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The present study aims to evaluate the occurrence and characterize Staphylococcus aureus in meat and meat products marketed in Mansoura, Egypt based on their antimicrobial-resistance pattern and production of enterotoxins. A total of 250 meat samples, categorized as 80 fresh beef samples besides 85 ground beef and 85 beef burger purchased from supermarkets and butchers' shops distributed in Egypt for isolation of Staphylococcus aureus. All isolates were screened for susceptibility to twelve antimicrobial discs. Minimal inhibitory concentration was carried out by twofold serial dilution in nutrient broth. Plasmid and genomic DNA| extraction were done. Polymerase chain reactions were performed for amplification of enterotoxin-encoding genes [sec and seg] Twenty five samples were isolated and identified as S. aureus. Sixty eight isolates were multidrug resistant since they were resistant to at least three different antimicrobial classes. Plasmids isolation from all isolates revealed that 76% of these isolates harbored plasmids. Fifteen isolates [60%] exhibited similar plasmid band size. The size of this plasmid was approximately 23 kbp. For seg gene, it was amplified in 8 isolates [32%] of S. aureus isolates at 550 bp. Five [63%] of the isolates harbored seg gene were multidrug resistant. On the other hand, none of the S. aureus isolates harbored sec gene. The present study confirmed the high prevalence of newly discovered enterotoxin genes [seg] in meat derived staphylococcus aureus and the association between the presence of this gene and multiple drug resistant phenomena
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Purpose: The present study aimed to investigate the distribution of methicillin resistance as well as some virulence factors in S.aureus strains isolated from diabetic and non-diabetic patients by Phenotypic and genotypic methods
Methods: A total of fifty eight isolates were identified as S.aureus [41 isolates from diabetics and 17 isolates from non-diabetics] from infected wounds and abscesses in type I diabetic and non-diabetic patients admitted to 4 different hospitals located at Mansoura and Damietta, Egypt. Resistance to eight antimicrobial agents was detected using disk diffusion method. The isolates were screened for some virulence factors, namely hemolysins, lipases, lecithinase, haemagglutination, slime production and carotenoid pigment. Also, some virulence genes, namely hla, hlb, icaA, icaD, geh and methicillin resistance gene, mecA were also detected
Results: S.aureus was prevalent in 46% of collected specimens. The antibiotic sensitivity test showed that vancomycin was the most active antibiotics against tested strains. Total hemolytic activity was shown by 91% of tested strains. Lipase enzyme was produced by 65.5% of strains while 56.9% of tested strains produce lecithinase enzyme. Haemagglutination was observed in 82.8% of tested strains although 77.6% of strains were positive slime producers. About 93% of tested strains were pigmented. The hla gene was amplified in 33 strains while hlb and geh genes were distributed in almost all tested strains. Both icaA and icaD genes were detected and amplified in 96.5% of tested strains. On the other hand, methicillin resistance was detected in 86% of S.aureus strains
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Background: Increased incidence of resistance to beta-lactams among members of the family Enterobacteriaceae has been reported worldwide. Extended spectrum beta-lactamase [ESBL] producing Gram-negative bacteria are becoming a major global concern and usually harbor plasmid-mediated enzymes of the TEM, SHV, OXA, PER, and CTX-M types. The aim of this study is to determine the prevalence of ESBL-producing Enterobacteriaceae in Mansoura hospitals and to molecularly characterize the ESBL-related bla genes, including blaTEM and blaCTX-M
Methodology: A total of 40 E. coli, 30 K. pneumoniae and 30 Proteus isolates were studied for antibiotic susceptibility pattern using different betalactam antibiotics and for the presence of ESBLs by combination of double-disc approximation test and inhibitor-potentiated disc-diffusion test. Subsequently, the hyper variable regions of beta-lactamase-encoding genes were amplified and sequenced using dye termination Sanger methodology to study the genetic variation among the clinical isolates
Results: All E. coli isolates were resistant to ampicillin, amoxicillin/clavulanate and cefadroxil. Regarding K. pneumoniae, all isolates were resistant to ampicillin, amoxicillin/clavulanate, cefadroxil, cefoxitin, cefuroxime and cefotaxime. Concerning Proteus species, all isolates were resistant to ampicillin, cefadroxil, cefotriaxone, cefuroxime and cefoperazone. In contrast 95% of E. coli isolates 80% of K. pneumoniae isolates and 90% of Proteus isolates were sensitive to imipenem. The detection of ESBLs by double-disc approximation test and inhibitor-potentiated disc-diffusion test was quiet different. Double disc approximation method lacks sensitivity. It showed false negative results in nearly 92% of the isolates that were concerned positive ESBLs producers by inhibitor-potentiated disc-diffusion test. PCR amplification and sequencing analysis revealed the presence of CTX-M and TEM type ESBLs in the tested isolates and could accurately characterize different types of blaTEM and blaCTX-M among the clinical isolates
Conclusion: Combined use of the conventional ESBLs screening methods and the molecular amplification of the ESBLs encoding genes followed by PCR based sequencing method provides a very valuable tool for identification and characterization of ESBLs producing E. coli, K. pneumoniae, and Proteus clinical isolates
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Aim: The present study was aimed to determine the antimicrobial resistance and Methicillin resistance gene of MRSA isolated from different clinical sources with a comparative study between phenotypic and genotypic methods in respect of accuracies
Methods: A total 49 isolates of MRSA were studied for antibiotic susceptibility pattern, oxacillin and cefoxitin disc diffusion test, SDS_PAGE analysis, DNA extraction and mecA resistant gene detection by PCR
Results: The study included 49 phenotypically detected MRSA isolates by convential methods. All MRSA isolates were resistant to cefoxitin. Although vancomycin was the first drug of choice in treatment for MRSA, it shows a certain resistant for 8.16% of the investigated isolates which is known as VRSA. The result of oxacillin disc diffusion test indicated that 43 isolates were MRSA, although all the tested isolates were considered MRSA according to the results of cefoxitin disc diffusion test. SDS-PAGE showed high degree of similarity among the banding patterns of MRSA. Detection of mecA gene reveled that, it was amplified on chromosomal DNA of 41 out of 49 isolates. Despite all isolates were proved to be a MRSA, only 83.67% gave positive results with PCR
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Background: Gram negative bacteria are responsible for numerous infectious diseases. These diseases can occur in and harm any part of the body, the skin, eyes and the nervous, cardiovascular, respiratory, gastrointestinal and urogenital systems
Methods: In the present study, some phenotypic and molecular typing techniques were applied on 108 strains of E. coli, 88 strains of Ps. aeruginosa and 8 strains of Serratia isolated from different clinical lesions in Mansoura University Hospitals, Egypt
Results: The distribution of antibiotic resistance among the isolated strains showed high incidence of resistance and imipenem was the most active antibiotic. Using the active pyocin typing, 72 strains of Ps. Aeruginosa could be typed into 35 pyotypes. Using PCR technique it was found that 84% of the 50 tested isolates were found to have at least one of the tested ESBLs. Also TolC and AcrA genes were present in all tested E. coli except 4 strains and did not present in Ps. aeruginosa except 4 strains. Plasmid profiles of 23 tested E. coli appear to be diverse. Also the prevalence of plasmids in 22 tested Ps. aeruginosa strains was lower than in tested E. coli therefore 59.1% of tested Ps. aeruginosa strains harbored plasmids. Using Pyrosequencing technique, the sequenced region of gyrA, gyrB and ParC were able to differentiate between the tested strains and neighbor-joining tree was constructed to determine relatedness between the isolated strains. Moreover, Molecular cloning of the whole sequence of bla-TEM, bla-SHV and bla-CTX-M was carried out experimentally to study the expression of these genes and determine which genes of them responsible for the resistance
Conclusion: Molecular-based typing methods of are more advantageous compared with phenotypic typing methods in terms of better discrimination and reproducibility. Significant genetic variation was observed among different strains represented by the diversity of their plasmid profiles. All molecular genetics methods for distinguishing organism subtypes are based on differences in the DNA sequence
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Background: Pseudomonas aeruginosa plays an important role in opportunistic and nosocomial infections affecting individuals with predisposing conditions
Methods: In this respect, we evaluated the production of MBLs among 100 clinical isolates of Pseudomonas aeruginosa sources in Mansoura University Hospitals
Results: Most isolates were highly resistant to penicillins and cephalosporins. On the other hand, most strains were sensitive to imipenem as 91% of the isolates were susceptible. The effect of MBL inhibitors using a simple disk diffusion test revealed the efficiency of EDTA and 2-mercaptoethanol as Metalo-beta-lactamase inhibitors due the observed expansion of the growth-inhibitory zone of the two inhibitors. Cupric chloride also gave a clear result, but with a weak inhibitory effect. IMP and VIM genes were amplified from both genomic and plasmid DNA extracted from 26 isolates. The amplification primers of both markers were specifically designed to amplify 600 bp for IMP and 500 bp for VIM. On the other hand, two isolates did not harbor IMP gene on their plasmids while six isolates did not contain VIM on their plasmids. Subsequent sequencing of the generated amplicons showed different types of mutation in the sequenced regions of the tested resistance genetic markers. They include insertion, deletion and substitution mutations. Moreover, the region 178-822 of IMP and the region 111-627 of VIM, commonly found in resistant Pseudomonas aeruginosa, are the most predominant variable regions
Conclusion: particular PCR and subsequent sequencing provide a useful tool for accurate and cost efficient characterization of MBLs producing Pseudomonas aeruginosa isolates. The accuracy of the sequencing method can answer the epidemiological questions that can't be answered by the traditional microbiological methods. This approach will help in choosing the best effective antibiotic to overcome the nosocomial infection
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This is a retrospective study of all cases of pediatric Craniopharyngioma who attended from January 1992 till January 2002 to the Pediatric Unit of Kasr El-Eini Center of Radiation Oncology and Nuclear Medicine [NEMROCK]. All cases were diagnosed by brain CT scan or Magnetic resonance imaging [MRI] and diagnosis was confirmed by pathological examination. Eight cases underwent total surgical excision and 16 cases underwent near total excision of the tumor and postoperative radiation therapy. All cases were followed up clinically every 3 months by assessment of neurological function. Brain MRI and endocrinal functions were assessed every 6 months for 5 years. The overall survival at 5 years was 90%. The 5 year progression free survival [PFS] was 62.5%, 5 cases developed surgery related complications and 4 cases developed radiation related complications as visual deterioration, pan-hypopituitrism and disturbed cognitive and neuropsychological disorders. The two standard treatment options in children with craniopharyngioma are primary total surgical excision of the tumor or subtotal resection followed by radiotherapy. In certain subgroups of patients such as those with large tumors and hypothalamic extension, primary surgery is associated with a high incidence of complications and high failure rates. We recommend the utilization of an individualized risk adapted treatment approach which attempts to maximize cure rates without compromising long-term functional outcome. Neuropsychological assessments with a focus on memory recall should be a component of the management of each case
Subject(s)
Humans , Male , Female , Child , Retrospective Studies , Tomography, X-Ray Computed , Magnetic Resonance Imaging , Disease Management , Follow-Up Studies , Survival Rate , Treatment Outcome , Palliative Care , Pituitary Neoplasms , Palliative CareABSTRACT
Our present study is a retrospective analysis of the treatment results of new rhabdomyosarcoma pediatric patients who had attended the pediatric unit clinic of Kasr El Aini Center of Radiation Oncology and Nuclear Medicine [NEMROCK] from January 1992 to January 2001]. Fifly-five new cases of pediatric rhabdomyosarcoma attended the pediatric unit outpatient clinic of [NEMROCK] from the period of January 1992 until January 2001. Patients were divided into 4 stages and classified into low-risk patients and high-risk patients according to the extent of resection. Stage I, II orbital and stage I para-testicular embryonal rhabdomyosarcomas received 32 weeks of vincristine and actinomycin-D [vincristine 1.5 mg/m2 weekly, actinomycin-D 0.015 mg/ Kg/day day ito day 5]. Other pathologies, sites and stages received 52 weeks of chemotherapy. Chemo-therapy regimens included VAC [vincristine 1.5 mg/m2 weekly, actinomycin-D 0.015 mg/Kg/day day ito day 5 and endoxan 2.2 gm/m2 I.V with mesna every 21 days], VAI [vincristine, actinomycin-D and ifosfamide 1.8 gmIm2 I.V day 1 to day 5 with mesna] or VIE [vincristine, ifosfamide and vepesid 100 mg/m2 I.V day 1 to day 5] 111, 12]. Stages I and II received conventional fractionation radiotherapy 414 OcGy on week 13, stages III and IV received conventional fractionation radiation therapy 5O4OcGy also, on week 13. The radiation volume included the tumor bed with a 2cm safety margin at least. Relapsing cases received palliative radiation therapy and chemotherapy [cisplatinum I.V 100 mg/m2 divided over 2 days and vepesid i00mg/m2 I.V day ito day 3 to be recycled every 21 days]. Patients were followed-up for 5 years, with a median follow-up of 36 months. Overall survival, disease free survival, treatment response, and complications of treatment were assessed and statistically analyzed. Fifty-five new cases of pediatric rhabdomyosarcoma attended the pediatric unit outpatient clinic of [NEMROCK] and were evaluated. Males constituted about 63.6% of the cases [35 cases] and females 36.4% [20 cases]. The median age was 6 years and the ages of the patients ranged from 1 to 9 years. Most of the cases were in early stages [40/55 i.e. 72.7%] versus late stages [15/55, i.e. 27.3%]. Pathologically, embryonal type was the commonest statistically [48/55, i.e. 87.3%] compared to the alveolar type [7/55, i.e. 12.7%]. Concerning site of the primary tumor it was found to be highest in the head and neck [20/55, i.e. 36.4%] followed by abdominal site [23.6%] excluding the genitourinary system which was classified separately because it included pelvis and abdomen [13/55, i.e. 23.6%]. The estimated 5-year Failure Free actuarial Survival [FFSR] for the entire study is 68% [n=55; 95% confidence interval [CI], 63% to 73%], and the estimated 5-year overall actuarial survival [OS] rate is 74% [95% CI, 69% to 79%]. Twenty cases experienced relapse during the 5 years follow up [i.e. 36.4%]. There was no lost follow-up in the selected group of children studied. In addition, only 3 cases showed distant metastasis at the onset of the study. Complete remission [CR] was achieved in 50.9% of the cases. Despite the advances in the therapy of rhabdomyosarcoma. Nearly 30% of the pediatric cases with rhabdomyosarcoma experience progressive or relapsing disease, which has a fatal end. The factors determining the 5-year survival after relapse at the time of initial diagnosis include histological subtype, and disease clustel. These findings will form the basis of a multi-institutional risk adapted relapse protocol for childhood rhabdomyosarcoma patients
Subject(s)
Humans , Male , Female , Rhabdomyosarcoma/radiotherapy , Child , Nuclear Medicine , Retrospective Studies , Follow-Up Studies , Survival RateABSTRACT
One hundred and twelve Pseudomonas aeruginosa strains were isolated from 436 different clinical specimens collected from patients attending different hospitals in El-Minia governorate. Antibiotics susceptibility patterns of the isolated Ps. aeruginosa isolates to quinolones were studied and results revealed higher percentage of resistance ranged from 22.32% to 75%. gatifloxacin was the most active quinolone against the tested isolates as the percentage of resistance was 22.32% while nalidixic acid was the least active one as the percentage of resistance was 75%. The percentage of resistance to ciprofloxacin, levofloxacin and ofloxacin was 41.96%, 47.32% and 49.1% respectively. Co - resistance to other chemically unrelated antibiotics was also studied and the result showed that, more than 90% of the tested Ps. aeruginosa isolates were resistant to amoxycillin, chlormphenicol and tetracyline. On the other hand, variable levels of resistance were obtained for gentamicin, azithromycin, cefoperazone and cefotaxime. Interestingly, all the tested Ps. aeruginosa isolates were 100% sensitive to amikacin. Ps. aeruginosa isolates showed multiple drug resistance patterns to quinolones and other antibiotics were selected to study the possible mechanisms of resistance to quinolones. Efflux mechanisms was studied flourometerically and the results revealed presence of active efflux pumps in the tested isolates as indicated by the increase in the fluorescence of N-phenyl-1-Naphthylamine [NPN] after preincubation of the cells with the efflux inhibitor carbonyl cyanide m-chlorophenylhydrazone [CCCP]. Also, examination of outer membrane proteins in the tested isolates revealed over production of outer membrane proteins of an apparent molecular mass of 50 KDa and 54 KDa suggesting the role of these proteins in quinolones resistance. In addition to the absence of outer membrane protein of molecular mass 46 KDa which aids the intake of the quinolones into the bacterial cells. In conclusion, quinolones resistance in Ps. aeruginosa were associated with multidrug efflux pumps and alteration in the outer membrane proteins
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Splenic cysts are rare. The authors describe a patient with an epithelial splenic cyst who presented with spontaneous rupture and was treated by splenic conservation. The types, presentations, diagnosis and treatment options of splenic cysts are discussed