于平缓,并控制社会中出现的新病例。与此同时,各国政府已实施封锁,目的是控制病毒的传播。社会的重新开放具有挑战性,并可能涉及威胁,其中许多威胁仍未被发现。我们在这里描述了一个动态的场景,解锁和重新开放社会使用基于证据的设计,建议使用RT-PCR和抗体在大量人群中筛选算法。
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引用次数: 0
A Ten Years Study of The Rates and Resistance Trends of the ESKAPE Bacteria Isolated from Sterile Body Sites (2010 – 2019) at a Single Hospital 2010 - 2019年某医院无菌部位ESKAPE菌率及耐药趋势的10年研究
Pub Date : 2020-10-19 DOI: 10.3823/847
J. Wadi Al Ramahi M.D, FIDSA, W. Jamal
Background To assess the rates and trends of resistance among ESKAPE pathogens during 2010 – 2019. Methods A retrospective, single-center study between 2010 –2019, non-duplicate isolates from six sterile sources were studied. Pathogens were processed through the  automated VITEK-2. The Clinical Laboratory Standards Institute (CLSI) breakpoints were referenced. The aim was to detect the rates and resistance trends of the ESKAPE pathogens, the rates of  ESBL-producing K. pneumoniae, and the carbapenem-resistant (CR)-K. pneumoniae, CRAb, CRPa, VRE, and MRSA for the inpatients. Trends for the prevalence and resistance rates were analyzed by linear regression. Missing values were averaged based on the neighboring values. Data analysis was by SPSS version 25, and statistical significance is considered for one-tailed P < 0.05. Results The ESKAPE bacteria (4286 isolate) comprised (45.57%) of the inpatients' isolates, the sterile sources consisted of 1421 (33.15%): K. pneumonia 272 isolates, the ESBL-producing K. pneumoniae significantly declined (Pearson R - 0.877, P = 0.001), CR-K. pneumoniae showed no significant trends (P = 0.475). P. aeruginosa 202 isolates; resistance to carbapenem (CRPa) averaged 42%. S. aureus 198 isolates; MRSA rates averaged 45%. A. baumannii 165 isolates; carbapenem-resistance (CRAb) average 93%. Vancomycin-resistant (VR)E. Faecium = 33%, and VRE. faecalis = 15% with a weighted average 17%. Enterobacter spp. resistance rates were: Amikacin 3.6%, Third and fourth generation cephalosporines 28% and 20% respectively, Quinolones 27% ± 3%, Piperacillin/tazobactam resistance 29%, Imipenem 15%, and Meropenem 27. Conclusion The ESKAPE pathogens were highly resistant, making treatment more complicated, and compromise the initial empiric treatment.  
背景评估2010 - 2019年ESKAPE病原菌的耐药率和趋势。方法对2010 -2019年6个无菌来源的非重复分离株进行回顾性单中心研究。病原体通过自动VITEK-2进行处理。参照临床实验室标准协会(CLSI)断点。目的是检测ESKAPE病原菌的感染率和耐药趋势、产esbl肺炎克雷伯菌的感染率以及碳青霉烯耐药(CR)-K。肺炎、螃蟹、CRPa、VRE和MRSA的住院患者。采用线性回归分析流行率和耐药率的变化趋势。缺失值基于相邻值平均。数据分析采用SPSS 25版,单侧P < 0.05认为有统计学意义。结果ESKAPE菌(4286株)占住院患者分离株(45.57%),无菌来源肺炎克雷伯菌(1421株)占肺炎克雷伯菌(33.15%)272株,产esbl的肺炎克雷伯菌明显下降(Pearson R = 0.877, P = 0.001), CR-K明显下降。肺炎无明显趋势(P = 0.475)。铜绿假单胞菌202分离株;对碳青霉烯(CRPa)的平均耐药性为42%。金黄色葡萄球菌198株;MRSA的平均发病率为45%。鲍曼不动杆菌165株;碳青霉烯耐药性(CRAb)平均93%。Vancomycin-resistant (VR) E。粪= 33%,VRE。粪球菌= 15%,加权平均值为17%。肠杆菌的耐药率为:阿米卡星3.6%,第三代和第四代头孢菌素分别为28%和20%,喹诺酮类药物为27%±3%,哌拉西林/他唑巴坦耐药29%,亚胺培南耐药15%,美罗培南耐药27%。结论ESKAPE病原菌耐药程度高,使治疗更加复杂,影响了初始经验性治疗。
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引用次数: 0
Trends of antimicrobial resistance in Escherichia coli isolates from urine cultures of women in Jordan: A 10-year retrospective study 约旦妇女尿液培养分离的大肠杆菌抗微生物药物耐药性趋势:一项10年回顾性研究
Pub Date : 2020-09-28 DOI: 10.3823/849
Mustafa Alrabayah, Nisreen Nadi, A. Suleiman, Ala' M. Abbad, Hadi Ghanem, Ahmad M. Obeidat, Maysarah Mahdi Alaqrabawi, M. Yousef, T. Harb, Isam K. Bsisu
Background: Urinary tract infection (UTI) is a common medical condition among women. E. coli is the most common causative organism. Appropriate understanding of the development of antimicrobial resistance over the past helps to establish efficient treatment strategies in the future. The study aims to determine the antimicrobial resistance trends exhibited by E. coli isolates from women urine cultures over the past 10 years. Methods: A total of 1874 positive urine samples over the years 2009 to 2018 were reviewed and classified according to the response to 24 different antimicrobial drugs in the laboratory. Relations between time and resistance evolutionary profiles were calculated. Results: Gentamicin (p value =0.039),amoxicillin(p value =0.017), cefoxitin (p value =0.001) and cefixime (p value =0.026) fulfilled satisfactory figures in terms of average resistance, regression of resistance, speed of resistance evolution, steadiness of performance, side effects, spectrum range and cost with high significance. Conclusion: Antibiotics that showed satisfactory susceptibility in culture are recommended for future treatment protocols of urinary tract infection in Jordan. Trends of antimicrobial resistance in Escherichia coli isolates from urine cultures of women in Jordan: A 10-year retrospective study Mustafa Alrabayah1, Nisreen Nadi2, Aiman Suleiman2, Ala' Abbad2, Hadil Ghanem2, Ahmad Obeidat2, Maysarah Alaqrabawi2, Mohammad Yousef2, Taima'a Harb2, Isam Bsisu2 1 Assistant professor at The University of Jordan School of Medicine/Amman. 2 Anesthesia and Intensive Care,The Jordan University Hospital/Amman, Jordan. Contact information: Dr. Nisreen Abdel-Kareem Nadi. Address: School of Medicine, The University of Jordan. PO Box 13046, Amman, 11942, Jordan.  nisreen.nadi@ymail.com
背景:尿路感染(UTI)是女性常见的疾病。大肠杆菌是最常见的致病菌。适当了解过去抗菌素耐药性的发展有助于在未来制定有效的治疗策略。该研究旨在确定在过去10年中从女性尿液培养中分离的大肠杆菌所表现出的抗微生物药物耐药性趋势。方法:对2009 - 2018年共1874份阳性尿样进行回顾性分析,并根据实验室对24种不同抗菌药物的反应情况进行分类。计算了时间与抗性进化曲线之间的关系。结果:庆大霉素(p值=0.039)、阿莫西林(p值=0.017)、头孢西丁(p值=0.001)、头孢克肟(p值=0.026)在平均耐药性、耐药性回归、耐药性演变速度、性能稳定性、副作用、谱域、成本等方面均达到满意水平,且具有高度显著性。结论:在约旦,尿路感染的培养敏感性良好的抗生素可作为今后尿路感染的治疗方案。约旦大学安曼医学院助理教授Mustafa Alrabayah1, Nisreen Nadi2, Aiman Suleiman2, Ala' Abbad2, Hadil Ghanem2, Ahmad Obeidat2, Maysarah alaqrabaw2, Mohammad youse2, Taima' A Harb2, Isam bsis2。2麻醉和重症监护,约旦大学医院/安曼,约旦。联系方式:Nisreen Abdel-Kareem Nadi博士。地址:约旦大学医学院。邮政信箱13046,安曼,11942,约旦。nisreen.nadi@ymail.com
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引用次数: 0
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The International Arabic Journal of Antimicrobial Agents
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