Epidemiology and antimicrobial resistance of staphylococci isolated from different infectious diseases

A total of 187 isolates from 470 clinical specimens were collected from three hospitals in El-Minia governorate and identified as 132 Staphylococcus aureus strains and 55 coagulase-negative staphylococci (CoNS) strains. Susceptibility of isolates to antimicrobial agents was tested by the agar dilution method. The isolated S. aureus strains showed low resistance to vancomycin (1.5 percent), amikacin (2.3 percent) and gatifloxacin (3.8 percent). Vancomycin was the most effective antibiotic against CoNS. The ampicillin-resistant isolates were tested for â-lactamase production where, 61.7 percent of S. aureus and 42.9 percent of CoNS were positive for â-lactamase enzyme. Beta-lactamase producing strains were screened for their plasmid profile using alkaline lysis method. Some of these strains carried at least one plasmid suggesting plasmid-mediated antibiotic resistance. When cells of these strains were exposed to curing agent ethidium bromide, the production of the â-lactamase was lost. Resistance by efflux was studied by a modified fluorometric assay. Addition of uncoupler carbonyl cyanide m-chlorophenylhydrazone (CCCP) increased norfloxacin accumulation in quinolone resistant S. aureus strains, suggesting endogenous energy-dependent efflux. Combinations of ciprofloxacin with four antimicrobial agents against methicillin resistant S.aureus (MRSA) strains were investigated using decimal assay for additivity (DAA) technique. Synergistic interaction was observed between ciprofloxacin and oxacillin. ciprofloxacin plus cefepime and gentamicin appeared to be additive, while ciprofloxacin plus erythromycin was antagonistic.

Appendicular intussusception into a polyp.

Intussusception of the appendix is a rare condition. We present the case of a 72-year-old woman with multiple polyps in the colon with an appendix completely intussuscepted into a polyp within the caecum. The clinical features, preoperative diagnosis, classification and treatment of this condition are discussed with reference to literature.

Improved diagnostic accuracy of inflammatory bowel disease: a clinicopathological collaborative approach.

Although colonic biopsies have become a major source of information to the clinician investigating cases of inflammatory bowel diseases (IBD), there are still some difficulties in making definitive diagnoses. This article looks into these challenges and possible ways of dealing with them. We strongly recommend supplying the pathologist with full clinical, radiological and endoscopic information with the request form. The pathologist may then issue a preliminary working report, while the final report should be reached at the much needed regular clinicopathological conference.

Host and parasite determinants of morbidity in Egyptian children with schistosomiasis.

The relation of morbidity due to schistosomiasis in Egyptian children to egg count, eosinophilic count, antibodies mediating eosinophil damage to schistosomula, total immunoglobulins and specific antischistosomal antibodies IgG and IgM anti-cercarial antigen preparation (CAP), anti-soluble worm antigen preparation (SWAP) and anti-soluble egg antigen preparation (SEA) were evaluated. The behavior of the immune parameters after treatment was also determined. The studied children were 78 males, aged 9-11 years. They were classified to control (14), simple intestinal (26) and hepatosplenic schistosomiasis (38) groups according to the clinical, parasitological and sonographic basis. The egg count was found higher in hepatosplenic schistosomiasis compared to that in simple group. Eosinophilic count did not differ between the two groups. Studies of immune responses revealed that antibodies mediating eosinophil adherence and damage to schistosomula rose in both groups particularly in hepatosplenic group. The levels of total and specific immunoglobulins were not significantly differed in both groups. The immune response was measured 2 months after treatment. The level of total IgA was increased in simple and decreased in hepatosplenic group. Total IgG and IgM were not affected by treatment in simple but IgM increased in hepatosplenic after treatment. Total IgE was decreased after treatment in both groups. This denotes that the behavior of the two groups after treatment was similar as regards the levels of IgG and IgE and differed as regards IgA and IgM. IgG anti-CAP and anti-SEA were declined after treatment but IgG- anti SWAP was elevated after treatment in both groups. The treatment has no effect on the levels of specific IgM against all used antigens. The antibodies mediating eosinophil adherence and damage to schistosomula rose in both groups after treatment. These indicated consistency of specific immune responses after treatment in schistosomal children. It is concluded that high intensity of infection may be one of the determinants of morbidity due to Schistosoma mansoni infection in Egypt. The elevated response of antibodies mediating adherence and damage to schistosomula may be associated or play a role with morbidity. Eosinophilic count, total IgA, IgG, IgM, IgE and specific antischistosomiasis IgG and IgM (Anti-CAP, anti-SWAP and anti-SEA) are not related to morbidity.