Background: Nosocomial infections caused by methicillin-resistant Staphylococci could lead to increased morbidity and mortality, but little is known about the prevalence of infections with these organisms in healthcare facilities and in the community in Tripoli. This study investigated the in vitro susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative staphylococci (MRCNS) to antimicrobial agents, and determined the molecular characteristics of MRSA. Methods: This is a retrospective observational study aiming at determining the prevalence and antibiotic resistance pattern of (MRSA) and (MRCNS) isolated from non-duplicated clinical specimens in Tripoli Central Hospital (TCH) between June 2013 and June 2014. Isolates were identified using standard laboratory procedures. Antimicrobial susceptibility tests were carried out by disk diffusion method and automated systems. DNA of the MRSA isolates was used for PCR to determine the molecular analysis. Results: 218 isolates of Staphylococci were obtained, 71.6% were coagulase positive staphylococci (CPS) and 28.4% were coagulase negative staphylococci (CNS). 39.7% of CPS were MRSA, while 75.8% of CNS were MRCNS. The rates of hospital-acquired MRSA (HA-MRSA) and community-acquired MRSA (CA-MRSA) among MRSA isolates were 61.3% and 38.7% respectively. A similar trend was detected among MRCNS isolates, where 74.5% were HA-MRCNS and 25.5% were CA-MRCNS. All the MRSA and MRCNS isolates were susceptible (100%) to vancomycin, tigecycline, linezolid, quinupristin/dalfopristin, daptomycin and moxifloxacin. Generally, hospital-acquired strains showed higher resistance rates than community-acquired ones to the most commonly tested non-beta-lactam antibiotics. 35.5% of all staphylococcal isolates exhibited mecA + gene and 12.9% expressed mecC + . Meanwhile, 38.7% of MRSA isolates harbored both mecA and mecC. However, 12.9% of MSSA isolates were negative for both mecA and mecC. The mecA gene was detectable in 59.1% and 40.9 % of HA-MRSA and CA-MRSA isolates respectively. Conclusion: Hospital-acquired MRSA and MRCNS isolates had higher resistance rates to non-beta lactam antimicrobial drugs than the respective community-acquired isolates. This was shown by early detection of mecC gene among MRSA isolates.

Background: Human enterovirus 71 (HEV71) is a common aetiology of hand-foot-and-mouth-disease (HFMD) where it occasionally causes CNS illnesses. In 1997, Sarawak experienced a HEV71-associated HFMD outbreak with 34 deaths reported. Following the outbreak, a prospective HFMD surveillance study showed that HE71-associated HFMD outbreaks occurred in Sarawak every three years, each caused predominantly by different genogroups of HEV71; genogroup-B3 in 1997, genogroup-B4 in 2000, and genogroup-B5 in 2003 This study attempts to investigate the circulation of HEV71 in between the three-year cycle outbreaks before an expected outbreak in 2006 in Sarawak.Methods: Three communities, Villages-A, B and C, were selected based on their locations with reference to the Rajang river, the epicenter of the 1997 outbreak. Stool samples were collected through 2 visits; the first collection in mid-2005 and the second in February 2006. Filter-sterilized samples were inoculated into rhabdomyosarcoma and QB1-293A cells. Virus cultures were observed for cytopathic effect (CPE) daily for 14-days. Upon blind-passage, cultures without CPE were considered negative. Reverse-transcription-polymerase-chain-reaction (RT-PCR) on positive cultures was done using primers for partial VP1 previously described by Oberste et al. RT-PCR positive products were subjected to DNA sequencing and molecular analysis.Results: During the first collection, 106 samples were collected from Village-A, 428 from Village-B and 183 from Village-C. The second collection yielded 88 samples from Village-A, 410 from Village-B and 177 from Village-C. While, no virus was isolated from the first collection of Village-A, 4% of samples from Village-B and 6% of samples from Village-C yielded enteroviruses respectively. From the second collection, 8% of samples from Village-A, 6.8% from Village-B and 4.5% from Village-C, yielded enteroviruses. The viruses isolated were identified mostly as echovirus-6 (E6), E7, E19, coxsackievirus-A (CA) 20, CA21, CA24 and coxsackievirus-B (CB) 4.Conclusion: HEV71 was not circulating in sampled villages but enteroviruses species B and C were.

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