Medical Microbiology & Diagnosis

Emergencies, caused by growth of world’s population, affects weather conditions and cause outbreaks of several communicable diseases that result in high morbidity and mortality specially in developing countries. The cumulative effects of these disasters include displacement, increasing vector breeding sites, unplanned and overcrowded shelters, poor water and sanitation conditions, poor nutritional status and poor personal hygiene, low levels of immunity to vaccine-preventable diseases or insufficient vaccination coverage, and limited access to healthcare services.

Flooding is one of the commonest natural disasters which results in contamination of drinking-water facilities, facilitation of the transmission of water-borne diseases (typhoid fever, cholera, leptospirosis and hepatitis A) and vector-borne diseases (malaria, dengue and dengue hemorrhagic fever, yellow fever, and West Nile Fever).

Malaria is among the most important diseases that are aggravated by movement and migration. The transmission of malaria is strongly influenced by population movements and by the process of urbanization. Pneumonia is one of the diseases which is more prevalent in overcrowded and unprotected communities. Similarly, diarrhoea is aggravated by unhygienic lifestyles which is common in case of emergencies. Since the occurrence of emergencies and natural disasters is uncertain, every country should develop a way of preventing infectious disease that may occur in consequence of natural disasters, war and terrorism.

Major progress has been made both in the field of vaccination and also in therapies against H. pylori infections in recent years. But, the increasing number of H. pylori infections and its resistance to current antibiotics has become a worldwide problem, due to the direct correlation between H. pylori infections and gastritis, gastric ulcers as well as cancer. In this regard, new alternative therapies or prevention methods turned into a global need. Therefore, an oral administration of chicken antibodies IgY specific to H. pylori can be very advantageous. Antibodies like anti-UreB IgYs or anti-VacA IgYs, produced by adult avian species immunized previously with UreB and VacA antigens respectively, are highly effective as a prophylaxis against H. pylori but as well as a treatment of already existing infection.

A cross sectional study was carried out which included 300 clinical specimens such as urine, pus, throat swabs, ear swabs, blood, taken from patients admitted to different departments, in addition to 300 samples from the surrounding environment in four hospitals in Benghazi. The aim is to identify the major strains of P aeruginosa isolated from various sources in different hospitals from both the patients and surrounding environment, also to determine the level of resistance to the widely used antibiotics in clinical isolates of P aeruginosa. P aeruginosa were isolated from 91 clinical specimens and 18 from environmental sources. All were Gram negative motile bacilli, oxidase positive and grew at 42ºC. All isolates were confirmed by Analytical Profile Index (API 20 NE) for their biochemical activity, all were positive for arginine dihydrogenase, citrate utilization and gelatin hydrolysis, while 37.4% were positive for aerobic glucose utilization. The antibiotic sensitivity tests were carried out according to the disc diffusion method (modified kirby bauer technique). Out of 91 strains of P aeruginosa isolated from clinical specimens and 18 strains from the environment, the most effective antibiotics were respectively Ciprofloxacin (82.2%, 83.3%), Imipenem (80.2%, 72.2%), Amikacin (72.5%, 77.8%) and Tobramycin (49.5%, 50%) Gentamicin showed lowest rate of sensitivity (42.2%, 50%). Other antibiotics tested: ampicillin, chloramphenicol, augmentin, pipemidic acid, colistin sulphate and nalidixic acid. The strains isolated were found to have high or total resistance to them. Pyocin typing was used for the characterization of 109 isolates of Pseudomonas aeruginosa isolated. The scheme of Gillies and Govan was adopted and the procedure gave 86.8% of clinical isolates were typable, while 50% of environmental isolates were typable, 12 (15%) of 79 typable strains isolates from clinical specimens were classifiable while 67 (85%) were nonclassifiable. More over all typable isolates from environment were nonclassifiable. The study concludes that Pseudomonas infection is high among our patients in Benghazi hospitals, and reflects the hospital environment as source of infection. This study also recommends that there should be a review in the current antibiotics policy.