Introduction Carbapenem-resistant Enterobacteriaceae (CRE) infections resist nearly most available antimicrobials, resulting in poor clinical outcomes. Saudi Arabia has a relatively high CRE prevalence. This study aims to evaluate the sensitivity of Rapidec Carba NP test and GeneXpert Carba-R assay compared with conventional manners for detection of carbapenemase-producing Enterobacteriaceae . Methods This is a cross-sectional study including a total of 90 CRE isolates examined at two tertiary hospitals in KSA from October 2020 to December 2021. Gram-negative Enterobacteriaceae were identified by using Vitek 2 system and were furtherly tested for imipenem and meropenem susceptibility by E- test strips, followed by Rapidec Carba NP test and the Xpert™Carba-R assay. Results Carbapenem-resistant K. pneumoniae (78.9%) and carbapenem-resistant E. coli (14.4%) were the two most common isolates species. Colistin (98.9%) and tigecycline (88.9%) were the most effective antibiotics against CRE isolates, followed by amikacin (52.2%), gentamicin (33.3%), cotrimoxazole (15.6%), and ciprofloxacin (8.9%). blaOXA-48 was the predominant carbapenemase gene (44.4%), followed by blaNDM (32.2%). blaKPC gene was not detected. The Rapidec Carba NP and the Xpert™Carba-R demonstrated an overall sensitivity of 69.3% and 88%, respectively, in comparison to gold standard detection of meropenem and imipenem resistance by Vitek 2 system and E- test strips. Discussion RAPIDEC ® CARBA NP may be a beneficial screening test for detecting CRE, but for confirmation of the results, Xpert Carba-R assay is more sensitive, significantly lowering the turnaround time compared to reference traditional methods. The information on carbapenemase genes may be used for epidemiologic purposes and outbreak management.

Acute respiratory tract infections (ARTIs) are associated with significant morbidity and mortality worldwide, especially in developing countries. Children under the age of 5 years old are mostly affected. Both viral and bacterial causes are implicated, but viral etiologies are more difficult to diagnose. Viral infections can occur either single or mixed, but the significance and association of polyviral agents with the severity of cases are poorly understood. More studies are critical for understanding this role, improving diagnosis and treatment.Objective: To identify the rule of five chosen viral pathogens in ARTIs in children below 5 years old and the association of polyviral etiology with the severity of the disease.Methods: Nasopharyngeal swabs were taken from 120 children who had symptoms and signs of ARTIs, attending the outpatient clinic and admitted in pediatric department or pediatric intensive care unit, Banha university hospital. All children were subjected to full history taking, analysis by multiplex PCR for five viruses (Rhinovirus, Respiratory syncytial virus, Human metapneumovirus, Adenovirus, and Human boca virus).Results: 54 viruses were identified by multiplex PCR from 41 children (34.2%), 75.6% of them had a single viral infection, (17% and 7.4%) were co-infected with two and three viruses respectively. Positive cases were mostly of children admitted in pediatric ward and the majority were infants. URTIs was the most common presentation followed by bronchiolitis then bronchopneumonia. HRV was the most frequently detected as a single and mixed infection (35.2%) followed by RSV (22.2%). Non-significant correlation was found between mixed infection and the severity of infection. Conclusion:HRV is the most frequently recognized viral pathogen either as single or mixed in children below 5 years old in our patient group. Mixed infection has no correlation with disease severity. And using Multiplex PCR is an ideal tool for investigating mixed infection.