Background: Pseudomonas aeruginosa ( P. aeruginosa ) represents a great threat to public health worldwide, due to its high ability to acquire resistance to different antibiotic classes. Carbapenems are effective against multidrug resistant (MDR) P. aeruginosa, but their widespread use has resulted in the emergence of carbapenem-resistant strains, which is considered a major global concern. This study aimed to determine the prevalence of carbapenem resistance among P. aeruginosa strains isolated from different sites of infection. Methods: Between October 2016 and February 2018, a total of 530 clinical specimens were collected from patients suffering from different infections, then processed and cultured. Isolates were tested for extended spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) production using double-disk synergy test, modified Hodge tests, and disc potentiation test. PCR was used for the detection of selected OXA carbapenemases encoding genes. Results: Of 530 samples, 150 (28.3%) P. aeruginosa isolates were obtained. MDR strains were found in 66.6% (100 of 150) of isolates. Of 100 MDR P. aeruginosa isolates, 54 (54%) were ESBL producers and 21 (21%) carbapenem resistant P. aeruginosa . MBL production was found in 52.3% (eleven) carbapenem-resistant isolates. CTX-M15 was found among 55.5% of ESBL- producing P. aeruginosa . Carbapenemase genes detected were bla IMP (42.8%, nine of 21), bla VIM (52.3%, eleven of 21), bla GIM (52.3%, eleven of 21), bla SPM (38%, 8/21). In addition, isolates that were positive for the tested genes showed high resistance to other antimicrobials, such as colistin sulfate and tigecycline. Conclusion: Our study indicates that P. aeruginosa harboring ESBL and MBL with limited sensitivity to antibiotics are common among the isolated strains, which indicates the great problem facing the treatment of serious infectious diseases. As such, there is a need to study the resistance patterns of isolates and carry out screening for the presence of ESBL and MBL enzymes, in order to choose the proper antibiotic.

The present experiment was conducted to study the effect of ethanolic extract of Egyptian propolis given alone or in combination with inactivatedPasteurella multocidavaccine on rabbits challenged with a virulent strain ofPasteurella multocida. Fifty-six New-Zealand rabbits, 6–8 weeks old and non-vaccinated against pasteurellosis, were randomly divided into eight equal groups. The first group was kept as a control for the experiment. The other groups received different treatments with propolis extract, inactivated vaccine, or both. The experiment continued for seven weeks during which clinical signs, body weight, and mortality rate were monitored, and blood samples were collected weekly for evaluating the leukogram, serum biochemistry, and immune response in all groups of animals. At the end of the seventh week, the animals were subjected to challenge with a virulent strain ofPasteurella multocida. Two weeks later, tissue specimens were collected from different organs for histopathological examination. Results showed that rabbits of the groups treated with both propolis and the vaccine by different routes appeared healthy after challenge. It has been concluded that alcoholic extract of propolis administrated in combination with inactivatedPasteurella multocidavaccine has no adverse effects on the general health conditions and enhances immune response in rabbits.

BACKGROUND:Because of lack of good evidence supporting laparoscopic approach for complicated appendicitis, we carried out this study to evaluate efficacy of laparoscopic appendectomy (LA) in management of patients with complicated appendicitis.MATERIALS AND METHODS:This study was carried out in Surgical Department, Minia University, Egypt involving 214 patients underwent appendectomy for complicated appendicitis over three years. 132 patients underwent LA and remaining 82 patients underwent OA. Parameters studied included operating time, return to oral feeding, postoperative pain, wound infection, intra-abdominal abscess, duration of abdominal drainage and hospital stay.RESULTS:There were four conversions, two due to extensive cecal adhesions and two due to friable appendix. LA took longer time to perform (p = 0.0002) but with less use of analgesics (p < 0.0001), shorter hospital stay (p < 0.0001), shorter duration of abdominal drainage (p < 0.0001) and lower incidence of wound infection (p = 0.0005). Nine patients in LA and seven patients in OA group developed intra-abdominal abscess treated successfully with sonographic guided percutaneous drainage. Postoperative ileus was recorded in two patients in LA group and three patients in OA group, chest infection in one patient in OA group, hernia in one patient in LA and fecal fistula was present in one patient in OA. Overall complications were significantly lower in laparoscopy group and managed conservatively with no mortality in either group.CONCLUSIONS:LA in complicated appendicitis is feasible and safe with lower incidence of complications than OA and should be the initial choice for all patients with complicated appendicitis.

The objectives of the present study were to identify a possible tick vector and to determine the prevalence of camel theileriosis in Egypt using blood smears stained with Giemsa's stain and PCR assay. Hemogram and serum biochemical constituents were also investigated. A total of 243 camels, aged 3-5 years, were examined. The results revealed that 75 (30.86 %) camels were infected with Theileria spp. of Giemsa-stained blood smears. Hyalomma dromedarii was identified as the carrier tick of Theileria spp. Multinucleated sporoblast and free sporozoite were observed in the salivary gland smears from collecting ticks. PCR result revealed that Theileria annulata was the most abundant in camels (60 %) followed by Theileria spp. (10 %). Macrocytic hypochromic anemia was recorded in the infected camels with T. annulata. Leukocytosis, neutrophilia, eosinophilia, and lymphopenia were also observed in the infected group. In the serum of infected camels, total proteins, albumin, β-globulin, and A/G ratio were significantly decreased (P < 0.05); however, total globulins and α- and γ-globulins were markedly increased (P < 0.05). The activity of aspartate aminotransferase and the levels of glucose, creatinine, and high-density lipoprotein cholesterol were markedly increased (P < 0.05) in the infected group. In contrast, triglycerides and total cholesterol concentrations were significant decreased (P < 0.001) in the infected group. In conclusion, a high prevalence of camel theileriosis was recorded in apparently healthy camels. H. dromedarii commonly infested these camels and were found infected with the transmissible forms of Theileria, indicating a role in transmission. Camels infected with T. annulata induced alterations in the cellular and biochemical constituents.