Extended Spectrum β-lactamases and antimicrobial susceptibility among clinical isolates of Pseudomonas aeruginosa in the West Bank, Palestine

Objectives: Class D oxacillinases are frequently acquired by gram negative bacteria in general and P. aeruginosa in particular.P. aeruginosa is commonly implicated in causing nosocomial infections. The evolution of antibiotic resistance inP. aeruginosa and the acquisition of blaOXA genes interfere with successful treatment.Methods: A total of 49 clinical isolates of P. aeruginosa were obtained from Rafidia Hospital, West Bank, Palestine.Antimicrobial susceptibility testing of the isolates was performed by the standard disc diffusion method following theguidelines of CLSI. The prevalence of class D β-lactamases (OXA groups I, II and III) as well as the pseudomonas specificenzymes (CARB-3) were determined by PCR.Results: Susceptibility of P. aeruginosa to carbapenems was the highest 89%, and lowest to ticarcillin/clavulanic acid70%. This study revealed that P. aeruginosa produced oxacillinase enzymes at rates of: OXA-10 (40.8%), OXA-2 (20.4%)and OXA-1 (18.4%). All ceftazidime resistant strains expressed OXA-1 and OXA-2, 18.4%. PSE group was expressed in10.2%.Conclusions: This is the first research conducted to investigate the correlation between OXA genes (blaOXA-1, bla-OXA-2 and blaOXA-10) and antimicrobial resistance among P. aeruginosa clinical isolates in Palestine. The results obtainedcould contribute to better treatment and reduction of the evolution of resistant strains. In addition, it will provideimportant information regarding the geographical distribution of class D β-lactamases. J Microbiol Infect Dis 2013; 3(2):56-60Key words: P. aeruginosa, β-lactamase, susceptibility, oxacillinases, blaOXA gene

New insights on the clinical variability of FKBP10 mutations

To date 45 autosomal recessive disease-causing variants are reported in the FKBP10 gene. Those variant were found to be associated with Osteogenesis Imperfecta (OI) for which the hallmark phenotype is bone fractuers or Bruck Syndrome (BS) where bone fractures are accompanied with contractures. In addition, a specific homozygous FKBP10 mutation (p.Tyr293del) has been described in Yup'ik Inuit population to cause Kuskokwim syndrome (KS) in which contractures without fractures are observed. Here we present an extended Palestinian family with 10 affected individuals harboring a novel homozygous splice site mutation, c.391+4A > T in intron 2 of the FKBP10 gene, in which the three above mentioned syndromes segregate as a result of skipping of exon 2 and absence of the FKBP65 protein. At the biochemical level, Hydroxylysyl pyridinoline (HP)/lysyl pyridinoline (LP) values were inversely correlated with OI phenotypes, a trend we could confirm in our patients. Our findings illustrate that single familial FKBP10 mutations can result in a phenotypic spectrum, ranging from fractures without contractures, to fractures and contractures and even to only contractures. This broad intrafamilial clinical variability within one single family is a new finding in the field of bone fragility

Overview On The Epidemiological Situation And The Brucellosis’ Control, Between 1974 -2014, In West Bank, Palestine

Brucellosis in Palestine is a problem of huge concern due to the human health impact, as consequence of the high prevalence level of the infection in livestock. The purpose of the research was to give an insight of the current epidemiological peculiarities of the brucellosis in livestock versus human population. This paper processed all data of the brucellosis’ control program and the epidemio-surveillance results. The seroprevalence of brucellosis in 1999, was 18% in sheep and goat and 80% in flocks, and more than 800 human cases. As result of mass vaccination, with 80% coverage vaccination rate, the decrease of brucellosis was registered: 4.8% in animals and 40% in flock; human infection less than 200 cases. The main conclusion of our study is that the vaccination must be in force up to the level of prevalence, below 2% in animals, allowing the next step, the “test-and-slaughter” strategy, toward the eradication goal

The Prevalence and Molecular Distinguishing of Brucella melitensis Rev1 Strain among Field Isolates the Brucella from Sheep and Goat Milk through PCR-RFLP Analysis of omp2 Gene Polymorphism

The present study was undertaken to characterize the prevalence and molecular distinguishing of Brucella melitensis field and vaccine Rev1 strains isolated from milk among the sheep and goat population. The study was carried out on flocks of sheep and goats suffering from Brucella infection outbreaks. A total of 171 milk samples were collected from different districts of the West Bank, part of Palestine, and isolated on Brucella agar. 86 cultures were confirmed by standard biochemical methods and screened for Brucella melitensis 16M of IS711 element by a conventional PCR technique. All these samples were also amplified for the omp2 gene to identify differences between field and Rev 1 strains in an infected flock. The results obtained from the PstI restriction enzyme pattern revealed that only 2 (4.5%) samples have specific polymorphism accomplished with the Brucella melitensis Rev1 strain. All other samples were restricted according to the Brucella melitensis 16M polymorphism pattern and originated from nonvaccinated flocks. Despite the adverse side effects of the Brucella melitensis vaccine, only a well-organized whole-flock vaccination and awareness campaign may inhibit the virulence of the field strain and, subsequently, reduce the prevalence of brucellosis infection among animals and humans in Palestine

Original Article Helicobacter pylori, a causative agent of vitamin B12 deficiency

Background: Helicobacter pylori is one of the most common causes of peptic ulcer disease worldwide and a major cause of chronic superficial gastritis leading to atrophy of gastric glands. Methodology: A total of 60 patients suffering from gastric disease due to H. pylori infection were evaluated. Endoscopy was performed and gastric biopsies were obtained for histopathology and urease test. Blood was simultaneously collected for the determination of the levels of vitamin B12 and the MCV. Vitamin B12 levels were determined by chemiluminescent assay. Results: Our results indicate that the mean vitamin B12 level + SEM for the total population, the H.pylori infected and non-infected patients were 264.5+22.9, 207.7+21.9 and 419.7+39.8 respectively. H. pylori was found in 71.7 % (43/60) of the patients tested. The level of vitamin B12 was lower than 200pg/ml (deficient) in 67.4 % (29/43) of patients tested positive for H. pylori. Conclusion: H. pylori appears to be implicated in causing vitamin B12 deficiency

Next Generation Sequencing to Determine the Cystic Fibrosis Mutation Spectrum in Palestinian Population

An extensive molecular analysis of the CF transmembrane regulator (CFTR) gene was performed to establish the CFTR mutation spectrum and frequencies in the Palestinian population, which can be considered as an understudied population. We used a targeted Next Generation Sequencing approach to sequence the entire coding region and the adjacent sequences of the CFTR gene combined with MLPA analysis of 60 unrelated CF patients. Eighteen different CF-causing mutations, including one previously undescribed mutation p.(Gly1265Arg), were identified. The overall detection rate is up to 67%, and when we consider only CF patients with sweat chloride concentrations >70 mEq/L, we even have a pickup rate of 92%. Whereas p.(Phe508del) is the most frequent allele (35% of the positive cases), 3 other mutations c.2988+1Kbdel8.6Kb, c.1393-1G>A, and p.(Gly85Glu) showed frequencies higher than 5% and a total of 9 mutations account for 84% of the mutations. This limited spectrum of CF mutations is in agreement with the homozygous ethnic origin of the Palestinian population. The relative large portion of patients without a mutation is most likely due to clinical misdiagnosis. Our results will be important in the development of an adequate molecular diagnostic test for CF in Palestine