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1.
East Mediterr Health J ; 24(9): 914-921, 2018 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-30570124

RESUMEN

Background: The Lebanese American University has a well-functioning inter-professional education (IPE) programme; this is a fundamental pedagogical approach in healthcare education in which students from different professions learn together, ultimately leading to improving the skills of the health care workforce and thus improving patient outcomes. The programme includes nursing, nutrition, medicine, pharmacy and social work students, and has now been running for 6 years. Aims: This paper aims at describing the implementation of an IPE programme in Lebanon by focusing on how to overcome the main challenges. Methods: We describe our experience using the categories of challenges developed by Sunguya et al. (2014), where they analysed published reports of IPE programmes in developed countries. We identified three additional challenges that might be relevant throughout the Middle East/North Africa (MENA) region or in countries with similar socioeconomic characteristics. Results: The challenges encountered in designing and implementing the IPE programme were similar to other programmes: curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargon and accreditation as well as assessment of learning, security and logistics. Conclusions: This paper provides data and successful strategies that can be used by planned or implemented programmes in similar socioeconomic contexts in the MENA region.


Asunto(s)
Personal de Salud/educación , Relaciones Interprofesionales , Curriculum , Humanos , Líbano , Evaluación de Programas y Proyectos de Salud
2.
J Infect Dev Ctries ; 12(2): 146-149, 2018 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-31825918

RESUMEN

Gemella haemolysans is a rare cause of human disease, namely infective endocarditis and brain abscesses. We report herein a case of Gemella haemolysans liver abscess in an immunocompetent adult patient secondary to blunt liver trauma and successfully managed by medical-surgical approach.

3.
Future Microbiol ; 12: 213-226, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-28262042

RESUMEN

AIM: Extended-spectrum ß-lactamase-producing (ESBL) Escherichia coli are a public threat worldwide. This study aimed at analyzing the genomic and functional attributes of nine ESBLs taken from rectal swabs. MATERIALS & METHODS: Samples were isolated from patients admitted for gastrointestinal and urological procedures at the University Medical Center-Rizk Hospital (UMCRH) in Lebanon. Illumina paired-end libraries were prepared and sequenced. RESULTS: The isolates were distributed into five lineages: ST131, ST648, ST405, ST73 and ST38, and harbored bla OXA-1, bla TEM-1B, bla TEM-1C and aac(6')Ib-cr. ST131 isolates were carriers of stx2 converting I phage. CONCLUSION: This is the first comprehensive genomic analysis performed on ESBLs in Lebanon.


Asunto(s)
Infecciones por Escherichia coli/microbiología , Escherichia coli/genética , beta-Lactamasas/genética , Antibacterianos/farmacología , Electroforesis en Gel de Campo Pulsado , Escherichia coli/clasificación , Escherichia coli/efectos de los fármacos , Escherichia coli/enzimología , Genoma Bacteriano , Genómica , Humanos , Líbano , Pruebas de Sensibilidad Microbiana , Filogenia , beta-Lactamasas/metabolismo
4.
J Interprof Care ; 30(2): 165-74, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27026188

RESUMEN

The Lebanese American University Interprofessional Education (LAU IPE) Steps Framework consists of a five-step workshop-based series that is offered throughout the curriculum of health and social care students at an American university in Lebanon. The aim of the present study was to report students' perceptions of their readiness for interprofessional learning before and after completing the IPE steps, their evaluations of interprofessional learning outcomes, as well as their satisfaction with the learning experience as a whole. A longitudinal survey design was used: questionnaires were completed by students before IPE exposure and after each step. The results showed that before IPE exposure, students' perceptions of their readiness for interprofessional learning were generally favourable, with differences across genders (stronger professional identity in females compared to males) and across professions (higher teamwork and collaboration in pharmacy and nutrition students compared to other professions and lower patient centredness in nursing students compared to others). After participation in the IPE steps, students showed enhanced readiness for interprofessional learning and differences between genders and professions decreased. Participants were satisfied with the learning experience and assessment scores showed that all IPE learning outcomes were met. The LAU IPE Steps Framework may be of value to other interprofessional education course developers.


Asunto(s)
Actitud del Personal de Salud , Personal de Salud/educación , Relaciones Interprofesionales , Estudiantes del Área de la Salud/psicología , Competencia Clínica , Conducta Cooperativa , Femenino , Humanos , Líbano , Estudios Longitudinales , Masculino , Atención Dirigida al Paciente/organización & administración , Percepción , Factores Sexuales
5.
Artículo en Inglés | MEDLINE | ID: mdl-25905047

RESUMEN

OBJECTIVE: The emergence of extended-spectrum ß-lactamase (ESBL)-producing bacteria is now a critical concern. The ESBL-producing Klebsiella pneumoniae constitutes one of the most common multidrug-resistant (MDR) groups of gram-negative bacteria involved in nosocomial infections worldwide. In this study we report on the molecular characterization through whole genome sequencing of an ESBL-producing K. pneumoniae strain, LAU-KP1, isolated from a stool sample from a patient admitted for a gastrointestinal procedure/surgery at the Lebanese Amrican University Medical Center-Rizk Hospital (LAUMCRH) in Lebanon. METHODS: Illumina paired-end libraries were prepared and sequenced, which resulted in 4,220,969 high-quality reads. All sequence processing and assembly were performed using the A5 assembly pipeline. RESULTS: The initial assembly produced 86 contigs, for which no scaffolding was obtained. The final collection of contigs was submitted to GenBank. The final draft genome sequence consists of a combined 5,632,663 bases with 57% G+C content. Automated annotation was performed using the RAST annotation server. Sequencing analysis revealed that the isolate harbored different ß-lactamase genes, including bla oxa-1, bla CTX-M-15, bla SHV-11, and bla TEM-1b. The isolate was also characterized by the concomitant presence of other resistance determinants most notably acc(6')-lb-cr and qnrb1. The entire plasmid content was also investigated and revealed homology with four major plasmids pKPN-IT, pBS512_2, pRSF1010_SL1344, and pKPN3. CONCLUSIONS: The potential role of K. pneumonia as a reservoir for ESBL genes and other resistance determinants is along with the presence of key factors that favor the spread of antimicrobial resistance a clear cause of concern and the problem that Carbapenem-non-susceptible ESBL isolates are posing in hospitals should be reconsidered through systematic exploration and molecular characterization.


Asunto(s)
Proteínas Bacterianas/metabolismo , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/enzimología , beta-Lactamasas/metabolismo , Proteínas Bacterianas/genética , Heces/microbiología , Femenino , Genoma Bacteriano , Humanos , Klebsiella pneumoniae/clasificación , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/aislamiento & purificación , Líbano , Persona de Mediana Edad , Filogenia , Análisis de Secuencia de ADN , beta-Lactamasas/genética
6.
Genome Announc ; 2(1)2014 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-24558251

RESUMEN

We present the draft genome sequence of extended-spectrum ß-lactamase (ESBL)-producing Klebsiella pneumoniae isolated from a stool sample collected from a patient admitted for a gastrointestinal procedure. The draft genome sequence consists of 86 contigs, including a combined 5,632,663 bases with 57% G+C content.

7.
Genome Announc ; 2(1)2014 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-24558252

RESUMEN

We present the draft genome sequences of nine extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli strains isolated from stool samples collected from patients admitted for gastrointestinal and urological procedures/surgeries. An average of 3,889,300 paired-end reads per sample were generated, which assembled in 77 to 157 contigs.

8.
Am J Infect Control ; 42(2): 160-3, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24360641

RESUMEN

BACKGROUND: There is an increasing concern about methicillin-resistant Staphylococcus aureus (MRSA) infections in the community. This study aimed to evaluate the rate of S aureus nasopharyngeal colonization in outpatients as the primary endpoint, and also to study the impact of several possible risk factors, including recent hospitalization, recent surgical procedures, and antibiotic intake. METHODS: A total of 1,526 consecutive outpatients underwent surveillance cultures after completing a questionnaire. Isolated S aureus strains were tested for antibiotic susceptibility. The Pearson χ(2) test was used for statistical analysis. The differences were considered to be statistically significant at a P value <.05. RESULTS: Out of the 1,526 outpatients tested, 133 (8.7%) carried S aureus in the nose and/or throat. Only 2 of those cases were MRSA, and both were isolated from the nose. One hundred thirty-one patients had methicillin-sensitive S aureus, 13 with simultaneous carriage in the nose and throat. Among the risk factors, a relative working in health care, presence of an intravascular device, recent dental procedure, and health club use were significantly associated with an increased risk of S aureus colonization, with P values of .00, .02, .04, and .00, respectively, calculated by the χ(2) test. CONCLUSIONS: The prevalence of MRSA is still low in our study population within the Lebanese community. The only significant risk factors playing a role in increasing the carriage of S aureus were related to health care exposure.


Asunto(s)
Portador Sano/epidemiología , Resistencia a la Meticilina , Mucosa Nasal/microbiología , Nasofaringe/microbiología , Pacientes Ambulatorios , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Portador Sano/microbiología , Niño , Preescolar , Femenino , Humanos , Lactante , Líbano/epidemiología , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/efectos de los fármacos , Encuestas y Cuestionarios , Adulto Joven
9.
Acta Trop ; 125(1): 115-8, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23022355

RESUMEN

Halzoun syndrome typically manifests in the form of an allergic pharyngitis following the consumption of raw or undercooked ovine liver. First described in Lebanon in 1905, it was initially attributed to Fasciola hepatica, while later publications have attributed it to other pathogens. There has been no definitive documentation of the pathogen causing the Lebanese Halzoun syndrome. The aim of our study was to identify the parasite responsible for the pathogenesis of the Lebanese Halzoun syndrome. 32 patients with typical clinical symptoms of Halzoun syndrome were recruited in the emergency room at our hospital from 2005 to 2007. One parasite was isolated from a patient's expectorations, and two others were isolated from pieces of a raw sheep liver retrieved from the patients' dishes. A piece of infected goat liver intended for consumption was also collected from a local butcher. All parasites were examined microscopically for identification. All patients presented with immune allergic-like symptoms of the eyes, ears, nose, or throat. All collected parasites were identified as Dicrocoelium dendriticum. Our study has identified D. dendriticum, rather than Linguatula serrata or F. hepatica, as the prime suspect in the pathogenesis of the Lebanese Halzoun syndrome.


Asunto(s)
Dicroceliasis/patología , Dicroceliasis/parasitología , Dicrocoelium/patogenicidad , Hipersensibilidad/patología , Hipersensibilidad/parasitología , Faringitis/patología , Faringitis/parasitología , Adolescente , Adulto , Animales , Dicrocoelium/anatomía & histología , Femenino , Microbiología de Alimentos , Enfermedades Transmitidas por los Alimentos/etiología , Enfermedades Transmitidas por los Alimentos/parasitología , Enfermedades Transmitidas por los Alimentos/patología , Humanos , Hipersensibilidad/etiología , Líbano , Hígado/parasitología , Masculino , Microscopía , Persona de Mediana Edad , Faringitis/etiología , Adulto Joven
11.
Int J Antimicrob Agents ; 31(5): 427-33, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18375104

RESUMEN

The main mechanism of imipenem resistance in Pseudomonas aeruginosa is via downregulation of the gene for OprD porin. In a previous study, it was shown that the level of resistance did not parallel with the degree of downregulation of the porin gene, thus arguing for the existence of other resistance mechanisms. Penicillin-binding protein (PBP) 2 and PBP3 are involved in carbapenem resistance in Escherichia coli. The genes for PBPs were sequenced in three imipenem-resistant clinical strains and these strains were conjugated with two susceptible P. aeruginosa PA0 strains, selecting for auxotrophic markers. In all the clinical and resistant isolates there was no obvious elevation of AmpC cephalosporinase. The active sites of PBP1b (ponB), PBP2 (pbpA), PBP3 (pbpB) and PBP6 (dacC) had no mutations in any of the examined strains. Production of oprD mRNA was significantly lower in clinical strains and transconjugants after selection for the proB marker (PA4565 at 5113kb). The clinical strains had alterations in OprD that were not found in transconjugants. Our findings suggest that PBPs do not play a role in imipenem resistance in the clinical strains examined here, but that a regulatory gene for oprD contributing to carbapenem resistance is located close to the proB gene.


Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Imipenem/farmacología , Proteínas de Unión a las Penicilinas/metabolismo , Porinas/metabolismo , Pseudomonas aeruginosa/efectos de los fármacos , Tienamicinas/farmacología , Análisis Mutacional de ADN , ADN Bacteriano/genética , Regulación hacia Abajo , Regulación Bacteriana de la Expresión Génica , Humanos , Meropenem , Pruebas de Sensibilidad Microbiana , Proteínas de Unión a las Penicilinas/genética , Porinas/genética , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/aislamiento & purificación , Pseudomonas aeruginosa/metabolismo , ARN Bacteriano/biosíntesis , ARN Mensajero/biosíntesis , Análisis de Secuencia de ADN
12.
J Infect ; 53(6): 403-7, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16483663

RESUMEN

OBJECTIVE: The rate of infection following cat bites appears to be greater than that from dog bites. To study the clinical picture, complications and microbiology (in humans and cats), this prospective study was performed. METHODS: A prospective study with patients with clinical symptoms of infection due to cat bites from three emergency wards during two years in Stockholm, Sweden. Aerobic and anaerobic cultures from the wounds were performed as well as cultures from the biting cat's mouth. Clinical data and complications were registered. RESULTS: Seventy-nine episodes in 78 patients with infective cat bites were included. Pasteurella multocida was isolated in 70% of the patients; in addition anaerobic pathogens were isolated in 16% concurrently with P. multocida, while Staphylococcus aureus was isolated in only two patients. Pasteurella spp. was also isolated from 80% of the pharynx of the biting cats. The dominating symptoms of infection were erythema, pain and oedema, often emerging as early as 3h after the bite. Complications such as tendosynovitis, arthritis, abscesses and septicaemia occurred in 18% of the patients. No patient died due to the infection. The majority of the patients received penicillin or amoxicillin as antibiotic treatment. CONCLUSIONS: P. multocida was the dominating pathogen among patients with infected cat bites and antibiotic treatment should cover P. multocida.


Asunto(s)
Mordeduras y Picaduras/fisiopatología , Gatos/microbiología , Pasteurella/aislamiento & purificación , Infección de Heridas/microbiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Antibacterianos/uso terapéutico , Mordeduras y Picaduras/tratamiento farmacológico , Mordeduras y Picaduras/microbiología , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Pasteurella/patogenicidad , Estudios Prospectivos , Suecia , Infección de Heridas/complicaciones , Infección de Heridas/tratamiento farmacológico
13.
Scand J Infect Dis ; 34(6): 449-55, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12160173

RESUMEN

Resistance rates among Escherichia coli isolates for quinolones and cotrimoxazole were analysed at 12 Swedish hospitals, and compared with antibiotic use. Resistance figures for E. coli were retrieved from the diagnostic microbiology service databases for the period 1989-99, and antibiotic sales figures were obtained from the National Corporation of Swedish Pharmacies. At the 2 university teaching hospitals included, norfloxacin resistance of E. coli increased significantly (p < 0.001) from 0% to 2.7% and 2.5%, respectively. Ciprofloxacin resistance increased (p < 0.001) in parallel. Quinolone use increased until 1992; subsequently, sales have remained at a stable level. The increase in norfloxacin and ciprofloxacin resistance started relatively simultaneously in all hospitals, around 1991. Cotrimoxazole resistance has also been increasing significantly in most hospitals, in spite of decreasing sales of cotrimoxazole and trimethoprim. Similar trends could be seen in blood isolates from the same hospitals for the period 1991-98. Clinical laboratory data are subject to bias but surveillance over longer periods of time provides a useful method for detecting trends in increasing resistance and therefore functions as a resistance warning system.


Asunto(s)
Antiinfecciosos/farmacología , Escherichia coli/efectos de los fármacos , Laboratorios de Hospital/estadística & datos numéricos , Combinación Trimetoprim y Sulfametoxazol/farmacología , Farmacorresistencia Microbiana , Fluoroquinolonas , Modelos Logísticos , Suecia
14.
Scand J Infect Dis ; 34(5): 372-8, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12069023

RESUMEN

Antibiotic resistance among Gram-negative bacteria and antibiotic consumption were investigated at the Karolinska Hospital, Stockholm, Sweden over a 12-y period. The investigation showed an increase in ciprofloxacin resistance of Escherichia coli from 0% in 1991 to 7% in 1997 and to 11% in 1999. Resistance among Pseudomonas aeruginosa isolates to ciprofloxacin increased from 2.5% in 1991 to 9.0% in 1997 and to 13% in 1999. Resistance levels for norfloxacin showed the same high statistical significance in terms of the temporal trend. A more detailed analysis showed higher resistance against norfloxacin in specific wards. Relationships between antibiotic use and antibiotic susceptibility showed different patterns. The increased ciprofloxacin resistance of E. coli and P. aeruginosa during the study period was paralleled by an increased consumption of quinolones. During the 12-y study period the total use of cephalosporins increased 2.5-fold, while the levels of E. coli resistance to cefuroxime and cefotaxime remained stable. A third pattern was seen with trimethoprim-sulfamethoxazole, namely increasing resistance of E. coli as the use of trimethoprim-sulfamethoxazole declined. The analysis of resistance levels and antibiotic consumption in the present study suggests different mechanisms for the increased resistance. The significant trend of increased resistance to antibiotics over time constitutes an important warning system.


Asunto(s)
Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Vigilancia de la Población , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/microbiología , Hospitales Universitarios , Humanos , Pruebas de Sensibilidad Microbiana , Suecia/epidemiología , Factores de Tiempo
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