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Dr. hoda mohamed rabie awad ahmed gabal :: Theses : |
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| Title | Bacteriological Profile and Antimicrobial Resistance in Ascitic Fluid of Patients with Community Acquired and Nosocomial Spontaneous Bacterial Peritonitis |
| Type | PhD |
| Supervisors | Prof. Fatma Mohamed Abd-Elsalam, Prof. Maha Zeinelabedin Omar, Prof. Soheir Abd-Elrahman Abd-Elsamie |
| Year | 2021 |
| Abstract | Background: Spontaneous bacterial peritonitis is the most frequent infection complicating liver cirrhosis. Recent changes in bacterial ecology and emerging antibiotic resistance have resulted in failure to respond to empirical therapy with 3rd generation cephalosporin in 33%-75% of cases and such failure is associated with reduced survival. Aim of the work: To identify the causative bacteria of community acquired and nosocomial SBP and their antimicrobial resistance patterns in an attempt to perform a local bacteriological surveillance to optimize empirical treatment. Patients and methods: Three hundred patients with ascites due to liver cirrhosis were enrolled in this study. All patients were subjected to history taking, clinical examination, ascitic fluid analysis, culture and ultrasonography. SBP was diagnosed by ascitic PNL ≥250/mm3. Results: One hundred and eighty-five patients (61.7%) were diagnosed as SBP. Community acquired SBP (83.8%) was more common than nosocomial SBP (16.2%). One hundred and forty patients (75.7%) had culture positive, and 45 patients (24.3%) had culture negative SBP. Gram positive (G+) cocci (64.3%) were more common than Gram negative (G-) bacilli (35.7%). Among culture positive cases, 110 patients had community-acquired and 30 patients had nosocomial SBP. The overall cefotaxime resistance was 44.4%; being higher in nosocomial (100%) than community acquired group (37.5%). No resistance to ampicillin/salbactam, piperacillin/tazobactam, vancomycin, linezolid, meropenem or tigecyclin was identified. Conclusion: There is an emerging pattern towards G+ bacteria and 3rd generation cephalosporins resistance in the causative bacteria of SBP especially nosocomial type while piperacillin/tazobactam, vancomycin, linezolid, meropenem or tigecycline still can be used in resistant cases. |
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| University | Benha |
| Country | Egypt |
| Full Paper | download paper |
| Title | Study Of Some Genetic Virulence Factors Of Helicobacter Pylori In Patients With Gastroduodenal Diseases |
| Type | MSc |
| Supervisors | Naglaa El-Toukhy, Amal M. Saeed and Nashwa M. Emara. |
| Year | 2014 |
| Abstract | Helicobacter pylori (H. pylori) is a gram-negative, micro-aerophilic, curved rod that causes a transmissible bacterial infection of the gastric mucosal surface and affect about one half of the world’s population. It induces chronic gastritis in all infected individuals, but only induces clinical diseases in 10-20% of them. This may be related to differences in genetic susceptibility of the host, environmental factors, and genetic diversity of H. pylori. Aim: This study was conducted to identify the frequency of the genetic virulence factors (cagA, vacA and babA2) of H. pylori and their possible association with gastroduodenal diseases. Methods: The study was conducted on 70 adult patients with upper gastrointestinal complaints. All patients were subjected to full history taking, clinical examination, gastroduodenoscopy. Four antral biopsies were taken for genotyping by PCR, histopathological examination and culture. Results: All the patients (100%) had chronic active H. pylori gastritis by histopathological examination. The most frequent H. pylori genotype was cagA (67.8%) followed by vacA s1a (61%) and vacA m2 (61%), while the least frequent was babA2 (18.6%). CagA was associated with vacA s1a in (83.3%) with statistical significance. Most patients with cagA positive isolates (77.8%) had no heart burn with statistical significance which may support the protective role of cagA against GERD. There was no significant difference between genotypes distribution as regards culture positive and culture negative H. pylori strains. CagA, vacA s1a and vacA m2 had the highest prevalence in patients with PUD, gastritis and duodenitis while babA2 had the least prevalence. Although in patients with PUD and NUD the prevalence of cagA was (65.1%, 75%) and vacA s1 was (62.8%, 56.3%) respectively, the association between these H. pylori genotypes and PUD did not reach a level of statistical significance. Conclusion: None of H. pylori genetic virulence factors individually can accurately predict clinical outcome and one has to recognize the importance of the bacteria-host interaction in the final outcome. |
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| University | Benha |
| Country | Egypt |
| Full Paper | - |
