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Background: Direct or indirect hand contact plays a significant role in health-care-associated infections. Family members of pediatric patients may have various hand hygiene practices. We aimed to evaluate the perceptions of hand hygiene and handshaking practices among family caregivers of hospitalized children in a tertiary care hospital. Methods: A cross-sectional study was conducted using a pretested two-part questionnaire for a randomly selected caregiver of hospitalized children at King Khalid University Hospital, Riyadh, Saudi Arabia, between January 21 and March 8, 2018. The survey data were analyzed using SPSS version 21. Results: One hundred and eighty caregivers voluntarily participated in the study. The mean age was 35.1 years, and female parents comprised 85.6% of the sample. The majority of participants (82.8%) did not receive any previous formal education on hand hygiene. Most of the participants (relative importance index of 84.6%) had correct answers on a modified version of the World Health Organization “Perception Survey for Health-Care Workers.” However, handshaking avoidance was low in general, with caregivers reporting their handshaking practices did not change even when dealing with people who have flu-like symptoms. There was no significant correlation between the participants' characteristics and handshaking avoidance practice, except for those who were working in the medical field, who showed a significantly higher handshaking avoidance. Conclusion: Formal education for hospitalized children's caregivers on hand hygiene and handshaking practice is lacking. Information on appropriate hand hygiene and potential risks of infection spread is required, especially for those parents without a previous medical background.

Aim: The incidence of urinary tract infections (UTIs) due to extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli is increasing worldwide. Infections with ESBL-producing E. coli are associated with prolonged length of hospital stay, cost, and need for parenteral therapy. This study was aimed to describe the prevalence and assess the risk factors of UTIs due to ESBL-producing E. coli and to describe the antimicrobial susceptibility patterns against E. coli. Methods: A retrospective, cross-sectional study was conducted at King Saud University Medical City from May 1, 2015, to May 1, 2016, and included all adult cases of UTIs caused by E. coli.Results: E. coli urine isolates were obtained from 301 patients; 107 (35.5%) isolates had ESBL-producing E. coli, and 194 (64.5%) had non-ESBL E. coli. On multivariate analysis, urinary catheterization (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.17–1.55, P < 0.00), antibiotic use in the past 3 months, (OR 1.3, 95% CI 1.16–1.4, P < 0.00), and diabetes mellitus (OR 1.2, 95% CI 1.04–1.31, P < 0.00) were significantly associated with ESBL-producing E. coli. infection. As expected, these ESBL producing isolates demonstrated higher resistance compared to non-ESBL E. coli to trimethoprim/sulfamethoxazole (64.5% vs. 43.8%), ciprofloxacin (64.4% vs. 28.7%), and gentamycin (36.4% vs. 9.2%). Conclusion: About one-third of UTI patients with E. coli presented with ESBL-producing bacteria. Significant risk factors were urinary catheterizations, history of antibiotic use, and diabetes mellitus. However, the associated OR was low for all predictors indicating their limited value in identifying patients at risk of ESBL.

Encephalitis is a serious clinical syndrome, which presents with a wide range of severity. Some cases might be missed due to non specific symptoms, especially in old debilitated patients and immunocompromised host. In this review, we cover the various clinical presentations of this syndrome and provide an overview of laboratory testing that can be performed in routine clinical microbiology laboratories and reference laboratories. Recently, the advance in medical care and advancing age of our patient population, as well as increased number of immunocompromised conditions either due to post chemotherapy, human immunodeficiency virus, transplant and autoimmune diseases complicated both clinical and laboratory diagnosis of encephalitis. Other noninfectious differential diagnoses of encephalitis should be ruled out with appropriate tests. There has been tremendous development in advanced laboratory testing including multiplex polymerase chain reaction, and next-generation sequencing requiring tedious validation and cost-effectiveness study to justify wise clinical utilization for these tests in the management of patients with encephalitis. Understanding of the interpretation of these new tests by treating physicians though better communication with medical microbiologists is required. Whole-genome sequencing is a new molecular test that enables us to detect a rare pathogen or even a new pathogen with a high degree of sensitivity and specificity if the standard recommendations are followed. The use of these tests should be available for specific clinical indications in an accredited reference laboratory for better utilization. Preanalytical parameters such as type of sample collected, tests requested, transportation, and storing of sample, could all affect the result of the test performed.

Background: This study was carried out to assess the prevalence and determinants of methicillin-resistant Staphylococcus aureus(MRSA) colonization among clinical clerkship medical students in Saudi Arabia. Methods: A cross-sectional study was performed at King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia. Nasal samples were obtained from 360 clinical clerkship medical students (3rd–5th years). Questionnaires were filled. MRSA identification was done using the standard laboratory procedures. Data were analyzed using SPSS Pc + 21.0 software. Results: Of 360 samples, 100 (27.7%) were positive for S. aureus and 12 (3.3%) were MRSA positive. The following variables and the outcome (MRSA+/MRSA−) showed statistically significant association; previous hospital admissions, immunocompromised status, chronic disease, and female gender. We found that our MRSA colonization prevalence rate of 3.3% predominately in female gender. Third-year medical students have the highest MRSA colonization of 4.8%, then 4th year 2.8%, and 5th year 1.2%. 17.6% of students with history of hospital admission where found to be MRSA positive, 10% of bronchial asthma sufferers, and 37.5% of immunocompromised students either due to medication or cancer were MRSA positive. Conclusion: MRSA nasal carriage among clinical medical students in KSUMC was found to be 3.3%. We recommend teaching standard practices of infection control protocols and additional precautions.