This is a case of young patient presented with granulomatous anterior and posterior uveitis, which turned to be fungal endophthalmitis after penetrating keratoplasty. Her symptoms were undetected because she was on systemic and topical steroids. Key words: Candida, Endophthalmiltis, Penetrating Keratoplasty, negative donner rim. The patient is 25 years old Caucasian female patient, previously medically free, who visited our department in the city of Amman, Jordan, for left penetrating keratoplasty for severe keratoconus. After an initial improvement in her vision and a smooth postoperative course, she presented with drop of vision, photophobia, and non-specific eye pain, on examination was found to have anterior granulomatous uveitis. She was started on systemic steroids and the topical steroids were increased in intensity. The initial systemic workup for granulomatous anterior uveitis was negative. However, culture from the aqueous was positive for Candida Galibrata, but the donor rim was negative. Later on the patient developed vitritis despite being on systemic fluconazole and topical Amphotericin B. She was treated with intravitreal Amphotericin B. The vitritis improved, but vitreous opacities developed which deteriorated her vision. A parsplana vitetrectony was done. Her final visual acuity remained poor because of opacified graft. The patient’s unfortunate case represents a Candida endophthalmitis after penetrating keratoplasty despite being medically free.
{"title":"Candida Endophthalmiltis Following Penetrating Keratoplasty in Patient with Negative Donor Rim; A case report with review literature of diagnosis and treatment of fungal endophthalmitis.","authors":"Mouna M. AlSaad, Sohaib Alkowni","doi":"10.3823/0807","DOIUrl":"https://doi.org/10.3823/0807","url":null,"abstract":"This is a case of young patient presented with granulomatous anterior and posterior uveitis, which turned to be fungal endophthalmitis after penetrating keratoplasty. Her symptoms were undetected because she was on systemic and topical steroids. \u0000Key words: Candida, Endophthalmiltis, Penetrating Keratoplasty, negative donner rim. \u0000The patient is 25 years old Caucasian female patient, previously medically free, who visited our department in the city of Amman, Jordan, for left penetrating keratoplasty for severe keratoconus. After an initial improvement in her vision and a smooth postoperative course, she presented with drop of vision, photophobia, and non-specific eye pain, on examination was found to have anterior granulomatous uveitis. She was started on systemic steroids and the topical steroids were increased in intensity. The initial systemic workup for granulomatous anterior uveitis was negative. However, culture from the aqueous was positive for Candida Galibrata, but the donor rim was negative. Later on the patient developed vitritis despite being on systemic fluconazole and topical Amphotericin B. She was treated with intravitreal Amphotericin B. \u0000The vitritis improved, but vitreous opacities developed which deteriorated her vision. A parsplana vitetrectony was done. \u0000Her final visual acuity remained poor because of opacified graft. \u0000The patient’s unfortunate case represents a Candida endophthalmitis after penetrating keratoplasty despite being medically free.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"158 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85563583","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}
Critically septic patients carry high mortality; however, it may be ameliorated to some extent by the appropriate prescription of antimicrobials and appropriate dosing strategy. Drug metabolism in critically septic patients differ from other less critical patients, and antimicrobial treatment need to be adjusted to prevent under dosing. The augmented clearance, acute kidney injury, microvascular ischemia, all affect antimicrobials’ levels. Methods of antimicrobial administration were explored, continuous infusion versus intermittent bolus, with the aim of maximizing drug exposure, hitherto, apart from PK/PD advantage, it was not translated clearly into patients’ clinical outcome. Biofilms have a unique management as they need elevated antimicrobial dosages to assure adequate drug exposure, and agents that work directly on biofilms to assure its disruption. Application of PK/PD knowledge in the management of critically septic patients maximize the clinical outcome and assures proper drug exposure, avoiding under dosing and drug toxicity, and decreasing the chance of antimicrobials mutant’s selection, and therapy failures. Pharmacokinetics/pharmacodynamics consideration in treating critically septic patients and correlates of bacterial killing: a review article Jamal Wadi MD, FIDSA1 1 The Medical Center, Jordan Hospital and Medical Center. 29 Adeeb Wahbah Street. Amman, Jordan 1118. Contact information:
{"title":"Pharmacokinetics / pharmacodynamics consideration in treating critically septic patients and correlates of bacterial killing: a review article","authors":"J. Wadi","doi":"10.3823/0806","DOIUrl":"https://doi.org/10.3823/0806","url":null,"abstract":"Critically septic patients carry high mortality; however, it may be ameliorated to some extent by the appropriate prescription of antimicrobials and appropriate dosing strategy. Drug metabolism in critically septic patients differ from other less critical patients, and antimicrobial treatment need to be adjusted to prevent under dosing. The augmented clearance, acute kidney injury, microvascular ischemia, all affect antimicrobials’ levels. Methods of antimicrobial administration were explored, continuous infusion versus intermittent bolus, with the aim of maximizing drug exposure, hitherto, apart from PK/PD advantage, it was not translated clearly into patients’ clinical outcome. Biofilms have a unique management as they need elevated antimicrobial dosages to assure adequate drug exposure, and agents that work directly on biofilms to assure its disruption. Application of PK/PD knowledge in the management of critically septic patients maximize the clinical outcome and assures proper drug exposure, avoiding under dosing and drug toxicity, and decreasing the chance of antimicrobials mutant’s selection, and therapy failures. Pharmacokinetics/pharmacodynamics consideration in treating critically septic patients and correlates of bacterial killing: a review article Jamal Wadi MD, FIDSA1 1 The Medical Center, Jordan Hospital and Medical Center. 29 Adeeb Wahbah Street. Amman, Jordan 1118. Contact information:","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77775524","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}
Ear, Nose & Throat (ENT) and acute respiratory tract (ART) infections are the main causes of inappropriate antibiotic prescribing. To evaluate the antibiotics prescribing practices for these infections, we conduct an observational study with 23 general practionners (GPs) working in private offices of the East Central Region of Tunisia. Among the 374 patients presenting ENT or ART infections, 193 were men (51.6%). The mean age was 45.6 ± 16.7 years. Comorbidities were present in 174 patients (51.9%). The first visit was made 3.7 ± 6 days after the beginning of the symptoms. The main diagnoses are acute bronchitis (37.4%), tonsillitis (33.4%) and acute maxillary sinusitis (20.9%). Additional tests (chest-X-ray and Lab-test) were prescribed for only 75 patients (20%). An antibiotic was prescribed for 360 patients (96.2%), for an average of 9.1 ± 2.3 days. The main prescribed antibiotics are β-lactams (58.3%), fluoroquinolones (23.5%) and macrolides (15.6%). Overall, the rate of inappropriate antibiotic prescription was 34.1%, the highest rates was noted in Exacerbation of the COPD (73.2%) and pneumonia (42.1%). Antipyretics and corticosteroids were prescribed in 71.4% and 44.7% respectively. The clinical success rate was noted in 375 cases (89%). The average cost of an infectious episode amounts to about $ 45 ± 20. This study underlines over-prescribing of antibiotics with unnecessary additional costs which may be related to the non-use of diagnostic tools. National guidelines should be developed in order to reduce unnecessary antibiotic prescription and emerging of bacterial resistance. Antibiotherapy management of respiratory infections in ambulatory in Tunisia M. Chakroun1, A. Chakroun1, M. Hsaïri2, Working group3 1 Department of Infectious Diseases. Fattouma Bourguiba Teaching Hospital. Monastir. 2 Department of epidemiology and medicine preventive. Faculty of Medicine. Tunis. 3 List of participating authors on page 7. Contact information:
耳鼻喉科(ENT)和急性呼吸道(ART)感染是抗生素处方不当的主要原因。为了评估这些感染的抗生素处方做法，我们对在突尼斯中东部地区私人诊所工作的23名全科医生(gp)进行了一项观察性研究。在374例出现耳鼻喉科或抗逆转录病毒治疗感染的患者中，男性193例(51.6%)。平均年龄45.6±16.7岁。174例(51.9%)患者存在合并症。首次访视时间为症状出现后3.7±6天。主要诊断为急性支气管炎(37.4%)、扁桃体炎(33.4%)和急性上颌窦炎(20.9%)。只有75名患者(20%)接受了额外的检查(胸部x光检查和实验室检查)。360例(96.2%)患者使用抗生素，平均使用时间为9.1±2.3天。主要处方抗生素为β-内酰胺类(58.3%)、氟喹诺酮类(23.5%)和大环内酯类(15.6%)。总体而言，抗生素处方不当率为34.1%，其中COPD加重(73.2%)和肺炎(42.1%)的比例最高。退烧药和皮质激素分别占71.4%和44.7%。临床成功率375例(89%)。一次感染发作的平均费用约为45±20美元。这项研究强调了抗生素的过度处方和不必要的额外费用，这可能与不使用诊断工具有关。应制定国家指南，以减少不必要的抗生素处方和细菌耐药性的出现。突尼斯门诊呼吸道感染的抗生素治疗M. Chakroun1, A. Chakroun1, M. Hsaïri2，传染病科第三工作组。法图玛布尔吉巴教学医院。莫纳斯提尔2流行病学和医学预防学系。医学院。突尼斯。3参与作者名单见第7页。联系信息:
{"title":"Antibiotherapy management in respiratory infections in ambulatory in Tunisia","authors":"M. Chakroun, A. Chakroun, M. Hsairi","doi":"10.3823/0805","DOIUrl":"https://doi.org/10.3823/0805","url":null,"abstract":"Ear, Nose & Throat (ENT) and acute respiratory tract (ART) infections are the main causes of inappropriate antibiotic prescribing. To evaluate the antibiotics prescribing practices for these infections, we conduct an observational study with 23 general practionners (GPs) working in private offices of the East Central Region of Tunisia. Among the 374 patients presenting ENT or ART infections, 193 were men (51.6%). The mean age was 45.6 ± 16.7 years. Comorbidities were present in 174 patients (51.9%). The first visit was made 3.7 ± 6 days after the beginning of the symptoms. The main diagnoses are acute bronchitis (37.4%), tonsillitis (33.4%) and acute maxillary sinusitis (20.9%). Additional tests (chest-X-ray and Lab-test) were prescribed for only 75 patients (20%). An antibiotic was prescribed for 360 patients (96.2%), for an average of 9.1 ± 2.3 days. The main prescribed antibiotics are β-lactams (58.3%), fluoroquinolones (23.5%) and macrolides (15.6%). Overall, the rate of inappropriate antibiotic prescription was 34.1%, the highest rates was noted in Exacerbation of the COPD (73.2%) and pneumonia (42.1%). Antipyretics and corticosteroids were prescribed in 71.4% and 44.7% respectively. The clinical success rate was noted in 375 cases (89%). The average cost of an infectious episode amounts to about $ 45 ± 20. This study underlines over-prescribing of antibiotics with unnecessary additional costs which may be related to the non-use of diagnostic tools. National guidelines should be developed in order to reduce unnecessary antibiotic prescription and emerging of bacterial resistance. Antibiotherapy management of respiratory infections in ambulatory in Tunisia M. Chakroun1, A. Chakroun1, M. Hsaïri2, Working group3 1 Department of Infectious Diseases. Fattouma Bourguiba Teaching Hospital. Monastir. 2 Department of epidemiology and medicine preventive. Faculty of Medicine. Tunis. 3 List of participating authors on page 7. Contact information:","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73492943","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}
Shereen Z Burjaq, Saeid M Abu-Romman, Moawya A. Haddad
Objective: Contamination of surface water with pathogenic organism is highly dangerous for people who used it for drinking or for domestic activities. Detection of Escherichia coli in water can be used as a general important indicator of fecal contamination. This study investigated the occurrence of fecal E. coli, two important toxigenic types of E. coli isolates and their antimicrobial resistance in water samples collected from the surface running source of Wadi Shueib in Jordan. Methods: A total of 51 water samples were collected from three different locations of wadi shueib over a three month, July through September, 2016. For each sample, 200 ml of water was collected in sterilized containers. All samples which were positive for fecal E. coli were subcultured on Eosin Methylelne Blue Agar and incubated at 37 oC for 24 hours. E. coli isolates were identified by API20 E test, and all isolates were tested for antimicrobial susceptibility and for the presence of virulence genes of enterotoxigenic E.coli (ETEC) and enterohaemorrhagic E.coli (EHEC). Results: A total of 46/51 (90%) of water samples were contaminated with fecal E. coli. The 46 E. coli isolates were resistant in the range between 4%-76% to commonly used antibiotics in the treatment of infection in Jordan. Multidrug resistant isolates to at least three antibiotics accounted for 17/46 (37%) of the isolates. Out of 46 fecal E. coli isolates, 4 (8.7%) were ETEC and 2 (4.3%) were EHEC as detected using PCR. Conclusion: This study indicated that the surface running water of Wadi Shueib is contaminated with potential enteropathogenic E. coli, Molecular characterization of virulence genes and antibiotic resistance among fecal Escherichia coli isolated from surface water of Wadi Shueib-Jordan Shereen Z. Burjaq1, Saeid M. Abu-Romman2, Moawya A. Haddad3 1 Department of Medical Analysis, Faculty of Science, Al-Balqa' Applied University, Salt, Jordan. 2 Department of Biotechnology, Faculty of Agricultural Technology, Al-Balqa Applied University Salt, Jordan. 3 Department of Nutrition and Food Processing, Faculty of Agricultural Technology, Al-Balqa Applied University Salt, Jordan. Contact information:
目的:地表水被病原微生物污染对饮用或家庭活动的人具有高度危险性。水中大肠杆菌的检测可作为粪便污染的一般重要指标。本研究调查了约旦Wadi Shueib地表水源水样中粪便大肠杆菌的发生情况、两种重要的产毒型大肠杆菌分离株及其耐药性。方法:2016年7月至9月，在瓦迪舒伊布三个不同地点采集51份水样。每个样品在消毒容器中收集200毫升水。所有粪便大肠杆菌阳性的样品在伊红甲基蓝琼脂上传代培养，37℃孵育24小时。采用api20e试验鉴定分离株大肠杆菌，并检测所有分离株的抗菌药物敏感性和产肠毒素大肠杆菌(ETEC)和肠出血性大肠杆菌(EHEC)毒力基因的存在。结果:51份水样中有46份(90%)被粪便大肠杆菌污染。46株大肠杆菌对约旦治疗感染常用抗生素的耐药率在4%-76%之间。对至少3种抗生素耐多药的分离株占分离株的17/46(37%)。PCR检测46株大肠杆菌，4株为ETEC(8.7%)， 2株为EHEC(4.3%)。结论:本研究提示Wadi Shueib地表水存在潜在致病性大肠杆菌污染，从Wadi Shueib地表水分离的粪便大肠杆菌毒力基因的分子特征及抗生素耐药性[j] -Jordan Shereen Z. burja1, Saeid M. Abu-Romman2, Moawya A. Haddad3 1约旦Al-Balqa应用大学理学院医学分析系2农业技术学院生物技术系3约旦Al-Balqa应用盐业大学农业技术学院营养与食品加工系，约旦Al-Balqa应用盐业大学;联系信息:
{"title":"Molecular characterization of virulence genes and antibiotic resistance among fecal Escherichia coli isolated from surface water of Wadi Shueib-Jordan","authors":"Shereen Z Burjaq, Saeid M Abu-Romman, Moawya A. Haddad","doi":"10.3823/0804","DOIUrl":"https://doi.org/10.3823/0804","url":null,"abstract":"Objective: Contamination of surface water with pathogenic organism is highly dangerous for people who used it for drinking or for domestic activities. Detection of Escherichia coli in water can be used as a general important indicator of fecal contamination. This study investigated the occurrence of fecal E. coli, two important toxigenic types of E. coli isolates and their antimicrobial resistance in water samples collected from the surface running source of Wadi Shueib in Jordan. Methods: A total of 51 water samples were collected from three different locations of wadi shueib over a three month, July through September, 2016. For each sample, 200 ml of water was collected in sterilized containers. All samples which were positive for fecal E. coli were subcultured on Eosin Methylelne Blue Agar and incubated at 37 oC for 24 hours. E. coli isolates were identified by API20 E test, and all isolates were tested for antimicrobial susceptibility and for the presence of virulence genes of enterotoxigenic E.coli (ETEC) and enterohaemorrhagic E.coli (EHEC). Results: A total of 46/51 (90%) of water samples were contaminated with fecal E. coli. The 46 E. coli isolates were resistant in the range between 4%-76% to commonly used antibiotics in the treatment of infection in Jordan. Multidrug resistant isolates to at least three antibiotics accounted for 17/46 (37%) of the isolates. Out of 46 fecal E. coli isolates, 4 (8.7%) were ETEC and 2 (4.3%) were EHEC as detected using PCR. Conclusion: This study indicated that the surface running water of Wadi Shueib is contaminated with potential enteropathogenic E. coli, Molecular characterization of virulence genes and antibiotic resistance among fecal Escherichia coli isolated from surface water of Wadi Shueib-Jordan Shereen Z. Burjaq1, Saeid M. Abu-Romman2, Moawya A. Haddad3 1 Department of Medical Analysis, Faculty of Science, Al-Balqa' Applied University, Salt, Jordan. 2 Department of Biotechnology, Faculty of Agricultural Technology, Al-Balqa Applied University Salt, Jordan. 3 Department of Nutrition and Food Processing, Faculty of Agricultural Technology, Al-Balqa Applied University Salt, Jordan. Contact information:","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81479982","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}
Sexually transmitted infections (STIs) are caused by a wide spectrum of bacteria, viruses and parasites. These agents can be easily transmitted during any direct genital or oral sexual contact. Recently, World Health Organization (WHO), reported that more than 1 million STIs are acquired every day worldwide, Each year, there are an estimated 357 million new infections with 1 of 4 STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis. There are few studies and official reports published on the prevalence of STIs in most Arab countries. However, few new recent studies showed increased prevalence of certain STIs in some Arab countries.
{"title":"Diagnosis And Antimicrobial Treatment Of Bacterial Of Neisseria Gonorrhea Infections: Update Review Article","authors":"A. Shehabi, M. Hamzé","doi":"10.3823/0803","DOIUrl":"https://doi.org/10.3823/0803","url":null,"abstract":"Sexually transmitted infections (STIs) are caused by a wide spectrum of bacteria, viruses and parasites. These agents can be easily transmitted during any direct genital or oral sexual contact. Recently, World Health Organization (WHO), reported that more than 1 million STIs are acquired every day worldwide, Each year, there are an estimated 357 million new infections with 1 of 4 STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis. There are few studies and official reports published on the prevalence of STIs in most Arab countries. However, few new recent studies showed increased prevalence of certain STIs in some Arab countries.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79727101","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. Urinary tract infection (UTI) is common infection feature worldwide. Infected patients are usually treated empirically treated without culture or antibiotics susceptibility testing, and which may lead to increase antibiotic resistance level. This study aims to determine the prevalence and antibiotic susceptibility patterns of common uropathogenic bacteria isolated at Youssef Hospital Center, Akkar governorate, North of Lebanon. Methods. Spot midstream of urine samples from 9662 patients with UTI symptoms who came for medical investigation to Youssef Hospital Center located in Akkar governorate. Urine specimens were collected in sterile plastic bottles. Culture, identification and antibiotic susceptibility testing were performed using conventional tools according to the recommendations of the European Committee on Antimicrobial Susceptibility Testing. Results. A total of 1009 bacterial uropathogens were isolated. Escherichia coli was most presented (72.5%) of all isolates, followed by Klebsiella pneumoniae (8.2%), Enterococcus spp. (5.5%), Pseudomonas aeruginosa (4.5%), Proteus spp. (3%), Enterobacter spp. (2%), Staphylococcus aureus (2%), Streptococcus agalactiae (1.6%), Staphylococcus saprophyticus (0.4%), Acinetobacter baumannii(0.2%) and Providencia rettgeri (0.1%). Moreover, the mean antibiotic resistance rates of isolates was relatively high, but comparable to previously published data in Lebanon. Conclusion. To the best of our knowledge, this is the first investigation reporting epidemiological data regarding the prevalence and antibiotic susceptibility patterns of bacterial uropathogens isolated from patients in the Akkar governorate. Our data indicated the urgent need of a strategic plan to tackle antibiotic resistance, particularly in deprived regions with poor healthcare centers. Keywords: Uropathogens, Epidemiology, Antibiotic susceptibility, Risk factors, Akkargovernorate, North Lebanon.
{"title":"Prevalence and antibiotic susceptibility patterns of bacteria causing urinary tract infections in Youssef Hospital Center: first report from Akkar governorate, North of Lebanon","authors":"M. Hamzé, Marwan Osman, H. Mallat, E. Raad","doi":"10.3823/0802","DOIUrl":"https://doi.org/10.3823/0802","url":null,"abstract":"Background. Urinary tract infection (UTI) is common infection feature worldwide. Infected patients are usually treated empirically treated without culture or antibiotics susceptibility testing, and which may lead to increase antibiotic resistance level. This study aims to determine the prevalence and antibiotic susceptibility patterns of common uropathogenic bacteria isolated at Youssef Hospital Center, Akkar governorate, North of Lebanon. \u0000Methods. Spot midstream of urine samples from 9662 patients with UTI symptoms who came for medical investigation to Youssef Hospital Center located in Akkar governorate. Urine specimens were collected in sterile plastic bottles. Culture, identification and antibiotic susceptibility testing were performed using conventional tools according to the recommendations of the European Committee on Antimicrobial Susceptibility Testing. \u0000Results. A total of 1009 bacterial uropathogens were isolated. Escherichia coli was most presented (72.5%) of all isolates, followed by Klebsiella pneumoniae (8.2%), Enterococcus spp. (5.5%), Pseudomonas aeruginosa (4.5%), Proteus spp. (3%), Enterobacter spp. (2%), Staphylococcus aureus (2%), Streptococcus agalactiae (1.6%), Staphylococcus saprophyticus (0.4%), Acinetobacter baumannii(0.2%) and Providencia rettgeri (0.1%). Moreover, the mean antibiotic resistance rates of isolates was relatively high, but comparable to previously published data in Lebanon. \u0000Conclusion. To the best of our knowledge, this is the first investigation reporting epidemiological data regarding the prevalence and antibiotic susceptibility patterns of bacterial uropathogens isolated from patients in the Akkar governorate. Our data indicated the urgent need of a strategic plan to tackle antibiotic resistance, particularly in deprived regions with poor healthcare centers. \u0000Keywords: Uropathogens, Epidemiology, Antibiotic susceptibility, Risk factors, Akkargovernorate, North Lebanon.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83389463","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. Urinary tract infection (UTI) is a severe public health problem. However, infected patients are usually treated empirically without preceding culture or antibiotics susceptibility testing, which may increase the antibiotic resistance level. The aim of this study is to determine the prevalence and antibiotic susceptibility patterns of common bacterial uropathogens isolated in Akkar governorate, North Lebanon. Methods. Spot midstream from urine samples from 9662 patients presenting UTI symptoms who came to Youssef Hospital Center located in Akkar governorate, were collected in sterile plastic cups. Culture, identification and antibiotic susceptibility testing were performed through conventional tools according to the manufacturer’s recommended procedures and the recommendations of the European Committee on Antimicrobial Susceptibility Testing. Results. Overall, a total of 1009 bacterial uropathogens were isolated. Escherichia coli was predominant and represented 72.5% of all isolates , followed by Klebsiella pneumoniae (8.2%), Enterococcus spp. (5.5%), Pseudomonas aeruginosa (4.5%), Proteus spp. (3%), Enterobacter spp. (2%), Staphylococcus aureus (2%), Streptococcus agalactiae (1.6%), Staphylococcus saprophyticus (0.4%), Acinetobacter baumannii (0.2%) and Providencia rettgeri (0.1%). Moreover, the mean antibiotic resistance rates of isolates was relatively high, but similar to previous investigations reported in our country. Conclusion. To our knowledge, this is the first investigation reporting epidemiological data regarding the prevalence and antibiotic susceptibility patterns of uropathogens isolated from patients in Akkar governorate. Our data indicated the urgent need of a strategic plan to tackle antibiotic resistance, particularly in deprived regions with poor healthcare structures such as Akkar governorate. DOI: http://dx.doi.org/10.3823/801
{"title":"Prevalence and antibiotic susceptibility of ear pathogens isolated from patients in Tripoli, north of Lebanon","authors":"M. Hamzé, Marwan Osman, H. Mallat, M. Achkar","doi":"10.3823/0801","DOIUrl":"https://doi.org/10.3823/0801","url":null,"abstract":"Background. Urinary tract infection (UTI) is a severe public health problem. However, infected patients are usually treated empirically without preceding culture or antibiotics susceptibility testing, which may increase the antibiotic resistance level. The aim of this study is to determine the prevalence and antibiotic susceptibility patterns of common bacterial uropathogens isolated in Akkar governorate, North Lebanon. \u0000Methods. Spot midstream from urine samples from 9662 patients presenting UTI symptoms who came to Youssef Hospital Center located in Akkar governorate, were collected in sterile plastic cups. Culture, identification and antibiotic susceptibility testing were performed through conventional tools according to the manufacturer’s recommended procedures and the recommendations of the European Committee on Antimicrobial Susceptibility Testing. \u0000Results. Overall, a total of 1009 bacterial uropathogens were isolated. Escherichia coli was predominant and represented 72.5% of all isolates , followed by Klebsiella pneumoniae (8.2%), Enterococcus spp. (5.5%), Pseudomonas aeruginosa (4.5%), Proteus spp. (3%), Enterobacter spp. (2%), Staphylococcus aureus (2%), Streptococcus agalactiae (1.6%), Staphylococcus saprophyticus (0.4%), Acinetobacter baumannii (0.2%) and Providencia rettgeri (0.1%). Moreover, the mean antibiotic resistance rates of isolates was relatively high, but similar to previous investigations reported in our country. \u0000Conclusion. To our knowledge, this is the first investigation reporting epidemiological data regarding the prevalence and antibiotic susceptibility patterns of uropathogens isolated from patients in Akkar governorate. Our data indicated the urgent need of a strategic plan to tackle antibiotic resistance, particularly in deprived regions with poor healthcare structures such as Akkar governorate. \u0000DOI: http://dx.doi.org/10.3823/801","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88784697","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}
Manar A. Al-Manasur, I. Al-Adham, E. Al-kaissi, E. Khalil, M. R. Feddah, P. Collier
Objectives: 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.
{"title":"Water-in-oil microemulsions exhibit antimicrobial activity","authors":"Manar A. Al-Manasur, I. Al-Adham, E. Al-kaissi, E. Khalil, M. R. Feddah, P. Collier","doi":"10.3823/795","DOIUrl":"https://doi.org/10.3823/795","url":null,"abstract":"Objectives: 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. \u0000Materials & 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). \u0000Results: 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. \u0000Conclusions: Thermodynamically stable water-in-oil microemulsions are antimicrobially active, self-preserving systems, as are their oil-in-water counterparts.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"15 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89426630","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. Elmanama, Philippe Hartemann, K. Elnabris, Adnan Ayesh, Samir Afifi, Fatma Elfara, Alaa R. Aljubb
Objectives: 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.
{"title":"Antimicrobial resistance of Staphylococcus aureus, fecal streptococci, Enterobacteriaceae and Pseudomonas aeruginosa isolated from the coastal water of the Gaza strip-Palestine","authors":"A. Elmanama, Philippe Hartemann, K. Elnabris, Adnan Ayesh, Samir Afifi, Fatma Elfara, Alaa R. Aljubb","doi":"10.3823/792","DOIUrl":"https://doi.org/10.3823/792","url":null,"abstract":"Objectives: 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.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84691234","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}
M. M. Yousef, A. I. Amer, A. Zidan, F. Amer, Rehab M. ElsaidTash
Objectives: This work was carried out to assess the frequency of spontaneous bacterial peritonitis (SBP) and its variants in the medical intensive care unit (ICU) of the Internal Medicine department, zagazig Faculty of Medicine, Egypt and to identify the causative organisms and their susceptibility to commonly used antimicrobials. Other objectives were to determine risk factors and clinical outcomes. Subjects and methods: One-hundred and eighty- nine patients having ascites due to liver cirrhosis were studied. Each patient was subjected to: history collection, physical examination, diagnostic paracentesis, radiological and laboratory investigations and assessment of disease severity. Organisms isolated were identified and their antibiotic susceptibility profiles were tested. MELD score was used for diseases assessment. Risk factors and clinical outcomes were concluded using statistical methods. Results: Frequency of SBP was 56.1%. Classic SBP accounted for 47.2% of cases, while the remaining 52.8% were culture negative neutrocytic ascites (CNNA). E-coli were the most frequently isolated bacteria. Piperacillin- tazobactam was the most effective antibiotic. SBP cases were significantly associated with hepatocellular carcinoma and with use of beta blockers. Patients with SBP were more likely to present with fever and abdominal pain, whereas those with non- SBP were more likely to present with hypotension. Non- significant relationship was found between SBP and non-SBP cases regarding ICU stay. Meanwhile mortality was higher among SBP cases; age and MELD score were the independent risk factor.
{"title":"Spontaneous Bacterial Peritonitis in the Medical Intensive Care Unit of a University Hospital in Egypt: Frequency, Bacteriological Profile, Risk Factors and Outcomes","authors":"M. M. Yousef, A. I. Amer, A. Zidan, F. Amer, Rehab M. ElsaidTash","doi":"10.3823/790","DOIUrl":"https://doi.org/10.3823/790","url":null,"abstract":"Objectives: This work was carried out to assess the frequency of spontaneous bacterial peritonitis (SBP) and its variants in the medical intensive care unit (ICU) of the Internal Medicine department, zagazig Faculty of Medicine, Egypt and to identify the causative organisms and their susceptibility to commonly used antimicrobials. Other objectives were to determine risk factors and clinical outcomes. Subjects and methods: One-hundred and eighty- nine patients having ascites due to liver cirrhosis were studied. Each patient was subjected to: history collection, physical examination, diagnostic paracentesis, radiological and laboratory investigations and assessment of disease severity. Organisms isolated were identified and their antibiotic susceptibility profiles were tested. MELD score was used for diseases assessment. Risk factors and clinical outcomes were concluded using statistical methods. Results: Frequency of SBP was 56.1%. Classic SBP accounted for 47.2% of cases, while the remaining 52.8% were culture negative neutrocytic ascites (CNNA). E-coli were the most frequently isolated bacteria. Piperacillin- tazobactam was the most effective antibiotic. SBP cases were significantly associated with hepatocellular carcinoma and with use of beta blockers. Patients with SBP were more likely to present with fever and abdominal pain, whereas those with non- SBP were more likely to present with hypotension. Non- significant relationship was found between SBP and non-SBP cases regarding ICU stay. Meanwhile mortality was higher among SBP cases; age and MELD score were the independent risk factor.","PeriodicalId":22518,"journal":{"name":"The International Arabic Journal of Antimicrobial Agents","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85599605","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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