Emergence of Vancomycin-resistantat a Teaching Hospital, Saudi Arabia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vancomycin-resistant enterococci (VRE) are a major and emerging hospital-acquired pathogen associated with high mortality, particularly among the critically ill and Intensive Care Units (ICUs) patients. This study aimed to determine the prevalence and demographic and clinical characteristics of VRE among patients admitted to a university hospital in Riyadh, Saudi Arabia.</p><p><b>METHODS</b>A study was conducted during the period from September 2014 to November 2015 at King Khalid University Hospital, a tertiary care hospital in Riyadh, Saudi Arabia, including in-patients with VRE infection. Data were collected using laboratory results and the medical records of admitted patients and were analyzed using SPSS version 19.0 statistical software.</p><p><b>RESULTS</b>In a one-year period, 231 enterococci were isolated from blood, urine, exudates, sputum, stool, and body fluid. There were 191 (82.7%) vancomycin-sensitive enterococci (VSE) and 40 (17.3%) isolates were VRE. The Enterococcus species included E. faecalis 168 (72.7%), E. faecium, 53 (22.8%) E. gallinarum 5 (2.2%), and E. avium 5 (2.2%). VRE were more significant from blood specimens (P< 0.0001) while VSE were significantly more predominant from urine specimens (P< 0.0001). VRE were more commonly isolated from patients in ICUs and oncology unit (P = 0.0151 and P< 0.001, respectively) while VSE were more predominant in the medical and surgical areas (P = 0.0178 and P = 0.0178, respectively).</p><p><b>CONCLUSIONS</b>This study highlights the high prevalence of VRE in the hospital and the association of enterococcal infections with high-risk areas and oncology units, which warrant more studies looking for better management of these infections.</p>

Viral agents causing acute lower respiratory tract infections in hospitalized children at a tertiary care center in Saudi Arabia

To determine the load and importance of respiratory viruses in hospitalized Saudi children with acute lower respiratory tract infections [ALRIs]. A retrospective study was performed in the Departments of Pediatrics, Pathology/Microbiology, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from January 2005 to December 2010. Nasopharyngeal aspirates were collected from 643 children with ALRI. Viruses were detected by direct immunofluorescence, respiratory syncytial virus [RSV], adenovirus [ADV], type 1 to 3 parainfluenza viruses [PIV], and type A and B influenza virus [flu]. Of the 643 children with ALRI, viruses were detected in 309 [48.1%] specimens. The viruses that were identified included RSV [n=295, 95.5%], PIV [n=8, 1.2%], ADV [n=2, 0.3%], flu A [n=2, 0.3%], and flu B [n=2, 0.3%]. The RSV was predominated in 231 [75%] children less than one year of age. Only younger age and male gender were associated with severe illness. The peak frequency of the viruses detected was in the winter. Of the 309 virus positive samples, bronchiolitis was detected in 81.2% [n=251], and pneumonia in 14.2% [n=44] [p<0.0001]. Viruses are an important cause of ALRIs in Saudi children constituting approximately 48.1% of the total cases. The RSV is the most common pathogen [95.5%] causing ALRIs. Most of the children were younger than one year of age, and were more likely to present with bronchiolitis than pneumonia

Panton-Valentine leukocidin Staphylococcus aureus osteomyelitis of the femur in a Saudi child

Staphylococcus aureus producing Panton-Valentine leukocidin [PVL] is well recognized to cause severe skin and soft tissue infections. Recently, it has been increasingly recognized as causing life-threatening musculoskeletal infection. We reported previously 3 children who had osteomyelitis caused by methicillin resistant Staphylococcus aureus. We report and discuss a case of Methicillin sensitive Staphylococcus aureus encoding the PVL genes isolated from a child with acute osteomyelitis from Saudi Arabia

Severe community-acquired infection caused by methicillin-resistant Staphylococcus aureus in Saudi Arabain Children

Community acquired methicillin-resistant Staphylococcus aureus [CA-MRSA] infection has become a major pathogen causing significant infection in children in Saudi Arabia. It has emerged as a frequent cause of skin and soft tissue infections and can be associated with life-threatening complications such as necrotizing pneumonia and sepsis. Between January 2005 and March 2008, 5 [6%] previously healthy children with invasive CA-MRSA infections were identified from 80 children with community-onset MRSA infections. Three children had osteomyelitis, with one patient presenting a fulminant and extensive soft tissue and bone destruction complicated by deep vein thrombosis and pathological fracture. One child had deep-seated infection, and one infant had severe orbital cellulitis and bilateral orbital abscess complicated by subdural empyema. The median age was 4-years [range 3 months to 17 years]. Only one patient had a risk factor. Two patients were initially treated with ineffective antimicrobial therapy [beta-lactam]. One isolate showed inducible clindamycin resistance. The recovery was uneventful in all patients. This report should increase the awareness of clinicians regarding severe CA-MRSA infections and highlight the challenges encountered in the choice of therapy of serious infections caused by this organism