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Souha S Kanj

Publications and source records attributed to Souha S Kanj.

At least 19 recordsLinked to original sources
PubMed2025

Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM.

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal resistance. Pathogens, such as Candida auris (Candidozyma auris) and fluconazole-resistant Candida parapsilosis, pose serious global health risks. Recent taxonomic revisions have reclassified several Candida spp, potentially causing confusion in clinical practice. Current management guidelines are limited in scope, with poor coverage of emerging pathogens and new treatment options. In this Review, we provide updated recommendations for managing Candida infections, with detailed evidence summaries available in the appendix.

Humans↗
PubMed2006

Surgical site infections following spinal surgery at a tertiary care center in Lebanon: incidence, microbiology, and risk factors.

Surgical site infections (SSIs) following spinal surgery are associated with significant morbidity and long-term complications. The epidemiology of these infections has not been previously studied in Lebanon. This nested case-control study was conducted between 2001 and 2003 at the American University of Beirut Medical Center. Cases were defined as patients who developed surgical site infection within 30 d of surgery. Controls were patients with no evidence of infection. There were 27 cases of surgical site infections among 997 surgeries with an incidence of 2.7%. Compared to controls, cases were older (mean age 59 vs 47 y, p=0.001), and were more likely to have diabetes (OR = 4.0; 95% CI 1.2-12.8) and foreign body implantation (OR = 3.4; 95% CI 1.3-9.3). Antibiotic prophylaxis was given for a range of 0-6 d in cases and 0-7 d in controls. Coagulase-negative staphylococci were the most commonly isolated organisms. Hospital stay was significantly longer in cases than controls. The rates of surgical site infections following spinal surgery at our center are comparable to worldwide rates. There is unjustified overuse of prophylactic antibiotics in our patients that has the potential of inducing emergence of antimicrobial resistance.

Adult↗
PubMed2006

Efficacy and safety of rabeprazole, amoxicillin, and gatifloxacin after treatment failure of initial Helicobacter pylori eradication.

OBJECTIVES: To evaluate the efficacy of a 7-day regimen of gatifloxacin (400 mg daily), amoxicillin (1 g twice a day), and rabeprazole (20 mg twice a day) in the secondary eradication of Helicobacter pylori infection. METHODS: Eligible patients with persistent infection following one or more conventional clarithromycin-containing triple therapies were enrolled in this open-label trial. Eradication of infection was documented by (14)C-urea breath test a minimum of 4 weeks after therapy and 2 weeks off any acid suppressive therapy. Culture of H. pylori and in vitro susceptibility testing to amoxicillin, clarithromycin, and gatifloxacin was done in cases of failed eradication. RESULTS: A total of 45 patients (22 females:23 males; mean age 44.5 +/- 13 years) were enrolled. Eradication occurred in 38 patients [both per-protocol (PP) and intention-to-treat analysis: 84.4%; 95% CI: 74-95%]. No significant adverse effects were reported. In vitro susceptibility testing showed no secondary resistance to gatifloxacin or amoxicillin in any of the seven nonresponders. Smoking, age, and sex were not predictors of potential eradication failure. CONCLUSIONS: A 7-day regimen of gatifloxacin, rabeprazole, and amoxicillin is effective after failed eradication therapy for H. pylori and does not appear to result in secondary resistance. This combination is simple, well tolerated, and may lead to higher compliance and lower costs.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2005

Ceramide regulates SR protein phosphorylation during adenoviral infection.

In this study, we show that adenoviral infection induced accumulation of the sphingolipid ceramide in a dose- and time-dependent manner. This accumulation preceded cell lysis, occurred in the absence of biochemical evidence of apoptosis, and was derived from de novo synthesis of ceramide. An adenovirus mutant that lacks the adenovirus death protein (ADP) produced ceramide accumulation in the absence of cell lysis. This suggested that ceramide accumulation was either driven by adenovirus or was a cellular stress response but was unlikely a result of cell death. The use of inhibitors of ceramide synthesis resulted in a significant delay in cell lysis, suggesting that ceramide was necessary for the lytic phase of the infection. Serine/arginine-rich (SR) proteins were dephosphorylated during the late phase of the viral cycle, and inhibitors of ceramide synthesis reversed this. These findings suggest that adenovirus utilizes the ceramide pathway to regulate SR proteins during infection.

Adenoviridae↗
PubMed2005

Antibiotic use in acute cholecystitis: practice patterns in the absence of evidence-based guidelines.

OBJECTIVES: Antibiotics are frequently administered in acute cholecystitis for preoperative prophylaxis or postoperative treatment. The optimal timing, choice, and duration of antibiotics are unclear. METHODS: We conducted a retrospective review of all cases of acute cholecystitis between 1996 and 2001 at the American University of Beirut Medical Centre. A survey among general surgeons was also performed to describe the pattern of antibiotic prescribing in uncomplicated acute cholecystitis. A MEDLINE search for guidelines for antibiotic use in acute cholecystitis was conducted. RESULTS: The number of cases of acute cholecystitis was 79. The mean duration of postoperative antibiotic therapy was 5 days. There was no correlation between the severity of symptoms, gallbladder description, or positive gallbladder culture and the use of antibiotics postoperatively. Sixty five percent of interviewed surgeons would continue antibiotic therapy postoperatively for 3 or more days. Search of the medical literature failed to provide clear guidelines for antibiotic use in acute cholecystitis. CONCLUSIONS: The use of antibiotics in patients with acute cholecystitis is erratic and costly. Prospective studies are needed to better study the effectiveness of a short course of antibiotics in uncomplicated cases. The role of gallbladder culture in guiding antibiotic therapy should be defined as routine cultures add to the cost without evident benefit.

Adult↗
PubMed2005

In vitro activity of antimicrobial agents against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care center in Lebanon.

Looking for therapeutic options, we assessed the minimum inhibitory concentrations (MICs) of 7 antimicrobial agents against extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (n = 58) and Escherichia coli (n = 84) isolates. High rates of susceptibility were shown for both E coli and K pneumoniae against ertapenem (100% for both), piperacillin/tazobactam (83% and 91%, respectively) and amikacin (96% and 82%, respectively). In addition, most K pneumoniae isolates were susceptible to quinolones (72%-75%) and cefepime (88%). However, clinical correlation is warranted.

Adolescent↗
PubMed2005

Epidemiology and risk factors for extended-spectrum beta-lactamase-producing organisms: a case control study at a tertiary care center in Lebanon.

BACKGROUND: Infections caused by extended-spectrum beta-lactamase (ESBL)-producing gram-negative bacilli constitute a growing problem worldwide. At the American University of Beirut Medical Center (AUBMC), we have observed a significant rise in the rates of ESBL-producing organisms over the past 5 years. METHODS: Using a case control study design, we compared 99 patients with infections caused by ESBL-producing Escherichia coli and Klebsiella species and 99 frequency-matched controls from which ESBL-nonproducing isolates were recovered at AUBMC. RESULTS: The most notable risk factor for acquiring infections with ESBL-producing organisms was antibiotic consumption within 30 days of the infection (OR, 7.06; 95% CI: 3.27-15.24), with third-generation cephalosporins being associated with the highest risk (OR, 28.4; 95% CI: 3.7-215.8). Other risk factors included recent surgery, presence of a urinary catheter, and need for mechanical ventilation. Moreover, cases had a longer mean duration of hospitalization and were more likely to have relapse of their infection than controls. CONCLUSIONS: Recent antibiotic use is by far the most important predisposing factor to infection with ESBL-producing organisms. Such infections are associated with prolonged hospital stay and increased morbidity. Attention should be redirected toward the unjustified liberal use of broad-spectrum antibiotics both in the hospital and in the community.

Anti-Bacterial Agents↗
PubMed2003

Ventilator-associated pneumonia at a tertiary-care center in a developing country: incidence, microbiology, and susceptibility patterns of isolated microorganisms.

OBJECTIVE: Ventilator-associated pneumonia (VAP) complicates the course of up to 24% of intubated patients. Data from the Middle East are scarce. The objective of this study was to evaluate the incidence, microbiology, and antimicrobial susceptibility patterns of isolated microorganisms in VAP in a developing country. DESIGN: Prospective observational cohort study. SETTING: The American University of Beirut Medical Center, a tertiary-care center that serves as a major referral center for Lebanon and neighboring countries. PATIENTS: All patients admitted to the intensive care and respiratory care units from March to September 2001, and who had been receiving mechanical ventilation for at least 48 hours, were included in the study. Results of samples submitted for culture were recorded and antimicrobial susceptibility testing of isolated pathogens was performed. RESULTS: Seventy patients were entered into the study. The incidence of VAP was 47%. Gram-negative bacilli accounted for 83% of all isolates. The most commonly identified organism was Acinetobacter anitratus, followed by Pseudomonas aeruginosa. Fifty percent of all gram-negative bacterial isolates were classified as antibiotic resistant. Compared with patients without VAP, patients with VAP remained intubated for a longer period and stayed in the intensive care unit longer. VAP was not associated with an increased mortality rate. CONCLUSION: Compared with other studies, the results from this referral center in Lebanon indicate a higher incidence of VAP and a high prevalence of resistant organisms. These data are relevant because they direct the choice of empiric antibiotic therapy for VAP.

Acinetobacter↗
PubMed2003

Endemic gastrointestinal anthrax in 1960s Lebanon: clinical manifestations and surgical findings.

Anthrax is an ancient disease caused by the gram-positive Bacillus anthracis; recently, it has gained much attention because of its potential use in biologic warfare. Anthrax infection occurs in three forms: cutaneous, inhalational, and gastrointestinal. The last type results from ingestion of poorly cooked contaminated meat. Intestinal anthrax was widely known in Lebanon in the 1960s, when a series of >100 cases were observed in the Bekaa Valley. We describe some of these cases, introduce the concept of the surgical management of advanced intestinal anthrax, and describe some of the approaches for treatment.

Adolescent↗
PubMed2002

Azithromycin-induced rash in infectious mononucleosis.

Antibiotic-induced skin eruption in the setting of infectious mononucleosis is a common and well-documented clinical scenario. The skin lesions are non-specific and the mechanisms causing them are unclear. Several reports have described this entity with different antibiotic classes, mainly penicillins. Only 1 case of azithromycin-induced skin eruption has previously been described in this setting. Herein, we report the second case.

Adult↗
PubMedDate not supplied

Anthrax: a review.

Explore the source record for details and available documents.

Anthrax↗
PubMedDate not supplied

Glycopeptide and oxacillin activity against Staphylococcus aureus isolates at a tertiary care center in Lebanon.

BACKGROUND: Worldwide reports have noted the emergence of glycopeptide-intermediate Staphylococcus aureus (GISA). However, data from Lebanon is lacking. METHODS: We conducted a study to determine the minimum inhibitory concentrations (MICs) for oxacillin (OXA), vancomycin (VAN) and teicoplanin (TEC) against consecutive clinical isolates of S. aureus at a tertiary care center in Lebanon. The categorization of isolates as susceptible, intermediately-resistant, or resistant was based on the OXA agar screen plate (OS) and the 1 microg OXA disk diffusion (OD) according to the National Committee for Clinical Laboratory Standards (NCCLS) guidelines. The MICs of OXA, VAN and TEC against these isolates were determined using the E-test. RESULTS: We tested 147 S. aureus isolates, 108 of which were methicillin-resistant (MRSA) and 39 methicillin-susceptible (MSSA). The rar ges of MICs (microg/ml) among MRSA and MSSA isolates respectively were : OXA 1.5- > or = 256 and 0.19-3; VAN 1-3 and 1.5-3; TEC 0.094-3 and 0.19-2. The MIC50/90 (microg/ml) for MRSA versus MSSA isolates were, respectively: 24/ > or = 256 vs. 1/2 for OXA; 2/3 vs. 2/2 for VAN; 1/1.5 vs. 0.75/1.5 for TEC. CONCLUSION: This data indicates that despite the presence of high rates of MRSA (around 38%), these strains remain fully susceptible to VAN and TEC. We did not detect any GISA at this tertiary care referral medical center in Lebanon.

Adolescent↗
PubMedDate not supplied

Fungal infections of the genitourinary tract.

Fungal infections of the urinary tract are increasing in incidence, mostly because of the increasing use of antibacterial agents and indwelling urinary catheters. This review will focus mainly on the spectrum of genitourinary infections caused by Candida spp., including asymptomatic candiduria, cystitis, pyelonephritis, and renal candidiasis. Special emphasis will be placed on the therapeutic approach to the various clinical entities. Other fungal infections, such as urinary aspergillosis and cryptococcosis will be discussed briefly.

Antifungal Agents↗