Vol. 33, September, 2012.

petite annonce kamagra paris 1/33 A STUDY OF VAGINAL MICRO FLORA IN VARIOUS PHASES OF MENSTRUAL CYCLE

Samya M. Rashedy, Mohamed I. Amer, Wafaa K. Zaki*and Mohamed S. El Sokkary

Department of Obstetric and Gynecology, Department of Medical Microbiology & Immunology*, Faculty of Medicine, Ain Shams University

Vaginal physiology depends on an appropriate hormonal and bacterial milieu. Vaginal flora forms the main vaginal defense mechanism, specifically, Gram positive anaerobic bacilli and other organisms including sortie du viagra generique corynbacterium, staphylococcus species, kamagra in france streptococcus species, cgv kamagra Enterobacter (except group A), bisoprolol et viagra Gardenrella vaginalis, Bacteroid species, peptostreptococcus species, ou trouver cialis 20 Clostridium species, Genital cialis drogue mycoplasma and viagra et coeur candida albicans. The aim of this study was to examine changes in the vaginal microbial flora at different phases of the menstrual cycle in asymptomatic women. The study was conducted on forty asymptomatic women attending the infertility clinic at Ain Shams Maternity hospital during the period from October 2007 to March 2008. A statistical significant difference was observed between follicular, luteal and menstrual phase with predominant ou trouver du viagra a lyon lactobacilli in follicular phase. while levitra patienteninformation staphylococci and Candida were significantly higher in the menstrual phase when compared to other two phases. It was concluded that lactobacilli was dominant in follicular phase when estrogen level at highest concentration. The candida, staph, diphteriod and Niesseria isolation was higher in menstrual phase when estrogen level become low denoting instability at this time.

 

 

2/33 DETECTION OF b-LACTAMASE GENES IN BACILLUS CEREUS ISOLATED FROM FOOD SAMPLES IN EGYPT

Dalia M. Hamed, Aymen S. Yassin*, Ramy K. Aziz* and Magdy A. Amin*

Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt.

*Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt.

Bacillus cereus is one of the most common food pathogens in Egypt. Infection is usually associated with the consumption of starchy foods. A total of 123 food samples were collected from different parts of Giza, Egypt and screened for the presence of B. cereus. Four B. cereus isolates were recovered from the different food sources and were identified by growthon selective media (PEMBA) that gives characteristic blue colonies. Identification was confirmed by nitrate reduction test. Antimicrobial susceptibility testing showed the resistance of the tested isolates to a variety of antibiotics, but their sensitivity to ciprofloxacin. MICs for B. cereus isolates against two different β-lactam antibiotics confirmedtheir high resistance to β-lactams. The β-lactamase genes were detected in the four isolates by uniplex and multiplex PCR. Bioinformatics analysis by construction of phylogenetic trees comparing the β-lactamases from B. cereus, B. thuringiensis and B. anthracis revealed that the similarities between them is due to gene conservation and suggeststhat the phenotypic differences between the three species is due to different expression levels rather thanhorizontal gene transfer.

 


3/33 BIODYNAMICS OF FUSARIUM SOLANI AND RHIZOCTONIA SOLANI IN PRESENCE OF PGPR BIOPREPARATE FOES REFLECT ON PHASEOLUS VULGARIS DEVELOPMENT AND HEALTH

Haidi M.A. El-Henawy, Nagi Y. Abd-Elgaffar*, Mona H. Badawi**

and Mohamed Fayez**

Ministry of Agriculture and land Reclamation,*Department of Plant Pathology, Faculty of Agriculture, Ain-shams University and **Department of Agricultural Microbiology, Faculty of Agriculture, Cairo University, Giza, Egypt.

A number of multifunctional commercial products for (biological control and bio nitrogen fixation) were experimented for their antibiosis towards Fusarium solani and Rhizoctonia solani causing root rot and damping-off on common bean (Phaseolus vulgaris L). The majority of the tested biopreparates did successfully alleviate the ability of pathogenic fungi to grow and multiply in the rhizosphere of the legume plant. Reductions of up to 12% in counts were recorded due to treatment of either legume seed or soil with the microbial formulations, particularly when added into soil in a high inoculum size equivalent to 36 ml kg-1. Both pre- and post- damping off disease significantly decreased in pathogen-infected beans when received the biopreparates. As expected, pathogen-infected bean seedlings conspicuously recorded the lowest survival percentages, the effect lowered when the majority of bioformulations were introduced into plant-soil system. The Rhizo-N biopreparate was the most efficient when added as soil or seed dressing, with respective average efficiency percentages of 20.9 and 14.8. On the contrary, lower efficiencies of 9.7 and 7.7% were recorded when Bio-health WGP was applied. The present study proved, the induction of non- nitrogen fixing nodule-like structures on common bean roots in absence of specific Rhizobium. Such spontaneously produced nodules somewhat stimulated due to biopreparate treatment. The ability of bean plants to form nodule-like structures in absence of Rhizobuim phaseoli inoculation is discussed.

 

 

4/33 COMPARISON BETWEEN A CHROMOGENIC MRSA SELECTIVE MEDIUM AND MANNITOL-SALT MEDIUM WITH CEFOXITIN FOR THE DETECTION OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS

Yasmin Mohamed, Nehal Anwar Fahim, Lamia Fouad Fathi and Hesham Ali Helal*

Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University

*Plastic and Reconstructive Surgery, Faculty of Medicine, Ain Shams University

Methicillin-resistant Staphylococcus aureus (MRSA) is an increasing problem. Early recognition of patients colonized or infected with MRSA has a direct impact on the selection of antibiotic therapy and the decision to initiate isolation procedures. Most laboratories have difficulty determining the optimal use of resources, considering options to balance cost, speed, and diagnostic accuracy. An ideal method for MRSA detection should have a high sensitivity and a short time to the reporting of the results. The aim of the work was to compare MRSA-Select, a commercially available chromogenic medium, as a rapid method for detection of MRSA in clinical samples to mannitol salt agar with cefoxiten (MSA-Cefoxitin). The results were evaluated using PCR as a gold standard. MSA-cefoxitin showed sensitivity and specificity of 87.01% and 100% respectively, positive predictive values (PPV) and negative predictive values (NPV) of 100% and 77.78% respectively. MRSA-Select after 24 hours incubation showed sensitivity and specificity of 87.01% and 100% respectively, positive predictive values (PPV) and negative predictive values (NPV) of 100% and 77.78% respectively. These values were the same as those of MSA-cefoxitin. We conclude that MRSA-Select is easy to use and interpret, but is much more expensive than MSA-cefoxitin. MSA-cefoxitin is easy, cost effective and fast.

 

 

5/33 INDOLE ACETIC ACID PRODUCTION IN RHIZOBIA TO IMPROVE WHEAT YIELD IN A NEWLY RECLAIMED SALINE SOIL

Amal A. Ali and Khaled A. Shaban

Soils, Water and Environ. Res. Inst., Agric. Res. Center, Giza, Egypt

Two effective rhizobial strains of R. leguminosarum bv. Viceae strains 481 & 207 were used in the present study and the cultural requirements were screened for maximum IAA production. The effect of carbon (1%) and nitrogen sources (0.1%) revealed that glucose and potassium nitrate were the best promoters for IAA production over controls. The effect of different concentrations of EDTA revealed that 0.2 μg ml-1 EDTA increased IAA production. Maximum amount of IAA was produced by the R. leguminosarum bv. Viceae strain 481. The effect of IAA synthesizing rhizobial strains on wheat plant growth and soil characteristics was studied in a field experiment on a newly reclaimed saline soil at Sahl El-Hussinia, El-Sharkia Governorate, Egypt, during the winter growing season of 2011- 2012. Soil was cultivated with wheat plants (Triticum aestivum L. cv. Sakha 93). The results obtained revealed that applying of rhizobia strains grown on glucose, potassium nitrate and EDTA led to improve many of soil variables such as, soil pH, EC and NPK concentrations as well as Fe, Mn and Zn contents with superiority for EDTA inoculants. The application of rhizobia strains grown on EDTA and glucose exhibited the best results of vegetative growth parameters, wheat yield and its components and increased nitrogen, phosphorus, potassium and micronutrients contents in wheat plants over the controls.

 

 

6/33 BIOCIDAL CAPABILITIES OF XENORHABDUS SP. ISOLATED FROM EGYPT

Gehan M. Sayed, Olfat S. Barakat*, Ahmed M. Azazy, Waleed D. Saleh* and Mohamed A. Ali*

Pest Physiol. Dept., Plant Protec. Res. Inst., Agric. Res. Center (ARC), Giza, Egypt

*Agric. MicrobiOL. Dept., Fac. Agric., Cairo Univ., Gza 121613, Egypt.

In this work, Xenorhabdus sp. was isolated from a local nematode strain Steinernema sp. and a foreign well-identified strain, i.e., Steinernema riborvae kindly supplied by Florida State University, USA. The identity of the isolated bacteria was authenticated referring to their cultural, morphological and biochemical traits as well as to their entomopathogenicity against Galleria mellonella. The 16S rRNA technique was adopted for conclusive identification of both strains. The antagonistic properties of the isolated Xenorhabdus spp. isolates were studied in submerged batch fermentations after 120 hrs using the Disc Diffusion Technique. Both Xenorhabdus spp. strains showed various antimicrobial activities against wide spectra of Gram +ve, Gram –ve bacteria as well as yeasts. Oral administration of cell-free culture supernatants of Xenorhabdus spp. isolates exhibited high levels of toxicity against Agrotis ipsilon and Spodoptera littoralis.

 

7/33 ENDOPHYTIC BACTERIAL INOCULA IMPROVE SORGHUM GROWTH AND FORAGE PRODUCTION IN HIGH SALINE SOIL

Heba B. Abdel-Samiee, Eman A. Tantawy, Mohamed A. Ali* and Mohamed Fayez*

Agric. Microbiol. Res. Dept., Soils, Water and Environ. Res. Insti, Agric. Res. Centre, 12619, Giza, Egypt.

*Agric. Microbiol. Dept.., Fac. Agric., Cairo Univ., 121613, Giza, Egypt.

Thirteen bacterial endophytes were isolated from 5 plant genotypes namely Imperata cylindrical, Rumex vesicarius, Suaeda monoica, Triticum aestivum and Zygophyllum spp. grown in highly saline soil. Isolation was performed on Congo Red-Yeast Extract Mannitol agar medium, Luria-Bertani agar medium and King's B agar medium. According to their cultural, morphological and primary biochemical characterization the isolates were tentatively grouped into three bacterial families. Applying the Biolog GN2 Micro-plate Biolog 102, Enterobacteriaceae members were identified as Pantoea agglomernas and Enterobacter cloacae ss dissolvens whereas the Pseudomonadaceae candidates were related to Pseudomonas stutzeri, Brevundimonas diminuta and Pseudomonas aeruginosa, while Bacillaceae isolates identified as Bacillus mycoides, Bacillus cereus and Bacillus thuringensis. All isolates were indol acetic acid and exopolysaccharide producers. Siderophore production was a common characteristic among > 60% of isolates. Inoculation of sorghum plants (Sorghum biocolor L.) cultivated in saline soil with the isolated bacterial strains improved dry matter accumulation, enhanced nitrogen uptake and reduced N2-fertilizer application by 50%.

 

 

8/33 ANTIMICROBIAL SUSCEPTIBILITY PATTERNS AND   PREVALENCE OF EXTENDED SPECTRUM Β-LACTAMASES -PRODUCING KLEBSIELLA SPECIES IN MENOUFIA UNIVERSITY HOSPITAL

Ahmed B. Mahmoud, Nahed A. AL Ragehy, Wafaa A. Zahran, Aza Z. Labib and Amira H. Abu EL-Soud

Medical Microbiology & Immunology Department, Faculty of Medicine,

Menofyia University

Klebsiella is emerging as an important nosocomialpathogen due to rapidly increasing resistance to all currentlyavailable antibiotics, in particular carbapenems. This study was performed at Menoufia University Hospital to determine the incidence of klebsiella infection and antibiotic resistance patterns. Also to study prevalence of ESβLs- producing klebsiella species. A total of 73 isolates of klebsiellae were isolated from 294 hospitalized cases. Klebsiella and ESβL- producing klebsiella were isolated from sputum (29.13% and 10.24 % respectively) more frequently than from other specimens. The highest rate of isolated klebsiella and ESβL was from ICU (32.5%). By disc diffusion method all Klebsiella isolates were resistant to amoxicillin, tetracycline. They were highly sensitive to imipenem (97.3%), followed by piperacillin -tazobactam (84.9%) and levofloxacin (74%). Rates of resistance to ceftriaxone, cefoxitin, cefepime, and amikacin were (39.7%, 52.1%, 60.27 % and 52.1% respectively). Detection of ESβLs among 73 Klebsiella isolates using double disc synergy test, revealed that 29 (40%) isolates were producers, while both cephalosporin/clavulanate combination discs and MIC methods, revealed that 27(37%) isolates were producers. According to the API identification system, the isolates of ESβL- producing   klebsiella were K. pneumoniae (72.42%) followed by K. oxytoca (17.24%) and K. ozaenae (10.34%).                             

 

9/33 DETECTION AND IDENTIFICATION OF STAPHYLOCOCCUS AUREUS ENTEROTOXINS IN MILK, MILK PRODUCTS AND FOOD HANDLERS IN ASSIUT GOVERNORATE

Michael N. Agban and Ahmed S. Ahmed

Microbiology and Immunology Department, Faculty of Medicine, Assiut University.

Staphylococus aureus may contain one or more genes that encodestaphylococcal enterotoxins (SE) that cause food poisoning. The previously known toxins were the five major classical types; however, with the extensive analysis of the S. aureus genome, new genes encoding enterotoxin-like superantigens have been identified. Milk and dairy products are frequently contaminated with enterotoxigenic S. aureus, which is often involved in staphylococcal food poisoning; these contaminations are either from animal or human sources. The work aimed to detect types of enterotoxins produced by S. aureus isolated from milk, kariesh cheese and ice-cream samples and in nasal swabs from food handlers, by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), and PCR. We examined 450 samples of Milk, ice-cream, kariesh cheese and nasal swabs from food handlers for the presence of Coagulase positive Staph aureus, using Mannitol salt agar, Baird-Parker agar, tube coagulase test, and latex agglutination test for protein A and capsular polysaccharides. Confirmed S. aureus isolates were examined for the production of SEs using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and the type of SE genes by polymerase chain reaction (PCR). We found that Coagulase positive S. aureus isolates were detected in 84% of Staphylococci colonized raw milk, 87.5% of Staph colonized ice-cream and 92.8% of Staphylococci colonized kariesh cheese samples and 50% of Staphylococci colonized nasal swabs, with 62.5% of total Staphylococci colonization which exceeds the Egyptian standards. Collectively, 49.5% of coagulase positive S. aureus isolates were enterotoxigenic and the highest percentages were detected in raw milk taken directly from animals (68.7%) and kariesh cheese from street distributors (65.7%). In all samples, the major classical enterotoxin genotype was SEA which was detected in 33 isolates of toxigenic isolates. SEC was detected in 17 isolates and SED in 11 isolates. SEB could not be detected. For the newly described genes, SEG was detected in 11 isolates and SEH in 8 isolates. Mixed forms were found in 25 isolated of toxigenic isolates and four strains carried undescribed genes. Therefore we concluded that: Raw milk and some dairy products in the markets in Assuit Governorate, Egypt, are contaminated with enterotoxigenic Staph aureus.The most common type in both milk and dairy products as well as in nasal swabs was SEA which is known to be less common among strains from animal origin than from human. Nasal carriage in human food handlers is considered a primary source of contamination of milk and dairy products.

 


10/33 EVALUATION OF DUPLEX-PCR BASED METHOD TO DIFFERENTIATE MYCOBACTERIUM TUBERCULOSIS COMPLEX AND NON-TUBERCULOUS MYCOBACTERIA USING RNA POLYMERASE (RpoB) GENE

Hala Abdel Salam Abdel Aziz, Azza Mahmoud El Hefnawy, Reem Abdel Hameed Harfoush and Rasha Sherif El Sheikh

Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Egypt.

Background: The detection of Mycobacterium tuberculosis (M.tuberculosis) in clinical samples is a major priority in the control of tuberculosis. Since the early 1980s, there has been an increase in diseases caused by Non-tuberculous Mycobacteria (NTM), affecting immunocompetent and immunocompromised persons. Mixed infections have been reported. Therefore, it is important to be able to differentiate both organisms during the early stage of diagnosis. Identification by conventional biochemical tests have been fraught with a long turn-around time, other methods based on lipid analysis are used only in few laboratories. The PCR linked methods using specific target genes have provided alternative rapid approaches.This study aimed at the evaluation of the efficiency and usefulness of duplex-PCR (DPCR) targeting RNA polymerase (rpoB) gene as a tool to differentiate M. tuberculosis complex from NTM strains from suspected patients of pulmonary tuberculosis compared to conventional culture-based methods. Methods: Forty one mycobacterial strains, isolated from sputum samples of pulmonary tuberculosis suspected patients, were subjected to different phenotypic (conventional culture and biochemical tests) and genotypic methods (DPCR targeting rpoB gene), for identification and differentiation of M.tuberculosis complex and NTM isolates. Sequencing and restriction fragment length polymorphism (RFLP) were used to assist in the further identification of NTM strains. Results: Thirty seven isolates identified as M.tuberculosis phenotypically, produced an amplicon of 235 bp using DPCR, while the remaining 4 isolates identified as NTM by phenotypic methods, produced an amplicon of 136 bp by the same assay. Accordingly, DPCR assay revealed 100% sensitivity and specificity as compared to phenotypic tests. Moreover, the four 136 bp amplicons when analyzed by sequencing and RFLP using Hae III and Msp I restriction enzymes, showed complete concordance with the phenotypic results. Conclusion: DPCR assay based on rpoB gene with 2 different sets of primers amplifying 2 different sized DNA from a single target gene provides a rapid and reliable mean for the differential identification of M.tuberculosis and NTM isolates in cultures, even coexistence of both organisms could be detected by the presence of 2 different amplicons in a single reaction mixture. Further studies are needed to evaluate other target genes in comparison with our gene, and to determine the applicability of these molecular assays on clinical samples.  

 

11/33 MATERNAL SERUM CYTOMEGALOVIRUS AND CHLAMYDIA PNEUMONIAE ANTIBODIES IN PREGNANT WOMEN WITH PREECLAMPSIA

Ola I. Ahmed, *Nashwa Elsaid Hassan and *Alaa Sayed Abdul-hafeez Hassanin

Medical Microbiology & Immunology Department and *Obstetrics & Gynecology Department, Faculty of Medicine, Ain Shams University

Pre-eclampsia and atherosclerosis share many risk factors and pathophysiologic features. There are epidemiological associations between atherosclerotic cardiovascular disease and infection with cytomegalovirus (CMV) and, particularly, Chlamydiae pneumoniae (C. pneumonia). Accordingly a similar association between pre-eclampsia and infection with CMV and C. pneumoniae may also exist. The aim of the present study was to investigate whether; there is a potential link between pre-eclampsia and infection with CMV and C. pneumoniae which may suggest new lines of treatmentthat might help to reduce the incidence of pre-eclampsia. The present study was carried out on 80 pregnant women attending outpatient antenatal clinics and the delivery room of obstetric department at Ain Shams University Maternity Hospital. Pregnant women were divided into three groups: group I included 30 healthy controls, group II included 20 patients with mild pre-eclampsia and group III included 30 patients with severe pre-eclampsia. Immunoglobulins G (IgG) against CMV and C. pneumoniae were determined using enzyme linked immunosorbent assay (ELISA) method. Regarding seropositivity of CMV IgG, results showed statistically insignificant difference on comparing the three studied groups (χ2 = 2.022, P>0.5).Results were also statistically insignificant when comparing the control group with the pre-eclamptic group (after combining the groups of mild and severe pre-eclampsia) (χ2 = 0.0675, P>0.5). However, Regarding CMV IgG concentration, Antibody levels was higher in mild and severe preeclamptic groups than control group (F= 11.190, P <0.001). And the difference was statistically significant when comparing control group with mild pre-eclamptic one, (P<0.01) and when comparing control group with severe pre-eclamptic one (P<0.001).Regarding C. pneumoniae IgG, results showed statistically insignificant difference among studied groups regarding seropositivity (χ2 = 4.702, P>0.5). The difference was also statistically insignificant when comparing the control group with the pre-eclamptic group (after combining the groups of mild and severe preeclampsia) (χ2 = 4.434, P>0.5). Antibody indices were higher in the control group, compared to mild and severe pre-eclampsia groups but the difference was statistically insignificant (F= 1.462, P>0.5). Thus, it could be concluded that CMV infection may act as a co-factor that lowers the threshold for developing pre-eclampsia. But, no evidence for a relation between C. pneumoniae and pre-eclampsia was established. However, our findings need to be confirmed in a larger, more representative obstetric population followed longitudinally.

 

 


12/33 MICROBIOLOGICAL STUDIES ON LACTOBACILLI IN ENDODONTIC INFECTIONS

Moselhy S. Mansy, Hamido M. Hefny, Sahar Radwan*, Mervat Fawzy** and

Ehab AbolyaZaid

* Microbiology & Immunology Dept., Faculty of Pharmacy(boys),

Al- Azhar University

** Microbiology & Immunology, Faculty of Pharmacy (Girls), Al-Azhar University

*** Endodontics Dept., Faculty of oral & dental medicine (Girls),

Al-Azhar University

Root canal therapy has been practiced ever since 1928 and the success rate has tremendously increased over the years owing to various advancements in the field. One main reason is the complete understanding of the microbiology involved in the endodontic pathology. The aim of this study is to define main microorganisms involved in endodontic infection and to explore the mechanism of its persistence. Culture of endodontic specimens were done, isolate the main microorganisms, and perform antibiotic sensitivity. The isolated Lactobacilli were examined for biofilm formation. Results showed that Lactobacilli were the main isolates from gram positive rods and they were resistant to most antibiotics tested. Biofilm formation was proved for Lactobacilli, especially L. acidophilus. It is concluded that Lactobacillus spp. predominated over other Gram-positive rods. These bacteria showed resistance to some antibiotics used for treatment of endodontic lesions. A possible association exists between Lactobacillus spp. and other Gram positive rods in root canals of teeth receiving treatment.

 

13/33 SOIL BORNE FUNGI IN ASWAN AREA, EGYPT

Mortada S.M. Nassar and Mohamed S. Massoud

Botany Department, Faculty of Science, Aswan University, Aswan, Egypt.

Seventy – five species belonging to thirty – six fungal genera were isolated from 50 soil samples collected randomly from different cultivated soil in Aswan Governorate (Edfu, Kom Ombo and Aswan cities) during the period from January to December 2010. From which the investigated soil samples 54 terretrial species belonging to 26 genera were recovered on Czapek's – glucose and cellulose agar media. On Czapek's - glucose agar media 48 species belonging to 23 fungal genera were recorded Aspergillus, Penicillium and Fusarium were came in the first position, they recovered with high incidence (50, 26 and 28 soil samples out of 50) constituting 58.73%, 5.84% and 3.54 % of total counts, respectively. 40 species appertaining to20 terrestrial genera recoverd on Czapek's - cellulose agar medium, Aspergillus and Penicilliumwere the leading genera which recovered in high occurrence (45 and 27 soil samples out of 50 samples comprising 51.7% and 7.39 % of total counts, respectively). Seventeen identified species and four unidentified species appertaining to 10 zoosporic fungal genera were recorded during this investigation. Allomyces was the leading aquatic fungal genera it was of high occurrence (50 samples; 100% of total samples). Pythium, Achlya, Phytophthora and Saprolegnia came after Allomyces and they appeared in (15, 12, 12 and 10 soil samples which comprising 30, 24, 24 and 20% of total samples) respectively. Physico-chemical characteristics (pH, water content and organic matter content) of the soil samples were measured; the pH meter were fluctuated between 7.9 and 8.9, the water content of soil samples were ranged between 1.3 % to 54.5 % and the organic matter content of soil samples were ranged from 3.6 mg/ L to 7.14 mg/L.   

 

14/33 DETECTION OF MULTIDRUG-RESISTANT PSEUDOMONAS AERUGINOSA ISOLATED FROM THE INTENSIVE CARE UNITS OF ALEXANDRIA UNIVERSITY HOSPITALS

Soad Hafez,   Assem Abd Rabo*,   Hala Ali, Hoda Hassan and May Moheb

Department of Microbiology Alexandria University, *Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Egypt

This study aimed at the identification of the role played by multidrug-resistant Pseudomonas aeruginosa strains in the intensive care unit (ICU) of the Alexandria University Hospital, to guide the development of local drug policy. Seven hundred and fourteen non replicate clinical isolates were collected from patients admitted to ICU. Susceptibility of all isolates to different antimicrobial agents was tested by the modified Kirby Bauer disc diffusion method. Phenotypic detection of extended-spectrum β-lactamases (ESBL) was carried out by the double disc diffusion test. Detection of PER-1 gene was tried in resistant strains. Seventy four out of 93 isolates (79.5%) were found to be multidrug resistant. Strains were most susceptible to Piperacillin – Tazobactam (TZP) (67.7%) and most resistant to Levofloxacin (LEV) (78.5%). Sixty four strains were resistant to both ceftazidime and cefepime; 13 of them only were confirmed to be ESBL producers by the double-disk synergy test (20.3%) while 21 strains (32.8%) were positive for PER-1 gene. ESBL producing strains are best detected by molecular methods. They play an important role in ICU of Alex University Hospital and mostly all of them are multidrug resistant. Typing denoted polyclonal emergence of these strains. Fluroquinolones are losing the therapeutic value in treatment of P. aeruginosa infections. Combination of piperacillin-tazobactam may be the best regimen in treatment when combined with amikacin.

 

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