Emergence of Gram-Negative Bacilli with Concomitant blaNDM-1- and blaOXA-48-Like Genes in Egypt
Maha Assem,
Mohamed-Naguib Abdalla Wifi,
Rasha Elsherif,
Ahmed Saad,
Dalia Kadry Ismail,
Ahmed Hasanin,
Rasha Bassyouni,
Mohamed Saeed Hussein Gomaa
Issue:
Volume 5, Issue 1, January 2017
Pages:
1-6
Received:
15 November 2016
Accepted:
30 November 2016
Published:
3 January 2017
Abstract: Multidrug-resistant Gram-negative organisms have emerged as a major threat to hospitalized patients, and are associated with serious morbidity and mortality. This study aimed to characterize carbapenem resistance genes among Gram-negative bacilli isolated from clinical samples from patients in the intensive care unit of Cairo University Hospital. A total of 211 samples were collected from patients showing clinical evidence of infection. Bacteria were isolated and identified by conventional microbiological methods. Acinetobacter baumannii isolates were furtherly characterized by polymerase chain reaction (PCR), using primers specific for blaOXA-51-like genes. The Kirby Bauer disc diffusion method was used to determine susceptibility patterns of isolates, and carbapenem resistance was further examined by a modified Hodge test. Positive isolates were tested for the presence of blaKPC, blaOXA-48, and blaNDM-like genes by PCR. NDM gene types were determined by direct sequencing. From the 211 samples, 229 Gram-negative bacilli were isolated. Fifty isolates (21.2%) were resistant to carbapenem. PCR analysis showed that none of the 50 isolates carried blaKPC-like genes, while 24 (48%) isolates carried blaOXA-48-like genes, 8 (16%) carried blaNDM-1, and five isolates (10%) carried both blaNDM-1 and blaOXA-48-like genes. These results indicate that continuous surveillance of these multidrug-resistant pathogens is urgently required. And that is very important is to activate the antimicrobial stewardship programs of which the most important is restriction of the big gun antibiotics like carbapenems, colistin, tigecyclin and vancomycin and restricting their prescription to privileged specialties.
Abstract: Multidrug-resistant Gram-negative organisms have emerged as a major threat to hospitalized patients, and are associated with serious morbidity and mortality. This study aimed to characterize carbapenem resistance genes among Gram-negative bacilli isolated from clinical samples from patients in the intensive care unit of Cairo University Hospital. A...
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The Correlation Between the Clinical Presentation and the Radiological Appearance in Patients with Myelitis at Alshaab Teaching Hospital-Sudan
Etedal Ahmed Ibrahim,
Hiba Hassan Ibrahim,
Mohammed Adam Elnour,
Hyder Osman Mirghani,
Mohamed Nageeb Abdallah
Issue:
Volume 5, Issue 1, January 2017
Pages:
7-11
Received:
30 November 2016
Accepted:
28 December 2016
Published:
1 February 2017
Abstract: Acute transverse myelitis is the leading cause of non-compressive myelopathy, linking the clinical presentation with Magnetic Resonance Imaging (MRI) may aid in proper stratification of patients improving management, we aimed to study the correlation between the clinical presentation of acute transverse myelitis with MRI findings. This cohort, hospital-based study conducted at Alshaab Teaching Hospital, Sudan among patients with acute transverse myelitis, Participants signed a written informed consent then the clinical presentation was recorded and followed including symmetry and extent of the lesion, site of lesion, sensory involvement. Correlation between various clinical presentations and MRI findings was done. The ethical committee of Alshaab Teaching Hospital approved the research, and the Statistical Package for Social Sciences was used for data analysis. Out of 100 patients infections was observed in 25%, and autoimmunity in 8%, involvement of more than three segments of the spinal cord was commoner among patients with symmetrical and complete presentation, no significant difference was evident between patients with symmetrical and complete presentation, compared to partial asymmetrical presentation regarding the site of spinal cord involvement on MRI. Complete and symmetrical presentation are commonly associated with more than three segments involvement of the spinal cord, no significant difference was found between complete symmetrical presentation and partial asymmetrical presentation regarding the site of involvement on MRI.
Abstract: Acute transverse myelitis is the leading cause of non-compressive myelopathy, linking the clinical presentation with Magnetic Resonance Imaging (MRI) may aid in proper stratification of patients improving management, we aimed to study the correlation between the clinical presentation of acute transverse myelitis with MRI findings. This cohort, hosp...
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Effect of Midodrine in Patients with Liver Cirrhosis and Refractory Ascites
Ahmed A. Obiedallah,
Essam Abdelmohsen,
Abdalla I. Kelani,
Mohamed Mousa
Issue:
Volume 5, Issue 1, January 2017
Pages:
12-17
Received:
1 January 2017
Accepted:
20 January 2017
Published:
20 February 2017
Abstract: Background: Ascites is the most common complication of liver cirrhosis and about 5-10% of all cases develop refractory ascites, 50% of such patients die within 6 months of its development. Aim of the Work: to assess the usefulness of adding midodrine beside the standard medical treatment for patients with liver cirrhosis and refractory ascites. Patients and Methods: This study included 78 patients with liver cirrhosis and refractory ascites or recurrent ascites, Group A: (n=37) patients on standard medical treatment (SMT) [low sodium diet + diuretic therapy (loop diuretic in a dose 40-160 mg/day and distal acting diuretic in a dose 100-400 mg/day + large volume paracentesis as needed] Group B: (n=41) patients with standard medical treatment (SMT) and midodrine tolerable dose. Results: Statistical significant difference between the SMT group and midodrine group as regard reduction in body weight and increase in mean arterial blood pressure and 24 h-urinary volume where P value was < 0.05. Conclusion, midodrine is a safe treatment for patients with liver cirrhosis and its addition to standard medical treatment is associated with better control of ascites.
Abstract: Background: Ascites is the most common complication of liver cirrhosis and about 5-10% of all cases develop refractory ascites, 50% of such patients die within 6 months of its development. Aim of the Work: to assess the usefulness of adding midodrine beside the standard medical treatment for patients with liver cirrhosis and refractory ascites. Pat...
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