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The 25th

Conference of the Egyptian Society for Medical Microbiology

1

The 25th

Conference of the Egyptian Society

for Medical Microbiology (ESMM)

Infection, Prevention and

Control; the Role of Microbiology

18th

April 2019

Helnan Dreamland Hotel. 6th

October. Giza

Program &

Abstract Book

Announcement

We have the pleasure to announce that the EJMM had been

published on the Google scholar link.

For Online Submission Use This Website:

www.ejmm-eg.com/e

http://www.ejmm-eg.com/e

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Welcome Message

On behalf of the Egyptian Society for Medical Microbiology

(ESMM), we have the pleasure to welcome you to share the activities of

the 25th Annual ESMM Conference.

The conference theme "Infection, Prevention and Control; the Role of

Microbiology" was selected to express the real need for updating our

knowledge, understanding and following up the enormous development

and the latest recent advances in treatment of some vital problems we are

facing in our microbiology practice.

Also we have the pleasure to meet several eminent guest speakers who

will focus on recent advances in infection control, and the problem of

drug resistance.

Many of the eminent scientists, both the leading generation and the

young promising researchers, are meeting to communicate and exchange

ideas and thoughts that will surely find the proper approaches for solving

medical problems and to celebrate our traditional annual meeting of

almost all microbiologists and immunologists in our beloved Egypt.

The scientific program covers about 30 topics including plenary

lectures and research oral presentations delivered by distinguished

professors, in addition to poster presentations.

We are looking forward to meeting you in the conference

participating in its activities to make it a successful and fruitful one.

President of ESSM President of the Conference

Prof. Samira Shoeb Prof. A. Ashraf Wegdan

Prof. Ahmed Omar Shafeik

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ESMM BOARD

President Prof. Samira Shoeb

Treasurer Prof. Ahmed Ashraf Wegdan

Secretary General Prof. Ahmed Amer Mossaad

Members Prof. Ahmed Omar Shafeik

Prof. Ahmed Sadek

Prof. Ahmed Saeed Osman

Prof. Ayman Allam

Prof. Mohamed Sherif

Prof. Rasha Bassyouni

Scientific Committee

Prof. Dr. Ahmed Amer Mossaad

Prof. Dr. Ahmed Ashraf Wegdan

Prof. Dr. Ahmed Omar Shafeik

Prof. Dr. Azza Al-Sharkawy

Prof. Dr. Ensaf Alazzazy

Prof. Dr. Ismail Sedeik

Prof. Dr. Rasha Bassiouny

Organizing Committee Mrs.: Soad Abou Elenein

Mr. Maher Mobarak

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Program Overview

Thursday, 18th

April 2019

8:00-9:30 Registration

9:30-10:00 Opening Ceremony

Plenary Session 10:00-11:40

Chairmen: Prof. Awatef Awaad

Prof. Azza Al Sharkawy

Prof. Ensaf E Azzazy

Prof. Saeed Al Abbady

10:00-10:20

Abeer Ezzat El-Sayed Mohamed Central Line Associated Infections and Bundle Care

10:20-10:40 Ahmed Morad Asaad

Proficiency of Information Technology for Surveillance of

antimicrobial resistance in Healthcare settings

10:40-11:00 Marwa Nasser

Phage Therapy: A Potential Solution in the Era of Multi-drug

Resistance

11:00-11:20 Nermine Elmaraghy

The Dilemma of Antibiotic Resistance

11:20-11:40 Rania Ahmed Hassan

Antibiotic resistance: A public health challenge

11:40:12:00 Coffee Break

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Session I 12:00-02:00

Chairmen:

Prof. Ashraf Wegdan

Prof. Ismail Sedeik

Prof. Mona Abdel Wahab

12:00-12:15 Phenotypic and Genotypic Characterization of

Stenotrophomonas maltophilia in Alexandria Main University

Hospital

Mona Gamal El Din Morsi, May Moheb El Din Raouf,

Marwa Ahmed Meheissen, Mabrouka Abdelsalam Hamad

12:15-12:30 Microbiological Studies on the Effect of Medicinal Plant

Extracts on Diabetic Foot Ulcer Bacteria

Mohamed E. Sarhan, Dalia Moemen, Manal Tarshoby,

Mahmoud A. Swelim, Mohamed Abd El-Raouf

12:30-12:45 Accuracy of Human Immunodeficiency Virus Diagnostic Tests

Simulating the CDC Algorithm

Youssra M. Mostafa and Doaa T. Masallat

12:45-01:00 MRSA Screening and Spa Gene Detection in Isolates from

Ophthalmology Hospital in Egypt Compared to MRSA Spa

Detection in USA

Maha G Haggag, Tamara Revazishvili, Amal E Abo Elnour,

Mai Al-Kaffas

01:00-01:15 Detection of Carbapenemase Genes among Carbapenem-

Resistant Enterobacteriaceae Isolates in Suez Canal University

Hospitals in Ismailia

Hasnaa A. Mohamed,Said H. Abbadi, Waheed F. Hessam,

Atef S. Raheel, Abeer Ezzat El Sayed

01:15-01:30 Correlation of Virulence Determinants of Staphylococcus

aureus to the Severity of Diabetic Foot Ulcers in a Tertiary

Care Centre, Egypt

Yasmin Nabiel

01:30-01:45 Human Papillomavirus Types, 16 and 18 Among HIV Sero

Positive Women Attending Aminu Kano Teaching Hospital,

Kano, Nigeria

Emmanuela CN, Taysir RH, Usman AD

01:45-02:00 Trouble Shooting in H pylori Diagnostics…. A Glance from

Real Life Stories

Marwa Saad Fathi and Nermin Mahmoud

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Session II 02:00-04:00

Chairmen:

Prof. Rasha Mohamed Fathi

Prof. Ahmed Omar Shafeik

Prof. Rasha Bassyouni

02:00-02:15 Could Training Programs Eliminate Hospital Environmental

Surfaces Contaminations with Multidrug Resistant Bacteria

Rasha H. Bassyouni, Sylvana Nady Gaber, Asmaa Younis Elsary,

Mohamed Safaa Arafa

02:15-02:30 Fluoroquinolone Resistance of Clinical E. coli Isolates in

Mansoura University Hospitals and its Control

Eldegla H.E., Abdel-Fattah G.M., and Salem A.M.

02:30-02:45 The Art of Article Critique" How to Review a Medical Article;

Advice From a Reviewer

Noha Tharwat Abou El-Khier

02:45-03:00 Single Closed Tube Tm-shift Method Versus PCR-Restriction

Fragment Length Polymorphism in Detection of Macrophage

Migration Inhibitory Factor-173 G>C (s755622) Single

Nucleotid Polymorphism in Patients with Rheumatoid

Arthritis

Hala A.Tabl and Nashwa I. Hashaad

03:00-03:15 Biochemical and Immunological Characterization of

Hemolysin Produced by Pseudomonas aeruginosa PAO1

Isolated from Burn Patients

Ayman A. Allam, Ashraf M. El-shawadfy, Wesam A. Hassanein,

Esraa H. Hamza

03:15-03:30 Human Herpes Virus Type 8 (HHV-8) Among People Living

with HIV Attending General Hospital, Jigawa State, Nigeria

Nazir A.Y., Taysir, R. H., Usman, A. D.

03:30-03:45 Interleukin-18 and Vascular Endothelial Growth Factor as

Predictors for End-stage Renal Disease Aml F.A. Makled, Eman H.M. Salem, Amira H.A. El-Khayat,

Mahmoud M.A. Emara, Sara I.M. El Shohady

03:45-04:00 Phenotypic and Molecular Characterization of Clinical

Acinetobacter isolates from Menoufia University Hospitals

Ahmed M. Baker, Amal F. Makled, Eman H. Salem,

Ahmed A. Salama,Soma E. Ajlan

04:00 Lunch

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Poster

1. Assessment of the level of Knowledge, Attitude and Practice Regarding

Influenza Vaccination in Community and Healthcare Settings in

Riyadh, Saudi Arabia

Dalia Saad ElFeky, Yomna Khaled Ramadan, Alhanouf Alsarhan, Rawabi

AlQurashi, Malak Alkhodaidi, Malak Albalawi

2. Antimicrobial Activities of Commercially Available Obturating

Materials in Primary Teeth Israa A. Ibrahim, Doaa T. Masallat, Ahmed H. Ibrahim, Ibrahim H. El Kalla

3. Helicobacter Pylori, Chlamydia Pneumoniae and c. Trachomatis as

Probable Etiological Agents of Preeclampsia

Yasmin Nabiel

4. Screening of the Antimicrobial Activity of Some Plant Aqueous Extracts

and Plant Oils and Enhancement of the Antimicrobial Activity of

Selected Plant Oil Using Liposomes as Nanoscale Carrier

Maha G Haggag, Medhat W Shafaa, Hossam S Kareem, Hoda H El-

Hendawy and Amir M El-Gamil

5. Colistin Resistance in Klebsiella pneumoniae and Esherichia coli Clinical

Isolates: A Microbiological and Molecular Study Amina Nour Eldin, Reem Abdelhamid Harfouh, Marwa Ahmed Meheissen,

Ahmed Mostafa Elmenshawy, Sara Mustafa Hendawy

6. Characterization of Fluoroquinolones-resistant Salmonella enterica

serovar typhi in Egypt

Amira Hisham El- Ashry, Mohammad Ahmed Abou El-Ela, Mohammad Abd

El- Razik El-Farrash, Hamdia Yehia Askar, Monir Hussein Hussein Bahgat

7. Association between Single-nucleotide Polymorphism of miR-146a and

Psoriasis

Hala A. Tabl and Hanan H. Sabry

8. Molecular Detection of bla OXA-48 Carbapenemase in Uropathogenic

Klebsiella pneumoniae strains from Suez Canal University Hospital

Rania Kishk, Marwa Azab, Ranya Hassan, Omar Dessouki

9. Molecular detection of Helicobacter pylori in children with Otitis media

with effusion at Assiut University and Sohag teaching Hospitals

Mohamed S Abd Elaal, Mohamed A Alfeky, Mohamed M Osman, Essam Abo

ELmagd, Trek A Hassan, Amal A Elkhawaga

10. In Vitro Assessment of Colistin-Carbapenem Combination Against

Multi Drug Resistant Enterobacteriaceae Isolates in Suez Canal

University Hospitals

Maha Mahdi, Omayma Aboul- Ola, Anwar Heiba, Rania Kishk

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Plenary Session

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Central Line Associated Infections and Bundle Care

Prof. Dr. Abeer Ezzat El-Sayed Mohamed Professor of Microbiology & Medical Immunology,

Head of Infection prevention & Control Unit Suez Canal Specialized Hospital,

Faculty of Medicine, SCU, Ismailia, Egypt

Intravascular catheter represents an essential part of the management of

critically ill patients, who present as acute emergency. However, their use is

often complicated by serious infections, mostly catheter related-blood stream

infections (CRBSIs) which are associated with increased morbidity & mortality,

increase in duration of hospitalization and additional medical costs. The

incidence of CRBSIs varies considerably by the type of catheter, frequency of

catheter manipulation, adherence to bundle care especially hand hygiene, patient

related factors and severity of illness. Accessing the catheter to administer

medications, flush the line & change tubing or caps introduces microorganisms

into the lumen. Hub manipulation is the most common source of infection in

long-term catheters, however it can trigger CR-BSIs in short term catheters as

well. The primary focus is on CVC insertion and nursing intervensions include

insertion and maintainance bundle care as:-

Perform proper hand hygiene.

Use maximal barriers during catheter insertion.

Provide antisepsis with chlorhexidine gluconate.

Choose an appropriate insertion site.

Avoid routine CVC replacement.

Evaluate the catheter insertion site daily for signs of infection and to

assess dressing integrity.

Daily review of catheter necessity with prompt removal when no longer

essential.

Conclusion: Most catheter-related BSIs with short term percutaneously

inserted, noncuffed CVCs were extraluminally acquired and derived from

cutaneous microflora. Strategies achieving successful suppression of cutaneous

colonization can substantially reduce the risk of catheter related blood stream

infection with short term CVCs.

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Proficiency of Information Technology for Surveillance of

antimicrobial resistance in Healthcare settings

Ahmed Morad Asaad Professor of Medical Microbiology and Immunology, Faculty of Medicine,

Zagazig University, ZUMJ Editor-In-Chief

Antimicrobial resistance (AMR) is a major global health problem. It is

estimated that 300 million people will die prematurely because of infections as a

result of antimicrobial-resistant organisms over the next 35 years. Besides, the

world can expect to lose 60-100 trillion Dollars in economic output if AMR is

not effectively tackled. The WHO has for many years promoted the global

monitoring of AMR and taken steps to raise awareness of the impending public

health crisis it will cause. Surveillance is essential to all aspects of the

management of healthcare-associated infections and antimicrobial resistance

because it provides the necessary information to develop and monitor therapy

guidelines, antibiotic formularies, antibiotic stewardship programmes, public

health interventions, infection control policies, and novel antimicrobials and

vaccines. With advances in information technology, the use of soft programs in

AMR surveillance becomes highly warranted. Many software programs are now

available including WHONET, SaTScan, FleXScan, FluNet, Google Flu Trend,

Google Maps, and HealthMap. However, WHONET is considered the best

choice in clinical and epidemiological fields. The WHONET is free and has

been used in >3000 hospitals over >200 countries. This microbiological and

epidemiological program can be used efficiently to study the emergence of

resistant genes, detect an outbreak within a hospital, identify antibiotic

resistance profiles, and to provide automated reporting with the ability for

space-time visualisation.

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Phage Therapy: A Potential Solution in the

Era of Multi-drug Resistance

Marwa Nasser

Microbiology Department, Faculty of Medicine, Ain Shams University

The emergence of multiple drug-resistant bacteria has prompted interest in

alternatives to conventional antimicrobials. One of the possible replacement

options for antibiotics is the use of bacteriophages. These naturally occurring

viruses attack and replicate only within specific bacteria. This is useful in

humans because not only do the bacteriophages not attack human cells, but they

also do not affect our normal flora. Phage therapy has less adverse effects than

antibiotics, can overcome resistance more efficiently, and can more easily

penetrate into biofilm. In this talk, we aim to discuss the history, recent

developments as well as the advantages and other challenges of bacteriophage

therapy as an alternative to antimicrobial chemotherapy.

[email protected]

mailto:[email protected]

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The Dilemma of Antibiotic Resistance

Nermine Elmaraghy

Faculty of Medicine, Suez Canal University; Ismailia, Egypt

Using antibiotics can lead to resistance. Each time you take antibiotics, sensitive

bacteria are killed. But resistant germs may be left to grow and multiply. They

can spread to other people. They can also cause infections that certain

antibiotics cannot cure. The world urgently needs to change the way it

prescribes and uses antibiotics. Even if new medicines are developed, without

behavior change, antibiotic resistance will remain a major threat.

Antibiotic resistance is rising to dangerously high levels in all parts of the

world. New resistance mechanisms are emerging and spreading globally,

threatening our ability to treat common infectious diseases. Where antibiotics

can be bought for human or animal use without a prescription, the emergence

and spread of resistance is made worse. Similarly, in countries without standard

treatment guidelines, antibiotics are often over-prescribed by health workers and

veterinarians and over-used by the public. Without urgent action, we are

heading for a post-antibiotic era, in which common infections and minor

injuries can once again kill.

[email protected]


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Antibiotic resistance: A public health challenge

Rania Ahmed Hassan

Assistant Professor of Medical Microbiology and Immunology

Faculty of Medicine, Ain Shams University

According to the CDC, An increasing number of infections became resistant

to available antibiotics; the ability to effectively prevent and treat a growing

list of diseases is being compromised. These diseases become harder,

and sometimes impossible, to treat. The diminishing number of effective

antibiotics also increases the risk of many medical procedures including

surgery, chemotherapy, and organ transplants.

In this presentation, I am going to highlight three serious resistance traits:

1. New Delhi metallo-β- lactamase (blaNDM-1): constitutes a critical medical

issue. there is a quite systematic association with other antibiotic resistance

determinants is observed in almost all blaNDM-1 producers

(Enterobacteriaceae, Acinetobacter, and Pseudomonas)

2. Emergence of E. coli sequence type 131 (ST131) which markedly

contributed to the increased prevalence of antimicrobial resistance among E.

coli isolates

3. Inducible resistance to macrolides, lincosamides and streptogramins B group

of antibiotics “termed as MLSB resistance”, that are used of treatment of

methicillin resistant Staphylococci (MRS) with decreased susceptibility or

resistance to glycopeptides.

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Session I

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Phenotypic and Genotypic Characterization of Stenotrophomonas

maltophilia in Alexandria Main University Hospital

Mona Gamal El Din Morsi, May Moheb El Din Raouf,

Marwa Ahmed Meheissen, Mabrouka Abdelsalam Hamad

Department of Medical Microbiology and Immunology,

Faculty of Medicine, Alexandria University, Egypt

Background and Objectives: Stenotrophomonas maltophilia emerged as an

important opportunistic nosoocomial pathogen, that causes a variety of infections

difficult to treat due to the intrinsic resistance to the important antimicrobial agents and

mobile genetic elements. Our aim was to determine the prevalence of S. maltophilia

among the clinical isolates of Alexandria Main University, to examine their

antimicrobial susceptibility, biofilm production, extracellular enzymes profile, and to

investigate the presence of class 1 and 2 integrons by PCR. Methodology: Fourteen

clinical isolates of S. maltophilia were collected from different specimens submitted to

Diagnostic Medical Microbiology Laboratory of AMUH over one year period, starting

from the first of April 2017 till the end of March 2018. All isolates were subjected to

antimicrobial susceptibility testing using the VITEK-AST-GN222 Cards (BioMerieux).

Biofilm production was tested by quantitative gold standard mirotitre plate test. The

extracellular enzymes were tested by inoculation of purified single colony on 5% blood

agar, Muller-Hinton agar plate contain 3% skimmed milk, and tryptic soya agar plates

contain 1% Tween 80, to test for hemolytic , protease and lipase activity respectively.

S. maltophilia integron class1 and 2 were identified by PCR. Results: The prevalence

of S. maltophilia (14) isolates among the non- lactose fermenters clinical isolate of

AMUH (1725) was 0.81%. The isolation of S. maltophilia was highest in blood

cultures (12; 85.7%), followed by sputum (1; 7.14%) and urine cultures (1; 7.14%). All

isolates (100%) were positive for hemolytic activity, while seven (50%) produced

protease activity. Eight (57.14%) produced lipase activity. Regarding biofilm

production, nine (64.28%) were moderate biofilm producers, while five (35.71%) were

weak biofilm producers. All isolates (100%) were susceptible to ticarcillin/clavulanic

acid, trimethoprime/sulphamethoxazole, minocycline. On other hand three (21.42%)

were resistance and one (7.14%) was intermediate susceptible to ceftazidime. Class 1

integrase was identified in four isolates (28.5%). Class 2 integrase was not detected in

any of the isolates. Conclusion: Our findings suggest that S. maltophilia can cause

serious healthcare associated infections particularly blood stream infections, though its

very low prevalence in our hospital. Trimethoprim/sulphamethoxazole (SXT) is still

the antibiotic of choice for treatment of S. maltophilia infections in our settings.

[email protected]


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Microbiological Studies on the Effect of Medicinal Plant

Extracts on Diabetic Foot Ulcer Bacteria

1Mohamed E. Sarhan,

2Dalia Moemen*,

3Manal Tarshoby,

1Mahmoud A. Swelim, and

4Mohamed Abd El-Raouf

1Botany Department, Faculty of Science, Banha University;

2Microbiology

Department, Faculty of Medicine, Mansoura University; 3Endocrinology and Diabetes

Department, Faculty of Medicine, Mansoura University; 4Botany Department, Faculty

of Science, Mansoura University, Egypt.

Background: The emergence of microbial resistance towards antibiotics

increased in a terrible rate. Screening of antimicrobial effect of plant extracts

represents hope for discovery of new antimicrobial agents.

Objectives: This research aimed to study the influence of the extracts of several

medicinal plants on diabetic foot ulcer bacteria.

Methodology: Swabs from deep tissues were collected from 56 patients

attending the outpatient clinic of diabetic foot Unit, and diagnosed clinically as

diabetic foot infections. The specimens were examined to identify the causative

bacteria and their antibiotic susceptibility pattern. Antimicrobial activity of

ethanol extracts of ten medicinal plant parts (cinnamon, henna, fennel, black

cumin, eucalyptus, clove, chamomile, ginger, sloenstemma and basil) were

investigated using well diffusion method. Phytochemical screening of effective

plants extracts were performed using tests for alkaloids, glycosides, cardiac

glycosides, saponins, phenols, sterols, tannins, flavonoids and diterpen. Results:

The commonest isolated organisms were S. aureus (33.9%), followed by S.

epidermidis (16.9%), P. aeruginosa (15.3%), P. mirabilis (13.6%), K.

pneumoniae (10.2%), E. coli (6.8%) and P. vulgaris (3.4%). Most bacteria were

resistant to tested antibiotics and 33.9% were multi-drug resistant bacteria.

Ethanol extract of solenstemma, clove, black cumin, and basil had effective

growth inhibition effect against isolated bacteria. Phytochemical screening

clarified that these plant parts contain powerful secondary metabolites and

active materials which explained their antimicrobial activity.

Conclusions: Some medical plants showed antimicrobial activity against

resistant bacteria, thus could be leading and useful therapeutic agents against

many bacterial infections.

[email protected]


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Accuracy of Human Immunodeficiency Virus Diagnostic Tests

Simulating the CDC Algorithm

1Youssra M. Mostafa and

2Doaa T. Masallat*

1Resident Microbiologist, Mansoura Fever Hospital, Ministry of health

2Medical Microbiology Department, Faculty of Medicine, Mansoura University

Background: The detection of HIV in Egypt is started by screening for HIV

antibodies or antigen by EIA and confirming the reactive samples by Western

blot test (WB). In many countries, a new algorithm has been proposed by

Centers for Disease Control and Prevention that uses an HIV-1/HIV-2 antibody

differentiation immunoassay instead of WB or immunofluoresence (IFA) for

confirmation. The initially reactive specimens are followed by same day

confirmation rapid assay that approved by FDA and if this test is negative they

make a nucleic acid test (NAT) to confirm. Objectives: comparing different

diagnostic tests results with WB result in HIV diagnosis and detecting the

accuracy of each assay. Methodology: This study was conducted from January

2016 to September 2017 on 100 people who were seeking for HIV diagnosis.

Blood samples were tested by Fourth generation Enzyme linked immunosorbent

assay (ELISA), Multispot rapid diagnostic test, and nested PCR. Results: The

sensitivity was the best with ELISA. PCR was the most specific test, followed

by Multispot, and finally ELISA. Conclusion: This algorithm provides accurate

results in short time.

[email protected]


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MRSA Screening and Spa Gene Detection in Isolates from

Ophthalmology Hospital in Egypt Compared to MRSA Spa

Detection in USA

Maha G Haggag1,2*

,Tamara Revazishvili3, Amal E Abo Elnour

4,

Mai Al-Kaffas1

1Microbiology & Immunology Unite, Microbiology & Parasitology Department,

2Allergy lab, Research Institute of Ophthalmology, Giza, Egypt.

3Department of Pathology, Immunology & Laboratory Medicine, College of Medicine,

University of Florida, Emerging Pathogen Institute, Gainesville, FL 32611, USA. 4Infection Control Team, Microbiology & Immunology Unite, Microbiology &

Parasitology Department, Research Institute of Ophthalmology, Giza, Egypt.

Background: Staphylococcus aureus is a major cause of ocular infections as

conjunctivitis, keratitis and endophthalmitis. Methicillin resistant Staphylococcus

aureus (MRSA) was almost restricted to hospitals but its prevalence has been

increased in peoples outside hospitals. Protein A is a cell wall component of

Staphylococcus aureus that binds to the Fc portion of IgG. The spa gene of

Staphylococcus aureus encodes protein A contains a highly polymorphic sequence

which is composed of repeats of 24 bp. Sequence typing of the spa gene repeat

region is used to study the epidemiology of MRSA. Methodology: In this study

screening of MRSA among healthcare workers in the Hospital of the Research

Institute of Ophthalmology in Egypt was done and detection of spa gene by PCR

was compared with that was done in USA as part of spa typing of MRSA referred

to the Department of Pathology, Immunology and Laboratory Medicine, Emerging

Pathogens Institute, University of Florida, Gainesville, FL, USA. Results: In the

present study 81 samples from healthcare providers in the Hospital of the Research

Institute of Ophthalmology (RIO), Egypt, were screened for MRSA. Out of these

81 samples, 41 isolates (50.6%) were identified as coagulase positive

Staphylococcus aureus. Twelve staphylococcal isolates were resistant to both

oxacillin and cefoxitin and those were identified as MRSA with percentage 14.8%

(12/81). Conventional PCR could detect spa gene in 10 out of 12 DNA MRSA with

percentage of 83.3% (10/12). On the other hand spa gene was identified by PCR in

all 28 DNA MRSA isolated from patients in the USA (100%). Conclusion: In the

present study the prevalence of MRSA in HCWs was 14.8%. Since amplification of

spa gene by PCR is a necessarily preliminary step for spa typing of MRSA and

since using different sequences for primers of spa gene in this study as well as in

others might affect PCR results then proper selection of the primers and thermal

cycling reaction conditions are recommended for PCR performance and spa typing.

[email protected]


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Detection of Carbapenemase Genes among Carbapenem-

Resistant Enterobacteriaceae Isolates in Suez Canal University

Hospitals in Ismailia

Hasnaa A. Mohamed1,Said H. Abbadi

1, Waheed F. Hessam

1, Atef S. Raheel

1,

Abeer Ezzat El Sayed1

1 Depatment of Medical Microbiology & Immunology, Faculty of Medicine,

Suez Canal University

Background: Carbapenem antibiotics are important therapeutic agents in the health

care setting, they are frequently used as an empiric therapy for life-threatening

infections as well as infections with multi-drug-resistant gram-negative bacilli.

Carbapenemase-producing Carbapenem-Resistant Enterobacteriaceae (CRE) are a

significant public health challenge worldwide. The detection of carbapenemases

productions in CRE strains is performed by phenotypic and genotypic methods.

The phenotypic methods target carbapenemases production but provide no

guidance regarding the specific carbapenemases types, while the genotypic

diagnosis has the benefit of determining the exact mechanism conferring

carbapenems resistance. Objective: Improvement of the antibiotic policy and

infection control strategies in Suez Canal University Hospitals in Ismailia; through

adequate detection of carbapenem resistance in the hospitals. Methodology: All the

CRE isolates were tested by the phenotypic methods (mCIM) test to detect

carbapenemases production, and screened by the conventional PCR for the

presence of five carbapenemase genes, namely blaKPC, blaIMI, blaVIM, blaNDM,

blaOXA-48. Results: The study showed that 34.1% of the Enterobacteriaceae

isolates were carbapenems resistant. Carbapenemases activity was detected in

67.9% of the examined CRE isolates using mCIM test,55.6% showed Metallo-

carbapenemases , 44.4% showed Serine-carbapenemases using the e CIM test.

Using PCR all the isolates (100%) harbor one or more carbapenemases genes. 51

(96.2%) were proved to harbor blaOXA-48 gene, 47 (88.7%) were proved to harbor

blaNDM gene, 28 (52.8%), were proved to harbor blaVIM,gene, the rate of blaIMI,

blaKPC isolation was 17 (32.1%), 4 (7.5%) respectively. Conclusion: The study

results suggest high frequencies of carbapenemase genes among CRE isolates with

carbapenemases activity detected in 67.9% of the examined CRE isolates.It is

extremely concerning and important element need proper antibiotic policy with

wise use of carbapenems and proper implementation of IPC isolation precautions to

monitor the spread of such isolates in the hospital.

[email protected]


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Correlation of Virulence Determinants of Staphylococcus aureus

to the Severity of Diabetic Foot Ulcers in a Tertiary Care

Centre, Egypt

Yasmin Nabiel

Microbiology and Immunology Department,

Faculty of Medicine, Mansoura University

Objectives: This study aimed to estimate the correlation of the Staphylococcus

aureus virulence determinants to the severity of the diabetic foot ulcers in

patients admitted to diabetic foot Unit at Mansoura University Hospitals.

Methodology: A prospective study was performed at the diabetic foot Unit of

Mansoura University hospital, Egypt. The study included 95 patients clinically

diagnosed as diabetic foot ulcers from whom swabs were obtained from the foot

lesions to be processed followed by detecting virulence determinants in isolated

S. aureus by PCR. Results: Staphylococcus aureus was isolated from 34 cases

(35.8%). icaA, icaD, pvl and tst genes were detected in 61.8%, 67.6%, 53%, and

32.4% of S. aureus isolates respectively with higher prevalence in isolated

strains from more severe infections and results were stastically significant. coa

and clfA genes were positive 97.1% and 94.1% isolates respectively.

Conclusion: The results showed that the S. aureus strains causing infections in

diabetic foot patients having genes: icaA, icaD, pvl and tst may be correlated to

the severity of lesions whereas coa and clfA were not.

[email protected]


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Human Papillomavirus Types, 16 and 18 Among HIV Sero

Positive Women Attending Aminu Kano Teaching Hospital,

Kano, Nigeria

1Emmanuela, C. N.,

2Taysir, R. H. and Usman, A. D.

1Department of Medical Microbiology and Parasitology Faculty of Clinical

Sciences, Bayero University Kano, Nigeria;

2Faculty of Medicine, Al-Azhar University, Cairo

Background: Human Papillomavirus (HPV) is one of the most common

sexually transmitted infections. It is the main etiologic agent in cervical cancer

development. HPV types 16 and 18 are more virulent, causing more than 16%

of all cervical carcinomas. It has been suggested that the oncogenic potential of

high-risk genital HPV types may be influenced by a concomitant infection with

the Human Immunodeficiency Virus (HIV). Objective: To determine the

prevalence of Human Papillo mavirus types 16 and 18 infection among HIV

sero positive women attending Aminu Kano Teaching Hospital (AKTH), Kano,

Nigeria. Methodology: The CD4 counts and HIV-viral load of the subject

women were obtained from their medical record. Data generated were analyzed

using SPSS software version 20. Results: This research involved 86 sexually

active HIV positive women in which 25(29.1) % were single, 61(70) % were

married. Their age group was between 20-50 years. 50 (58.1%) out of the 86

women enrolled in this study were positive for HPV, while 36 (41.9%) were

negative for HPV. From the pap smear carried out, low squamous intra-

epithelial lesion (LSIL) that were found was 17 (19.8%), atypical Squamous

Cell-High Squamous intra-epithelial lesion (ASC-HSIL cannot be excluded)

seen were 11 (12.8%) and negative with inflammation were 38 (44.2%). From

the 28 samples that have cell abnormalities, 6 (21.4%) were positive for HPV

type 16, while 16 (57.1%) were positive for HPV type 18. This study showed

that women living with HIV are prone to develop cervical cancer, as 28 (32.6%)

out of 86 women enrolled in this study had cell abnormalities, which indicate

that, there is a possibility for cervical cancer occurrence. This study also showed

that there is a high prevalence of Human Papillomavirus Infection, as type 16

and 18 were detected from these women. Conclusion: There should be an

effective pap smear annual screening among women living with HIV, and early

treatment of precancerous cervical lesions, to prevent cervical cancer

occurrence.

[email protected]


The 25th


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Trouble shooting in H pylori diagnostics…. A glance from real

life stories

Marwa Saad Fathi and Nermin Mahmoud

Medical Microbiology & Immunology Department, Faculty of Medicine

Ain shams University

H. pylori stands as one of the most important pathogens causing gastritis &

gastric erosions that may extend to gastric ulcer. Different studies illustrated the

methods attempted for successful yielding of the pathogen & thus performing an

adequate antibiogram to target the ultimate goal of clearance of the pathogen

after treatment; yet very few researchers highlighted definite solutions to

overcome difficulties clouding the process of culture & sensitivity as well as the

molecular tools for diagnosis. The pathway for accurate diagnosis is full of

obstacles that may obviously hinder back the adequacy of culture & sensitivity

steps. We faced several troubles within our series of studies which we tried to

plan it out to reach a solution that may help in further studies. Problems starts

from sampling including the technique, site of biopsy, rapid urease test,

transport medium, this is followed by culture troubles including high cost media

supplement availability, contamination after long incubation, anaerobic

supplementation, reaching up to susceptibility lack of antimicrobial

susceptibility CLSI guidelines as well as difficulty in yielding & reding

susceptibility patterns. The standard treatment for eradication of H. pylori is a

combination regimen of clarithromycin, amoxicillin and proton pump inhibitor.

In one study high resistance to metronidazole and clarithromycin have been

reported to be 86.7% and 50%, respectively. While resistance to amoxicillin

was 20% however tetracycline and levofloxacin resistance was rare 13.3% and

6.7%, respectively. Predictors for antibiotic resistance were either the body

weight, endoscopic findings or abuse of antibiotics and metronidazole.

Consequently, it is mandatory that antimicrobial susceptibility testing should be

done before initiating treatment; thus, better benefits is achieved for patient care

and also cost effective.

[email protected]


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Session II

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Could Training Programs Eliminate Hospital Environmental

Surfaces Contaminations with Multidrug Resistant Bacteria

1Rasha H. Bassyouni,

1Sylvana Nady Gaber,

2Asmaa Younis Elsary,

3Mohamed Safaa Arafa

1Department of Medical Microbiology and Immunology, Faculty of Medicine,

Fayoum University, Egypt. 2

Department of Public Health and Community

Medicine, Faculty of Medicine, Fayoum University, Egypt. 3

Department of

Orthopaedic surgery, Faculty of Medicine, Fayoum University, Egypt.

Background: Hospital environment could be a risk for transmission of

nosocomial infections. Objective: This study aimed to evaluate the effect of

training program on the elimination of microbial contamination of hospital

environmental surfaces, devices and health care workers (HCWs) hands.

Methodology: Two phases interventional study was conducted for basal

evaluation and training of HCWs and housekeepers on standard precautions

with evaluation of environmental surfaces, devices and hands contamination at

basal level before as well as after routine cleaning and hand hygiene, also after

implantation of a training program. Results: Significant reduction of

environmental surfaces and devices contamination was detected after

educational intervention at all departments (p-value >0.001). The most

common isolate was S. aureus in operating rooms, orthopedic, and general

surgery departments (44.4%, 26.9%, and 22.2% respectively), E.coli was the

most common isolate in urology department (21.8%). Bed ledges/ bed arms

samples showed the highest contamination level (39%) while curtain edges

showed the least contamination site (4.2%). Nurses had the lowest frequency of

hand contamination (30%) followed by physicians, the highest hand

contamination recorded for housekeepers (50%). E.coli isolated from 47.4% of

hands. The most isolated Multidrug Resistant Bacteria was MRSA (54.3%)

followed by ESBLs producing E.coli (38.7%). After education there were

significant improvements in practice observed for all subjects (p-value< 0.05)

and environmental contamination decreased to zero level. Conclusion:

Intervention with a training program has a positive impact on elimination of

hospital environment contamination.

[email protected]


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Fluoroquinolone resistance of clinical E. coli isolates in Mansoura

University Hospitals and its Control

1Eldegla H.E.,

2Abdel-Fattah

G.M.,

2Salem A.M.

1Department Medical Microbiology and Immunology, Faculty of Medicine,

Mansoura University, Mansoura, Egypt; 2Department of Botany, Faculty of

Science, Mansoura University, Mansoura, Egypt

Background: Fluoroquinolones resistance usually occurs due to mutation in the

quinolone resistance-determining regions (QRDRs) in the gyrA and parC genes

that can be detected by multiplex allele-specific PCR (MAS-PCR). Herbal

medicines are used as alternative treatment for disease caused by resistant

bacteria. Objectives: This work aimed to detect resistance to fluoroquinolones in

E. coli isolates from patient admitted in Mansoura University Hospitals;

additionally, to identify certain natural plant extracts that could be used against

fluoroquinolone resistant E. coli. Methodology: Fifty clinical E. coli isolates were

collected from patients admitted in Mansoura University Hospitals.

Fluoroquinolones susceptibility pattern was tested by disk diffusion method. Out

of 50 isolates, 25 fluoroquinolone resistant E. coli were selected to detect

mutations in gyrA and parC genes by MAS-PCR. Ethanolic plant extracts were

tested against FQ resistant E. coli isolates by using agar well diffusion method.

Results: E. coli isolates showed highest resistance to ciprofloxacin (76%)

followed by norfloxacin (72%), levofloxacin (70%), and ofloxacin (68%). Double

mutations at gyrA gene were detected at position 83 and 87 of QRDRs in 12

(48%) FQ resistant E. coli and at parC gene at position 80 and 84 of QRDRs in 3

(12%) FQ resistant E. coli. While single mutation at position 83 and 87 was found

in QRDR of gyrA in 8 (32%) and 5 (20%) of FQ-resistant E. coli, respectively

and single mutation at position 80 and 84 was found in QRDR of parC in 21

(84%) and 1 (4%) of FQ-resistant E. coli, respectively. Ethanolic extract of Clove

had more antibacterial activity compared to other extracts. Conclusion: high rate

of fluoroquinolone resistance among clinical E. coli isolates was detected and this

necessitates monitoring the microbial trends and resistance patterns. Plants may

be used as natural antibiotics in the treatments of antibiotic resistant E. coli

infections.

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"The art of article critique"

How to Review a Medical Article; Advice from a reviewer

Noha Tharwat Abou El-Khier

Medical Microbiology & Immunology, Faculty of Medicine, Mansoura

University, Egypt

Peer review is the process used to assess an academic paper before deciding

whether it should be published or not. The paper is looked at by experts in the

field, known as reviewers or referees. The peer-review system is essential in

order to ensure that only credible, high- quality research is published. It not only

improves the quality of published papers, it also ensures that readers can trust a

journal to provide reliable information. As members of the scientific

community, researchers are expected to review papers. The role of a peer

reviewer is substantial. First and foremost, the reviewer’s role is to tell the

author the strengths and weaknesses of the manuscript and to provide

constructive criticism about how it could be improved. The second

responsibility of the reviewer is to suggest to the Editors whether the manuscript

should be accepted, rejected, or revised and resubmitted. The responsibility of

the peer reviewer is to thoroughly evaluate the science of a submitted

manuscript. The time spent reading, evaluating, and writing a peer review is

substantial.

[email protected]


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Single closed tube Tm-shift method versus PCR-Restriction

Fragment Length Polymorphism in detection of Macrophage

Migration Inhibitory Factor-173 G>C (s755622) single nucleotid

polymorphism in patients with rheumatoid arthritis

1Hala A.Tabl, and

2Nashwa I. Hashaad

Departments of 1Medical Microbiology &Immunology and

2Rheumatology, Rehabilitation & Physical Medicine, Faculty of Medicine,

Benha University

Background: Macrophage migration inhibitory factor (MIF) might has a role in

the development and disease activity of Rheumatoid arthritis (RA). There are

several disadvantages in the conventional methods for MIF genotyping and

there is a strong need for convenient, flexible, accurate and inexpensive method.

Objectives: This study was designed to study the application of single closed

tube melting temperature (Tm)-shift method in genotyping of MIF-173 G>C

(s755622) gene in RA patients and to compare its result with the conventional

PCR-Restriction Fragment Length Polymorphism (PCR-RFLP) and to

investigate the potential association of these variants of MIF gene with

susceptibility and activity of RA. Methodology: GC-rich tail was attached to 5'-

end of one of the two allele specific forward primers, such that MIF alleles can

be discriminated by the Tm of the PCR products. One hundred RA patients and

40 healthy controls were genotyped for MIF-173 G>C by both Tm-shift method

and conventional PCR-RFLP. Results: The comparison of the PCR-RFLP and

the Tm-shift method showed one discordant result in 140 samples tested.

Retesting this sample with prolonged time of incubation with the restriction

enzyme, corrected the result to become 100% agreement between the two

methods. No significant association could be found between MIF-173 G>C

SNP and risk of RA. C/C genotype is more prone to higher disease activity than

other genotypes. Conclusion: The single closed-tube Tm-shift method is

reliable, rapid and cost-effective and it is superior to conventional PCR-RFLP in

genotyping of MIF.

[email protected]


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Biochemical and Immunological Characterization of Hemolysin

Produced by Pseudomonas aeruginosa PAO1 Isolated from Burn

Patients

1Ayman A. Allam,

2Ashraf M. El-shawadfy,

2Wesam A. Hassanein, and

2Esraa H. Hamza

*Medical Microbiology and Immunology Department, Faculty of medicine,

**Botany and Microbiology Department, Faculty of science, Zagazig

University, Egypt.

Objectives: The aim of the study was to purify and characterize the haemolysin

produced by multidrug resistant Pseudomonas aeruginosa PAO1 isolated from

burn patients. Methodology: Isolation and identification of Pseudomonas

aeruginosa from burn patients was done by standard bacteriology methods.

Characterizarion of Pseudomonas aeruginosa PAO1 was done by PCR

amplification and sequencing of the gene 16 S rRNA. The hemolysin produced

by Pseudomonas aeruginosa PAO1 (NR 074828 1) under optimal cultural

conditions (pH 7, incubation at 37 °C, yeast extract as nitrogen source and

glucose as carbon source) was purified by successive fractional precipitation

using ammonium sulphate 70% concentration followed by gel filtration on

Sephadex G -100. Results: The specific activity of purified enzyme increased to

30-fold with a 15.6 % yield after gel filtration on Sephadex G -100. Pure

enzyme revealed an apparent molecular weight of 37 KDa after SDS-poly

acrylamide Gel Electrophoresis. High performance liquid chromatography

showed that the hemolysin is rich in glycine (26.7) %. The physical

characteristics of the haemolysin were determined, and the obtained results

showed that it was inactivated above 70C. Purified enzyme was stable within

pH range of 4-9 and the maximum activity was at pH 7. It was also activated by

metal ions such as Ca2+, Fe3+ and Cu2+ while iodine and EDTA inhibited the

enzyme activity. The hemolysin lost its half activity after storage period of 48

day at 4°C. It completely lost its toxicity after heating for 15 min in boiling

water bath. Mice toxicity of the fresh and heated hemolysin revealed that

injecting mice with 0.5 ml of fresh hemolysin hemolytic titer (128 HU/ml)

caused 100 % mortality within 5 days while 0.5 ml of hemolytic titer 64 HU/ml

of the heated hemolysin (toxoid) caused 50% mortality. In vitro toxin antitoxin

neutralization test revealed that anti-hemolysin antitoxin was present in the

serum of the mice that previously injected by heated toxin (toxoid).

Conclusion: The study concluded that this hemolysin can be a component of a

vaccine for preventing hemolysis caused by multidrug resistant Pseudomonas

aeruginosa in burn patients.

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Human Herpes Virus Type 8 (HHV-8) among People Living with HIV

Attending General Hospital, Jigawa State, Nigeria

1Nazir A.Y.,

2Taysir R. H. and Usman A. D.

1Department of Medical Microbiology and Parasitology

Faculty of Clinical Sciences, Bayero University Kano, Nigeria and 2Faculty of Medicine, Al-Azhar University, Cairo

Background: Human Herpes virus type 8 is among the frequent opportunistic

infections among individuals infected with human immunodeficiency virus

(HIV) and may result in severe morbidity and mortality among this group of

patients. It is known to be the causative agent of Kaposi’s Sarcoma (KS), as

well as other malignancies such as primary effusion lymphoma. Objective: This

study investigates the prevalence of HHV8 antigen among people live with HIV

as well as its correlation with the patients CD4 counts and Viral loads.

Methodology: This cross-sectional study involved 182 blood sample collected

from HIV sero positive individuals attending antiretroviral therapy clinic

(ART), Babura General Hospital, Jigawa State, Nigeria. Samples were analyzed

for HHV-8 antigen using Enzyme linked immunosorbent assay and CD4+ cell

Count. Socio-demographic informations such as age, gender, and marital status

were obtained from patient folder. Results: Of the 182 subject studied 6(3.3%)

were positive for HHV-8 antigen. All subjects (100%) who were HHV8

Positive have low CD4 Count and high HIV Viral loads. There was a

statistically significant difference between HHV8 and respondents CD4 count (p

= 0.001). However no association was observed between HHV8 and

respondents gender and their age.

[email protected]


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Interleukin-18 and Vascular Endothelial Growth Factor as

Predictors for End-stage Renal Disease

1Aml F.A. Makled,

1Eman H.M. Salem,

1Amira H.A. El-Khayat,

2Mahmoud M.A. Emara,

3Sara I.M. El Shohady

Departments of 1Microbiology and Immunology and

2Internal Medicine, Faulty

of Medicine, Menoufia Universality, Shebin Elkom 3Menoufia University

Hospital, Menoufia University, Menoufia Governorate, Egypt

Background: IL-18 and VEGF are inflammatory cytokines playing important

roles in the pathogenesis of ESRD and related comorbidities like diabetic

nephropathy and viral hepatitis. Objective: The objective of this study was to

evaluate the role of interleukin-18 (IL-18) and vascular endothelial growth

factor (VEGF) in end-stage renal disease (ESRD), and the influence of

comorbidities like diabetes and viral hepatitis on their levels. Methodology:

This study was conducted on 96 patients undergoing hemodialysis (25 diabetic

patients with hepatic viral infections, 25 diabetic patients without hepatic viral

infections, 25 nondiabetic patients with hepatic viral infections, and 21

age-matched and sex-matched healthy individuals as a control group). All

patients were subjected to full history taking, clinical examination, and

laboratory investigations. Serum IL-18 and VEGF levels were measured for all

the study individuals by using enzyme-linked immunosorbent assay technique.

Results: The prevalence of IL-18 and VEGF was higher in diabetic patients and

patients with hepatitis comparing with the controls (P = 0.001). A detectable

level of IL-18 was found in 100% of diabetic patients with and without viral

hepatitis, and in 44% of the ones with only hepatitis (P = 0.001). A detectable

level of VEFG was found in 100% of the patients with only diabetes and only

hepatitis, and in 80% of the ones with combined diabetes and hepatitis (P =

0.001). Conclusion: There is high elevation of both IL-18 and VEGF serum

levels in ESRD associated with diabetic nephropathy and viral hepatitis. Serum

IL-18 is higher in diabetic than hepatic nephropathy, whereas the opposite is

seen with VEGF.

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Phenotypic and molecular characterization of clinical

Acinetobacter isolates from Menoufia University Hospitals

Ahmed M. Baker, Amal F. Makled, Eman H. Salem, Ahmed A. Salama,

Soma E. Ajlan

Department of Microbiology and Immunology, Faulty of Medicine,

Menoufia Universality, Shebin Elkom

Background: Acinetobacter spp. is important opportunistic pathogens

responsible for nosocomial infections. Objectives: The aims of this study were

to investigate the prevalence of Acinetobacter spp. in Menoufia University

Hospitals, to investigate their antimicrobial susceptibility patterns, and to assess

carbapenemases production in these isolates. Methodology: This study was

conducted on 603 clinical samples from patients admitted to Menoufia

University Hospitals. Acinetobacter spp. were identified by standard

microbiological methods and API20NE test kits. Antimicrobial susceptibility

was tested using disk diffusion and agar dilution methods. Imipenem‑resistant

Acinetobacter isolates were further tested for metallo‑β‑lactamase (MβL)

production. Results: This study was conducted at Medical Microbiology and

Immunology Laboratory, Faculty of Medicine, Menoufia University.

Acinetobacter spp. represented 10.6% of all collected nosocomial isolates. With

regards to API20NE results, A. baumanii was the predominant Acinetobacter

spp. (80.8%) followed by A. baumannii–A. calcoaceticus complex (7.7%), A.

lwoffii (5.8%), A. haemolyticus (3.8%), and A. pitti (2.6%). Acinetobacter

isolates were highly resistant to cefepime (92.3%), ampicillin–sulbactam,

piperacillin, piperacillin–tazobactam, ceftazidime, tobramycin (91% for each),

amikacin (84.6%), and imipenem (67.9%). Overall, 56.4% of Acinetobacter

isolates were susceptible to tigecycline. On agar dilution method, 96.2% of

Acinetobacter isolates were found to be susceptible to colistin and 66.7% were

imipenem resistant. Imipenem/ethylenediaminetetraacetic acid combined disk

test showed that 81.1% of imipenem‑resistant Acinetobacter were MβL

producers, and multiplex PCR showed that 15.1% of imipenem‑resistant

Acinetobacter were positive for blaVIM2, but none of them were positive for

blaIMP1 gene. Conclusion: Acinetobacter spp. are serious nosocomial

pathogens with high prevalence of carbapenems resistance. Production of

carbapenemases, especially MβLs, is considered the main

carbapenem‑resistance mechanism. Tigecycline and colistin can be valuable

therapeutic options for the treatment of Acinetobacter infections.

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Posters

The 25th


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[1] Assessment of the level of Knowledge, attitude and practice regarding

influenza vaccination in Community and healthcare settings in Riyadh,

Saudi Arabia

Dalia Saad ElFeky1&2

, Yomna Khaled Ramadan1&3

, Alhanouf Alsarhan1,

Rawabi AlQurashi1, Malak Alkhodaidi

1, Malak Albalawi

1

1College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh,

2Department of Medical Micrrobiology and Imunology, Faculty of Medicine; Cairo

University; 3Department of Internal Medicine, Faculty of Medicine, Cairo University

Introduction: Seasonal influenza is a major health issue. Each year, about 3–5

million cases of severe illness and 250,000–500,000 deaths globally result from

epidemic seasonal influenza. Vaccination against influenza viruses is the most

efficient way to prevent influenza related complications. Compliance to receive

the influenza vaccination is very low and potential barriers of influenza

vaccination are in need to be identified to raise awareness and acceptance of the

vaccine. Objectives: The Aim of this study was to assess knowledge, beliefs

and attitudes regarding influenza vaccination in community and healthcare

settings in Riyadh city and to identify reasons for electing or declining the

immunization. Methodology: It is a cross-sectional questionnaire based study

conducted between January and March 2018 using a closed ended, interviewer

based questionnaire. The study enrolled 500 adults of Riyadh city population

including participants from general population, students and HCWs. The

questionnaire was distributed in shopping malls and parks in different areas in

Riyadh, in Princess Nourah Bint Abdulrahman University and in King Abdullah

Bin Abdulaziz University Hospital. Results: A total of 500 participants were

included in the study including 124 HCWs (24.8%), 195 students (39%) and

181 (36.2%) participants from general population. The knowledge score of

participants in this study ranged between 5-35 with mean of 18 ±5.85. Mean

knowledge score was highest among HCWs followed by students and lastly

general population with a statistically significant difference (p<0.00). However,

the majority of participants in all groups have poor knowledge when using a cut

off 60% and 70% of knowledge score for the general population and HCWs,

respectively. Conclusion: There is poor knowledge about influenza disease and

influenza vaccination among the studied population including HCWs.

Compliance to influenza vaccination was poor among different groups of the

studied population.

[email protected]


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[2]

Antimicrobial Activities of Commercially Available Obturating

Materials in Primary Teeth

1Israa A. Ibrahim,

2Doaa T. Masallat,

3Ahmed H. Ibrahim,

3Ibrahim H. El Kalla

1Faculty of Dentistry, Science and Technology University, Republic of the

Sudan; 2Department of Microbiology and Immunology, Faculty of Medicine,

Mansoura University, Egypt; 3Department of Pedodontics and Preventive

Dentistry, Faculty of Dentistry, Mansoura University, Egypt

Background: Preservation of primary dentition is a must for orofacial

development as it helps to maintain the eruption of permanent teeth, aids in

mastication, and phonation. Objectives: The present study compares the

antimicrobial activities of commonly used obturating materials for filling the

root canals of primary teeth against the microorganisms commonly infect the

roots. Methodology: the antimicrobial activities of four commonly used

obturating materials, ZOE; Iodoform; Vitapex; and Endoflas, were evaluated by

three methods; the first method was electron microscope images which detected

the presence of the bacteria in dentinal tubules. The second method was CFU

count method in which thirty extracted deciduous mandibular molars were

incubated in a mixed-species suspension, obturated, cultured and the numbers of

the bacterial colonies were reported for each obturated group. The third method

was the agar diffusion method in which the antimicrobial activities of the

obturating materials were tested against four microbial isolates (E. faecalis; E.

coli; S. aureus and Ps. aeruginosa). Results: The four obturating materials

reported different antimicrobial effect in CFU test which was not statistically

significant; however, Endoflas and ZOE were superior to Vitapex and

Iodoform. Bacterial resistances were detected against Vitapex and Iodoform.

Conclusion: Obturating materials containing eugenol were more effective than

other materials without eugenol.

[email protected]


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[3]

Helicobacter pylori, Chlamydia pneumoniae and c. trachomatis as

Probable Etiological Agents of Preeclampsia

Yasmin Nabiel

Microbiology and Immunology Department,

Faculty of Medicine, Mansoura University

Objectives: The aim of this study was to evaluate the evidence for Helicobacter

pylori, Chlamydiae pneumoniae and trachomatis to act as a probable etiology

for preeclampsia (PE), together with estimating the prevalence of such

infections in pregnant women with PE. Methodology: We performed a

prospective study in Mansoura University Hospitals, Egypt, for detecting H.

pylori infection by estimating H. pylori IgG and IgM, in addition to detection of

Chlamydiae infections by PCR in 90 pregnant women with PE and 90

normotensive pregnant women of the same age and body mass index who were

studied as control. Results: The prevalence of H. pylori infection in

preeclamptic pregnant women was 54.4% with a statistically significant

association to PE. The prevalence of C. pneumoniae was 27.8% whereas that of

C. trachomatis was 4.44%. The infected preeclamptic cases showed high levels

of leucocytes besides elevated C-reactive protein concentrations. Conclusion:

Helicobacter pylori were found to act as a cofactor in the development of PE.

Occurrence of C. trachomatis was low in pregnant women in our community;

however, it showed that it may act as a cofactor in PE, whereas C. pneumoniae

was attributed to have no role in PE pathogenesis until supported by further

studies.

[email protected]


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[4]

Screening of the Antimicrobial Activity of Some Plant Aqueous

Extracts and Plant Oils and Enhancement of the Antimicrobial

Activity of Selected Plant Oil Using Liposomes as Nanoscale

Carrier

Maha G Haggag1*, Medhat W Shafaa

2, Hossam S Kareem

3,

Hoda H El-Hendawy4and Amir M El-Gamil

4

1Department of Microbiology & Immunology, Research Institute of

Ophthalmology, Giza, Egypt. 2Department of Physics, Faculty of Science,

Helwan University, Cairo, Egypt; 3Department of physiological Optics,

Research Institute of Ophthalmology, Giza, Egypt. 4Department of Botany and

Microbiology, Faculty of Science, Helwan University, Egypt.

Background: A considerable interest in the possible use of natural alternatives as food

preservative either to delay food spoilage or to prevent food-borne pathogens growth. Many

spices and herbs extracts possess antimicrobial activity, almost invariably due to the

essential oil fraction. Liposomes can encapsulate both hydrophilic and lipophilic materials.

Liposome entrapment may stabilize encapsulated bioactive materials against a range of

environmental and chemical stresses, including the presence of enzymes or reactive

chemicals and exposure to extreme pH, temperature, and high ion concentration thus

providing protection of the antimicrobial peptides, enhancing their efficacy and stability for

food applications. Objectives: This study aimed to test the antimicrobial activity of

Aqueous plant extracts & oils against selected strains of pathogenic Gram-positive and

Gram-negative bacteria and yeast. Furthermore clove oil was selected to be encapsulated

into liposomes as nanoscale carriers to examine the possible enhancement of its

antimicrobial activity. Methodology: Aqueous extracts of clove flower buds, black seed,

Lupine, curcuma, cinnamon, ginger, and chamomile were prepared and their antimicrobial

activities were tested against 5 types of pathogenic isolates; Staphylococcus aureus, salmonella, Escherichia coli, Pseudomonas aeruginosa, Klebsiella and Candida spp using

agar well diffusion method. Also six ready-made oils of clove, black seed, thyme, garlic,

rosemary and green tea were purchased and tested for their antimicrobial activity. Clove oil

was selected to be encapsulated into liposomes and antimicrobial activity enhancement was

tested by MIC and MBC. Results: Antimicrobial activity of Clove extract was stronger

than other plant aqueous extracts. All oils showed antimicrobial activity against at least two

of the tested microorganisms. The antimicrobial activity of liposome encapsulated clove oil

was enhanced by 5 times more than that of un-encapsulated clove oil. Tetracycline was also

encapsulated into liposomes and its antimicrobial activity was found to be improved by 12

times when compared with un-encapsulated one. Conclusion: Liposome is an efficient

carrier that significantly enhancing the antimicrobial activity of some plant oils as clove and

also significantly strengthen the antibiotic activity in vitro.

[email protected]


The 25th


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[5]

Colistin Resistance in Klebsiella pneumoniae and Esherichia coli

clinical Isolates: A Microbiological and Molecular Study

Amina Nour Eldin1, Reem Abdelhamid Harfouh

1, Marwa Ahmed Meheissen

1, Ahmed Mostafa Elmenshawy

2, Sara Mustafa Hendawy

1

1Medical Microbiology & Immunology Department, faculty of Medicine,

University of Alexandria; 2 Critical care Department, faculty of Medicine,

University of Alexandria

Background: The global increase in multidrug resistant Enterobacteriaceae has

resulted in increased use of colistin with the inevitable risk of emerging

resistance. Klebsiella pneumoniae and Esherichia coli have been recently

showing an appreciable resistance to colistin. Objectives: The aim of the

present work was to: 1. Evaluate the performance of the rapid polymyxin

Nordmann Poirel test for phenotypic detection of colistin resistance in K.

pneumoniae and E. coli clinical isolates. 2. Determine the antimicrobial

susceptibility pattern of those isolates. 3. Estimate the prevalence of plasmid

mediated colistin resistance among resistant clinical isolates. Mothodology: A

total of 50 K. pneumoniae and E. coli (25 colistin susceptible and 25 colistin-

resistant) isolated from different clinical specimens collected from Alexandria

University hospitals intensive care units were included in the study. All isolates

were subjected to the following: 1. Identification to the species level by

MALDI-TOF. 2. Detection of colistin resistance by phenotypic methods. a.

Broth microdilution method according to EUCAST 2018 guidelines.b. Rapid

Polymyxin NP Test. 3. PCR for detection of mcr-1 and mcr-2 genes for plasmid

mediated colistin resistance. Results: Using broth microdilution test, the MIC of

colistin susceptible isolates ranged from 0.12- < 2 μg/mL, while that of colistin

resistant isolates ranged from 4 – 128 ug/ml. With regard to performance of the

rapid polymyxin NP test with colistin-susceptible isolates (13 K. pneumoniae,

12 E. coli), the 25 isolates tested (MICs of colistin) gave negative results,

similarly all colistin resistant isolates (20 K. pneumoniae, 5 E. coli) gave a

positive result. Thus the test provided 100% sensitivity and specificity. None of

the colistin resistant isolates harbored mcr-1 or mcr-2 genes. Conclusions: The

rapid polymyxin NP test is useful for first-step screening of colistin resistance in

K. pneumoniae and E. coli. The mechanism of colistin resistance could be

explained by mechanisms other than plasmid-mediated resistance. Further study

with larger sample size is needed to investigate the presence of plasmid

mediated colistin resistance genes.

The 25th


40

[6]

Characterization of Fluoroquinolones-resistant Salmonella

enterica serovar Typhi in Egypt

1Amira Hisham El- Ashry,

1Mohammad Ahmed Abou El-Ela,

1Mohammad Abd El- Razik El-Farrash,

1Hamdia Yehia Askar,

1Monir Hussein Hussein Bahgat,

2Mansoura, Egypt

Department of Medical Microbiology and Immunology a and the Department of

Internal Medicine, b Faculty of Medicine, Mansoura University, Egypt

Background: Typhoid fever is endemic in developing countries including

Egypt, producing major public health problems with high mortality and

morbidity. The emergence of resistant serovar Typhi (S. typhi) to commonly

recommended antimicrobials is alarming in developing countries.

Fluoroquinolones have been the empirical drug of choice for multidrug-resistant

MDR typhoid. However, there have been several alarming reports of

fluoroquinolones therapeutic failure in typhoid patients. Resistance of S. typhi to

fluoroquinolones commonly results from target site mutation. Objectives:

Determination of antimicrobial resistance pattern of S. typhi isolated from

Egyptian patients with typhoid fever admitted to or attended Mansoura

University

Hospitals (MUHs) and Mansoura Fever Hospital, detection of

quinolones resistant strains and using PCR-RFLP and sequencing techniques for

testing mutation at QRDR of gyrA gene in the isolated strains. Methodology:

Blood and Stool samples from clinically suspected typhoid patients were

screened by culture on suitable media and were identified biochemically. The

identified S. typhi isolates were tested for susceptibility to antimicrobials using

the Kirby Bauer disk diffusion method. Minimum inhibitory concentrations of

ciprofloxacin was determined by E test. Interpretation of all results was done

according to the CLSI guidelines 2015. Mutations in gyrA gene were detected

by PCR-RFLP and sequencing methods. Results: Out of 500 blood and stool

samples, 57 isolates were S. typhi (96.6%) and only two were S. paratyphi A

(3.4%). Of the 57 S. typhi, 80.7% were resistant to nalidixic acid, 50.9% had

ciprofloxacin MIC 0.125-0.5 μg/ml and 19.3% had ciprofloxacin MIC >1

μg/ml. Ser 83 mutation in gyrA was detected in 63.1% of the isolates.

Conclusion: Increased emergence of fluoroquinolones -resistant typhoidal

Salmonella in Egypt which is caused mainly by point mutation at codon 83

(Ser83-Phe substitution TCC→TTC) in QRDR of gyrA gene.

[email protected]


The 25th


41

[7]

Association between single-nucleotide polymorphism of miR-

146a and psoriasis

Hala A. Tabl and Hanan H. Sabry

Departments of Medical Microbiology & Immunology and Dermatology,

Venereology and Andorology Faculty of Medicine, Benha University, Egypt

Background: Micro-RNAs (miRNAs) play important roles in the development

of different inflammatory conditions of the skin. However, few studies

investigated the association between miR-146a and psoriasis. Objectives: This

work aimed to study the association between miR-146a single-nucleotide

polymorphism (SNP) rs2910164 and the risk of psoriasis and to study the

association between levels of skin expression of miR-146a and the response to

treatment. Methodology: The study was carried out on 120 patients with

psoriasis and 60 control subjects. The miR-146a rs2910164 SNP was detected

by using polymerase chain reaction-restriction fragment length polymorphism

(PCR-RFLP) analysis. Levels of skin expression of miR-146a were detected by

Real Time PCR before and 3 months after treatment with PUVA therapy.

Results: Non significant association could be found between combined (CG +

GG) genotypes and risk of psoriasis [OR (95% CI) = 0.81 (0.41-1.60)],

(P=0.52). The level of miR-146a expression was significantly increased in

patients compared to controls, with the highest level recorded in patients with

CC genotype. There was a significant decrease in the miR-146a levels after

treatment in both CC (P<0.001) & CG (P=0.01) genotypes but not in GG

genotype (P=0.29). MiR-146a levels were higher in patients responding to

treatment than non-responders (P<0.001). Also, there was significantly higher

response to PUVA treatment in CC genotype (100%) than in CG genotype

(50%) and GG genotype (20%) (P<0.001). In conclusion, no significant

association could be found between combined rs2910164 genotypes (CG + GG)

and risk of psoriasis. Moreover, measuring miR-146a level and knowing

patients' genotype could be useful predictors of therapeutic response.

[email protected]


The 25th


42

[8]

Molecular detection of bla OXA-48 carbapenemase in

uropathogenic Klebsiella pneumoniae strains from Suez Canal

University Hospital

1Rania Kishk,

2Marwa Azab,

3Ranya Hassan,

3Omar Dessouki

1Microbiology and Immunology department, Faculty of Medicine, Suez Canal

University; 2Microbiology and Immunology department, Faculty of pharmacy,

Suez Canal University; 3

Clinical Pathology department, Faculty of Medicine,

Suez Canal University

Background: The emergence of multidrug resistant Klebsiella pneumoniae (K.

pneumonia) has a new concern in antibiotic resistant threats. The emergence of

carbapenems resistance, antibiotics of last resort, is considered a critical clinical

and public problem. Aim: this study aimed to make recommendations for the

identification and detection of Klebsiella Producing Carbapenemases (KPC) to

improve patient management and antimicrobial stewardship. Methodology: this

study included 120 consecutive and non-duplicate clinical strains of K.

pneumoniae isolated from cases of urinary tract infections. Phenotypic detection

of ESBL and Carbapenemases production were performed. Identification of

class D carbapenemases by 16S rRNA gene sequence was performed.

Carbapenem resistance bla OXA-48 gene was detected using conventional

PCR. Results: Phenotypic tests show 57 strains (47.5%) were carbapenem

resistance (p value = 0.002) and 47 strains (39.1%) were ESBL producers (p

value = 0.001). By 16S rRNA sequencing analysis, most of class D

carbapenemases were K. pneumoniae (17 strains out of 20 strains). Two strains

were K. oxytoca and the other strain was Bacillus cereus. Among class D

carbapenemase resistant K. pneumoniae identified by 16S rRNA sequencing,

PCR for bla OXA-48 gene produced amplified product of 744 bp and was

positive in 10 isolates (58.8%). All these isolates were ESBL producers by

phenotypic tests and resistant to ciprofloxacin, levofloxacin, gentamycin and

amikacin. Conclusion: There are high frequencies of both carbapenem

resistance (47.5%) and ESBL production (39.1%) among K. pneumoniae

isolates. Effective infection control and strict antimicrobial stewardship are

crucial elements to limit the spread of resentence genes.

[email protected]


The 25th


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[9] Molecular detection of Helicobacter pylori in children with Otitis

media with effusion at Assiut University and Sohag Teaching

Hospitals

Mohamed S Abd Elaal a, Mohamed A Alfeky

b, Mohamed M Osman

a, Essam

Abo ELmagd, c Trek A Hassan

a and Amal A Elkhawaga

b

aOtolaryngology department, Faculty of Medicine, Assiut University

bMedical Microbiology and Immunology department, Faculty of Medicine,

Assiut University cOtolaryngology Department, Faculty of Medicine, Aswan University

Background: Otitis media with effusion (OME) is a commonest cause of

hearing loss in childhood especially in developing countries. The study included

50 patients with OME. In all cases, myringotomy operation was done.

Objectives: Our work aimed to investigate the prevalence of aerobic and

anaerobic bacteria in children with OME; to determine the presence of H. pylori

in middle ear effusions (MEE) using polymerase chain reaction (PCR); and to

examine the antibiotic susceptibility profile of isolated bacterial strains. Results:

Staphylococcus aureus (28%) was the most prevalent, followed by

Peptostreptococcus species (19.2%), Coagulase negative staphylococci

(17.5%), Klebsiella species (8.7%), E. coli (5.2%), and Pseudomonas

aeruginosa (3.2%). H. pylori could be detected in (5.2%) cases using PCR.

Regarding antibiotic sensitivity, most isolated strains were sensitive for

ciprofloxacin and chloramphenicol while they were resistant to cephalothin

except Peptostreptococcus species. Conclusion: The obtained results indicate

that H. pylori may play a role in the pathogenesis of OME.

[email protected]


The 25th


44

[10] In Vitro Assessment of Colistin-Carbapenem Combination

Against Multi Drug Resistant Enterobacteriaceae Isolates in

Suez Canal University Hospitals Maha Mahdi, Omayma Aboul- Ola, Anwar Heiba, Rania Kishk

Microbiology and Immunology Department, Faculty of Medicine, Suez Canal

University, Ismailia, Egypt

Background: Health crisis of Multi-Drug Resistant (MDR) Gram Negative

Bacteria, including Enterobacteriaceae, seems overwhelming as its persistence

and worldwide spread causes clinical failures in the treatment of infections by

these organisms and results in significant morbidity and mortality. Combination

therapy, using two or more drugs, may be the last resort for treatment of these

MDR organisms. Objective: this study aimed to assess the effect of colistin

carbapenem combination on MDR-Enterobacteriaceae in vitro. Methodology:

Out of 219 of Enterobacteriaceae strains isolated from different types of

infections in SCUHs, 21.91% were detected to be MDR. In vitro assessment of

Imipenem-colistin combination on the 46 MDR-Enterobacteriaceae strains was

performed using the checkerboard technique. Results: The combination had a

synergistic effect on 63.04% of the isolates and additive effect on 23.9%.

Indifferent effect was shown in 10.8%, while antagonism was shown in 2.1% of

the strains. At least, four-fold decrease in imipenem MIC was proved in 86.9%

of the strains, 30.43% had a reversal of imipenem resistance with change of

MICs from ≥ 4 to ≤ 1μg/ml, 15.21% changed to intermediate resistance with

MIC decrease from ≥ 4 to 2 μg/ml. Three of the 5 strains that showed

indifference and the only strain which showed antagonism were the colistin

resistant strains. Conclusion: Carbapenem and colistin combination against

MDR-Enterobacteriaceae is supported in vitro by high synergy and the reversal

of imipenem resistance with low antagonism, which may encourage clinical

trials of combination therapy in treatment of HAIs by MDR pathogens.

[email protected]


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