Metallo-Beta-Lactamase Producing Pseudomonas aeruginosa in a Healthcare Setting in Alexandria, Egypt.

Pseudomonas aeruginosa has emerged as a major healthcare associated pathogen that creates a serious public health disaster in both developing and developed countries. In this work we aimed at studying the occurrence of metallo-beta-lactamase (MBL) producing P. aeruginosa in a healthcare setting in Alexandria, Egypt. This cross sectional study included 1583 clinical samples that were collected from patients admitted to Alexandria University Students' Hospital. P. aeruginosa isolates were identified using standard microbiological methods and were tested for their antimicrobial susceptibility patterns using single disc diffusion method according to the Clinical and Laboratory Standards Institute recommendations. Thirty P. aeruginosa isolates were randomly selected and tested for their MBL production by both phenotypic and genotypic methods. Diagnostic Epsilometer test was done to detect metallo-beta-lactamase enzyme producers and polymerase chain reaction test was done to detect imipenemase (IMP), Verona integron-encoded (VIM) and Sao Paulo metallo-beta-lactamase (IMP) encoding genes. Of the 1583 clinical samples, 175 (11.3%) P. aeruginosa isolates were identified. All the 30 (100%) selected P. aeruginosa isolates that were tested for MBL production by Epsilometer test were found to be positive; where 19 (63.3%) revealed blaSPM gene and 11 (36.7%) had blaIMP gene. blaVIM gene was not detected in any of the tested isolates. Isolates of MBL producing P. aeruginosa were highly susceptible to polymyxin B 26 (86.7%) and highly resistant to amikacin 26 (86.7%). MBL producers were detected phenotypically by Epsilometer test in both carbapenem susceptible and resistant P. aeruginosa isolates. blaSPM was the most commonly detected MBL gene in P. aeruginosa isolates.

Nasal carriage of methicillin-resistant Staphylococcus aureus and the effect of tea extracts on isolates.

OBJECTIVES: This study aimed to determine the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage among patients, healthcare workers (HCWs), and community individuals, as well as to test the effect of tea extracts on detected S. aureus isolates. MATERIALS AND METHODS: This cross-sectional study that was followed by an experimental study included a total of 1021 nasal swab samples that were collected from 470 community cases, 191 HCWs, and 360 patients. Isolation of S. aureus and MRSA was carried out on mannitol salt agar plates. S. aureus isolates were identified according to standard microbiological methods. Methicillin resistance was determined by disc-diffusion method according to the Clinical and Laboratory Standard Institute recommendations. A total of six tea samples (black and green) were purchased from different markets in Alexandria and were extracted. The antibacterial effects of these tea extracts were tested against identified MRSA isolates using agar gel diffusion method. RESULTS: The overall S. aureus nasal carriage rate was 12.5%, distributed as 7.9% MRSA and 4.6% methicillin-susceptible S. aureus. The rates of MRSA nasal carriage among HCWs, patients, and community cases were 10.5, 8.1, and 6.8%, respectively. Green tea had a strong effect on more than half of the isolates (55%) and an intermediate effect on 45% of them. It had no weak effect on any of the MRSA isolates. CONCLUSION: Among all tested individuals, HCWs had the highest percentage of MRSA nasal carriage. Green tea had a significantly stronger inhibitory effect than black tea on almost all tested isolates.

Comparative study on efficacy of different alcohol hand rubs and routine hand wash in a health-care setting, alexandria, egypt.

BACKGROUND: Antiseptic agents or plain soap and water are mainly used for hand hygiene in Egypt. The impact of hand hygiene depends not only on the regularity and thoroughness of the procedures used but also on the type of hand-washing agent selected. OBJECTIVES: To compare the efficacy of alcohol-based hand rubs versus traditional hand washing with soap and water in reducing hand contamination during routine patient care. MATERIAL AND METHODS: The study included 20 volunteered nurses in 3 intensive care units and the renal dialysis unit, in the Alexandria University Students' Hospital. A total of 200 samples were collected by direct finger-print of the dominant hand taken from all nurses before and after applying hand hygiene procedures. Three hand-rubs available in the Egyptian market (Brands A, B; alcohol-based liquid, and C; alcohol-based gel) were used and compared to a locally prepared hand-rubbing solution (D) and to hand washing with non-antiseptic soap and water (SW). RESULTS: Hand washing with non-antiseptic soap and water and all of the four used alcohol-based hand-rubs showed significant reduction of bacterial counts on the examined hands. The median percentage reductions were 99%, 94%, 77%, and 87% with brands A, B, C and D respectively and only 30% reduction with soap and water (x2: 23.023, p <0.001). CONCLUSIONS AND RECOMMENDATIONS: Alcohol-based hand rub is far more efficient than traditional hand washing, and more convenient and time saving. Locally prepared hand rub is comparable to readymade ones. It is recommended as a hand hygiene practice in critical areas, particularly when sink and running water are inaccessible.