Multi-drug resistant acinetobacter species as a cause of hospital acquired infections

Acinetobacter baumannii is an important opportunistic pathogen that is rapidly evolving toward multidrug resistance and is involved in various nosocomial infections that are often severe. Carbapenems are considered one of the very few antibiotics left to treat infections caused by this organism. The aim of this work is to study the antibiotic resistance pattern of Acinetobacter species isolated from different sites of nosocomial infections

Patients and Methods: antibiotic resistance pattern for 30 clinical isolates Of Acinetobacter was determined by the Kirby Bauer disk diffusion method Extended spectrum beta lactamase [ESBLs] production was detected by double disc synergy test. Isolates detected to be imipenem resistant were tested for metallo -lactamase [MBL] production by E test

Results: Extended spectrum beta lactamase production is high [19/30] 63.3% among Acinetobacter species. Ten [33.3%] isolates are found to be resistant to imipenem and meropenem by the disk diffusion method and 3/30 [10%] of them are found to be MBLs producers

Conclusion: acinetobacter spp. are resistant to many classes of antibiotics. Production of ESBLs, and MBLs are responsible for the multidrug resistance of these pathogens

Detection of streptococcus pneumonia in middle ear -effusion from patients with otitis media

In spite of the availability of effective antimicrobial therapy, Otitis media with effusion [OME] is still an important infection leading to serious health problems in both children and adults. [Streptococcus pneumonia] S. pneumoniae is one of the most frequently isolated bacteria from middle ear effusion [MEE] samples of OME patients. Since it is fastidious bacteria, various problems may arise in the rapid diagnosis of OME settings. Knowing which bacterium is involved is essential for the prognosis and treatment of otitis media with effusion, as the high frequency of its presentation may be linked to the etiology and/or course of the process in many patients

Objective: the aim of this study was to evaluate the use of nested polymerase chain reaction [PCR] assay for S.pneumonia as a diagnostic tool in patient with OME, and to detect the relation of the organism to other factors contributed to pathogenesis of OME

Subjects and Methods: middle ear fluid samples were aspirated from 34 patients presented with OME. Each sample was subjected to cultivation on selective media, and nested PCR test using specific primers directed to selected pneumolysin gene fragment of S.pneumonia

Results: S.pneumonia was recovered by culture in 4/34 [11.87%] of middle ear fluid samples; 3/4 [75%] from children and ¼ [25%] from Adults. Nested PCR detected S.pneumonia in 11/134 [32.4%] of the samples; 8/11 [72. 7%] were children and 3/11 [27.3%] were adults. All culture positive samples were PCR positive, but 7 [63.6%] of the PCR positive samples were culture negative. There were strong effects of the age, pervious history of acute otitis media, sinusitis and allergic rhinitis. The recovery rate of the organism was [72.7%, 54.5 %, 36.4% and 27.3%] respectively

Conclusion S.pneumonia was detected in high rates in MEE samples. This suggests that it may play a role in the pathogenesis of otitis media with effusion. In addition, PCR was more sensitive compared to culture for detection of S. pneumoniae in MEE samples

Role of western blotting in serological diagnosis of helicobacter pylori infection

Background: Helicobacter pylori [H.pylori ] is the key pathogen for gastroduodenal diseases. The clinical outcome of H.pylori infection is influenced by the presence of strain-specific virulence factors that are usually detected by the presence of specific anti-H.pylori antibodies in serum. Apart from the detection of these antibodies by enzyme-linked immunosorbent assay [ELISA], it is desirable to obtain additional information concerning the presence of certain virulence factors of H.pylori that could be detected by immunoblot analysis

Objective: the aim of this work was to evaluate if blotting can replace the need for invasive endoscopy for diagnosis of virulent H.pylori infection , compare between it and ELISA as serodiagnostic test, and to focus on identifying factors and markers that define high-risk patients in whom H.pylori infection needs to be eradicated

Subjects and Methods: 19 dyspeptic patients were subjected to upper gastrointestinal endoscopy to obtain antral biopsy, direct urease test and culture of biopsy on specific media . Sera were obtained from the patients for IgG examination by ELISA and western blotting

Results: Western blotting was more sensitive [100%] than ELISA [sensitivity 81.8%], but specificity was the same for both [87.5%]. Only western blotting was able to detect antibodies to virulence antigens especially cytotoxin associated antigen [CagA] and vacuolating cytotoxin antigen [VacA]

Conclusion: Western blotting is a highly sensitive noninvasive test to diagnose toxigenic H.pylori infection. So that unnecessary gastroscopy and treatment can be avoided