Prevalence of efflux mediated ciprofloxacin and levofloxacin resistance in pseudomonas aeruginosa urinary isolates

Pseudoinonas aeruginosa [P. aeruginosa] represents a phenomenon of antibiotic resistance, and demonstrates practically all known mechanisms of bacterial resistance. Active efflux is an important mechanism of resistance in P. aeruginosa. It contributes to the development of multiple resistances to all strategic antipseudonional antibiotics. More than five hundred urine samples were collected from patients in Assiut University Hospital. Fifty P. aeruginosa isolates were identified by conventional methods. The antibiotic susceptihity testing of isolates showed that 68% of isolates were resistant to ciprofloxacin and 62% were resistant to levofloxacin. A comparison between the effect of three efflux pump inhibitors [Reserpine, Pantoprazole and Carbonyl cyanide m-chlorophenylhydrazone [CCCP]] on the activity of ciprofloxacin and levofloxacin was done by measuring ability of these agents to potentiate effect of ciprofloxacin and levofloxacin against resistant P. aeruginosa isolates. Outer membrane profile of P. aeruginosa isolates was also done using sodium dodecyl sulfate polyacrylamide gel electrophoresis [SDS-PAGE]. Reserpine was able to potentiate effect of ciprofloxacin in 50% of isolates, and in 5.5% for levofloxacin. Pantoprazole results were 33.3% for ciprofloxacin, 16 7% for levofloxacin. Finally CCCP potentiate. Regarding the SDS-PAGE of P. aeruginosa isolates, all isolates produced proteins with apparent molecular masses in the range of 50-54kDa.Reserpine-ciprofloxacin proved to be the best combination against multidrug resistant P. aeruginosa. Over production of 50-54 KDa outer membrane proteins is responsible for emergence of P. aeruginosa strains highly resistant to fluoroquinolones in clinical settings

Biofilm formation by e-coli causing catheter associated urinary tract infection [CAUTI] in Assiut university hospital

Urinary tract infections [UTIs] are the most common cause of nosocomial infection and up to 80% of UTIs are associated with the use of urinary catheter. Inappropriate use of this device may lead to an increase incidence of infectious complications. It has been estimated that 65 % of nosocomial infections are biofilm associated urinary tract infections, loading the health care system enormous costs. These biofilm infections are 10 to 1000 times more resistant to the effects of antimicrobial agents. In this study urine samples were collected from 150 patients with CAUTI [group 1] giving one hundred and fifty bacterial isolates and 70 non catheterized UTI patients [group 2] giving fifty bacterial isolates. Out of the two hundred isolates the most common isolated pathogens were: Escherichia coli[E.coli] [50%] in group I, [48%] in group 2, followed by Klebsiella [26.7%] in group J, [28%] in group 2, pseudomonas aeruginosa [8%] in group 1, [12%] in group 2 then Staphylococcus aureus [8.6%] in group 1, [4.%] in group 2, Proteus [4.6%] in group 1, [4%] in group 2, and lastly, Candida albicans [2%] in group 1,[4. %] in group 2. The E.coli isolates were evaluated for biofilm formation using congo red agar [CRA] and microtitre plate methods. Out of 99 E.coli isolates; 27 were non biofilm forming in group 1, 19 isolates in group 2 while 48 isolates were biofilm forming in group 7, only 5 isolates in group 2 . Using microtitre plate method; out of 48 biofilm forming isolates in group 1; 8 isolates [16.6%] were weak biofilm forming, 10 [20.8%] were moderate biofilm and 30 isolates [62.5%] were strong biofilm forming while, 3 isolates were weak biofilm forming in group2. The two methods used to detect biofilm formation [CRA test and spectrophotometer], both are valid tests. CRA is simpler but spectrophotometer differentiates between weak and strong biofilm producers

Pattern of candida urinary tract infections among cancer patients in south Egypt cancer institute

The last decade has seen the sustained medical importance of opportunistic infections due to different Candida species mainly because of the worldwide increasing in the number of immunocompromised patients, who are highly susceptible to opportunistic infections. Urine samples were collected from 106 cancer patients in South Egypt Cancer Institute [SECI] that were cultured on Sabouraud dextrose agar media for isolation of Candida species. After Gram staining subculture was done on Hicrome Candida Differential Agar media. Results of the previous media were compared with those obtained with API 20C AUX yeast identification kits. The study revealed an overall isolation rate of Candida species among urinary tract infections was 20.8% [22/106]. Single type of Candida species was isolated from cancer patients with candiduria 16/22 [72.7%] while six patients had mixed species. Candida albicans was the most frequent species isolated responsible for fungal urinary tract infections 27.3% [6/22]. Non-Candida albicans species including Candida tropicalis [13.6%], Candida glabrata [13.6%], Candida stellatoides [9.1%], Candida krusei [4.5%] and Candida guilliermondii [4.5%] were also isolated. Candida albicans, Candida stellatoides and Candida guilliermondii could not be identified on chrom agar as all the isolates gave similar green colonies. Also Candida glabrata and Candida krusei could not be identified on chrom agar as they gave similar white colonies. Chrom agar identifies all Candida tropicalis as the isolates gave the typical pattern of purple to blue colonies. Candida albicans identified on Czapek Dox Agar media as they produced chlamydospores. The results of API 20C AUX were in 100% agreement with the results of Chrom agar in identification of Candida tropicalis. E-test on [SDA] was found to be an accurate method for antifungal susceptibility as it was compared with the reference broth microdilution method recommended by National Committee for Clinical Laboratory Standards [NCCLs]. For fluconazole the E-test demonstrated 94.1% agreement for all candida species