In-vitro activity of tigecycline against multidrug-resistant Gram negative bacteria: The experience of a university hospital.

The emergence of multidrug-resistant Gram negative bacteria has given rise to significant therapeutic challenges. These pathogens may have developed resistance to tigecycline, which is an alternative antibiotic used empirically in the treatment of serious infections. The objectives of this study were to identify the in-vitro activity of tigecycline against multidrug-resistant Gram negative strains isolated from clinical specimens and their related genes, at a university hospital. For this, 150 clinical isolates of multidrug-resistant Gram negative cultures from various clinical specimens were collected. Bacterial isolates were cultured, identified and their antibiotic susceptibilities were determined. Polymerase chain reaction was performed to amplify AcrB, AmpC, RamR, MexR, AdeB, TetA genes. Results revealed that all isolates were multidrug-resistant. The resistance of isolates was 91.4% to aztreonam, 94.6% to piperacillin, 34% to imipenem, 38.7% to meropenem, 71.3% to levofloxacin, 97.3% to ceftriaxone, 94.7% to cefepime, 9.3% to colistin, 78% to tetracycline, 21.4% to tigecycline and 68% to trimethoprim. AcrB, AmpC, RamR, MexR, AdeB, TetA genes were present in multidrug-resistant Gram negative bacteria. AcrB, RamR, TetA genes were related to tigecycline resistance. It is concluded that infections caused by multidrug-resistant Gram negative bacteria occur at a high rate. Most isolates were multi drug resistant, with 21.4% being resistant to tigecycline.

Correlation between meticillin-resistant Staphylococcus aureus prevalence and infection control initiatives within southern and eastern Mediterranean hospitals.

The Mediterranean region has been identified as an area of hyper-endemicity for multi-resistant hospital pathogens. To better understand potential drivers behind this situation, we attempted to correlate already published meticillin-resistant Staphylococcus aureus (MRSA) data from 27 hospitals, participants in the Antibiotic Resistance Surveillance & Control in the Mediterranean Region (ARMed) project, with responses received from the same institutions to questionnaires which dealt with various aspects of infection control and antibiotic stewardship. No difference could be ascertained between high and low prevalence hospitals in terms of scores from replies to structured questions regarding infection control set-up, hand hygiene facilities and antibiotic stewardship practices. However, we did identify differences in terms of bed occupancy and isolation facilities. Hospitals reporting frequent episodes of overcrowding, particularly involving several departments, and which found regular difficulties sourcing isolation beds, had significantly higher MRSA proportions. This suggests that infrastructural deficits related to insufficient bed availability and compounded by inadequate isolation facilities could potentiate MRSA hyper-endemicity in south-eastern Mediterranean hospitals.

Learning priorities and attitudes towards computer-assisted learning of general medical practitioners, general dental practitioners and dental hygienists.

OBJECTIVES: The objectives of this survey were to assess the attitudes and learning priorities of general medical practitioners (GMPs), general dental practitioners (GDPs), and dental hygienists (DHs) working at Jordan University of Science and Technology (JUST), Irbid, Jordan in relation to post-graduate education, to gather information on their attitudes and skills in using computers and computer-assisted learning (CAL) and to see whether the material in this form is acceptable to participate as a means of teaching. METHODS: Data for this study was gathered via a questionnaire distributed to 63 health professionals including GMPs, general dental practitioners and DHs (mean age 24.79 +/- 2.69 years) working at JUST. RESULTS: Of the 63 participants, 80% of the participants have home computers, 38% have office computers at work and only 25% have both home and office computers. Approximately 53% of the participants had their first CAL experience at home. Seventy-three of the participants indicated that connection to Internet is necessary for their work. Seventy-one of the participants were interested in the possibility of using CAL to further improve and increase their medical knowledge. The most important topic for doctors was 'learning about new techniques which may supersede those in current use', for DHs it was 'improve knowledge or skill in radiology', and for dentists it was 'reinforcement of well established techniques commonly used in dental practice'. CONCLUSIONS: It is necessary for practicing health care professionals to update themselves by taking continuous education courses after graduation more conveniently via CAL methods.