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

Anticancer, antibacterial, and antifungal activities of arum palaestinum plant extracts

Traditional natural remedies have long played an important role in the treatment of cancer and infectious diseases. A part from the high cost and undesirable side effects associated with synthetic drugs, increased interest has intensified to determine the biological effects of plant extracts on malignant cells as alternative for conventional drugs used in the markets. The medicinal properties of Arum Palaestinum Boiss were in-vitro investigated in this research project. Arum palaestinum is chosen based on its use in traditional palestinian herbal medicine. The leaves of this plant were air dried in the shade and then three types of extract were obtained and their antimicrobial and for anticancer activity testing. Investigations on three different cancer cell lines (C2Cl2, 3T3-L1, Hela) revealed direct inhibitory effect of the extracts. This effect differs according to concentrations used. Aqueous boiled extract was more effective at lower extract concentrations as compared to other two extracts. Arum palaestinum plant extracts showed no inhibitory effect on bacterial species (Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa) as well as yeasts (Candida albicans). In conclusion, Arum palaestinum has potentially anticancer effect. Further investigations are required to confirm this conclusion and to elucidate the mechanisms of actions and toxicity of this herb

Pre-operative Over-investigation of Routine Tests Prior to Elective Surgeries

Background: Previous studies stressed on the burden raised by routine pre-operative test ordering, which should be based on the assessment of patient physical status. In a tertiary hospital in Jordan, we aim to study the compliance with guidelines regarding pre-operative routine testing prior to an elective surgery, cholecystectomy, and calculate the estimated cost from non-compliance with the guidelines.Methods: We included laparoscopic cholecystectomy (through ICD-9 code) to represent an elective surgery. For each surgery done from the period 1/1/2016 to 31/12/2016, data regarding preoperative investigations, admission history note, operative and discharge note were obtained. Tests that are considered routine investigations are Complete blood count (CBC), kidney function tests (KFT), electrolytes, chest X-ray, electrocardiogram, coagulation studies, and urine-analysis. We classified patients who underwent cholecystectomy according to the latest version of the American Society of Anesthesiologists (ASA) physical status system to assess the need for routine tests, then we calculated the number and cost of excess tests.Results: A total 382 routine, non-emergent laparoscopic cholecystectomy surgeries were performed. 319 (83.5%) of patients were classified as ASA-1, 60 (15.7%) were classified as ASA-2, and only 3 (0.8%) were classified as ASA-3. Age was a significant determinant in obtaining chest X-ray ordering and findings (p< 0.001) and electrolytes ordering and findings (p= 0.001). Total routine tests cost for elective cholecystectomy during 2016 was 16,021$. Regarding operative compilations, only 14 (3.7%) complication occurred, all of which were bleeding related.Conclusion: Oversighting routine preoperative test ordering before elective cholecystectomy will significantly reduce the cost without increasing post-operative complications

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

PTHrP gene expression in prostate cancer cell proliferation.

PTHrP gene expression in prostate cancer cell proliferation

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