Genotypes and serotype distribution of macrolide resistant invasive and non- invasive Streptococcus pneumoniae isolates from Lebanon

<p>Abstract</p> <p>Background</p> <p>This study determined macrolide resistance genotypes in clinical isolates of <it>Streptococcus pneumoniae </it>from multiple medical centers in Lebanon and assessed the serotype distribution in relation to these mechanism(s) of resistance and the source of isolate recovery.</p> <p>Methods</p> <p>Forty four macrolide resistant and 21 macrolide susceptible <it>S. pneumoniae </it>clinical isolates were tested for antimicrobial susceptibility according to CLSI guidelines (2008) and underwent molecular characterization. Serotyping of these isolates was performed by Multiplex PCR-based serotype deduction using CDC protocols. PCR amplification of macrolide resistant <it>erm </it>(encoding methylase) and <it>mef </it>(encoding macrolide efflux pump protein) genes was carried out.</p> <p>Results</p> <p>Among 44 isolates resistant to erythromycin, 35 were resistant to penicillin and 18 to ceftriaxone. Examination of 44 macrolide resistant isolates by PCR showed that 16 isolates harbored the <it>erm</it>(B) gene, 8 isolates harbored the <it>mef </it>gene, and 14 isolates harbored both the <it>erm</it>(B) and <it>mef </it>genes. There was no amplification by PCR of the <it>erm</it>(B) or <it>mef </it>genes in 6 isolates. Seven different capsular serotypes 2, 9V/9A,12F, 14,19A, 19F, and 23, were detected by multiplex PCR serotype deduction in 35 of 44 macrolide resistant isolates, with 19F being the most prevalent serotype. With the exception of serotype 2, all serotypes were invasive. Isolates belonging to the invasive serotypes 14 and 19F harbored both <it>erm</it>(B) and <it>mef </it>genes. Nine of the 44 macrolide resistant isolates were non-serotypable by our protocols.</p> <p>Conclusion</p> <p>Macrolide resistance in <it>S. pneumoniae </it>in Lebanon is mainly through target site modification but is also mediated through efflux pumps, with serotype 19F having dual resistance and being the most prevalent and invasive.</p

Servitude et grandeur militaires

Ġabra ta’ poeżiji u proża li tinkludi: Notturn op. 9 nru 2 ta’ Beverly Agius – Naf ta’ Carmel Azzopardi – Ħsejjes ħajja ta’ Clifton Azzopardi – Il-ġrajja t’għasfur stramb ta’ Mario Azzopardi – Tektik...u għana ta’ Rena Balzan – Kun af li f’qiegħ għajnejk ta’ Charles Bezzina – Il-qalb imwebbsa ta’ Ġorġ Borg – Bħal ħuta mġewħa ta’ Louis Briffa – Taħt il-Mezquita, Cordòba ta’ Norbert Bugeja – Il-maskarat ta’ Alfred Degabriele – Trid mara ta’ Leanne Ellul – Id-dgħajsa ta’ Victor Fenech – Ilħna ta’ Joe Friggieri – Roulette ta’ Joe Friggieri – Għera ta’ Joe P. Galea – Ħġieġa ta’ Maria Grech Ganado – Ġenna qatt mirbuħa ta’ Karmenu Mallia – Il-fantażma tal-mara mqarba ta’ Albert Marshall – Daħlet Qorrot ta’ Daniel Massa – Granada, parque central ta’ Immanuel Mifsud – Waħda mara ta’ Immanuel Mifsud – Mors ta’ Therese Pace – Għada ta’ Alfred Palma – Emmint xejn ma jintemm ta’ Ġorġ Peresso – Tuffieħa bl-imsiemer tal-qronfol ta’ John Peter Portelli – Lil Karmenu Vassallo ta’ Andrew Sciberras – Irrid il-qamar jiddi ta’ Carmel Scicluna – Din il-biċċa ħuta ta’ Steve Borg – Karta li taret mar-riħ ta’ Lina Brockdorff – Nixtieq, u kemm nixtieq! ta’ J. J. Camilleri – Caterina ta’ Sandro Mangion – L-għajta tal-pappagall ta’ Pierre J. Mejlak – Id-destin ta’ Laurence Mizzi – L-arloġġ tal-bozza ta’ Rita Saliba – Kurżità ta’ Alfred Sant – Il-ġeneral ta’ Vincent Vella – Mirja ta’ Trevor Żahra – L-adulteri ta’ Golan Haji, traduzzjoni ta’ Clare Azzopardi u Albert Gatt – L-istennija ta’ Berislav Blagojević, traduzzjoni ta’ Kit Azzopardi – Il-qattus ta’ Ghassan Kanafani, traduzzjoni ta’ Walid Nabhan – L-iben addottat ta’ Guy de Maupassant, traduzzjoni ta’ Josette Attard – Sunett nru. 18 ta’ William Shakespeare, traduzzjoni ta’ Alfred Palma – Llanto por Ignacio Sánchez Mejías ta’ Federico Garcia Lorca, traduzzjoni ta’ Therese Pace – Servitude et grandeur militaires ta’ Alfred de Vigny, traduzzjoni ta’ Paul Zahra.peer-reviewe

Thoughts on Change and the Blind Language / ﺃﻓﻜﺎﺭ ﻋﻦ ﺍﻟﺘﻐﻴﺮ ﻭ ﺍﻟﻠﻐﺔ ﺍﻟﻌﻤﻴﺎﺀ

[abstract not available

Traduction de l'arabe de La Porte de Ghassan Kanafani (الباب / كنفاني غسان)

International audienceAvec cette édition bilingue de la Porte de Ghassan Kanafani, associant un texte arabe soigneusement établi à une traduction rigoureuse, l’atelier de traduction arabe de Houda Ayoub à l’ENS de la rue d’Ulm met pour la première fois à la portée d’un large lectorat francophone un texte méconnu.Extrait — Tu vois cette porte ? Regarde-la bien ! Je me suis usé les ongles à la griffer comme un chat fou furieux, je me suis rompu les os à force de me jeter dessus... je me suis cassé la tête pour y faire une brèche par où puisse s’envoler un seul mot de vérité... Et après? Je m’affaissais comme du coton, ici, oui, ici! Là où tu te tiens, à te pavaner comme un paon... Crois-tu être le seul à avoir percé le secret ? Nous l’avons tous fait... Tous... Au bout d’un jour, d’une heure, d’une année, d’une génération... L’important, c’est que nous l’avons percé... Crois-tu que cela justifie de se tuer pour cela? [...] Vois ce que tu as fait de toi, pauvre fou! Te voilà ici! Allez, vas-y, brise la porte, brise-toi toi-même ! Tu ne peux échapper au piège dans lequel tu t’es toi-même jeté !Ghassan Kanafani — Écrivain palestinien né à Acre en 1936 et mort en 1972 à Beyrouth. Il est l’auteur de nombreux articles, d’essais, de romans, de nouvelles et de pièces de théâtre. Il est l’un des plus grands écrivains arabes du XXe siècle et un pionnier de la littérature palestinienne et arabe contemporaine.Pdf intégral en ligne : https://spartacus-idh.com/058.html

Traduction de l'arabe de La Porte de Ghassan Kanafani (الباب / كنفاني غسان)

الباب / كنفاني غسانAvec cette édition bilingue de la Porte de Ghassan Kanafani, associant un texte arabe soigneusement établi à une traduction rigoureuse, l’atelier de traduction arabe de Houda Ayoub à l’ENS de la rue d’Ulm met pour la première fois à la portée d’un large lectorat francophone un texte méconnu.Extrait — Tu vois cette porte ? Regarde-la bien ! Je me suis usé les ongles à la griffer comme un chat fou furieux, je me suis rompu les os à force de me jeter dessus... je me suis cassé la tête pour y faire une brèche par où puisse s’envoler un seul mot de vérité... Et après? Je m’affaissais comme du coton, ici, oui, ici! Là où tu te tiens, à te pavaner comme un paon... Crois-tu être le seul à avoir percé le secret ? Nous l’avons tous fait... Tous... Au bout d’un jour, d’une heure, d’une année, d’une génération... L’important, c’est que nous l’avons percé... Crois-tu que cela justifie de se tuer pour cela? [...] Vois ce que tu as fait de toi, pauvre fou! Te voilà ici! Allez, vas-y, brise la porte, brise-toi toi-même ! Tu ne peux échapper au piège dans lequel tu t’es toi-même jeté !Ghassan Kanafani — Écrivain palestinien né à Acre en 1936 et mort en 1972 à Beyrouth. Il est l’auteur de nombreux articles, d’essais, de romans, de nouvelles et de pièces de théâtre. Il est l’un des plus grands écrivains arabes du XXe siècle et un pionnier de la littérature palestinienne et arabe contemporaine.Pdf intégral en ligne : https://spartacus-idh.com/058.html

Profile of opportunistic infections in HIV-infected patients at a tertiary care center in Lebanon

Objectives: According to statistics published in December 2007 by the National AIDS Program, Lebanon is home to 1056 individuals infected with HIV. Little is known about the clinical profile of opportunistic infections (OIs) and AIDS defining illnesses (ADIs) and their relative contribution to the morbidity and mortality of HIV-infected patients in Lebanon. The aim of this study is to describe the spectrum of OIs and ADIs in HIV-infected patients diagnosed and/or treated at the American University of Beirut Medical Center (AUBMC) in Lebanon. Methods: Data on various OIs and ADIs were collected from the medical records of patients with HIV infection who were diagnosed or received their medical care at AUBMC from 1984 to January 2008. Results: Eighty-nine HIV-infected patients were included in the analysis. The incidence of ADIs was 72% (64/89). The most commonly diagnosed OIs were cerebral toxoplasmosis (21%), followed by fungal infections (17%). The majority of ADIs (75%) occurred when the CD4 count was below 200 cells/mm3. Conclusion: Clinical guidelines for the prevention of OIs in HIV-infected individuals have been developed on the basis of natural history data collected in industrialized countries. Our results can be used to define local priorities for opportunistic infection prophylaxis. Keywords: HIV, Opportunistic infections, Lebano

Assessment of Combination Therapy in BALB/c Mice Injected With Carbapenem-Resistant Enterobacteriaceae Strains

Monotherapeutic options for carbapenem resistant infections are limited. Studies suggest that combination therapy may be associated with better outcomes than monotherapies. However, this is still controversial. This study assessed, the efficacy of combination therapy against carbapenem resistant Enterobacteriaceae harboring singly various ESBL or carbapenemase encoding genes. Thus, four isolates harboring either blaCTXM-15, blaCTXM-15 and blaOXA-48, blaNDM-1, or blaKPC-2 genes were selected for testing. Minimal Inhibitory Concentration (MIC) was determined by broth dilution method. Gene transcript levels on single and combined treatments were done in vitro and in vivo by q RT-PCR. Assessment of treatments was done in BALB/c mice according to a specific protocol. As such, the qRT-PCR revealed a significant decrease of transcript levels in all isolates upon using rifampicin or tigecycline, singly or in combination with colistin. However, variable levels were obtained using colistin singly or in combination with meropenem or fosfomycin. In vivo assessment showed that all combinations used were effective against isolates harboring blaCTXM-15, blaOXA-48, and blaNDM-1. Conversely, the most significant combination against the isolate harboring blaKPC-2 gene was colistin with carbapenem, fosfomycin, or kanamycin. As a conclusion, combination therapy selected based on the type of carbapenemase produced, appeared to be non-toxic and might be effective in BALB/c mice. Therefore, the use of a rationally optimized combination therapy might lead to better results than monotherapy, however, clinical trials are needed for human consumption

Multi-drug resistant Acinetobacter species: a seven-year experience from a tertiary care center in Lebanon

Abstract Background Acinetobacter species have become increasingly common in the intensive care units (ICU) over the past two decades, causing serious infections. At the American University of Beirut Medical Center, the incidence of multi-drug resistant Acinetobacter baumannii (MDR-Ab) infections in the ICU increased sharply in 2007 by around 120%, and these infections have continued to cause a serious problem to this day. Methods We conducted a seven-year prospective cohort study between 2007 and 2014 in the ICU. Early in the epidemic, a case-control study was performed that included MDR-Ab cases diagnosed between 2007 and 2008 and uninfected controls admitted to the ICU during the same time. Results The total number of patients with MDR-Ab infections diagnosed between 2007 and 2014 was 128. There were also 99 patients with MDR-Ab colonization without evidence of active infection between 2011 and 2014. The incidence of MDR-Ab transmission was 315.4 cases/1000 ICU patient-days. The majority of infections were considered hospital-acquired (84%) and most consisted of respiratory infections (53.1%). The mortality rate of patients with MDR-Ab ranged from 52% to 66%. Conclusion MDR-Ab infections mostly consisted of ventilator-associated pneumonia and were associated with a very high mortality rate. Infection control measures should be reinforced to control the transmission of these organisms in the ICU