ABSTRACT Community-acquiredpneumoniaisacommondiseaseandafrequentcauseofmorbidityandmortalityworldwide.HaemophilusinfluenzaeisaleadingcauseofCAP.ThecurrentstudywasconductedtodeterminetheserotypedistributionandantimicrobialsusceptibilitypatternsofHaemophilusinfluenzaeisolatedfromunvaccinatedadultpatientswithCAPatAssiutUniversityHospitals.MaterialsandMethods:FromSeptember2013toaugust2014,sputumsamplesfrom132adultpatientswithCAPwereanalyzedforthedetectionofHaemophilusinfluenzausingconventionalmethods.AntimicrobialsusceptibilityandserotypingofHaemophilusinfluenzaewasperformed.Results:Haemophilusinfluenzaeweredetectedin21(16%)CAP-patients.Non-typeableHinfluenzaewerethemostfrequentlyisolatedserotypethatfoundin15(71%)ofHinfluenzae-cases.Hinfluenzaetypebwasfoundin5(24%)cases.WhileHinfluenzaetypefwasfoundinone(5%)case.CasesweredetectedmainlyduringJanuary,February,andMarch.ResistancewashighestfortheB-lactamgroupofantibiotics.Conclusion:CAPhasadiseaseburdeninadultpatientsatAssiutUniversityHospitals,Egypt.HinfluenzaeisaleadingcauseofCAPwhichwasassociatedmostlywithnon-typeableserotypes.ResistancetopenicillinandotherantimicrobialagentsincreasedrapidlyduringthelastyearsamongH influenzaestrains. Keywords:Haemophilusinfluenzae,community-acquiredpneumonia,serotyping, antimicrobialresistance.

ABSTRACT Community-acquiredpneumoniaisacommondiseaseandafrequentcauseofmorbidityandmortalityworldwide.Streptococcuspneumoniaeisthemostcommoncauseofcommunity-acquiredpneumonia. ThecurrentstudywasconductedtodeterminetheserotypedistributionandantimicrobialsusceptibilitypatternsofStreptococcuspneumoniaeisolatedfrompatientswithcommunity-acquiredpneumoniaatAssiutUniversityHospitals.FromFebruary2013toMay2013,sputumsamplesfrom60adultpatientswithcommunity-acquiredpneumoniawereanalyzedforbacterialetiologyusingconventionalmethods.Antimicrobialsusceptibility and serotyping of Streptococcuspneumoniae wasperformed. bacterialagentsweredetectedin53patients(88%).Streptococcuspneumoniaewasthemostcommon(30%)isolatedbacteria.Eightco-infectionswereidentified.Thedetectedpneumococcal-serotypeswereindecreasingorder;1,9V,6B,19F,23F,14,and19A.Pneumococcal-antibioticresistancewashighestforpenicillinandampicillinantibiotics.Streptococcuspneumoniaeisthemostcommonisolatedbacteriaincasesofcommunity-acquiredpneumoniawhichisassociatedwithcertainserotypes.Resistancetopenicillinandotherantimicrobialagentsincreasedrapidlyduringthelastyearsamongpneumococcalstrainsworldwide. Keywords:Streptococcuspneumoniae,community-acquiredpneumonia,serotyping,antimicrobialresistance.

ABSTRACT Community-acquiredpneumoniaisacommondiseaseandafrequentcauseofmorbidityandmortalityworldwide.Streptococcuspneumoniaeisthemostcommoncauseofcommunity-acquiredpneumonia. ThecurrentstudywasconductedtodeterminetheserotypedistributionandantimicrobialsusceptibilitypatternsofStreptococcuspneumoniaeisolatedfrompatientswithcommunity-acquiredpneumoniaatAssiutUniversityHospitals.FromFebruary2013toMay2013,sputumsamplesfrom60adultpatientswithcommunity-acquiredpneumoniawereanalyzedforbacterialetiologyusingconventionalmethods.Antimicrobialsusceptibility and serotyping of Streptococcuspneumoniae wasperformed. bacterialagentsweredetectedin53patients(88%).Streptococcuspneumoniaewasthemostcommon(30%)isolatedbacteria.Eightco-infectionswereidentified.Thedetectedpneumococcal-serotypeswereindecreasingorder;1,9V,6B,19F,23F,14,and19A.Pneumococcal-antibioticresistancewashighestforpenicillinandampicillinantibiotics.Streptococcuspneumoniaeisthemostcommonisolatedbacteriaincasesofcommunity-acquiredpneumoniawhichisassociatedwithcertainserotypes.Resistancetopenicillinandotherantimicrobialagentsincreasedrapidlyduringthelastyearsamongpneumococcalstrainsworldwide. Keywords:Streptococcuspneumoniae,community-acquiredpneumonia,serotyping,antimicrobialresistance.

Themajorityofchronicobstructivepulmonarydiseaseexacerbationsarecausedbyinfectionsofthetracheobronchialtree.PreviousdataonbacterialexacerbationsofCOPDinUpperEgyptarelimited.Hence,thisstudywasconductedfortheidentificationofthecausativebacteriainexacerbationsofCOPD,andtoillustratetheirantimicrobialsusceptibilitypatternsatAssiutUniversityHospitals,UpperEgypt.Atotalof116COPDpatientswhounderwent167infectionexacerbationattacksparticipatedinthisprospectivestudy during2013.Significantbacterialgrowthwasfoundin143(86%)out ofthe167 exacerbationattacks.Themostcommondetected bacteriawereHaemophilusinfluenzae(19.4%),Escherichiacoli(18%),Streptococcuspneumoniae(16.7%),Klebsiellapneumoniae(14%),Streptococcuspyogenes(10%),Pseudomonasaeruginosa(5.6%),methicillinresistantStaphylococcusaureus(5.6%),Acinetobacter baumannii(4.2%),andMoraxellacatarrhalis(2.8%).The majority of theisolatedstrainsshowedhighresistanceratesto mostgroupsofantibioticswhere91(63%) oftheisolated strainswere multidrug resistant, 37(26%)strainswereextremedrugresistantand16(11%) bacterialstrainswerepandrugresistant.Highresistancerateswereobservedagainstpenicillinsandcephalosporins.Moderateresistanceratesweredetectedagainstthefluoroquinolones.Highsusceptibilitiesweredetectedtothecarbapenemgroup.AlltheisolatedGram-positivebacteriaweresensitivetolinezolid

Themajorityofchronicobstructivepulmonarydiseaseexacerbationsarecausedbyinfectionsofthetracheobronchialtree.PreviousdataonbacterialexacerbationsofCOPDinUpperEgyptarelimited.Hence,thisstudywasconductedfortheidentificationofthecausativebacteriainexacerbationsofCOPD,andtoillustratetheirantimicrobialsusceptibilitypatternsatAssiutUniversityHospitals,UpperEgypt.Atotalof116COPDpatientswhounderwent167infectionexacerbationattacksparticipatedinthisprospectivestudy during2013.Significantbacterialgrowthwasfoundin143(86%)out ofthe167 exacerbationattacks.Themostcommondetected bacteriawereHaemophilusinfluenzae(19.4%),Escherichiacoli(18%),Streptococcuspneumoniae(16.7%),Klebsiellapneumoniae(14%),Streptococcuspyogenes(10%),Pseudomonasaeruginosa(5.6%),methicillinresistantStaphylococcusaureus(5.6%),Acinetobacter baumannii(4.2%),andMoraxellacatarrhalis(2.8%).The majority of theisolatedstrainsshowedhighresistanceratesto mostgroupsofantibioticswhere91(63%) oftheisolated strainswere multidrug resistant, 37(26%)strainswereextremedrugresistantand16(11%) bacterialstrainswerepandrugresistant.Highresistancerateswereobservedagainstpenicillinsandcephalosporins.Moderateresistanceratesweredetectedagainstthefluoroquinolones.Highsusceptibilitiesweredetectedtothecarbapenemgroup.AlltheisolatedGram-positivebacteriaweresensitivetolinezolid

Themajorityofchronicobstructivepulmonarydiseaseexacerbationsarecausedbyinfectionsofthetracheobronchialtree.PreviousdataonbacterialexacerbationsofCOPDinUpperEgyptarelimited.Hence,thisstudywasconductedfortheidentificationofthecausativebacteriainexacerbationsofCOPD,andtoillustratetheirantimicrobialsusceptibilitypatternsatAssiutUniversityHospitals,UpperEgypt.Atotalof116COPDpatientswhounderwent167infectionexacerbationattacksparticipatedinthisprospectivestudy during2013.Significantbacterialgrowthwasfoundin143(86%)out ofthe167 exacerbationattacks.Themostcommondetected bacteriawereHaemophilusinfluenzae(19.4%),Escherichiacoli(18%),Streptococcuspneumoniae(16.7%),Klebsiellapneumoniae(14%),Streptococcuspyogenes(10%),Pseudomonasaeruginosa(5.6%),methicillinresistantStaphylococcusaureus(5.6%),Acinetobacter baumannii(4.2%),andMoraxellacatarrhalis(2.8%).The majority of theisolatedstrainsshowedhighresistanceratesto mostgroupsofantibioticswhere91(63%) oftheisolated strainswere multidrug resistant, 37(26%)strainswereextremedrugresistantand16(11%) bacterialstrainswerepandrugresistant.Highresistancerateswereobservedagainstpenicillinsandcephalosporins.Moderateresistanceratesweredetectedagainstthefluoroquinolones.Highsusceptibilitiesweredetectedtothecarbapenemgroup.AlltheisolatedGram-positivebacteriaweresensitivetolinezolid

Abstract Allovahlkampfiaspelaeawasidentifiedforthefirsttimein2009.Asafreelivingamoeba,ithasbeensuggested tobeaprotectivehostforsomebacterialpathogensagainstharshenvironmentalconditionsandcantransmitthem tovulnerablehosts.WeaimedinthisstudytotesttheinteractionsbetweenAllovahlkampfiaspelaeaandsomewaterborneandfoodbornebacteriaandunravelifthetestedbacteriacansurviveandmultiplyinsideamoeba.WeusedakeratitisisolateofAllovahlkampfiaspelaeagrowninPYGmediumcontainingproteosepeptone,yeast extracts,andglucose.WeexaminedamoebainteractionswithMethicillinresistantStaphylococcusaureus,Escherichiacoli1,Klebsiellapneumoniae,Enterobacteraerogenes,Citrobactercloaca,Proteusmirabilis,Raoultella terrigena,Raoultellaornitholytica,AeromonashydrophilaandPseudomonasaeruginosausingtheco-culture assays.Amoebalsurvivalratewithdifferentbacterialstrainsweredetermined.WiththeexceptionofProteusmirabilisthatshoweddecreasedsurvivalratesinsideamoebalcells,otherbacterialisolatescouldsurviveand multiplyinsideAllovahlkampfiaspelaeathatwasassociatedwithdecreasedsurvivalratesoftheamoeba. Particularly,Pseudomonasaeruginosa,AeromonashydrophilaandMRSAexhibitedsignificantlyincreasedmultiplicationratesinsideamoeba.OurstudydemonstratedthatAllovahlkampfiaspelaeamayactasareplicative host for pathogenic bacteria with environmental and clinical implications.

Abstract Allovahlkampfiaspelaeawasidentifiedforthefirsttimein2009.Asafreelivingamoeba,ithasbeensuggested tobeaprotectivehostforsomebacterialpathogensagainstharshenvironmentalconditionsandcantransmitthem tovulnerablehosts.WeaimedinthisstudytotesttheinteractionsbetweenAllovahlkampfiaspelaeaandsomewaterborneandfoodbornebacteriaandunravelifthetestedbacteriacansurviveandmultiplyinsideamoeba.WeusedakeratitisisolateofAllovahlkampfiaspelaeagrowninPYGmediumcontainingproteosepeptone,yeast extracts,andglucose.WeexaminedamoebainteractionswithMethicillinresistantStaphylococcusaureus,Escherichiacoli1,Klebsiellapneumoniae,Enterobacteraerogenes,Citrobactercloaca,Proteusmirabilis,Raoultella terrigena,Raoultellaornitholytica,AeromonashydrophilaandPseudomonasaeruginosausingtheco-culture assays.Amoebalsurvivalratewithdifferentbacterialstrainsweredetermined.WiththeexceptionofProteusmirabilisthatshoweddecreasedsurvivalratesinsideamoebalcells,otherbacterialisolatescouldsurviveand multiplyinsideAllovahlkampfiaspelaeathatwasassociatedwithdecreasedsurvivalratesoftheamoeba. Particularly,Pseudomonasaeruginosa,AeromonashydrophilaandMRSAexhibitedsignificantlyincreasedmultiplicationratesinsideamoeba.OurstudydemonstratedthatAllovahlkampfiaspelaeamayactasareplicative host for pathogenic bacteria with environmental and clinical implications.

Abstract Allovahlkampfiaspelaeawasidentifiedforthefirsttimein2009.Asafreelivingamoeba,ithasbeensuggested tobeaprotectivehostforsomebacterialpathogensagainstharshenvironmentalconditionsandcantransmitthem tovulnerablehosts.WeaimedinthisstudytotesttheinteractionsbetweenAllovahlkampfiaspelaeaandsomewaterborneandfoodbornebacteriaandunravelifthetestedbacteriacansurviveandmultiplyinsideamoeba.WeusedakeratitisisolateofAllovahlkampfiaspelaeagrowninPYGmediumcontainingproteosepeptone,yeast extracts,andglucose.WeexaminedamoebainteractionswithMethicillinresistantStaphylococcusaureus,Escherichiacoli1,Klebsiellapneumoniae,Enterobacteraerogenes,Citrobactercloaca,Proteusmirabilis,Raoultella terrigena,Raoultellaornitholytica,AeromonashydrophilaandPseudomonasaeruginosausingtheco-culture assays.Amoebalsurvivalratewithdifferentbacterialstrainsweredetermined.WiththeexceptionofProteusmirabilisthatshoweddecreasedsurvivalratesinsideamoebalcells,otherbacterialisolatescouldsurviveand multiplyinsideAllovahlkampfiaspelaeathatwasassociatedwithdecreasedsurvivalratesoftheamoeba. Particularly,Pseudomonasaeruginosa,AeromonashydrophilaandMRSAexhibitedsignificantlyincreasedmultiplicationratesinsideamoeba.OurstudydemonstratedthatAllovahlkampfiaspelaeamayactasareplicative host for pathogenic bacteria with environmental and clinical implications.

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