Clinical practice guidelines for the treatment of invasive Aspergillus infections in adults in the Middle East region: Expert panel recommendations.

The incidence of invasive Aspergillus infections in the Middle East continues to rise with the increase in the number of immunocompromised patients, and carries significant morbidity and mortality. A panel of experts analysed the evidence from the most recent international guidelines and relevant published literature to reach consensus and develop clear clinical practice guidelines to aid diagnosis and treatment of invasive Aspergillus infections in the Middle East. Disease-specific recommendations were provided for the management of invasive aspergillosis. The expert panel acknowledged that these guidelines should be followed as closely as possible but used alongside clinical judgement.

Clinical practice guidelines for the management of invasive Candida infections in adults in the Middle East region: Expert panel recommendations.

Invasive Candida infections contribute to significant morbidity and mortality in patients with healthcare-associated infections. They represent a major burden on the public health system, and are challenging to diagnose and treat. A multidisciplinary expert panel critically reviewed available evidence to provide consensus recommendations for the management of invasive Candida infections in the Middle East. Based on diagnosis, recommendations were provided for the management of Candida infections in non-neutropenic and neutropenic patients. Polyenes (amphotericin B-deoxycholate [AmB-d] and lipid formulations amphotericin B [LFAmB]), triazoles (fluconazole, itraconazole and voriconazole), echinocandins (caspofungin, anidulafungin, and micafungin) and flucytosine are the recommended categories of antifungal agents for treatment of Candida infections. Echinocandins are preferred for treatment of proven and suspected Candida infections, especially in critically ill patients or those with previous exposure to azoles. Recommendations were also provided for infections caused by specific Candida species as well as management of different disease conditions. The experts highlighted that the guidelines should be used along with clinical judgment. Given the paucity of published data from the region, research in the form of randomized clinical trials should be given priority.

Epidemiology of invasive pneumococcal infection in children aged five years and under in Saudi Arabia: a five-year retrospective surveillance study.

BACKGROUND: The epidemiology of invasive pneumococcal disease (IPD) in children aged

MRSA prevalence in a teaching hospital in Western Saudi Arabia.

OBJECTIVE: To determine the prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) colonization in our institution. METHODS: A 5-day period prevalence study of all adult and pediatric patients. Excluded areas were the adult intensive care unit (screened on admission and weekly thereafter), the outpatient hemodialysis population (screened monthly), and newborns. Our facility is a referral/teaching hospital for the National Guard population and their dependants in Western Saudi Arabia. A total of 240 patients were screened. Nasal sampling was carried out and isolation/identification of MRSA was performed using standard microbiological methods. RESULTS: The total number of patients sampled was 240 and of those 10 (4%) were colonized. The 10 positives were found in 4 patient care areas; adult male medicine 5, adult male oncology 3, adult female medicine one, adult high dependency unit one. These patients care areas had 69 patients (42 males and 27 females). Ten (14%) were colonized by MRSA; 9 males (21%) and one female (3%). Statistical analysis Chi Square for discontinuous variables, "F" test for continuous variables found that one), male gender (p=0.04), 2) the presence of a long term invasive device (p=0.04), 3), length of stay (p=0.004) were predictive of MRSA colonization. CONCLUSION: The overall prevalence of MRSA colonization in our hospital was low, however a sub-segment of the population identified as male, having long term invasive devices, and hospitalized more than 2 weeks, were frequently colonized. Any strategy, in our hospital, to control the spread of MRSA should include the testing of this population.