Group B streptococcal carriage, antimicrobial susceptibility, and virulence related genes among pregnant women in Alexandria, Egypt

Background and aim: Group B Streptococcus (GBS) has emerged as a leading cause of illness and death among neonates. The study was conducted to estimate the prevalence of recto-vaginal carriage of GBS among pregnant women at 35–37 weeks, gestation, to describe GBS antimicrobial susceptibility profile and to investigate selected virulence genes by PCR.Subjects and methods: Two-hundred pregnant women at 35–37 weeks of gestation attending antenatal clinic at Al-Shatby University Hospital were enrolled in the study. Both vaginal and rectal swabs were collected from each subject. Swabs were inoculated onto CHROMagarTM StrepB and sheep blood agar plates. All GBS isolates were subjected to antimicrobial susceptibility testing using disc diffusion. Disc approximation test was performed to detect erythromycin resistance phenotype (MLSB). GBS virulence genes scpB, bac, bca, and rib were identified by PCR.Results: Among the 200 pregnant women, 53 (26.5%) were identified as GBS carriers. All carriers had vaginal colonization (100%), four (7.5%) had combined recto-vaginal colonization. None of the carriers had rectal colonization alone. All isolates (100%) were susceptible to penicillin, ampicillin, ceftriaxone, cefotaxime, cefepime, vancomycin, and linezolid. On the other hand, 43.4%, 28.3%, 22.6%, and 15% of isolates were resistant to levofloxacin, azithromycin, erythromycin, and clindamycin respectively. Out of 12 erythromycin resistant isolates, six isolates had constitutive while two had inducible MLSB resistance. scpB was identified in 100%, rib in 79.2%, and bac in 35.8% of GBS isolates. None of the isolates possessed the bca gene.Conclusion: Introduction of GBS screening in Egyptian pregnant women is recommended. Penicillin or ampicillin is still the antibiotic of choice for intrapartum prophylaxis.Keywords:  Group B streptococci, Rib gene, Penicillin susceptibility, Vaginal carriag

Development of Primary Percutaneous Coronary Intervention as a National Reperfusion Strategy for Patients with ST-Elevation Myocardial Infarction and Assessment of Its Use in Egypt

Objective: Early treatment of acute ischemia of the heart by performing immediate percutaneous coronary intervention (PCI) to restore blood flow in patients with the clinical presentation of an acute coronary syndrome and more specifically with ST-elevation myocardial infarction (STEMI) can save lives. This study aims to identify the mean time (door to balloon time and first contact to balloon time) to primary PCI for STEMI patients and to assess the percentage of primary PCI and its success rate in Egypt. Methods: A registry study of patients presenting to cardiac centers in Egypt was designed, where patients’ basic characteristics, the treatment strategy, and the door to balloon time and the first contact to balloon time were assessed. Results: One thousand six hundred fifty STEMI patients with a mean age of 57 years were included in the study. Immediate transfer for primary PCI was the most used treatment strategy, representing 74.6% of all treatment strategies used. The door to balloon time and the first contact to balloon time were 50 and 60 minutes, respectively, with a primary PCI success rate of 65.1%. Conclusion: The registry study results showed a marked improvement by implementation of the best treatment strategy with respect to the time factor to achieve a better outcome for STEMI patients in Egypt

Group B streptococcal carriage, antimicrobial susceptibility, and virulence related genes among pregnant women in Alexandria, Egypt

Background and aim: Group B Streptococcus (GBS) has emerged as a leading cause of illness and death among neonates. The study was conducted to estimate the prevalence of recto-vaginal carriage of GBS among pregnant women at 35–37 weeks, gestation, to describe GBS antimicrobial susceptibility profile and to investigate selected virulence genes by PCR. Subjects and methods: Two-hundred pregnant women at 35–37 weeks of gestation attending antenatal clinic at Al-Shatby University Hospital were enrolled in the study. Both vaginal and rectal swabs were collected from each subject. Swabs were inoculated onto CHROMagar™ StrepB and sheep blood agar plates. All GBS isolates were subjected to antimicrobial susceptibility testing using disc diffusion. Disc approximation test was performed to detect erythromycin resistance phenotype (MLSB). GBS virulence genes scpB, bac, bca, and rib were identified by PCR. Results: Among the 200 pregnant women, 53 (26.5%) were identified as GBS carriers. All carriers had vaginal colonization (100%), four (7.5%) had combined recto-vaginal colonization. None of the carriers had rectal colonization alone. All isolates (100%) were susceptible to penicillin, ampicillin, ceftriaxone, cefotaxime, cefepime, vancomycin, and linezolid. On the other hand, 43.4%, 28.3%, 22.6%, and 15% of isolates were resistant to levofloxacin, azithromycin, erythromycin, and clindamycin respectively. Out of 12 erythromycin resistant isolates, six isolates had constitutive while two had inducible MLSB resistance. scpB was identified in 100%, rib in 79.2%, and bac in 35.8% of GBS isolates. None of the isolates possessed the bca gene. Conclusion: Introduction of GBS screening in Egyptian pregnant women is recommended. Penicillin or ampicillin is still the antibiotic of choice for intrapartum prophylaxis

Prevalence of Chlamydophila pneumoniae in patients with pneumonia in the main university hospital in Alexandria

Background: Pneumonia is a common illness in all parts of the world. It is a major cause of death among all age groups and is the leading cause of death in children in low income countries. Methods: This prospective study was done at Department of chest diseases and microbiology from January 2011 to July 2011. A total of 60 patients, with pneumonia were included in the study. Results: The present study was conducted on 60 patients with pneumonia who have been admitted to the Chest Department in the Main University Hospital in Alexandria (55 patients) and El Maamoura Chest Hospital (5 patients) in the period from January 2011 to April 2011. The patients were subdivided into 2 groups: group I includes 30 patients with CAP and group II includes 30 patients with HAP; 16 patients with COPD, 7 patients with bronchial asthma, 4 patients with bronchogenic carcinoma and 3 patients with ILF. Conclusions: We can conclude that, Chlamydophila pneumoniae cannot be ignored as a cause of pneumonia. ELISA is an excellent screening test because of its high sensitivity for detection of C. pneumoniae while PCR is more accurate because of its high sensitivity and high specificity in diagnosis of C. pneumoniae infection.DM is a risk factor for C. pneumoniae infection