Of great concern is the increased frequency of carbapenem-resistant Acinetobacter baumannii (CRAB) causing healthcare-associated infections. Different classes of β-lactamases are involved in this resistance through hydrolyzing carbapenems. Multilocus sequence typing (MLST) has been applied successfully for characterizing different varieties of bacterial pathogens epidemiologically. In the present study, we aimed to type and characterize the resistance profile of clinical isolates of CRAB causing healthcare-associated infections in patients admitted to Kasr Al-Aini hospital, using MLST, and compare with sequence types (STs) from other countries. A total of 50 isolates were collected from clinical samples (predominantly wound and blood), then identified by blaOXA-51-like gene PCR, and subjected to Oxford MLST scheme. The ST was designated according to PubMLST database, and e-BURST algorithm was used to assign clonal complexes. Four sets of multiplex PCR were performed to detect common carbapenem resistance genes. ST391 was the predominant ST detected in 17 cases, 70.5% of which harbored blaOXA-23 alone, both blaOXA-23 and blaKPC in 11.8%. Newly recognized 13 STs were submitted to the PubMLST database. Carbapenem resistance due to blaOXA-23 carbapenemase was detected in 36/50 (72%), followed by blaOXA-23 concomitant with blaKPC in 7/50 (14%), while blaNDM with blaOXA-58 in 3/50 (6%) and blaNDM alone in 1 case (2%). To conclude, this study demonstrates the propagation of highly resistant clone of STs 391 and 1151, carrying blaOXA-23 genes, with the first report of blaKPC in blaOXA carrying CRAB and the presence of new STs by performing the MLST technique in an Egyptian laboratory facility.
Background: Infectious diarrhea represents a life-threatening problem among children in developing countries. Objectives: This work aimed to study bacterial, viral and parasitic causes of acute diarrhea; with genetic determination of diarrheagenic E. coli (DEC) in <5 years children. Methodology: Stool specimens were collected from 206 diarrheal children. Bacterial agents were isolated and identified by standard microbiological procedures. Multiplex PCR was done for genetic determination of DEC subtypes. ELISA was used for detection of viral and parasitic agents. Results: Stool specimens with at least single positive enteropathogen accounted for 98.5% with bacterial, viral and parasitic rates of 98.5%, 42.7% and 25.2%, respectively. Isolated bacteria were DEC (98.5%); Campylobacter (14%), Shigella (3.8%) and Salmonella (1.4%). Rota and Noroviruses showed prevalence of 32.5% and 5.3%, respectively. Conclusion: Infectious diarrhea were mostly due to bacterial agents. DEC and Campylobacter were predominant. EAEC and EPEC were the most genetically determined DEC subtypes.
Background
Invasive fungal infections (IFIs) are a main cause of morbidity and mortality. High-resolution melting polymerase chain reaction (HRM PCR) is promising for the identification of fungal species via the detection of internal transcribed spacer 2 (ITS2).
Objectives
To assess the sensitivity and specificity of HRM PCR in diagnosing IFIs, compared with blood culture.
Methods
Our study included 100 patients who were suspected of having IFIs; we analyzed their specimens via blood culture and HRM PCR.
Results
Blood culture results were positive in 57 cases and negative in 43 cases. HRM PCR results were positive in 14 cases and negative in 86 cases. The 14 cases with positive results included 4 with Candida tropicalis, 4 with Candida glabrata, and 6 with Candida krusei. HRM PCR sensitivity was 24.6%, specificity was 100%, positive predictive value (PPV) was 100%, and negative predictive value (NPV) was 50%.
Conclusions
HRM PCR is specific but not sensitive. Blood culture is more sensitive and cannot be replaced by HRM PCR.
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