Browsing by Author "Ashour M.S."

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Antimicrobial activities against biofilm formed by Proteus mirabilis isolates from wound and urinary tract infections
(2012) Wasfi R.; Abd El-Rahman O.A.; Mansour L.E.; Hanora A.S.; Hashem A.M.; Ashour M.S.; Department of Microbiology; Faculty of Pharmacy; University for Modern Sciences and Arts; Giza; Egypt; Department of Microbiology and Immunology; Faculty of Pharmacy; Al-Azhar University; Cairo; Egypt; Department of Microbiology and Immunology; Faculty of Pharmacy; Suez Canal University; Ismailia; Egypt; Department of Microbiology and Immunology; Faculty of Pharmacy; Cairo University; Cairo; Egypt
Background: Bacterial species are capable of living as biofilm and/or planktonic forms. There is increasing evidence for the role of bacterial biofilm in various wound and urinary tract infections (UTIs). The aim of the present study was to evaluate the ability of the bacteria, isolated from urinary tract infections (UTIs) and wound infections, to form biofilm and correlate the role of biofilm with their antimicrobial resistance. Materials and Methods: All the isolated bacteria were screened for their ability to form biofilm using the microtitre plate method. Results: Wound isolates of Staphylococcus aureus and Enterobacter sp. had more biofilm forming capacity than the UTI isolates. Proteus mirabilis isolates were among the strongest biofilm forming bacteria and were chosen for antimicrobial study. In sub-MIC concentrations of antimicrobial agents used, ciprofloxacin was found to be the most effective in decreasing biofilm formation. On the other hand, ceftriaxone and ciprofloxacin were effective in partial removal of preformed biofilm biomass. Conclusion: Ciprofloxacin was more effective in killing bacterial cells especially at high antimicrobial concentrations that could be reached in urine levels and can be used in impregenating catheters.
Central venous catheter-related infections in the intensive care units in Egypt
(2012) Omran M.E.; Gomma F.M.; Hayder W.A.; Ali N.K.; Afifi S.S.; Ashour M.S.; Department of Microbiology and Immunology; Al-Azhar University; Egypt; Department of Clinical Pathology; Al Azhar University; Egypt; Department of Microbiology and Immunology; MSA University; Egypt
Central venous catheter-related blood stream infection (CRBSI) is associated with high rates of morbidity and mortality in critically ill patients. This study was conducted to determine the incidence of central venous catheter-related infections (CRIs) according to different access sites, isolation, identification and determination of the predominant microorganisms involved and to determine the risk factors for infection by statistical analysis of the results to contribute the elaboration of actions to prevent and control blood stream infections and mortality among those patients. A total of 160 adult patients with indwelling central venous catheters hospitalized at intensive care units (ICUs) were enrolled in this study. A total of 640 clinical samples were collected from the patients; 4 different samples collected from each patient: 320 blood samples; 160 (pre-catheterized) and the other 160 (postcatheterization), 160 catheter tips and 160 swabs. The clinical samples were cultured on ordinary media for isolation and identification of the isolated microorganisms. Antibiotic sensitivity was determined by disk diffusion method according to National Committee of Clinical Laboratory Standard 2007 (NCCLS). Microscan automated system was also used for both identification and antimicrobial sensitivity testing. Statistical analysis used SPSS-10 version statistical software. One hundred forty two out of 160 patients (88.75%) suffered from CRIs. Catheter related infections were categorized according to CDC guidelines into Catheter-Related Blood Stream Infection (CR-BSI), Clinical Blood Stream Infection (C-BSI), Bloodstream Infection (BSI), Catheter bacteremia (CB) and Exit Site Infection (ESI), their rates were 23.2%, 8.5%, 47.9%, 2.8 % and 0.7% respectively and 16.9% were mixed infections. Semiquantitative culture was used for CRIs diagnosis. The total number of pathogens was 293 microorganisms were isolated from 261 positive cultures. Out of them 139 (47.4%) were Gram positive bacteria, 136 (46.4%) were Gram negative bacteria and 18 (6.1%) were Fungi. High frequency of microorganisms were isolated from post catheterization blood specimens (80.63%) followed by catheter tip samples (44.3%), swabs (29.4%) and the pre-catheterization blood specimens showed the lowest frequency of isolated microorganisms (6.88%).The isolated microorganisms identified by conventional and semiquantitative methods were belonging to 17 different species. The main etiological Gram positive bacteria was Coagulase negative Staphylococci (CoNS) representing (30.8%) and the main etiological Gram negative bacteria was Klebsiella pneumonia representing (10.6%). Pathogens isolated from CR-BSI were 42 isolates belonging to 13 different species; the most prevalent isolate was CoNS representing (42.9%). Pathogens isolated from C-BSI were 12 isolates belonging to 6 different species, the most prevalent isolate was S. aureus representing (41.7%) while 83 pathogens were isolated from BSI and they were belonging to 14 different species, the most prevalent isolates were CoNS representing (38.6%). Pseudomonas aeruginosa was the microorganism isolated from the single ESI detected in the study. The isolated pathogens from CRIs showed a wide range of antibiotic resistance. The emergence of multi-resistant pathogens in ICUs was highly detected in the present study. The most Gram positive and Gram negative bacteria causing CRIs were sensitive to imipenem and vancomycin. Proper insertion and care of catheters are essential to avoid infection. Education and training of health professionals on the practice of dealing with the CVC is an important tool in preventing and reducing CRIs.
Multiple mechanisms contributing to ciprofloxacin resistance among Gram negative bacteria causing infections to cancer patients
(Nature Publishing Group, 2018) Hamed S.M.; Elkhatib W.F.; El-Mahallawy H.A.; Helmy M.M.; Ashour M.S.; Aboshanab K.M.A.; Department of Microbiology and Immunology; Faculty of Pharmacy; October University for Modern Sciences and Arts; 6th of October; Giza; Egypt; Department of Microbiology and Immunology; Faculty of Pharmacy; Ain Shams University; African Union Organization St. Abbassia; Cairo; 11566; Egypt; Department of Clinical Pathology; National Cancer Institute; Cairo University; Cairo; Egypt; Department of Microbiology and Immunology; Faculty of Medicine; Zagazig University; Zagazig; Egypt; Department of Microbiology and Immunology; Faculty of Pharmacy; Al-Azhar University; Cairo; Egypt
Fluoroquinolones have been used for prophylaxis against infections in cancer patients but their impact on the resistance mechanisms still require further investigation. To elucidate mechanisms underlying ciprofloxacin (CIP) resistance in Gram-negative pathogens causing infections to cancer patients, 169 isolates were investigated. Broth microdilution assays showed high-level CIP resistance in 89.3% of the isolates. Target site mutations were analyzed using PCR and DNA sequencing in 15 selected isolates. Of them, all had gyrA mutations (codons 83 and 87) with parC mutations (codons 80 and 84) in 93.3%. All isolates were screened for plasmid-mediated quinolone resistance (PMQR) genes and 56.8% of them were positive in this respect. Among PMQR genes, aac(6?)-Ib-cr predominated (42.6%) while qnr genes were harbored by 32.5%. This comprised qnrS in 26.6% and qnrB in 6.5%. Clonality of the qnr-positive isolates using ERIC-PCR revealed that most of them were not clonal. CIP MIC reduction by CCCP, an efflux pump inhibitor, was studied and the results revealed that contribution of efflux activity was observed in 18.3% of the isolates. Furthermore, most fluoroquinolone resistance mechanisms were detected among Gram-negative isolates recovered from cancer patients. Target site mutations had the highest impact on CIP resistance as compared to PMQRs and efflux activity. � 2018, The Author(s).
Plasmid-mediated quinolone resistance in gram-negative pathogens isolated from cancer patients in Egypt
(Mary Ann Liebert Inc., 2018) Hamed S.M.; Aboshanab K.M.A.; El-Mahallawy H.A.; Helmy M.M.; Ashour M.S.; Elkhatib W.F.; Department of Microbiology and Immunology; Faculty of Pharmacy; October University for Modern Sciences and Arts; Egypt; Department of Microbiology and Immunology; Faculty of Pharmacy; Ain Shams University; African Union Organization; Abbassia; Cairo; 11566; Egypt; Department of Clinical Pathology; National Cancer Institute; Cairo University; Cairo; Egypt; Department of Microbiology and Immunology; Faculty of Medicine; Zagazig University; Zagazig; Egypt; Department of Microbiology and Immunology; Faculty of Pharmacy; Al-Azhar University; Cairo; Egypt
Fluoroquinolones (FQs) are the drugs of choice for prophylaxis of bacterial infections in immunocompromised cancer patients. This study aimed to investigate FQ resistance and the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants in 239 Gram-negative isolates collected at a tertiary care cancer hospital in Cairo, Egypt. Disc diffusion and broth microdilution tests showed that 70.7% of the isolates were nonsusceptible to ciprofloxacin (MIC50 = 64 ?g/ml). Polymerase chain reaction (PCR) revealed that 53.6% of the isolates carried at least one PMQR determinant, of which 23.4% were susceptible to ciprofloxacin. The most prevalent gene, aac(6?)-Ib-cr, was identified in 36.8% of the isolates, while qnr genes were harbored by 31.0% (qnrS, 24.3%; qnrB, 7.1%, and qnrA, 0.4%). The oqxAB genes were only detected in Klebsiella sp. isolates (92.5%). PMQR determinants were more likely detectable among isolates recovered from pediatric patients than adults (59.3% vs. 43.8%) and were significantly associated with ceftriaxone and gentamicin resistance. A combined genetic analysis using random amplified polymorphic DNA-PCR and enterobacterial repetitive intergenic consensus-PCR showed that most of the qnr-positive isolates were not clonal. Findings of the current study raised concerns about the efficacy of prophylactic use of FQs in cancer patients in our region. It also demonstrates the possible role of PMQR-positive ciprofloxacin-susceptible isolates in the dissemination of resistance to other antimicrobial agents and the urgent need to reconsider the existing FQ breakpoints defined by the Clinical and Laboratory Standards Institute. � Copyright 2018, Mary Ann Liebert, Inc., publishers 2018.
Seroprevalence of occult hepatitis B among Egyptian paediatric hepatitis C cancer patients
(Blackwell Publishing Ltd, 2015) Raouf H.E.; Yassin A.S.; Megahed S.A.; Ashour M.S.; Mansour T.M.; Department of Microbiology and Immunology; Faculty of Pharmacy; Modern Sciences and Arts University; Giza; Egypt; Department of Microbiology and Immunology; Faculty of Pharmacy; Cairo University; Kasr El-Aini St.; Cairo; 11562; Egypt; Cancer Biology Department; National Cancer Institute; Cairo University; Cairo; Egypt
Occult hepatitis B infection is characterized by the presence of hepatitis B virus (HBV) DNA in the serum in the absence of hepatitis B surface antigen (HBsAg). Prevalence of hepatitis C virus (HCV) infections in Egypt is among the highest in the world. In this study, we aim at analysing the rates of occult HBV infections among HCV paediatric cancer patients in Egypt. The prevalence of occult HBV was assessed in two groups of paediatric cancer patients (HCV positive and HCV negative), in addition to a third group of paediatric noncancer patients, which was used as a general control. All groups were negative for HBsAg and positive for HCV antibody. HBV DNA was detected by nested PCR and real-time PCR. HCV was detected by real-time PCR. Sequencing was carried out in order to determine HBV genotypes to all HBV patients as well as to detect any mutation that might be responsible for the occult phenotype. Occult hepatitis B infection was observed in neither the non-HCV paediatric cancer patients nor the paediatric noncancer patients but was found in 31% of the HCV-positive paediatric cancer patients. All the detected HBV patients belonged to HBV genotype D, and mutations were found in the surface genome of HBV leading to occult HBV. Occult HBV infection seems to be relatively frequent in HCV-positive paediatric cancer patients, indicating that HBsAg negativity is not sufficient to completely exclude HBV infection. These findings emphasize the importance of considering occult HBV infection in HCV-positive paediatric cancer patients especially in endemic areas as Egypt. � 2014 John Wiley & Sons Ltd.