Detection of virulent of Klebsiella isolates from ñlinical samples / Монголын Анагаах Ухаан

IntroductionKlebsiella spp is a well-known opportunistic pathogen associated with nosocomial infections such asurinary tract, septicaemia and pneumonia number of multi-drug resistant strains and infections causedby Klebsiella has progressively increased, causing treatment limitations.GoalIdentify of phenotype of Klebseilla isolates from ñlinical samplesMaterials and MethodsA total of 112 Klebsiella strains were isolated from clinical samples in State Central First Hospital and StateCentral Third Hospital from July 2015 through December 2015. The bacterial isolates were identifi edaccording to cultural characteristics, biochemical test and API20E. The serum resistance, capsule andhypermucoviscosity, cell surface protein (curly), a-hemolysin and ability to form biofi lm were sought byphenotypic assays. Antimicrobial susceptibility was tested by diffusion method.ResultA total of 112 Klebsiella samples were collected. The bacterial isolates were identifi ed according tocultural characteristics, biochemical test and API20E, the results revealed that 16.1 percent isolateswere identifi ed as K.oxytoca all of them 83.9 percent isolates were belong to K.pneumonia. Therewere observed for ampicillin (99 percent), nitrofurantoin (53.6 percent), cepalotin (50.6 percent) and51 percent of isolates were considered as a multiple drug resistant. Serum resistance properties ofK.pneumoniae was resistance 89.4 percent, intermediately susceptible 4.3 percent, sensitive 6.4percent and for K.oxytoca resistance 88.9 percent, intermediately susceptible 5.6 percent, sensitive 5.6percent. The hemolysin àalpha was detected in 32.2 percent, and gamma, beta in 66.96 percent, 0.9percent respectively. The capsule was observed in 46.5 percent and hypermucoviscosity in 27.7 percentof isolates. The cell surface protein (curly) and biofi lm were detected in 100 percent.Conclusion:Both K.pneumoniae and K.oxytoca isolates from clinical samples have similar virulent properties, andthe a-hemolysin and hypermucoviscosity positive isolates were more resistance to antibiotics.

BRAIN ABSCESS IN CHILDREN / Мэс засал

Introduction: A brain abscess is aserious disease of the central nerve system.We conducted this study to summarize theclinical manifestations and outcomes ofbrain abscesses.Materials and Methods: A retrospectivechart review of pediatric patients diagnosedwith brain abscesses from November 2000 toJаn 2016 was performed at Shastin MedicalHospital neurosurgery department.Results: Twenty-five patients wereincluded in this study. On average, 1.67cases per year were identified and themedian age was 4.3 years. The commonpresenting clinical manifestations were fever(18/25, 72%), seizure (12/25, 48%), alteredmental status (11/25, 44%), and signs ofincreased intracranial pressure (9/25, 36%).A total of 14 (56%) patients had underlyingillnesses, with congenital heart disease(8/25, 32%) as the most common cause.Predisposing factors were identified in 15patients (60%). The common predisposingfactors were otogenic infection (3/25, 12%)and penetrating head trauma (3/25, 12%).Causative organisms were identified in 64%of patients (16/25). The causative agentswere S. intermedius (n=3), S. aureus (n=3),S. pneumoniae (n=1), Group B streptococcus(n=2), E. coli (n=1), P. aeruginosa (n=1),and suspected fungal infection (n=5). Sevenpatients received medical treatment onlywhile the other 18 patients also requiredsurgical intervention. The overall fatality ratewas 16% and 20% of patients had neurologicsequelae. There was no statistical associationbetween outcomes and the factors studied.Conclusion: Although uncommon, a brainabscess is a serious disease. A high level ofsuspicion is very important for early diagnosisand to prevent serious consequences.

BRAIN ABSCESS IN CHILDREN / Мэс засал

Introduction: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Materials and Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 2000 to Jаn 2016 was performed at Shastin Medical Hospital neurosurgery department. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were S. intermedius (n=3), S. aureus (n=3), S. pneumoniae (n=1), Group B streptococcus (n=2), E. coli (n=1), P. aeruginosa (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.

The detection of adherence factorsby Escherichia coli cause of urinary tract infectionsin Ulaanbaatar, Mongolia / Монголын Анагаах Ухаан

INTRODUCTION: Urinary tract infections among the most common bacterial infectious diseases encountered at all ages. Escherichia coli are being the etiologic agent in 50–80%. Therefore, it is an important public health problem. E.coli causing urinary tract infections express pilli, fimbriae and others adherence virulence factors. GOAL: To detect the some adherence virulence factors of Uropathogenic Escherichia coli (UPEC) in Ulaanbaatar, Mongolia MATERIALS AND METHODS: A total of 76E.colisampleswere collected. These samples were positive bacteriological examination of urine, performed at the bacteriological laboratory of the State Central Third Hospital and State Central First Hospital, Ulaanbaatar, Mongolia. The biofilm formation was evaluated by the growth rate of E.coli on plastic surface.The detection of the virulence factors type 1 fimbriae (fimA gene) and P-fimbriae (papC) was performed by multiplex PCR using gene specific primers.Curli expression was determined by using congo red agar. RESULTS: The evaluation of bacterial biofilm formation using 96 well plates showed 40 negative (52.6%), 32 weak biofilm (42.1%) and 4 moderate biofilm (5.3%) formation for E.coli and no strong biofilm forming strain was detected. The cell surface protein (curli) was detected by Congo red agar. The result was 71% positive for studied E.coli strains. The detection result of pili genes by multiplex PCR showed that fimH gene detected for 73 (96.1%) and papC gene detected for 18 (23.7%) E.coli cultures. CONCLUSION: Almost half of surveyed Uropathogenic E.coli isolated in Ulaanbaatar, Mongolia had ability of biofilm formation and it has been determined by the bacterial surface protein (curli), which is one of bacterial adherence factors, may cause biofilm formation.