ABSTRACT
Introduction: Aspirin is widely used as either a primary or secondary preventive measure in of cardiovascular events however, platelets from diabetic patients are less responsive to aspirin and are unable to protect themselves from thrombotic events
Objective and Method: 180 diabetic patients were enrolled for measuring their platelet aggregation. The aim was to evaluate the prevalence of aspirin non?responsiveness among Saudi type II diabetic patients. Serum glucose level and other clinical data were collected to find out the possible determinant of reduced platelet sensitivity to aspirin
Results: The prevalence of aspirin non?responsiveness was 9.44%. A significant correlation between aspirin test and each of fasting blood sugar, HbA1c, cholesterol and platelet count was observed. In contrast, there was no correlation among aspirin non?response, body mass index, age or hypertension
Conclusion: The relationship between the levels of glucose in the blood and aspirin resistance relates the importance of controlling blood glucose in diabetic patients to guarantee better aspirin action. Regular examining of type II diabetic patients to determine the sensitivity of platelet to the antiplatelet therapy is necessary to protect them from the risks of cardiovascular complications
ABSTRACT
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