ABSTRACT
Globally, lower respiratory tract infections (LRTIs) are one of the lead causes of death. Bacterial and susceptibility profiles are not constant over time and geographically, and different patient factors can be correlated with those infections. Objective: This study aimed to scan the bacterial spectrum causing LRTIs, their susceptibility profile and patient related risk factors. Material and methods: Two hundred sixty-eight specimens from LRTIs suspected patients attending University Hospital were collected. Specimens included bronchial washings, transtracheal aspiration samples and sputum. After appropriate culture and identification tests, susceptibility test was done using minimum inhibitory concentration method. Data were collected from patients for further analysis. Results: of total specimens, 150 showed positive culture results (Acinetobacter baumannii, Pseudomonas aeruginosa, Citrobacter koseri, Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Streptococcus pneumonia and Candida spp.). The antibiogram showed high resistance among all bacterial isolates against most antibiotics. Good susceptibility rates were shown to colistin in Gram-negative group and piperacillin\tazobactam in Gram-positive group. Trimethoprim\sulfamethoxazole showed good susceptibility results in both groups. Many factors showed correlation with LRTIs such as age (P=0.004), smoking (P=0.049), residency (P=0.043), hypertension (P=0.012), lung chronic disease (P=0.007) and cancer (P=0.048). Conclusion: The leading cause of LRTIs in our study were A. baumannii and P. aeruginosa which both are very troublesome pathogens and multidrug resistant frequency was alarming. Random empirical antibiotic using can highly lead to increased resistance. Further care must be taken after patients with risk factors, and adjustments should be done to those modifiable factors.
ABSTRACT
Currently, coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are among the most important causes of respiratory infections around the world. Both of them are sources of concern for human health and life safety. COVID-19 caused the deaths of millions of people, and many of them suffered from what has become known as 'post-COVID squeal'. Immunosuppression is one of the most important of these symptoms that leave patients susceptible to severe infections like TB. Case Presentation: In these two cases, the authors observed the development of active TB after a period of COVID recovery. Two patients who were admitted to the hospital complained mainly, among other symptoms, of fever and a continuous cough after a period of COVID-19 recovery. Clinical Discussion: Radiological examination revealed a caving density in the two cases, and the Gene-Xpert test proved the presence of Mycobacterium tuberculosis bacteria despite the negative result of the Ziehl-Neelsen stain. The two patients were improved after standard TB treatment. Conclusion: Patients with post-COVID-19 chronic respiratory symptoms should be screened for TB, especially in TB-endemic areas, even though the result of the Ziehl-Neelsen stain was negative.
ABSTRACT
AIMS: The aim of this research is to conduct green synthesis of silver nanoparticles in an eco-friendly, economical and more effective approach using Acacia cyanophylla plant extract as well as to study the effects of the preparation conditions on the size of synthesized nanoparticles and its antibacterial activity. METHODOLOGY: In this study, silver nanoparticles have been synthesized by reduction method using aqueous silver nitrate solution and aqueous extract of Acacia cyanophylla. Then, their characterization has been studied by several methods, such as visual inspection, UV-Vis spectroscopy, dynamic light scattering and scanning electron microscope. In addition, the effects of (silver nitrate: extract) ratio, type extract, temperature and reaction time have been studied on the size of prepared silver nanoparticles. Furthermore, the antibacterial effect of these nanoparticles was studied on Escherichia coli using micro-dilution method and determination the Minimum Inhibitory Concentration (MIC). RESULTS: The results showed that the silver nanoparticles prepared using Acacia cyanophylla extract have reported visible yellowish brown color formation and the absorption peak at 460 nm indicated the biosynthesis of silver nanoparticles. Moreover, they have average diameter (88.11) nm and the polydispersity index (PdI) was suitable. The optimal conditions for synthesis silver nanoparticles were using aqueous extract in 9:1 ratio (silver nitrate: extract) at 35 °C for 48 h. These silver nanoparticles were stable in the in the fridge at 5 °C for a maximum period of 15 days. On the other hand, the antibacterial tests showed that these nanoparticles have high antibacterial activity where the MIC value ranged between (3.125-12.5) µg/ml on E. coli isolates. CONCLUSION: We conclude that Acacia cyanophylla extract is considered effective as a reducing agent for the preparation of stable silver nanoparticles in certain conditions and this silver nanoparticle has a high antibacterial activity.
ABSTRACT
Antibiotic resistance is a major public health concern. This study was conducted to evaluate the knowledge, attitudes of community pharmacists regarding antibiotic use and potential drug resistance besides assessing their behaviors about dispensing antibiotic without prescription and correlation of the outcomes with demographic variables. A cross-sectional survey was conducted on a random sample of 250 pharmacies in Aleppo, using validated self-administered questionnaire. The total scores of the pharmacists' knowledge and attitudes were correlated with participant demographics using Chi-squared test. One-hundered-seventy-three pharmacies out of 250 agreed to participate in the study. The overall prevalence of dispensing antibiotic without prescription was 85.5%. Only 30.8% of participants exhibited good attitude and 37% had adequate knowledge about antibiotic resistance. Good attitude was strongly correlated with age (P = 0.023), years of experience (P = 0.007), socioeconomic location of the pharmacy (P = 0.009) and number of clinics near pharmacy (P = 0.008). The results of this study confirmed that dispensing antibiotic without prescription is a common practice in Aleppo pharmacies despite being unlawful. The half of community pharmacists has a poor attitude and inadequate knowledge with regard to antibiotic resistance, reflecting the need for awareness-raising campaigns directed to community pharmacists to equip them for their main role in the community.
ABSTRACT
OBJECTIVES: To evaluate the in vitro interaction between different extracts of Thymbra spicata L. and certain antimicrobial drugs of different mechanisms, including ampicillin, cefotaxime, amikacin and ciprofloxacin. This study was performed against multidrug-resistant strains of Staphylococcus aureus and Klebsiella pneumoniae. MATERIALS AND METHODS: Evaluation of antibacterial activity and synergy interaction between plant extracts and antimicrobial agents was carried out using checkerboard microdilution. RESULTS: Different interactions (synergistic, additive and indifference) were observed between plant crude extracts and used antibiotics depending on the strain. The fractional inhibitory concentration (FIC) index ranged from 0.02 to 1.5 for S. aureus and 0.25 to 2 for K. pneumoniae strains. The best synergistic capacity appeared with cefotaxime against S. aureus strains, where the activity of cefotaxime was increased from 8- to 128-fold. CONCLUSION: These results may indicate that T. spicata extracts potentiates the antimicrobial action of antibiotics, suggesting a possible utilization of this herb in combination therapy against emerging multidrug-resistance S. aureus and K. pneumoniae.
