Maternal intrapartum antibiotic use and severity of neonatal infection in Qatar: a hospital-based cohort study

To study the effect of intrapartum antibiotics on neonatal mortality and morbidity for infants with culture-proven neonatal sepsis the records were reviewed of all live born infants with culture positive neonatal septicemia admitted to the Neonatal Intensive Care Unit [NICU], Women's Hospital, Qatar between January 1st 2004 and April 30th 2005. Of 113 infants with culture-proven septicemia, 59 had received intrapartum antibiotics. Using univariate analysis, infants whose mothers had received intrapartum antibiotics were less likely to survive the septic episode [OR 0.09, 95% CL 0.11-0.75, p=0.009] and more likely to have severe septicemia [OR 4.38, 95% CI 1.74-11.02, p = 0.01] but gestational age adjusted estimates of survival and severe sepsis showed no difference between study and comparison groups. Being retrospective the study had certain limitations in variables but there is no clear evidence that intrapartum use of antibiotics plays a direct role in increasing mortality in septicemic infants

Streptococcus pneumonia serotypes in newly developed state of Qatar: consideration for conjugate vaccine

The objective of the study was to determine prevalent pneumococcal serotypes causing infections in different age groups, their susceptibility to beta-lactams and macrolides and whether these serotypes are covered by the conjugated pneumococcal vaccines. Streptococcus pneumonia strains isolated from different patients at Hamad Medical Corporation, Microbiology Laboratory between September 1999 and July 2000 were sent to Statum Serum Institute in Denmark for serotyping. The strains were tested for their susceptibility to penicillin, ceftriaxone and erythromycin by Vitek 2 machine [bioMerieux, France] at Hamad Medical Corporation, Microbiology Laboratory. Predominant serotypes in children <2 years were: 6A, 6B, 9V, 11A, 14, 19A, 19F and 23F, predominant serotypes in children between 2-7 years were: 3, 6B, 15B, 19A, 19F and 23F, while predominant serotypes in adults were: 3, 8, 9V, 14, 15B, 20 and 22F. In children less than 2 years, the 7-valent and 9-valent conjugate vaccines covered 52% of serotypes. 33% of strains were moderately resistant to penicillin, 27% showed high-level resistance to penicillin, 30% resistant to erythromycin and 2% resistant to ceftrixone. The 7-valent and 9-valent vaccines offer similar coverage of serotypes in children less than 2 years while the 11-valent vaccines offers 55% coverage. This difference is not statistically significant. Resistance to penicillin was high which leaves ceftriaxone as the drug of choice for empirical treatment of invasive pneumococcal diseases

Acute bacterial meningitis in Qatar

To study the changes in the epidemiology, clinical and bacteriological profiles of bacterial meningitis in the era of the Haemophilus influenzae type b [Hib]vaccine and pneumococcus resistance. This is a retrospective study of children aged <12 years admitted to the Hamad Medical Corporation, Qatar between January 1998 through December 2002 with positive cerebrospinal fluid culture. We described 64 patients with culture proven bacterial meningitis. In infants <3 months [n=29 [45%]], the most common organism was Group B Streptococcus [GBS] [20%]. Children >3 months [n=35 [55%]]; Hib [25%] and Streptococcus pneumoniae [STP] [20%] were the most common organisms before introduction of Hib vaccination. A significant drop of Hib infections were noticed after introduction of the vaccine. Fever, neck stiffness, seizure, vomiting, and bulging fontanel were the most frequent presenting features. Group B Streptococcus were sensitive to ampicillin and cefotaxime with no resistance detected. Forty percent of STP isolates were resistant to penicillin and 12% were resistant to ceftriaxone. Fifty percent of Hib were resistant to ampicillin; while none of Hib were resistant to ceftriaxone. No case of Listeria monocytogenes meningitis was diagnosed. Morbidity was 28%, and one patient expired [2%] after Klebsiella pneumoniae meningitis. Streptococcus pneumoniae was associated with the highest morbidity [62%] while Hib had zero morbidity in our patients. Bacterial meningitis is a serious illness with a significant morbidity and mortality. Haemophilus influenzae type b infection decreased which indicated an effective vaccination. As there is 12% bacterial resistance of STP reported against ceftriaxone; We recommend Cefotaxime for infants <3 months while ceftriaxone plus vancomycin as empiric therapy for older patients with community acquired bacterial meningitis. A pneumococcal vaccination may further decrease the incidence of meningitis in our community. A continuos surveillance to detect changes in the microbiology of organisms causing bacterial meningitis or their sensitivity in our community is essential to update these recommendations

Stenotrophomonas maltophilla isolated from the sputum of the patient with cystic fibrosis mutation i1234v: first qatari report

A17 year old Qatari female of Arab descent with cystic fibrosis [CF] carrying pathogenic mutation II234V had severe respiratory disease associated with chronic Pseudomonas aeruginosa broncho-pulmonary infection with recurrent episodes of mild hemoptysis. Despite regular courses of intravenous anti-pseudomonal antibiotics, she continued to deteriorate over six months and died. It is suggested that the presence of Stenotrophomonas maltophilia was an important factor in this case, which illustrates the need for continuing vigilance in considering the acquisition of resistant organisms in such patients on long-term antibiotic therapy

Gemella morbillorum endocarditis

A case of Gemella morbillorum [G.morbillorum] endocarditis of the mitral valve in a patient with previously normal heart valves is reported. The presentation was subacute, and the infection was complicated by perforation of the posterior mitral leaflet that necessitated valve repair. Gemella morbillorum infections are uncommon, and endocarditis is the most common presentation. G.morbillorum endocarditis is probably under recognized, and has not been reported from our region. The case is described, and problems in the identification of the organism are discussed

Cryptosporidiosis in children from the Sultanate of Oman

Over a one year period, 807 faecal samples from children [0-12 years] were submitted for routine microbiological examination and screening for Cryptosporidium oocysts. A Phenol-auramine stain was used and putative oocysts were measured after confirmatory staining with the modified Ziehl Neelsen method. Cryptosporidium were identified in 16 [1.9%] of the samples, and was the third most common enteropathogen after Giardia Iamblia [6.0%] and Entamoeba histolytica/dispar [2.3%]. With the exception of two patients with underlying immunodeficiency disorders, all were immunocompetent. No cases of Cryptosporidium were diagnosed during the hottest months of May and June

Synthesis and antiallergic activity of some coumarinyloxyamines

The design and synthesis of novel [3-[[coumarin-7[5]-yl]oxy]-2-hydroxypropyl] amine derivatives 11-34 were described. Several of these compounds were screened for in vitro H1-antihistamine and mast cell stabilization activities against histamine-induced contraction in guinea pig ileum and ovalbumin- induced contraction in the sensitized ileum. The most active among them were 1-[3-[[4-methylcoumarin-7-yl]oxy]-2-hydroxypropyl]-4-phenylpiperazine [11], 1-[3-[[8-allyl -4-methylcoumarin-7yl] oxy]-2-hydroxypropyl]-4-phenylpiperazine [18] and 1-[3[4, 7-dimethyl- coumarin-5-yl]oxy]-2-hydroxypropyl]-4-phenylpiperidine [28]

Resistance of clinical isolates of haemophilus influenzae to ampicillin, cotrimoxazole and chloramphenicol in Muscat area, Oman

Haemophilus influenzae strains isolated from clinical specimens by the Royal Hospital Microbiology Laboratory and Sultan Qaboos University Hospital Microbiology Laboratory in Oman, between September 1990 and September 1991, were analysed for their susceptibility to ampicillin, chloramphenicol and cotrimoxazole. Of 577 strains 191 [33.01%] were resistant to ampicillin; of 503, 106 [20.83%] were resistant to cotrimoxazole, and of 277, 13 [5.68%] were resistant to chloramphenicol