Search

Introduction: Considering the absence of effective treatment, the World Health Organization had recommended stringent infection prevention and control (IPC) measures against coronavirus disease 2019 (COVID-19) to reduce its transmission. The non-adherence of healthcare workers (HCWs) to these measures had been reported as a major cause of infection. Aim: To assess the level of self-reported adherence of HCWs to IPC measures during their social life and work time. Methods: This cross-sectional study included 559 HCWs (411 females and 148 males) working at 39 hospitals across different Egyptian governorates. A predesigned structured questionnaire about COVID-19 IPC measures was completed by trained interviewers. Results: Washing hands before eating (98.2%), using soap for hand wash (97.9%), washing hands after returning home (96.6%), and wearing a face mask when going outside in public places (83.7%) were the commonest daily-life practices among the 559 studied HCWs, while the least common was social distancing (46.0%). Less than half of the studied HCWs were adherent to the proper duration of handwashing (P < 0.01). Only 5.9% of the studied HCWs usually wore full personal protective equipment (PPE) at work (P = 0.051). The highest percentages of HCWs working at outpatient clinics and laboratories (98.1% each) ‘sometimes’ used PPE (P = 0.017). There was a significant difference in self-reported adherence to wearing face masks at hospitals according to specialties (P < 0.01). HCWs working at intensive care units (ICUs) recorded the highest attendance rates at IPC training (53.8%, P = 0.012). A relatively higher percentage of HCWs at COVID-19 isolation hospitals wore PPE (15.7%) versus 2.2–4.7% in other hospitals (P = 0.015). Conclusion: The majority of HCWs sometimes complied with wearing PPE (93.6%). HCWs were more adherent to wearing masks at hospitals (94.6%) compared to community settings (42.9%). Older age and female gender were significantly associated with self-reported adherence to some IPC measures. Hand hygiene training session emphasizing the proper duration of hand wash is mandatory.

Background: T2DM patients are more likely to have UTIs caused by resistant organisms such as ESBLs producing bacteria. Challenging reliable identification and prompt characterization of in-vitro susceptibilities of these bacteria are the first steps of deciding the appropriate antimicrobial therapy for UTIs caused by them. Objectives: To isolate and identify E. coli and K. pneumoniae from urine of T2DM patients with UTIs, to determine antibiotic resistance pattern among isolates, and to identify ESBLs production phenotypically and genotypically. Material and method: All samples were cultured on Cystine-Lactose-Electrolyte-Deficient Agar medium (CLED) by using calibrated loop. Growth of 100 colonies or more, i.e. 105 colony forming units (CFU)/mL urine was considered as signifi- cant bacteriuria. Isolation and identification were done according to standard method. All isolates were tested for antibiotic susceptibility testing by the disc diffusion method according to CLSI guidelines. Phenotypic detection of ESBLs was done by double-disk synergy test. Genotypic detection of blaTEM, blaSHV and blaCTX-M genes by using PCR. Results: Results of this study showed that E. coli and K. pneumoniae were the dominant bacterial isolates, they constituted 103 (91.2%) out of 113 urine isolates. E. coli (58. 4%) K. pneumoniae (32.7%), Enterococcus spp. (4.4%), Proteus spp. (2.7%) and Pseu- domonas spp. (1.8%). About 25 (24.3%) out of 103 E. coli and K. pneumoniae isolates were ESBLs positive by DDST, and 22 (88.0%) out of them had ESBLs encoding genes by conventional PCR. The most common gene detected was blaTEM (59.1%), followed by blaSHV (27.3%). CTX-M had not been detected in any of testes isolates. Conclusion: blaTEM and blaSHV genes were detected in 22 out of 25 ESBLs producing E. coli and K. pneumoniae isolates phenotypically detected by DDST. blaTEM was found to be the predominant gene (59.1%), while blaCTX-Mene was not detected in any of tested isolates. Keywords: Extended Spectrum β-Lactamases; Type 2 diabetes mellitus; Urinary tract infections; Phenotypic; genotypic methods.

Background: To determine minimum inhibitory concentration (MIC) of the Eucalyptus essential oil (EEO) and different antibiotics on Staphylococcus aureus ATCC 29213 and Pseudomonas aeruginosa ATCC 27853, and on twenty bacterial isolates from wound swabs (10 S. aureus and 10 P. aeruginosa). In addition, to evaluate the antibacterial effect of combinations of EEO with selected antibiotics. Methods: Skin infection swabs were cultured; all bacterial isolates were identified according to conventional methods. Ten-gram positive isolates (S. aureus), and ten gram negative isolates (P. aeruginosa) were used to determine MIC of some antibiotics and EEO by broth microdilution methods. Checkerboard method was used to calculate fractional inhibitory concentration indexes. Findings: EEO exhibited a synergistic activity against S. aureus ATCC 29213 but only gave additive effect against P. aeruginosa ATCC 27853. Outcome of oil/vancomycin combination found to be synergistic in all tested clinical S. aureus isolates from infected wound swabs. While 80% of clinical P. aeruginosa isolates showed additive outcome of EEO/ ceftazidime combination, and only 20% of them gave indifference outcome. Application: Dermatological applications of EEOs have been growing with great popularity worldwide. It can be used as ointments to treat various dermatological conditions such as abscesses, athlete’s foot, dermatitis, bacterial infections, blisters, boils, burns, cuts, and wounds Keywords: Bacterial Drug Resistance; Essential Oils; Infected Wounds; Natural Compounds, Synergism.

Background The context and purpose of the study: The spready dissemination of resistance mechanisms among extended spectrum beta-lactamases (ESBL) producing bacterial isolates has increasingly been reported. There is an urgent need to explore the antibacterial property of nontoxic biosafe compounds. This In-vitro experimental study aimed to evaluate the effect of silver nanoparticles (AgNPs) alone and in combination with ineffective antibiotics against ESBL producing isolates. Results Ciprofloxacin with AgNPs combination had the highest synergistic percentage against 91.43% of ESBL Escherichia coli isolates, and it was additive against 8.57% of them. As regards ESBL K. pneumoniae isolates, AgNPs with cefotaxime were synergistic against 75.00% of them, followed by ceftazidime and ciprofloxacin (62.50%). The least effective combination was ampicillin with AgNPs. The greatest enhancement of activity of the antibiotics was observed at silver minimum inhibitory concentration (MICAg) MICAg/2 and MICAg/4. At lower AgNPs concentrations, enhanced effects were less obvious. AgNPs inhibited the production of beta-lactamase enzymes in 91.43% of E. coli and 75% of Klebsiella pneumoniae isolates. Conclusion AgNPs are a valuable alternative to combat drug resistance, as they had synergistic effects when combined with different ineffective antibiotics against ESBL producing bacteria. AgNPs had lowered MIC values of antibiotics by several folds. Moreover, they inhibited the production of beta-lactamase enzymes.

BACKGROUND The central venous line is an essential component in monitoring and managing critically ill patients. However, it poses patients with increased risks of severe infections with a higher probability of morbidity and mortality. AIM To define the trends of the rates of central line-associated bloodstream infections (CLABSI) over four years, its predicted risk factors, aetiology, and the antimicrobial susceptibility of the isolated pathogens. METHODS The study was a prospective case-control study, performed according to the guidelines of the Center for Disease Control surveillance methodology for CLABSI in patients admitted to the adult intensive care unit (ICU) and auditing the implementation of its prevention bundle. RESULTS Thirty-four CLABSI identified over the study period, giving an average CLABSI rate of 3.2/1000 central line days. The infection's time trend displayed significant reductions over time concomitantly with the CLABSI prevention bundle's reinforcement from 4.7/1000 central line days at the beginning of 2016 to 1.4/1000 central line days by 2018. The most frequently identified pathogens causing CLABSI in our ICU were gram-negative organisms (59%). The most common offending organisms were Acinetobacter, Enterococcus, and Staphylococcus epidermidis, each of them accounted for 5 cases (15%). Multidrug-resistant organisms contributed to 56% of CLABSI. Its rate was higher when using femoral access and longer hospitalisation duration, especially in the ICU. Insertion of the central line in the non-ICU setting was another identified risk factor. CONCLUSION Implementing the prevention bundles reduced CLABSI significantly in our ICU. Implementing the CLABSI prevention bundle is crucial to maintain a substantial reduction in the CLABSI rate in the ICU setting.