ABSTRACT
Background: beta-lactam antibiotics have often been used together with vancomycin, and this treatment has been a common combination for long time, beta - lactam-induced vancomycin-resistant methicillin-resistant Staphylococcus aureus [MRSA; BIVR] is a subtype of MRSA, which is otherwise vancomycin susceptible that shows vancomycin resistance in the presence of beta -lactam antibiotics
Objective: In our study, we aimed to characterize and evaluate the antimicrobial profile of BIVR isolated from Mansoura University Hospitals [MUH] and prove the association between usage of fi-lactam antibiotics and BIVR development
Patients and Methods: We studied 40 MRSA strains, identified by detection of MeCA gene and they were selected to be vancomycin sensitive with minimum inhibitory concentration [MIC] [< 2microg/ml] by subjecting these strains to simplified population analysis, p-lactamase activity was tested by nitrocefin test. BIVR strains were subjected to time kill study
Results: eight of 40 MRSA strains isolated from different nosocomial infections in MUH were BIVR [20.0%]. Wound infection is the common infection from which BIVR strains were isolated [75.0]. Only one strain [12.5%] of BIVR strains is J3 lactamase producer, while the majority of non-BIVR strains were fi lactamase producer [93.8%] [P<0.05]
Conclusion: BIVR phenomenon is induced only in the presence of fi-lactam antibiotics, proving that BIVR cells seem to have a low level of fi-lactamase activity compared with that ofnon-BIVR MRSA
ABSTRACT
Portal hypertensive gastropathy [PHG] is an important complication of both generalized and segmental portal hypertension. The pathophysiology of PHG is still unclear. The aim of this study was to detect the prevalance of PIEIG and factors influencing its development. This study was conducted on 82 patients with portal hypertension. They were divided into 2 groups: Group I [non-bleeders] comprised 31 patients, serves as a control group. Group II [bleeders] comprised 51 patients and were subdivided into: Group IIa 28 patients who were followed up by endoscopic sclerotherapy [[EST] and Group IIb: 23 patients who were followed up by endoscopic band ligation [EBL]. Endoscopy was repeated every 2 weeks till variceal obliteration. All patients were subjected to thorough history taking, clinical examination, laboratory investigations and Doppler ultrasonographic evaluation. In this study the prevalance of PHG was 756%, with no age or sex difference, with increased frequency and severity in patients with child-pugh class B than in patients with class A and C but without statistically significant difference. Again the prevalance of PHG was higher in patients with post-hepatitic cirrhosis than in patients with mixed cirrhosis and patients with pure bilharzial fibrosis but without statistically significant difference. The prevalance and severity of PI-IG was in the presence of esophageal varices, large variceal size, and presence of red signs, while the prevalance and severity was decreased in the presence of gastric varices; however, there were no statistically significant difference. The prevalance and severity of PHG were collectively after endoscopic managment especially with EBL without statistically significant difference. PHG was associated with insignificantly increased portal cross-sectional area, congestion index and portal blood flow. Also, it was associated with decreased portal maximum and mean velocities but the difference was statistically insignificant. We concluded that PHG is quite frequent in patients with cirrhosis, however, the factors studied are not good predictors for its presence