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Article
Determiation the antibacterial activity of Punicagranatum Extract towards Streptococcus Pneumonia and Klebsella Pneumonia
تحديد الفعالية المضادة للبكتريا لمستخلص نبات Punica granatum لبكتريا الـ Streptococcus Pneumonia وKlebsella Pneumonia

Author: Ruaa Hassan Lateef رؤى حسن لطيف
Journal: Tikrit Journal of Pure Science مجلة تكريت للعلوم الصرفة ISSN: 18131662 Year: 2019 Volume: 24 Issue: 2 Pages: 14-18
Publisher: Tikrit University جامعة تكريت

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Abstract

This study was carried out to determine the inhibitory effect of the alcoholic and aquatic extracts of Punicagranatum (pomegranate peel) agaiestmultiresistantto antibiotic bacteria Streptococcus pneumonia and Klebsella pneumonia bacteria with some antibiotics. These isolated from the sputum and urine samples from patients whom lies in Tikrit Teaching Hospital in Tikrit city. The results showed various effects of the water and alcoholic extracts used in the study. The results showed that the highest inhibitory effect of the alcoholic extract against the bacteria Streptococcus Pneumonia at concentration (150)Inhibition zone was (24) mm and this is higher than the water extract at concentration (150) which was (16) mm. The results indicated that the highest Inhibitory effect of the alcoholic extract against the Klebsella Pneumonia at concentration (150) was (23) mm whereas the results of the inhibitory effect of the water extract against Klebsella Pneumonia are similar with the inhibitory effect of the extract of Streptococcus Pneumonia at (150) which was(16) mm.The results showed that the highest inhibitory diameter zone of Imipenem antibiotic on Streptococcus pneumonia bacteria is (38) m and is higher than the inhibitory effect of Imipenem antibiotic on Klebsellapneumonia bacteria which is (37) m in diameter.

تناولت الدراسة مقارنة الفعالية التثبيطية للمستخلص المائي والكحولي لقشور الرمان على البكتريا Streptococcus Pneumonia وKlebsella Pneumonia مع بعض المضادات الحيوية، وهذه العزلات تم الحصول عليها من القشع والإدرار من المرضى الراقدين في مستشفى تكريت التعليمي في مدينة تكريت. وأظهرت النتائج تأثيرات متباينة للمستخلصات المائية والكحولية المستخدمة في الدراسة. وتشير النتائج إلى إن أعلى تأثير تثبيطي للمستخلص الكحولي ضد البكتريا Streptococcus Pneumonia عند التخفيف (150) مايكروغرام/مل هو (24) ملم أعلى من المستخلص المائي عند التخفيف (150) مايكروغرام/مل وهو (16) ملم، بينما أشارت النتائج إلى أن أعلى تأثير تثبيطي للمستخلص الكحولي ضد البكتريا Klebsella Pneumonia عند التخفيف (150) مايكروغرام/مل هو (23) ملم. أما نتائج التأثير التثبيطي للمستخلص المائي ضد بكتريا Klebsella Pneumonia كانت متشابهه مع التأثير التثبيطي للمستخلص المائي لـStreptococcus Pneumonia عند التخفيف (150) مايكروغرام/مل وهو (16) ملم. وأشارت النتائج الى أن أعلى تأثير تثبيطي للمضاد الحيوي Imipenem على بكتريــــــا Streptococcus Pneumonia هو(38) ملم وكانت أعلى من التاثير التثبيطي للمضاد Imipenem على بكتريا وKlebsella Pneumonia وكان قطره (37) ملم.


Article
Stroke Related Pneumonia Incidence and Possible Risk Factors

Authors: Ahmad M. Jaffer --- Kassim M. Sultan --- Akram Al-Mahdawi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 3 Pages: 376-381
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:The stroke patient is at risk of developing hospital acquired infection, with the lungs being especially vulnerable. Stroke associated pneumonia (SAP) occurring after two days of admission and is the most nosocomial infection seen in the medical wards , pneumonia is the major cause of morbidity and mortality after stroke .The establishment of an accurate diagnosis of stroke associated pneumonia remains problematic and yet there is still no accepted "gold standard" for diagnosis.OBJECTIVE:To determine the incidence and risk factors of stroke associated pneumonia.METHODS:This is prospective cohort study for 82 stroke patients admitted to medical wards .The study conduct from the 1st July 2009 to the 10th January 2010. Initially stroke diagnosed clinically and by CT scan. Theses cases are assessed after 48 hours after admission, full history, physical examination and investigations were done using clinical criteria (body temperature, WBC count and chest radiography ) for diagnosis of pneumonia.RESULTS:11(13.4%) patients developed stroke associated pneumonia from 82 stroke patients admitted to medical wards. Most patients who were developed pneumonia were older than patients who did not developed pneumonia . The incidence is higher in patient with infarction and older age groups than patients with hemorrhagic stroke and younger age groups, and there is no association between the disease and gender .The incidence of late onset is more common than early onset pneumonia. Presence of dysphagia was present in (81.8%) nasogastric tube in (72.7% ),unconsciousness(54.5%),tobacco ,vomiting (36.6%) and fit (27.2%) were found as an important risk factors .The mortality more in hemorrhagic(75%) than thrombotic stroke (14.3%).CONCLUSION:stroke associated pneumonia is an important cause of mortality. It is associated with older age, dysphagia , NG intubation ,coma ,vomiting and fit .Simple assessment of these variables could be used to identify patients at high risk of developing pneumonia after stroke.

Keywords

Pneumonia --- stroke --- risk factors


Article
Risk Factors and Common Causes of Death Due to Measles in AL-Kadhimiyia Teaching Hospital.2009

Authors: Lamia Abdul Karim --- Abdul-KaremJasemAlbahadle --- Ali Kadhim Al-Husainawi*
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 32-39
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Remains a common disease in many parts of the world. According to the World Health Organization (WHO), more than 20 million people worldwide are affected by measles each year. It is the leading cause of vaccine-preventable deaths among young children.OBJECTIVE:To find out the epidemiological criteria of died patients because of measles& the main causes of death.PATIENTS AND METHODS:Prospective study carried out in the pediatric ward of Al-Kadmyia Teaching Hospital between the 1st of January to the 1st of May 2009,the total number of measles cases admitted were 894 , the number of died cases in the same period due to measles were 52 case , the age of the studied sample (1month- 10 years).The data collected through a data sheet asked to the parents of the patient including the age ,sex, body weight, feeding history, history of contact, vaccination history , maternal vaccination status and her educational level.All the patients examined systematically and investigated and followed up till discharged or unfortunately diedRESULTS:The age of the died cases mostly in the 1st2years(27 case), there is male(31) , female(21) died cases.The mortality occur more in under weight cases27 , the died cases were either on mixed feeding 17cases, bottle feeding 10, solid feeding 25 cases.All the died cases had history of contact with measles., there were 49 cases non-vaccinated, the vaccination status of the mothers were 38 mother were not vaccinated. The educational level of the mothers were 29 illitrate,15 primary and 8 secondary school.The most common causes of death :16 encephalitis, 36 pneumonia.CONCLUSION:The death occurs more in infants and toddlers than in other age groups, more in males,underweight, and the non-vaccinated than in the vaccinated patients.Death is more common among children belong to non-vaccinated, illiterate mothers.Pneumonia is the most frequent complication of measles and encephalitis is the most lethal complication.


Article
Pneumonia in children admitted with lower respiratory tract infections… A hospital based study
ذات الرئة عن الاطفال المصابين بالتهاب المجاري التنفسية السفلى الراقين في مستشفى حماية الاطفال التعليمية في بغداد

Author: Muhi K. Al Janabi* MRCPCH , FICMS , DCH (Pediatric pulmonologist). د. محي كاظم وناس الجنابي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2012 Volume: 54 Issue: 4 Pages: 294-229
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:Background: Pneumonia is a common form of lower respiratory tract infection (LRTI) in children under five years of age and it is the leading cause of morbidity and mortality in this age group. Early management is important in decreasing its complications and mortality.Methods: A cross sectional study of 100 patients, their ages ranged from 2 months to 5 years. They were admitted to Children Welfare Teaching Hospital Medical City–Baghdad in a period from 7th of November 2010 to 5th of May 2011, suffering from Lower Respiratory Tract Infections (fever, cough and tachypnea) and classified into two groups according to chest radiograph (CXR) findings, those with a patch (pneumonia) and others with normal or hyper inflated CXR. The possibility of various demographic and clinical symptoms and signs to predict the presence or absence of the patch were evaluated.Results: From a total of 100 patients enrolled in this study, 42%had a patch and 58% had normal or hyperinflated CXR. Older age, male gender, longer duration of hospitalization, high level of paternal education and family history of same disease are significantly associated with the presence of patch. Signs and symptoms like deterioration in the level of consciousness, lung crepitation and decrease in air entry and convulsion are significantly associated with the presence of the patch.Conclusion: Pneumonia is frequent in children with LRTI. Presence of convulsions, deterioration in the level of consciousness, lung crepitation and decrease in air entry in a child with LRTI may raise the suspicion of having pneumonia. Factors like older age, male gender, and high level of paternal education were associated with increase the susceptibility to have pneumonia in children with LRTI. Key word: children; predictors; pneumonia.

الخلاصة : يعتبر ذات الرئة من الامراض الاكثر شيوعا بين عوى المجاري التنفسية السفلى عدد الاطفال دون السنة الخامسة وهو احد مسببات المراضة والوفيات في هذه الفئة العمرية لذلك يعتبر التشخيص والعلاج المبكر ركن اساسي في تقليل المضاعفات ومعدل الوفيات.طرق البحث: دراسة وصفية استباقية لمئة مريض تتراوح اعمارهم بين شهرين وخمس سنوات والذين رقدوا في مستشفى حماية الاطفال التعليمي في بغداد للفترة منذ السابع من تشرين الاول 2010 ولغاية الخامس من ايار 2011 والذين كانوا يعانون من ارتفاع في رجة حرارة الجسم والسعال وزيادة في سرعة التنفس وتم اخذ رقائق الرقائق الشعاعية للصر وقسمت العينة الى مجموعتين ذات الرقائق الموجبة وذات الرقائق السالبة وتم دراسة بعض الاعراض السريرية والوبائية للتنبؤ بوجود ذات الرئة .النتائج: بلغت نسبة ذات الرئة اثنين واربعين بالنئة وعدمها بنسبة ثمانية وخمسين بالمئة وتعتبر بعض العوامل مثل العمر والجنس وفترة الرقود في المستشفى ومستوى ثقافة الاب ووجود ذات المرض في العائلة واصابة الطفل بالصرع اثناء فترة المراضة وانحدار مستوى الادراك ووجود طقطقة وقلة دخول الهواء الى الصدر لها اهمية بوجود ذات الرئة .الاستنتاجات : استنتجت الدراسة ان ذات الرئة مرض متكرر وقد مثل اثنين واربعين بالمئة في عدو المجاري التنفسية السفلى عند الاطفال دون الخامسة وان هناك بعض العلامات السريرية الصدرية وغير الصدرية متلازمة مع ايجابية الرقاقة الشعاعية تعطي القدرة على تشخيص هذا المرض.

Keywords

: children --- predictors --- pneumonia


Article
Analysis of chest x-ray and clinical finding in children with pneumonia
تحليل الصدر بالأشعة السينية والاكتشاف السريري عند الأطفال المصابين بالتهاب رئوي

Authors: Isam Al- Hatam --- Abbas Al-Rabaty --- Salwa Ahmad Al-Najjar
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2013 Volume: 17 Issue: 2 Pages: 477-481
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The objectives of the study research were to determine the relationship between clinical and chest X-ray findings of pediatric patients.Methods: A Prospective clinical study carried out at Raparin hospital in Erbil city, Iraq. A sample of 356 children admitted between Decembers 2004 and June 2005 from emergency ward and inwards in Raparin hospital were collected with age range from 2 months to 10 years with mean age of 19 months. All children had chest radiography on the bases of clinical decision by pediatricians. Descriptive and statistical procedures were used to analyze the data. Results: All children had signs and symptoms of respiratory infections for instance, fever (87.4%), shortness of breath (99.5 %),cough (98%), tachypnea (73.5%), wheezes (93.3% ), chest retraction (80%), crepitations (82%) and, 42.4% of chest X-rays showed focal infiltrations. Three clinical parameters related to pneumonia diagnosed by chest X-ray these were, chest retraction with sensitivity of 80%, and specificity of 88.29%), tachypnea with sensitivity of 73.5% and specificity of 56.59% fever with sensitivity of 87.42% and specificity of 60.98%.Conclusion: Tachypnea, chest retraction and fever were found to be highly suggestive of pneumonia, chest x-rays was positive in about 425 of patients with pneumonia.

Keywords

Pneumonia --- Chest-X-ray


Article
Detection of Carbapenem-Resistant Klebsiella pneumonia using two Sensitivity Methods
التحري عن بكتریا Klebsiella pneumonia المقاومة لمجموعة الكاربابنیم باستخدام اختباري حساسیة

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Carbapenems, potent β-lactams antibiotics, were initially used as last-resort treatmentsfor severe Gram-negative bacteria such as Klebsiella pneumonia. These bacteria wereconsidered one of Enterbacteriaceae family associated with pneumonia and urinary tractinfection. In the current research, Carbapenems were studied to identify the resistant K.pneumonia isolates and identifying the relation with some β-lactam resistance to avoid theirabuse for treatment.A urine sample got from 80 infected female with chronic urinary tract infection, thesesamples tested for K. pneumonia and their carbapenemase production. The procedure wasbased on disc diffusion and Landman e,t al. methods.The results pointed out that Klebsiella pneumonia is significantly present in patientswith urinary tract infection, the carbapenem resistance in disc diffusion and Landmanprocedure was 100% and 88.5% for meropenem (MEM), while it was 57.2% and 65.4% forimipenem (IPE), respectively. Regarding the carbapenem resistance in same isolate for both(MEM and IPE), 69.23% (18/26) were coincidence and 30.77% (8/26) were mismatch in bothmethods. In addition, the Landman procedure more accurate than disc diffusion forcarbapenem resistance and there is a strong association with Beta-lactam resistance.It can be conclude that there is a high incidence of carbapenem resistance in localisolates of Klebsiella pneumonia. We recommend to use the supercarba media in diagnoses ofbacteria routine work because it is more specific along with disc diffusion method for patientswith urinary tract infection and the use of other treatments to decrease the level of resistance

:تعد مجموعة الكاربابنیم من مضادات البیتالاكتام القویة المستخدمة كخیار اخیر لعلاج البكتریا السالبة لصبغة كرامتنتمي ھذه البكتریا الى عائلة البكتریا المعویة المسببة لإصابات المجاري البولیة وذات .Klebsiella pneumonia مثلالرئة.المقاومة لھذه المجموعة من Klebsiella pneumonia الھدف من ھذه الدراسة ھو تشخیص عزلات بكتریا المضادات وعلاقتھا بمقاومة مضادات البیتالاكتام لتجنب الاستخدام الخاطيء في العلاج.جمعت 80 عینة إدرار من نساء مصابات بالتھاب المجاري البولیة المزمن, وتم التحري فیھا عن عزلات بكتریا المقاومة لمجموعة الكربابنیم (المیروبنیم والامیبنیم). تم اختبار مقاومة البكتریا باستخدام Klebsiella pneumonia طریقتي انتشار الاقراص وطریقة لاندمان.ھي المسبب لالتھاب المجاري البولیة بصورة معنویة Klebsiella pneumonia أظھرت النتائج أن بكتریااوكانت حساسیة البكتریا باستخدام طریقة انتشار الاقراص وطریقة لاندمان بنسبة 100 % و 88.5 % للمیروبنیم، بینما كانت%57.2 و 65.4 للامیبنیم على التوالي، وعند الاخذ بنظر الاعتبار مقاومة العزلات نفسھا للمضادین المذكورین, فقد كانت8) غیر متتطابقة في حساسیتھا /26) % 18/26 ) من العزلات مقاومة لكلا المضادین بینما كانت 30.77 ) %69.23للطریقتین، كما أظھرت النتائج أن طریقة لاندمان كانت أكثر دقة من طریقة إنتشار الأقراص لدراسة مقاومة مجموعة الكاربابنیم كما أن ھنالك إرتباط بین مقاومة العزلات المدروسة لھذه المجموعة والمقاومة للبیتالاكتام.المقاومة لمجموعة الكاربابنیم Klebsiella pneumonia نستنتج من ھذه الدراسة أن ھنالك إنتشار كبیر لبكتریا تشجع نمو البكتریا المقاومة لمجموعة الكربابنیم) في الشخیص ) supercarba وبذلك نوصي بإعتماد الوسط الزرعي الروتیني لھذه البكتریا، فضلاً عن طریقة الإنتشار بالأقراص وإستخدام علاجات أخرى لالتھاب المجاري البولیة للتقلیل من المقاومة.


Article
Round Pneumonia
جولة الالتهاب الرئوي

Author: Ashoor R. Sarhat عاشور رفعت سرحت
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2007 Volume: 1 Issue: 131 Pages: 144-148
Publisher: Tikrit University جامعة تكريت

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Abstract

Round Pneumonia constitutes an atypical radiological presentation of pulmonary infections which occurs in less than 1% of cases of pneumonia. It is most commonly seen in children less than eight years of age and may simulate a pulmonary or mediastinal mass and is very rare in adults. The recognition of this entity is important, 1st in that the pneumonia may be confidently diagnosed as bacterial in etiology, usually pneumococcal; therefore appropriate antibiotic therapy may be instituted. 2nd ly, that in children it shouldn’t to be confused with mass which may have an alarming appearance on chest radiograph. So undue anxiety and unnecessary imaging may be avoided by properly diagnosing and treating the pneumonia. Here, are two cases of round pneumonia documented with their chest radiographs, which show radiological progression from round to lobar pneumonia followed by resolution after treatment with appropriate antibiotics

الالتهاب الرئوي جولة يشكل عرضا الإشعاعية شاذة من الالتهابات الرئوية التي تحدث في أقل من 1٪ من حالات الالتهاب الرئوي. هو الأكثر شيوعا وينظر إليه في الأطفال أقل من ثماني سنوات من العمر، وربما محاكاة الشامل الرئوي أو المنصف ونادر جدا في البالغين. الاعتراف بهذا الكيان هو المهم، في 1 التي يمكن أن الالتهاب الرئوي تشخيص بثقة والجرثومية في المسببات، الالتهاب الرئوي عادة، لا يجوز تحريك العلاج بالمضادات الحيوية المناسبة لذلك. 2 لاي، أن لدى الأطفال يجب أن لا يجب الخلط بينه والشامل الذي قد يكون له مظهر على نحو ينذر بالخطر تصوير شعاعي للصدر. ويمكن تجنب القلق لا مبرر له حتى والتصوير لا لزوم لها من خلال تشخيص سليم وعلاج الالتهاب الرئوي. هنا، نوعان من حالات الالتهاب الرئوي جولة موثقة مع صور الأشعة صدورهم، والتي تظهر تقدم الإشعاعية من جولة إلى التهاب رئوي فصي يليه قرار بعد العلاج بالمضادات الحيوية المناسبة


Article
Identification and treatment of a patient with pneumocystis pneumonia (case report)

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ABSTRACTA case of pneumocystis pneumonia was diagnosed on clinical and mycological grounds. A 35 - year - old man was presented with severe chest infection. His medical history included lymphoma for 5 years and under treatment with cytotoxic drugs. The patient diagnosed as a case of pneumonia and treated with antibiotics for one week but with no response. Later on, his sputum was sent for mycological examination that revealed the cysts and trophic forms of pneumocystis jirovecii. Good response with complete healing was achieved after 3 weeks of treatment with co-trimoxazole. Pneumocystis pneumonia may be suspected clinically in hospitalized patients, but this is the first case to be confirmed mycologicaly in Mosul. Good awareness of the full clinical spectrum of the disease aided by mycological study is needed to minimize the misdiagnosis of cases.Keywords: Pneumocystis jirovecii, pneumocystis pneumonia, pneumocystosis

الخلاصةشخصت حالة مريض متوقع الإصابة بذات الرئة بالمتكيسات الرئوية مختبرياً بالفحوصات الفطرية لتأكيد التشخيص السريري. أحيل رجل عمره 35 سنة إلى قسم العناية المركزة التنفسية في مستشفى ابن سينا التعليمي. حيث كان المريض مصاباً بسرطان الغدد اللمفية منذ 5 سنوات وتحت العلاج الدوري المستمر. يعاني المريض من التهابات رئوية معندة للمعالجة التقليدية. تم إرسال عينة من البلغم إلى مختبر الأحياء المجهرية في كلية طب الموصل للتحري عن المتكيسات الرئوية الفطرية. تم التشخيص الفطري بظهور الأكياس الفطرية لفطر pneumocystis jirovecii في البلغم. بعدها كانت استجابة المريض لعلاج co-trimoxazole لمدة ثلاثة أسابيع جيدة وتماثل للشفاء. من المتوقع ان مرض ذات الرئة بالمتكيسات الرئوية يصيب كثير من المرضى ضعيفي المناعة والراقدين في المستشفيات. قد تكون المرة الأولى التي تم التشخيص المختبري في الموصل لمثل هذه الحالة، لذا انه من المؤكد والمفيد أن تكون الإصابة بذات الرئة بالمتكيسات الرئوية من ضمن التشخيص التفريقي لأي حالة مماثلة مستقبلاً.


Article
Real-Time PCR For Direct Detection of Streptococcus Pneumoniae In Patients Suffering From Upper Respiratory Tract Infection in Babylon Province

Author: Abdul-kareem Salman Al-Yassari
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2014 Volume: 11 Issue: 3 Pages: 712-718
Publisher: Babylon University جامعة بابل

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Abstract

Streptococcus pneumoniae is one of the main humans pathogens, it is important cause of community-acquired pneumoniae. It causes clinical respiratory signs in lower and upper respiratory tract. S. pneumoniae may also occur in the upper respiratory tract, and can be detected from nasopharyngeal secretions. In this study, we developed a Real-Time PCR specific for direct detection of Streptococcus pneumoniae to be applied from nasopharyngeal secretions in adult patients with respiratory tract infections. The Real-Time PCR Primers were designed from the highly conserved of 16S ribosomal RNA gene of S. pneumoniae. Study results, were show that Real-Time PCR was highly sensitive and specific of up to 98% in detection of S. pneumoniae from nasopharyngeal secretions. Where, the bacteria recorded 34 positive out of 46 specimens (73.9%). The study concluded that the used Real-Time PCR assay was provide a sensitive and reliable means for rapid detection of S. pneumoniae in upper respiratory tract infection and this assay may serve a suitable molecular diagnostic tool for detection of S. pneumoniae from nasopharyngeal secretions.

تعتبر بكتيريا Streptococcus pneumonia واحدة من أهم العوامل المرضية للإصابة بالالتهابات الرئوية المكتسبة والتي تظهر اعراضها السريرية من خلال التهابات وإصابة الجهاز التنفسي العلوية والسفلية والتي تم عزلها من الإفرازات التنفسية من الانف والحنجرة ، في هذه الدراسة تم استخدام تقنية RT-PCR في التشخيص المباشر للإصابات التنفسية للمرضى من عينات الافرازات التنفسية وقد تم تصميم البرايمرات الخاصة بهذه الدراسة وفق البرنامج المتبع في تصميم البرايمرات على اساس جين 16S ribosomal RNA. أثبتت الدراسة أن تقنية PCR أكثر حساسية وخصوصية في التشخيص المباشر للعينات ووصلت النسبة في هذه الدراسة إلى 73,9%من العينات 34 من العدد الكلي البالغ 46 عينة إفراز تنفسي من المجرى الأنفي والحنجرة للمرضى المصابين بالتهابات الجهاز التنفسي العلوية والسفلية .


Article
Molecular Detection of CTX-M Genes in Klebsiella pneumoniae Isolated from Different Clinical Samples in Baghdad City

Author: Ahmed Salim Mohammed
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 1 Pages: 152-160
Publisher: Babylon University جامعة بابل

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Abstract

CTX-M extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae have been reported to be an important nosocomial infections. A total of 50 K. pneumonia isolates were isolated from different clinical samples in some public hospitals in Baghdad city during the period from October to December 2013. Bacterial identification was done using conventional cultural & chemical methods &and VITEK 2 cards (GN) for identification, while the antimicrobial drug susceptibility of K. pneumoniae was performed by disk diffusion test and the minimum inhibitory concentration (MIC) testing was performed using VITEK 2 automated system (bioMérieux, France). ESBL production was phenotypically detected by double disk synergy test according to the Clinical and Laboratory Standards Institute(CLSI) guidelines. The presence of bla-gene encoded CTX-M was detected by conventional PCR technique.Out of 50 K. Pneumonia isolates,13 (26%) were ESBL producer by CDT, the minimum inhibatory concentration (MIC) of different antibiotics was performed on these 13(26%) isolates using VITEK2 AST-GN30 showed that 13 (100%) isolates were Ceftazidime,Ceftraiaxone and Cefepime resistant with MIC ≥16- ≥64 µg/ml,and 8(61.53%) of ESBL producing isolates were carbapenem sensitive 8 (61.53%) with MIC <=0.25 µg/ml. PCR assay revealed that 4 (30.76%) of the ESBL producing isolates harbored blaCTX-M gene.Extended spectrum beta lactamase mediated resistance in K. pneumonia is a cause for concern in the therapy of critically ill patients. The ESBL producing K. pneumoniae isolates were more resistant to various antimicrobial agents. This suggests that ESBL producing isolates in hospitals may cause serious infections that illustrated when these strains were responsible for a nosocomial outbreak.The findings strongly suggest that there is a need to track the detection of ESBL producers and that judicious use of carbapenems is necessary to prevent the further spread of these organisms. The prevalence of multi-drug resistant K. pneumoniae isolates especially ESBL producing bacteria was increased in Baghdad city .Phenotypic and molecular characterization of ESBL provide information about the prevalence of ESBL producing K. pneumoniae in Baghdad. The blaCTX-M was one of the predominant ESBL genes in K. pneumoniae in this study.

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