Assessment of gentamicin dosing and monitoring in neonates: A single center experience.

BACKGROUND: Gentamicin is a commonly used medication in NICUs. It is known to have ototoxic & nephrotoxic side effects. To date there is no consensus about dosing regimen in different institutions. Our study aims to evaluate the Neofax® dosing regimen for gentamicin in neonatal early onset sepsis in relation to trough level before the second dose and its association with the incidence of gentamicin side effects, namely hearing impairment/loss and acute kidney injury. METHODS: Retrospective chart review of newborns admitted to Tawam hospital NICU (June 2019-May 2020) who received gentamicin for early onset sepsis (≤72 hours old). Trough levels before the second dose at 24,36 and 48 hours were reviewed (≥1 mg/L is high). Excluded patients with renal risk factors. Side effects (hearing impairment, acute renal injury) were also assessed. RESULTS: Total of 265 infants were included, among whom 149 patients received gentamicin at 24 hours interval, 99 at 36 and 17 at 48 hours interval. Trough level was high in 76% (P = 0.022), 65% (P = 0.127), and 53% (P = 0.108) of patients who received gentamicin at 24, 36, and 48 hours, respectively. Hearing screening was normal in 99.2% of patients, while 2 patients failed the test (Both with normal trough levels). No patients in our study developed renal injury related to gentamicin use. CONCLUSION: Neofax® gentamicin dosing often results in high trough levels, especially in late preterm/term infants. This study found no correlation between high trough levels and hearing impairment upon discharge or acute kidney injury. Further studies with larger sample size are recommended.

First report of detection of IgA anti-Acanthamoeba antibodies among Saudi population and amoeba isolation from their surroundings.

Acanthamoeba is an opportunistic protozoan pathogen which is found in diverse environment worldwide. Being ubiquitous nature of this amoeba we come across it in our daily life. Acanthamoeba species are recognized as human pathogens; that may cause blinding keratitis and rare but fatal granulomatous encephalitis involving central nervous system. To date, there is not a single report in literature demonstrating anti-Acanthamoeba antibodies among the Saudi population, and thus aim of the present study. Using ELISA, we identified the antibody level in the local population. Our results represent the secretory IgA antiAcanthamoeba in mucosal secretions from 133 individuals aged 15-60 years. The antiAcanthamoeba antibody prevalence rate was > 80%, and no considerable differences were observed between prevalence in males (80.28%) and that in females (80.64%). In addition, environmental sources (soil and water) from the environment of the participants in our study were evaluated for amoeba incidence. The amoeba was identified by morphological characteristics of cysts or trophozoites on non-nutrient agar plates grown with E. coli. Overall, 58.75% of samples from water and 32.85% of those from soil were culture positive for outgrowth of amoeba on non-nutrient agar plates. Furthermore, PCR was carried out with genus-specific primers to confirm the presence of Acanthamoeba DNA. Our results revealed that about 68% of cultures from water and 43% of those from soil were successfully amplified and proved to be amoeba DNA. Interestingly, a few samples yielded more than one product, which suggests that some other amoebic species may be present in the same sample (MAC-W1 and MADW1). To the best of our knowledge, we described for the first time the amoeba isolation from the participant's close environment and antibodies level among Saudi population. Our future studies will be focused on additional molecular characterization of isolated amoeba and their pathogenic potential which could be a possible threat for the community.

First report of detection of IgA anti-Acanthamoeba antibodies among Saudi population and amoeba isolation from their surroundings

@#Acanthamoeba is an opportunistic protozoan pathogen which is found in diverse environment worldwide. Being ubiquitous nature of this amoeba we come across it in our daily life. Acanthamoeba species are recognized as human pathogens; that may cause blinding keratitis and rare but fatal granulomatous encephalitis involving central nervous system. To date, there is not a single report in literature demonstrating anti-Acanthamoeba antibodies among the Saudi population, and thus aim of the present study. Using ELISA, we identified the antibody level in the local population. Our results represent the secretory IgA antiAcanthamoeba in mucosal secretions from 133 individuals aged 15–60 years. The antiAcanthamoeba antibody prevalence rate was > 80%, and no considerable differences were observed between prevalence in males (80.28%) and that in females (80.64%). In addition, environmental sources (soil and water) from the environment of the participants in our study were evaluated for amoeba incidence. The amoeba was identified by morphological characteristics of cysts or trophozoites on non-nutrient agar plates grown with E. coli. Overall, 58.75% of samples from water and 32.85% of those from soil were culture positive for outgrowth of amoeba on non-nutrient agar plates. Furthermore, PCR was carried out with genus-specific primers to confirm the presence of Acanthamoeba DNA. Our results revealed that about 68% of cultures from water and 43% of those from soil were successfully amplified and proved to be amoeba DNA. Interestingly, a few samples yielded more than one product, which suggests that some other amoebic species may be present in the same sample (MAC-W1 and MADW1). To the best of our knowledge, we described for the first time the amoeba isolation from the participant’s close environment and antibodies level among Saudi population. Our future studies will be focused on additional molecular characterization of isolated amoeba and their pathogenic potential which could be a possible threat for the community.

Phytosynthesis of silver nanoparticles using Mangifera indica flower extract as bioreductant and their broad-spectrum antibacterial activity.

The present study focused on the evaluation of antibacterial property of silver nanoparticles (AgNPs) synthesized using mango flower extract. The morphology of the synthesized AgNPs was observed under transmission electron microscopy and the particles have shown spherical shape in the range of 10-20 nm. X-ray powder diffraction analysis confirmed the crystalline nature of the AgNPs. The atomic percentage of the Ag element in the nanoparticles was about 7.58% which is greater than the other elements present in the sample. The AgNPs showed extensive lethal effect on both Gram-positive (Staphylococcus sp.) and Gram-negative (Klebsiella sp., Pantoea agglomerans, and Rahnella sp.) bacteria. The extensive lethal effect of AgNPs against clinically important pathogens demonstrated that the mango flower mediated AgNPs could be applied as potential antibacterial agent to control the bacterial population in the respective industries.

In vitro invasion of laying hen ovarian follicles by Salmonella Enteritidis strains.

Salmonella is the major foodborne bacterial pathogen worldwide. Among numerous serotypes, Salmonella Enteritidis (SE) is one of the most common Salmonella serotypes responsible for human infections in the United States. The main source of SE outbreaks is foods associated with raw or undercooked chicken eggs. Salmonella Enteritidis is the only serotype that routinely contaminates eggs. The transovarian transmission of SE and subsequent contamination of the eggs before egg shell formation is considered to be the main route of egg contamination by SE. To evaluate whether invasion of ovarian follicles is an important step during the production of eggs contaminated by SE, we used an in vitro invasion assay to determine ovarian follicle invasion by 5 SE strains. After inoculating the freshly collected ovarian follicles, all 5 SE strains were able to invade into the follicles after 2 h of incubation at 37°C. The mean percentage of SE invasion ranged from 0.016 to 0.034% and no significant difference was found among the SE strains. For Escherichia coli K-12 strain, which was used as a negative control, the mean percentage of invasion was 0.0003%. The in vitro follicle invasion by SE strains demonstrated in this study may reflect the ability of the strains to invade ovarian follicles in laying hens once SE cells reach ovaries through various routes.