study of the microbiology of diabetic foot infections in a teaching hospital in Kuwait

The purpose of this study was to determine the microbiological profile of diabetic foot infections [DFIs] and assess the antibiotic susceptibility of the causative agents. Data were obtained from a retrospective analysis of DPI samples collected from June 2007 to July 2008. Specimens were cultured using optimal aerobic and anaerobic microbiological techniques, and antibiotic susceptibility testing was performed according to the methods recommended by the Clinical and Laboratory Standards Institute [CLSI]. Extended-spectrum beta-lactamase [ESBL] production was measured using the double disk synergy test and the ESBL Etest. A total of 440 patients were diagnosed with DFIs during this period, and a total of 777 pathogens were isolated from these patients with an average of 1.8 pathogens per lesion. We isolated more Gram-negative pathogens [51.2%] than Gram-positive pathogens [32.3%] or anaerobes [15.3%]. Polymicrobial infection was identified in 75% of the patients. The predominant organisms isolated were members of the Enterobateriaceae family [28.5%], Pseudomonas aeruginosa [17.4%], Staphylococcus aureus [11.8%], methicillin-resistant S. aureus [7.7%], anaerobic Gram-negative organisms [10.8%], and Enterococcus spp. [7%]. Vancomycin was the most effective treatment for Gram-positive bacteria, and imipenem, piperacillin-tazobactam and amikacin were the most effective treatments for the Gram-negative bacteria. In conclusion, DFI is common among diabetic patients in Kuwait, and most of the cases evaluated in this study displayed polymicrobial etiology. The majority of isolates were multi-drug resistant. The data gathered in this study will be beneficial for future determinations of empirical therapy policies for the management of DFIs. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved

study of the microbiology of breast abscess in a teaching hospital in Kuwait

To determine the microbiological profile of breast abscess and assess the antibiotic susceptibility of the causative agents. Data obtained from cases of breast abscess over a period of 3.5 years, June 2006 to December 2009, were retrospectively analyzed. Specimens were cultured using optimal aerobic and anaerobic microbiological techniques. The antibiotic susceptibility test was carried out using the methods recommended by the Clinical and Laboratory Standards Institute. One specimen per patient was analyzed. Of the 114 patients, 107 [93.8%] non-lactating and 7 [6.1%] lactating women were diagnosed with breast abscess during this period. Of the 114 specimens, 83 [73%] yielded bacterial growth. Of these, 115 pathogens were isolated with an average of 1.4 pathogens per abscess. Eighteen [22%] of the 83 specimens yielded mixed bacterial growth. There were more Gram-positive pathogens [60, 52%] than anaerobes [32, 28%] and Gram-negative pathogens [22, 19%]. The predominant organisms were methicillin-susceptible Staphylococcus aureus [37, 32%], methicillin-resistant S. aureus [MRSA; 11, 10%], Bacteroides spp. [16, 14%], anaerobic streptococci [14, 12%] and Pseudomonas aeruginosa [9, 8%]. Of the 48 S. aureus, MRSA accounted for 11 [23%]. All MRSA isolates were susceptible to trimethoprim-sulfamethoxazole and vancomycin. Conclusion:S. aureus was the most common pathogenic organism isolated in breast abscesses at Al Amiri Hospital, Kuwait, of which 23% were MRSA. Nearly a third of the cases were caused by anaerobes, particularly B. fragilis. The data present a basis for the formation of empirical antimicrobial therapeutic policy in the management of breast abscess

incidence of lung cancer in the Gulf cooperation council countries

Lung cancer is the most common cancer in the world, with an estimated number of 1.3 million new cases as of 2002. This is the first report from the countries that comprise the Gulf Cooperation Council [GCC]. All the primary lung cancer cases registered in the Gulf Center for Cancer Registration during 1998 to 2001 were used to calculate the age-standardized incidence rate [ASR] per 100 000 person-years by the direct standardization method. Overall, there were 1607 [1261 males, 346 females] primary lung cancer cases registered during this period with the male to female ratio of 3.6:1. The highest ASR was in Bahrain [34.3 for males, 12.1 for females] followed by Qatar [18.5 for males, 5.5 for females] and Kuwait [13.8 for males, 4.0 for females]; the lowest rate was in Saudi Arabia [4.8 for males, 1.3 for females]. The mean age at diagnosis for males ranged from 68.7 years in Bahrain to 59.2 years in Oman. For females it ranged from 68.2 years in Bahrain to 58.0 years in Oman. Squamous cell carcinoma in males [except in Qatar] and adenocarcinoma in females were the predominant histological type. Cancer of the lung is one of the common cancers among males in all the GCC countries and ranks second among Bahraini females. Adenocarcinomas were more common in women than men