Methicillin-resistant in Staphylococci is a serious public health issue. It is mostly encoded by the mecA gene. The mecC gene is a new mecA analog responsible for resistance to methicillin in some Staphylococcal clinical isolates. This mecC gene is still underestimated in Egypt. The aim of the current study was to detect mecA and mecC genes in clinical Staphylococci isolates from a tertiary care university hospital in Egypt compared to the different phenotypic methods. A total of 118 Staphylococcus aureus (S. aureus) and 43 coagulase-negative Staphylococci (CoNS) were identified from various hospital-acquired infections. Methicillin resistance was identified genotypically using the PCR technique and phenotypically using the cefoxitin disc diffusion test, oxacillin broth microdilution and the VITEK2 system in all Staphylococcal isolates. The mecA gene was detected in 82.2% of S. aureus and 95.3% of CoNS isolates, while all of the isolates tested negative for the mecC gene. Interestingly, 30.2% of CoNS isolates showed the unique character of inducible oxacillin resistance, being mecA-positive but oxacillin-susceptible (OS-CoNS). The dual use of genotypic and phenotypic methods is highly recommended to avoid missing any genetically divergent strains.

Background: Acinetobacter baumannii, are involved in hospital-acquired infections and are increasingly developing resistance to fluoroquinolones, such as ciprofloxacin. The most common method of fluoroquinolone resistance is alteration in genes that encode DNA gyrase (gyrA) and topoisomerase IV (parC).Methods: We sought to isolate fluoroquinolone-resistant A. baumannii and search for changes in gyrA (Ser83Leu) and parC (Ser80Leu) loci by polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP).Results: We found that all 68 A. baumannii isolates that were part of this research were multidrug resistant and harbored gyrA and parC loci. Most isolates had ciprofloxacin minimal inhibitory concentrations of >128 μg/mL (50.8%). Mutations in gyrA were the most prevalent (47.45%), followed by parC mutations (33.9%) and combined mutations in both genes (23.7%).Conclusions: Single mutations in either gyrA (Ser83Leu) or parC (Ser80Leu) genes may be attributed to fluroquinolone resistance in A. baumannii.

Globally, Klebsiella pneumoniae (K. pneumoniae) has been identified as a serious source of infections. The objectives of our study were to investigate the prevalence of multidrug-resistant (MDR) K. pneumoniae in Tanta University Hospitals, Gharbia Governorate, Egypt; characterize their carbapenem resistance profiles; and identify their different capsular serotypes. We identified and isolated 160 (32%) K. pneumoniae from 500 different clinical samples, performed antimicrobial susceptibility testing, and then used multiplex PCR to detect carbapenemase genes and capsular serotypes K1, K2, K3, K5, K20, K54, and K57. We detected phenotypic carbapenem resistance in 31.3% (50/160) of the isolates; however, molecular assays revealed that 38.75% (62/160) of isolates were carrying carbapenemase-encoding genes. Generally, blaOXA-48 was the prevalent gene (15.5%), followed by blaVIM (15%), blaIMP (7.5%), blaKPC (4%), and blaNDM (3.8%). BlaVIM and blaOXA-48 correlated with phenotypic resistance in 91.67% and 88% of the isolates that harbored them, respectively. Capsular typing showed that the most prevalent pathotype was K1 (30.6%), followed by K57 (24.2%), K54 (19.35%), K20 (9.67%), and K2 (6.45%). A critical risk to community health is posed by the high incidence of multidrug-resistant (MDR) virulent K. pneumoniae isolates from our hospital, and our study examines this pathogen’s public health and epidemiological risks.

Objective: Infection is a leading cause of hospitalization and the second most common cause of mortality among hemodialysis (HD) patients. The aim of this study is to assess the impact of infection prevention and control education program on improving healthcare workers knowledge, attitude and practices and reducing incidence of infection in the hemodialysis unit. Methodology: All patients and healthcare workers in the unit within the study period were included. This study was conducted through 3 phases; Phase I: base line survey for assessment of infection prevention and control knowledge, attitude and practices among healthcare workers, Phase II: Intervention that included infection control standardized education program followed by post education survey. Phase III: Implementation of infection control program was done associated with assessment of blood born viruses (HCV, HBV & HIV) and monitoring patients for fever and/or local signs of inflammation at catheter exit or at skin around shunt to be subjected to blood culture. Results: Health care workers knowledge, attitude and practices of infection prevention and control before intervention were unsatisfactory followed by significant improvement reflecting the effectiveness of such interventions. Regarding incidence of infection there were three cases of blood stream infections; two of them were multidrug resistant organisms (MDROs) and no reported cases of seroconverion for HIV, HCV or HBV during study period.  Conclusion: Lack of knowledge about infection prevention and control practices in hemodialysis unit could be significantly improved by standardized education program which results in reducing incidence of infections in such units.

Background: Coronavirus disease 2019 , caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared as a pandemic in 2019-2020. Most cases are usually self-limited; however, it may unpredictably progress to severe form with high mortality rate. Objectives: To highlight the role of measuring serum procalcitonin (PCT) and receiving early prophylactic antibiotic therapy in terms of their relation to the mortality rate in hospitalized critical COVID-19 patients. Methods: this study analyzed sixty COVID-19 critical patients admitted to Tanta University Isolation Hospital from June to November, 2020. Respiratory tract and blood samples were collected Results: Our results showed that the mean serum PCT levels were significantly higher in deceased patients (15%) than in those who could survive corona-virus infection. Patients who received early prophylactic antibiotic therapy showed significant better survival rate than those who didn't. Conclusion: This study demonstrated that measuring PCT shows statically significant results with COVID-19 patients' outcome more than other commonly used laboratory markers such as CRP. Moreover, early administration of prophylactic antibiotic therapy in COVID-19 patients, especially critical ones, is crucial even in those with negative PCT values.