The incidence of Extended-spectrum β-lactamase (ESBL)-encoding genes (blaCTX-M and blaTEM) among Gram-negative multidrug-resistant pathogens collected from three different countries was investigated. Two hundred and ninety-two clinical isolates were collected from Egypt (n = 90), Saudi Arabia (n = 162), and Sudan (n = 40). Based on the antimicrobial sensitivity against 20 antimicrobial agents from 11 antibiotic classes, the most resistant strains were selected and identified using the Vitek2 system and 16S rRNA gene sequence analysis. A total of 85.6% of the isolates were found to be resistant to more than three antibiotic classes. The ratios of the multidrug-resistant strains for Egypt, Saudi Arabia, and Sudan were 74.4%, 90.1%, and 97.5%, respectively. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa showed inconstant resistance levels to the different classes of antibiotics. Escherichia coli and Klebsiella pneumoniae had the highest levels of resistance against macrolides followed by penicillins and cephalosporin, while Pseudomonas aeruginosa was most resistant to penicillins followed by classes that varied among different countries. The isolates were positive for the presence of the blaCTX-M and blaTEM genes. The blaCTX-M gene was the predominant gene in all isolates (100%), while blaTEM was detected in 66.7% of the selected isolates. This work highlights the detection of multidrug-resistant bacteria and resistant genes among different countries. We suggest that the medical authorities urgently implement antimicrobial surveillance plans and infection control policies for early detection and effective prevention of the rapid spread of these pathogens.

Background: Hospital acquired pneumonia occurs more than 48 h after hospital admission and was not present at the time of admission, while ventilator associated pneumonia occurs after 48-72 h of endotracheal intubation or within 48 h of extubation. HAP is the second most common nosocomial infection and accounts for approximately 25% of all infections in the Intensive Care Unit worldwide.Purposes: To identify the etiology, initial evaluation, prevention, and treatment of adult patients with ICU HAP, and VAP in Suez Canal University hospital and their management strategies.Methods: This study was conducted in the department of ICU, Suez Canal University Hospital; Ismailia, Egypt in the period from May to August 2013. All the patients were subjected to clinical and radiological assessment, Endotracheal aspirate samples for culture, and sensitivity to determine the causative organisms, Clinical Pulmonary Infection Score was done in order to determine the severity of HAP.Results: 89% of patients were suffering from VAP, while 11% were suffering from HAP, with mean age of 63.8 ± 10.47 years. Methicillin-resistant Staphylococcus aureus, and Klebsiella pneumoniae represented the most common isolated organisms that accounted about 65% of the studied population. The isolated microorganisms were resistant to Amoxicillin, MRSA showed highest sensitivity (44.4%) to Vancomycin and (27.8%) to Imipenem. K. pneumoniae were sensitive mainly to Imipenem (75.9%) and to Levofloxacin (44.8%).Conclusion: Gram-negative organisms were isolated in 46% of cases, gram-positive organisms in 41% and the isolated organisms showed high resistance to most of the tested antibiotics.

Background: urinary tract infections is one of the most prevalent bacterial infections worldwide. The present study aims to study and survey different isolates from urine specimens from different countries to assess their prevalence and their relation to urinary tract infections. One hundred and sixty-eight samples were randomly collected from three countries, Egypt, Sudan and Saudi Arabia, as follows: 43, 33 and 92, respectively. Samples were collected from private laboratories and from both sexes. The ages of the patients differed between three years and 89 years for females and from one year to 85 years for males between 4 / 2015-7 / 2016. All samples were inoculated on different selective and differential sterile culture media. After growth, isolated bacteria were identified by physiological and biochemical characteristic. Among all clinical samples, five bacterial genera were detected. The isolates were identified as Escherichia coli (93), Klebseilla spp. (32), Pseudomonas spp. (26), Proteus spp. (14), and Staphylococcus spp. (3). Regarding the sex of the patient, this study showed that females are more likely to be infected than males, with 53 (31.55%) of the patients being males and 115 (68.45%) of being females. The most common UTI bacterium was Escherichia coli, followed by Klebseilla spp. Majority of female infected cases were in menstruation age stage (14-44 years), while majority males were in old age stage (52-85 years). Surveys and studies of infectious factors are considered one of the most important epidemiological tools for tracking infectious diseases and predicting disease patterns, especially with regard to urinary tract infections due to their widespread prevalence and serious complications between the sexes at the global level.

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This paper presents the results of an investigative study on the development of an affordable and functional prosthetic foot for below knee amputees. A prototype was successfully manufactured using three-dimensional (3D) printing technology. This continuously evolving technology enables the rapid production of prosthetics that are individually customized for each patient. Our prototype was developed after conducting a topology optimization study that interestingly converged to the shape of the biological human foot. Afterward, a design was envisioned where a simple energy storage and release (ESAR) mechanism was implemented to replace the Achilles tendon, which minimizes the metabolic energy cost of walking. Our mechanism can successfully manage 70% of the energy compared to a normal person during each walking step. A finite element (FE) model of the prosthetic was developed and validated using experimental tests. Then, this FE model was used to confirm the safe operation of the prosthetic through simulating different loading scenarios according to the ISO standard. A prototype was successfully tested by a healthy person using an adapter that was designed and 3D printed for this purpose. Our study clearly showed that customizable prosthetics could be produced at a fraction 1/60 of the cost of the commercially sold ones.