ABSTRACT
Background:Carbapenem resistant Acinetobacter baumannii has emerged worldwide in the hospitals especially in Intensive care units [ICU]
Objectives: to detect carbapenems resistance and characterization of some carbapenem resistant genes among acinetobacter baumannii isolated from patients in ICU unit in Giza Chest Hospital, Egypt
Methodology: This study was designed to detect the prevalence of carbapenem resistance among A. baumannii species isolated from patients having nosocomial infections in Egypt. Antimicrobial susceptibility pattern was done. Identification and susceptibility testing was confirmed by VITEK 2 Compact system. Isolates were further tested by the modified Hodge test [MHT] to detect carbapenem resistance. PCR was used to detect some carbapenem resistant genes
Results: A. baumanniii represent 22[16.1%] of total isolates causing nosocomial infection in ICU. A. baumanniii were resistant to sulfamethoxazole-trimethoprim,amoxicillin/clavulanicacid,ciprofloxacin,piperacillin/tazobactamandceftazidime 100%, 90.9%, 90.9,90.9%,81.8% and 81.8% respectively.Imipenem resistance was 14/22[63.6%]. Colistin showed the highest activity against A. baumannii isolates; the resistance rate was 4.5%. Total number of carbapenem-resistant gram-negative isolates was [38.9%]. Regarding A. baumanniii 14 out of 22[63.6%] werecarbapenem resistant as detected by the antibiotic susceptibility test. According to this antibiogram result, 14 A. baumanniii isolates screened for carbapenemase production by MHT, carbapenemase activity was detected among 10[71.4%] of carbapenem-resistant A. baumanniii isolates. Molecular detection of carbapenem resistant genes showed that BlaOXA-23 was the common detected gene 6/14 [42.8%]. BlaOXA-58 was detected among 1/14[7.1%] of isolates
Conclusion: A. baumannii with multidrug resistance become a problem especially in immunocompromised patient. Resistance among A. baumannii caused by several mechanisms. OXA-23-like carbapenemase-producing strains have been among the most detected patterns
ABSTRACT
Objectives: This study aimed to investigate Staphylococcal aureus [S. aureus]carriage among health care workers [HCWs] in Burn and Surgical Critical Care Units in Menoufia University Hospital, Egypt, following an outbreak of S. aureus wound infection in patients
Methods: The study involved 60 HCWs. They were 9 Doctors [15.0%] and 51 nurses and workers[85.0%]. Each participant completed a questionnaire that covered demographic data, smoking habits, riskfactors of S. aureus colonization and general infection control procedures. To detect S. aureuscolonization, both nasal and hand swabs were collected from HCWs. Testing for sensitivity to methicillin was performed by cefoxitin disc diffusion method [30 micro g]
Results: S. aureus was isolated from 53.3% of HCWs and 68.8% of them were colonized with MRSAstrains. The overall MRSA carriage rate was 36.7%. MRSA was confined only in Surgical intensive careunits [ICUs]. MRSA isolates were sensitive to amikacin, chloramphenicol, vancomycin and ceftriaxone. There was no correlation between infection control training, antibiotic intake in the preceding month,duration of work, diabetes mellitus and smoking of HCWs and carriage rate of MRSA [P >0.5]
Conclusion: HCWs who had contact with patients were at risk of acquisition and colonization with S.aureus and antimicrobial resistant bacteria especially MRSA. Training of HCWs on hygienic measures especially proper hand hygiene is the key to overcome S. aureus infection in Surgical ICUs and BurnUnits
ABSTRACT
The p53 gene is located on human chromosome 17p13.1 and consists of 11 exons. Deficiencies in the p.53 gene can cause the cancerous cells to spread to distant organs. The most common p53 abnormalities that can lead to metastasis of colorectal tumours are mutation and deregulation of the gene. Aim of the study in the present study, we assessed the presence of P53 gene mutations and p53 protein expression and their prognostic significance in 43 patients with colorectal cancer. Histopathological examination of colonoscopic biopsies specimens, chest and abdomen CT were done for all patients. Genomic DNA was extracted, and exons 4-8 of the p53 gene were amplified, and analyzed for mutations by single strand conformation polymorphism [SSCP] and direct sequencing. The production of p53 proteins was studied by immunohistochemistry [IHC]. Results P53 mutations were found in 27/43 [63%] cases. A total of 11 types of p53 gene mutations were found by direct sequencing. More than half of these mutations appear in three hot spot codons: 175, 248 and 273. The SSCP analysis demonstrate that most common p53 gene alterations were found in exon 5 [35%]. IHC detected 34 tumors [79%] with protein overexpressior [when a cut point of 20% positive cells] and 25 tumours [58%] [When a cut point of >/= 50% positive cells were used]. it was found that p53 mutation analysis corresponds well with p53 immunohistochemistry [p < 0.001]. The majority of gene mutations were found in tumours from the rectum and distal colon. No statistical signitficant relation was found between P53 gene mutations and Duke's staging [P > 0.05]. However, a significant statistical relation was found between P53 gene mutations and prognosis in the studied colorectal cancer patients [p < 0.05]. Molecular and cellular evaluation. of p53 is clinically important, and there are strong indications, especially in colorectal cancer, that mutational status and mutational position in the P53 gene have a prognostic value. However the study of other genes involved in colorectal cancer is necessary