ABSTRACT
To carry out a retrospective study on Acinetobacter baumannii [A.baumannii] isolates and analyze its epidemiology, antimicrobial resistance patterns, and nosocomial status from various clinical isolates of patients samples admitted in a tertiary care Hospital, King Abdulaziz hospital, Jeddah, Saudi Arabia. The clinical specimens over a period of 4 years from January 2010 to December 2013 were identified and analyzed, by the conventional microbiology methods and/or an automated identification systems [Pheonix and MicroScan] and there covered A. baumannii isolates were segregated for further study to detect the prevalence and tested for antibiotic susceptibility patterns used the automated susceptibility systems, and/or the disk diffusion and E test methods A total 1176 A. baumannii strains out of 13440 isolates were collected from various specimens during study period. The overall proportion of A. baumannii isolates among all clinical isolates has increased throughout the study from 4.2% [N.134] in 2010 to 12.3%[N.443] in 2013. Most of the source of infections was obtained from the intensive care unit [27.3%], followed by male surgical ward [11.4%], female surgical ward [9.7%] male medical ward [7.7%], female medical ward [7.5%], renal unit [6.7%], neonatal intensive care [5.7%], pediatric Intensive care [4.9%] and lastly out patient, private ward, Ob-Gyne ward and cardiac unit were 4.3%, 2.7%, 2.5% and 2.3% respectively.cefoxitin was the most resistant agents with [100%], then ceftriaxone [92.3%], gentamicin [90.3%], cefepime [88.7%], levofloxacin [88.5%], piperacellin/ tazobactam [88.4%], ciprofloxacin [88.4%], meropenem [88.2%], ceftazidime [88.2%], imipenem [86.5%], amikacin [84.6%], trimethoprim/sulphamethoxazole [69.3%], while colistin and tigecycline were with no resistance. The prevalence of MDR and PDR A. baumannii was increased throughout this study from 55% and 20%, respectively in 2010 to 67% and 33% in 2013. Trend of A. baumannii infection incidence is on the increase with increase of MDR and PDR suggests that prevention of healthcare-associated transmission of A. baumannii infection is essential
ABSTRACT
Typhoid fever, a food-borne disease caused by salmonella species, is a worldwide prevalent disease. In endemic areas, children are at highest risk owing to weaning from passively acquired maternal antibody and lack of acquired immunity. Several studies have been done to clarify the pathogenesis and underlying immune aspects of typhoid fever. Study the changes of some proinflammatory cytokines in plasma of children with typhoid fever. Thirty consecutive children admitted to Zagazig Fever Hospital with proven diagnosis of typhoid fever were included in the study. They were 20 males and 10 females, of ages ranging from 3 to 13 years. In addition, 10 age and sex matched healthy children served as a control group. A verbal consent was obtained from parent[s] of each child before inclusion to the study. All children were subjected to history taking, clinical examination, and routine investigations [CBC, ESR, CRP, Widal test and stool culture], as well as determination of serum interleukin-6 [IL-6] and tumor necrosis factor receptor-1 [TNF-R1], before and 5 days after start of treatment [for patients]. Twenty patients [66.7%] were responsive to therapy and 10 patients [33.3%] were resistant. Toxic look, constipation, high fever, splenomegaly, increased CRP and ESR were significantly presented in patients who displayed resistance to drug therapy. Both IL-6 and TNF-R1 plasma levels were significantly higher in patients than in control children, and in resistant cases than in responsive cases [before and 5 days after treatment]. ESR and S. typhi H agglutination titre correlated significantly with plasma levels of IL-6 and TNF-R1, whereas S. typhi O agglutination titre and total leucocytic count did not. patients with typhoid fever resistant to combined therapy with chloramphenicol and co-trimoxazole have higher plasma levels of IL-6 and TNF-R1. Toxic look, constipation and splenomegaly may be considered as indicators of drug resistance