Mais les résultats doivent être attendus longtemps et il n'y a généralement pas de temps amoxicilline prix L'autre cas, c'est que l'achat d'un ou d'un autre antibiotique dans une pharmacie classique nécessite des dépenses matérielles considérables et pas toutes les personnes ne peuvent acheter des produits pharmaceutiques aussi coûteux.
Enterococci are a group of microorganisms that commonly inhabit the gastrointestinal tract of
animals and humans.They are incriminated in causing severe life threatening infections.
Enterococci are recognized as a major cause of nosocomial infections worldwide. The majority
of infections are caused by E. faecalis
followed to a much lower extent by E. faecium
Enterococci have both intrinsic and acquired resistance to several classes of antibiotics.
The goal of this study was to determine the scope of resistance of enterococci to antibiotics and
to correlate that with resistance genes. In addition, we determined the relatedness of the isolates
A total of 89 vancomycin resistant enterococcus isolates were collected from major hospitals in
Jerusalem. Antimicrobial susceptibility and minimal inhibitory concentration was performed on
all isolates following the CLSI guidelines. Subsequently, DNA was extracted by lysing the cell
wall with lysozyme followed by applying the DNAzol method to isolate the DNA. Molecular
characterization for vanA
genes was determined by PCR. Plugs for pulsed field gel
electrophoresis were prepared from an overnight culture. After preparing a cell suspension in TE
buffer with an optical density of 0.9-1.1 at a wave length of 610, Lysozyme and proteinase K
were added to the suspension and mixed with 1.2% agarose. The plugs were then restricted for
two hours with sma
enzyme and loaded in 1% pulsed field certified agarose prepared in TBE
buffer and electrophoresis was performed using CHEF-DRIII instrument for 18 hours. The gels
were stained with ethidium bromide, then viewed and photographed using a gel documentation
system. Lambda ladder was applied in the first and last well of each gel to determine the size of
The results reflected that 68.5% (61/89) of the isolates were E. faecium
and 31.5% (28/89) were
. All E. faecalis
isolates were susceptible to ampicillin while all E. faecium
were resistant to it. Both E. faecalis
and E. faecium
isolates were resistant to vancomycin,
ciprofloxacin and erythromycin. Resistance of E. faecalis
isolates to teicoplanin,
chloramphenicol and tetracycline was 85.7% (24/28), 21.4% (6/28) and 17.9% (16/28)
respectively. Resistance of E. faecium
to teicoplanin, chloramphenicol, and tetracycline was 77%
(47 /61), 8.2% (5/61) and 90.2% (55 /61) respectively.
The MIC results for vancomycin in both E. faecalis
and E. faecium
were > 256 ug/ml for all
isolates. The MICs for E. faecalis
isolates tested with teicoplanin were < 4ug/ml in 14.3% (4/28)
and > 64 in 85.7% (24/28) of the isolates. On the other hand, the MICs for E. faecium
teicoplanin were > 64 ug/ml in77 %( 47/61) and < 8ug/ml in 22.9 %( 14/61).
Molecular characterization of the VRE isolates revealed that 24/28 of E. faecalis
gene while 4/28 carried vanB
gene. There was 45/61 of E. faecium
isolates carried vanA
while 14/61 carried vanB
gene. Interestingly 2/61 harboured genes, vanA
. None of the
enterococcus isolates tested carried vanD
PFGE results showed a wide range of variation between the E. faecium
isolates. Although the 52
isolates were divided into 31 PFGE patterns, two patterns showed high relatedness:
Pattern I had a cluster of 6 strains, most were isolated from the same hospital ward. Pattern II had
a cluster of 5 strains isolated from 2 hospital wards. The rest of the isolates showed considerable
variation that made it impossible to cluster them in groups.
The PFGE results for E. faecalis showed tremendous variation that the 26 vancomycin resistant
isolates were divided into 17 different profiles.
In conclusion, the vancomycin resistant enterococci (E. faecalis
and E. faecium
) pose a great risk
for hospitalized patients on one hand and stand defiant and resistant to most antibiotic classes.
Therefore, the health officials in this country must take drastic steps to curb the spread of this
A Study to Evaluate the Safety and Performance of ArterX™ Surgical Sealant in Sealing Synthetic Arterial Grafts. 1. Introduction Intra-operative bleeding from the suture lines after the implantation of synthetic vascular grafts can result in extended operative times to ensure the anastomosis is adequately sealed prior to the patient being closed. Synthetic grafts, particularly PTFE grafts
SAFETY DATA SHEET according to Regulation (EU) No. 1907/2006 1. IDENTIFICATION OF THE SUBSTANCE/PREPARATION AND OF THE COMPANY/UNDERTAKING : Tetracycline hydrochloride The Old Brickyard NEW ROAD, GILLINGHAM Dorset SP8 4XT UNITED KINGDOM 2. HAZARDS IDENTIFICATION Risk advice to man and the environment Irritating to eyes, respiratory system and skin. 3. COMPOSITION/INFORMATIO