Strongyloides stercoralis hyperinfection after corticosteroid therapy: a report of two cases

Two cases of Strongyloides stercoralis hyperinfection are described. Both patients were expatriates from the Indian subcontinent, and reported the use of corticosteroids. The first patient presented with severe pulmonary disease that necessitated respiratory support, followed by acute abdomen and intestinal obstruction and he succumbed to these diseases. The second patient also presented with acute pulmonary disease, which responded to antihelmintic treatment and supportive care; however, he died later due to his primary disease. The clinical features of S stercoralis hyperinfection are nonspecific; therefore, a high index of suspicion is required for early diagnosis and to start appropriate therapy. Because of the seriousness of the disease and the associated high mortality we suggest screening for S stercoralis in patients from endemic areas who will be taking immunosuppressive therapy

β-Lactamase Production in Key Gram-Negative Pathogen Isolates from the Arabian Peninsula

Infections due to Gram-negative bacilli (GNB) are a leading cause of morbidity and mortality worldwide. The extent of antibiotic resistance in GNB in countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, United Arab Emirates, Kuwait, Qatar, Oman, and Bahrain, has not been previously reviewed. These countries share a high prevalence of extended-spectrum-β-lactamase (ESBL)- and carbapenemase-producing GNB, most of which are associated with nosocomial infections. Well-known and widespread β-lactamases genes (such as those for CTX-M-15, OXA-48, and NDM-1) have found their way into isolates from the GCCstates. However, less common and unique enzymes have also been identified. These include PER-7, GES-11, and PME-1. Several potential risk factors unique to the GCC states may have contributed to the emergence and spread of β-lactamases, including the unnecessary use of antibiotics and the large population of migrant workers, particularly from the Indian subcontinent. It is clear that active surveillance of antimicrobial resistance in the GCC states is urgently needed to address regional interventions that can contain the antimicrobial resistance issue