Group B Streptococcus Colonization, Antibiotic Susceptibility, and Serotype Distribution among Saudi Pregnant Women / 감염과화학요법

Background@#Group B Streptococcus (GBS) comprises the normal flora of the female urogenital tract and can be transferred to neonates during delivery, causing invasive diseases.This study was performed to investigate the colonization rate, antibiotic susceptibility, and serotype of GBS among Saudi pregnant women. @*Materials and Methods@#In this cross-sectional study, vagino-rectal swabs from 400 pregnant women were collected over a period of one year. Identification of GBS isolates and determination of their antibiotic susceptibility were performed using the Microscan Walk Away system. The isolates were then typed using both latex agglutination and capsular genebased multiplex polymerase chain reaction assays. @*Results@#Sixty (15.0%) subjects were colonized by GBS, with serotype Ia as the dominant type (30.0%) followed by serotype III and V (25.0%, each). Only 43 (71.7%) isolates were typed by latex agglutination, whereas the remaining isolates were not typable or were non-specifically typed as compared to the genotyping assay, which revealed the specific type of each GBS isolate. The highest resistance rates were observed for erythromycin and clindamycin (16.7%, each), which were mainly restricted to the prevalent serotypes. @*Conclusion@#This study is the first to report the distribution of GBS serotypes based on molecular genotyping in Saudi Arabia. GBS colonization was evident among pregnant women, and resistance to erythromycin and clindamycin was predominant among serotypes Ia, III, and V. Molecular genotyping using capsular gene-based multiplex PCR provided reliable typing of the investigated GBS isolates in terms of sensitivity and specificity as compared to conventional serotyping using latex agglutination.

Team based learning in pathology: effect on test scores and student satisfaction

Objective: The objective of this study was to compare the impact of team based learning [TBL] on student's test scores in comparison with didactic lectures. We also wanted to assess to the level of students satisfaction regarding TBL as a teaching methodology

Study Design: Quasi experimental study

Place and Duration of Study: Department of Pathology, University Medical and Dental College Faisalabad, from May to July 2013

Material and Methods: Fourth year undergraduate medical students attending Pathology course at University Medical and Dental College [UMDC], Faisalabad in year 2013 involved the portion of Haematology were divided into two halves. The first half [H-1] was covered in two TBL sessions of two hours and 15 minutes duration each

The second half [H-2] was covered in 8 lectures of 45 minutes duration each

After completion of the course, students took test comprising of problem based SEQs regarding Hematology. The test comprised of two segments with questions of equal difficulty, representing the two halves of the topic

Students scores in these two segments were compared by using paired sample t-test

The students were given a validated questionnaire. This data was analyzed by using SPSS version 20

Results: The test scores were highly significant [p=0.000] in TBL as compared to lecture group. In addition to positive significant relationship, majority of students also agreed that TBL motivated them to learn Pathology [71.72%], promoted better understanding of the subject matter [68.92%], helped to gain in depth knowledge of the subject [62.06%] and helped to remove misconceptions about the topic [65.51%]. Sixty two percent students preferred TBL to didactic lectures

Conclusion: Our study proved to have a significant impact of TBL on student test scores as compared to didactic lectures. Majority of the students were satisfied with TBL as a teaching methodology in Pathology and preferred it to didactic lectures

Efficacy of cefoxitin disk diffusion in predicting mecA gene mediated oxacillin resistance in coagulase negative staphylococci

Accurate detection of mecA gene mediated resistance to oxacillin is necessary for appropriate antimicrobial chemotherapy for staphylococcal infections. To determine the efficacy of cefoxitin disk diffusion tests in detecting mecA gene mediated oxacillin resistance in coagulase negative Staphylococci. This descriptive study was carried out after the approval of Bioethical Committee of the Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia. Clinical isolates of coagulase negative Staphylococci from blood culture of neonates suspected to be suffering from septicemia from January 2012 to December 2013 at Maternity and Children hospital Makkah, Saudi Arabia were studied. In this study 241 coagulase negative Staphylococci clinical isolates from Maternity and Children hospital, Makkah were included. Identification of coagulase negative Staphylococci species and their antibiotic susceptibility testing i.e., minimum inhibitory concentration was performed using Microscan Walk Away system. Concurrently, all isolates were subjected to disk diffusion tests [oxacillinmicrog disc, cefoxitin 30micro g disc] following Clinical and Laboratory Standards Institute guidelines. A total of 241 coagulase negative Staphylococci strains isolated from neonatal blood cultures included S.epidermidis 99[41.1%], S.haemolyticus 71[29.4%], S.hominis 38[15.7%], S.xylosus 14[5.9%], S.capitis 9[3.9%] and others 10[4.2%]. The results of phenotypic detection of mecA gene by cefoxitin and oxacillin disk diffusion were compared with their MIC results. The cefoxitin disk diffusion predicted mecA gene in 89.6% isolates and oxacillin disk diffusion in 83.8%. The cefoxitin minimum inhibitory concentration results matched totally with cefoxitin disk diffusion results but oxacillin minimum inhibitory concentration results did not match totally with its disk diffusion results. Minimum inhibitory concentration results of oxacillin were same as that of the cefoxitin minimum inhibitory concentration and disk diffusion results. Cefoxitin disk diffusion has an edge over oxacillin disk diffusion in predicting mecA mediated oxacillin resistance in coagulase negative Staphylococci. Those using disk diffusion as their routine susceptibility testing method for Staphylococci may replace lug oxacillin disc with 30microg cefoxitin disc for routine testing but should report oxacillin in its place

Drug resistance patterns of acinetobacter baumannii in Makkah, Saudi Arabia

Acinetobacter baumannii causes infections of respiratory, urinary tract, blood stream and surgical sites. Its clinical significance has increased due to its rapidly developing resistance to major groups of antibiotics used for its treatment. There is limited data available on antimicrobial susceptibility of A.baumannii from Saudi Arabia. To determine the patterns of drug resistance of Acinetobacter baumannii and predisposing factors for its acquisition. In this descriptive study, 72 hospitalized patients infected with A.baumannii were studied. The clinical and demographic data of the patients were collected using a predesigned questionnaire. Isolation and identification of A.baumannii from all clinical specimens were done using standard microbiological methods. Antibiotic susceptibility testing was performed by disk diffusion method recommended by Clinical Laboratory Standards Institute. Majority of the isolates [61.1%] were from respiratory tract infections. A.baumannii isolates showed high drug resistance to piperacillin [93.1%], aztreonam [80.5%], ticarcillin, ampicillin, and tetracycline [76.4%, each] and cefotaxime [75%]. Only amikacin showed low rate of resistance compared to other antibiotics [40.3%]. About 36% patients had some underlying diseases with diabetes mellitus [11%] being the predominant underlying disease. High antimicrobial resistance to commonly used antibiotics was seen against A.baumannii isolates. Only amikacin was most effective against it