1
|
Sokhn ES, Salami A, El Roz A, Salloum L, Bahmad HF, Ghssein G. Antimicrobial Susceptibilities and Laboratory Profiles of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis Isolates as Agents of Urinary Tract Infection in Lebanon: Paving the Way for Better Diagnostics. Med Sci (Basel) 2020; 8:medsci8030032. [PMID: 32823619 PMCID: PMC7565412 DOI: 10.3390/medsci8030032] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Urinary tract infections (UTIs) are major healthcare problems that are usually treated empirically. However, antimicrobial resistance has been increasing across many settings. This study aims to elucidate the antibiotic resistance profiles of three common uropathogens, Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Proteus mirabilis (P. mirabilis) and compare between extended spectrum beta-lactamase (ESBL) and non-ESBL strains among Lebanese patients. Methods: This retrospective study was conducted at multiple tertiary healthcare centers in South Lebanon, between January and September 2017, including 551 patients of all age groups. Demographic, clinical, and laboratory data of patients were collected and analyzed statistically. Results: The prevalence of UTI in Lebanon was highest in adults between 19 and 64 years (44%). E. coli was the predominant uropathogenic organism (67.1%) followed by K. pneumoniae (10%) and P. mirabilis (3.7%). ESBL represented 32.9% of the UTI agents. The three common uropathogens studied were found to be most susceptible to imipenem (100%) and meropenem (100%). Interestingly, 115 (25.1%) out of the 458 E. coli isolates were resistant to more than eight antibiotics while 107 (23.4%) were susceptible to all antibiotics studied. Conclusions: Our study underlined the importance of adequate antimicrobial prescription for UTIs in Lebanon to avoid multidrug resistance.
Collapse
Affiliation(s)
- Elie S. Sokhn
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut 11-5020, Lebanon;
| | - Ali Salami
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Faculty of Sciences (V), Lebanese University, Nabatieh 6573/14, Lebanon; (A.E.R.); (L.S.)
- Correspondence: (A.S.); (G.G.)
| | - Ali El Roz
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Faculty of Sciences (V), Lebanese University, Nabatieh 6573/14, Lebanon; (A.E.R.); (L.S.)
| | - Lamis Salloum
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Faculty of Sciences (V), Lebanese University, Nabatieh 6573/14, Lebanon; (A.E.R.); (L.S.)
| | - Hisham F. Bahmad
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107-2020, Lebanon; or
- Arkadi M. Rywlin M.D. Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Ghassan Ghssein
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Faculty of Sciences (V), Lebanese University, Nabatieh 6573/14, Lebanon; (A.E.R.); (L.S.)
- Department of Laboratory Sciences, Faculty of Nursing and Health Sciences, Islamic University of Lebanon, Khalde 30014, Lebanon
- Correspondence: (A.S.); (G.G.)
| |
Collapse
|
2
|
Salami A, Fakih H, Chakkour M, Salloum L, Bahmad HF, Ghssein G. Prevalence, risk factors and seasonal variations of different Enteropathogens in Lebanese hospitalized children with acute gastroenteritis. BMC Pediatr 2019; 19:137. [PMID: 31039787 PMCID: PMC6489254 DOI: 10.1186/s12887-019-1513-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/12/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Acute gastroenteritis (AGE) is a major cause of pediatric morbidity and mortality around the world. It remains a frequent reason for infection-related admissions to emergency units among all age groups. Following the Syrian refugee crisis and insufficient clean water in our region, we sought to assess the etiological and epidemiological factors pertaining to AGE in South Lebanon. METHODS In this multi-center cross sectional clinical study, we analyzed the demographic, clinical and laboratory data of 619 Lebanese children from the age of 1 month to 5 years old who were admitted with AGE to pediatrics departments of three tertiary care centers in South Lebanon. RESULTS Our results revealed that males had a higher incidence of AGE (57.3%) than females. Enteropathogens were identified in 332/619 (53.6%) patients. Single pathogens were found in 294/619 (47.5%) patients, distributed as follows: Entamoeba histolytica in 172/619 (27.8%) patients, rotavirus in 84/619 (13.6%), and adenovirus in 38/619 (6.1%). Mixed co-pathogens were identified in 38/619 (6.1%) patients. Analyzing the clinical manifestations indicated that E. histolytica caused the most severe AGE. In addition, children who received rotavirus vaccine were significantly less prone to rotavirus infection. CONCLUSIONS Our findings alluded to the high prevalence of E. histolytica and other unidentified enteropathogens as major potential causes of pediatric AGE in hospitalized Lebanese children. This should drive us to widen our diagnostic panel by adopting new diagnostic techniques other than the routinely used ones (particularly specific for the pathogenic amoeba E. histolytica and for the unidentified enteropathogens), and to improve health services in this unfortunate area of the world where insanitary water supplies and lack of personal hygiene represent a major problem.
Collapse
Affiliation(s)
- Ali Salami
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon.
| | - Hadi Fakih
- Department of Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Mohamed Chakkour
- Department of Biology, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Lamis Salloum
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon
| | - Hisham F Bahmad
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghassan Ghssein
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon.
| |
Collapse
|
3
|
Salami A, Bahmad HF, Ghssein G, Salloum L, Fakih H. Prevalence of anemia among Lebanese hospitalized children: Risk and protective factors. PLoS One 2018; 13:e0201806. [PMID: 30086152 PMCID: PMC6080804 DOI: 10.1371/journal.pone.0201806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 07/23/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Anemia is a global health problem associated with short- and long-term consequences especially in children. The incidence of anemia along with the factors associated with its increased or decreased risk is not yet well studied in Lebanon. Our study aims at determining the demographics of this health burden and identifying some of the important factors linked to it among the pediatric population. METHODS A 4-months cross-sectional study was performed between August and November 2017 including 295 children aged 1 month to 12 years, who were hospitalized in a tertiary care hospital located in South Lebanon. We analyzed the different demographic data, age, gender, breast feeding duration, solid food introduction, iron supplementation and disease of diagnosis in association with multiple hematological parameters. RESULTS The prevalence of both mild and moderate anemia was 71.8 and 25.4%, with only 2 cases of severe anemia encountered among children aged 6 months or above. Results showed that the risk of anemia increases by around 3.4 folds among malnourished children than in well-nourished children. This risk also decreased by almost 42% in children receiving iron supplement. CONCLUSION In consideration to the fact that anemia is a prevalent disease in the Lebanese childhood population, especially in infancy, simple preventive measures such as proper nutritional habits and supplementation of iron rich food to children are highly recommended and should be respected by public health providers.
Collapse
Affiliation(s)
- Ali Salami
- Department of Mathematics, Faculty of Sciences (V), Lebanese University, Nabatieh, Lebanon
| | - Hisham F. Bahmad
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghassan Ghssein
- Department of Biology, Faculty of Sciences (V), Lebanese University, Nabatieh, Lebanon
| | - Lamis Salloum
- Pediatrics Department, Ragheb Harb Hospital, Iranian Red Crescent, Toul, Lebanon
| | - Hadi Fakih
- Pediatrics Department, Ragheb Harb Hospital, Iranian Red Crescent, Toul, Lebanon
- Pediatrics Department, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| |
Collapse
|
4
|
Ghssein G, Salami A, Salloum L, Chedid P, Joumaa WH, Fakih H. Surveillance Study of Acute Gastroenteritis Etiologies in Hospitalized Children in South Lebanon (SAGE study). Pediatr Gastroenterol Hepatol Nutr 2018; 21:176-183. [PMID: 29992117 PMCID: PMC6037795 DOI: 10.5223/pghn.2018.21.3.176] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/16/2018] [Accepted: 01/19/2018] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Acute gastroenteritis (AGE) is a major cause of morbidity and remains a major cause of hospitalization. Following the Syrian refugee crisis and insufficient clean water in the region, this study reviews the etiological and epidemiological data in Lebanon. METHODS We prospectively analyzed demographic, clinical and routine laboratory data of 198 children from the age of 1 month to 10 years old who were admitted with the diagnosis of AGE to a private tertiary care hospital located in the district of Nabatieh in south Lebanon. RESULTS Males had a higher incidence of AGE (57.1%). Pathogens were detected in 57.6% (n=114) of admitted patients, among them single pathogens were found in 51.0% (n=101) of cases that consisted of: Entamoeba histolytica 26.3% (n=52), rotavirus 18.7% (n=37), adenovirus 6.1% (n=12) and mixed co-pathogens found in 6.6% (n=13). Breast-fed children were significantly less prone to rotavirus (p=0.041). Moreover, children who had received the rotavirus vaccine were significantly less prone to rotavirus (p=0.032). CONCLUSION Our findings highlight the high prevalence of E. histolytica infection as the major cause of pediatric gastroenteritis in hospitalized children, during the summer period likely reflecting the insanitary water supplies and lack of hygiene. Moreover the 42.4% of unidentified causative pathogens should prompt us to widen our diagnostic laboratory arsenal by adopting new diagnostic technologies.
Collapse
Affiliation(s)
- Ghassan Ghssein
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon
| | - Ali Salami
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon
| | - Lamis Salloum
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon
| | - Pia Chedid
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
| | - Wissam H Joumaa
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon
| | - Hadi Fakih
- Department of Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| |
Collapse
|
5
|
Sarkis P, Nawfal G, Salloum L, Kamel G, Zanati M, Saad E, Karam R, Chemaly A. [Retroprostatic cyst draining ejaculatory ducts with secondary obstructive azoospermia]. Gynecol Obstet Fertil 2013; 41:735-737. [PMID: 24183517 DOI: 10.1016/j.gyobfe.2013.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Accepted: 02/21/2013] [Indexed: 06/02/2023]
Abstract
Obstructive azoospermia constitutes 35 to 40% of azoospermia. Etiologies may be acquired or rarely congenital. Congenital utricular or Mullerian duct cyst may result in compression of ejaculatory ducts. However, they must be differentiated from exceptional wolffian or urogenital cysts, which are located at the same site but in which ejaculatory ducts may drain inside. We report a case of retroprostatic duct cyst diagnosed during work up of male infertility where magnetic resonance imaging (MRI) showed the drainage of both ejaculatory ducts inside and the presence of a thin canal ended blindly in the wall of prostatic urethra. Transurethral resection guided by MRI has been performed resulting in urethral drainage of the cyst, relieving of obstruction and normalization of spermogramm.
Collapse
Affiliation(s)
- P Sarkis
- Service d'urologie, hôpital Saint-Joseph, Hôtel-Dieu de France, Beyrouth, Liban.
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Tran D, Salloum L, Tshibaka C, Moser R. Eosinophilic gastroenteritis mimicking acute appendicitis. Am Surg 2000; 66:990-2. [PMID: 11261632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Eosinophilic gastroenteritis is a rare entity that can be treated successfully with glucocorticoid therapy if the appropriate diagnosis is made. However, it may present with symptomatology mimicking acute surgical conditions. We present the case of a 26-year-old man who presented with diffuse epigastric pain, nausea, vomiting, and diarrhea. Extensive workup including upper endoscopy and imaging study revealed gastritis with ulcer and ascites. The patient developed right lower quadrant pain with localized peritonitis and leukocytosis. He underwent appendectomy and small bowel biopsy. Pathology revealed eosinophilic cellular infiltrate of both the appendiceal and small intestinal wall. The unique features of this condition are reviewed and surgical approaches are discussed.
Collapse
Affiliation(s)
- D Tran
- Department of Surgery, St. Francis Medical Center, Trenton, New Jersey, USA
| | | | | | | |
Collapse
|
7
|
Slaba S, Semrani-Younan H, Hokayem N, Malek G, Abadjian G, Aoun N, Haddad S, Salloum L, Atallah N. [Venous malformation of the corpus adiposum buccae]. Ann Otolaryngol Chir Cervicofac 1999; 116:372-5. [PMID: 10615530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
We report on a venous malformation (previously known as a cavernous angioma) with an unusual location in the corpus adiposum buccae. Diagnosis, histologic classification and management of these rare lesions are discussed.
Collapse
Affiliation(s)
- S Slaba
- Service de Radiodiagnostic, Hôtel-Dieu de France, Liban
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Funicello A, De Sandre R, Salloum L, Oza K, Moser RL. Infiltrating ductal carcinoma of the hypomastic breast: a case report. Am Surg 1998; 64:1037-9. [PMID: 9798764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- A Funicello
- St. Francis Medical Center, Trenton, New Jersey, USA
| | | | | | | | | |
Collapse
|