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Title: Epidemiology and treatment of methicillin resistant Staphylococcus aureas in Jeddah
Author: Sultan, Rania Mohammad Sabri
ISNI:       0000 0004 2714 9868
Awarding Body: Manchester Metropolitan University
Current Institution: Manchester Metropolitan University
Date of Award: 2012
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Staphylococcus aureus is the most frequently isolated pathogen in hospitals and community and methicillin-resistant S. aureus (MRSA) prevalence has increased in Saudi Arabian hospitals from 2% in 1989 to 33% in 1998. In this study, the prevalence of healthcare associated infections and the predominant organisms was investigated through survey of the infection control departments in three hospitals in Jeddah, namely King Abdul Aziz University Hospital (KAUH), King Fahad Hospital (KFH), and the Maternity and Children Hospital (MCH). Two hundred and seven MRSA isolates were collected from the three respective laboratories and their multiple antibiotic resistance (MAR) profiles identified. Twenty three strains were selected for further investigation using Pulse Field Gel Electrophoresis (PFGE) and Spa typing based on MAR profile and demographic data. In addition, the antimicrobial activity of some Saudi herbs and spices were assessed in vitro and in vivo as possible alternative treatments for MRSA. Data showed there was a similarity in infection control policies across the three hospitals. Collective data from all hospitals showed that MRSA was frequently isolated from wounds (36.7%) and respiratory tract infections (30.4%). They were resistant to penicillin (100%), oxacillin (100%), erythromycin (62.9%), gentamicin (51.2%), trimethoprim-sulfamethoxazole (54.6%) and ciprofloxacin (50.2%). All strains were sensitive to vancomycin, teicoplanin and rifampicin. Ten MAR profiles were identified. Two MAR profiles were endemic in KAUH and KFH and resistant to six out of nine antibiotics. One MAR profile was endemic in MCH and showed resistance to five out of nine antibiotics. The majority of strains were PFGE type 1 predicted as EMRSA 1 and spa type t-363, t-037 and these were seen in the eight of the ten MAR profiles. The minimal inhibitory concentration, minimal bacteriocidal concentration and time kill assays of aqueous and alcoholic extracts of Pimenta dioica and Punica garantum singly or combination were active at 512mg/ml for 90% of MRSA strains. Gas chromatography-mass spectrometry analysis confirmed the major components in both extracts were in the phenolic group. An in vivo study using both extracts and combinations as an aqueous wash and ointment showed some potential but would not be a suitable replacement for chlorhexidine or fucidin as decontamination treatment. Future work on determining the correct concentration for in vivo use needs to be undertaken.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available