Microbiology, diseases, and epidemiology of Kingella kingae in young children: A short review

Kingella kingae is a Gram-negative coccobacilli and it is a member of the HACEK (Haemophilus species, Aggregatibacte actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and  K. kingae). HACEK organisms are typically oropharyngeal commensals and have long been recognized as a cause of infective endocarditis in children and adults. K. kingae in difficult to be recovered from cultured pharyngeal samples due to its slow growth and the high presence of resident bacterial flora, however, the organism can be better detected using PCR tests. Based on our search in PubMed and other sources, we couldn't discover any study about K. kingae originated from any Arab country. Therefore, we wrote this review to draw the attention of our physicians and clinical microbiologists on the importance of this neglected group of organisms in clinical medicine.   However, this review article aims to cover the most important diseases of K. kingae in the pediatric population

Clostridium difficile : Infection, diagnosis and treatment with antimicrobial drugs : A review article

Clostridium difï¬cile infection (CDI) is increasing problem in healthcare, associated with high incidence, mortality, and costs in hospitalized patients.  Dramatic increases in the incidence and severity of healthcare-associated C. difficile infection have occurred since the last decade, including elderly population, young adults, pregnant females, infants and children. C. difï¬cile infections are mainly linked to the prolonged use of wide-spectrum antibiotics that disrupt the intestinal microbiota equilibrium. Toxigenic strains of C. difï¬cile commonly produce two clostridial toxins, toxins A (TcdA) and B (TcdB), to which disease symptoms are attributed. Few strains of C. difï¬cile may also produce another more powerful binary toxin associated with high fatality. The clinical manifestations of infection with toxin-producing strains of C. difï¬cile range from symptomless carriage, to mild or moderate watery-bloody diarrhea, and few percentage developed fulminant and sometimes fatal pseudomembranous colitis. Complications that have been associated with CDI include dehydration, electrolyte disturbances, toxic megacolon, bowel perforation, hypotension, renal failure, systemic inflammatory response syndrome, sepsis, and death. The most important step in treating CDI is immediately discontinuing use of offending antimicrobial drug. Both metronidazole and vancomycin are equally effective for the treatment of mild CDI, but vancomycin is superior for treating patients with severe C. difï¬cile disease. Recently, fidaxomicin proved to be superior to other drugs in treatment of patients who are at high risk for CDI relapse.Â

The emergence of antimicrobial resistance in enterococci isolates from infants: A review study

The emergence of antibiotic resistance in potential bacterial pathogens is considered as an important consequence of antibiotic misuse and overuse in humans and animals husbandry. In addition,  lacks of adequate infection-control practice in hospital and medical care settings have led to the continuing development of extensive resistance problems worldwide. Certain multidrug-resistant commensal and potential pathogens are now   widely spread in community and hospital patients worldwide . Examples are meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistance enterococcci (VRE), extended-spectrum β-lactamase- and carbapenemase-producing coliforms, and toxin-hyperproducing Clostridium difficile. During the last decade, Enterococcus faecalis and Enterococcus faecium are the most prevalent species cultured from human infections. Incidence of enterococci resistant to multiple antibiotics has become increasingly common in the hospitalized patients all over the world. E. faecium is reported to be responsible for most vancomycin-resistant enterococci (VRE) infections.Â

Short Term Outcomes of Neonates Born after Prolonged Premature Rupture of Membranes < 34 Weeks Gestation

Background: Preterm premature rupture of membranes (PPROM) is responsible for one?third of all preterm births worldwide. This aim of this study was to investigate the outcome of neonates born after prolonged PPROM with gestational age below 34 weeks. Materials and methods: This retrospective study included 65 patients who were born to mothers with Prolonged PPROM <34 weeks gestation between January 2011 and December 2015 and admitted to the neonatal intensive care unit (NICU) at Jordan University Hospital. Results: The mean gestational age of included patients was (31.9 ± 2.5 weeks), mean birth weight was (1840 ± 583 g) and 43 (66.2%) were males. The mortality rate in those infants was 12.3 %. Gestational age, birth weight, and Apgar score were significantly lower among mortality cases compared to surviving cases (P < 0.05). Conclusion: Prolonged PPROM before the 34th gestational week is associated with high rate of morbidity and mortality, for which early identification of risk factors for developing PPROM can help in reducing the risk for preterm labors and subsequent burden on healthcare system

High incidence of multidrug resistant Escherichia coli producing CTX-M-type ESBLs colonizing the intestine of Jordanian infants

Background. This prospective study investigated major characteristics of E.coli colonizing the intestine of out-patient and in-patient infants, especially their association with CTX-M-type  extended spectrum  β-Lactamases (ESBLs), integrons and  fluoroquinolone resistance genes (gyrAandparC) . Method. A total of 288 stool samples were collected from infants aged less than 1 year which were admitted at the pediatric department, Jordan University Hospital, Amman. The E.coli isolates were investigated using antimicrobial susceptibility tests and PCR for detection of CTX-M genes and integrons .   Results. A total of 170 (59%) infants were colonized with E.coli, including 73 (42.9%) females and 97 (57.1%) males.  A significant difference was observed between gender and age groups according to the presence or absence of E.coli (P= 0.001). Multidrug resistant (MDR) accounted for 52 (30.6%) of the isolates and all were ESBL producers. The detection rate of CTX-M genes among  MDR E.coli isolates was 49 (94.2%), CTX-M group 1 accounted for  41 (87.8%) of the  isolates and 30(73.2%) were CTX-M-15 producers.  Only Class I integron was detected in 20/52 (38.5%) of  MDR  E. coli isolates, and resistance to fluoroquinolones accounted for 45/52(86.5%) of these isolates . A total of 33/52 (63.5%) of MDR E.coli isolates were resistant to  potential Quinolone resistance genes (parC) and (gyrA) in association with CTX-M group. Conclusion. This study demonstrates that formula-fed infants, vaginal delivery and old age of infants were higher and significant associated with colonization of E .coli. High incidence of CTX-M  ESBL-producing E. coli was found in association with  fluoroquinolones-resistance and Class I integrons colonizing the intestine of Jordanian infant

Coronavirus disease 2019 (COVID-19): a brief overview of features and current treatment

Since the report of the first cases of pneumonia caused by SARS-CoV-2 in December 2019, COVID-19 has become a pandemic and is globally overwhelming healthcare systems. The symptoms of COVID-19 vary from asymptomatic infection to severe complicated pneumonia with acute respiratory distress syndrome (ARDS) and multiple organ failure leading to death. The estimated case-fatality rate among infected patients in Wuhan, the city where the first case appeared, was 1.4%, with 5.1 times increase in the death rate among those aged above 59 years than those aged 30–59 years. In the absence of a proven effective and licensed treatment, many agents that showed activity against previous coronavirus outbreaks such as SARS and MERS have been used to treat SARS-CoV-2 infection. The SARS-CoV-2 is reported to be 80% homologous with SARS-CoV, and some enzymes are almost 90% homologous. Antiviral drugs are urgently required to reduce case fatality-rate and hospitalizations to relieve the burden on healthcare systems worldwide. Randomized controlled trials are ongoing to assess the efficacy and safety of several treatment regimens

Machine learning techniques for predicting depression and anxiety in pregnant and postpartum women during the COVID-19 pandemic: A cross-sectional regional study

Background: Maternal depression and anxiety are significant public health concerns that play an important role in the health and well-being of mothers and children. The COVID-19 pandemic, the consequential lockdowns and related safety restrictions worldwide negatively affected the mental health of pregnant and postpartum women. Methods: This regional study aimed to develop a machine learning (ML) model for the prediction of maternal depression and anxiety. The study used a dataset collected from five Arab countries during the COVID-19 pandemic between July to December 2020. The population sample included 3569 women (1939 pregnant and 1630 postpartum) from five countries (Jordan, Palestine, Lebanon, Saudi Arabia, and Bahrain). The performance of seven machine learning algorithms was assessed for the prediction of depression and anxiety symptoms. Results: The Gradient Boosting (GB) and Random Forest (RF) models outperformed other studied ML algorithms with accuracy values of 83.3% and 83.2% for depression, respectively, and values of 82.9% and 81.3% for anxiety, respectively. The Mathew\u27s Correlation Coefficient was evaluated for the ML models; the Naïve Bayes (NB) and GB models presented the highest performance measures (0.63 and 0.59) for depression and (0.74 and 0.73) for anxiety, respectively. The features\u27 importance ranking was evaluated, the results showed that stress during pregnancy, family support, financial issues, income, and social support were the most significant values in predicting anxiety and depression. Conclusion: Overall, the study evidenced the power of ML models in predicting maternal depression and anxiety and proved to be an efficient tool for identifying and predicting the associated risk factors that influence maternal mental health. The deployment of machine learning models for screening and early detection of depression and anxiety among pregnant and postpartum women might facilitate the development of health prevention and intervention programs that will enhance maternal and child health in low- and middle-income countries

Longevity-Related Gene Transcriptomic Signature in Glioblastoma Multiforme

Glioblastoma multiforme (GBM) (grade IV astrocytoma) has been assumed to be the most fatal type of glioma with low survival and high recurrence rates, even after prompt surgical removal and aggressive courses of treatment. Transcriptional reprogramming to stem cell-like state could explain some of the deregulated molecular signatures in GBM disease. The present study aimed to quantify the expression profiling of longevity-related transcriptional factors SOX2, OCT3/4, and NANOG to evaluate their diagnostic and performance values in high-grade gliomas. Forty-four specimens were obtained from glioblastoma patients (10 females and 34 males). Quantitative real-time polymerase chain reaction was applied for relative gene expression quantification. In silico network analysis was executed. NANOG and OCT3/4 mRNA expression levels were significantly downregulated while that of SOX2 was upregulated in cancer compared to noncancer tissues. Receiver operating characteristic curve analysis showed high diagnostic performance of NANOG and OCT3/4 than SOX2. However, the aberrant expressions of the genes studied were not associated with the prognostic variables in the current population. In conclusion, the current study highlighted the aberrant expression of certain longevity-associated transcription factors in glioblastoma multiforme which may direct the attention towards new strategies in the treatment of such lethal disease

Dietary intake and lifestyle practices of eastern mediterranean postpartum women before and during COVID-19 pandemic: An internet-based cross-sectional survey

Background: During the lockdown period, a substantial group of these women reported lifestyle changes. Aim: The aim of the study is to characterize the dietary patterns, intake and the adherence to the United States Department of Agriculture (USDA) pregnancy guidelines before and during the COVID-19 pandemic in Eastern Mediterranean postartum women. Methods: An internet-based cross-sectional survey was used to collect the data. The survey was carried out among 1,939 postpartum women from five countries from the Eastern Mediterranean region. Change in dietary intake from the five food groups and the adherence to USDA's daily recommendations were assessed. Findings: There was a significant increase in the mean (SD) consumption of all the food groups, including bread, rice, and other cereals, fruits, vegetables, milk and milk products, white and red meat, and nuts during the pandemic. Around 84% of participants reported no/low adherence (0–2) to USDA guidelines, whereas only 15% reported moderate or high adherence (3–5) to the guidelines before the pandemic. However, there was an increase in the proportion of subjects reporting moderate/high adherence (22%) during the pandemic. Discussion and conclusions: A substantial proportion of our study participants reported a lower dietary intake than the recommended amounts, and low adherence to the five food groups. Reasonable and applicable actions should be taken to protect postpartum women and their children from the effects of low dietary intake, particularly during pandemics and lockdowns. More researches are needed to identify the modifiable factors which could improve the nutritional status of the postpartum women during the pandemic