Risk factors for neonatal sepsis in tertiary hospital in Jordan

To study incidence, mortality, maternal and neonatal risk factors and causative microorganisms for neonatal sepsis. A total of 60 neonates with sepsis were studied during the period between January and December 2005. The clinical presentations, maternal, and neonatal risk factors and the time of neonatal death were recorded. Four hundred ninety nine [10.2%] out of 4902 live neonates were admitted for various reasons to the neonatal intensive care unit at King Hussein Medical Centre. Sixty [12.0%] babies had proven sepsis, 28 [46.7%] of these with early onset and 32 [53.3%] with late onset sepsis. Maternal risk factors associated with neonatal sepsis were: cesarean section in 22 [36.7%] cases, premature rupture of membranes in 4 [6.7%] cases, eclampsia in 4 [6.7%] cases, and maternal urinary tract infection in 3 [5%]. Neonatal risk factors observed were: male gender in 40 [66.7%] cases, low birth weight in 38 [63.3%] cases, prematurity in 32 [53.3%] cases, low Apgar score in 10 [16.7%] cases, and mechanical ventilation in 12 [20.0%] cases. Gram positive bacteria were isolated in 44 [73.3%] cases of which four died. However gram negative sepsis was associated with higher morbidity and mortality rates. Twelve [20%] babies died, seven of them due to Klebsiella sepsis. Candida sepsis caused three cases of sepsis with one death. Most of deaths occurred out of working hours. Early recognition and prompt treatment of neonatal sepsis are of paramount importance particularly in the presence of risk factors

Evidence of human coronavirus-Nl63 infection in Jordanian children

To detect and evaluate the role of the newly recognized human coronavirus [HCoV]-NL63 and HCoV-HKUl as aetiologic agents of acute respiratory tract infections in hospitalized Jordanian children younger than 5 years of age. Between December 2003 and May 2004, a total of 326 nasopharyngeal aspirates were collected from Jordanian children hospitalized with acute respiratory tract infections. Total DNA and RNA were extracted using Qiagen commercial kits. HCoV-NL63 and HCoV-HKUl were detected by random reverse transcription-polymerase chain reaction using random hexamer primer for the reverse transcription step, and specific primers that target the replicase and polymerase genes to produce 215-bp and 392-bp amplicons respectively. Other potential respiratory pathogens w7ere detected according to previously published protocols. HCoV-NL63 was detected in 4 [1.2%] out of 325 examined nasopharyngeal aspirates. HCoV-NL63 was detected in two children with severe, and in two with mild to moderate acute respiratory tract infections. HCoV-NL63 was the only pathogen detected in three patients, and mixed with adenovirus in one patient. HCoV-HKUl was not detected in the 325 nasopharyngeal aspirates examined. HCoV-NL63 is a significant causative agent of acute respiratory tract infections in hospitalized Jordanian children. HCoV-NL-63 can cause the respiratory disease either alone or in combination with other potential respiratory pathogens. Further studies are required to further characterize the clinical and epidemiological features of these newly recognized HCoVs in Jordan

Acute primary cutaneous nocardiosis in diabetic woman: a case report

We describe a diabetic woman suffering from a rare form of acute primary cutaneous nocardiosis, a superficial skin infection. Diagnosis was established by direct examination and cultures from discharging pus. The infection was successfully treated with a six-week course of trimethoprim-sulphamethoxazole

African furuncular myiasis in a Jordanian peace-keeping officer: a case report

Furuncular Myiasis is a common cutaneous disease in tropical areas with poor sanitary facilities. This case report of a 41-year-old Jordanian officer working with the United Nations Peace-Keeping Forces in Sierra Leone - Africa, highlights the importance of prompt and proper management of this disease acquired when traveling to tropical countries

Assessment of the knowledge and practices of Jordanian hospital staff in infection control

To study and evaluate the knowledge and practices of Jordanian hosoital staff in infection control. Identical copies of self-administered confidential questionnaire were distributed to forty-three medical and forty-four nursing staff at one day. The questionnaire contained three types to assess hospital staff's familiarity with written policies and procedures of infection control, intended course of action in situations where no formal policies were available, and willingness to give specimens and attend lectures. All the medical [100%] and nursing [100%] staff returned their competed copies. Nurses were significantly more familiar with all written policies and procedures than medical staff. They were also more likely to seek advice in situations where there were no written guidelines. Many hospital staff was uncertain about the practical details of policies and procedures for infection control. Ways to educate and motivate staff to comply with infection control measures are urgently required. Some degree of national standardization of policies and procedures in infection control is desirable

Scintimammography with 99M technetium - methoxyisobutylisonitrile versus X-Ray mammography in the evaluation of breast masses

To evaluate the diagnostic accuracy of scintimammography using 99m Technetium - methoxyisobutylisonitrile [99mTc-MIBI] in the detection of breast cancer in comparison with conventional mammography. A total of 113 patients with clinically suspicious breast masses and/or positive mammograms suggesting breast cancers were included in this study. After 10 minutes of 99mTc-MIBI injections, one anterior image in the prone positive and two lateral prone images were acquired for 10 minutes eash. Another set of images was taken in the same position after 60 min of injection. One-hundred and nineteen lesions [92 palpable and 27 non-palpable] were detected. There were 75 malignant and 44 benign lesions according to the histopathology findings obtained during excisional biopsies. The relation with the histopathology showed that the overall sensitivity and specificity of scintimammography were 68% and 73% respectively. However for palpable lesions, the sensitivity and specificity were 79% and 76% respectively. Sensitivity was not dependent on the density of the breast tissue. The sensitivity and specificity of mammography were 89% and 43% respectively, and did not depend on the tumor size. In 60% of false-negative mammograms, 99mTc-MIBI was able to diagnose malignancy [True-positive]. Imaging with 99mTc-MIBI showed a high diagnostic accuracy for the detection of breast cancer and could be used as a complementary imaging modality to conventional mammography in diagnosing breast cancer at an earlier stage particularly in patients with dense breasts

Evaluation of direct light microscopy for rapid detection of microorganisms in blood cultures

The aim of this study was to evaluate the use of direct light microscopy [x 40 objective] of unstained uncentrifuged blood-broth mixtures for rapid detection of microorganisms in blood cultures. Two thousand two hundred and ninety-four blood cultures were investigated in this study. Blood cultures were processed in the Clinical Microbiology Laboratory, Queen Alia General Hospital, Amman, Jordan from January to December 2001. We compared the results of direct light microscopy and subcultures in 3 stages: macroscopically positive blood culture bottles, macroscopically negative blood culture bottles after 9-17 hours, and macroscopically negative blood culture bottles after 7 days of incubation. The total positive blood cultures was 434 [18.9%]. Three hundred and fifty three [81.3%] were positive by macroscopic examination and direct light microscopy and grew viable organisms, 34 were macroscopically negative blood cultures that grew viable organisms after 9-17 hours of incubation in which 32 [94.1%] were positive by direct light microscopy and 47 macroscopically negative blood cultures that grew viable organisms after 7 days of incubation in which 45 [95.7%] were positive by direct light microscopy. The direct light microscopy methodology proved to be simple, rapid, cost effective, accurate and sensitive technique for the early detection of bacteremia