RESUMEN
This report presents the prevalence of Palestinian isolates of methicillin-resistant Staphylococcus aureus (MRSA) in nosocomial infections and their antibiotic resistant pattern. A total of 321 clinical isolates of S. aureus were identified from different patients. The prevalence of methicillin resistance among S. aureus isolates was 8.7% (28 isolates). Resistance rates of MRSA to other antibiotics were as follows: 82.1% resistant to erythromycin, 67.9% to clindamycin, 64.3% to gentamicin, and 32.1% to ciprofloxacin. No co-trimoxazole- and vancomycin-resistant isolates were identified in this study. The proportion of methicillin resistance was highest among S. aureus isolates associated with upper respiratory specimens (42.8%); the proportion of methicillin resistance was 39.3% among skin ulcer isolates, 10.7% among urinary tract infection isolates, and lowest among isolates associated with blood and prostate discharge (3.6% each).
Asunto(s)
Infección Hospitalaria/microbiología , Resistencia a la Meticilina , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/efectos de los fármacos , Infección Hospitalaria/epidemiología , Farmacorresistencia Bacteriana , Humanos , Prevalencia , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Staphylococcus aureus/fisiologíaRESUMEN
To evaluate the effectiveness of hepatitis B virus (HBV) vaccination of household contacts of HBV carriers in Tulkarm district, Palestine, quantitative hepatitis B surface (anti-HBs) antibody response in 161 household contacts was measured after vaccination. A seroprotective anti-HBs response (titre > or = 10 IU/L) was elicited in all vaccinated subjects. Of these 2.5% had titres of 10-99 IU/L, 61.5% 100-999 IU/L and 36.0% > or = 1000 IU/L. The number of vaccination doses had no effect on the achievement of seroprotection. HBV infection was demonstrated in 13 cases and their anti-HBV titres were in the range 25-350 IU/L.
Asunto(s)
Portador Sano/prevención & control , Composición Familiar , Anticuerpos contra la Hepatitis B/sangre , Vacunas contra Hepatitis B/inmunología , Hepatitis B/prevención & control , Programas de Inmunización/organización & administración , Programas Obligatorios/organización & administración , Vacunación/métodos , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Portador Sano/epidemiología , Portador Sano/inmunología , Niño , Preescolar , Trazado de Contacto , Enfermedades Endémicas/prevención & control , Enfermedades Endémicas/estadística & datos numéricos , Femenino , Hepatitis B/epidemiología , Hepatitis B/inmunología , Humanos , Esquemas de Inmunización , Masculino , Persona de Mediana Edad , Medio Oriente/epidemiología , Selección de Paciente , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Estudios SeroepidemiológicosRESUMEN
To evaluate the effectiveness of hepatitis B virus [HBV] vaccination of household contacts of HBV carriers in Tulkarm district, Palestine, quantitative hepatitis B surface [anti-HBs] antibody response in 161 household contacts was measured after vaccination. A seroprotective anti-HBs response [titre > or = 10 IU/L] was elicited in all vaccinated subjects. Of these 2.5% had titres of 10-99 IU/L, 61.5% 100-999 IU/L and 36.0% > or = 1000 IU/L.The number of vaccination doses had no effect on the achievement of seroprotection. HBV infection was demonstrated in 13 cases and their anti-HBV titres were in the range 25-350 IU/L
Asunto(s)
Adolescente , Adulto , Niño , Trazado de Contacto , Enfermedades Endémicas , Portador SanoRESUMEN
Eighty isolates of Escherichia coli were collected in Northern Palestine throughout the 1996 to 2000 period from hospitalized patients with urinary tract infections (UTIs). Resistance rates were ampicillin, 65%; co-trimoxazole, 55%; cefuroxime, 10%; cefotaxime, 7.5%; ceftazidime, 2.5%; ciprofloxacin, 12.5%; gentamicin, 6.25% and amikacin, 1.25%. No imipenem-resistant isolates were identified. To determine whether this was due to intra-hospital transmission of resistant strains, clonal structure of 10 multiple-resistant isolates was examined by genomic DNA fingerprinting by enterobacterial repetitive intergenic concensus-polymerase chain reaction (ERIC-PCR) and all were clonally distinct. Thus, these strains are likely resistant due to convergent acquisition of resistance determinants by genetically unrelated uropathogenic strains rather than epidemic spread of resistant isolates.
Asunto(s)
Escherichia coli/efectos de los fármacos , Infecciones Urinarias/microbiología , Farmacorresistencia Bacteriana , Escherichia coli/genética , Hospitalización , Humanos , Reacción en Cadena de la PolimerasaRESUMEN
Shiga toxigenic Escherichia coli (STEC) isolates from symptomatic and asymptomatic patients in northern Palestine in 1999 were screened for serotype O157 and characterised for virulence genes by multiplex PCR assay. Of the 176 STEC isolates, 124 (70.5%) were of serotype O157. All these isolates carried the gene for Shiga toxin type 1 (stx,) and 112 (90.3%) carried stx2. The intimin encoding gene locus eae was detected in 16 isolates (12.9%) and the enterohaemolysin encoding gene, hlyA, in 18 (14.5%). Statistical analysis showed a significant association between the presence of eaeA and hlyA, either alone or combined with stx1 and stx2 genes in O157 isolates from symptomatic infection. ERIC-PCR analysis of DNA from 80 serotype O157 isolates revealed three major clonal populations.
Asunto(s)
Diarrea/microbiología , Infecciones por Escherichia coli/microbiología , Escherichia coli/aislamiento & purificación , Toxinas Shiga/biosíntesis , Antibacterianos/farmacología , Árabes , ADN Bacteriano/análisis , ADN Bacteriano/química , Diarrea/epidemiología , Escherichia coli/clasificación , Escherichia coli/efectos de los fármacos , Escherichia coli/patogenicidad , Infecciones por Escherichia coli/epidemiología , Escherichia coli O157/clasificación , Escherichia coli O157/efectos de los fármacos , Escherichia coli O157/aislamiento & purificación , Escherichia coli O157/patogenicidad , Heces/microbiología , Humanos , Israel/epidemiología , Pruebas de Sensibilidad Microbiana , Reacción en Cadena de la Polimerasa/métodos , Prevalencia , Toxinas Shiga/genética , VirulenciaRESUMEN
The surgical incidence of cystic echinococcosis (CE) due to Echinococcus granulosus was investigated in hospitals of the West Bank, Palestinian Authority between January 1990 and December 1997. Serum samples from school-children in Yata town, which showed the highest surgical incidence, were tested for anti-hydatid antibodies. A total of 390 surgically confirmed cases were recorded throughout the 8-year period, with an overall mean annual surgical incidence (MASI) of 3.1 per 100,000. A high MASI of 4.9, 5.0 and 5.1 per 100,000 was found in Hebron, Jericho and Bethlehem Governorates, respectively. Yata town, Hebron governorate, showed the highest MASI, at 16.8 per 100,000. The highest incidence was found in age groups 11-20 and 21-30 years, at 27.4% and 21.5% of the total number of cases. While there was no significant gender difference in the number of cases in the age groups of 20 years or less, the male to female case ratio was 1:3.2-4.1 in the older age groups. The liver was the most common site of hydatid cysts in 69.9% of cases. Lung cysts were predominant in younger age groups (20 years or less). The seropositivity for CE in the school-children of Yata was 2.4% and 2.1% using enzyme-linked immunosorbent assay and the indirect haemagglutination test, respectively. CE is a significant endemic disease throughout the West Bank. The disease is acquired early in life and is more prevalent among females than males. Behaviour and life-style favour the spread of the disease.
Asunto(s)
Equinococosis/epidemiología , Adolescente , Adulto , Distribución por Edad , Animales , Niño , Equinococosis/diagnóstico , Equinococosis/parasitología , Equinococosis/cirugía , Femenino , Interacciones Huésped-Parásitos , Humanos , Incidencia , Estilo de Vida/etnología , Masculino , Persona de Mediana Edad , Medio Oriente/epidemiología , Estudios Retrospectivos , Estudios Seroepidemiológicos , Pruebas Serológicas , Distribución por Sexo , Factores SexualesRESUMEN
One hundred and thirteen consecutive isolates of Streptococcus pneumoniae were collected in Nablus, Palestine between March and Aug. 1997 from children with acute lower respiratory tract infections. Resistance rates were: penicillin 88%, cefuroxime 85%, erythromycin 63%, tetracycline 45%, chloramphenicol 27% and ofloxacin 2%. Resistances to erythromycin and cefuroxime were significantly associated with penicillin resistance. Ofloxacin may be useful against pneumococci resistant to traditional antimicrobial agents. Factors associated with penicillin resistance included hospitalisation and previous use of beta-lactam antibiotics.
Asunto(s)
Resistencia a las Penicilinas , Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/efectos de los fármacos , Antibacterianos/farmacología , Niño , Preescolar , Resistencia a Múltiples Medicamentos , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Medio Oriente/epidemiología , Infecciones Neumocócicas/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/microbiología , Streptococcus pneumoniae/aislamiento & purificaciónRESUMEN
Seven strains of Enterobacteriaceae resistant to gentamicin obtained as representatives of the predominant resistance profiles in the clinical laboratories of Rafeidia and Al-Watani Hospitals in Nablus (Palestine) were included. Five strains showed a broad aminoglycoside resistance profile but contained no evidence of gentamicin acetylation, adenylation, or phosphorylation. Gentamicin uptake in two tested strains was significantly reduced, compared to that of gentamicin-sensitive E. coli (MIC, 0.5 microgram/mL). These strains are likely resistant due to a relative reduction of the amount of gentamicin and other aminoglycosides entering the bacterial cell. Two strains showed evidence of adenyltransferase ANT(2")-I activity.
Asunto(s)
Infecciones por Enterobacteriaceae/microbiología , Enterobacteriaceae/efectos de los fármacos , Gentamicinas/metabolismo , Gentamicinas/farmacología , Antibacterianos/farmacología , Farmacorresistencia Microbiana/genética , Enterobacteriaceae/crecimiento & desarrollo , Enterobacteriaceae/aislamiento & purificación , Escherichia coli/efectos de los fármacos , Escherichia coli/genética , Humanos , Klebsiella/efectos de los fármacos , Klebsiella/genética , Pruebas de Sensibilidad Microbiana , Plásmidos/genética , Proteus/efectos de los fármacos , Proteus/genética , Providencia/efectos de los fármacos , Providencia/genéticaRESUMEN
Twenty-four gentamicin-resistant isolates of Enterobacteriaceae, obtained from the clinical laboratories of three health centres in Nablus, Palestine, were tested for susceptibility to neomycin, kanamycin, tobramycin and amikacin. Resistance rates were 29.2% for neomycin, 58.3% for kanamycin, 45.8% for tobramycin and 8.3% for amikacin. Fourteen (58.3%) isolates were noted to be multiresistant, i.e., resistant to gentamicin and two or more other aminoglycosides; resistance to gentamicin, kanamycin and tobramycin was the most common pattern of multiple resistance. This pattern implies the involvement of adenyltransferase ANT(")-I activity. Plasmid profiles and curing experiments suggested a plasmid localisation of gentamicin, neomycin, kanamycin and tobramycin resistance genes. However, a chromosomal location is proposed for plasmid-deficient strains. Cross-resistance in two isolates to all aminoglycosides tested suggested membrane impermeability to aminoglycosides as the mechanism of resistance.
Asunto(s)
Antibacterianos/farmacología , Enterobacteriaceae/efectos de los fármacos , Amicacina/farmacología , ADN Bacteriano/análisis , Farmacorresistencia Microbiana/genética , Enterobacteriaceae/genética , Etidio/farmacología , Colorantes Fluorescentes/farmacología , Gentamicinas/farmacología , Humanos , Resistencia a la Kanamicina/genética , Pruebas de Sensibilidad Microbiana , Neomicina/farmacología , Factores R/efectos de los fármacos , Factores R/genética , Factores R/fisiología , Tobramicina/farmacologíaRESUMEN
A protein factor has been found in serum which converts the M form of placental alkaline phosphatase (PLAP) to the A and B forms. The identity of the conversion products has been confirmed by analysis of their dimers and polypeptides. Proteolysis is not implicated in this phenomenon. This report establishes microvillous M-PLAP as the precursor of the A and B forms.
Asunto(s)
Fosfatasa Alcalina/aislamiento & purificación , Isoenzimas/aislamiento & purificación , Placenta/enzimología , Fosfatasa Alcalina/sangre , Femenino , Humanos , Isoenzimas/sangre , Microvellosidades/enzimología , Peso Molecular , Embarazo , Conformación ProteicaRESUMEN
Human placental microvillous alkaline phosphatase (M-PLAP) was extracted from microvilli either by butanol extraction or subtilisin proteolysis. The data indicate that subtilisin cleavage of PLAP removes a membrane-binding domain of approximately 2000 molecular weight, leaving the catalytic site intact and the protein in solution. Sequencing studies on the N-terminal 13 amino acids of both the subtilisin-cleaved and uncleaved forms of M-PLAP indicate that the enzyme is anchored to the plasma membranes by its carboxy-terminus. The N-terminal 13 amino acids of A-PLAP were the same as those of M-PLAP. Trypsin solubilization failed to release M-PLAP from these membranes and it appears to cleave a portion of molecular weight of about 9K from the amino terminus, leaving an enzymatically active portion of PLAP associated with the membrane. On SDS gels, subtilisin-cleaved M-PLAP showed an apparent dimeric molecular size larger than that of the original uncleaved enzyme, presumably due to the generation of a less compact conformational state. On starch gels, cleaved M-PLAP showed a single zone of enzyme activity with a mobility sightly greater than that of A-PLAP, which did not require the presence of Triton X-100 to enter the gel. Variations in the apparent molecular sizes of the different allelic forms of PLAP were also observed.
Asunto(s)
Fosfatasa Alcalina/metabolismo , Isoenzimas/metabolismo , Microvellosidades/enzimología , Placenta/enzimología , Membrana Celular/enzimología , Bromuro de Cianógeno , Femenino , Humanos , Fragmentos de Péptidos/análisis , Fenotipo , Embarazo , Conformación Proteica , SubtilisinasRESUMEN
A high molecular weight form of human placental alkaline phosphatase has been detected in extracts of placenta at term by electrophoresis in starch gels containing 0.5 per cent Triton X-100. The enzyme has a mobility intermediate between the previously described A and B forms of the enzyme and has been called the 'M' form of placental alkaline phosphatase. The M form is the major form of the enzyme found in microvilli extracted from syncytiotrophoblast, though trace amounts of membrane-associated M form can be found in extracts of placentae which had previously been experimentally depleted of microvilli. The M form is present in both of the two recently described subfractions of placental microvilli (see Davies, Parry and Sutcliffe, 1981; Truman, Wakefield and Ford, 1981). A variety of experiments show that the M form is not an artefact of extraction. The characteristic mobility of the M form in starch/Triton gels is the same, whether the microvilli are extracted in butanol, chloroform/methanol, Nonidet P40, Triton X-100 or Na deoxycholate. Serological, heat-stability and genetic studies showed that the A and M forms contain the same enzymatic polypeptide. Gel filtration of butanol/H2O and butanol/saline extracts of microvilli provided an estimated molecular weight of the A form of 127000 and of the M form of 725000; these values were unaffected by the presence of Triton in the medium.
Asunto(s)
Fosfatasa Alcalina/aislamiento & purificación , Placenta/enzimología , Cromatografía en Gel , Electroforesis en Gel de Almidón , Femenino , Humanos , Microvellosidades/enzimología , Peso Molecular , Embarazo , Trofoblastos/enzimologíaRESUMEN
Microvillous M-PAP and A-PAP were purified to homogeneity from butanol extracts of syncytiotrophoblastic microvillous membranes using DEAE Sepharose CL-6B chromatography. The two isoenzymes had indistinguishable pH optima and Km values. Under reducing conditions in SDS-polyacrylamide gels, both forms showed a similar subunit molecular weight of 69 000. In the absence of reduction M-PAP was present in a dimeric form similar to A-PAP. However, the mobility of the dimer of M-PAP corresponded to a molecular weight of 116 000 compared with 130 000 for A-PAP. It was concluded that this difference is due to the A and M dimers being in different conformations. In SDS-polyacrylamide gels the M form also showed a higher molecular weight species corresponding to a mobility of 180 000, but species corresponding to the native molecular weight of 725 000 wer not found. Under different alkylating conditions the polypeptide subunits of both forms showed similar isoelectric banding patterns. The M-PAP showed some extra bands with a relatively high pI value. The hydrophobicity of the different forms of PAP was investigated by testing their affinities for columns of various hydrocarbon-coated agaroses. Unalkylated agarose did not bind the enzyme; C6 alkyl chains bound A, B and M-PAP. C2 alkyl chains bound M-PAP, but not A or B-PAP. This provided a potentially new and simple method of purifying M-PAP, and supports the view that M-PAP is hydrophobic relative to the A and B forms. The structural implications of this hydrophobicity are discussed.