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Antibiotic resistance of Escherichia coli isolated from urinary tract infections (UTIs) is increasing worldwide. A total of 41 E. coli isolates were obtained from urine samples from hospitalized patients with a UTI in three hospitals in the northern districts of the West Bank, Palestine during March and June 2011. Resistance rates were: erythromycin (95 %), trimethoprimsulfamethoxazole (59 %), ciprofloxacin (56 %), gentamicin (27 %), imipenem (22 %), amoxicillin (93 %), amoxicillin-clavulanic acid (32 %), ceftazidime (66 %) and cefotaxime (71 %). No meropenem-resistant isolates were identified in this study. Among the isolates, phylogenetic group B2 was observed in 13 isolates, D in 12 isolates, A in 11 isolates and B1 in five isolates. Thirty-five of the isolates were positive for an extended-spectrum b-lactamase phenotype. Among these isolates, the bla CTX-M gene was detected in 25, and eight harboured the bla TEM gene. None of the isolates contained the bla SHV gene. Transformation experiments indicated that some of the b-lactamase genes (i.e. bla CTX-M and bla TEM ) with co-resistance to erythromycin and gentamicin were plasmid encoded and transmissible. Apart from this, enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR) revealed that the 41 isolates were genetically diverse and comprised a heterogeneous population with 11 ERIC-PCR profiles at a 60 % similarity level.

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Community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) is becoming an important public-health problem. This study attempted to investigate S. aureus and MRSA colonization in nasal swabs obtained from 843 patients without a history of hospitalization at the time of hospital admission and from 72 health-care workers chosen for comparison. Of the patients, S. aureus was detected in 218/843 (25.9 %) and MRSA in 17/843 (2.0 %). Of the health-care workers, S. aureus was detected in 15/72 (20.8 %) and MRSA in 10/72 (13.9 %). The majority of the 27 MRSA isolates exhibited a sensitivity pattern expected for CA-MRSA. Multilocus restriction fragment typing resolved the isolates into eight restriction fragment types. The predominant restriction fragment types were AAACCAA and AAAAAAA, accounting for 51.9 % (14/27) of the MRSA isolates and included CC5 and CC1 groups, respectively. This study thus demonstrated the transmission of CA-MRSA strain types into a health-care setting, emphasizing the need for implementation of a revised set of control measures in both hospital and community settings.

The surgical incidence of cystic echinococcosis (CE) due to Echinococcus granulosus was investigated in hospitals of the West Bank, Palestinian Authority between January 1990 and December 1997. Serum samples from school-children in Yata town, which showed the highest surgical incidence, were tested for anti-hydatid antibodies. A total of 390 surgically confirmed cases were recorded throughout the 8-year period, with an overall mean annual surgical incidence (MASI) of 3.1 per 100,000. A high MASI of 4.9, 5.0 and 5.1 per 100,000 was found in Hebron, Jericho and Bethlehem Governorates, respectively. Yata town, Hebron governorate, showed the highest MASI, at 16.8 per 100,000. The highest incidence was found in age groups 11-20 and 21-30 years, at 27.4% and 21.5% of the total number of cases. While there was no significant gender difference in the number of cases in the age groups of 20 years or less, the male to female case ratio was 1:3.2-4.1 in the older age groups. The liver was the most common site of hydatid cysts in 69.9% of cases. Lung cysts were predominant in younger age groups (20 years or less). The seropositivity for CE in the school-children of Yata was 2.4% and 2.1% using enzyme-linked immunosorbent assay and the indirect haemagglutination test, respectively. CE is a significant endemic disease throughout the West Bank. The disease is acquired early in life and is more prevalent among females than males. Behaviour and life-style favour the spread of the disease.

Seven strains of Enterobacteriaceae resistant to gentamicin obtained as representatives of the predominant resistance profiles in the clinical laboratories of Rafeidia and Al-Watani Hospitals in Nablus (Palestine) were included. Five strains showed a broad aminoglycoside resistance profile but contained no evidence of gentamicin acetylation, adenylation, or phosphorylation. Gentamicin uptake in two tested strains was significantly reduced, compared to that of gentamicin-sensitive E. coli (MIC, 0.5 microgram/mL). These strains are likely resistant due to a relative reduction of the amount of gentamicin and other aminoglycosides entering the bacterial cell. Two strains showed evidence of adenyltransferase ANT(2")-I activity.