R. Waked, Danielle Jaafar, M. Chedid, G. Saliba, E. Haddad, J. Choucair
BACKGROUND: The role of the infectious disease specialist continues to evolve. The purpose of this study is to demonstrate the value of infectious disease consultation in the inpatient setting. METHODS: This is a prospective cohort study that took place in a tertiary care university hospital. During the period from April to June 2016, 224 cases of patients receiving antibiotics in the hospital with the request of an infectious diseases’ consultation, were evaluated. The following variables were assessed: the referring department, purpose of the consultation, the antibiotic used before requesting the infectious diseases consultation, the antibiotic modifications after the infectious disease’s visit, whenever the antibiotic usage was switched to a mono or bi-therapy. RESULTS: The most frequent requesting departments were Oncology (23.2%) and Urology (21.4%). The purpose of the consultations was diagnosis (29%), therapy (41%), both diagnosis and therapy (21%), and prophylaxis (9%). An infectious diseases consultation was given at a rate of 4.9 consultations per 100 hospitalized patients. Antibiotic was discontinued in 14.7% of cases. There was no indication for the antibiotic treatment in 11.6% of cases. Modifying the antibiotic therapy was done in 25.4% of cases. Adjusting the antibiotic dosage was done in only one case. Carbapenem antibiotics were discontinued in 31.6 % of cases and Quinolones discontinuation accounted for 22.7% of cases. CONCLUSION: Infectious disease consults contributed to the optimization of the diagnostic and therapeutic approaches for suspected or confirmed infections in hospitalized patients.
{"title":"Impact of the inpatient infectious disease consultations at a tertiary care university hospital","authors":"R. Waked, Danielle Jaafar, M. Chedid, G. Saliba, E. Haddad, J. Choucair","doi":"10.21203/rs.2.17410/v1","DOIUrl":"https://doi.org/10.21203/rs.2.17410/v1","url":null,"abstract":"BACKGROUND: The role of the infectious disease specialist continues to evolve. The purpose of this study is to demonstrate the value of infectious disease consultation in the inpatient setting. \u0000METHODS: This is a prospective cohort study that took place in a tertiary care university hospital. During the period from April to June 2016, 224 cases of patients receiving antibiotics in the hospital with the request of an infectious diseases’ consultation, were evaluated. The following variables were assessed: the referring department, purpose of the consultation, the antibiotic used before requesting the infectious diseases consultation, the antibiotic modifications after the infectious disease’s visit, whenever the antibiotic usage was switched to a mono or bi-therapy. \u0000RESULTS: The most frequent requesting departments were Oncology (23.2%) and Urology (21.4%). The purpose of the consultations was diagnosis (29%), therapy (41%), both diagnosis and therapy (21%), and prophylaxis (9%). An infectious diseases consultation was given at a rate of 4.9 consultations per 100 hospitalized patients. Antibiotic was discontinued in 14.7% of cases. There was no indication for the antibiotic treatment in 11.6% of cases. Modifying the antibiotic therapy was done in 25.4% of cases. Adjusting the antibiotic dosage was done in only one case. Carbapenem antibiotics were discontinued in 31.6 % of cases and Quinolones discontinuation accounted for 22.7% of cases. \u0000CONCLUSION: Infectious disease consults contributed to the optimization of the diagnostic and therapeutic approaches for suspected or confirmed infections in hospitalized patients.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75613339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fidsa Jamal Ahmad Wadi Al Ramahi, Omran Abu Khalaf, Lamya Abu Shanab, Mohammad Obaidat Pharm, M. Hasan, M. Mhanna, Maha Hashim Abdulghani
Background To compare the recent de-escalations rates with a six-year earlier study, and mortality associated with de-escalation. Methods Settings A prospective multicenter study including septic patients, all were on broad-spectrum antimicrobials (BSA). Excluded from the study patients on antimicrobial prophylaxis, and patients without a microbiological diagnosis, or bacteria were solely BSA-susceptible. The study team made recommendations for antimicrobials de-escalation to the treating physician(s) must an opportunity loomed. Results 182 patients were available for analysis. De-escalation was achieved in 43 (24%) patients. The clinical diagnoses, comorbidities, commonly used antimicrobials, the microbiological diagnoses were not different between the two groups (patients with and without de-escalation). Logistic regression analysis showed no correlation between bacterial species and de-escalation (Nagelkerke R2 = 0.076). Relapsing sepsis and reinfection were not different (P > 0.05). The in-hospital mortality rates for the de-escalated patients were lower (P = 0.015), not on day 30 (P = 0.354). The length of the ICU stay and ward stay were not different (P >0.05), but more de-escalated patients were discharged home from the ICU (P = 0.034), however, patients without de-escalation were discharged more from the ward (P = 0.002). Conclusion De-escalation rates increased within six years from 6.7% - 24% (P = 0.000), with added benefits of shorter ICU stay and less in-hospital mortality
{"title":"Compliance with antimicrobials de-escalation in septic patients and mortality rates","authors":"Fidsa Jamal Ahmad Wadi Al Ramahi, Omran Abu Khalaf, Lamya Abu Shanab, Mohammad Obaidat Pharm, M. Hasan, M. Mhanna, Maha Hashim Abdulghani","doi":"10.3823/836","DOIUrl":"https://doi.org/10.3823/836","url":null,"abstract":"Background \u0000To compare the recent de-escalations rates with a six-year earlier study, and mortality associated with de-escalation. \u0000Methods \u0000Settings \u0000A prospective multicenter study including septic patients, all were on broad-spectrum antimicrobials (BSA). Excluded from the study patients on antimicrobial prophylaxis, and patients without a microbiological diagnosis, or bacteria were solely BSA-susceptible. The study team made recommendations for antimicrobials de-escalation to the treating physician(s) must an opportunity loomed. \u0000Results \u0000182 patients were available for analysis. De-escalation was achieved in 43 (24%) patients. The clinical diagnoses, comorbidities, commonly used antimicrobials, the microbiological diagnoses were not different between the two groups (patients with and without de-escalation). Logistic regression analysis showed no correlation between bacterial species and de-escalation (Nagelkerke R2 = 0.076). Relapsing sepsis and reinfection were not different (P > 0.05). The in-hospital mortality rates for the de-escalated patients were lower (P = 0.015), not on day 30 (P = 0.354). The length of the ICU stay and ward stay were not different (P >0.05), but more de-escalated patients were discharged home from the ICU (P = 0.034), however, patients without de-escalation were discharged more from the ward (P = 0.002). \u0000 Conclusion \u0000De-escalation rates increased within six years from 6.7% - 24% (P = 0.000), with added benefits of shorter ICU stay and less in-hospital mortality","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81188489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hend Abdalla El sayed, NahlaAbdEL Hamid, Elsaed M. Galal ElBadrawy, S. Monem, F. Amer
Background: SEN virus (SENV) and Torque teno virus (TTV) are blood born viruses. Their effect on the development and progress of liver diseases is still unclear. The aim of this study was to determine the prevalence and effect of SENV and TTV among chronic hepatitis C (CHC) patients. Patients and Methods: two hundred patients with CHC were the subjects of this work. A single blood sample was collected from each patient. Thorough clinical examination and relevant laboratory and radiological investigations were done. SENV and TTV were tested for by polymerase chain reaction (PCR). Results: SENV was identified in 3 and TTV was found in 21 (10.5%) of patients. No statistically significant difference was detected as regards clinical status, laboratory findings or radiological examination between SENV or TTV positive and negative patients. Conclusion: SENV and TTV exist among CHC patients. They had insignificant implications on the course or progression of liver diseases.
{"title":"Prevalence and Clinical Significance of SEN-virus and TT- virus Infection in Chronic HCV Patients","authors":"Hend Abdalla El sayed, NahlaAbdEL Hamid, Elsaed M. Galal ElBadrawy, S. Monem, F. Amer","doi":"10.3823/835","DOIUrl":"https://doi.org/10.3823/835","url":null,"abstract":"Background: SEN virus (SENV) and Torque teno virus (TTV) are blood born viruses. Their effect on the development and progress of liver diseases is still unclear. The aim of this study was to determine the prevalence and effect of SENV and TTV among chronic hepatitis C (CHC) patients. \u0000Patients and Methods: two hundred patients with CHC were the subjects of this work. A single blood sample was collected from each patient. Thorough clinical examination and relevant laboratory and radiological investigations were done. SENV and TTV were tested for by polymerase chain reaction (PCR). \u0000Results: SENV was identified in 3 and TTV was found in 21 (10.5%) of patients. No statistically significant difference was detected as regards clinical status, laboratory findings or radiological examination between SENV or TTV positive and negative patients. \u0000Conclusion: SENV and TTV exist among CHC patients. They had insignificant implications on the course or progression of liver diseases. \u0000 \u0000 ","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"219 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77243434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Pseudomonas.aeruginosa is among the most common opportunistic hospital pathogens, which exhibit an innate resistance and has developed increasing resistance to many useful antimicrobial agents over the last decades. This study investigated the occurrence of important types of ESBLs and MBLs in association with potential important virulence factors among P. aeruginosa isolates from feces of Jordanian infants. Methods: A total of 302 feces samples were obtained randamely from neonates and infants admitted to Pediatric Clinic and the Neonate Intensive Care Unit (NICU)/Jordan University Hospital (JUH), over a 9-months period(2016- 2017). Fecal samples were cultured for P.aeruginosa and their growth was identified and tested using microbiological and antibiotic susceptibility methods. Additionly, virulence factors, antimicrobial resistance genes and genotypes were detected using Polymerase Chain Reaction (PCR). Results: A total of 16/302 (5.3%) of P. aeruginosa isolates were recovered from feces samples. Antimicrobial susceptibility of the isolates ranged between the lowest 18.75% to meropenem and highest of 87.5% to azetreonam among 9 tested drugs. The percentage of specific genes of ESBLs and MBLs in 16 P.aeruginosa isolates were the following: blaOXA-50, blaTEM, blaCTX-M , blaVIM ,blaKPC , blaSHV ,blaGES, and blaVEB were detected at the rate of 13(81.2%), 13(81.2%), 12(75%), 12(75%), 11(68.7%), 10(62.5%), 2(12.5),1(6.2%), respectively. The percentage of the potential virulence genes in the same isolates were detected as follow: lasB, algD , toxA, exo S and exo U at the rate of 100%, 87.5% , 81.2%, 81.2%,31.2, respectively. All P.aeruginosa isolates observed to develop beta-hemolysis on both human and sheep blood agar, and to produce either pyoverdin ((56.3%) or pyocyanin (43.7%). Conclusions: The present study demonstrates high occurrence of multidrug resistant P.aeruginosa isolates in infant feces which carried high rates of important genes of ESBLs and MBLs and potential virulence factors.
{"title":"Intestinal colonization of infants with multidrug resistant Pseudomonas aeruginos in tertiary care center in Jordan","authors":"A. Shehabi, Noor Issam Shishtawi, Manar Al-lawama","doi":"10.3823/834","DOIUrl":"https://doi.org/10.3823/834","url":null,"abstract":"Background: Pseudomonas.aeruginosa is among the most common opportunistic hospital pathogens, which exhibit an innate resistance and has developed increasing resistance to many useful antimicrobial agents over the last decades. This study investigated the occurrence of important types of ESBLs and MBLs in association with potential important virulence factors among P. aeruginosa isolates from feces of Jordanian infants. \u0000Methods: A total of 302 feces samples were obtained randamely from neonates and infants admitted to Pediatric Clinic and the Neonate Intensive Care Unit (NICU)/Jordan University Hospital (JUH), over a 9-months period(2016- 2017). Fecal samples were cultured for P.aeruginosa and their growth was identified and tested using microbiological and antibiotic susceptibility methods. Additionly, virulence factors, antimicrobial resistance genes and genotypes were detected using Polymerase Chain Reaction (PCR). \u0000Results: A total of 16/302 (5.3%) of P. aeruginosa isolates were recovered from feces samples. Antimicrobial susceptibility of the isolates ranged between the lowest 18.75% to meropenem and highest of 87.5% to azetreonam among 9 tested drugs. The percentage of specific genes of ESBLs and MBLs in 16 P.aeruginosa isolates were the following: blaOXA-50, blaTEM, blaCTX-M , blaVIM ,blaKPC , blaSHV ,blaGES, and blaVEB were detected at the rate of 13(81.2%), 13(81.2%), 12(75%), 12(75%), 11(68.7%), 10(62.5%), 2(12.5),1(6.2%), respectively. The percentage of the potential virulence genes in the same isolates were detected as follow: lasB, algD , toxA, exo S and exo U at the rate of 100%, 87.5% , 81.2%, 81.2%,31.2, respectively. All P.aeruginosa isolates observed to develop beta-hemolysis on both human and sheep blood agar, and to produce either pyoverdin ((56.3%) or pyocyanin (43.7%). \u0000Conclusions: The present study demonstrates high occurrence of multidrug resistant P.aeruginosa isolates in infant feces which carried high rates of important genes of ESBLs and MBLs and potential virulence factors. ","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88530137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Moraxella catarrhalis is an important bacterial pathogen. Although national data have shown an increase in the levels of antimicrobial resistance in clinical settings in Lebanon, there is a lack of data regarding this human pathogen. This study aimed to determine for the first time the antimicrobial susceptibility profiles of M. catarrhalis isolates in Lebanon. Methods. A total of 34 M. catarrhalis strains were isolated from clinical specimens during the period from November 2010 to March 2019. Bacterial identification was carried out using matrix assisted laser desorption ionization–time of flight mass spectrometry. Antibiotic susceptibility of all isolates was performed according the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Results. A total of 34 non-duplicated M. catarrhalis strains were isolated from nose (n=19), ear (n=7), sputum (n=5), blood (n=1), eye (n=1), and throat (n=1) of patients referred to Nini Hospital in Tripoli, North governorate of Lebanon. Regarding antibiotic susceptibility rates, the percent susceptibility is 100% to the majority of antibiotics, except ampicillin (7.4%), trimethoprim-sulfamethoxazole (85.3%), nalidixic acid (85.3%), and ciprofloxacin (97.1%). Conclusion. To our knowledge, this study is the first investigation regarding the antimicrobial susceptibility patterns of M. catarrhalis isolates in Lebanon. In addition to the high level of resistance to ampicillin, our findings showed the emergence of resistance to trimethoprim-sulfamethoxazole, nalidixic acid and ciprofloxacin. Even if this study provides useful information to develop effective empirical treatment, we recommend the implementation of reliable diagnostic tools to guide appropriate treatment.
{"title":"First data on antimicrobial susceptibility patterns of Moraxella catarrhalis isolates in Lebanon","authors":"M. Hamzé, Marwan Osman, H. Mallat, M. Achkar","doi":"10.3823/833","DOIUrl":"https://doi.org/10.3823/833","url":null,"abstract":"Background. Moraxella catarrhalis is an important bacterial pathogen. Although national data have shown an increase in the levels of antimicrobial resistance in clinical settings in Lebanon, there is a lack of data regarding this human pathogen. This study aimed to determine for the first time the antimicrobial susceptibility profiles of M. catarrhalis isolates in Lebanon. \u0000Methods. A total of 34 M. catarrhalis strains were isolated from clinical specimens during the period from November 2010 to March 2019. Bacterial identification was carried out using matrix assisted laser desorption ionization–time of flight mass spectrometry. Antibiotic susceptibility of all isolates was performed according the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). \u0000Results. A total of 34 non-duplicated M. catarrhalis strains were isolated from nose (n=19), ear (n=7), sputum (n=5), blood (n=1), eye (n=1), and throat (n=1) of patients referred to Nini Hospital in Tripoli, North governorate of Lebanon. Regarding antibiotic susceptibility rates, the percent susceptibility is 100% to the majority of antibiotics, except ampicillin (7.4%), trimethoprim-sulfamethoxazole (85.3%), nalidixic acid (85.3%), and ciprofloxacin (97.1%). \u0000Conclusion. To our knowledge, this study is the first investigation regarding the antimicrobial susceptibility patterns of M. catarrhalis isolates in Lebanon. In addition to the high level of resistance to ampicillin, our findings showed the emergence of resistance to trimethoprim-sulfamethoxazole, nalidixic acid and ciprofloxacin. Even if this study provides useful information to develop effective empirical treatment, we recommend the implementation of reliable diagnostic tools to guide appropriate treatment.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79468635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A hundred raw eggs samples randomly selected from Aswan university residence restaurant due to students' complain of bitter taste presence in the table eggs served to them during breakfast. The samples were examined physically and chemically for antibiotic residues and vitamins A, D3 levels concentration by Spectrophotometer. The result showed that all interior egg quality traits were normal except the presence of small blood spots in 5 eggs yolk, bitter taste were present in 18 eggs yolk, antimicrobial residues were detected in 19 eggs yolk and 4 eggs white. Antimicrobial residues positive samples were examined quantitatively by HPLC for Doxycycline (DC) residues presence. The results showed that 100% of examined samples having DC residues with means concentrations of 35±1.46 and 97±4.46 ppb for eggs white and yolk respectively. The mean levels of vitamin A and D3 in eggs yolk were 447±5.49 µg/100g and11±1.35 µg/100g respectively. The paper concludes that the high concentrations of Vitamins and Doxycycline may be the cause of bitter taste of egg.
{"title":"Impact of misuse of antimicrobial agents on egg bitterness","authors":"M. Karmi, A. Zakaria, M. Khalifa","doi":"10.3823/832","DOIUrl":"https://doi.org/10.3823/832","url":null,"abstract":"A hundred raw eggs samples randomly selected from Aswan university residence restaurant due to students' complain of bitter taste presence in the table eggs served to them during breakfast. The samples were examined physically and chemically for antibiotic residues and vitamins A, D3 levels concentration by Spectrophotometer. The result showed that all interior egg quality traits were normal except the presence of small blood spots in 5 eggs yolk, bitter taste were present in 18 eggs yolk, antimicrobial residues were detected in 19 eggs yolk and 4 eggs white. Antimicrobial residues positive samples were examined quantitatively by HPLC for Doxycycline (DC) residues presence. The results showed that 100% of examined samples having DC residues with means concentrations of 35±1.46 and 97±4.46 ppb for eggs white and yolk respectively. The mean levels of vitamin A and D3 in eggs yolk were 447±5.49 µg/100g and11±1.35 µg/100g respectively. The paper concludes that the high concentrations of Vitamins and Doxycycline may be the cause of bitter taste of egg.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76617422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isam K. Bsisu, Zaina Obeidat, N. Ababneh, Mai Altous, M. Obeidat, Mousa A Amer, Mona Freihat, H. Khalil, Randa I. Farah, Rasha Bsisu, M. Mansour, A. Mahafzah, N. Obeidat
Background Lower respiratory tract infection (LRTI) is the most common condition treated in primary care and is considered the third leading cause of death worldwide. The objective of our study is to determine the etiological agents that cause viral LRTI in Jordan, aiming to help physicians to choose the appropriate treatment strategy. Materials and Methods We conducted a retrospective study on patients who were admitted with the diagnosis of LRTI between January, 2011 and January, 2016. We used Fast-track Diagnostics (FTD)® Respiratory 21 Kit (Fast-track Diagnostics, Luxembourg) real-time PCR to determine the viral etiology of LRTI, and we investigated pandemic H1N1 2009 swine flu virus using rapid test PCR. Results This study involved 495 patients with a mean age of 57.79 ± 18.43 years. The causative agents were identified in 157 patients out of 495 patients (31.7%). FTD real-time PCR was done for 170 patients, and the test was positive for seasonal Influenza A virus in 7.1% of patients, influenza B in 4.1%, RSV in 4.7%, metapneumovirus in 4.1%, adenovirus in 4.1%, corona 229E/NL63 in 4.1%, parainfluenza virus in 7.6%, and rhinovirus in 3.5%. The percent of cases who were positive for pandemic H1N1 2009 swine flu virus was 4.2%. The rate of ICU admission was 16.8%, and the mortality rate of LRTI was as low as 3.64%. Conclusions Viral LRTI is more common in winter season in Jordan, especially in January. Remarkably, Influenza A and Parainfluenza viruses were the main viral causative agents for LRTI in our study.
{"title":"The Etiology of Viral Lower Respiratory Tract Infections at a Tertiary Hospital in Jordan over Five Years","authors":"Isam K. Bsisu, Zaina Obeidat, N. Ababneh, Mai Altous, M. Obeidat, Mousa A Amer, Mona Freihat, H. Khalil, Randa I. Farah, Rasha Bsisu, M. Mansour, A. Mahafzah, N. Obeidat","doi":"10.3823/831","DOIUrl":"https://doi.org/10.3823/831","url":null,"abstract":"Background \u0000Lower respiratory tract infection (LRTI) is the most common condition treated in primary care and is considered the third leading cause of death worldwide. The objective of our study is to determine the etiological agents that cause viral LRTI in Jordan, aiming to help physicians to choose the appropriate treatment strategy. \u0000Materials and Methods \u0000We conducted a retrospective study on patients who were admitted with the diagnosis of LRTI between January, 2011 and January, 2016. We used Fast-track Diagnostics (FTD)® Respiratory 21 Kit (Fast-track Diagnostics, Luxembourg) real-time PCR to determine the viral etiology of LRTI, and we investigated pandemic H1N1 2009 swine flu virus using rapid test PCR. \u0000Results \u0000This study involved 495 patients with a mean age of 57.79 ± 18.43 years. The causative agents were identified in 157 patients out of 495 patients (31.7%). FTD real-time PCR was done for 170 patients, and the test was positive for seasonal Influenza A virus in 7.1% of patients, influenza B in 4.1%, RSV in 4.7%, metapneumovirus in 4.1%, adenovirus in 4.1%, corona 229E/NL63 in 4.1%, parainfluenza virus in 7.6%, and rhinovirus in 3.5%. The percent of cases who were positive for pandemic H1N1 2009 swine flu virus was 4.2%. The rate of ICU admission was 16.8%, and the mortality rate of LRTI was as low as 3.64%. \u0000Conclusions \u0000Viral LRTI is more common in winter season in Jordan, especially in January. Remarkably, Influenza A and Parainfluenza viruses were the main viral causative agents for LRTI in our study.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75205138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Alsayed, Malek Alzihlif, Fidsa Jamal Ahmad Wadi Al Ramahi
Background: Staphylococcus aureus is a serious pathogen with high rates of complications. We aim to study the susceptibility and outcome of S. aureus infection. Methods: A retrospective multicentre study conducted in three hospitals, Amman - Jordan. Between June 2013 and March 2014 laboratory records were reviewed for culture-positive samples growing S. aureus, also, medical records for the patients were reviewed for the demographic data, predisposing conditions, vancomycin MIC level and outcome. Inpatients and outpatients were included, a case was classified as either hospital-associated (HA), community-associated (CA), or healthcare-associated (HCA). Data were entered as excel sheets and were statistically analysed using SPSS version 22. Results: A total of 127 patient (46% MRSA) were culture-positive for S. aureus from different sources were collected. Eighty (63%) were inpatients. High resistance rates to non β-lactam antimicrobials were recorded. Glycopeptides agents were the antibiotics of choice for the treatment of infections caused by MRSA strains. Complications rates were higher for patients with MRSA infections including mortality, but hospital stay was longer for MSSA. Conclusion MRSA rates were high though it lately appeared plateauing in Jordan. There is a value for knowing vancomycin MICs for S. aureus as it has its own implications for outcomes, though most outcomes evaluated were significantly worse with MRSA infection.
背景:金黄色葡萄球菌是一种严重的病原体，并发症发生率高。我们的目的是研究金黄色葡萄球菌感染的敏感性和结果。方法:在约旦安曼的三家医院进行回顾性多中心研究。2013年6月至2014年3月期间，对金黄色葡萄球菌培养阳性样本的实验室记录进行了审查，并对患者的医疗记录进行了审查，包括人口统计数据、易感条件、万古霉素MIC水平和结局。纳入住院和门诊患者，病例分为医院相关(HA)、社区相关(CA)或卫生保健相关(HCA)。数据以excel表格形式输入，并使用SPSS version 22进行统计分析。结果:共收集不同来源金黄色葡萄球菌培养阳性127例(46%)。住院患者80例(63%)。对非β-内酰胺类抗菌素的高耐药率被记录。糖肽类药物是治疗MRSA菌株引起的感染的首选抗生素。MRSA感染患者的并发症发生率更高，包括死亡率，但MSSA患者的住院时间更长。结论耐甲氧西林金黄色葡萄球菌在约旦的感染率较高，但近期呈稳定期。了解万古霉素对金黄色葡萄球菌的mic是有价值的，因为它对结果有自己的影响，尽管大多数评估的结果与MRSA感染明显更差。
{"title":"Relevance of vancomycin suceptibility on patients outcome infected with Staphylococcus aureus","authors":"A. Alsayed, Malek Alzihlif, Fidsa Jamal Ahmad Wadi Al Ramahi","doi":"10.3823/830","DOIUrl":"https://doi.org/10.3823/830","url":null,"abstract":"Background: Staphylococcus aureus is a serious pathogen with high rates of complications. We aim to study the susceptibility and outcome of S. aureus infection. Methods: A retrospective multicentre study conducted in three hospitals, Amman - Jordan. Between June 2013 and March 2014 laboratory records were reviewed for culture-positive samples growing S. aureus, also, medical records for the patients were reviewed for the demographic data, predisposing conditions, vancomycin MIC level and outcome. Inpatients and outpatients were included, a case was classified as either hospital-associated (HA), community-associated (CA), or healthcare-associated (HCA). Data were entered as excel sheets and were statistically analysed using SPSS version 22. Results: A total of 127 patient (46% MRSA) were culture-positive for S. aureus from different sources were collected. Eighty (63%) were inpatients. High resistance rates to non β-lactam antimicrobials were recorded. Glycopeptides agents were the antibiotics of choice for the treatment of infections caused by MRSA strains. Complications rates were higher for patients with MRSA infections including mortality, but hospital stay was longer for MSSA. Conclusion MRSA rates were high though it lately appeared plateauing in Jordan. There is a value for knowing vancomycin MICs for S. aureus as it has its own implications for outcomes, though most outcomes evaluated were significantly worse with MRSA infection.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"144 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91554330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fidsa Jamal Ahmad Wadi Al Ramahi, Nidal Hamad, H. Annab, K. Khalidi, Omran Abu Khalaf, M. Obaidat
We report a case of hemorrhagic pericarditis caused by Mycobacterium tuberculosis infection of the pericardium which is an extremely rare diagnosis. The literature review showed that there were rare cases of tuberculosis-causing hemorrhagic pericarditis, but the diagnosis was made either postmortem or not firmly diagnosed. Our patient was diagnosed as hemorrhagic pericarditis due to M. tuberculosis, he was treated and was discharged.
{"title":"A Patient Presented with High Fever and Bloody Pericardial Effusion (Hemorrhagic Pericarditis)","authors":"Fidsa Jamal Ahmad Wadi Al Ramahi, Nidal Hamad, H. Annab, K. Khalidi, Omran Abu Khalaf, M. Obaidat","doi":"10.3823/829","DOIUrl":"https://doi.org/10.3823/829","url":null,"abstract":"We report a case of hemorrhagic pericarditis caused by Mycobacterium tuberculosis infection of the pericardium which is an extremely rare diagnosis. The literature review showed that there were rare cases of tuberculosis-causing hemorrhagic pericarditis, but the diagnosis was made either postmortem or not firmly diagnosed. Our patient was diagnosed as hemorrhagic pericarditis due to M. tuberculosis, he was treated and was discharged.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82169152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Alsalman, Y. Alalwan, Mohamed Redha Rajab, N. Saeed
Background: Hospital acquired infections increase the morbidity and mortality of the inpatient population. Pathogens like Staphylococcus aureus and Enterococci are transmitted by direct contact or transmitted by fomites such as healthcare personnel’s attires. This is a cross-sectional study aimed to explore the prevalence ofcontamination of the attires of healthcare personnel working atSalmanyia Medical Complex. Method: We randomly selected 100 doctors and nurses working in different departmentsand swabbed their attire's sleeves and pockets. We then stored both swabs in their accompanying syringe that contains a bacterial transportation media, and sent them to the lab for culturing. SPSS 23 was used for data entry and analysis. After that, percentages and frequencies were computed for different categorical variables, and a cross-tabulation was computed between each two categorical variables. Chi-Squared test was used to determine whether there were significant relationships between each two categorical variables. Results:Of the total samples, 44 pocket and 45 cuff samples were contaminated with staphylococcus epidermidis (skin flora). Thirty eight participants were found to have contamination of both the cuff and pocket. Nurseshad slightly higher prevalence of cuff contamination than doctors (P=0.032). Amongst doctors, surgeons had the highest prevalence (P=0.006). Discussion:Compared to the data available in the literature, our data did not reveal contamination with significant pathogens such as staphylococcus aureus or MRSA.Nevertheless, contamination with staphylococcus epidermidis could be whether from autoinoculation or contamination from the hospital environment and could correlate to level of hygiene. Frequent washing of attire doesn’t reduce the level of contamination.
{"title":"Bugs on Cuffs and Pockets: A Cross-sectional Study of the Contamination of Healthcare Personnel Attire at Salmanyia Medical Complex","authors":"J. Alsalman, Y. Alalwan, Mohamed Redha Rajab, N. Saeed","doi":"10.3823/828","DOIUrl":"https://doi.org/10.3823/828","url":null,"abstract":"Background: Hospital acquired infections increase the morbidity and mortality of the inpatient population. Pathogens like Staphylococcus aureus and Enterococci are transmitted by direct contact or transmitted by fomites such as healthcare personnel’s attires. This is a cross-sectional study aimed to explore the prevalence ofcontamination of the attires of healthcare personnel working atSalmanyia Medical Complex. \u0000Method: We randomly selected 100 doctors and nurses working in different departmentsand swabbed their attire's sleeves and pockets. We then stored both swabs in their accompanying syringe that contains a bacterial transportation media, and sent them to the lab for culturing. SPSS 23 was used for data entry and analysis. After that, percentages and frequencies were computed for different categorical variables, and a cross-tabulation was computed between each two categorical variables. Chi-Squared test was used to determine whether there were significant relationships between each two categorical variables. \u0000Results:Of the total samples, 44 pocket and 45 cuff samples were contaminated with staphylococcus epidermidis (skin flora). Thirty eight participants were found to have contamination of both the cuff and pocket. Nurseshad slightly higher prevalence of cuff contamination than doctors (P=0.032). Amongst doctors, surgeons had the highest prevalence (P=0.006). \u0000Discussion:Compared to the data available in the literature, our data did not reveal contamination with significant pathogens such as staphylococcus aureus or MRSA.Nevertheless, contamination with staphylococcus epidermidis could be whether from autoinoculation or contamination from the hospital environment and could correlate to level of hygiene. Frequent washing of attire doesn’t reduce the level of contamination.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82415491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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