Anti-atherosclerotic Effects of Eurycoma Longifolia (Tongkat Ali) in Rats Fed on High-fat Diet

Atherosclerosis in cardiovascular disease (CVD) is a growing health problem, especially in developing countries. Hyperlipidemia is known as a dominant risk factor for the development of atherosclerosis. This study was designed to investigate the effects of Eurycoma Longifolia (EL) also known as Malaysian Ginseng/ Tongkat Ali on the testosterone level, biochemical changes of lipid profile and intima media thickness (IMT) in rats fed on high-fat diet. Twenty young, adult male Sprague-Dawley (SD) rats were housed for 12 weeks. After one week of acclimatization, they were randomly divided into four groups of 5 animals each and treated for 12 weeks as follow: Group ND was given only normal diet, group NDEL was given normal diet and EL extracts (15mg/kg) dissolved in distilled water, group HFD was given only high fat diet and group HFDEL was given high fat diet and EL extracts (15mg/kg). Rats which were treated with EL (NDEL and HFDEL) showed a significant increase (p<0.05) in the testosterone levels. There was a significant decrease (p<0.05) in triglyceride (TG) in HFDEL group compered to HFD group. The histological sections of aortas revealed a significant decrease (p<0.05) in IMT in HFDEL as compared with HFD group. No histological changes were observed in NDEL group compared with ND group and there was no significant difference in IMT values between NDEL and ND. These findings suggest that EL is a promising protective agent against atherosclerosis induced by high-fat diet.

Prevalence of methicillin-resistant and methicillin-sensitive staphylococcus aureus nasal colonization among patients at the time of admission to the hospital

Methicillin-resistant Staphylococcus aureus [MRSA] is an important agent of hospital-acquired infection. The mode of entry of MRSA in the hospital might be on admission of patients with MRSA infection or nasal colonization. The present study was undertaken to determine the prevalence of MRSA nasal colonization among patients on admission to hospital. Six hundred patients were screened for nasal colonization of MRSA on admission to hospital. Nasal swabs were cultured on salt mannitol agar and blood agar. Age, sex, previous admission to hospital and antibiotic therapy were recorded. S. aureus was isolated from the nasal swabs of 122 patients [20.2%] on admission to hospital. MRSA was isolated from 7 patients [1.1%] and methicillin-sensitive S. aureus [MSSA] from 115 patients [19.1%]. Nasal colonization of S. aureus was higher in younger and elderly patients and significantly higher colonization was observed among females. The MRSA strains isolated from nasal swabs had a different antibiotic susceptibility pattern than those isolated from patients having hospital-acquired MRSA infection. Previous admissions to hospital, underlying disease antibiotic therapy were not risk factors for MRSA nasal colonization. MRSA nasal colonization of patients on admission to hospital is low in this region. The screening of every new admission would not be cost effective, but patients transferred form other institutions should be screened for MRSA. Standard infection control precautions should be strictly implemented to prevent the spread and control of MRSA infections

Advancing age and the risk of nasal carriage of Staphylococcus aureus among patients on long-term hospital-based hemodialysis

Background: Elevated nasal carriage rates of Staphylococcus aureus and ensuing complications among the elderly and in those on long-term hemodialysis [HD] are well recognized. The aim of the present study was to determine the extent to which advancing age is associated with the risk of persistent S. aureus nasal carriage among end-stage renal disease [ESRD] patients on long-term HD

Patients and Methods: This prospective study involved 205 ESRD patients enrolled for maintenance HD from July 1997 to July 2000. Persistent nasal carriage was defined by two or more positive cultures for methicillin-susceptible [MSSA] or methicillin-resistant S. aureus [MRSA]. Five standardized swabs were taken from the anterior nares of all the patients on long-term HD. S. aureus nasal carriage rates were estimated and compared among ESRD patients of different age groups

Results: Overall, a prevalence of 38.05% [78/205] for S. aureus nasal carriage was observed, including 27.3% [56/205] for MSSA and 10.7% [22/205] for MRSA. Patients aged 75 to 84 years had the highest [84.6%, 11/13] prevalence of S. aureus nasal carriage [RR, 7.000, 95% CI, 4.350-11.763, P<0.00001]. Those aged 65 to 74 years had the next highest [49.0%, 25/51] nasal carriage rates [RR, 4.083, 95% CI, 2.302-7.658, P<0.0001] while patients aged 15 to 24 years [reference group] had the lowest [12.8%, 1/8] prevalence of nasal carriage. The 75 to 84 year age group also had the highest rates of MSSA [46.2%, 6/13], [RR- 3.833, 95% CI, 2.144-7.234, P<0.0001] and MRSA [38.5%, 5/13] [RR, 6.333, 95%CI, 2.767-16.198, P<0.0001] nasal carriage compared to the reference group

Conclusion: Significantly higher persistent MSSA and MRSA nasal carriage rates among ESRD patients >75 years of age are suggestive of an elevated risk of potentially serious S. aureus- related complications among the very elderly during long-term HD. These findings might be helpful in the identification of elderly HD patients as a high-risk group for S. aureus-linked vascular access-related septicemia [VRS] and to evolve appropriate preventive strategies

Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae hospital acquired bacteremia. Risk factors and clinical outcome

To study the risk factors and clinical outcome in patients having extended-spectrum beta-lactamase producing [ESBL] Klebsiella pneumoniae [K. pneumoniae] hospital acquired bacteremia. The study was conducted at 500 bedded King Fahad Hospital and Tertiary Care Center, Al-Hofuf, Al-Hasa, Eastern Province of Saudi Arabia. Retrospectively infection control and microbiology records of patients having hospital acquired K. pneumoniae bacteremia during July 2001 to July 2003 were reviewed. Data on age, gender, location, onset of bacteremia, hospital stay after onset of bacteremia, prior antibiotic therapy, comorbid conditions and clinical outcome were recorded. During 2 years of study period 26 patients developed hospital acquired K. pneumoniae bacteremia, out of them 10 patients had bacteremia due to ESBL producing strains. Extended-spectrum beta-lactamase producing K. pneumoniae bacteremia was significantly higher among patients of less than 65 years of age [p=0.004]. Klebsiella pneumoniae bacteremia was more common [12/26, 46.1%] among diabetic patients and 8/12 had ESBL K. pneumoniae bacteremia. [p=0.02]. Invasive devices [urinary and vascular catheters] were more commonly observed among patients having ESBL K.pneumoniae bacteremia [p=0.004, 0.001]. Significantly higher number [9/10] of patients with ESBL K.pneumoniae bacteremia received prior third generation cephalosporins [p=0.001]. Extended-spectrum beta-lactamase K. pneumoniae hospital acquired bacteremia had significantly longer hospital stay and higher mortality [p=0.0001]. Elderly age, diabetes, invasive devices and prior third generation cephalosporin therapy are the major risk factors for hospital acquired ESBL K.pneumoniae bacteremia, leading to significantly higher mortality and prolonged hospitalization. Infection control measures should be aggressively followed to prevent such infections among these high risk patients