Detection of bla SHV and bla CTX-M genes in ESBL producing Klebsiella pneumoniae isolated from Egyptian patients with suspected nosocomial infections

The correct identification of the genes involved in ESBL mediated resistance is necessary for the surveillance and epidemiological studies of their transmission in hospitals. The aim of the present study was to find the prevalence of ESBL producing Klebsiella pneumonia among K. pneumonia isolates separated from Egyptian patients with suspected nosocomial infections, to detect their drug resistance pattern and to look for bla SHV and bla CTX-M genes in such organisms. 138 K. pneumonia isolates from Egyptian patients with suspected nosocomial infections were screened for ESBL production by the pattern of antimicrobial susceptibilities. Phenotypic identification for ESBL production was confirmed by double disc synergy test, phenotypic confirmatory double disc test and by MicroScan panel system. bla SHV and bla CTX-M genes in ESBL producing K. pneumonia were detected using multiplex PCR. The prevalence of ESBL producing K. pneumonia was 21% [30/138]. Their pattern of antimicrobial susceptibility showed that 90% was resistant to [Sulphamethoxazole / Trimethoprim], 70% was resistant to [Amoxicillin / Clavulanate], 63.3% was resistant to Cefotaxime and Ceftazidime, 60% was resistant to Amikacin, 46.7% was resistant to Doxycycline, Cefoxitin, Ceftriaxone and Levofloxacin, 40% was resistant to Cefepime, 20% was resistant to Ertapenem and [Sulbactam / Cefoperazone], 13.3% was resistant to [Piperacillin / Tazobactam], 10% was resistant to [Imipenem/Cilastatin] and Gentamycin and 6.7% was resistant to Meropenem and Ciprofloxacin. Among the ESBL producing K. pneumoniae, three out of 30 [10%] and 16 out of 30 [53.3%] were positive for bla SHV and bla CTX-M genes respectively. It could be concluded that ESBL producing isolates of K. pneumonia have been increasingly recognized in the hospital settings in Egypt and are associated with multiple drug resistance. Thus, molecular identification of the genes encoding beta lactamases would be essential for a reliable epidemiological investigation of their transmission in hospitals and antimicrobial resistance

Effect of the degree of polymerization on the intrinsic discoloration of light activated resin composite restorations

This study was carried out to investigate the effect oft he degree of polymerization on the intrinsic discoloration of light activated resin composite restorations. Three different commercially available resin composites were used in this study. Each group was subdivided into three sub groups, according to time of curing. Half of the specimens in each sub group, where stored in dry condition while the other half was stored in coffee. Color was assessed by the spectrophotometer and degree of polymerization was measured by FTIR. The collected data were statistically analyzed using two way analysis of variance [ANOVA]. Reverse relationship was found between the intrinsic discoloration and the degree of polymerization. The curing time should not be less than 40 sec. to ensure better color stability of different resin composites

Evaluation of qualitative and quantitative platelet defects using flow cytometry

The diagnosis of platelet defects and inappropriate platelet activation is associated with some difficulties. Flowcytometry has been reported to be ideally suited for studying several clinical aspects of platelet pathophysiology and platelet function. In this study, the methodology and clinical utility of reticulated platelet analysis, platelet associated immunoglobulin and platelet expression of P-selectin [CD62] and glycoprotein IIbIIIa [CD41] in some platelet disorders were explored. The study included a total of 72 cases classified into 35 cases of ITP, ten cases of ITP in remission, seven cases of Glanzmanns thrombasthenia, six cases with aplastic anemia and 14 age matched controls. Data showed that flowcytometric analysis can be used as a reliable measure of important diagnostic aspects of qualitative and quantitative platelet disorders and it can be used to assess circulating activated platelets