ABSTRACT
Background: Asthma prevalence in adults is globally increasing with variations between and within countries. Data are lacking regarding the prevalence of asthma among adults in Najran area , the southern region of Saudi Arabia. Objectives: The study aimed at estimating the prevalence and risk factors for asthma symptoms in Najran University students. Materials and Methods: A cross-sectional study was performed in Najran University Saudi students during the academic year 2017–2018. A modified translated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was distributed to Najran University Saudi students, males and females aged 18 and above living in Najran for more than 1 year. Samples were taken using multistage random sampling. Results: A total of 418 participants (269 males and 149 females) with a mean age of 21.05 ± 1.56 were included in the study. The prevalence of asthma depending on the wheezing symptom in the past 12 months was 27% and physician-diagnosed asthma was 13.6%. Most of the asthmatic subjects (>85%) have intermittent symptoms. The first-degree family history, active tobacco smoking, allergic rhinitis (AR), dust, and smoke are the major risk factors for asthma symptoms. Conclusions: The study revealed a high prevalence of self-reported asthma symptoms among adults in Najran University associated with a high prevalence of AR, which needs particular attention by the health stakeholders.
ABSTRACT
To analyze integrons gene cassettes Class I among Escherichia coli [E. coli] isolates from Sudan and to determine their effect on the prevalence of resistance to antimicrobials. This cross-sectional study was conducted at 6 hospitals in Khartoum State, Sudan between April and August 2011. Escherichia coli [n=133] isolated from clinical specimens of patients were included. Isolates were identified and tested for antimicrobial susceptibility following standard procedures. Multi-drug resistance [MDR] patterns was defined as non-susceptibility to >/= 3 antimicrobials. Class I integrons was detected by polymerase chain reaction, and gene cassettes were characterized via sequencing analysis. Of the 133 E. coli isolates, 40.6% [n=54] harbored Class I integrons. All the 54 integron carriage, E. coli was found to be MDR strains. Integron carriage isolates confer higher levels of resistance than any other isolates [p<0.05] such as amoxicillin-clavulanic acid [66.7% versus 36.7%], ceftazidime [46.3% versus 17.7%], chloramphenicol [29.6% versus 7.6%], ciprofloxacin [70.4% versus 43%], tetracycline [88.9% versus 57%] and trimethoprim-sulfamethoxazole [98.1% versus 69.6%]. Sequencing of gene cassettes harbored mostly dihydrofolate reductase [dfrA], which encodes resistance to trimethoprim and aminoglycoside adenyltransferase [aadA] that encodes resistance to streptomycin. The most frequent combination types were dfrA17 and aadA5 genes. Class I integrons were quite common and its carriage contributed significantly to the emergence of MDR among E. coli. Nevertheless, factors leading to the wide spread of integrons are still to be determined
Subject(s)
Humans , Female , Male , Drug Resistance, Multiple , Prevalence , Integrons , Microbial Sensitivity TestsABSTRACT
This study aimed to determine the prevalence and assess antimicrobial susceptibility of extended- spectrum beta -lactamase-producing Escherichia coli isolated from clinical specimens of patients at hospitals in Khartoum State, Sudan. During April to August 2011, a total of 232 E. coli isolates were collected from various clinical specimens of patients. Isolates were identified, tested for antimicrobial susceptibility and screened for ESBL production as per standard methods. The double-disk diffusion method was used to confirm ESBL production using antimicrobial disks of ceftazidime [30 micro g], cefotaxime [30 micro g], with or without clavulanic acid [10 micro g]. A zone difference of >5 mm between disks was considered indicative of ESBL production. Out of 232 E. coli isolates, 70 [30.2%] were found to be positive for ESBL by the applied phenotypic methods. ESBL-producing isolates yielded high resistance rates for trimethoprim-sulfamethoxazole [98.6%], tetracycline [88.6%], nalidixic acid [81.4%] and ciprofloxacin [81.4%]. The highest antimicrobial activities of ESBL-producing isolates were observed for amikacin [95.7%], followed by tobramicin [74.3%] and nitrofurantoin [68.6%]. Resistance to quinolones, aminoglycosides, trimethoprim-sulfamethoxazole, tetracycline, nitrofurantoin and chloramphenicol was higher in ESBL than non-ESBL isolates [p<0.05]. The frequency of ESBL-producing isolates varied among hospitals [18.2% to 45.1%], although a high prevalence was recorded as 45.1% at Khartoum Teaching Hospital. Wound specimens were the most common source of ESBL-producing isolates. The proportion of ESBL-producing E. coli did not differ significantly between adults and children [31% vs. 27%]. The prevalence of ESBL-producing E. coli detected in this study is of great concern, which requires sound infection control measures including antimicrobial management and detection of ESBL-producing isolates