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Salawudeen A, Raji YE, Jibo GG, Desa MNM, Neoh HM, Masri SN, Di Gregorio S, Jamaluddin TZMT. Epidemiology of multidrug-resistant Klebsiella pneumoniae infection in clinical setting in South-Eastern Asia: a systematic review and meta-analysis. Antimicrob Resist Infect Control 2023; 12:142. [PMID: 38062531 PMCID: PMC10704709 DOI: 10.1186/s13756-023-01346-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
The rising prevalence of multidrug-resistant (MDR) and extended-spectrum beta lactamase-resistant (ESBL) Klebsiella pneumoniae (K. pneumoniae) is an important global public health challenge. This threat is even more pertinent in clinical settings. Morbidity and mortality associated with this condition are alarming particularly in the developing regions of the world. A comprehensive evaluation of the epidemiology of this phenomenon will assist towards the global effort of reducing its burden. So, this systematic review and meta-analysis was conducted to evaluate the epidemiology of MDR K. pneumoniae in South-Eastern Asia (SEA). The study was done under the PRISMA guidelines and was preceded by the development of a priori protocol. The protocol was then registered in PROSPERO-the public registry for systematic reviews. Seven important outcomes which include the assessment of the overall MDR K. pneumoniae prevalence were designed to be evaluated. A literature search was carried out in five selected electronic databases and 4389 were screened. Of these articles, 21 studies that met the eligibility criteria were included in the review. Relevant data were extracted from the included studies. By conducting a quality effect meta-analysis, the pooled prevalence for MDR and ESBL K. pneumoniae in SEA was estimated at 55% (CI 9-96) and 27% (CI 32-100) respectively. The review also identified ESBL genes types of allodemic situations occurring mostly in respiratory tract infections. The high prevalence of MDR and ESBL K. pneumoniae in this subregion is highly significant and of both public health and clinical relevance. Overall, the findings of this review will assist in the effective prevention and control of this threat in SEA.
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Affiliation(s)
- Adamu Salawudeen
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
- Department of Microbiology, Faculty of Science, Gombe State University, Tudun Wada, Gombe, 760214, Gombe State, Nigeria
| | - Yakubu Egigogo Raji
- Department of Pathology, Clinical Microbiology Unit, College of Health Sciences, Ibrahim Badamasi Babangida University Lapai, Lapai, 911101, Nigeria
| | - Garba Gidandawa Jibo
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
- Department of Microbiology, Faculty of Life Sciences, Kebbi State University of Science and Technology, Aliero, 863104, Nigeria
| | - Mohd Nasir Mohd Desa
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Hui-Min Neoh
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Ya'acob Latiff, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
| | - Siti Norbaya Masri
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
- Department of Medical Microbiology, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Sabrina Di Gregorio
- Instituto de Investigaciones en Bacteriologia y Virologia Molecular (IBaViM), Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires, Postal Code 1113, Buenos Aires, Argentina
- CONICET, National Scientific and Technical Research Council - Argentina, Postal Code 1425, Buenos Aires, Argentina
| | - Tengku Zetty Maztura Tengku Jamaluddin
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.
- Infection Control Unit, Department of Medical Microbiology, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, 43400, Serdang, Malaysia.
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Venne DM, Hartley DM, Malchione MD, Koch M, Britto AY, Goodman JL. Review and analysis of the overlapping threats of carbapenem and polymyxin resistant E. coli and Klebsiella in Africa. Antimicrob Resist Infect Control 2023; 12:29. [PMID: 37013626 PMCID: PMC10071777 DOI: 10.1186/s13756-023-01220-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/18/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Carbapenem-resistant Enterobacterales are among the most serious antimicrobial resistance (AMR) threats. Emerging resistance to polymyxins raises the specter of untreatable infections. These resistant organisms have spread globally but, as indicated in WHO reports, the surveillance needed to identify and track them is insufficient, particularly in less resourced countries. This study employs comprehensive search strategies with data extraction, meta-analysis and mapping to help address gaps in the understanding of the risks of carbapenem and polymyxin resistance in the nations of Africa. METHODS Three comprehensive Boolean searches were constructed and utilized to query scientific and medical databases as well as grey literature sources through the end of 2019. Search results were screened to exclude irrelevant results and remaining studies were examined for relevant information regarding carbapenem and/or polymyxin(s) susceptibility and/or resistance amongst E. coli and Klebsiella isolates from humans. Such data and study characteristics were extracted and coded, and the resulting data was analyzed and geographically mapped. RESULTS Our analysis yielded 1341 reports documenting carbapenem resistance in 40 of 54 nations. Resistance among E. coli was estimated as high (> 5%) in 3, moderate (1-5%) in 8 and low (< 1%) in 14 nations with at least 100 representative isolates from 2010 to 2019, while present in 9 others with insufficient isolates to support estimates. Carbapenem resistance was generally higher among Klebsiella: high in 10 nations, moderate in 6, low in 6, and present in 11 with insufficient isolates for estimates. While much less information was available concerning polymyxins, we found 341 reports from 33 of 54 nations, documenting resistance in 23. Resistance among E. coli was high in 2 nations, moderate in 1 and low in 6, while present in 10 with insufficient isolates for estimates. Among Klebsiella, resistance was low in 8 nations and present in 8 with insufficient isolates for estimates. The most widespread associated genotypes were, for carbapenems, blaOXA-48, blaNDM-1 and blaOXA-181 and, for polymyxins, mcr-1, mgrB, and phoPQ/pmrAB. Overlapping carbapenem and polymyxin resistance was documented in 23 nations. CONCLUSIONS While numerous data gaps remain, these data show that significant carbapenem resistance is widespread in Africa and polymyxin resistance is also widely distributed, indicating the need to support robust AMR surveillance, antimicrobial stewardship and infection control in a manner that also addresses broader animal and environmental health dimensions.
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Affiliation(s)
- Danielle M Venne
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA
| | - David M Hartley
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, 45229, USA
| | - Marissa D Malchione
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA
- Sabin Vaccine Institute, Influenza Vaccine Innovation, 2175 K St NW, Washington, DC, 20037, USA
| | - Michala Koch
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA
| | - Anjali Y Britto
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA
| | - Jesse L Goodman
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA.
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Tilahun M. Multi-Drug Resistance Profile, Prevalence of Extended-Spectrum Beta-Lactamase and Carbapenemase-Producing Gram Negative Bacilli Among Admitted Patients After Surgery with Suspected of Surgical Site Nosocomial Infection North East Ethiopia. Infect Drug Resist 2022; 15:3949-3965. [PMID: 35924020 PMCID: PMC9341454 DOI: 10.2147/idr.s376622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Mihret Tilahun
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- Correspondence: Mihret Tilahun, Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie and Borumeda, PO.BOX 1145, Ethiopia, Tel +251 920988307, Fax +251 333115250, Email
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Layer-By-Layer Self-Assembled Dip Coating for Antifouling Functionalized Finishing of Cotton Textile. Polymers (Basel) 2022; 14:polym14132540. [PMID: 35808585 PMCID: PMC9269539 DOI: 10.3390/polym14132540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 02/02/2023] Open
Abstract
The fouling of surfaces such as textiles is a major health challenge, and there is a continuous effort to develop materials and processes to overcome it. In consideration of this, this study regards the development of antifouling functional nanoencapsulated finishing for the cotton textile fabric by employing a layer-by-layer dip coating technique. Antifouling textile finishing was formulated by inducing the nanoencapsulation of the antifouling functional group inside the hydrophobic polymeric shell. Cotton fabric was taken as a substrate to incorporate antibacterial functionality by alternatively fabricating multilayers of antifouling polymeric formulation (APF) and polyelectrolyte solution. The surface morphology of nanoencapsulated finished textile fabric was characterized through scanning electron microscopy to confirm the uniform distribution of nanoparticles on the cotton textile fabric. Optical profilometry and atomic force microscopy studies indicated increased surface roughness in the coated textile substrate as compared to the uncoated textile. The surface thickness of the fabricated textile increased with the number of deposited bilayers on the textile substrate. Surface hydrophobicity increased with number of coating bilayers with θ values of x for single layer, up to y for 20 bilayers. The antibacterial activity of the uncoated and layer-by-layer coated finished textile was also evaluated. It was significant and exhibited a significant zone of inhibition against microbial strains Gram-positive S. aureus and Gram-negative E. coli. The bilayer coating exhibited water repellency, hydrophobicity, and antibacterial activity. Thus, the fabricated textile could be highly useful for many industrial and biomedical applications.
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Tilahun M, Gedefie A, Bisetegn H, Debash H. Emergence of High Prevalence of Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Acinetobacter Species and Pseudomonas aeruginosa Among Hospitalized Patients at Dessie Comprehensive Specialized Hospital, North-East Ethiopia. Infect Drug Resist 2022; 15:895-911. [PMID: 35299856 PMCID: PMC8921833 DOI: 10.2147/idr.s358116] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/24/2022] [Indexed: 12/27/2022] Open
Abstract
Background The emergence of extended spectrum beta lactamase and carbapenemase production of Acinetobacter and Pseudomonas aeruginosa is a great concern and major cause of nosocomial infections due to its ability to production of extended spectrum beta lactamase and carbapenemase enzymes. Objective To assess Emergence of high prevalence of extended-spectrum beta-lactamase and Carbapenemase producing Acinetobacter species and Pseudomonas aeruginosa among hospitalized patients at Dessie Comprehensive Specialized Hospital, North-East Ethiopia. Materials and Methods A hospital-based cross-sectional study was conducted from February–August 2021 at Dessie Referral Hospital in the North eastern Ethiopia. A total of 423 clinical samples taken from admitted patients. Clinical specimens were collected aseptically and inoculated on blood agar and MacConkey agar media. Antimicrobial susceptibility test, ESBL and carbapenemase production were performed as CLSI guideline. The data were entered into the Epi-data and imported to Statistical Package for Social Science version 25. P value of <0.05 with odds ratio and 95% confidence interval was considered as statistically significant. Results Out of 423 clinical specimens 17.7% (75/423) were culture positive nosocomial infection. The proportions of nosocomial infection were higher in blood stream followed by wound infection which accounted 24.6%, 20.8%, respectively. Overall, 32/75 (42.7%) and 19/75 (25.3%) patients had infection with ESBL and CP producing bacterial infection. P. aeruginosa was the most predominant isolated bacteria 46/75 (52.9%). The overall multidrug resistance rate of the isolated bacteria was 88% (66/75). The majority of highest resistance rate was Piperacillin tazobactam 50 (66.7%) and Aztreonam 26 (56.5%), respectively, while least resistance rate was Amikacin 27 (36%). Conclusion The incidence rates of ESBL, carbapenemase production and antimicrobial resistant Acinetobacter species and P. aeruginosa infections are high. Therefore, treatment should be based on culture and antimicrobial test result and minimize the use of antibiotics empirically.
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Affiliation(s)
- Mihret Tilahun
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- Correspondence: Mihret Tilahun, Department of Medical Laboratory Science College of Medicine and Health Sciences, Wollo University, PO.Box: 1145, Dessie, Ethiopia, Tel +251 920988307, Fax +251 333115250, Email
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Habitye Bisetegn
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Habtu Debash
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Alebel M, Mekonnen F, Mulu W. Extended-Spectrum β-Lactamase and Carbapenemase Producing Gram-Negative Bacilli Infections Among Patients in Intensive Care Units of Felegehiwot Referral Hospital: A Prospective Cross-Sectional Study. Infect Drug Resist 2021; 14:391-405. [PMID: 33564247 PMCID: PMC7867495 DOI: 10.2147/idr.s292246] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background Owing to the specific risk profile of its residents, intensive care units (ICUs) are the best place for selection pressure and the epicenter for resistance development and dissemination. Infections with β-lactamase releasing Gram-negative bacilli (GNB) at ICUs are an emerging global threat. This study dogged the magnitude of extended-spectrum β-lactamase (ESBL) and carbapenemase releasing Gram-negative bacilli infections and associated factors among patients in the ICUs of Felegehiwot Referral Hospital, Ethiopia. Methods A cross-sectional study was done through February to June 2020. Wound swabs, urine, blood and sputum samples were collected from patients in the ICUs symptomatic for infections while excluding those under coma and shock. Bacterial species were verified using standard microbiological methods. Carbapenemase and ESBL production were identified using modified carbapenem inactivation and combined disk diffusion methods, respectively. Multivariable analysis was calculated for factors associated with ESBL production. P-value < 0.05 was taken as cut-off for statistical significance. Results Out of 270 patients in the ICU, 67 (24.8%) and 14 (5.2%) had infections with ESBL and carbapenemase releasing GNB, respectively. The most frequent ESBL producing isolates were P. aeruginosa (100%), E. cloacae (100%), K. pneumoniae (82.8%) and E. coli (64%). The predominant carbapenemase producer isolates were K. pneumoniae (27.6%) and E. cloacae (33.3%). Overall, 77 (81.1%) of species were multi-drug resistant. All GNB species were 100% resistant to tetracycline and ampicillin. They are also resistant to cefuroxime, ceftazidime, sulfamethoxazole-trimethoprim and cefotaxime. Prior hospitalization (AOR = 5.5, CI = 2.63-11.46), support with medical care devices (AOR = 23.7, CI = 4.6-12) and arterial intravenous catheterization (AOR = 2.7, CI = 1.3-5.3) had significant association with β-lactamase producing GNB infection. Conclusion Infection with ESBL and carbapenemase producing Gram-negative bacilli linked with an alarming degree of multi-drug resistant isolates is a major healthcare threat among patients in ICUs. Hence, strict adherence to infection prevention practices and wise use of antibiotics are recommended to slow the spread of antimicrobial resistance.
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Affiliation(s)
- Mekonnen Alebel
- Department of Clinical Laboratory Science, Chagni Hospital, Chagni, Ethiopia
| | - Feleke Mekonnen
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wondemagegn Mulu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Bouacha M, Ayed H, Grara N. Honey Bee as Alternative Medicine to Treat Eleven Multidrug-Resistant Bacteria Causing Urinary Tract Infection during Pregnancy. Sci Pharm 2018; 86:scipharm86020014. [PMID: 29652864 PMCID: PMC6027671 DOI: 10.3390/scipharm86020014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 03/28/2018] [Accepted: 04/10/2018] [Indexed: 01/24/2023] Open
Abstract
Medicinal benefits of honey bee have been recognized in the medical community since ancient times as a remedy for many diseases and infections. This study aimed to investigate the in vitro susceptibility of 11 multidrug-resistant bacterial strains, isolated from urinary tract infections of pregnant women, to six honey samples collected from different localities in the east of Algeria. The evaluation of the antibacterial activity was performed by the well method followed by the broth dilution method using two-fold dilutions of each honey sample ranging from 2.5 to 80% (w/v). The results obtained in this study revealed that all tested honeys exhibited potent antibacterial activity against the tested strains. The diameters of inhibition ranged from 19.67 to 53.33 mm, with minimum inhibitory concentrations (MICs) ranging from 2.5 to 40% (w/v) and minimum bactericidal concentration (MBCs) varied between 2.5 and 80% (w/v). Gram-positive bacteria were found to be more susceptible than Gram-negative bacteria with diameters ranging from 43.33 to 53.33 mm; MIC and MBC values ranged from 2.5 to 5% (w/v). The P.aeruginosa strain was found to be less susceptible than other strains with inhibitory diameters ranging from 19.67 to 27.33 mm; MICs ranged from 20 to 40% and MBCs ranged from 20 to 80% (w/v). This contribution has provided a broad overview of the antibacterial activity of Algerian honey and shown that honey bee has great potential for therapeutic use as an alternative therapy for urinary tract infection treatment which is safe and efficient during pregnancy.
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Affiliation(s)
- Mabrouka Bouacha
- Laboratory of Biochemistry and Microbiology, Department of Biochemistry, Faculty of Sciences, University of Badji Mokhtar,23000 Annaba, Algeria.
| | - Hayette Ayed
- Department of Biology, Faculty of Biology, University 8 May 1945, 24000 Guelma, Algeria.
| | - Nedjoud Grara
- Department of Biology, Faculty of Biology, University 8 May 1945, 24000 Guelma, Algeria.
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El-Nawawy A, Ashraf GA, Antonios MAM, Meheissen MA, El-Alfy MMR. Incidence of Multidrug-Resistant Organism Among Children Admitted to Pediatric Intensive Care Unit in a Developing Country. Microb Drug Resist 2018; 24:1198-1206. [PMID: 29589993 DOI: 10.1089/mdr.2017.0414] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM Multidrug-resistant infections are an increasingly common condition particularly in critical care units. This study aimed to determine the incidence and types of resistant bacteria acquired in a pediatric intensive care unit (PICU) of a university hospital. SUBJECT AND METHODS A prospective study was conducted during the year 2016. All children aged below 16 years were studied for infection development and pattern of susceptibility to various groups of antibiotics. RESULTS A total of 264 patients were admitted to the PICU: 16 patients had community-acquired infection (CAI), 23 had hospital-acquired infection, and 24 patients had PICU-acquired infection (with 36 episodes) which is equivalent to 14.75 case/1,000 patient days. The study revealed high incidence of resistant organisms in the PICU but more important is the appearance of multi- and extreme drug-resistant bacteria in CAI. The study revealed that gram-negative bacteria were more prevalent in PICU, especially Klebsiella (30.5%), Acinetobacter baumanii (22.22%), and Pseudomonas (16.67%). Infection with resistant organisms in the PICU caused initial treatment failure and increased fourfold risk of mortality. CONCLUSION The incidence of resistant bacteria especially gram-negative pathogens was very high in the PICU. The top three resistant organisms of concern were Klebsiella, Acinetobacter, and Pseudomonas. This is a global concern that necessitates new strategies.
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Affiliation(s)
- Ahmed El-Nawawy
- 1 Department of Pediatrics, Alexandria University , Faculty of Medicine, El-Shatby Children's Hospital, Alexandria, Egypt
| | | | - Manal A M Antonios
- 1 Department of Pediatrics, Alexandria University , Faculty of Medicine, El-Shatby Children's Hospital, Alexandria, Egypt
| | - Marwa A Meheissen
- 3 Department of Clinical Microbiology, Alexandria University , Faculty of Medicine, Egypt
| | - Marwa M R El-Alfy
- 1 Department of Pediatrics, Alexandria University , Faculty of Medicine, El-Shatby Children's Hospital, Alexandria, Egypt
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