Serotype Distribution and Drug Resistance in Streptococcus pneumoniae, Palestinian Territories

To determine antimicrobial drug resistance of Streptococcus pneumoniae serotypes, we analyzed isolates from blood cultures of sick children residing in the West Bank before initiation of pneumococcal vaccination. Of 120 serotypes isolated, 50.8%, 73.3%, and 80.8% of the bacteremia cases could have been prevented by pneumococcal conjugate vaccines. Serotype 14 was the most drug-resistant serotype isolated

Evaluation of Meropenem, Imipenem and Ertapenem Impregnated MacConkey Agar Plates for the Detection of Carbapenem Resistant Enterobacteriaceae

Background: Rapid detection of carbapenem resistant bacteria, in particular, members of the Enterobacteriaceae family (CRE), is of utmost importance for the management of infected or colonized patients. Methods: Three carbapenems; meropenem, imipenem and ertapenem, with two different concentrations (0.5 mg/ml and 1.0 mg/ml), were impregnated in MacConkey agar. The carbapenem impregnated MacConkey agar plates; ([Mac-Mem], [Mac-Imp] and [Mac-Ert]), were then evaluated for the detection of carbapenem resistant Gram-negative bacteria in particular the blaKPC producing Enterobacteriaceae. The Limit of Detection (LOD) of the plates was determined after counting the colonies that grew on the plates after serial logarithmic dilutions of ten. Carbapenem resistant Gram-negative bacteria were prepared in normal saline, inoculated on the different plates and incubated at 35oC for 18-24 hours. The specificity and the shelf-life of the plates were determined by challenging the plates with six ESBL positive members of the Enterobacteriaceae family (K. pneumoniae, Salmonella species, Shigella species, E. coli, Proteus species and Citrobacter species) and one Enterobacter species with the blaAmpC phenotype. Finally, the MacConkey agar plates impregnated with 0.5 mg/ml meropenem were further challenged by incorporating them in the routine Caritas Baby Hospital active surveillance program for the detection of carbapenem resistant bacteria. Results: Of the three carbapenems impregnated plates, Mac-Ert plates gave the lowest number of colony forming units (CFU’s) detected regardless of the concentration of the antibiotic used. This was followed by the Mac-Mem plates which showed an LOD of less than 200 CFU’s for most of the blaKPC positive bacteria tested at both antibiotic concentrations. The worst performance was noted for the Mac-Imp plate regardless of the antibiotic concentration used as a number of carbapenem resistant bacterial strains failed to grow on the plate. The Mac-Mem plates showed the best specificity as none of the ESBL and blaAmpC positive isolates grew on the plates at either antibiotic concentration tested after 18-24hours incubation in ambient air at 35oC. On the other hand, the Mac-Ert plates failed to inhibit the growth of the Citrobacter species tested at both antibiotic concentrations and the Proteus species tested at the 0.5µg/ml antibiotic concentration. The Mac-Imp plates showed poor specificity as both concentrations failed to inhibit the growth of the Proteus, Enterobacter and Citrobacter species evaluated after 18-24 hours incubation in ambient air at 35oC. Of all the plates tested, the 0.5 µg/ml Mac-Mem agar had the best shelf-life of up to one month at 4-8oC. Conclusions: The high specificity and the good selectivity, in addition to the long shelf-life allowed the 0.5µg/ml Mac-Mem agar to be used as a cost effective selective medium for the isolation of carbapenem resistant Gram-negative bacteria, in particular the blaKPC producing members of the Enterobacteriaceae family

Emergence of Klebsiella pneumoniae Carbapenemase (blaKPC-2) in members of the Enterobacteriaceae family in Palestine

Abstract Background: The global spread of carbapenem resistant Enterobacteriaceae (CRE) has limited the physicians’ antimicrobial treatment options of infected patients. CRE’s which carry the Klebsiella pneumonia Carbapenemase (blaKPC) resistance mechanism have been rapidly spreading in many parts of the world, and have been responsible for high patients’ morbidity and mortality. Methods: Two protocols recommended by the Center for Disease Control and Prevention (CDC) were followed to detect CRE’s in Palestine. In addition, the antimicrobial sensitivity patterns for several antibiotic classes were determined for the isolated CRE’s by the disc diffusion method according to the clinical and laboratory standard institute (CLSI) M100-S22 guidelines. The Minimal Inhibitory Concentrations (MICs) of the carbapenem, ertapenem, imipenem and meropenem were determined for all the CRE’s by E-test. The isolates β-lactam resistance mechanisms were further investigated by analyzing 31 different types of β–lactamase genes by polymerase chain reaction (PCR). Results: Four bacterial isolates, 3 Enterobacter cloacae and 1 Klebsiella pneumoniae, were determined to be non-susceptible to one or all of the carbapenems (ertapenem, imipenem and meropenem) tested. All isolates which carried the blaKPC-2 gene showed an extreme drug resistance profile. These isolates were resistant to all β-lactam antibiotics, co-trimoxazole and gentamicin, while susceptible to only amikacin and colistin sulfate. Different combination of plasmid encoded b–lactamase genes (blaTEM, blaSHV, blaOXA-1, blaMIR-1, blaGES-23 and blaKPC-2) were present in these isolates. Of interest, was the isolation of the first E. cloacae strains co-producing the blaKPC-2 and a novel blaGES-23 β-lactamase. Conclusions: The presence of all these plasmid encoded b-lactamase in Palestine is alarming and mandates actions to be taken to control antibiotics usage and the activation of hospital infection control programs in order to prevent the spread of these extremely drug resistant bacteria

Measurement of satiety of wheat-based bulgur by intervention and sensory evaluation

Twenty-two healthy subjects consumed the following four test meals: Australian bulgur processed by boiling (boiled bulgur), Australian bulgur processed by steaming (steamed bulgur), Turkish bulgur, and high-amylose rice. Australian bulgur was made from durum wheat by using a traditional boiling and drying method and a method in which steaming replaced boiling. Meals were presented in a randomized order, one meal per test session at the same time and day of each week over four consecutive weeks. A within subject crossover design was used to investigate the satiety of bulgur in which each subject acted as their own control. Visual analogue scales were used to measure each subject’s feelings of hunger and calculate rankings. Mean satiety index scores and area under the “How hungry do you feel right now?” curve values showed that the bulgur samples provided greater satiety than the high-amylose rice. Testing for differences in rank sums showed that bulgur (boiled and steamed) ranked significantly lower (P < 0.05) for hunger at 1 and 1.5 hr when compared with high-amylose rice. At 2.5 hr, bulgur (boiled) was ranked as significantly different to high-amylose rice (P < 0.05). Australian bulgur processed by boiling or steaming was more satiating than high-amylose rice

Distribution of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Mutations in a Cohort of Patients Residing in Palestine.

Cystic fibrosis (CF) is an autosomal recessive inherited life-threatening disorder that causes severe damage to the lungs and the digestive system. In Palestine, mutations in the Cystic Fibrosis Transmembrane Conductance Regulator gene (CFTR) that contributes to the clinical presentation of CF are ill defined. A cohort of thirty three clinically diagnosed CF patients from twenty one different Palestinian families residing in the central and southern part of Palestine were incorporated in this study. Sweat chloride testing was performed using the Sweat Chek Conductivity Analyzer (ELITECH Group, France) to confirm the clinical diagnosis of CF. In addition, nucleic acid from the patients' blood samples was extracted and the CFTR mutation profiles were assessed by direct sequencing of the CFTR 27 exons and the intron-exon boundaries. For patient's DNA samples where no homozygous or two heterozygous CFTR mutations were identified by exon sequencing, DNA samples were tested for deletions or duplications using SALSA MLPA probemix P091-D1 CFTR assay. Sweat chloride testing confirmed the clinical diagnosis of CF in those patients. All patients had NaCl conductivity >60 mmol/l. In addition, nine different CFTR mutations were identified in all 21 different families evaluated. These mutations were c.1393-1G>A, F508del, W1282X, G85E, c.313delA, N1303K, deletion exons 17a-17b-18, deletion exons 17a-17b and Q1100P. c.1393-1G>A was shown to be the most frequent occurring mutation among tested families. We have profiled the underling mutations in the CFTR gene of a cohort of 21 different families affected by CF. Unlike other studies from the Arab countries where F508del was reported to be the most common mutation, in southern/central Palestine, the c.1393-1G>A appeared to be the most common. Further studies are needed per sample size and geographic distribution to account for other possible CFTR genetic alterations and their frequencies. Genotype/phenotype assessments are also recommended and finally carrier frequency should be ascertained

Conception et réalisation d'un démonstrateur pour un système hybride projectile/drone miniature - état des travaux après 8 mois

National audienceDans le cadre de la protection du citoyen et des infrastructures vitales et des réseaux, l'Institut franco-allemand de recherches de Saint-Louis (ISL) propose un concept innovant de drone miniature : il s'agit de lancer à partir d'un tube portable dédié, un projectile subsonique qui se transforme en drone miniature (MAV) une fois arrivé au-dessus du site à observer. Un tel système hybride, appelé GLMAV pour Gun Launch Micro Air Vehicle, est dédié à toutes formes de surveillance et de contrôle de personnes et d'infrastructures par la voie aérienne puisqu'il sera doté d'un système de vision embarqué avec transmission des images en temps réel. L'ISL s'est associé au Centre de Recherche en Automatique de Nancy (CRAN - Nancy-Universités), à l'unité mixte de recherche Heuristique et Diagnostic des Systèmes Complexes (HEUDIASYC - Université de Technologie de Compiègne) et à la très petite entreprise SBG Systems SAS. Le consortium étudie le projet " DEMONSTRATEUR_GLMAV " dans le cadre de l'ANR CSOSG qui aboutira vers la fin 2012 à la réalisation d'un démonstrateur. Le Groupe d'Intervention de la Gendarmerie Nationale (GIGN) et la Direction Générale de l'Armement (DGA) en tant qu'experts opérationnels et MBDA-Systems en France en tant qu'expert industriel sont associés au comité de pilotage du projet. L'état d'avancement des travaux relatifs à ce projet après huit mois d'études est présenté dans cette publication. Certains points durs non soupçonnés au début de l'étude se sont révélés et ils devront être levés afin de conduire, à l'issue du projet, à la réalisation d'une démonstration de mise en œuvre du système GLMA

CFTR mutations distribution, sweat chloride testing results, clinical presentations and Palestinian patients’ demographics.

<p>Pal = Palestine, Cos = cousin; BMI = Body Mass Index; PI = pancreatic insufficiency; Het = Heterozygous, MRSA = Methicillin Resistant <i>Staphylococcus aureus</i>; <i>P</i>. <i>aeruginosa = Pseudomonas aeruginosa</i>, NA = Not Available.</p><p>CFTR mutations distribution, sweat chloride testing results, clinical presentations and Palestinian patients’ demographics.</p

Distribution of CFTR mutations in the Palestinian Families.

<p>Distribution of CFTR mutations in the Palestinian Families.</p

Conception et réalisation d'un démonstrateur pour un système hybride projectile/drone miniature - état des travaux après 8 mois

National audienceDans le cadre de la protection du citoyen et des infrastructures vitales et des réseaux, l'Institut franco-allemand de recherches de Saint-Louis (ISL) propose un concept innovant de drone miniature : il s'agit de lancer à partir d'un tube portable dédié, un projectile subsonique qui se transforme en drone miniature (MAV) une fois arrivé au-dessus du site à observer. Un tel système hybride, appelé GLMAV pour Gun Launch Micro Air Vehicle, est dédié à toutes formes de surveillance et de contrôle de personnes et d'infrastructures par la voie aérienne puisqu'il sera doté d'un système de vision embarqué avec transmission des images en temps réel. L'ISL s'est associé au Centre de Recherche en Automatique de Nancy (CRAN - Nancy-Universités), à l'unité mixte de recherche Heuristique et Diagnostic des Systèmes Complexes (HEUDIASYC - Université de Technologie de Compiègne) et à la très petite entreprise SBG Systems SAS. Le consortium étudie le projet " DEMONSTRATEUR_GLMAV " dans le cadre de l'ANR CSOSG qui aboutira vers la fin 2012 à la réalisation d'un démonstrateur. Le Groupe d'Intervention de la Gendarmerie Nationale (GIGN) et la Direction Générale de l'Armement (DGA) en tant qu'experts opérationnels et MBDA-Systems en France en tant qu'expert industriel sont associés au comité de pilotage du projet. L'état d'avancement des travaux relatifs à ce projet après huit mois d'études est présenté dans cette publication. Certains points durs non soupçonnés au début de l'étude se sont révélés et ils devront être levés afin de conduire, à l'issue du projet, à la réalisation d'une démonstration de mise en œuvre du système GLMA