PubMed · 11637676
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C Dolzani. [Not Available].. https://pubmed.ncbi.nlm.nih.gov/11637676/
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OBJECTIVES: Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections in low- and middle-income countries (LMICs), but there are few resistome data available for relevant uropathogens. The goal of this study was to characterize the antimicrobial resistance (AMR) phenotypes and genotypes of a large collection of Gram-negative bacteria recovered from CAUTIs in a hospital in Mansoura, Egypt. METHODS: Phenotypic AMR profiles and whole-genome sequence data were generated for 132 isolates. Resistomes were predicted using ResFinder, CARD and AMRFinder. Similarity of uropathogen genomic data was determined using sourmash (kmer signatures). Escherichia coli genomic data were subject to a pangenome analysis using Panaroo. RESULTS: Sixty-seven E. coli (Phylogroup B2; 53.7%, 36/67), 14 Pseudomonas aeruginosa, 11 Klebsiella pneumoniae, 9 Proteus mirabilis, 8 Providencia spp., 5 Enterobacter hormaechei and 18 rare CAUTI-associated isolates were identified. Several (22/132) isolates were multidrug-resistant, while almost half (62/132) were extensively drug-resistant. Phenotype-genotype discordance was found to be an important consideration in resistome studies in Egypt, with a total concordance of 91% (1115/1225), 85.7% (1273/1485) and 80.5% (1196/1485) for ResFinder, CARD and AMRFinder, respectively. Pseudomonas, at the species level, exhibited the greatest discordance. At the antimicrobial level, meropenem was subject to greatest discordance. New AMR variants were found for Egypt for Pseudomonas (blaOXA-486, blaOXA-488, blaOXA-905, blaIMP-43, blaPDC-35, blaPDC-45, blaPDC-201) and E. coli (blaTEM-176, blaTEM-190). CONCLUSIONS: This study shows that there is phenotype-genotype discordance in AMR profiling among CAUTI isolates, highlighting the need for comprehensive approaches in resistome studies. We also show the genomic diversity of Gram-negative uropathogens contributing to disease burden in a little-studied LMIC setting.
BACKGROUND: The strategy recommended by the World Health Organization (WHO) to curtail outbreaks of meningococcus in Africa is enhanced surveillance with administration of oily chloramphenicol as well as vaccination when incidence thresholds are exceeded. The role of capsular polysaccharide meningococcal vaccine in outbreak prevention has been the subject of considerable debate. The Egyptian Ministry of Health and Population initiated a school-based vaccination program with bivalent A/C capsular polysaccharide vaccine in 1992. This investigation reviews data on meningococcal meningitis in Egypt comparing years before and after introduction of the vaccine. METHODS: This is a retrospective review of several sources to examine the rates and serogroups of meningococcal meningitis before and after the introduction of the meningococcal A/C vaccine in Egypt. FINDINGS: Between 1967 and 1991, outbreaks of meningococcal disease were documented with a periodicity of 8 years in Egypt. However, there has not been an outbreak since 1991 and over the same period, there has also been a progressive decline in the baseline incidence of meningococcus. Also, a shift from a serogroup A to serogroup B predominance in meningococcal disease was noted during the study period. These data suggest that there has been an alteration in the epidemiology of meningococcal disease in Egypt that coincided with the implementation of the school-based vaccination program. INTERPRETATION: Routine use of the bivalent A/C meningococcal vaccine may be an alternative for the control and prevention of meningococcal disease in high-risk areas including the "meningitis belt".
The first Egyptian (ET-RR1) research reactor has been in operation since 1961 at the Egyptian Atomic Energy Authority (EAEA) Inshas site. Therefore, at present, it faces a serious problem due to aging equipment, especially those directly in contact with the environment such as the underground settling tanks of nuclear and radioactive waste. The possible leakage of radionuclides from these aging tanks and their migration to the aquifer was studied using instantaneous release. This study was done based on the geological and hydrological characteristics of the site, which were obtained from the hydrogeological data of 25 wells previously drilled at the site of the reactor[1]. These data were used to calculate the trend of water levels, hydraulic gradient, and formulation of water table maps from 1993-2002. This information was utilized to determine water velocity in the unsaturated zone. Radionuclides released from the settling tank to the aquifer were screened according to the radionuclides that have high migration ability and high activity. The amount of fission and activation products of the burned fuels that contaminated the water content of the reactor pool were considered as 10% of the original spent fuel. The radionuclides considered in this case were H-3, Sr-90, Zr-93, Tc-99, Cd-113, Cs-135, Cs-137, Sm-151, Pu-238, Pu-240, Pu-241, and Am-241. The instantaneous release was analyzed by theoretical calculations, taking into consideration the migration mechanism of the various radionuclides through the soil space between the tank bottom and the aquifer. The migration mechanism through the unsaturated zone was considered depending on soil type, thickness of the unsaturated zone, water velocity, and other factors that are specific for each radionuclide, namely retardation factor, which is the function of the specific distribution coefficient of each radionuclide. This was considered collectively as delay time. Meanwhile, the mechanism of radionuclide migration during their passage in the water body of the aquifer was the main focus of this study. The degree of water pollution in the aquifer at a point of contact with the main water body of Ismailia Canal 1000 m from the reactor site was assessed for the instantaneous release by comparing the results obtained with the regulations of the standard limit of radionuclides in drinking water.