Prevalence and risk factors of carbapenem-resistant gram negative bacilli in Assiut University Hospital

Carbapenem-resistant Gram negative bacilli [CRGNB] resulting from carbapenemase enzyme production have been reported to be an important cause of nosocomial infection and are a critical therapeutic problem worldwide. This study was conducted to determine the prevalence of carbapenem-resistant Gram negative bacilli in Asiut University Hospital and relevant risk factors associated with its occurrence. The study was conducted over a period of 12 month from January 2011 to January 2012 on 355 specimen of 134 nosocomialy infected patients, aged two month to 82 years, admitted to the ICUs at Assiut University Hospital. Patient demographics, comorbidities, antibiotics, invasive devices were determined to identify risk factors associated with CRGNB infections. Three hundred and fifty five Gram negative bacilli isolates [47.92%] were isolated from patients. Ninety seven [27.17%] of Gram negative bacilli isolates were carbapenem-resistant. Patients aged above 40 years, male sex, prior antibiotic treatment, the presence of a urinary catheter, mechanical ventilation and central line in ICU were the most prevalent risk factors associated with the accurence of nosocomial CRGNB infections. The prevalence of CRGNB was 27.17% among GNB isolates. Patients aged above 40 years, male sex, prior antibiotic treatment, the presence of a urinary catheter, mechanical ventilation and central line in ICU were the most prevalent risk factors Interventions aimed reducing initial broad spectrum antibiotics are clearly needed to help control the spread in of these difficult to treat infections

Molecular identification and antifungal susceptibility of pathogenic fungi isolated at Assiut university hospitals

The incidence of invasive opportunistic mycoses [10Ms] has increased because of the expanding population of immunosuppressed patients raising the demand for identification of local epidemiologic trends, the degree of virulence and antifungal susceptibility pattern of fungal pathogens. Identification of the local epidemiology of l0Ms at Assiut University hospitals showed that there is a marked shift to Candida non albicans [can], rare yeasts that cause Candida like infections, zygomycetes, hyaline moulds and a wide variety of dematiaceous fungi. In vitro susceptibility testing pattern of isolated fungal pathogens against 8 antifungal agents; Amphotericin B [AP], Nystatin [NS], l;luconalole [FU], Ketoconazole [KT], Clotrimazole [CC], Voriconazole [VOR], Itraconazole [IT] andv Terbinafinc showed that these emerging pathogens are resistant to conventional antifungals, in addition, they pose a high enzymatic and toxigenic ability making them more virulent and infections caused by them more aggressive and very difficult to manage