Clinical spectrum of fever of unknown origin among adult Egyptian patients admitted to Ain Shams university hospitals: a hospital based study

This prospective study was designed to analyze the clinical spectrum of fever of unknown origin [FUO] among adult Egyptian patients admitted to Ain Shams University Hospitals during the period from May 2009 till the end of December 2010. All Egyptian patients fulfilling the criteria of FUO admitted during this period were followed up till reaching the diagnosis. 93 patients were included in the study. They were 48 [51.6%] females and 45 [48.4%] males, their ages ranged from 15 to 65 years [34.39 +/- 13.6]. Infections were the commonest cause of FUO[41.94%] followed by malignancies[30.11%]. While autoimmune diseases represented 15.05% and in 12.9% of patients the diagnosis was not established. Brucellosis and infective endocarditis were the commonest infections, while hematological malignancies were the commonest oncological diseases. Systemic lupus erythematosus [SLE] was the commonest auto-immune disease. Brucellosis, infective endocarditis, hematological malignancies and SLE must be considered in the differential diagnosis of adult FUO in Egypt

Antimicrobial resistant bacteria among health care workers in intensive care units at Ain Shams university hospitals

Fifty HCWs in ICUs of Internal medicine, Chest, Neonatology and Burn were included in prospective cohort study. Collection of nasal, hand and rectal swabs, proper biochemical identification, culture media and antibiotic sensitivity tests were used to detect Methicillin-resistant Staphylococcus aureus [MRSA]; vancomycin-resistant Enterococci [VRE] and extended spectrum beta-lactamase producing gram -ve bacilli [ESBLs]. S. aureus was isolated from 34% of HCWs; 28% were nasal carriers, 4% were hand carriers and 2% had S. aureus at both sites. Nasal and hand carriage rates of MRSA were 20% and 4% respectively, with an overall rate of 22%. Gram -ve bacilli were isolated from 8% of HCWs hand swabs and showed Citrobacter koseri, Escherichia coli, Kiebsiella pneumoniae and Pseudomonas aeruginosa. Hand carriage rate of ESBLs was 2%. Hand contamination with gram -ve bacilli and S. aureus was in 14% of HCWs. VRE carriage rate was 9.5%. ESBLs carriage rate in rectal swabs was 21.43%. K. pneumoniae was the most common ESBLs producing isolate [33.3%], followed by E. coli [18.75%]. In combined disc method, aztreonam was the most sensitive [90%] in detecting ESBLs. Burn ICU had highest% of MRSA and ESBLs carriage. Neonatal ICU showed highest% of VRE carriage. An insignificant association was between infection control training or antimicrobial intake and carriage of antimicrobial resistant bacteria