Evaluation of the BD GeneOhm MRSA and VanR Assays as a Rapid Screening Tool for Detection of Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci in a Tertiary Hospital in Saudi Arabia

Objectives. The aim of this study was to evaluate the diagnostic performance of BD GeneOhm VanR Assay, a rapid PCR test that detects the presence of vanA and/or vanB genes and the performance of BDGeneOhm MRSA Assay which detects the staphylococcal cassette chromosomemec (SCCmec cassette) carrying the mecA gene and Staphylococcus aureus specific sequence located within the orfX gene. Methods. 300 duplicate rectal swabs collected consecutively were analyzed for the presence of VRE by culture and BD PCR. 2267 duplicate swabs were collected (728 nasal and 1539 groin swabs) and analyzed for the presence of MRSA by culture method and BD PCR. Results. Compared to culture, the BD GeneOhm VanR Assay showed a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100%, 91.1%, 23.5%, and 100%, respectively. The BD GeneOhm MRSA Assay revealed sensitivity, specificity, PPV, and NPV of 97.2%, 99.4%, 89.7%, and 99.9%, respectively, for nasal swabs. For groin swabs, it was 100%, 98.7%, 61.5% and 100%, respectively. Conclusion. The BD GeneOhm vanR Assay is a good screening test for rapid exclusion of VRE carriers in hospitals. The BD GeneOhm MRSA Assay represents a reliable screening test. The true strength of the BD GeneOhm Assay for MRSA and VRE is its exceptionally high NPV making the test an ideal tool for rapid exclusion of MRSA and VRE carriers in hospitals. As a consequence, this would dramatically shorten the patient isolation time

An unusual case of Escherichia coli meningitis and bacteremia in an elderly woman presenting with intractable low back pain

Abstract Introduction: We report an unusual case of E. coli meningitis in an elderly woman who presented to the emergency room with a chief complaint of intractable low back pain. Case Description: A 67 year old woman presented to the emergency room for a chief complaint of intractable low back pain. After admission, the patient developed delirium. Blood cultures were drawn. Patient underwent a lumbar puncture which revealed purulent cerebrospinal fluid. Results of the cerebrospinal fluid and blood cultures revealed pan-sensitive E. coli. Conclusion: In the geriatric population, delayed presentation of meningitis can occur for various reasons. With the older adult population, existing co-morbidities and decline in immunologic function can mask symptoms. Clinicians caring for the elderly population need to have a high index of suspicion in the setting of subtle symptoms when it comes to diagnosing acute bacterial meningitis. Key Words: bacteremia, meningitis, geriatric, E. Coli, clinical, cerebrospinal, cultures, deliriu

Buccal dental microwear and stable isotopes of El Collado: A mesolithic site from Spain

This study examines the correlation between buccal dental microwear and stable isotopes. The buccal surface of post-canine teeth casts from El Collado, the largest Mesolithic site in Spain, were examined under Scanning Electron Microscope; photomicrographs were taken from the middle third of the buccal surface with magnification 100X. Only six individuals passed the criteria for buccal dental microwear analysis. The photomicrographs were treated by adobe Photoshop 8.01 to cover an area 0.56 mm² of middle third of buccal surface, the output photomicrographs were digitized using Sigmascan Pro 5 by SPSS. Then the correlation between buccal microwear pattern and stable isotopes of the same individuals, of the previous study of Guixe et al., 2006, was examined using a Pearson test. Statistical analysis revealed that there is no significant correlation between stable isotopes and buccal dental microwear of the people of the Mesolithic site of El Collado. The historical and archaeological documentation suggest that the Mesolithic people tended to consume marine food. Fish-drying techniques were used during the Mesolithic period which allowed the introduction of dust and sand to the fish. These abrasive particles affected the buccal dental microwear pattern, so that no correlation between the isotopes and microwear may be expected. This also suggests that the buccal dental microwear pattern exceeds dietary reconstruction to reconstruct food processing techniques

Digital Service Quality and Customer Loyalty of Commercial Banks in Jordan: the Mediating Role of Corporate Image

The major goal of this research is to examine the influence of corporate image on the relationship between digital service quality and customer loyalty for Jordanian commercial banks. The current research focuses on Jordan’s banking sector. Jordan has a unique financial structure that has helped it to rise to prominence in the Middle East and around the world. This sector is made up of 20 commercial banks and four Islamic banks. The core data for this study was gathered using a random sample method. The research was conducted using a self-report questionnaire as the primary tool. The study hypotheses were tested using the structural equation modeling (SEM) technique. The findings confirmed that the quality of digital services had a direct impact on customer loyalty, with corporate image serving as a mediating effect. The researchers proposed that the top management of the organizations questioned work on involving the customer in the production process by taking into account his opinion on electronic service components and characteristics, which allows the consumer to decide on product quality

An unusual case of Escherichia coli meningitis and bacteremia in an elderly woman presenting with intractable low back pain

Introduction: We report an unusual case of E. coli meningitis in an elderly woman who presented to the emergency room with a chief complaint of intractable low back pain. Case Description: A 67 year old woman presented to the emergency room for a chief complaint of intractable low back pain. After admission, the patient developed delirium. Blood cultures were drawn. Patient underwent a lumbar puncture which revealed purulent cerebrospinal fluid. Results of the cerebrospinal fluid and blood cultures revealed pan-sensitive E. coli. Conclusion: In the geriatric population, delayed presentation of meningitis can occur for various reasons. With the older adult population, existing co-morbidities and decline in immunologic function can mask symptoms. Clinicians caring for the elderly population need to have a high index of suspicion in the setting of subtle symptoms when it comes to diagnosing acute bacterial meningitis

An Adaptive Fractal Image Steganography Using Mandelbrot and Linear Congruent Generator

Despite the advancements that occurred in the field of technology, information security (i.e., IS) is still deemed important and critical topic. It is still especially deemed so during the transfer process. In this research, a new approach is proposed for hiding information through the use of iterated function systems (i.e., IFS) from Fractals. This approach employs the main feature of fractals that concentrate on the idea that hackers who seek to find the hidden data shall not be able of locating it. Therefore, there is a need to carry out a decoding process in the aim of revering the conversion for securing the transmitted information. In this research, the secure information is hidden inside a fractal Mandelbrot image using the Linear Congruent Generator (i.e., LCG). Regarding the proposed system, it generates the fractal image through the use of the predefined knowledge gained from the hider site that works as a host for different types of secret messages. The knowledge that comes from the key of image dimensions, parameters of Mandelbrot, LCG key, and key agreement of cryptography method, which makes Stego-image analyses of hidden data unacceptable without the correct knowledge. Based on the results that are obtained through carrying out experiments showed the proposed method meets all the requirements for steganography. Such requirements include: the ones related to capacity, visual appearance, undetectability, robustness against extraction (i.e., security), and hit the highest capacities with a visual appearance of high quality

Buccal dental microwear and stable isotopes of El Collado: A mesolithic site from Spain

This study examines the correlation between buccal dental microwear and stable isotopes. The buccal surface of post-canine teeth casts from El Collado, the largest Mesolithic site in Spain, were examined under Scanning Electron Microscope; photomicrographs were taken from the middle third of the buccal surface with magnification 100X. Only six individuals passed the criteria for buccal dental microwear analysis. The photomicrographs were treated by adobe Photoshop 8.01 to cover an area 0.56 mm² of middle third of buccal surface, the output photomicrographs were digitized using Sigmascan Pro 5 by SPSS. Then the correlation between buccal microwear pattern and stable isotopes of the same individuals, of the previous study of Guixe et al., 2006, was examined using a Pearson test. Statistical analysis revealed that there is no significant correlation between stable isotopes and buccal dental microwear of the people of the Mesolithic site of El Collado. The historical and archaeological documentation suggest that the Mesolithic people tended to consume marine food. Fish-drying techniques were used during the Mesolithic period which allowed the introduction of dust and sand to the fish. These abrasive particles affected the buccal dental microwear pattern, so that no correlation between the isotopes and microwear may be expected. This also suggests that the buccal dental microwear pattern exceeds dietary reconstruction to reconstruct food processing techniques