In vitro evaluation of the antimicrobial activity of nine root canal sealers: direct contact test.

PURPOSE: The aim of this in-vitro study was to analyze the antimicrobial activity of root canal sealers by using the direct contact test. MATERIALS AND METHODS: Nine root canal sealers (4 resin-based sealers, 3 zinc oxide-eugenol based (ZOE) sealers, and 2 calcium hydroxide based sealers) and three microbial strains (Staphylococcus aureus, Candida albicans and Enterococcus faecalis) were used in the present study. The antimicrobial activity of root canal sealers was tested by using the direct contact test at three time intervals. Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS). Tests of differences were analyzed by T tests and a value of p < or = 0.05 was statistically significant. RESULTS: Staphylococcus aureus: All sealers showed significant differences when freshly mixed except Endorez and sealapex. Candida albicans (90028): Only the 48 hours and the one week preparations of Sealapex showed significant differences. The 48 hrs preparations of Topseal and AH plus showed significant differences. The ZOE based sealers showed significant differences at all time intevals. Candida albicans (10231): All sealers showed significant differences when freshly mixed except the two calcium hydroxide based sealers that showed no significant differences at all time intervals. Enterococcus faecalis: Topseal, AH plus, AH 26, Sealite regular and Acroseal showed significant differences only when freshly mixed. The 48 hours and the week preparations of all root canal sealers showed no significant differences. CONCLUSIONS: It was concluded that that antimicrobial activity of the tested sealers depends on the time interval between mixing and testing. Most sealers exhibited antibacterial activity when freshly mixed that is lost over time.

Prevalence of Chlamydia trachomatis infection in infertile women at a university hospital in Jordan.

In a prospective controlled study, we aimed to determine the prevalence of Chlamydia trachomatis infection in Jordanian women attending an infertility clinic and whether screening is useful as part of routine investigations for infertility. Two groups of patients (152 infertile patients and 146 control patients) had endocervical swab testing by polymerase chain reaction for the presence of C. trachomatis infection. A total of 6/152 patients in the infertility group tested positive for C. trachomatis (3.9%), compared with 1/146 patients in the control group (0.7%), a difference that was not statistically significant. In view of the tendency toward increased prevalence of C. trachomatis infection, screening women for chlamydial infection as part of routine investigations for infertility is recommended.

Prevalence of Chlamydia trachomatis infection in infertile women at a university hospital in Jordan

In a prospective controlled study, we aimed to determine the prevalence of Chlamydia trachomatis infection in Jordanian women attending an infertility clinic and whether screening is useful as part of routine investigations for infertility. Two groups of patients [152 infertile patients and 146 control patients] had endocervical swab testing by polymerase chain reaction for the presence of C. trachomatis infection. A total of 6/152 patients in the infertility group tested positive for C. trachomatis [3.9%], compared with 1/146 patients in the control group [0.7%], a difference that was not statistically significant. In view of the tendency toward increased prevalence of C. trachomatis infection, screening women for chlamydial infection as part of routine investigations for infertility is recommended

Antimicrobial resistance and plasmid profiles of urinary Escherichia coli isolates from Jordanian patients.

We investigated antimicrobial resistance patterns and plasmid profiles of uropathogenic Escherichia coli isolates from inpatients and outpatients at Jordan University Hospital in 2000 and 2001. E. coli accounted for 32.4% and 37.4% of all isolates respectively. The lowest susceptibility was for ampicillin (11%), cotrimoxazole (23%) and tetracycline (26%). The relative incidence of resistant isolates of E. coli to nalidixic acid, gentamicin, norfloxacin, cefuroxime and nitrofurantoin was significantly greater for inpatients than for outpatients (P< 0.05). A large, transferable R-plasmid of 28 kb was found in most E. coli isolates (67%) that were resistant to at least ampicillin, cotrimoxazole and tetracycline. This R-plasmid reservoir may contribute to the spread of multiple antibiotic resistance in our Region.

Antimicrobial resistance and plasmid profiles of urinary Escherichia coli isolates from Jordanian patients

We investigated antimicrobial resistance patterns and plasmid profiles of uropathogenic Escherichia coli isolates from inpatients and outpatients at Jordan University Hospital in 2000 and 2001. E. coli accounted for 32.4% and 37.4% of all isolates respectively. The lowest susceptibility was for ampicillin [11%], cotrimoxazole [23%] and tetracycline [26%]. The relative incidence of resistant isolates of E. coli to nalidixic acid, gentamicin, norfloxacin, cefuroxime and nitrofurantoin was significantly greater for inpatients than for outpatients [P< 0.05]. A large, transferable R-plasmid of 28 kb was found in most E. coli isolates [67%] that were resistant to at least ampicillin, cotrimoxazole and tetracycline.This R-plasmid reservoir may contribute to the spread of multiple antibiotic resistance in our Region

Screening of antibiotic resistant inhibitors from local plant materials against two different strains of Staphylococcus aureus.

The inhibitory effects of methanolic extracts of 19 Jordanian plants and their combinations with seven antibiotics, on the resistance of Staphylococcus aureus were checked. Methicillin resistant S. aureus (MRSA), which was isolated from patient and a standard strain of S. aureus were used. Our results showed that there are variations in the effect of some combinations used on the resistant and the standard strains probably due to structural changes. Common results between the two strains showed that combinations of gentamicin and chloramphenicol could be improved by the use of plant materials, whereas nalidixic acid activity cannot be improved when combined with plant materials.

Screening of antibiotic resistant inhibitors from local plant materials against two different strains of Pseudomonas aeruginosa.

The methanolic extracts of 19 Jordanian plants were combined with seven different antibiotics and applied to check the inhibitory effects of the combination on the resistance of Pseudomonas aeruginosa. A resistant strain of Ps. aeruginosa, which was isolated from a patient and a standard strain of the same microorganism were used in this study. Our results showed that there are significant variations in the effects of some combinations used on the resistant and the standard strains probably due to structural changes. Almost all the plant materials used in combination with penicillin G and erythromycin allowed full growth of the standard strain, while the combination with some plant materials like Gundelia tournefortii L. and Lepidium sativum L. inhibited the growth of the resistant strain. Chloramphenicol, gentamicin and cephalosporin can be given advantageously with almost all the plant materials used with few exceptions on the resistant strain. Nalidixic acid activity was improved significantly when combined with all plant materials and tested on standard strain. On the other hand, its activity on the resistant strain was slightly improved using the same combinations.

High incidence of Klebsiella pneumoniae clinical isolates to extended-spectrum B-lactam drugs in intensive care units.

A prospective study conducted among Jordanian ICU patients in 1997 using Etest identified resistance rates among isolates of E. coli (25%-44%), Enterobacter spp. (54%-62%), and Klebsiella spp. (30%-80%) to extended-spectrum B-lactams (ESBLs): ceftazidime, cefotaxime, ceftriaxone, and aztreonam. All these isolates were susceptible to imipenem and showed low resistance rate to ciprofloxacin (5%-19%) and amikacin (13%-18%). Higher and significant resistance rates of Klebsiella isolates to ceftazidime (80%) and aztreonam (65%) were observed in 1997 compared with a previous study performed in 1994. The majority of Klebsiella pneumoniae (70%) express different ESBL phenotypes that were almost resistant to aztreonam and ceftazidime but susceptible or resistant to cefotaxime and/or ceftriaxone. This prospective study strongly suggests that ESBL production of Klebsiella pneumoniae isolates have been highly disseminated among ICU patients during 1997.

Epidemiology of needlestick and sharp injuries at a university hospital in a developing country: a 3-year prospective study at the Jordan University Hospital, 1993 through 1995.

OBJECTIVE: To study the epidemiology of needlestick and sharp injuries in a university hospital in a developing country, Jordan. METHODS: A prospective study was undertaken of all needlestick and sharp injuries among workers at the Jordan University Hospital between 1993 and 1995. Health care workers were asked to report in person to the infection-control team to verify the incident and to respond to a questionnaire. Blood was obtained from patients and health care workers immediately and from the health care workers 6 months later for hepatitis B virus, hepatitis C virus, and HIV testing. RESULTS: During the 3-year period, 248 health care workers had needlestick and sharp injuries. Of these, 34.6% were staff nurses, 19%, environmental workers, 15.7%, interns, 11.7%, residents, 8.5%, practical nurses, and 6% were technicians. The incidence density was highest for the interns followed by staff nurses and environmental workers. Of incidents, 22.6% occurred during blood drawing, 11.3% during placing intravenous lines, 8.5% during administration of medication, 11% during recapping the needle, 10.5% during needle disposal, 12.5% during garbage collection, and 5% were caused by a neglected needle. Only 117 patients were identified; 36 of 62 of these had positive results for hepatitis B surface antigen, and 8 of 13 for hepatitis C virus. CONCLUSION: Needlestick and sharp injuries occur frequently in developing countries. Safer disposal facilities and routine hepatitis B vaccine should be adopted.

Outbreak of paralytic poliomyelitis in a highly immunized population in Jordan.

Between November 1991 and March 1992, 37 cases of paralytic poliomyelitis occurred in Jordan, where none had been reported since 1988. Of these, 17 (50%) of 34 patients had received at least three doses of oral poliovirus vaccine (OPV3). The first and 2 subsequent case-patients were children of Pakistani migrant workers, and the first 8 and a total of 27 (75%) case-patients resided in or near the Jordan Valley. A seroepidemiologic study of 987 children in all regions of Jordan was performed to assess OPV3 coverage and immune response to OPV. Although OPV3 coverage by 12 months of age was high (96%) in the general population, coverage was lower among Pakistani (21%), Bedouin (63%), and Gypsy (9%) children (P < .001). Seroprevalences for poliovirus type 3 were 71% in the Jordan Valley versus 81% in other regions after 3 doses of OPV (P < .06) and 77% in the Jordan Valley versus 98% in other regions after 5 doses of OPV (P < .001). This outbreak demonstrates the importance of achieving high seroimmunity to infection in all geographic areas to prevent the reintroduction and spread of imported strains of wild poliovirus.

Restriction endonuclease analysis of adenovirus isolates from sporadic and epidemic ocular infections: experience in a clinical laboratory.

Adenovirus isolates from 52 patients with ocular infection over a 3-year period were typed by restriction endonuclease analysis in a clinical laboratory. The results indicated that adenovirus type 8 was the most common cause of adenovirus eye infection during this period, being responsible for 42 (81%) of the 52 cases. Of 42 adenovirus type 8 isolates, 22 showed variant patterns by restriction endonuclease analysis and required multiple enzyme digests for identification. These isolates were readily identified by neutralisation tests.

Evaluation of immunofluorescent reagents, centrifugation, and conventional cultures for the diagnosis of adenovirus infection.

In this study we have evaluated four fluorescent antibody reagents, three monoclonal and one polyclonal, for identification of adenovirus isolates and compared four conventional cultures (human embryonic kidney, A549, HEp-2, and MRC-5 cells) with centrifugation culture for rapid diagnosis. For identification of adenovirus isolates by immunofluorescence, CDC reagent and Adenoclone, both monoclonal antibodies to the hexon group-reactive antigen, were more sensitive and easier to interpret than the other two reagents tested. HEK and A549 cells were the most sensitive for isolation of adenovirus. Although A549 cells were an inexpensive alternative to HEK, A549 cell monolayers deteriorated more rapidly and passages were more often required. Centrifugation cultures with A549 cells detected 77% of positives within 2 days and 100% within 5 days, whereas isolation in conventional culture required up to 10 days for HEK and up to 20 days for MRC-5 cells.