Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait

The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia [CAP] in Kuwait. The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classified according to the Pneumonia Outcome Research Team [PORT] severity index. The microbial etiology was determined using st and ard methods for bacteria and serological tests for atypical and viral pathogens. The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3 +/- 18 years. The severity class distribution was: class 131%, class II 37%, class III 17%, class IV 13%, and class V 2%. Etiological agents were identified from 44 patients [35%], with one pathogen in 31 [25%], two in 9 [7%], and three or more in 4 [3%]. The most common pathogens identified were: Mycoplasma pneumoniae in 14 patients [11%], Legionella pneumophila in 10 [8%], Chlamydia pneumoniae in 8 [6%], influenza B virus in 8 [6%], influenza A virus in 5 [4%], Haemophilus influenzae in 4 [3%], Streptococcus pneumoniae in 3 [2%], Staphylococcusaureus in 3 [2%], gram-negative enterobacteria in 5 [4%], Moraxella catarrhalis in 2 [2%], and viruses in 4 [3%]. The yields from laboratory tests were 48% for paired serology, 20% from adequate sputum sample, and 3% from blood culture. Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait, Atypical pathogens have a significant role in the etiology of CAP. There is overtreatment of CAP with a combination treatment consisting mainly of third-generation chephalosporins and macrolides

Seroprevalence of three emerging arboviral infections in Kuwaiti nationals

Diseases caused by dengue, s and fly fever and hanta viruses pose a major health risk in many countries. We determined the threat of these arboviral infections through a serologic using enzyme linked immunosorbent assay [ELISA] based tests. Hantavirus-specific antibodies were also detected using immunofluorescence. Of 499 samples tested for dengue virus IgG antibodies l4% were as positive for dengue positive by all the ELISA tests. Among the 42 showing strong IgG reactivity, only 1 was positive for dengue virus IgM antibodies. All samples tested for IgG antibodies to s and fly fever virus were negative. Hantavirus antibodies were detected in 11% of the 46 samples from high-risk individuals. The low prevalences suggest that at present these infections are not a serious problem in Kuwait

Polio eradication: intratypic characterization of poliovirus strains isolated in Kuwait

It is expected that the circulation of wild-type poliovirus strains will stop world-wide due to the WHO-recommended expanded programme of immunization. In Kuwait the situation is rather unique because thousands of the workforce come from countries where a number of polio cases are reported every year. The question is whether imported wild polio strains can survive in a well-vaccinated population. To answer this question we investigated the vaccine-relatedness of 60 poliovirus strains isolated in Kuwait. Reverse-transcription polymerase chain reaction [RT-PCR] coupled with restriction fragment length polymorphism assay were used for the identification of poliovirus isolates. Fragments obtained after digesting the RT-PCR-amplified product with three restriction enzymes [HaeIII, DdeI, HpaII] were compared with that of standard wild and vaccine type poliovirus strains. Isolates from healthy, vaccinated infants [n = 15], children [n = 15] and from patients with the diagnosis of aseptic meningitis [n = 30] were analysed. Molecular characterization revealed a strict vaccine-relatedness of all the 60 poliovirus isolates. The results suggest that rigorous vaccination policy implemented in Kuwait provides a high level of immunity which prevents the circulation of wild poliovirus strains in Kuwait

Poliomyelitis: immune status of the populotion of Kuwait

A comprehensive program to immunize children against polioviruses was started in Kuwait in 1976. This report is the first laboratory study aimed at investigating the immune status of the population of Kuwait to polioviruses. By using a virus neutralization procedure, the prevalence and the titer of poliovirus-specific antibodies were determined in 759 serum samples. Samples represented the following age groups: 0-1 months, 1-9 years, 10-19 years, 20-29 years, 30-39 years and 40-60 years. The first two age groups, during which the polio vaccinations are given, were studied in detail. Results allow for the following conclusions: [1] Monovalent [type 1] polio vaccine, given at birth, has an impact on the early development of immunity. It prevents the drop in the [maternal] antibody level during the first 2 months of life. [2] Immunity to all three types of polioviruses reaches a high level at the age of 5-6 months. [3] Both the prevalence and the level of antibody remain high in older age groups. The data reported here prove that the use of trivalent oral polio vaccine along with an efficient vaccination coverage has led to the complete elimination of paralytic poliomyelitis in Kuwait. Maintaining the polio-free status requires laboratory monitoring of the antibody level and nature of circulating poliovirus strains