8 research outputs found
Antimicrobial Resistance for Enteric Pathogens Isolated from Acute Gastroenteritis Patients in Gaza strip, Palestine
The antibiotic resistance of enteropathogenic bacteria has profound clinical implications. Hence, this research was in part an attempt for isolation of enteropathogenic bacteria and determines their antimicrobial susceptibility patterns. Samples were collected from acute gastroenteritis patients inGazastrip,Palestine. This method of investigation is a matched case-control study. A total of 132 stool samples were collected from Palestinian patients with acute diarrhea (gastroenteritis). Among 132 diarrheal patients, 12 (9.1%) of enteropathogenic bacteria were isolated. Salmonella, Campylobacter coli/jejuni, and Aeromonas hydrophilia were isolated in equal numbers from samples 3/12 (25% each), Shigella 2/12 (16.7%), Yersinia enterocolytica 1/12 (8.3%). The two Shigella spp. are Shigella boydii. The antimicrobial profile of twelve isolated enteropathogenic bacteria showed high resistance rates for Campylobacter coli/jejuni (52.4%), followed by Aeromonas hydrophilia (49.2%), Yersinia enterocolytica (42.9%), Shigella (26.2%) and Salmonella spp. (22.2%). Children younger than 5 years old are more susceptible to infectious diarrhea; in addition, diarrhea is more frequent in crowded houses with low room's number, and among peoples living in houses rearing poultry, and pigeons. Findings from this study demonstrated that Campylobacter coli/jejuni, Aeromonas hydrophilia, and Yersinia enterocolytica, which are not screened during routine examinations of stool samples in Palestinian health laboratories in Gaza strip, were significant enteropathogens in the studied patients. Therefore, we recommend improving of laboratories inGaza strip to increase their ability to isolate all types of enteropathogenic bacteria especially those, which have not isolated routinely in these laboratories, which require special techniques
Antimicrobial Resistance of Enteric Pathogens Isolated from Acute Gastroenteritis Patients in Gaza strip, Palestine
Background: Acute gastroenteritis is a severe infection of the gastrointestinal tract (GI). The antibiotic resistance of enteric bacteria has profound clinical implications because it threats the life and worsens the acute gastroenteritis disease. This study is a matched case-control study and aims to determine enteropathogenic bacteria, their antibiotic resistance and associated-risk factors in diarrheal patients in Gaza Strip.   Methods: 132 patients with acute diarrhea were investigated. In addition, data were collected from 132 healthy controls having the same characteristics of patients except the fact they didn’t suffer from diarrhea within the last three months. The age categories of patients are < 5 and > 5 years old. Data were collected through completing a questionnaire form for cases and controls and stool samples were collected from six Primary Health Care Clinics and these samples were inoculated on selective media in Remal clinic- Microbiology laboratory. Results: 12 (9.1%) enteropathogenic bacteria were isolated from 132 stool samples. Salmonella, Campylobacter coli/jejuni, and Aeromonas hydrophilia were isolated in equal numbers from samples 3/12 (25% each), Shigella 2/12 (16.7%), and Yersinia enterocolytica 1/12 (8.3%). The two Shigella spp. are Shigella boydii. The antimicrobial profile of all isolated enteropathogenic bacteria showed high resistance rates for the tested antimicrobials (C. coli/jejuni (52.4%), followed by A. hydrophilia (49.2%), Y. enterocolytica (42.9%), Shigella (26.2%) and Salmonella spp. (22.2%). In addition the antimicrobial profile of the isolated enteropathogenic bacteria showed high resistance rate to rifampin (91.6%), clindamycin (83.3%), erythromycin (75%), cephalexin and tetracycline (66.6%).  Conclusions: The isolated enteropathogenic bacteria showed high resistance rate to several antimicrobials. This study isolated C. coli/jejuni, A. hydrophilia, and Y. enterocolytica, which are not screened for during routine examinations of stool samples in Palestinian health laboratories in Gaza Strip.  Recommendations: We recommend improving of laboratory services in Gaza Strip to extend their ability to isolate all types of enteropathogenic bacteria especially those, which are not isolated routinely. Â
Resistance profiles and biofilm formation of coagulase negative staphylococci isolated from clinical specimens in a tertiary care hospital in Palestine: Resistance profiles and biofilm formation of CoNS from Palestine
Background: Coagulase-negative staphylococci (CoNS) represent one of the major resistant nosocomial pathogens where its biofilm-related infections often fail to respond to antibiotic chemotherapy. Here, we studied the resistance profiles and biofilm formation in CoNS isolates from clinical specimens at Al Shifa hospital in Gaza, Palestine.
Methods: This study was carried out from March to July 2016 and included 81 clinical isolates. Identification and antibiotic susceptibility testing were performed using VITEK-2 system. The presence of nuc and mecA genes was performed using multiplex PCR. Qualitative and quantitative biofilm assays were performed using standard methods.
Results: Of the 81 clinical CoNS isolates, S. haemolyticus was the most common species (34, 42%), followed by S. epidermidis (26, 32.1%) and S. saprophyticus (13, 16%). The majority of isolates (83.9%) were from surgery, ICUs, pediatrics and medicine wards and the most common source was pus (28, 34.6%). Antibiotic resistance was highest against aminoglycosides, β-lactams, carbapenems, cephalosporins, fluoroquinolones, fosfomycin and macrolides. Though, no resistance was detected against rifampicin, vancomycin, teicoplanin, nitrofurantoin, linezolid and mupirocin. The antibiotic resistance among MR-CoNS was significantly higher than that among MS-CoNS. Nearly 88.9% of isolates were multidrug resistant with higher percentage among MR-CoNS. Most S. epidermidis (76.9%) isolates were biofilm producer, with statistically significant association between methicillin resistance and biofilm production.
Conclusions: High rates of antibiotic resistance were found among CoNS to commonly used antibiotics and the majority were methicillin and multidrug resistance. Most S. epidermidis isolates were biofilm producer. These results justified the necessity for national programs and measures to monitor and manage the usage of antibiotics in the Palestinian hospitals and community
Bacterial and Parasitic Etiologic Agents among Acute Gastroenteritis Patients in Gaza strip, Palestine.
Enteric illnesses are common and costly problem that cause significant morbidity and mortality worldwide in children. In Palestine, diarrhea is one of the major causes of many outpatient visits and hospitalizations. These diseases account for approximately 5-10 million deaths each year in Asia, Africa and Latin America
MRSA clonal complex 22 strains harboring toxic shock syndrome toxin (TSST-1) are endemic in the primary hospital in Gaza, Palestine.
Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in both community and healthcare-related settings worldwide. Current knowledge regarding the epidemiology of S. aureus and MRSA in Gaza is based on a single community-based carriage study. Here we describe a cross-sectional analysis of 215 clinical isolates collected from Al-Shifa Hospital in Gaza during 2008 and 2012.All isolates were characterized by spa typing, SCCmec typing, and detection of genes encoding Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin (TSST-1). Representative genotypes were also subjected to multilocus sequence typing (MLST). Antibiotic susceptibility testing was performed using VITEK2 and MicroScan.MRSA represented 56.3% of all S. aureus strains, and increased in frequency from 2008 (54.8%) to 2012 (58.4%). Aside from beta-lactams, resistance was observed to tetracycline, erythromycin, clindamycin, gentamicin, and fluoroquinolones. Molecular typing identified 35 spa types representing 17 MLST clonal complexes (CC), with spa 998 (Ridom t223, CC22) and spa 70 (Ridom t044, CC80) being the most prevalent. SCCmec types I, III, IV, V and VI were identified among MRSA isolates, while type II was not detected. PVL genes (lukF/S-PV) were detected in 40.0% of all isolates, while the TSST-1 gene (tst) was detected in 27.4% of all isolates, with surprisingly high frequency within CC22 (70.4%). Both PVL and TSST-1 genes were found in several isolates from 2012.Molecular typing of clinical isolates from Gaza hospitals revealed unusually high prevalence of TSST-1 genes among CC22 MRSA, which is noteworthy given a recent community study describing widespread carriage of a CC22 MRSA clone known as the 'Gaza strain'. While the latter did not address TSST-1, tst-positive spa 998 (Ridom t223) has been detected in several neighboring countries, and described as endemic in an Italian NICU, suggesting international spread of a 'Middle Eastern variant' of pandemic CC22 strain EMRSA-15
Relative frequencies of <i>spa</i> types among <i>S</i>. <i>aureus</i> isolates in this study.
<p>Vertical bars denote the relative frequencies of 35 <i>spa</i> types observed among <i>S</i>. <i>aureus</i> isolates in this study. a. Black bars denote <i>spa</i> types observed among MRSA isolates (<i>n</i> = 17); gray bars denote <i>spa</i> types observed among MSSA isolates (<i>n</i> = 24). b. Gray bars denote <i>spa</i> types observed among isolates from 2008 (<i>n</i> = 19); black bars denote <i>spa</i> types observed among isolates from 2012 (<i>n</i> = 28). eGenomics <i>spa</i> type numbers are depicted (corresponding Ridom <i>spa</i> types are listed in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0120008#pone.0120008.t001" target="_blank">Table 1</a>). <i>Spa</i> types are grouped together by MLST clonal complex; subgroups CC239 and CC34 are grouped with their parent complexes (CC8 and CC30, respectively). CC, clonal complex; MLST, multilocus sequence typing; <i>spa</i>, staphylococcal protein A.</p
Antimicrobial resistance frequencies among <i>S</i>. <i>aureus</i> isolates in this study.
<p>Vertical bars denote relative resistance to selected antimicrobials described in the text. a. Black bars denote percent resistance among MRSA isolates; gray bars denote resistance among MSSA isolates. b. Gray bars denote percent resistance among <i>S</i>. <i>aureus</i> isolates from 2008; black bars denote resistance among <i>S</i>. <i>aureus</i> isolates from 2012. Only antimicrobials tested in both 2008 (VITEK 2) and 2012 (MicroScan) are depicted. Amp, ampicillin; CA, clavulanic acid; MRSA, methicillin-resistant <i>Staphylococcus aureus</i>; MSSA, methicillin-susceptible <i>Staphylococcus aureus</i>; TMP-SMX, trimethoprim-sulfamethoxazole.</p
MRSA Clonal Complex 22 Strains Harboring Toxic Shock Syndrome Toxin (TSST-1) Are Endemic in the Primary Hospital in Gaza, Palestine
Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in both community and healthcare-related settings worldwide. Current knowledge regarding the epidemiology of S. aureus and MRSA in Gaza is based on a single community-based carriage study. Here we describe a cross-sectional analysis of 215 clinical isolates collected from Al-Shifa Hospital in Gaza during 2008 and 2012.All isolates were characterized by spa typing, SCCmec typing, and detection of genes encoding Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin (TSST-1). Representative genotypes were also subjected to multilocus sequence typing (MLST). Antibiotic susceptibility testing was performed using VITEK2 and MicroScan.MRSA represented 56.3% of all S. aureus strains, and increased in frequency from 2008 (54.8%) to 2012 (58.4%). Aside from beta-lactams, resistance was observed to tetracycline, erythromycin, clindamycin, gentamicin, and fluoroquinolones. Molecular typing identified 35 spa types representing 17 MLST clonal complexes (CC), with spa 998 (Ridom t223, CC22) and spa 70 (Ridom t044, CC80) being the most prevalent. SCCmec types I, III, IV, V and VI were identified among MRSA isolates, while type II was not detected. PVL genes (lukF/S-PV) were detected in 40.0% of all isolates, while the TSST-1 gene (tst) was detected in 27.4% of all isolates, with surprisingly high frequency within CC22 (70.4%). Both PVL and TSST-1 genes were found in several isolates from 2012.Molecular typing of clinical isolates from Gaza hospitals revealed unusually high prevalence of TSST-1 genes among CC22 MRSA, which is noteworthy given a recent community study describing widespread carriage of a CC22 MRSA clone known as the 'Gaza strain'. While the latter did not address TSST-1, tst-positive spa 998 (Ridom t223) has been detected in several neighboring countries, and described as endemic in an Italian NICU, suggesting international spread of a 'Middle Eastern variant' of pandemic CC22 strain EMRSA-15