Background: Carbapenem antibiotics are important therapeutic agents in the health care setting, they are frequently used as an empiric therapy for life-threatening infections as well as infections with multi-drug-resistant gram-negative bacilli. Carbapenemaseproducing Carbapenem-Resistant Enterobacteriaceae (CRE) are a significant public health challenge worldwide. The detection of carbapenemases productions in CRE strains is performed by phenotypic and genotypic methods. The phenotypic methods target carbapenemases production but provide no guidance regarding the specific carbapenemases types, while the genotypic diagnosis has the benefit of determining the exact mechanism conferring carbapenems resistance. Aim: Improvement of the antibiotic policy and infection control strategies in Suez Canal University Hospitals in Ismailia; through adequate detection of carbapenem resistance in the hospitals. Methods: All the CRE isolates were tested by the phenotypic methods (mCIM & eCIM) test to detect carbapenemases production, and screened by the conventional PCR for the presence of five carbapenemase genes, namely blaKPC, blaIMI, blaVIM, blaNDM, blaOXA-48. Results: The study showed that (53/155) 34.1% of the Enterobacteriaceae isolates were carbapenems resistant. Carbapenemases activity was detected in (36/53) 67.9% of the examined CRE isolates using mCIM test (20/36)37.8 % showed Metallocarbapenemases and (16/36) 30.2% showed Serine-carbapenemases by eCIM test. 60.4% (32/53) were sensitive to colistin. While by PCR, all the isolates (100%) harbor one or more carbapenemases genes. (51/53) 96.2% were proved to harbor blaOXA-48 gene, (47/53) 88.7% were proved to harbor blaNDM gene, (28/53) 52.8%, were proved to harbor blaVIM,gene, the percentage of blaIMI, blaKPC isolation was (17/53) 32.1%, (4/53)7.5% respectively. Conclusion: High frequencies of carbapenemase genes among CRE isolates.
Purpose: This study aimed to investigate the effect of concentrated growth factors (CGF) with partially and completely amputated pulp tissue on the histologic outcome of dentin-pulp complex regeneration in immature dogs' teeth with non-infected pulp and apical tissue. Materials and Methods: In this study fifty six immature teeth in four mongrel dogs were involved and simple randomization design was used. The teeth were divided into four groups; group (I): the teeth were left with no treatment (negative control), group (II): the teeth underwent complete pulp extirpation where blood clots filled the root canals (positive control), group (III): the root canals were packed with CGF after complete pulp extirpation and group (IV): the pulp was partially removed leaving the last 1-4mm and the root canals were packed with CGF. The animals were euthanized at 1and 3 months and samples were processed for histological analysis. Results:The best results appeared in CGF treated groups, where the immature roots continued their development in a way simulating the normal and this was represented histologically in closure of the root apex, increasing the root canal wall thickness and ingrowth of soft tissue into the root canals. However, the pulp architecture and pulpdentin relation appeared better when the pulp was partially removed. Conclusion: Dentin-pulp regeneration of the immature teeth can be promoted by CGF with faster root development and better pulp architecture when the apical 1-4mm of the pulp tissues are left.
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