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Evaluation of multi drug resistance among extended spectrum β-lactamase-producing Escherichia coli causing urinary tract infection in Erbil City
تقييم المقاومة المتعددة للأدوية بين الإشريكية القولونية الممتدة المنتجة للطيف والمنتجة للكتاماز والتي تسبب عدوى المسالك البولية في مدينة أربيل

Authors: Sayran Hamad Haji --- Safaa Toma Aka
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 2 Pages: 998-1004
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Bacterial resistant to broad spectrum β-lactams, which is mediated by the extended spectrum beta lactamase enzyme, has emerged recently as increasing problem. Extended spectrum beta lactamase producing strains can also displaying multi-drug resistance. Thus, increased number of infections due to these strains is a public health issue associated with high morbidity, mortality, high health-care costs and prolonged hospitalization. Therefore, this study aimed to evaluate multi-drug resistance among extended spectrum beta lactamase producing E. coli causing urinary tract infections. Methods: A total of 400 mid-stream urine specimens were collected from patients with urinary tract infection. Disk diffusion agar method on Muller-Hinton agar plates was carried out. Double Disc Synergy Test was used for detection of extended spectrum beta lactamase producer. All the isolates that were screened out for extended spectrum beta lactamase production were also subjected to confirmation by using the Phenotypic Confirmatory Combination Disc Diffusion Test.Results: The urinary tract infection cases were mainly due to Gram negative bacteria (87%). E. coli was isolated from 195 (48%) specimens. Sixty isolates of E. coli (31%) were found to be extended spectrum beta lactamase producers. The resistance to antibiotics tested was significantly higher (P <0.001) among extended spectrum beta lactamase producing isolates. Conclusion: The prevalence of multi-drug resistance to the antibiotics among extended spectrum beta lactamase producing E. coli isolates was established. Imipenems are recommended for the treatment of serious infections caused by these organisms.


Article
Phenotypic changes in pseudomonas aeruginosa induced by sub-inhibitory exposure to chlorohexidine
التغيرات المظهرية في الزائفة الزنجارية الناتجة عن التعرض شبه المثبط للكلوروهيكسيدين

Authors: Sayran Hamad Haji --- Safaa Toma Aka
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 3 Pages: 844-852
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Many bacterial isolates show an increased antimicrobial resistance due to biofilm production. Repeated exposure to sub lethal concentrations of antimicrobial agents certainly contributes to the resistance as compared to planktonic bacteria. The aim of this study was to test whether the bacterial phenotypes of P. aeruginosa can be changed during exposures to the concentrations at sub lethal doses of chlorhexidine.Methods: Sheep blood agar plates were used for evaluation of haemolysin assay for isolates of P. aeroginusa. A 96-flat bottom well microtiter plates were used for determination of MIC of antibiotic and biofilm formation. Results: All tested isolates were able to lyse RBCs after exposure to sub-MIC of chlorhexidine. Effectiveness of sub-lethal doses of chlorhexidine on biofilm formations varied depending on the contact time. In general, long contact time exhibited increasing biofilm than short time. No significant difference in biofilm was detected among contact times: day I, day II and day III (P = 0.132, P = 0.139 and P = 0.125, respectively). The most effective sub-MIC of CHX was against azithromycin, since the resistance increased significantly (P = 0.008).Conclusion: Surviving P. aeruginosa to low concentration of chlorhexidine can exhibit stronger biofilm and increased resistance to antibiotics.


Article
Molecular detection of SHV-Type ESBL in E. coli and K.pneumoniae and their antimicrobial resistance profile
الاكتشاف الجزيئي لـ ESV-Type ESBL في E. coli و K.pneumoniae ومظهر مقاومتهما المضادة للميكروبات

Authors: Ahang Hasan Mawlood --- Sharmin Abdullah Omer --- Salah Tofik Jalal --- Sayran Hamad Haji
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 2 Pages: 262-272
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The increase in the incidence of Beta-lactam resistance in Gram-negative bacteria has become a main clinical problem worldwide that limits therapeutic options. The production of extended-spectrum blactamases is the major source of resistance to newer beta-lactam antibiotics in Enterobacteriaceae. This study aimed to check the presence of extended-spectrum β-lactamase producing K. pneumoniae and E. coli and the evaluation of ESBL among those isolates.Methods: A total of 120 E. coli and K. pneumoniae clinical isolates were obtained from Rizgary Teaching Hospital in Erbil City, Iraqi Kurdistan Region, during the first six months of 2016. All isolates were identified and checked for the production of ESBL using Vitek 2 automated system. The technique of PCR was performed for the detection of the presence of blaSHV gene from these isolates. The antibiotic resistant profiles for these isolates were also investigated.Results: The overall proportion of ESBL-producing E. coli and K. pneumoniae isolates, 77 (76.2%) and 15 (78.9%) isolates were ESBL producers, respectively. ESBL-producing isolates were significantly more resistant than Non-ESBL-producers (P < 0.05). PCR performed on 30 ESBL positive isolates, 21(70%) isolates were of E. coli, and 9 (30%) isolates were of K.pneumoniae. The ESBL B-lactamase related SHV gene was detected only in 11 (36.6%) isolates, 6 (28.5 %) of E. coli and 5(55.5%) of K. pneumoniae isolates respectively. All isolates were susceptible to carbapenems.Conclusion: The great diversity of ESBL and the prevalences of clinical isolates of E. coli and K. pneumoniae producing these enzymes indicate that this is an important problem in our region. The most active antimicrobial agent against isolates used in this study was carbapenem. It is, therefore strongly recommended to consider carbapenems as the drug of choice for such multi-drug resistant ESBL-producing microorganisms.

Keywords

ESBL --- blaSHV gene --- E. coli --- K. pneumoniae

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