Objective: To estimate the prevalence and associated risk factors of extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL) in King Khaled General Hospital, Saudi Arabia. Methods:A twelve -month retrospective study for the presence of ESBL producing Enterobacteriaceae infection was performed by using the Microbiology and Infection Control Departments' database. For all the collected specimens, microbiological identification and antimicrobial sensitivity testing were done using MicroScan WalkAway system and then confirmed by API 20E and E-test respectively. Results:The prevalence of ESBL producing Enterobacteriaceae infection among studied patients was 22%. The most common types of infections were urinary tract infections representing 59.2%. Previous use of antibiotics, urinary catheter, mechanical ventilation, previous hospitalization, previous intensive care unit admission and nosocomial origin of infection were significant risk factors for acquiring infection. Amikacin had the highest activity against ESBL producing isolates, whereas 20% of isolates were resistant to carbapenems Conclusions:The study revealed that prevalence of ESBL producing Enterobacteriaceae infection was relatively high. Our findings suggest that invasive devices, the use of antibiotics, prolonged hospitalization especially in the intensive care unit increases the risk of acquiring such infections. A strict antibiotic policy should be addressed especially with observed emergence of carbapenem resistance. Continuous review of need to invasive devices and strict compliance with basic infection control measures are mandatory to limit the spread of ESBL Enterobacteriaceae. Bulgular: Çalışmaya alınan hastalarda GSBL üreten Enterobacteriaceae prevelansı % 22 olarak bulundu. En sık karşılaşılan enfeksiyon % 59,2 ile üriner sistem enfeksiyonu idi. Antibiyotik kullanımı, üriner kateterizasyon, mekanik ventilasyon, daha önce hastanede yatış, yoğun bakım ünitesinde tedavi görme ve enfeksiyonun hastane kaynaklı olması GSBL üreten Enterobacteriaceae ile enfeksiyon gelişmesi için risk faktörleri olarak bulundu. GSBL üreten bakterlere karşı en etkin antibiyotik amikasinken, izolatların % 20'sinde karbapenemlere karşı direnç saptandı. Sonuçlar:Bu çalışmanın sonuçları GSBL üreten Enterobacteriaceae oranının yüksek olduğunu göstermektedir. Bulgular; antibiyotik kullanımı, invaziv işlemler ve özellikle yoğun bakım ünitesine olmak üzere uzamış hastane yatışının GSBL üreten bakterilerle enfeksiyon gelişme riskini artırdığını göstermektedir. Gözlenen yüksek karbapenem direnç oranı antibiyotik kullanımıyla ilgili etkin politikalar oluşturulması gerektiğini ortaya koymaktadır. GSBL üreten Enterobacteriaceae yayılmasının engellenmesi için kullanılan invaziv cihazlara ihtiyacın sürekli olarak değerlendirilmesi ve temel enfeksiyon kontrol önlemlerine etkin şekilde uyulması gerekmektedir.

hMPV is an emerging cause of acute respiratory infection in Mansoura University Children Hospital (MUCH), and may have a significant clinical impact on infants and children and thus, must be considered in etiological diagnosis.

The Middle East syndrome coronavirus (MERS-CoV) is a recently emerging betacoronavirus with high fatality. Recently, dipeptidyle peptidase (CD26, DPP4) was identified as the host cell receptor for MERS-CoV. Interestingly, despite of common presence of DPP4 receptors the binding and infection of various cells shows imminent variability. In this report, we provide a tool for prediction of the host tropism of the virus based on the host receptor binding interface. We found out that, in the binding of MERS-CoV to cells the amino acid residues in lancets 4 and 5 of DPP4 receptor, namely K267, Q286, T288, R317, R336, Q344 A291, L294, and I295 are involved. Changes in these residues correspond to profound decrease in virus binding to cells. The nine residues at the interface between the virus spikes and the lancets 4 and 5 of host DPP4 can be used as a predictive tool for the host tropism and virus affinity to host cell receptors.

Objective: Detect the presence of carbapenemases producing Enterobacteriaceae (CPE) and associated epidemiological, microbiological, and clinical characteristics of patients in our hospital Methods: During 15 months period, all non duplicate Enterobacteriaceae isolates with reduced susceptibility to carbapenem detected by MicroScan WalkAway system and confirmed by E test were collected. These suspected isolates were further screened by modified Hodge test and carbapenemase inhibition discs to identify CPE. Results: Out of 54 suspected Enterobacteriaceae isolates, 44 (88.5%) isolates were either extended spectrum beta-lactamases (ESBLs) or AmpC producers with porin loss whereas 10 isolates (18.5%) were confirmed to produce carbapenemase representing (0.74%) of the total Enterobacteriaceae. Among these 10 isolates, 6 were OXA 48 producers and 2 isolates were class B and class A each. Six out of the 10 CPE were detected in ICU and specimen source was tracheal aspirate in 5 CPE isolates. All CPE isolates were sensitive to colistin and all but one to tigecycline. All patients had history of previous antibiotic exposure and hospital stays for more than 5 days. Conclusion: Although CPE is not the main cause of carbapenem resistance in Enterobacteriaceae in our setting, its emergence there represents a serious infection control and therapeutic challenge. This mandates its early detection using MHT and carbapenemase inhibition tests together with strict infection control measures to limit its spread.

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