Background: Meropenem resistance of Pseudomonas aeruginosa (P. aeruginosa) is considered an increasing problem. Efflux pump is one of multiple mechanisms that are responsible for this resistance. This study aimed to phenotypically and genotypically detect prevalence of efflux pump mediated meropenem resistance among P. aeruginosa isolates. Methods: Pseudomonas aeruginosa was isolated from different clinical specimens and identified by conventional methods and confirmed by Viètek MS Malditof Mass Spectroscopy. Antibiotic susceptibility test was done by disc diffusion method then minimum inhibitory concentrations (MIC) for meropenem was detected twice by agar dilution method without and after addition of carbonyl cyanide m-chlorophenylhydrazone (CCCP). Efflux pump genes were detected by polymerase chain reaction ( PCR). Results: Out of 265 specimens, 78 P. aeruginosa were isolated with an isolation rate (29.4%). By disc diffusion method and MIC by agar dilution methods, 35 (44.8%) isolates were meropenem resistant. There was a significant difference regarding distribution of efflux pump genes in meropenem resistant isolates as 23 isolates (65.7%) were positive for efflux pump genes and 12 (34.3%) were negative (p value= 0.13). The MICs of meropenem for P. aeruginosa isolates were significantly decreased after addition of CCCP where MIC of 21 (60%) meropenem resistant isolates had an efflux pumpoverexpressing phenotype (p value =0.001). Conclusion: High prevalence of meropenem resistance in P. aeruginosa is mediated by efflux pump genes including, mex A, mex B and opr M.
Background: Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) dissemination is a major healthcare problem due to its limited treatment options.Objective: This study aimed to determine the prevalence and antimicrobial resistance profile of hospital infections caused by CR-Kp in Al-Ahrar Teaching Hospital. The study was conducted through the period from January 1, 2021 to December 31, 2021. Patients and Methods: 650 clinical samples were collected from different ICU departments. Klebsiella pneumoniae isolates were identified by conventional methods. Susceptibility to carbapenems and other antibiotics was determined by disk diffusion method. Results: Out of 650 clinical specimens, 142 K. pneumoniae were isolated with an isolation rate of 21.8%. K. pneumoniae showed that the majority (60.6%) of isolates were extensively-drug resistant (XDR), while 30.3% were multidrug resistant (MDR) and only 9.2% were susceptible. By disk diffusion method, the incidence of CR-Kp was 25.4% (36/142). Antibiotic susceptibility test showed that 100% of CR-Kp isolates were resistant to Amoxicillin/Clavulanic acid, Ampicillin/Sulbactam, Pipracillin/Tazobactam, cefepime, ceftriaxone, cefotaxime, cefoxitin, ceftazidime and nitrofurantoin. High rate of resistance was also evident to aztreonam, norfloxacin (88.9%, for each) and amikacin (61.1%). Levofloxacin owned the lowest resistance rate (30.6%), followed by ciprofloxacin (44.4%) and gentamycin (47.2%). Antibiotic resistance pattern of isolated CR-Kp showed that the majority of the isolates (97.2%) were XDR, while only 2.8% were MDR. Conclusion: About quarter of K. pneumoniae isolates were carbapenem-resistant with predominance of XDR isolates which represents a warning sign for which application of antibiotic stewardship is mandatory as well as strict infection control policies for prevention of development of pan-drug resistant bacteria.
Back ground: Colistin is considered the last option for severe infections caused by multidrug resistant Gram negative bacteria. The emergence of its resistance constitutes a very serious problem; hence, this study was established. Objectives: This study aims to estimate prevalence of colistin resistance among the clinical isolates of E.coli and k.pneumoniae with detection of the presence of mobilized colistin genes mcr-1 and mcr-2 in those resistant isolates as a possible molecular mechanism for such resistance.
Background
Single nucleotide polymorphisms (SNPs) in the interleukin 13 (IL13) gene are associated with vulnerability to allergic diseases, such as asthma and allergic conjunctivitis (AC). Periostin, as an IL13-induced protein, has emerged as a novel biomarker in several allergic diseases. Data among Egyptian patients are still scarce.
Aim
To find out the association of IL13 rs20541 gene polymorphism and serum levels of periostin with asthma and AC among Egyptian patients.
Patients and Methods
Eighty-one Egyptian allergic patients with asthma, AC, and both asthma and AC (27 each), were enrolled in this case–control study. Twenty-seven age and gender-matched healthy volunteers served as controls. All participants were tested for IL13 rs20541 SNP by real-time polymerase chain reaction, TaqMan method. Serum levels of periostin and IL13 were assessed by ELISA.
Results
Compared to healthy subjects, asthmatic patients had a higher frequency of the homozygous adenine/adenine (AA) genotype at IL13 rs20541 SNP (14.8% vs 3.7%) and a lower frequency of the guanosine/guanosine (GG) genotype (51.9% vs 55.6%), while AC patients had higher GG genotype (70.4% vs 55.6%) with no AA genotype detected, yet no significant difference was noticed (p = 7.053). A significantly higher serum periostin in asthmatic patients compared to controls was found (p = 0.005). Higher levels of serum periostin, although nonsignificant, were recorded in AC patients compared to controls (22.88 ± 10.01ng/mL and 17.51 ± 3.17ng/mL, respectively). Periostin was significantly higher in patients with IL13 AA and GA genotypes compared to those with GG genotype (p = 0.016). A significant positive correlation between serum periostin and serum IL13 among allergic patients was recorded (r = 0.352, p < 0.001).
Conclusion
Among Egyptian patients, serum level of periostin is significantly associated with asthma and positively correlates with IL13 level supporting its utility as a diagnostic biomarker. IL13 rs20541 gene polymorphism does not seem to play an obvious role in asthma and AC, which requires further evaluation.
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