ABSTRACT
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
ABSTRACT
Many illnessess now can be treated on an ambulatory base [outpatient care] due to the shortage of hospital beds and escalation in operating expenses for inpatient care. The objective of this study is to evaluate the health service performance in Outpatient Clinics in Zagazig, University Hospitals for the sake of promotion of health services in these clinics. This work was done at the Pediatric and Gynecologic Outpatient Clinics, Zagazig University Hospitals. The health care - providers [physician number 37] and a random sample of 800 consumers of both studied clinics, were included in the present study The performance of the health service was evaluated by assessment of structure, care process, and outcome of care of the studied clinics.The work conditions of the studied outpatient clinics were satisfactory in general, but that for site, area and artificial ventilation of the Gynecologic clinic were inadequate. Lavatones and booklets were not adequate in both clinics while posters were not available in Gynecologic clinic The required medical equipments were available in Pediatric [35%] and Gynecologic clinics [73.9%], while non medical ones represented 62.5% and 68.7% of the required items respectively. Drugs availability was not satisfactory [at both studied clinics] according to both providors and consumers oponion. One record was present at each clinic in which recorded data were inaccurate and incomplete. Functional analysis of physicians showed that their performance was generally satisfactory except for completing ticket data and supervising subordinates. About case management, there was deficiency in communication skills [e.g. welcoming of the patient] versus manual skills [e, g.local examination] Consumer study revealed that rural residence and lower levels of education were significantly associated with higher degree of satisfaction. But consumers of both studied clinics were generally satisfied with service offered except for waiting time at Pediatric clinic. Institution of a quality assurance program to monitor the health service performance at the outpatient clinics on a regular basis is highly recommended