Sana’a University Journal of Medicine and Health Sciences

Aerobic, Gram-negative, non-fermenting Chrysobacter endologins are bacilli that are inherently multidrug resistant. Among the infections that have been reported include keratitis, polymyositis, meningitis, pneumonia, and bacteremia in immobilized devices. We describe a rare instance of C. indolognes infection that resulted in bacteremia in a patient receiving intensive care and offer an analysis of cases that are comparable. This report emphasizes the importance of individualized treatment and promotes awareness about this organism as one of many emerging pathogens in immunocompromised adults who are often ICU residents. The most effective agents reported against C. indologes are the quinolones (gatifloxacin and levofloxacin) and trimethoprim-sulfamethoxazole (more than 95% sensitivity). Ciprofloxacin, cefepime, ceftazidime, piperacillin, and rifampin showed significant sensitivity. C. indologenes was obtained from blood cultures. Based on sensitivity, a successful response was observed with piperacillin/tazobactam. Guidelines for this pathogen's management should be taken into consideration given the rise in cases that have been documented in the literature. Levofloxacin, Ciprofloxacin, Piperacillin/Tazobactam, Trimethoprim/Sulfamethoxazole, Piperacillin/Tazobactam, and Rifampin were other effective antimicrobials against C. indologenes.

Background: The distinctive feature of acute myeloid leukemia (AML) is the infiltration of abnormal myeloid precursors into the bone marrow and other tissues, frequently accompanied by the appearance of these abnormal cells in the peripheral blood. This study aimed to describe the hematological features and demographic characteristics of patients with AML who attended the National Oncology Center in Sana’a, Yemen.

Subjects and Methods: This descriptive study was carried out on 124 newly diagnosed AML patients of all ages and both genders who attended the National Oncology Center in Sana’a City, Yemen, during the period from November 2022 to November 2023. The complete blood count test was performed by drawing a few milliliters of blood sample, then was analyzed through a hematology analyzer, which performs quantitative analysis of blood elements including white blood cell count, WBC differential count, red blood cell count, hemoglobin, and platelet count.

Results: The median age of the patients was 35 years and a range (0.9-779 years); the majority of cases were older than 18 years (62.9%); and the frequency of AML was higher in males than in females (57.26% and 42.74%), respectively. Of 124 newly diagnosed AML patients, the median (range) of WBC and platelets were 50.47 (1.18-534.32 103/uL) and 45 (343 103/uL), respectively. The mean SD for RBC was 2.85 0.78 106/uL,, Hb was 8.40.94 g/dL, and Blast count was 75.26 16.04%). Leukocytosis was detected in (62.9%), Hyperleucotyosis in (25%), Erythropenia in (87.1%), and Thrombocytopenia in (86.3%). There was a significant positive correlation between age and platelets (r = 0.194, p-value = 0.03), WBC and Blast cells (r = 0.285, p-value = 0.001), and highly significant between RBC and Hb (r = 0.623, p-value = <0xC6><0xB0>0.001). For the WBC and platelet counts, there were variations between age groups and two genders; the variations were little in other hemological patterns, and there was no significance for all parameters. For WBC count, the median was 62 x 103 uL in the female group, higher than in the male group (46.5 x 103 uL), while there wasn't or little variation in the hematological features among male and female AML patients.

Conclusion: Hematological features of bone marrow/peripheral blood are essential diagnostic tools in AML patients. In the present study, approximately 87% of patients present with leucotyosis or hyperleucotyosis, erythropenia, and thrombocytopenia. And the blast cell count was > 20% for all AML patients, which is considered a diagnostic reference.

Background and aims This research investigates the link between biofilm formation and antibiotic resistance among Klebsiella pneumoniae bacteria in Sana'a city, Yemen, a common cause of hospital-acquired infections and community-acquired infections.

Methods: A 6-month study investigated 300 urinary tract infections samples, with 241 culture-positive. Standard methods were used for isolation and identification, including biofilm production and antibiogram susceptibility patterns of Klebsiella pneumoniae.

Results: The study reveals that penicillin resistance is linked to Klebsiella pneumoniae's ability to form biofilms. Ampicillin-resistant isolates formed biofilms 97.5% of the time, while non-biofilm-producing isolates had a lower rate of resistance. Carbapenem group resistance was also significant, with Meropenem-resistant isolates forming biofilms 42.5% of the time. Cephalosporin resistance ranged from 80-95% for Biofilm-Forming Isolates, while Quinolones resistance ranged from 65-82%. Aminoglycoside resistance was also significant, with gentamicin and amikacin resistance rates being 42.5% and 42.5%, respectively. These findings highlight the importance of understanding the phenotypes of Klebsiella pneumoniae in forming biofilms.

Conclusion: The study found a strong correlation between the biofilm production of Klebsiella pneumoniae and antibiotic resistance, with quinolones and cephalosporins being the least active, while carbapenems and aminoglycosides showed slight sensitivity.

Many corneal lesions end in corneal blindness by opacity. Eye Bank, which is not yet available in Yemen, is the source of substituted corneal grafts to retain eye vision. This study compared percentages and incidence rates of corneal lesions in two samples of total 2600 patients in 1993 and 1440 patients in 2004 who attended the same clinic. From the total new eye patients, these with corneal lesions either isolated or combined underwent the same determinants to show demography, etiology, and laterality through documenting their basic data, full history, and examinations.

Results: Respectively among the tow samples, a total of (141) 5.42% and (135) 9.38% (belonging to (130) 5.0% and (118) 8.19% patients) had corneal lesions distributed among all age groups, with the age group of 19- 50 years constituted (66) 50.77% and (65) 55.08%. The demography in (number) percentage and incidence rates were as follows: samples were comparable higher among males in (80) 61.54%, 3.08%, and (84) 71.19%, 5.48%, monocular (130) 92.2%, 5.00%, and (118) 87.41%, 8.19%, and AGMH received (79) 66.94%, 5.49%, and (118) 87.0%, 8.00% of the total attendance from outside Sana'a city. Right eye was in (48) 34.04%, 1.85%, and (75) 55.5%, 5.21%. Among etiologies, the incidences were: trauma (69) 2.65%, (61) 4.24%, inflammation (36) 1.38%, 3.08%, and (18) 1.25%; both are controllable and constituted 66.7% and 51% of the total corneal lesions. Then degenerative lesions (12) 0.423%, (9) 0.625%, keratoconus (8) 0.307%, (12) 0.833%, edema (5) 0.231%, (12) 0.833%, dryness (5) 0.192%, (7) 0.278%, dystrophy (4) 0.154%, (8) 0.416%, congenital (2) 0.076%, (6) 0.416%, and tumors were only in 2004 as (2) 0.138%. Conclusion: The incidence rates of corneal lesions were 5.0 and 8.0%, and the proportions of the controllable trauma and inflammations were 66.67% and 51.1%, reflecting the need for wide distribution of eye health centers among the country.

Background and objectives: The pathogenic species that is most frequently isolated from fungus infections is Candida albicans. The host's immune system, the severity of the infection, and the antifungal medication of choice all influence the management of these infections. Despite the advancement of novel antifungal medications, epidemiological investigations have demonstrated that resistance to antifungal agents in C. albicans strains is becoming a significant issue. The aims of this study were to (I) determine the prevalence of antifungal resistance in 53 oral Candida albicans isolates and (II) investigate the effect of biofilm production capacity on antifungal resistance rates.

Methods: Fifty-three isolates of Candida albicans were evaluated for biofilm production using the Tissue Culture Plate Method (TCPM). The antifungal susceptibility pattern of these isolates for amphotericin B, caspofungin, anidulafungin, voriconazole, itraconazole, ketoconazole, and posaconazole was determined using the E-test.

Results: The present study showed strong, moderate, weak, and negative biofilm production in 18.9%, 34.0%, 26.4%, and 20.8% of the C. albicans isolates, respectively. Amphotericin B, anidulafungin, and caspofungin effectively inhibited all of the tested isolates. The resistance rates of C. albicans isolates to fluconazole, itraconazole, ketoconazole, voriconazole, and posaconazole were 35.8%, 20.7%, 37.7%, 13.2%, and 20.7%, respectively. Strong and moderate biofilm-producing isolates displayed higher resistance rates compared to weak and negative biofilm producers. The majority of antifungal treatments showed a significant difference (p <0.05)".

Conclusion: Our results suggest that the study area has a higher prevalence of azole-resistant Candida albicans. Thus, there is an urgent need to develop a plan to decrease the overuse and unneeded adverse effects of antifungal medications. Testing for antifungal susceptibility and fungus culture will be helpful in monitoring resistance and providing therapy for patients. It was observed that the development of Candida albicans biofilms was correlated with the drug resistance component of oral Candida albicans isolates.

Objectives: The aim of this study was to consider the potential association between the formation of bucall mucusa streptococcus biofilms and a high DMFT index, as well as the occurrence of antibiotic resistance among adult patients in Sana'a, Yemen.

Study design: A total of 100; 34-85 year old. Clinical examinations of patients were performed to estimate dental caries experience with the Silness-Loe index, as well as bucall mucusa swabs were collected to assess biofilm production by the phenotypic method, i.e., tissue culture palate methods (TCPM). Finally, the antibiogram susceptibility pattern of isolated S. mutans was done by the Kirby-Bauer disc diffusion method for L-Lactam antibiotics (as ampicillin and penicillin) and non-L-Lactam antibiotics (clindamycin, erythromycin, lincomycin, and vancomycin).

Results: When isolated S. mutans were exposed to biofilm detection by the TCP method, 1 (1.2%) showed strong biofilm formation capacity, 71 (86.6%) showed moderate biofilm formation capacity, and 10 (12.2%) showed non/weak formation capacity of biofilm. There was an escalation in the rate of formation of S. mutans biofilms with an increased degree of caries index. The S. mutans biofilms positively showed a higher rate of resistance than non/weak biofilm formation, e.g., ampicillin (91.1% versus 8.9%, p <0x7E> 0.0001), tetracycline  (87.8% versus 12.2%, p <0x7E> 0.0001), and co-trimoxazole (90%% versus 10%, p <0x7E> 0.0001), etc.

Conclusion: The present study proved that S. mutans is still the major bacteria isolated from the oral cavity, but few persons might not have a significant number of S. mutans in the oral cavity. The S. mutans biofilm producers were more able to cause dental caries compared to the S. mutans biofilm non-producers. Drug-resistant factor in the S. mutans isolates was found to be associated with S. mutans biofilm formation.