Colistin-resistance genes in Escherichia coli isolated from patients with urinary tract infections.

BACKGROUND: The incidence of antimicrobial resistance is alarmingly high because it occurs in humans, environment, and animal sectors from a "One Health" viewpoint. The emergence of plasmid-carried mobile colistin-resistance (MCR) genes limits the efficacy of colistin, which is the last-line treatment for multidrug resistance (MDR) against gram-negative infections. OBJECTIVES: The current study aimed to investigate emergence of colistin-resistance (MCR 1-5) genes in E. coli isolated from patients with urinary tract infections (UTIs) in Jordan. METHODS: E. coli (n = 132) were collected from urine specimens. The E. coli isolated from human UTI patients were examined the resistance to colistin based on the presence of MCR (1-5). All isolates were tested against 20 antimicrobials using the standard disk diffusion method. The broth microdilution technique was used to analyze colistin resistance. In addition, the MCR (1-5) genes were detected using multiplex PCR. RESULTS: Out of the 132 isolates, 1 isolate was colistin-resistant, having a minimum inhibitory concentration of 8 µg/mL and possessing MCR-1. All the E. coli isolates showed high resistance to penicillin (100%), amoxicillin (79.55%), cephalexin (75.76%), nalidixic acid (62.88%), tetracycline (58.33%), or cefepime (53.79). CONCLUSION: To our knowledge, this is the first report on the presence of plasmid-coded MCR-1 in E. coli from a patient with UTIs in Jordan. This is a problematic finding because colistin is the last-line drug for the treatment of infections caused by MDR gram-negative bacteria. There is a crucial need to robustly utilize antibiotics to control and prevent the emergence and prevalence of colistin-resistance genes.

Mediterranean Fast Food: A Leading Cause of Hypercholesterolemia among University Students in Northern Jordan.

Background: Consumption of fast food is pervasive among young adults. This research aimed to assess the impact of consuming fast foods on total cholesterol level among university students in Northern Jordan. Methods: Using a cross-sectional design, a blood sample to investigate cholesterol level was drawn from a sample of university students in Northern Jordan. Besides, students' dietary habits and anthropometric measurements were obtained. Results: Out of 201 participants, 57% (n=115) were male and 43% (n=86) were female. More than three quarters of the sample ate shawarma (Mediterranean fast food) at least once per week. About 44% of the study subjects had increased BMI and about 37% had increased serum cholesterol level. Participants' gender, age, marital status, physical activity, BMI, living status, and daily pocket money significantly correlated with cholesterol level (P<0.05). In the regression analysis, eating fast foods and increased BMI were strong predictors of high cholesterol level. Students who ate shawarma more than 3 times a week had more than 8 folds to have hypercholesterolemia (OR=8.4; CI: 2.62-26.72), and obese students were more than 14 folds at higher risk to have hypercholesterolemia compared to those with normal BMI (OR=14.2; CI: 4.80-42.29). In addition, male students had doubled odds for having abnormal cholesterol level compared to females (OR=2.1; CI: 1.10-4.44). Conclusion: Fast food consumption among university students in Jordan was significantly associated with increased total cholesterol level. Encouraging healthy diet and lifestyle are the basis for prevention of dyslipidemia.

Children's rates of COVID-19 vaccination as reported by parents, vaccine hesitancy, and determinants of COVID-19 vaccine uptake among children: a multi-country study from the Eastern Mediterranean Region.

BACKGROUND: Huge efforts are being made to control the spread and impacts of the coronavirus pandemic using vaccines. However, willingness to be vaccinated depends on factors beyond the availability of vaccines. The aim of this study was three-folded: to assess children's rates of COVID-19 Vaccination as reported by parents, to explore parents' attitudes towards children's COVID-19 vaccination, and to examine the factors associated with parents' hesitancy towards children's vaccination in several countries in the Eastern Mediterranean Region (EMR). METHODS: This study utilized a cross-sectional descriptive design. A sample of 3744 parents from eight countries, namely, Iraq, Jordan, Kuwait, Lebanon, Palestine, Qatar, Saudi Arabia (KSA), and the United Arab Emirates (UAE), was conveniently approached and surveyed using Google forms from November to December 2021. The participants have responded to a 42-item questionnaire pertaining to socio-demographics, children vaccination status, knowledge about COVID-19 vaccines, and attitudes towards vaccinating children and the vaccine itself. The Statistical Package for Social Sciences (SPSS- IBM, Chicago, IL, USA) was used to analyze the data. A cross-tabulation analysis using the chi-square test was employed to assess significant differences between categorical variables and a backward Wald stepwise binary logistic regression analysis was performed to assess the independent effect of each factor after controlling for potential confounders. RESULTS: The prevalence of vaccinated children against COVID-19 was 32% as reported by the parents. Concerning parents' attitudes towards vaccines safety, about one third of participants (32.5%) believe that all vaccines are not safe. In the regression analysis, children's vaccination was significantly correlated with parents' age, education, occupation, parents' previous COVID-19 infection, and their vaccination status. Participants aged ≥50 years and those aged 40-50 years had an odds ratio of 17.9 (OR = 17.9, CI: 11.16-28.97) and 13.2 (OR = 13.2, CI: 8.42-20.88); respectively, for vaccinating their children compared to those aged 18-29 years. Parents who had COVID-19 vaccine were about five folds more likely to vaccinate their children compared with parents who did not receive the vaccine (OR = 4.9, CI: 3.12-7.70). The prevalence of children's vaccination in the participating Arab countries is still not promising. CONCLUSION: To encourage parents, vaccinate their children against COVID-19, Arab governments should strategize accordingly. Reassurance of the efficacy and effectiveness of the vaccine should target the general population using educational campaigns, social media, and official TV and radio channels.

Is wearing a face mask associated with symptomatic dry eye disease among medical students during the COVID-19 era? An online survey.

BACKGROUND: Coronavirus disease 2019 has necessitate the routine use of masks worldwide. This study assessed the relationship between wearing a facemask and dry eye disease (DED) among a sample of medical students in Jordan. METHODS: This cross-sectional online survey enrolled medical students from all medical schools in Jordan. The questionnaire, which was shared via social media platforms, assessed sociodemographic information, ocular and medical history, facemask-wearing habits, the use of ocular devices, and the relationship with ocular discomfort. The ocular surface disease index (OSDI) questionnaire was also administered to quantify DED symptoms. RESULTS: A total of 1,219 students participated in this study. In total, 58.3% participants were females, and 52% were in the clinical science years. Symptomatic DED was found in 71.7% of participants. Female sex, basic science years, allergy reporting, and spending more than 6 h looking at screens were significantly associated with symptomatic DED. CONCLUSION: Wearing a facemask was not significantly associated with symptomatic DED. Further studies are needed to investigate the effect of wearing a facemask on the ocular surface.

Antibiotic Profile of Pathogenic Bacteria Isolated from Postsurgical Site Infections in Public Hospitals in Northern Jordan.

BACKGROUND: Surgical site infections are hospital-acquired, vary from one hospital to another, and can cause significant postoperative morbidity, mortality, and prolonged hospital stay. OBJECTIVE: The main aim of the study was to identify the bacterial pathogens associated with surgical site infections and their antibiotic susceptibility in a public hospital in northern Jordan. METHODS: Postsurgical wound samples were collected and processed in a microbiology laboratory using standard microbiological techniques. Antibiotic susceptibility tests were performed using 13 antibiotics covering the gram-positive and gram-negative bacteria using the disc diffusion test. RESULTS: The bacterial species that were identified in this study include Escherichia coli 8 (29%), Pseudomonas aeruginosa 3 (11%), Proteus mirabilis 1 (3.5%), Klebsiella pneumoniae 4 (14%), Salmonella enterica 2 (7%), Staphylococcus aureus 8 (29%), Staphylococcus epidermidis 1 (3.5%), and Streptococcus pyogenes 1 (4%). The antibiotic profiles of these bacteria showed high resistance. The MAR indices showed that 17 of 28 bacteria isolated were above 0.2 indicating high resistance. CONCLUSION: Resistant bacteria are becoming more dominant in wound infections with a high prevalence of multidrug resistant isolates. Hospital disinfection and treatment protocols regarding the use of antibiotics should be practiced vigorously and monitored regularly to combat resistance.

Fast Food Consumption, Liver Functions, and Change in Body Weight Among University Students: A Cross-Sectional Study.

BACKGROUND: Over the past decades, the consumption of fast foods has increased worldwide and became favored by people of most age groups. The objective of this research was to assess the impact of fast foods on liver enzyme levels and body weight. METHODS: A cross-sectional study was conducted at Yarmouk University/Jordan using survey questionnaire and enquired university students about their dietary habits, in addition to laboratory investigations of liver enzymes. RESULTS: In the cross-tabulation analysis, only age and body mass index (BMI) were significantly associated with alanine aminotransferase (ALT) enzyme level. However, all differences between aspartate aminotransferase (AST) level and other variables were statistically insignificant. The AST/ALT ratio was calculated and revealed significant statistical association with BMI of participants (P = 0.001). Change in body weight during one year was significantly associated with eating fast food (P = 0.031), drinking beverages with fast food meals (P = 0.001), and ALT level (P = 0.026). However, this association was statistically insignificant with AST level. CONCLUSIONS: Fast food consumption among university students in Jordan was not significantly associated with increasing levels of ALT and AST liver enzymes. However, eating fast food and drinking soft drinks were associated with increasing body weight, which is expected to have adverse effect on liver functions in the long term.

Evaluation of antioxidant status and oxidative stress markers in thermal sulfurous springs residents.

Sulfurous springs have been traditionally used in medical treatment for different purposes. These beneficial effects of sulfurous water have been attributed to the presence of sulfurous compounds mainly in the form of hydrogen sulfide (H2S). The purpose of the present study is to explore the effects of long-term exposure to sulfurous springs on oxidative stress and antioxidant biomarkers responses in individuals who lived nearby the sulfurous springs. The studied area was Al- Hammah sulfurous springs, which is located in the northern part of the Jordan Rift Valley and host many sulfurous springs. Residents in sulfurous springs area are continuously exposed to water and gases emission more than the overall population. We have found that the sulphate levels were 7 times higher in sulfurous springs water samples than control water samples. The majority of the volunteers involved in the present study were more than ten years long residence and lived in range distance between one to five kilometers (less than 3 miles) away from main sulfurous spring, and visited the sulfurous spring at least once a month. We did not find any noticeable symptoms in sulfur spring residents such as headaches, nausea, breathing problems. The total oxidative stress (TOS) and oxidative stress index (OSI) in sulfurous spring residents were lower than control individuals. The total antioxidant capacity (TAC) and total nitric oxide (NOX) levels were higher in sulfurous spring residents compared to control group. Furthermore, we have highlighted that living nearby the sulfurous springs does not affect oxygen saturation levels (SPO2) or heart pulse rate . These findings suggest that long-term exposure to sulfurous springs boost the antioxidant capacity and reduce oxidative stress levels in the human body. Hence, visiting sulfurous springs can act as natural remedies to diminish oxidative stress as they show promising potential in several-oxidative stress-related diseases treatment.

Antibiotic susceptibility of bacterial pathogens recovered from the hand and mobile phones of university students.

INTRODUCTION: This study aimed to isolate bacterial pathogens from the dominant hand and mobile phones and to determine their antibiotic susceptibility profiles. The dominant hand and mobile surfaces were swabbed to detect the transmission of bacterial pathogens among university students. METHODS: Two hundred and twenty hand and mobile phone swabs were collected from the students of four different colleges in a Jordanian university between October and December 2017. The swabs were collected and transported to the Microbiology laboratory within one hour. At the lab, swabs were inoculated on nutrient agar, MacConkey agar, blood agar and mannitol salt agar. The subsequent bacterial isolates were identified by their cultural, morphological and biochemical characteristics. RESULTS: Eight bacterial species were isolated and identified in the current study, namely Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Enterococcus faecalis, Bacillus cereus, Micrococcus spp. and Escherichia coli. The percentage of isolated bacteria was 54.5%, 25.5%, 14.5% and 5.5% from veterinary, biology, biomedical engineering and chemistry students, respectively. Many isolates were highly resistant to most tested antibiotics. CONCLUSIONS: Pathogenic bacteria were detected with multiple antibiotic resistance indexes. Hands and mobile phones can act as carriers for infectious agents, suggesting the need for proper hand hygiene and disinfecting mobile phones surfaces.

Mycoplasma bovis arthritis and pneumonia in calves in Jordan: An emerging disease.

AIM: Clinical, microbiological, molecular, and pathological assays were undertaken to characterize an outbreak of increasingly reported signs of unresponsive arthritis and pneumonia of Mycoplasma bovis infection in young calves in Jordan. MATERIALS AND METHODS: Clinical history of the affected bovine herd was investigated for the presence of respiratory and/or joint problems. Two calves with such history were clinically examined and necropsied. Representative tissues were sent for microbiological, molecular, and pathological examinations for M. bovis infection. RESULTS: The outbreak started in a herd of 220 nursing calves, 2 months before the receiving of two calves for postmortem examination. Clinically, respiratory signs and infection of one or more joints dominated in the affected calves. The morbidity and case fatality rates were 27.27% and 61.7%, respectively. The left carpal joint was markedly swollen in both calves and exhibited necrofibrinous to granulomatous arthritis in varying degrees of severity. The anteroventral lung lobes in both calves were consistently affected and revealed multifocal to coalescing severe necrogranulomatous and fibrinopurulent bronchopneumonia. Microbiological and molecular findings confirmed the pathological examination. Furthermore, bovine viral diarrhea (BVD) was diagnosed in one calf by histopathology and polymerase chain reaction. CONCLUSION: This investigation reports the first outbreak of M. bovis infection in calves located in Jordan that could occur concurrently with BVD.

Synthesis and Biological Activities of Lanthanide (III) Nitrate Complexes with N-(2-hydroxynaphthalen-1-yl) methylene) Nicotinohydrazide Schiff Base.

BACKGROUND: The field of coordination chemistry has registered a phenomenal growth during the last few decades. It is well known that precious metals have been used for medicinal purposes for at least 3500 years. At that time, precious metals were believed to benefit health because of their rarity, but research has now well established the link between medicinal properties of inorganic drugs and specific biological properties. METHODS: The current study was designed to explain the synthesis and characterization of the lanthanide (III) nitrate complexes with N-(2-hydroxynaphthalen-1-yl) methylene) nicotinohydrazide schiff base and to evaluate the antibacterial and the antioxidant activities of the schiff base and it's lanthanide ion complexes. Antimicrobial activity of the Lanthanide (III) nitrate complexes with N-(2- hydroxynaphthalen-1-yl) methylene) nicotinohydrazide schiff base was estimated by minimum inhibitory concentration (MIC, µg/mL) using a micro-broth dilution method for different clinical isolates such as Eschereshia coli and Enterococcus faecalis. The antioxidant activities of the ligand and its lanthanide complexes were tested using a UV-Visible spectrophotometer by preparing 5x10-4M of all tested samples and DPPH in Dimethyl sulphoxide (DMSO). RESULTS: Our present study has shown that moderate antimicrobial activity exists against both ligand and its complexes. There was no significant difference between Gram-positive and Gram-negative bacteria towards the tested ligand and its complexes. The free ligand has scavenging activity between 13-21 % while all complexes are more efficient in quenching DPPH than free ligand. CONCLUSION: The results obtained herein indicate that the ligand and its complexes have a considerable antibacterial activity as well as antioxidant activity in quenching DPPH.

A study of in vitro antibacterial activity of lanthanides complexes with a tetradentate Schiff base ligand.

OBJECTIVE: To establish the antibacterial activity of lanthanides complexes with a tetradentate Schiff base ligand L. METHODS: (N, N'-bis (1-naphthaldimine)-o-phenylenediamine) was prepared from the condensation of 2-hydroxy-1-naphthaldehyde with o-phenylenediamine in a molar ratio of 2:1. The antimicrobial activity of the resultant Ln (III) complexes was investigated using agar well diffusion and micro-broth dilution techniques; the latter was used to establish the minimum inhibitory concentrations for each compound investigated. RESULTS: Most of Ln (III) complexes were found to exhibit antibacterial activities against a number of pathogenic bacteria with MICs ranging between 1.95-250.00 µg/mL. Staphylococcus aureus was the most susceptible bacterial species to [LaL(NO3)2(H2O)](NO3) complex while Shigella dysenteriae and Escherichia coli required a relatively higher MIC (250 µg/mL). The complexes La (III) and Pr (III) were effective inhibitors against Staphylococcus aureus, whereas Sm (III) complex was effective against Serratia marcescens. On the other hand, Gd (III), La (III) and Nd (III) were found to be more potent inhibitors against Pseudomonas aeruginosa than two of commonly used antibiotics. The remaining Ln (III) complexes showed no remarkable activity as compared to the two standard drugs used. CONCLUSIONS: Tetradentate Schiff base ligand L and its complexes could be a potential antibacterial compounds after further investigation.

Syntheses, characterization, biological activities and photophysical properties of lanthanides complexes with a tetradentate Schiff base ligand.

A tetradentate Schiff base ligand L (N,N'-bis(1-naphthaldimine)-o-phenylenediamine) was prepared from the condensation of 2-hydroxy-1-naphthaldehyde with o-phenylenediamine in a molar ratio of 2:1. New eight lanthanide metal complexes [LnL(NO(3))(2)(H(2)O)(x)](NO(3)) {Ln(III) = Nd, Dy, Sm, Pr, Gd, Tb, La and Er, x = 0 for Nd, Sm, 1 for La, Gd, Pr, Nd, Dy, and 2 for Tb} were prepared. The characterization and nature of bonding of these complexes were elucidated by elemental analysis, spectral analysis ((1)H NMR, FT-IR, UV-vis), molar conductivity measurements, luminescence spectra and thermogravimetric studies. Analytical and spectral data revealed that the ligand L coordinates to the central Ln(III) ions by its two imine nitrogen atoms and two phenolic oxygen atoms with 1:1 stoichiometry. Under the excitation with 329 nm at room temperature, Tb and Dy complexes exhibited characteristic luminescence of the central metal ions attributed to efficient energy transfer from the ligand to the metal center. Most of Ln(III) complexes found to exhibit antibacterial activities against a number of pathogenic bacteria. We found that the antioxident activity of Ln(III) complexes on DPPH(•) is concentration dependent and higher than that of the free ligand L.

Seroprevalence of and risk factors for Mycoplasma mycoides subspecies capri infection in small ruminants in Northern Jordan.

During the period from January 2002 to December 2003, serum samples were collected from 104 small ruminant flocks consisting of 18 sheep flocks, 27 goat flocks, and 59 mixed flocks containing both sheep and goats in northern Jordan. Only female sheep and goats were sampled. At least five females aged over 2 years per flock per species were sampled and examined for Mycoplasma mycoides subspecies capri using the latex agglutination test. To increase the chances of detecting positive flocks, sick or older ewes were sampled. Specific information was obtained using a questionnaire to identify potential risk factors for M. mycoides subsp. capri seropositivity in small ruminants. The true flock-level seroprevalences of M. mycoides subsp. capri were 34%, 32%, and 38% in small ruminants (sheep and goats), sheep, and goats, respectively. Differences between flock-level seroprevalences in sheep and goats were not significant (p = 0.7). Multivariable logistic regression analysis of 21 production and health management practices showed four to be associated with M. mycoides subsp. capri seropositivity including flocks which were grazed and fed concentrate supplement (OR = 4.6), improper cleaning of milking utensils (OR = 4.7), buying new animals to replace culled ones (OR = 0.3), and treating against helminths when clinical signs of helminth infections appear (OR = 0.4).

Risk factors associated with Mycoplasma agalactiae infection of small ruminants in northern Jordan.

Serological detection of Mycoplasma agalactiae was carried out in 104 small ruminants flocks consisting of 18 sheep, 27 goat and 59 flocks containing both sheep and goats in northern Jordan between 2002 and 2003. At least 5 serum samples per flock were tested using an indirect ELISA for antibodies to M. agalactiae. To increase the chances of detecting this mycoplasma, sick or older animals were sampled. A high seropositivity to M. agalactiae was found in small ruminants suggesting a major role for M. agalactiae in contagious agalactia in northern Jordan. There was no significant difference in the seroprevalence of M. agalactiae in sheep and goats at flock level (X(2)=0.14, d.f.=1, p=0.7). A total of 31 variables including production and health management practices were tested as risk factors for seropositive flocks and analyzed using logistic regression analysis. Increasing risk factors for M. agalactiae seropositive flocks were: using outsider rams, improper cleaning of the milking utensils and separating young from dam, with odds ratios of 5, 3, 4.2, respectively; having mastitis problems in the flock was negatively associated (p=0.04) with M. agalactiae seropositivity. Educating small ruminant farmers to avoid the use of outsider rams, ensuring adequate cleaning of milking utensils and separating the young from dams would enhance the health of small ruminants.