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ANTIMICROBIAL RESISTANCE PATTERNS OF ESCHERICHIA COLI O157:H7 ISOLATED FROM STOOL SAMPLE OF CHILDREN

Author: Jabbar S. Hassan جبار سلمان حسن
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2015 Volume: 13 Issue: 3 Pages: 259-264
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Enterohemorrhagic Escherichia coli is a subset of Shiga toxin-producing E. coli that can cause diarrhea or hemorrhagic colitis in humans. Hemorrhagic colitis occasionally progresses to hemolytic uremic syndrome, is a major cause ofacute renal failure in children and morbidity and mortality in adults.Objective:To determine the susceptibility and resistance of the most effective antibiotic to E.coli O157:H7 associated with bloody diarrhea.Methods:Two hundred patients with bloody diarrhea were enrolled in this study. Escherichia coli were isolated on Sorbitol MacConkey agar with Cefixime and Tellurite and tested by latex agglutination test. The susceptibility and resistance for all bacterial isolates were identified by standard procedures resistance patterns such as disk diffusion test and minimum inhibitory concentration.Results:E.coli O157:H7 found in 37 (18.5%) out of two hundred stool samples. The highest rate was found in 18 cases (48.64%) out of 37 infants aged 3-12 months, 12 cases (32.43%) in infants aged 13-24 months, and the lower rates was in children over two years old (18.9%). E.coli O157: H7 was completely resistant to gentamicin, ampicillin, nalidixic acid and co-trimoxazole; high rate of resistance to cefotaxime and ceftazidime, moderate-to-low rate of resistance to ciprofloxacin, amikacine, ceftriaxone and Imipenem and no resistances rate to levofloxacin. Out of 37 isolates 29 (78.3%) were β-lactamase producer and 8 (21.6 %) isolates resistant to β-lactamase antibiotic patterns but not produce β-lactamase enzyme.Conclusion:The high-incidence rate of E. coli O157:H7 infection in children associated with limited number of drugs effective against E. coli O157:H7 with high prevalence of resistance to more than three antibiotics.Keywords:E.coli O157:H7, Enterohemorrhagic Escherichia coli, disk diffusion test, minimum inhibitory concentration.


Article
3.DETECTION OF NEW DELHI METALLO-BETA-LACTAMASE-1 (BLANDM-1) IN CARBAPENEM-RESISTANT PSEUDOMONAS AERUGINOSA ISOLATED FROM CLINICAL SAMPLES IN WASIT HOSPITALS

Authors: Zeyad K. Hussein --- Haider S. Kadhim --- Jabbar S. Hassan
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 3 Pages: 239-246
Publisher: Al-Nahrain University جامعة النهرين

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Background:Pseudomonas aeruginosa (P. aeruginosa) infections are clinical problem, it is a difficult to treat because of high resistant to many antibiotics (Multi-drug resistant) and a high risk of emergence of resistance during therapy. Carbapenems are therapeutic choice against infections caused by Gram-negative bacilli including strains of P. aeruginosa. New Delhi metallo-β-lactamase-1 (blaNDM-1) gene, an acquired class B carbapenemase. Dissemination predominantly involves transfer of the blaNDM-1 gene among promiscuous plasmids and clonal outbreaks. Bacteria with NDM-1 are typically resistant to nearly all antibiotics.Objective:To detect blaNDM-1 in the isolates of P. aeruginosa, which were recovered from various clinical samples from hospitalized patients in Wasit hospitals.Methods: This cross-sectional study involved 200 clinical samples were collected from three major hospitals in Wasit province. Samples were inoculated in Mackonkey and blood agar for primary isolation and then biochemical tests were used to confirm diagnosis of P. aeruginosa. The susceptibility test for 14 types of antibacterial drugs were tested by using disk diffusion method. Chromosomal and plasmid DNA were extracted by using special methods.Results: Out of 36 carbapenems resistant P. aeruginosa (CRPA) isolates, there were 18 isolates (50%) positive for blaNDM-1 gene.Conclusion: Rate of occurrence of blaNDM-1producers is highest among carbapenem-resistant P. aeruginosa isolated from clinical samples in Wasit hospitals. Therefore, its recognizable proof in clinical bacterial diseases will be suspected in any carbapenem resistance P. aeruginosa.Keywords: P. aeruginosa; carbapenems; metallo-β-lactamase; blaNDM-1Citation: Hussein ZK, Kadhim HS, Hassan JS. Detection of New Delhi metallo-beta-lactamase-1 (blaNDM-1) in carbapenem-resistant pseudomonas aeruginosa isolated from clinical samples in Wasit hospitals. Iraqi JMS. 2018; 16(3): 239-246. doi: 10.22578/IJMS.16.3.3


Article
8.PRE AND POST EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) URINE CULTURE AS A GUIDE FOR ANTIBIOTICS MANAGEMENT

Authors: Laith A. Al-Anbary --- Ahmed A. Khaleel --- Jabbar S. Hassan
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 3 Pages: 289-297
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:The lifetime prevalence of kidney stone disease is estimated at 1-15%. The positive urine cultures can be obtained not only from Struvite stones, but also from calcium oxalate stones and also high levels of endotoxins are found both in infection stones (Struvite and carbonate apatite stones), and in non-infection stones. High concentrations of endotoxins (lipopolysaccharides) are thought to be released in the systemic circulation during stone treatment, inducing a systemic inflammatory response (SIRS) and this leads to urosepsis. Pre-Extracorporeal shock wave lithotripsy (ESWL) prophylactic antibiotics have an important role in reducing post-SWL infections, however, previous studies reported conflicting results. The issue of administering prophylactic antibiotics remains controversial in patients with sterile urine undergoing ESWL.Objective: To evaluate possible risk factors for post ESWL bacteriuria and consequently to identify patients with higher danger for urinary tract infection (UTI) or sepsis.Methods:Urine samples from 50 patients underwent ESWL, were collected by clean catch mid-stream urine collection method in sterile containers. Those patients were attending and admitting to Al-Imamein Al-Kadhimein Medical City during the period from October 2016 to January 2017. All patients had a urine culture performed before and after shock wave lithotripsy. Statistical analysis was performed with Epi-Info 7 and Excel programs. Statistical significance was evaluated using the Fisher's exact test with p <0.05 considered statistically significant.Results: A total of 50 patients who underwent ESWL during; the 2- months study period was enrolled in the study. Thirty-three 33 (66%) out of 50 were men and 17 (34%) out of 50 were women. 10 (20%) of patients had hypertension and 5 (10%) had diabetes mellitus. Fifty urine samples were collected from patients enrolled in this were cultivated on blood and MacConkey agar Pre-and post-ESWL Regarding Pre-ESWL results revealed 14 (28%) were urine culture positive while 23 cases were post-SWL urine culture positive. Conclusion: Antibiotic prophylaxis is not justified without defined risk factors such as positive urine culture before ESWL, an external bladder catheter or nephrostomy tube and a history of infectious stones or recurrent urinary tract infection.Keywords: Extracorporeal shock wave lithotripsy (ESWL), urine culture, renal stone and antibioticsCitation: Al-Anbary LA, Khaleel AA, Hassan JS. Pre and post extracorporeal shock wave lithotripsy (ESWL) urine culture as a guide for antibiotics management. Iraqi JMS. 2018; 16(3): 289-297. doi: 10.22578/IJMS.16.3.8


Article
Evaluation of Rapid Chromatographic Immunoassay with Latex Agglutination Test and (ELISA) for Diagnosis of Human Toxoplasmosis

Authors: Abid Al-Razaq H.Ahmed --- Haider f. Ghazi --- jabbar S. Hassan
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 4 Pages: 468-474
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: there are different procedures for the diagnosis of females suspected with toxoplasmosis. However, time, cost, and accuracy of the test should meet patient’s needs.Material and methods: one hundred and eleven female with suspected toxoplasmosis were under go three different procedures for the diagnosis of Toxoplasma gondii infection. Latex agglutination test, rapid chromatographic (immunoblot) and ELISA test were done for all patients. The results were described as frequency and percentage of positivity; also, specificity and sensitivity of immunoblot were assessed according to the result of other tests.Results: The Latex test has shown 80% and 61.54% sensitivity and specificity respectively with IgG measured by ELISA while it has shown 100% sensitivity and specificity with IgM measured by ELISA. IgM immunoblot give a relatively higher sensitivity and specificity (95% and 98.89%) respectively than IgG immunoblot (88% and 89.29%) made with IgM and IgG ELISA respectively. Conclusion: Rapid chromatographic test considered as a good test for detection of IgG and IgM anti Toxoplasma gondii antibodies in both acute and chronic Toxoplasmosis.


Article
COMPARATIVE STUDY OF ENZYME LINKED IMMUNOSORBANT ASSAY AND AGGLUTINATION TESTS IN THE DIAGNOSIS OF HUMAN BRUCELLOSIS IN BAGHDAD

Authors: Haidar A Shamran حيدر احمد شمران --- Haidar F Ghazi حيدر فيصل غازي --- Jabbar S Hassan جبار سلمان حسان
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 2 Pages: 170-175
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Human infection with Brucella spp. had been able to evoke humeral immune response containing both IgG and IgM.Objective:This study designed to compare results obtained from Rose Bengal Test (RBT), Tube Agglutination Test (TAT) and Enzyme Linked Immunosorbent Assay (ELISA) employ serum are described and compared for the detection of human IgG and IgM anti-brucella antibodies.Methods:Serum samples from 105 subjects were collected. 90 were clinically infected with human brucellosis, and 15 were age and gender matched controls. RBT and TAT are the two screening tests routinely recognized, while the 2-mercaptoethanol test (2ME) is the confirmatory assays currently in use. In order to improve the serological diagnosis of human brucellosis, an indirect IgG, IgM and IgG-IgM ELISA kits were evaluatedResults:Totally, 90 cases were positive in RBT, from those only 92% shows positive TAT, and by ELISA there are IgG (27.78%), IgM (14.44%) and (57.78%) were Positive for both immunoglobulins.Conclusion:Although RBT and TAT are widely applied tests, they cannot differentiate acute and chronic states of brucellosis. Our data suggest that IgM ELISA may be a suitable test for diagnosis acute brucellosis.Keywords: Brucellosis, ELISA, Tube Agglutination.


Article
12.IDENTIFICATION COMMON CAUSE OF NEONATAL SEPSIS BY ANALYTICAL PROFILE INDEX SYSTEM (API)

Authors: Hesnaa S. M. Al-Mossawi --- Jabbar S. Hassan --- Nada M. Al-bashier --- Areej A.A. Al-Omrani
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2018 Volume: 16 Issue: 3 Pages: 327-334
Publisher: Al-Nahrain University جامعة النهرين

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Background: Neonatal Sepsis is a bacterial infection of the blood in a neonate and an infant younger than 4 weeks of age. The analytical profile index or API is a classification of bacteria based on experiments, allowing fast identification. This system is developed for quick identification of clinically relevant bacteria.Objective: To identify the pattern of organisms in neonatal sepsis using API system in Baghdad City hospital, Al-Imamein Al-Kadhimein Medical City and Central Pediatrics Teaching Hospital.Methods:In this cross-sectional study, blood samples from 100 neonatal patients were inoculated into a blood culture bottle and incubated at 37 °C under aerobic conditions, subculture was done after 24 h of incubation, the growth was identified by phenotypic characteristics, gram's stain, and API system.Results: Positive blood cultures were detected in 82 (82%), according to API system the most prominent bacterial isolates from blood culture in neonates with early-onset sepsis were non-coagulase Staphylococcus (20.4%) Staphylococcus aureus (18.1 %), Acinetobacter bumanii (13.6%), Pseudomonas aeruginosa (11.36 %), Streptococcus agalactiae (11.3 %), while in late-onset sepsis the most common bacteria were Staphylococcus aureus (21.0%), non-coagulase Staphylococcus (13.1%), Citrobacter freundii and Pseudomonas aeruginosa (10.5 %) respectively. Conclusion: The API 20E may be useful for the identification of the bacterial species rarely described as pathogens in neonatal sepsis will help us to study the clinical burden resulting from the emergence of these species as causes for this neonatal infection.Keywords: Early-onset sepsis, late-onset sepsis, blood culture, API systemCitation: Al-Mossawi HSM, Hassan JS, Al-bashier NM, Al-Omrani AAA. Identification common cause of neonatal sepsis by analytical profile index system (API). Iraqi JMS. 2018; 16(3): 327-334. doi: 10.22578/IJMS.16.3.12


Article
COCCIDIOIDAL MENINGITIS: CASE REPORT

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Abstract

Coccidioidomycosis is caused by the dimorphic fungi of the genus Coccidioides (C. immitis and C. posadasii), which are endemic in desert regions of the southwestern United States, and Central and South America. Meningitis is the most lethal complication of coccidioidomycosis and thus is crucial to recognize. A 64 years old diabetic patient suffering from meningitis was studied. Cerebrospinal fluid (CSF) sample was collected by lumber puncture technique under aseptic conditions from female patients who admitted to Baghdad City hospital, conventional methods included cell count and differentiation, biochemical analysis, staining and culturing of CSF sample was applied. CSF smear with lactophenol cotton blue, revealed a typical picture of Coccidioidis spp. This is the first case reported in Iraq. In conclusion, fungal meningitis should be included as one of the most causes in chronic meningitis in Iraq.

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Article
THE EFFICIENCY OF MOLECULAR AND CONVENTIONAL METHODS IN DETECTION OF CANDIDA ALBICANS ISOLATED FROM IMMUNOCOMMPROMSED PATIENTS WITH PULMONARY SYMPTOMS

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Background:Candida albicans (C. albicans) has emerged as a potentially pathogenic fungus rather than benefit mucosal commensal in patients with pulmonary diseases. Although respiratory candidiasis secondary to pulmonary tuberculosis has been reported in the past, it has gained more relevance recently due to increased use of broad spectrum antibiotics and immunosuppressive drugs. Objective:To detect C. albicans in sputum samples from patients with pulmonary diseases using conventional and molecular methods.Methods:One hundred sputum samples obtained from patients with pulmonary symptoms were included in this study. Sputum samples were dispensed into three specimen parts; the first one was applicated for cultured on Sabouraud dextrose agar at 37 °C for 48 hrs and then the purified colony of Candida underwent biochemical tests including API Candida strips, and germ tube. The second part was undergone direct gram stain, while the third part was applicated for DNA extraction and then molecular diagnosis with PCR technique using specific primers.Results:Culture result revealed 43 positive samples for Candida species out of 100 samples. Among these positive samples, 23 (53.5%) were positive for C. albicans in each of culture, germ tube and API. Molecular test revealed an amplicon with 538bp fragment of phospholipase gene from the same 23 samples.Conclusion:C. albicans is highly prevalent among patients suffering from bronchopulmonary symptoms. The molecular and conventional methods gave concomitant results as detection tools for the diagnosis of such microorganisms.Keywords:Candida albicans, phospholipase B gene, sputum.


Article
MOLECULAR DETECTION OF MULTIDRUG RESISTANT ACINETOBACTER BAUMANNII FROM DIFFERENT CLINICAL SAMPLES

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Background:Acinetobacter baumannii (A. baumanii) has recently emerged as a major pathogen causing nosocomial infections in patients admitted to intensive care units with a surprisingly rapid acquisition of antibiotic resistance. Objective:To study the rate of occurrence of A. baumanii isolated from different clinical specimens and to study the rate of occurrence of multidrug resistance especially NDM-1 and qnrA genes.Methods:A total of sixty-two (62) clinical isolates of A. baumanii were tested against 14 antibiotics by disc diffusion method. Minimum inhibitory concentration was determined by agar dilution method for resistant isolates. Polymerase chain reaction (PCR) was performed to detect bla NDM-1 and qnrA genes.Results:All Acinetobacter isolates were complete resistant to Colistin and Tigacycline (100%), while high rate of resistance was to Aztronem (93.54%), Cefotaxime, (91.93%), Ceftriaxone (88.70%) and Meropinem (80.64%). Moderate - to- low rate of resistance was to Ceftazidime (77.41%), Cefepim (75.80%), Peperacillin and Ciprofloxacin (74.19%), Gentamicin (69.35%), Levofloxacin (64.51%), Amikacin (61.29%) and Impenim (50%). The highest minimum inhibitory concentration value 128 μg/mL was to Cefotaxime, Tigacycline and Colistin. While the lowest value 8 μg/mL was to Gentamicin, Imipenem, Ciprofloxacin and Levofloxacin. The PCR results showed that 50% of Metallo beta lactamase producers A. baumannii was carried bla NDM-1 gene in chromsomal DNA and 24 (48%) of Flouroquinolone resistance A. baumannii harbored qnrA gene in chromsomal DNA while the prevalence of qnrA gene was (60.6%) in plasmid DNA.Conclusion:There is a high prevalence of multidrug resistant A. baumannii in different samples from Baghdad with the high prevalence of bla NDM-1 and qnrA genes among this bacterium.Keywords:Acinetobacter baumannii, bla NDM-1, qnrA- gene, MDRCitation:Mshachal MA, Abdulrahman TR, Khudair MS, Hassan JS. Molecular detection of multidrug resistant Acinetobacter baumannii from different clinical samples. Iraqi JMS. 2017; Vol. 15(3): 314-323. doi: 10.22578/IJMS.15.3.14


Article
Humoral immune factor changes in group of patients with Non-muscle invasive bladder cancer treated with intravesical therapy
التغيرات في بعض العوامل المناعية في مجموعة من المرضى الذين يعانون من سرطان المثانة غير العضلي الذي يعالج بالعلاج داخل المثانة

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Background: Bladder cancer (BC) one of the most common urologic cancer characterized by the highest recurrence rate, many types belong to BC, but most common of them worldwide are transitional cell carcinoma(TCC) which constitute about 90-95% cases, squamous cell carcinoma (SCC) and adenocarcinomasObjective: This study was designed to evaluate parameters of humoral immunity in Non-muscle invasive (superficial or early) bladder cancer patients in Iraq that may provide a new insight into the future of immunotherapies development and BC management.Materials and methods: Fifty-nine volunteer's patients ranged from 24 to 83years old, and 30 control individuals ranged from 51-80 years old, who attended and admitted to Hospital of Gazi AL-Harery in medical city of Baghdad, and Al-Emamain Al-Khadhemain Teaching hospital was recruited in this investigation. The sera of study groups were subjected to serological test to estimate the levels of (IgA, IgG, IgM and C3) by Single radial immunodiffusion (sRID) assay and Enzyme-Linked immunosorbent assay (ELISA) was used to estimate the serum levels of IL-10.Results: The ages ranged from 24 to 83years (females: 26 to 72years, males: 38 to 83years) with male to female ratio 4.9:1 and ages of controls ranged from 51 to 80years (females: 54 to 70years, males: 51 to 80years) with male to female ratio 2.75:1, the mean ages of cases and controls groups were (61.65±11.04) , current study showed significance dropping in C3 levels in patients control and Mitomycin C groups compared with apparently healthy, levels of IgM showed significant elevation in BCG group compared with apparently healthy group while patients control and mitomycin C groups showed insignificant elevation of IgM. Levels of IgG showed significant elevation in patients control and mitomycin C groups compared with apparently healthy group while in BCG group showed no differences. Serum levels of IL-10 showed no differences between apparently healthy group and each of patient's groups, also showed no differences within patient's groupsConclusions: Bladder cancer is a common urologic malignancy in male than female patients enrolled in this study. Intravesical BCG or Mitomycin C leading to effective anti-bladder cancer immunity in the majority of PatientsKeywords: Keywords: humoral immunity, BC, MMC, BCG, IL-10, C3, IgA, IgM, IgG.

الخلفية: سرطان المثانة واحدة من أكثر سرطان المسالك البولية شيوعا تتميز أعلى معدل تكرار، العديد من الأنواع تنتمي إلى سرطان المثانة ، ولكن الأكثر شيوعا منهم في جميع أنحاء العالم هي سرطان الخلايا الانتقالية التي تشكل حوالي 90-95٪ من الحالات. الهدف: تم تصميم هذه الدراسة لتقييم المعلمات من المناعة الخلطية في مرضى سرطان المثانة في العراق التي قد توفر نظرة جديدة في مستقبل العلاج المناعي لهذا المرض . المواد والأساليب: تراوح عدد المرضى المتطوعين الذين تتراوح أعمارهم بين 24 و 83 سنة، و 30 فردا من الأشخاص الذين تتراوح أعمارهم بين 51 و 80 عاما، والذين حضروا إلى مستشفى غازي الحريري في مدينة بغداد الطبية، و مدينة الامامين الكاظمين . تم اختبار مصل الدم من مجموعات الدراسة لاختبار المصلية لتقدير مستويات (IgA, IgG, IgM and C3 ) من خلال فحص المناعي الشعاعي واحد وبواسطة فحص (إليسا) النتائج: تراوحت الأعمار من 24 إلى 83 سنة (الإناث: 26 إلى 72 سنة، ذكور: 38 إلى 83 سنة) مع نسبة الذكور إلى الإناث 4.9: 1 وأعمار الضوابط تراوحت بين 51 إلى 80 سنة (الإناث: 54 إلى 70 سنة، ذكور: 51 إلى (61.65 ± 11.04)، وأظهرت الدراسة الحالية انخفاض معنوي في مستويات C3 في السيطرة على المرضى ومجموعات ميتوميسين C مقارنة بمستويات سليمة على ما يبدو من IgM أظهرت ارتفاع كبير في مجموعة IgGمقارنة مع مجموعة صحية بينما أظهرت الدراسة السيطرة على المرضى والمجموعات ميتوميسين C ارتفاع كبير من IgM. وأظهرت مستويات IgG ارتفاع ملحوظ في السيطرة على المرضى والمجموعات ميتوميسين C مقارنة مع مجموعة على ما يبدو صحي أظهرت مستويات مصل الدم من IL10 عدم وجود فروق بين المجموعة الصحية على ما يبدو وكل من مجموعات المريض، كما أظهرت أي اختلافات داخل مجموعات المريضالاستنتاجات: سرطان المثانة هو الأورام الخبيثة المسالك البولية شيوعا في الذكور من الإناث المرضى المسجلين في هذه الدراسة. BCG أو ميتوميسين C يؤدي إلى فعالية المناعة المضادة لسرطان المثانة في غالبية المرضى. BC, MMC, BCG, IL-10, C3, IgA, IgM, IgG كلمات الدلالة:

Keywords

humoral immunity --- BC --- MMC --- BCG --- IL-10 --- C3 --- IgA --- IgM --- IgG. --- . BC --- MMC --- BCG --- IL-10 --- C3 --- IgA --- IgM --- IgG

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