ABSTRACT
Objective: A prospective study aimed at isolation, biochemical identification and determination of the antibiotic resistance pattern of the bacteriologic agents causing surgical site infection in surgical wards in Sohag University hospital and confirmation of isolated MRSA by detection of mecA gene by PCR assay
Patients and Methods: This study included 100 patients suffering from nosocomial SSI and recruited from different surgical wards in Sohag University hospital in the period from October 2005 to July 2006. SSI was identified using CDC definitions. The collected samples were cultured, the isolated organisms identified, tested for their antibiotic sensitivity and mecA gene detected in the isolated MRSA strains by PCR assay
Results: Gram-negative bacteria were involved in 62 [70.5%] and Gram-positive cocci in 26 [29.5%]. Five species were isolated most frequently: Staphylococcus aureus [20], Escherichia coli [20], Pseudomonas aeruginosa [16], Proteus mirabilis [12] and Klebsiella pneumoniae [11]. Resistance to most commonly available antibiotics was moderate to very high among Gram-positive and Gram-negative isolates. Almost all Gram-negative bacteria were sensitive to imipenem and amikacin. PCR assay revealed that all the isolated Staphylococcus aureus strains [100%] were positive for mecA gene
Conclusion: It is of utmost importance to estimate the frequency of surgical site infections and identify associated risk factors in order to undertake adequate measures for their prevention and control
ABSTRACT
Tumor necrosis factor-alpha [TNF-alpha] is involved in many acute and chronic liver disease [CLD]. This work was conducted on 69 patients with CLD [50 patients with overt hepatic encephalopathy [HE] and 19 patients with no evidence of HE] and 13 healthy subjects as a control group. The aim was to assess the serum level TNF-alpha in patients with HE due CLD and to correlate this level with the severity and precipitating factors of HE. All patients and control subjects were subjected to clinical, laboratory and abdominal ultrasonography in addition to measurement of serum level of TNF-alpha. HE was more common in male patients [P<0.002] but not related to the age [P = 0.826]. Serum TNF- alpha level was significantly elevated in patients with CLD in comparison with the control and patients with overt HE than those with no evidence of HE [16.88 pg/ml. 33.85 pg/ml and 78.48 pg/ml] respectively. TNF-alpha was positively correlated to the synthetic liver function but not related to the liver enzyme levels. TNF-alpha was positively related to the severity of liver disease represented by Child-Pugh score [P<0.001] being highest in Child C patients. The serum level of TNF-alpha was significantly correlated to the severity of HE reaching its highest levels in Grade IV. but not related to the precipitating factors of HE. serum level of TNF-alpha was higher in cirrhotic patients with HE and correlates with severity but not the precipitating factors of HE