RESUMO
Purpose: The objectives of this study were to determine the magnitude of antibiotic resistance problem among Klebsiella pneumoniae isolates from patients with ventilator associated pneumonia and to investigate the association between multidrug resistance [MDR] strains and DNA, elements called "integrons, ". Also study aimed to test the effect of combined drugs therapy as alternative strategy for these MDR strains
Materials and methods: A total of 32 Klebsiella pneumoniae isolates were isolated from 130 endotracheal samples, randomly collected from suspected cases of ventilator associated pneumonia admitted to the ICU ofzagazig University hospitals and their resistance to different groups of antibiotics were analyzed. All MDR K. pneumoniae strains were tested against Combined antibiotics including Polymyxin B in combination with gentamicin, and rifampin. Also combined ciprofloxacin plus amikacin were tested to identify new treatment strategy. These isolates were further characterized by molecular studies to identify the Class I integr on-encoded intll integrase conferring the antibiotic resistance
Results: Although 22 of the 32 K. pneumoniae strains were MDR [i.e. resistant to three or more classes of antibiotics], all the strains were sensitive to imipenem. PCR detection using resistance gene-specific primers showed that 86.3% of MDR K. pneumoniae strains harboured Class I integr on-encoded intll integrase . Synergy was observed with the combination ofpolymyxin B and rifampin as well as with ciprofloxacin and amikacin
Conclusion: There was an increase in the spread of the MDR clinical isolates of Klebsiella pneumoniae among ventilator associated pneumonic patients. The results suggest that rifampin, may be useful additions to polymyxin B and ciprofloxacin plus amikacin in the treatment of infections caused by MDR K. pneumoniae. The study concluded high prevalence of Class 1 integr on-encoded intll integrase in MDR Klebsiella pneumoniae isolates?
RESUMO
Background: HBV infection is a major Egyptian and global health problem. Occult hepatitis B virus [HBV infection has been reported in patients with chronic hepatitis C who are negative, for HBV, surface antigen [HBs Ag]. However, the significance of "silent" HBV in hepatitis C virus [HCV] infection is unknown. Overt HBV and HCV co-infection has been reported to be associated with a more severe liver disease, increased frequency of HCC and resistance to a-interferon [alpha-INF] therapy
Aim of work: to determine the prevalence and clinical significance of occult HBV infection in chronic HCV-positive HBs Ag-negative patients in Al-Ahrar General Hospitals
Study design: a cross sectional study was done on chronic hepatitis C virus infected patients [HBs Ag-negative] who were receiving their treatment, 150 patients were randomly selected at different stages of treatment. Their sera were investigated for the presence of anti-core antibodies by ELZSA then HB V- DNA was detected by polymerase chain reaction [PCR]
Results: HBV-DNA has detected in [4%] of HCV-injected patients. HBV-DNA was detected in [24%] of anti-HBc-positive chronic HCV patients' sera, it was not detected in any of anti-HBc-negative chronic HCV patients. There was no significant difference in any of the clinical and/or laboratory data tested between anti-HBc-positive patients with and without HBV-DNA in the serum
Conclusion: About 4% of HCV-infected patients had occult HBV infection. Occult HBV infection in patients with chronic hepatitis C does not seem to modify the progression of chronic liver disease in short term follow up on small numbers of patients. Anti-HBc antibody detection ELISA is a cheap and sensitive method, so it can be used as only a screening tool preliminary before HBV DNA detection by PCR for occult HBV
RESUMO
Purpose: To demonstrate the prevalence and possible risk factors of retinal complications of pegylated interferon plus ribavirin treatment on patients involved in the national campaign for treatment of chronic hepatitis C in Sharkia governorate in Egypt
Methods: The study included 646 patients with chronic hepatitis C who were receiving treatment with pegylated interferon- alpha and ribavirin combination. Ophthalmologic examination was carried out on all patients of the study that were at different times of the treatment course. Ocular examination consisted of best corrected visual acuity measurement, anterior segment biomicroscopy and dilated fundoscopy. Patients with retinopathy had colored fundus photography. Statistical analysis was done to determine the prevalence of retinopathy and the possible correlation of several variables [age, sex, duration of treatment, dose of ribavirin, virus load, type of peginterferon [PEG-IFN alpha-2a or PEG-IFN alpha-2b], diabetes, hypertension etc] to the occurrence of retinopathy in this group of patients
Results: Out of 646 patients, 120 patients developed interferon induced retinopathy, so the prevalence of interferon induced retinopathy is 18.6%. 85% of the patients with retinopathy were asymptomatic; there were statistically significant correlations between patients' age, body mass index, dose of ribavirin, diabetes mellitus, hepatitis C virus load, general side effects of interferon treatment and the occurrence of retinopathy
Conclusions: Interferon induced retinopathy is not uncommon side effect of interferon plus ribavirin treatment and stress on regular ophthalmologic follow up is mandatory especially in patients with risk factors