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Enterobacter species are members of ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species) which are described as the leading cause of resistant nosocomial infections.Objectives: The present study aimed to estimate the frequency of Multi-Drug resistant Enterobacter species isolated from Patients with different Clinical manifestations in Khartoum state, Sudan.Methods: A cross-sectional laboratory-based study was conducted from February 2021 to October 2021. To isolate and identify Enterobacter species from different clinical specimens by conventional cultural methods, and to determine the antimicrobial profile of Enterobacter species by Kirby–Bauer disc diffusion technique.Result: A total of three hundred and eighty-four (n=384) different clinical specimens (urine 232(60%), wound swab 61 (16%), sputum 19(5%), and blood 72 (19%) specimens were collected from Yastabshiroon Hospital, Khartoum, 129(33.6%), Ribat Teaching Hospital, Khartoum, 255(66.4%), 173 (45.0%) were from males, while 212 (55.0%) from females, among 154(40%) bacterial isolate 22(14.3%) were identified as Enterobacter spp. All Enterobacter spp isolates (100%) were multidrug resistant, The Prevalence rates of resistance of the isolates among antibiotic classes were as follows; (Penicillin 100%, Cephalosporin 96.4%, Tetracycline group 100%, Aminoglycosides 47.7%, Sulfonamides and trimethoprin 86.4%, Nitrofuran 100%, Quinolone 72.75%, Glycopeptides 100%, Chloramphnicol 100%, Tetracycline 81.8% and Carbapenem 52.3%).Conclusion: This study is the first study reporting the frequency of Multi-drug resistance Enterobacter species in Sudan. The results of this study indicated the high prevalence of Enterobacter species resistant to the majority of assessed antibiotics, and high prevalence rates of carbapenemase and ESBL-producing Enterobacter species In Khartoum- Sudan. [ABSTRACT FROM AUTHOR]

Background: P.aeruginosa infection is one of the major health problems in the world. It’s an opportunistic human pathogen that causes serious problems. Usually resistant to several antibiotics, show a particular ability to spread in hospitals. In recent times, Metallo-β-lactamase resistance in this bacterium has imposed some difficulties in treating bacterial infections. This study was a qualitative study, aimed to detect Metallo-βLactamase in Carbapenems-resistant P. aeruginosa isolated from inpatients admitted to Intensive Care Unit and Operating Room in different hospitals in Jeddah city, KSA during the period from March 2019 to September 2022.Methods: In this study, a total of (234) were cultured and identified using API 12A/12E. All isolates were subjected to antimicrobial susceptibility testing using Kirby Bauer method, for selected imipenem and meropenem. Results: Out of 234 specimens 154 Pseudomonas aeruginosa were isolated and identified, with different ratios (males, 62.3: females, 37.7), which occurred highest in the adult age group. The highest frequency of isolate 152 (98.7%) was in the intensive care unit while the lowest frequency of isolate 2 (1.3%) was in the operating room. (9%), (5.8%), (10.38%) and (1.2%) were found resistant to imipenem, meropenem, ciprofloxacin and amikacin respectively.Conclusion: Carbapenems have great bactericidal activity against Ps. aeruginosa, while, this notorious pathogen acquisition resistance against these drugs and limited treatment options. Our isolated strains showed a low rate of resistance (9%) and (5.8%) against imipenem and meropenem respectively. Aminoglycoside is crucial for the treatment of various Ps. aeruginosa infections. However, our study showed that (1.2%) of Ps. aeruginosa strains were resistances to amikacin and Ciprofloxacin has been extensively used to treat wide a variety of Ps. aeruginosa infections. While Ps. aeruginosa rapidly acquired resistance to ciprofloxacin that creating a therapeutic challenge. In this study, 10.38% of Ps. aeruginosa was found resistant to Ciprofloxacin. We recommended further studies and a regular monitoring system for the early detection of MBL-producing organisms. [ABSTRACT FROM AUTHOR]

Background: Staphylococcal enterotoxins (SEs) are family members of more than 20 different staphylococcal and streptococcal exotoxins. SEA and SEB are the most common toxins in staphylococcus-related food poisoning. Objectives The present study aimed to estimate the prevalence of SEs Methicillin-Resistant Staphylococcus aureus (MRSA) isolated from different clinical samples. Methods: A cross-sectional laboratory-based study was conducted from November 2020 to January 2021. To isolate and identify S. aureus, the conventional method and protein A latex test were used. MRSA was detected using methicillin (MET 5μg) by using the Kirby-Baur disk diffusion method. Extracted DNA was amplified for the specific Staphylococcal enterotoxins (SE) gene to confirm the SEA, SEB and SEC. Result: The SEA gene was observed among 120 (100%) clinical isolates. The combined staphylococcal enterotoxin genes A, B and C were found in 33.3% of the isolates. Respiratory tract infection (RTI) shows the highest percentage of SEA 28.3%. Conclusion: The present study showed a high prevalence of SEA in clinical settings at Khartoum State. A high prevalence of the combination of more than one gene occur in SEA with SEC, which was represented 82.5%. The present study showed a strong relationship between MRSA and SEA that could be due to a specific strain of MRSA carrying the SEA gene. Further studies should be done about Staphylococcal enterotoxins. [ABSTRACT FROM AUTHOR]

Background: The interaction of T cells with infected macrophages depends on the interplay of cytokines produced in each cell, and this mechanism is a key to protective immunity against Mycobacterium tuberculosis. Extensive research has been devoted to studying the changes in systemic cytokine levels in patients with tuberculosis (TB), but the results are inconclusive. Determine Th1 and Th2 cytokine immune response levels among new TB patients compared to follow-up and healthy control. Design: Cross-sectional laboratory-based study. Setting: Immunology Laboratory, National Center for Research. Methods: Blood samples (n = 145) were collected from confirmed new TB cases, follow-up TB cases, and from healthy controls. Participants were initially diagnosed by microcopy using Ziehl--Neelsen smear method and confirmed by polymerase chain reaction using IS6110. Cytokine levels (interleukin-10 [IL-10], tumor necrosis factor alpha [TNF-α], and Interferon-gamma [IFN-γ]) were measured directly from plasma using sandwich enzyme-linked immunosorbent assay. Main Outcome Measures: Measuring Th1 cytokines (IFN-γ and TNF-α) and Th2 cytokine (IL-10). One hundred and forty-five cases (new TB cases, 85; follow-up, 25; and healthy control, 35) were included in this study. Results: The study population were mainly males (70.3%) compared to females (29.7%) and 87.5% aged between 21 to 60 year. The plasma IFN-γ levels were found significantly higher in new TB cases (mean 35.38 pg/m; confidence interval: 29.32-41.43) than in the follow-up patients and the healthy control (P = 0.000). There were no significant differences in TNF-α and IL-10 levels among the new TB cases and the follow-up and healthy control (P = 0.852 and P = 0.340, respectively). Conclusions: Direct plasma IFN-γ level can be used in TB patient follow-up as a recovery marker as it correlated well with the appearance of the disease and treatment response. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to highlight the importance of mutations within Proteus mirabilis genome that are related to fluoroquinolone resistance. Methods: This is a cross sectional study performed in different teaching hospitals in Khartoum State from June 2016 to May 2017. A total of (120) P mirabilis isolates from patients with symptoms of UTIs attending different hospitals in Khartoum State were examined. First, modified Kurby Bauer method was performed for phenotypical detection of resistant isolates. Then polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) followed by sequencing were applied for detection of mutations in GyrA, GyrB, ParC and ParE genes of isolates. Results: P. mirabilis showed 30% resistance to ciprofloxacin. All samples revealed mutation at (serine 83) of GyrA and (serine 84) of ParC by Hinf1 restriction endonuclease digestion. Sequencing was performed for 12 samples. For each gene, two resistant and one susceptible strains were randomly selected. The mutations associated with ciprofloxacin resistant P. mirabilis were as follows; (1/3) GyrA (Ser 83 to Ile) and (2/3) ParC (Ser 81 to Ile). Also it revealed silent mutations at codons of GyrB 474 leucine (3/3), 585 valine (2/3), 612 histidine (1/3) and 639 asparagine (1/3) and ParE 469 isoleucine (2/3), 531 aspartic (2/3) and 533 glycine (1/3). Conclusions: Ciprofloxacin resistance in P. mirabilis could be monitored through detection of mutations within DNA gyrase (encoded by gyrA and gyrB) and topoisomerase IV (encoded by parC and parE). [ABSTRACT FROM AUTHOR]

Objective: To investigate the epidemiological trends of cutaneous leishmaniasis (CL) in Al-Madinah Al-Munawarah, western region of KSA. Materials and Methods: Four hundred and sixty-seven parasitologically confirmed CL cases attending Al-Meeqat Hospital, Al-Madinah, during 2012-2015, were included in this study. Results: Both Saudi and non-Saudi nationals were infected, with the highest infection rate being among Saudis (68.7%). Males were more affected than females as 86.9% of the total CL cases were males. Moreover, CL was prevalent in all age groups with higher frequency among young adults and adolescents (23.1% and 22.7%, respectively). Interestingly, almost all the patients in the adolescent and child age groups were Saudis (96.2% and 93.5%, respectively). Considering geographical distribution, the highest percentage of the cases (40.5%) were from the northern parts of Al-Madinah province while the eastern parts reported the least infection rate (7.3%). Few cases (2.5%) were supposed to encounter the infection abroad. Additionally, the frequency of infection was found to follow a seasonal distribution. Regarding treatment, pentostam, ketoconazole, or cryotherapy were the treatment options usually used. Conclusion: CL is prevalent in Al-Madinah Al-Munawarah area and new foci are being introduced. Thus, detailed studies with large surveillances regarding vector and reservoir hosts in and around the area are needed. [ABSTRACT FROM AUTHOR]

This study was carried out in Khartoum state during the period from January 2010 to December 2013 to detect Mycobacterium tuberculosis in children with symptoms of tuberculosis infection using different conventional and advanced diagnostic techniques. One hundred ninety seven specimens of gastric lavage and sputum were collected from different hospital in Khartoum state.specimens were decontaminated and inoculated on Lowenstein Jensen media according to modified Pettrof's method, two smears were prepared and stained by Ziehl Neelsen stain bacterial DNA was extracted from each specimen by using phenol chloroform method, and then the Polymerase Chain Reaction technique was adopted to detect Insertion Sequence IS6110 gene of M. tuberculosisin in these specimens. This study showed that the positive results for ZN, Culture and PCR were 16 (8.1%), 32 (16.2%) and 35(17.8%) respectively. The study concluded that the PCR technique is a most sensitive and specific technique for a fast identification of M. tuberculosis in gastric lavage and sputum from children who are unable to expectorate good quality sputum sample or diagnosed as negative using conventional diagnostic methods. [ABSTRACT FROM AUTHOR]

Absolute dependence on mecA gene as the defining standard in determining the resistance of S. aureus to methicillin became the subject of distrust by many researchers. The present study aimed to determine the frequency of mecA gene in methicillin resistant S. aureus (MRSA) isolates using polymerase chain reaction and to correlate its presence to conventional method. In this regard, two hundred S. aureus isolates were collected from patients with different diseases attending different hospitals in Shandi City, Sudan. Phenotypic Kirby-Bauer method confirmed the existence of methicillin resistant S. aureus in 61.5% of the subjected isolates with MICs ranging from 4 μg/mL to 256 μg/mL when using E-test. However, when amplifying a 310 bp fragment of the mecA gene by PCR, twelve out of the 123 MRSA isolates (9.8%) were mecA negative, whereas all the 77 methicillin sensitive S. aureus (MSSA) were mecA negative. In conclusion, this study drew attention to the credibility of the mecA gene and its usefulness in the detection of all MRSA strains without referring to the traditional methods. Hence, it is highly recommended to consider alternative mechanisms for β-lactam resistance that may compete with mecA gene in the emergence of MRSA phenomenon in the community. [ABSTRACT FROM AUTHOR]

Since the authors are not responding to the editor’s requests to fulfil the editorial requirement, therefore, the article has been withdrawn from the journal "Infectious Disorders - Drug Targets" Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused., Bentham Science Disclaimer: It is a condition of publication that manuscripts submitted to this journal have not been published and will not be simultane-ously submitted or published elsewhere. Furthermore, any data, illustration, structure or table that has been published elsewhere must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and by submit-ting the article for publication the authors agree that the publishers have the legal right to take appropriate action against the authors, if plagiarism or fabricated information is discovered. By submitting a manuscript the authors agree that the copyright of their article is transferred to the publishers if and when the article is accepted for publication., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Infections caused by Nocardia are rare, but misguided to clinicians, especially if there is a delay in the diagnosis and/or low response to chemotherapy. The incidence of nocardiosis is increasing constantly worldwide, and the situation is getting worse if we consider immunocompromised individuals, such as human immune virus (HIV) positive patients since they are at higher risk. Surgical amputation, although not common, but should be considered as a result in some cases that cause partial disability., Aims: To throw light on the situation of nocardiosis in Sudan, the possible reasons for the increased prevalence are investigated and discussed the possible strategies for prevention and control. Data Review: PubMed investigations were adopted using terms that included nocardiosis in Sudan as well as in other parts of the world. Part of the review has been retrieved from the main library of the postgraduate college, University of Khartoum and University of Newcastle upon Tyne., Findings: In Sudan, nocardiosis revealed wide geographical distribution; different cases were reported from western, middle as well as the northern parts of the country. Moreover, several clinical presentations were seen. While pulmonary, coetaneous and subcutaneous infections represent the primary types caused by Nocardia, disseminated infection in two or more organs had also been reported. As in all other infectious diseases, opportunistic nocardiosis is more prevalent among HIV patients. Zoonotic transmission of the disease was also proved; several cases of bovine and caprine mastitis were due to one or another species of Nocardia. The effect of ecology on the prevalence and pathogenicity of Nocardia is proved by the isolation of Nocardia and other actinomycetes from Sudanese soil, which represents the most probable source of infection. Regarding treatment, effective results are usually obtained by the use of sulfonamides and thirdgeneration cephalosporins. However, surgical interference is also used when necessary, such as in cases of drainage of abscesses., Conclusion: Since the description of Nocardia by Edmond Nocard in 1888, it started to be well known worldwide. In Sudan, however, the awareness regarding this bacterium is still below the level and is only due to the end of the fifties of the twentieth century, which is relatively late. Hence, attention towards this neglected pathogen may lead to early recognition and prompt treatment, resulting in complete cure., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: The pattern of Mycobacterium tuberculosis susceptibility to first line drugs and multidrug resistance in Al-Madinah Al-Munawarah, a seasonally overcrowded are during Hajj and Omrah, is not well studied., Objective: This study aimed to investigate anti-tuberculosis drug resistance and its distribution among new cases in Al-Madinah Al-Monawarah., Methods: Study subjects included 622 patients with first time confirmed TB referred to the central tuberculosis laboratory in Al-Madinah between January 2012 and December 2014., Results: Out of the 622 isolates, 99 (15.9%) were Mycobacteria Other Than Tuberculosis (MOTTS) and 25 (4.0%), three of which (12%) were children under five years of age, revealed multidrug resistance (MDR). Monoresistance to isoniazid (H) was (1.8%), to rifampin (R) was (1.4%), to streptomycin (S) was (1.9 %) to ethambutol (E) was (1.1 %) and to pyrazinamide (Z) was (2.1%)., Conclusion: Being among the new cases, multidrug resistant tuberculosis (MDR TB) is supposed to be caused by strains which are originally multidrug resistant. Neither nationality nor gender was found to be associated with MDR TB. Since 12% of MDR cases were among children, a probability of primary infection with MDR strains is to be considered. Moreover, mass gathering during Hajj and Omrah seasons does not seem to increase the burden of MDR in the region. However, further investigation is needed to molecularly characterize MDR isolates and their phylogenetics and geographical origin., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)