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The antibacterial efficacy of restorative materials had an important role in preventing the recurrent caries. The objective of this study was to evaluate in-vitro the antibacterial and mechanical assays of Vitremer containing ethanolic extract of propolis (EEP). Materials and methods: I-Antibacterial Assay: The standard strain of Streptococcus mutans and Lactobacillus acidophilus were used for determination of minimum inhibitory concentration (MIC) of EEP/Vitremer. II-Mechanical Assay: A-Shear bond strength (SBS): sixty half-crowns of non-carious extracted 2 nd primary molars were placed at standard moulds containing Teflon disc that had 4mm x 3mm central hole and divided into 4 groups (n=15) according to the different EEP concentrations. Group I: 10%, group II: 25%, group III: 50% EEP-Vitremer mixture, and group IV (control): 0% EEP/ Vitremer and SBS was assessed using Instron machine. B-Microhardness: Sixty standard discshaped specimens were prepared from mixture 0%, 10%, 25%, and 50%, n=15 and nanoindentation value was recorded. Data were analyzed using one-way ANOVA and post-hoc test. Results: Only MIC of 10%, 25%, and 50% mixture showed growth inhibition against S. mutans, compared to 25% and 50% against L. acidophilus. SBS showed that 0% EEP recorded the highest value followed by10% mixture but the difference was not significant (p>0.05), while 25% and 50% reported the lowest values and the differences were significant (p< 0.05). 25% and 50% mixtures recorded the highest significant microhardness (p<0.05). 0% EEP and 10% mixtures displayed no significant differences between them (P>0.05). Conclusions: 25% EEP-Vitremer mixture was the most suitable concentration as it exhibits positive significant antibacterial and mechanical assays.

Ventilator-associated pneumonia (VAP) is the most frequent infection in intensive care units (ICU). It is associated with high rates of long morbidity and mortality. Management of a case of VAP is often said to add $40,000 to hospital costs USA. All these data directed our interest to study the etiology, risk factors, and antibiotic susceptibility patterns of VAP in ICU of Tanta University Hospital. This study included 36 cases of VAP. Endotracheal aspirates were obtained from all cases and microbiologically analyzed. Samples were collected over 1 year. Forty-two strains were isolated from 28 cases, while eight cases showed no bacterial growth. The most frequent organism was Staphylococcus aureus (30.95%), followed by Acinetobacter baumannii and Pseudomonas aeruginosa (21.43% for each), and the least common was Staphylococcus epidermidis (2.38%). Multi-drug resistance was detected in (50%) of the isolated bacteria in this study. Imipenem, amikacin, linezolid, vancomycin, and levofloxacin are recommended to be the most effective drugs in management of VAP. VAP is a serious problem in ICU carrying many risks for the patient live. Regimens of empirical treatment should take in consideration the update in the bacterial etiology and antibiotic susceptibility patterns of VAP.

Background:The re-use of colistin (last-resort drug) to treat infections caused by resistant Gram-negative bacteria, has led to the emergence of a serious resistance against colistin. A new transferable plasmid-mediated colistin-resistance gene (mcr-1) has been described globally. Screening for such gene will provide an aiding step to explore the extent of colistin-resistance in Egypt. Objectives: To isolate the causative Gram-negative bacteria from different hospital-acquired (HA) and community-acquired (CA) infections, determine the antibiotic susceptibility pattern of the isolated bacteria, detect colistin-resistance and investigate the existence of mcr-1 gene in colistin-resistant isolates. Methodology: This study was carried out on 400 patients with HA-and CAinfections. Samples were taken from sputum, endotracheal aspirates, bronchoalveolar lavage, surgical and burn wounds, stool and blood. Bacterial isolation and identification were done by standard microbiological methods. Colistin-resistance was assessed by broth macrodilution method, then mcr-1 gene was detected in colistin-resistant isolates by conventional polymerase chain reaction (PCR). Results: Gram-negative organisms were the commonest isolates in both HA (67.6%) and CA (79.4%) infections. Colistinresistance was detected in only 10 cases. mcr-1 gene was not detected in any of the tested colistin-resistant isolates. Conclusion: The prevalence of colistin-resistance in the study cases is still low and has not extended to the community yet. Colistin intake is not a prerequisite for the occurrence of resistance, but could be a supporting factor.

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