Genetic and phenotypic study of methicillin-resistant Staphylococcus aureus among patients and health care workers in Mansoura University Hospital, Egypt.

BACKGROUND AND OBJECTIVES: Staphylococcus aureus is common pathogen that is associated with many hospital acquired infections. The virulence of S. aureus is identified with resistance to antibiotics especially to methicillin. Therefore the aims of the present study were to detect the carrier rates of methicillin-resistant S. aureus (MRSA) among health care Workers (HCWs) and patients and to compare use of specific chromogenic agar for MRSA culture with PCR for detection of MRSA genes. MATERIALS AND METHODS: Samples obtained were subjected to full microbiological laboratory studies involving culture on specific chromogenic medium and antibiotics susceptibility testing for detection of MRSA and their resistance rates to other commonly used antibiotics. Furthermore multiplex PCR was carried out to detect SCCmecA genes. RESULTS: Staphylococcus aureus was isolated from 70 (29.9%) of the studied subjects. MRSA isolates (n=28) had high resistance rates for the used antibiotics and the most common resistance was for ciprofloxacin and chloramphenicol (57.1% for each). MRSA was isolated mainly from health care workers (17.02%). The frequency of SCCmecA was 60.7% for type I, 25% for type III and 14.3% for type II. Chromogenic agar identified correctly MRSA isolates in 92.9%. PCR was positive in all isolates with resistance to cefoxitin disc. CONCLUSIONS: The present study highlights that MRSA carriage is common among health care workers in one Egyptian tertiary care hospital. The major genotype of MRSA is belonging to SCCmecA type I followed by type III and type II. ChromID medium is an accurrate culture method for detection of MRSA compared to molecular method.

Molecular and Phenotypic Identification and Speciation of Malassezia Yeasts Isolated from Egyptian Patients with Pityriasis Versicolor.

INTRODUCTION: Pityriasis Versicolor (PV) is a common health problem caused by genus Malassezia, a lipophilic fungi found as a part of the normal flora of skin. Although PV is common in Egypt, there is little information regarding the Malassezia species distribution in PV patients to date. AIM: To spot a light on the distribution and clinico-epidemiological features of the Malassezia species in PV patients and healthy individuals that were established by conventional phenotypic and molecular techniques. MATERIALS AND METHODS: A cross-sectional study including 167 individuals; 137 clinically suspected PV patients attending Mansoura University Hospitals, Egypt and 30 healthy control individuals, was carried out. Characterization of Malassezia species was performed phenotypically by conventional, culture-based methods and biochemical tests. Genomic DNA was extracted from isolated colonies for PCR amplification of the highly conserved 26S rDNA region with further species level identification by Restriction Fragment Length Polymorphism (RFLP) using Hha1 and BstC1 enzymes. The association of Malassezia species with epidemiological profile and clinical characteristics was studied. RESULTS: A 94.2% of PV samples and 13.3% of control samples were positive by Potassium Hydroxide (KOH) while 71.5% of PV samples and 16.7% of control samples yielded growth in culture with high statistically significant differences (p=0.0001, for both methods). By phenotypic methods, only 75.5% of isolates from patients were identified as: M. furfur (51.4%), M. globosa, (29.7%), M. restricta (13.5%) and M. pachydermatis (5.4%) while by RFLP technique, six species were revealed: M. furfur (44.9%), M. globosa (24.5%), M. sympodialis (12.2 %), M. restricta (10.2%), M. obtusa (4.1%) and M. pachydermatis (4.1%). Most species were isolated from hypopigmented lesions of PV patients aged between 20-29 years. Neck and back were the most common affected sites. Only M. furfur (10%) and M. globosa (6.7%) were identified in healthy controls. CONCLUSION: M. furfur and M. globosa are the commonly encountered species in both healthy and diseased human skin although other species were identified in PV patients. PCR-RFLP method represents a considerably accurate technique in identification of different Malassezia species for better understanding of their effect on the clinico-epidemiological characterization of PV patients in Egypt.

Genotyping and Clinicoepidemiological Characterization of Rotavirus Acute Gastroenteritis in Egyptian Children.

Group A rotavirus (RVA) acute gastroenteritis (AGE) is a common cause of severe childhood diarrhea. The dominant circulating RVA genotypes in a given region may vary between and within the geographic regions and from year to year. Our cross-sectional study was designed to determine the burden of RVA genotypes among children with AGE admitted to referral Children Hospital at Egypt prior to implementation of the vaccine. Stool samples with clinico-epidemiological data were collected from 92 children ≤ 3 years-old with AGE. RVA G and P typing were performed with type-specific primers. RVA was detected in 48.9% of patients. Higher rates of RVA infections, 73.3% were detected in infants < 1 year-old. Breast-fed infants were significantly fewer in RVA positive group (P = 0.0006). Non-breastfeeding was a major risk factor for RVA AGE (OR 0.3, P = 0.02). RVA diarrhea occurred mostly in autumn and winter months (55.4% and 26.6%) with a significant difference in autumn (P = 0.0005) and was associated with vomiting and dehydration (OR; 1.66, P = 0.021 & 1.4, P = 0.03). RVA genotypes G1P[8] (26.7%), G9P[8] (20%) and G3P[8] (15.6%) were accounting for 62.3% of RVA AGE. G9 was significantly associated with mucus diarrhea, than G1 or G3 which were associated with watery diarrhea (P = 0.025). Also, G9 was significantly associated with loose stool for > 5 days (P = 0.006) and 54.4% of G9 patients had severe dehydration. The diversity of RVA strains detected in Nile Delta Egypt and emergence of G9 RVA highlight the need to apply vaccines against this genotype in Egypt.

The impact of environmental and agricultural pollutants on the prevalence of allergic diseases in people from Qassim, KSA.

BACKGROUND: There are multiple environmental factors that influence a sensitized (IgE antibody positive) patient's predisposition to manifest allergic symptoms following allergen exposure. The majority of allergens are known to induce morbidity with chronic symptoms such as rhinitis, pruritis, dermatitis and urticaria. AIM: To study the impact of environmental and agricultural pollutants with different pollens on the immunological, hematological and biochemical markers and to determine the prevalence of sensitization to allergens among exposed individuals as well as to identify the eliciting allergens. SUBJECTS AND METHODS: Ninety six highly exposed individuals to environmental and agricultural pollution in addition to 20 as controls were selected. A solid phase enzyme-linked immunosorbent assay and the EUROLINE test kit were used for the quantitative determination of total IgE concentration and semi-quantitative in vitro assay of human IgE antibodies to some of the inhalant, ingestant and contactant allergens in serum samples, respectively. Percentage and absolute eosinophil counts and biochemical parameters were analyzed. RESULTS: Thirteen (13.5%) out of the 96 studied highly exposed subjects were manifesting allergic symptoms. Higher significant total serum IgE levels and absolute eosinophil counts in groups 1 and 3 of the highly exposed individuals compared to the control group were found (p1=0.00, p3=0.001 and p1=0.016, p3=0.028, respectively). Higher sensitization with inhalant Timothy grass, Aspergillus fumigatus, Der. Farinae and Olive; ingestant Egg yolk, Mango, Strawberry and Codfish and with contactant Latex/plastic and Crude oil was found in the studied groups compared with the controls. CONCLUSION: The present data suggest that the highly exposed subjects to pollution are at high risk of developing an allergy. For the screening of those with suspected allergen sensitization, the determination of specific IgE antibodies is a suitable marker of type I allergy.