Brucella spp isolated from respiratory sample and grown in Mycobacterium growth indicator tube (MGIT).

Brucellosis remains endemic in many countries including Saudi Arabia. The disinfection of objects and surfaces contaminated with Brucella spp is not difficult, but we encountered a situation in which the organism survived the decontamination and liquefaction procedure adopted for AFB culture. A sputum specimen from a patient was sent for TB culture and the BACTEC MGIT 960 system isolated an organism identified as Brucella spp. The blood cultures and the serological testing had confirmed this case to be brucellosis. Isolation of Brucella spp from sputum samples is rare; this case appears to be the first of its kind. As the clinical presentation of TB may mimic brucellosis and vice versa, we recommend that handling specimens from all cases of undiagnosed PUO should be done with care because of the possibility that it may contain either of these organisms.

Mycobacterium chelonae complex bacteremia from a post-renal transplant patient: case report and literature review.

In this report we present a case of a young lady with abdominal abscesses and septicemia caused by Mycobacterium chelonae complex. Identification of the organism and initiation of the appropriate antimicrobial therapy was delayed, resulting in significant morbidity and multiple hospital admissions. Gram staining of these organisms from blood culture can be easily overlooked or confused with either debris or diptheroids. We concluded that detection of Gram-positive rod colonies should prompt an acid-fast stain to distinguish diphtheroids from rapidly growing mycobacteria in immunosuppressed patients.

Superiority of D-zone Testing Method over Standard Method to detect Rnducible Resistance in Gram Positive Bacteria: a Prospective Surveillance from a Teaching Hospital in Saudi Arabia.

OBJECTIVE: In this prospective study, we determined phenotypic resistance to erythromycin among gram positive bacteria. METHODS: BACTERIAL ISOLATES WERE IDENTIFIED BY CONVENTIONAL METHODS AND BY THE MICROSCAN: D-test zone was performed according to the Clinical and Laboratory Standards institutes (CLSI) recommendations to determine inducible resistance to clindamycin on gram positive bacteria isolated from different clinical specimens. Bacterial isolates included : group A streptococci (GAS), group B streptococci (GBS), viridans streptococci, S.pneumoniae, Staphylococcus aureus (S.aureus) (both methicillin susceptible (MSSA) and methicillin resistant (MRSA). RESULTS: A total of 1072 gram positive bacterial isolates were tested. The majority was from swabs collected from outpatient clinics. Erythromycin resistance was 8/23 (35%) for S. pneumoniae, 12/91(13%) for GAS and 17/300(5.7%) for GBS. All GAS and viridans streptococci possessed the efflux phenotype only, 8(8.8% and 1(20%), respectively. For GBS, cMLS(B) was 11(3.7%), 3 (1%) iMLS(B) and 2(0.33%) were of efflux phenotype. All S.pneumoniae strains possessed cMLS(B) phenotype. Seventy five isolates (16.3%) of MSSA were resistant to erythromycin compared to 160(83%) of MRSA. The majority of MSSA, 31/460 (6.7%) had an efflux phenotype while 26/460(5.6%) were of cMLS(B) and 19/460(4%) iMLS(B) phenotypes. Constitutive MLS(B) was the most predominant resistant phenotype, 152/193(78.8%) among MRSA. CONCLUSION: D-test zone should be considered for routine testing to detect inducible clindamycin resistance among significant gram positive bacteria.

Antimicrobial resistance among clinical isolates of Pseudomonas aeruginosa from patients in a teaching hospital, Riyadh, Saudi Arabia, 2001-2005.

Antimicrobial resistance to nine anti-pseudomonal agents (azteronam, ceftazidime, cefepime, piperacillin/tazobactam, imipenem, meropenem, ciprofloxacin, amikacin and gentamicin), the magnitude of multidrug resistance, associated underlying conditions, and mortality among patients with Pseudomonas aeruginosa isolates from King Khalid University Hospital, Riyadh, Saudi Arabia from 2001 to 2005 were determined. The results showed that antimicrobial resistance among P. aeruginosa is gradually increasing for most anti-pseudomonal agents, particularly aztreonam, ceftazidime, piperacillin/tazobactam and imipenem. There were 19 (3%) and 12 (2%) multidrug-resistant (MDR) P. aeruginosa patients in 2004 and 2005, respectively, and MDR P. aeruginosa was more commonly found in non-intensive care unit (ICU) patients. Most MDR isolates were from surgical and diabetic patients. The mortality rate was higher among ICU patients.