Al-Abri S.S.,Royal Hospital |
Al-Jardani A.K.,Royal Hospital |
Al-Hosni M.S.,Royal Hospital |
Al-Busaidi S.,Central Public Health Laboratory
Journal of Infection and Public Health | Year: 2011
Objectives: To investigate the course of a hospital acquired outbreak of Bacillus cereus gastroenteritis outbreak, and the interventions that were taken to prevent such an outbreak from occurring again. Methods: On May 3-5 2008, 58 cases of gastroenteritis were reported among patients and their attendants in a referral hospital in Oman. All affected had eaten meals served by the hospital kitchen the previous day. An outbreak investigation team conducted active surveillance and interviewed people about symptoms and food consumed on the preceding day in the hospital. Food samples from the kitchen and faecal samples from the kitchen staff and those affected were cultured. An environmental audit of the kitchen was conducted. Results: The majority of the 58 persons affected by the outbreak were adult females, predominantly attendants of patients. 90% had diarrhoea and 10% had vomiting, usually mild. All those affected were managed symptomatically except for two patient attendants who required intravenous rehydration. The meal exposure histories implicated at least one meal from the kitchen. Many violations of basic food hygiene standards were observed in the kitchen. Toxin producing B. cereus was isolated from faeces of 3/12 (25%) patients and 19/25 (76%) of food handlers, and 35/61 (57%) of food samples from the kitchen. Conclusion: This is the first report of a nosocomial outbreak of foodborne B. cereus infection from this region. The importance of appropriate epidemiological and microbiological investigation and public relations management is emphasized, in addition to the need for continuing training of food handlers and rigorous enforcement of food hygiene regulations. © 2011 King Saud Bin Abdulaziz University for Health Sciences.
Mohareb E.,Centers for Disease Control and Prevention |
Elassal E.M.,Centers for Disease Control and Prevention |
Al-sanouri T.,Central Public Health Laboratory |
Haddadin A.,Central Public Health Laboratory
Journal of Clinical Microbiology | Year: 2014
A new human coronavirus (CoV), subsequently named Middle East respiratory syndrome (MERS)-CoV, was first reported in Saudi Arabia in September 2012. In response, we developed two real-time reverse transcription-PCR (rRT-PCR) assays targeting the MERS-CoV nucleocapsid (N) gene and evaluated these assays as a panel with a previously published assay targeting the region upstream of the MERS-CoV envelope gene (upE) for the detection and confirmation of MERS-CoV infection. All assays detected< 10 copies/reaction of quantified RNA transcripts, with a linear dynamic range of 8 log units and 1.3103 50% tissue culture infective doses (TCID50)/ml of cultured MERS-CoV per reaction. All assays performed comparably with respiratory, serum, and stool specimens spiked with cultured virus. No false-positive amplifications were obtained with other human coronaviruses or common respiratory viral pathogens or with 336 diverse clinical specimens from non-MERS-CoV cases; specimens from two confirmed MERS-CoV cases were positive with all assay signatures. In June 2012, the U.S. Food and Drug Administration authorized emergency use of the rRT-PCR assay panel as an in vitro diagnostic test for MERS-CoV. A kit consisting of the three assay signatures and a positive control was assembled and distributed to public health laboratories in the United States and internationally to support MERS-CoV surveillance and public health responses. Copyright © 2014, American Society for Microbiology.
Miriagou V.,Hellenic Pasteur Institute |
Tzouvelekis L.S.,National and Kapodistrian University of Athens |
Vatopoulos A.C.,Central Public Health Laboratory
Journal of Antimicrobial Chemotherapy | Year: 2013
To determine the complete nucleotide sequence of the VIM-1-encoding plasmid pKP1780 from Klebsiella pneumoniae ST147 representing a distinct group of IncR replicons. The plasmid pKP1780 was from a K. pneumoniae clinical strain (KP-1780) isolated in Greece in 2009. Plasmid DNA was extracted from an Escherichia coli DH5a transformant and sequenced using the 454 Genome Sequencer GS FLX procedure on a standard fragment DNA library. Contig gaps were filled by sequencing of PCRproducedfragments. AnnotationandcomparativeanalysiswereperformedusingsoftwareavailableontheInternet. Plasmid pKP1780 (49770 bp) consisted of an IncR-related sequence (12083 bp) including replication and stability systems, and a multidrug resistance (MDR) mosaic region (37687 bp). blaVIM-1 along with the aacA7, dfrA1 and aadA1 cassettes comprised the variable region of an integron similar to In-e541 from pNL194. The mosaic structure also included the strA, strB, aphA1 andmphA resistance genes aswell as intact (n=10) ordefective (n=3) insertion sequences and fragments of various transposons. Themosaic structure of pKP1780 exhibited high similaritywith the acquired region of the IncN plasmid pNL194, indicating the acquisition of the VIM-1-encoding MDR region frompNL194 by an IncR-type plasmid. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Abdel-Maksoud M.,Us Naval Medical Research Unit |
House B.,Us Naval Medical Research Unit |
Wasfy M.,Us Naval Medical Research Unit |
Abdel-Rahman B.,Us Naval Medical Research Unit |
And 4 more authors.
Annals of Clinical Microbiology and Antimicrobials | Year: 2012
Background: Brucellosis poses a significant public health problem in Mediterranean countries, including Egypt. Treatment of this disease is often empirical due to limited information on the antibiotic susceptibility profiles of Brucella spp. in this region of the world. The aim of this study was to determine the antibiotic susceptibility profiles of Brucella blood isolates in Egypt, a country endemic for brucellosis.Methods: Brucella spp. isolates were identified from the blood cultures of acute febrile illness (AFI) patients presenting to a network of infectious disease hospitals from 1999-2007. Minimum inhibitory concentrations were determined for tetracycline, gentamicin, doxycycline, trimethoprim-sulfamethoxazole, streptomycin, ceftriaxone, ciprofloxacin and rifampin using the E-test. Interpretations were made according to Clinical and Laboratory Standards Institute (CLSI) guidelines.Results: A total of 355 Brucella spp. isolates were analyzed. All were susceptible to tetracycline, doxycycline, trimethoprim-sulfamethoxazole, streptomycin and ciprofloxacin; probable resistance to rifampin and ceftriaxone was observed among 277 (64%) and 7 (2%) of the isolates, respectively. Percentages of isolates showing probable resistance to rifampin were significantly lower before 2001 than in the following years (7% vs. >81%, p < 0.01).Conclusions: Despite the high burden of brucellosis in Egypt and frequent empirical treatment, isolates have remained susceptible to the majority of tested antibiotics. However, this is the first report of high rates of probable resistance to rifampin among Brucella isolates from Egypt. Patients should be closely monitored while following standard treatment regimens. Continued surveillance, drug susceptibility studies and updated CLSI interpretive criteria are needed to monitor and update antibiotic prescribing policies for brucellosis. © 2012 Abdel-Maksoud et al.; licensee BioMed Central Ltd.
Magalhaes Oliveira A.,Central Public Health Laboratory |
Vasconcelos Oliveira M.,Federal University of Bahia |
Lima Souza C.,Federal University of Bahia
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2014
Introduction: Because of the increase in diagnostic resources, laboratory tests have become an essential tool in diagnostic elucidation. Therefore, we observe an increase in the number of tests request. Objectives: To determine the prevalence of laboratory tests requests by the intensive care unit (ICU) of the General Hospital at southwest Bahia, and to anticipate the expenses with unnecessary laboratory tests, indicating avoidable costs, and aiming at rationalization of laboratory tests use. Methods: This is a cross-sectional retrospective study, in which a survey on medical records and laboratory tests results of patients admitted to the ICU was conducted, in the period from August to September 2013. Results: The sample consisted of 105 patients, 58.1% males, 47.6% aged between 18-59 years. During the period, 12.217 laboratory tests were ordered, of which 49.4% was within the normal limits. The more requested exams were: complete blood count, sodium, and potassium. A number of 1.750 laboratory tests could be evaluated according to criteria established in the literature, among them, 719 (41%) were considered unnecessary. A greater number of requests (29%) were observed on Mondays, compared with the average of the rest of the week. Conclusion: Significant number of unnecessary testing was found, with occurrence pattern on Monday and not dependent on age or length of stay. The data indicate the need to implement guidelines or protocols for ordering laboratory tests in the ICU, which have proven effective in helping the prescribing professional in their clinical practice, and contribute to optimize for health care spending.
Araujo F.M.C.,Central Public Health Laboratory |
Araujo F.M.C.,Federal University of Ceará |
Araujo M.S.,Neurology Service Of Dr Jose Frota Institute |
Nogueira R.M.R.,Oswaldo Cruz Institute |
And 6 more authors.
Neurology | Year: 2012
Objective: This study aimed to determine the frequency of CNS infection by dengue virus (DENV) in individuals with fatal outcomes. Methods: Samples of 150 individuals suspect of an infection disease and with fatal outcomes were investigated for evidence of the presence of DENV. The sampling was made up of 150 CSF, 120 tissue samples, and 109 blood specimens. The tests used were viral isolation, reverse transcriptase PCR, immunohistochemistry, nonstructural 1 antigen, and immunoglobulinMdetection. Results: Out of 150 studied patients, 84 were dengue positive. Evidence of the presence of DENV was found in 41 CSF, showing the following neurologic diagnosis: 46.3% encephalitis, 34.1% meningoencephalitis, and 19.5% meningitis, giving a frequency of 48.8% of the 84 dengue-positive cases. The major clinical manifestations observed on these individuals were fever, headache, mental irritability, breathless, vomiting, muscle pain, tiredness, abdominal pain, somnolence, restlessness, dizziness, cough, seizure, coma, and neck stiffness. Conclusion: Clinical manifestations and laboratory-positive results in CSF that may indicate the presence of DENV led to consider the invasion of CNS by DENV in these fatal cases studied, and showed that neurologic pathology was an important fatal complication in dengue cases. Copyright © 2012 by AAN Enterprises, Inc.
PubMed | Pediatric Infectious Diseases, Central Public Health Laboratory and Royal Hospital
Type: Journal Article | Journal: Oman medical journal | Year: 2016
The introduction of measles vaccination programs and broad coverage worldwide has meant this infection a rare encounter for pediatricians. In Oman, with almost 100% measles vaccination coverage for children, this infection disappeared from the list of fever and rash differential diagnoses. Encephalitis is a well-known complication of measles infection and sometimes can be the only manifestation especially in adults. We report a seven-year-old Syrian immigrant who was admitted to the Royal Hospital, Muscat, with acute encephalitis secondary to wild measles infection. Although she had a classical presentation of measle infection, the diagnosis was missed in the private and regional hospital she attended before getting referred to Royal Hospital. She was later identified to be exposed to an outbreak of the infection in an unvaccinated population. Magnetic resonance imaging showed high signal intensity of both basal ganglia suggestive of measles encephalitis. The diagnosis was confirmed by detection of measles virus from her urine and blood, and a throat swab. The isolated measles virus was D8 serotype, which was prevalent in Syria around the same time. The child was treated with steroids and vitamin A. She achieved full recovery despite her severe presentation. A high degree of suspicion for measles infection should be maintained in unvaccinated children with a compatible presentation of the infection or its complications. There might be a role for steroid use in cases of acute measles encephalitis.
Al-Abri S.S.,Dir. General for Disease Surveillance and Control |
Abdel-Hady D.M.,MoH |
Al Mahrooqi S.S.,MoH |
Al-Kindi H.S.,Central Public Health Laboratory |
And 2 more authors.
Travel Medicine and Infectious Disease | Year: 2015
Background The number of travelers in Oman has increased significantly in the last 2 decades with an increase in the expatriate population workforce leading to the emergence of infections related to travel. This paper aims to highlight the burden of travel-related infections in Oman. Method Our study is a descriptive record-based review and analysis of travel-associated diseases over a 14 year time period from 1999 to 2013. The data was sourced from the communicable disease surveillance system, and central public health laboratory results. Results From 1999 to 2013 there were a combined total of 7022 cases of cholera, chikungunya, dengue, filariasis, leptospirosis, meningococcal infection, poliomyelitis, measles, schistosomiasis, viral hepatitis (A), typhoid and para-typhoid reported to and subsequently investigated by the Department of Communicable Diseases. Among these cases, 558 (7.9%) were attributed to travel. Fifty percent of these patients were admitted to hospitals. Conclusion Travel-associated infections account for about 8% of notifiable infections in Oman and have low mortality rate. However, some travel-associated infections are considered as a threat to polio eradication and measles elimination programs. Furthermore, some can cause outbreaks that can overwhelm the healthcare system. © 2015 Elsevier Ltd.
Zgair A.K.,University of Baghdad |
Zgair A.K.,Central Public Health Laboratory |
Ghafil J.A.,University of Baghdad |
Al-Sayidi R.H.E.,Central Public Health Laboratory
Journal of Medical Virology | Year: 2015
Chronic hepatitis B involves different immune cells. The direct role of antibody-secreting B cells in the severity of chronic hepatitis B unclear. In this study, the number of plaque forming cells [PFC-(IgG, IgM, anti-HBc IgG, and anti-HBc IgM)], liver function tests (LFT) [alkaline phosphatase (ALP), alanine aminotransferase (ALT), and total serum bilirubin (TSB)], the levels of IL-10 in sera and in lymphocyte cultures, the number of CD4+ and CD8+ cells were measured in the peripheral blood of patients and in the controls. In addition, the hepatocytotoxic effect of anti-HBc and anti-HBe in vitro was studied. The largest number of PFCs was observed in the peripheral blood of patients with chronic hepatitis B. This was concomitant with a decrease in CD4+/CD8+ ratio versus this ratio in asymptomatic HBV carriers and in healthy volunteers (P<0.05). An increase in immunoglobulin (IgG and IgM) levels, anti-HBc IgG, and anti-HBc IgM levels and LFTs in peripheral blood of patients with chronic hepatitis B was seen. Anti-HBc induced hepatocytotoxicity in vitro. The expression of mRNA and protein for IL-10 production was observed at a significant level in culture of lymphocytes isolated from patients with chronic hepatitis B. In addition, a high level of IL-10 was found only in the sera of patients with chronic hepatitis B. It is concluded that the antibody-secreting B cells and the antibodies, which are produced, play an important role in the severity of chronic hepatitis B, which was related negatively with CD4+/CD8+ ratio and positively with IL-10 expression. J. Med. Virol. 87:407-416, 2015. © 2014 Wiley Periodicals, Inc.
Yahya Z.M.,Nahrain University |
Ali H.H.,Nahrain University |
Hussein H.G.,Central Public Health Laboratory
Oman Medical Journal | Year: 2013
Objective: To evaluate the sensitivity and specificity of Calretinin and Carcinoembryonic antigen as immunocytochemical markers in distinguishing mesothelial cells from metastatic adenocarcinoma cells in effusion cytology. Methods: This study included 50 patients who presented with effusions (26 pleural and 24 peritoneal), at Al-Kadhimya Teaching Hospital who were selected according to their preliminary diagnosis from 1st December 2010 to 30th June 2011. Effusion fluids were aspirated and processed for both conventional cytological methods using Papanicolaou-stain and immunocytochemical staining with anti Calretinin and Carcinoembryonic antigen. Results: The sensitivity of cytology for detection of malignant cells was 77%, with 100% specificity and 86% accuracy. Calretinin was observed to be a specific (100%) and sensitive (90%) marker for mesothelial cells (of benign etiology). Carcinoembryonic antigen exhibited 70% sensitivity and 100% specificity for adenocarcinoma cells. When the results of both cytology and immunocytochemistry were considered in conjunction, the sensitivity for the detection of malignancy increased to 97%, with 100% specificity and 98% accuracy. Conclusion: Calretinin and Carcinoembryonic antigen were found to be useful markers for differentiating reactive mesothelial cells from metastatic adenocarcinoma cells in smears prepared from body fluids. Also, the combination of both cytology and immunocytochemical studies using the two markers can greatly enhance the diagnostic accuracy, sensitivity and specificity in malignant effusions. © OMSB, 2013.