Background: Empirical antibiotic treatment is a common practice to manage chronic dacryocystitis in many healthcare settings in spite of the probability for changing in the types of microbial isolates. The aims of this study were to find out the current clinicomicrobiological profile of adult cases with chronic dacryocystitis and to determine the antibiogram of the isolated organisms to the commonly prescribed antibiotics. Results: Of the 25 samples obtained, 15 (60%) yielded a positive culture, 12 (48%) showed single bacterial isolate while 3 (12%) had mixed (two types) bacterial isolates. A total of 18 different strains of microorganisms were obtained from 25 cases, with 12/18 (66.7%) Gram-positive, 5/18 (27.7%) Gram-negative isolates, and 1/18 (5.5%) was fungal isolate. Coagulase-negative staphylococci were the most frequently found Gram-positive bacteria (22.2%), while Klebsiella species was the predominant of Gram-negative bacteria (16.6%). The majority of the isolated bacterial strains were sensitive to gatifloxacin (88%) and amikacin (88%) while the main resistance of the bacterial isolates, recovered from chronic dacryocystitis, was to cephalexin (59%). Conclusion: There is a continuous possibility of changing the type of pathogens responsible for dacryocystitis as well as their susceptibility to antibiotics. Microbiological study with microbial culture and antibiotic sensitivity test has to be done to all cases of chronic dacryocystitis for a better choice of antibiotic prophylaxis and treatment options, and to guard against the emergence of more drug-resistant strains.

Background: Proper management of medical wastes can help prevent serious consequences of catastrophic events or accidents in the hospital and its near or far environment. Method: A quality performance improvement project has been carried out to increase adherence to waste management policy of infection control, to ensure that departments are following basic health rules of their communities. In this project, the team utilized the basic Six Sigma breakthrough problem-solving methodology: Define, Measure, Analyze, Improve and Control (DMAIC) to examine the original (root) causes of the problem, in a healthcare facility in Egypt from January to August 2016. The team re-modulated a place for interim storage of hospital-regulated hazardous medical waste and compensate for workers' fatigue by participation of professional housekeeping company. Results: Weekly recording of errors in performance in waste management process demonstrates process stability through the first 12 weeks, and shifting towards the desired direction of reduced errors in waste management performance was obtained from the 13th week ongoing. Conclusion: Infection preventionists using their routine monitoring data could help the organization to fulfill accreditation requirements for quality assurance through the performance improvement project and to keep all hospital staff, visitors, and the surrounding environment safe and secure.

Background Corneal ulcer is a potentially sight threatening ocular condition and the leading cause of monocular blindness in developing countries. Knowing the predisposing factors and etiologic microorganism can help prompt diagnosis and treatment to prevent devastating outcomes The aim of this study was to detect the prevalence of bacteria and fungi in infectious keratitis. And to detect the antimicrobial susceptibility pattern against these causative bacterial and fungal pathogens using antibacterial and antifungal disces. Results Out of 50 cases (= 50 eyes), fungal growth was predominant 23/50 representing 46% with Aspergillus flavus being the most prevalent 14/23(61%). Bacterial growth was 7/50 (14%), 4/7 was gram-positive cocci (Staphylococcus aureus and Streptococcus pneumonie) and 3/7 was pseudomonas spp. While twenty out of 50 cases (40%) showed no growth. Conclusion Ocular trauma was the major cause of infectious keratitis, more in rural population. Fungal growth; mainly Aspergillus spp. was the most prevalent pathogen encountered in all cases. Voriconazole proved to be the first choice in the treatment of mould keratitis with 100% susceptibility. While alarmingly, fluconazole should no longer be used for the empirical therapy as it showed resistance to all the fungal isolates.

Background: Staphylococcus aureus has a major role in different types of eye infections as conjunctivitis, keratitis, and endophthalmitis. Methicillin-resistant Staphylococcus aureus (MRSA) was almost restricted to hospitals, but its prevalence has been increased in people outside hospitals. The cell wall of Staphylococcus aureus has protein A which can bind to the Fc portion of IgG. This ptnA is encoded by surface protein A of Staphylococcus aureus (spa) gene that contains a highly polymorphic sequence which is composed of repeats of 24-bp. Sequence typing of the spa gene repeat region is used to study the epidemiology of MRSA. The purpose of this study was screening of MRSA strains among healthcare workers (HCWs) in the Hospital of the Research Institute of Ophthalmology (RIO), Giza, Egypt, and detecting spa gene in their DNAs by PCR. Results: In the present study, 81 samples from healthcare providers in the hospital of the Research Institute of Ophthalmology, Egypt, were screened for MRSA. Out of these 81 samples, 41 isolates (50.6%) were identified as coagulase-positive Staphylococcus aureus. Twelve staphylococcal isolates were resistant to both oxacillin and cefoxitin, and those were identified as MRSA with a percentage of 14.8% (12/81). Conventional PCR could detect spa gene in 10 out of 12 DNA MRSA with a percentage of 83.3% (10/12). Conclusion: In the present study, the prevalence of MRSA in HCWs was 14.8%. Since amplification of spa gene by PCR is a necessary preliminary step for spa typing of MRSA and since using different primers for spa gene amplification might affect PCR results, then proper selection of the primers and thermal cycling reaction conditions are recommended for PCR performance and spa typing.

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