Viral, bacterial and parasitic etiology of pediatric diarrhea in Gaza, palestine

To determine the etiology of acute diarrhea in Palestinian children under 5 years of age and to improve knowledge of the etiology of gastrointestinal pathogens using traditional and molecular diagnostic techniques. Various common enteropathogens [viral, bacterial and parasites] associated with diarrhea were investigated by conventional and molecular techniques [PCR] in 150 children less than 5 years of age admitted to the Central Pediatric Hospital, Gaza Strip, Palestine. The occurrence of enteropathogens identified was as follows: rotavirus 42/150 [28%], Entamoeba histolytica/dispar 23/150 [15%], Shigella spp. 9/150 [6%], Campylobacter coli/jejuni and Escherichia coli O157:H7 7/150 [5%] each, Salmonella spp. 3/150 [2%], Giardia intestinalis 1/150 [1%], and Strongyloides stercoralis 1/150 [1%] of the samples. Shigella and Salmonella isolates were tested for their susceptibility to common antimicrobial agents and most of the isolates were resistant to ampicillin and trimethoprim/sulfamethoxazole. This study demonstrated that rotavirus, E. coli O157:H7 and Campylobacter, which are not routinely screened for in Gaza Strip, were significant enteropathogens. The results highlight the value of using a combination of traditional and PCR techniques in the diagnosis of enteropathogens related to gastroenteritis

Pseudomonas aeruginosa distribution in clinical sample and their antibiogram from Al-Shifa Hospital, Gaza, PNA

To assess antibiotic resistance of Pseudomonas aeruginosa isolates from four types of clinical specimen at Al-Shifa hospital, and to compare susceptibilities of those isolates according to their source. Clinical specimens from Al-Shifa hospital in Gaza were analyzed between January and December 2002. Pseudomonas aeruginosa were isolated and identified by conventional methods. The antibiotic resistance rates were measured by modified Kirby-Bauer disk diffusion method. Data were analyzed statistically using SPSS [version 11]. The number of isolated P. aeruginosa was 541, obtained from 4 types of clinical specimens. Pus was the major source of P. aeruginosa isolates [64%], followed by urine [24%], sputum [7.0%] and Blood [5.0%]. However, considering the number of specimens cultured, sputum showed the highest Pseudomonas isolation rate [49%], followed by Pus [23%], urine [8.0%] and Blood [6.0%]. The highest percentage rates of resistance were found against amoxicillin [99% of all isolates], cephalexin [98.5%], cefaclor [97.4%], doxycycline [96.2%], trimethoprim/ sulfamethoxazole [94.7%] and nalidixic acid [93.5%]. Ciprofloxacin was the most effective of all the tested antimicrobials, followed by Gentamicin and Amikacin. Significant statistical [P >/= 0.05] difference in isolated strain susceptibility was detected among some of the antimicrobials depending on the specimen source. This study showed that antimicrobial resistance of Pseudomonas aeruginosa was high and alarming. Significant difference in the resistance pattern of isolates from different specimen type can be useful in clearing the picture of resistance problem and suggests that due care must be taken in hospital settings to adequately diagnose pseudomonal infections and prescribe the antibiotic treatment most effective in preventing the increase in multidrug resistant organisms

Rotavirus infection in infants and young children with acute gastroenteritis in Gaza, Palestine

To detect rotavirus antigen in infants and young children with acute diarrhea and gastroenteritis. Rotavirus is a major cause of gastroenteritis and diarrhea in infants and young children worldwide. Fecal samples from 150 children with ages ranging from 1 month to 5 years, living in Gaza, who presented with acute diarrhea episodes, were analyzed for rotavirus antigen. The analysis was carried out using an immunochromatography-based diagnostic kit [The Rota Stick One-Step test, Novamed Ltd, Jerusalem]. The study was conducted during the peak diarrheal season [May-August] of the year 2005. Rotavirus was detected in 28% [42/150] of the fecal specimens examined, and the majority of patients 90% [38/42], who were positive for the virus were 1 to 24 months old, and the infection rate decreased with increasing age. The highest rate of rotavirus antigen detection was observed among the 12 to 24 months age group 41.9%. Children infected with rotavirus were more likely to have watery stool [95.2%], vomiting [92.9%], moderate dehydration [14.3%] and fever has low frequency [73.8%]. The findings of this study demonstrate that rotavirus is one of the most frequently detected, yet a routinely neglected pathogen during stool examinations in Gaza strip health laboratories. Timely diagnosis of rotavirus infection in patients with acute diarrhea helps to determine appropriate treatment, prevents the unnecessary use of antibiotics and minimizes the spread of the disease. To our knowledge, this is the first report on occurrence of rotavirus infection among children of Gaza since 1994