Background: Chronically infected wounds represent a major public health problem which is associat... more Background: Chronically infected wounds represent a major public health problem which is associated with increased morbidity and mortality, particularly with the global threat of antimicrobial resistance. Objectives: Isolation of pathogenic microorganisms from chronic ulcerative lesions, identification and evaluation of their biofilm formation and antimicrobial resistance pattern. Methodology: This study was carried out on 50 specimens, collected from chronic ulcerative lesions of patients admitted to the Inpatient and Outpatient Surgical Units, Tanta university hospitals. Pathogenic organisms were isolated and identified. Antimicrobial susceptibility was determined, and biofilm formation assay was performed using a tissue culture plate method. Results: The most frequently isolated organisms were Pseudomonas spp. (26.42%), Klebsiella spp. (24.52%) then E. coli (16.98%). All E. coli isolates showed resistance to aztreonam and Ampicillin /sulbactam. Also, all Klebsiella isolates showed resistance to ciprofloxacin, levofloxacin and Ceftazidime. While 92.86% of Pseudomonas isolates showed resistance to Ceftazidime. About 58.5 % of isolated pathogens were biofilm producers with Pseudomonas spp. were the most frequently biofilm producers. Conclusion: The isolated pathogens showed high rate of resistance to most of the tested antimicrobial agents, with high rate of biofilm formation among most of isolates.
Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has b... more Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has been proven to be an escalating public health challenge in Egypt owing to its high mortality rate and raised health care costs. Purpose: Detection of carbapenem-resistant gram-negative bacilli among VAP patients, genotypic identification of carbapenemase genes in the isolated strains with evaluation of their impact on patient outcome and detection of carbapenemase-producing enterobacterales by MASTDISCS combi Carba plus disc system. Methods: Broncho-alveolar lavage fluid (BALF) and endotracheal aspirate were collected aseptically from clinically suspected VAP patients. Pathogen identification and antibiotic sensitivity testing were done. Carbapenemase-encoding genes (bla KPC , bla NDM , and bla OXA-48) were tested by PCR in all carbapenem-resistant gram-negative isolates. Performance of MASTDISCS combi Carba plus in isolated Enterobacterales was assessed in relation to the PCR results. Results: Eighty-three carbapenem-resistant gram-negative isolates were detected. The most frequent pathogens were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa representing 34.9%, 20.5% and 18.1%, respectively. bla KPC was the predominant gene. Patients with persistent mechanical ventilation less than 15 days and Pseudomonas aeruginosa infection were significantly associated with a higher death rate. MAST-Carba plus had the highest sensitivity, specificity, positive and negative predictive values for detecting OXA-48 carbapenemases representing 81.8%, 92.5%, 75% and 94.9%, respectively. Conclusion: Worse outcome in VAP patients was associated with carbapenem-resistant gram-negative bacilli. MASTDISCS combi Carba plus is an efficient simple method for identification of different carbapenemases among enterobacterales.
Background: The primary burden among severely ill COVID-19 cases allocated to ICUs is secondary b... more Background: The primary burden among severely ill COVID-19 cases allocated to ICUs is secondary bacterial and fungal infections. Antimicrobial resistance is aggravated more likely by empiric overusing of antimicrobials. This study aimed to assess the microbiological profile of fungal and bacterial superinfections in laboratory confirmed COVID-19 cases and their antimicrobial susceptibility pattern. Methods: Various clinical samples were obtained from 117 critically ill COVID-19 patients in the clinical suspicion of secondary infections for assessing the pathogens accountable for the superinfections and their antimicrobial susceptibility pattern according to standard microbiological procedures. Results: Among 117 COVID-19 patients allocated to ICU, 68 (58%) had secondary infections. The most prevalent infection was of the lower respiratory tract. Most infections were bacterial 85.8%. Gramnegative isolates were the most predominant strains, accounting for 71.7%. among them, Klebsiella pneumoniae 43.4 % and Acinetobacter baumannii 20.7% were the most predominant. Majority of the bacterial strains were multidrug-resistant, all gram-negative strains showed one hundred percent resistance rate to cephalosporins, amoxicillin, and amoxicillin-clavulanic. The lowest resistance was observed for tigecycline. All gram-positive strains were susceptible to linezolid and vancomycin. Additionally, all candida isolates were susceptible to the tested antifungals. Conclusions: In hospitalized severely ill COVID-19 patients, secondary infections are most frequently caused by Gram-negative pathogens exhibiting high rate of antibiotic resistance and are associated with poor outcomes. Strict adherence to infection control measures as well as regular microbiological surveillance are required.
Background: Chronically infected wounds represent a major public health problem which is associat... more Background: Chronically infected wounds represent a major public health problem which is associated with increased morbidity and mortality, particularly with the global threat of antimicrobial resistance. Objectives: Isolation of pathogenic microorganisms from chronic ulcerative lesions, identification and evaluation of their biofilm formation and antimicrobial resistance pattern. Methodology: This study was carried out on 50 specimens, collected from chronic ulcerative lesions of patients admitted to the Inpatient and Outpatient Surgical Units, Tanta university hospitals. Pathogenic organisms were isolated and identified. Antimicrobial susceptibility was determined, and biofilm formation assay was performed using a tissue culture plate method. Results: The most frequently isolated organisms were Pseudomonas spp. (26.42%), Klebsiella spp. (24.52%) then E. coli (16.98%). All E. coli isolates showed resistance to aztreonam and Ampicillin /sulbactam. Also, all Klebsiella isolates showed resistance to ciprofloxacin, levofloxacin and Ceftazidime. While 92.86% of Pseudomonas isolates showed resistance to Ceftazidime. About 58.5 % of isolated pathogens were biofilm producers with Pseudomonas spp. were the most frequently biofilm producers. Conclusion: The isolated pathogens showed high rate of resistance to most of the tested antimicrobial agents, with high rate of biofilm formation among most of isolates.
Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has b... more Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has been proven to be an escalating public health challenge in Egypt owing to its high mortality rate and raised health care costs. Purpose: Detection of carbapenem-resistant gram-negative bacilli among VAP patients, genotypic identification of carbapenemase genes in the isolated strains with evaluation of their impact on patient outcome and detection of carbapenemase-producing enterobacterales by MASTDISCS combi Carba plus disc system. Methods: Broncho-alveolar lavage fluid (BALF) and endotracheal aspirate were collected aseptically from clinically suspected VAP patients. Pathogen identification and antibiotic sensitivity testing were done. Carbapenemase-encoding genes (bla KPC , bla NDM , and bla OXA-48) were tested by PCR in all carbapenem-resistant gram-negative isolates. Performance of MASTDISCS combi Carba plus in isolated Enterobacterales was assessed in relation to the PCR results. Results: Eighty-three carbapenem-resistant gram-negative isolates were detected. The most frequent pathogens were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa representing 34.9%, 20.5% and 18.1%, respectively. bla KPC was the predominant gene. Patients with persistent mechanical ventilation less than 15 days and Pseudomonas aeruginosa infection were significantly associated with a higher death rate. MAST-Carba plus had the highest sensitivity, specificity, positive and negative predictive values for detecting OXA-48 carbapenemases representing 81.8%, 92.5%, 75% and 94.9%, respectively. Conclusion: Worse outcome in VAP patients was associated with carbapenem-resistant gram-negative bacilli. MASTDISCS combi Carba plus is an efficient simple method for identification of different carbapenemases among enterobacterales.
Background: The primary burden among severely ill COVID-19 cases allocated to ICUs is secondary b... more Background: The primary burden among severely ill COVID-19 cases allocated to ICUs is secondary bacterial and fungal infections. Antimicrobial resistance is aggravated more likely by empiric overusing of antimicrobials. This study aimed to assess the microbiological profile of fungal and bacterial superinfections in laboratory confirmed COVID-19 cases and their antimicrobial susceptibility pattern. Methods: Various clinical samples were obtained from 117 critically ill COVID-19 patients in the clinical suspicion of secondary infections for assessing the pathogens accountable for the superinfections and their antimicrobial susceptibility pattern according to standard microbiological procedures. Results: Among 117 COVID-19 patients allocated to ICU, 68 (58%) had secondary infections. The most prevalent infection was of the lower respiratory tract. Most infections were bacterial 85.8%. Gramnegative isolates were the most predominant strains, accounting for 71.7%. among them, Klebsiella pneumoniae 43.4 % and Acinetobacter baumannii 20.7% were the most predominant. Majority of the bacterial strains were multidrug-resistant, all gram-negative strains showed one hundred percent resistance rate to cephalosporins, amoxicillin, and amoxicillin-clavulanic. The lowest resistance was observed for tigecycline. All gram-positive strains were susceptible to linezolid and vancomycin. Additionally, all candida isolates were susceptible to the tested antifungals. Conclusions: In hospitalized severely ill COVID-19 patients, secondary infections are most frequently caused by Gram-negative pathogens exhibiting high rate of antibiotic resistance and are associated with poor outcomes. Strict adherence to infection control measures as well as regular microbiological surveillance are required.
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Papers by Eman Hegazy