Detection of Clostridium difficile Infection in Al-Quwayiyah General Hospital, Riyadh, Kingdom of Saudi Arabia

Clostridium difficile infections (CDIs) is considered healthcare-associated infections which cause watery diarrhea to long stayed hospitalized patients and cause increased mortality rate. Aim: Detection of the prevalence and risk factors of C. difficile in Al Quwayiyah General hospital, Riyadh, Kingdom of Saudi Arabia and compairing between GeneXpert® PCR assay and Quikchek complete-enzyme imunoassay QCC, (QCC-EIA) in detection of C. difficile infection and toxicity Materials and Methods: A cross sectional and prospective study was performed for one year started from June 2019 to June 2020. The data collected include demographic, laboratory and clinical data. A total of 104 stool samples were collected from patients presented with diarrhea. GeneXpert® PCR assay and Quikchek complete-enzyme imunoassay QCC (QCC-EIA) were conducted to each stool sample. Results: Only 15(14.4%) of the 104 studied patients had CDI while 89 (85.6%) were non CDI patients, 13 (86.7%) of the CDI patients were males and 2 (13.3%) were females with mean age for CDI cases 61 (±19.9), while non CDI cases involved 55(61.8%) were males and 34 (38.2%) were females with mean age for cases of non CDI, 60 (±18.7) years. Of the CDI and non CDI cases respectively 12 (80%) and 14(15.7%) had fever, 5 (27%) and 6 (6.7%) had vomitting and 7 (46.7%) and 12 (13.5%) of cases had abdominal pain. There was statistical significant difference between patients with fever while no statistical significant difference regarding vomitting and abdominal pain. There was statistical significant difference between patients with peptic ulcers, patients received proton pump inhibitors and patients received broad-spectrum antibiotics, while There was no statistical significant difference between cardiac disease, cerebrovascular disease, diabetes, pulmonary disease, hepatic disease and Renal disease. Gene expert PCR detected 15/104(14.4%) as positive CDI while QCC-EIA detected 21/104 (20.5%) as positive CDI. On comparison between gene expert PCR technique and QCC-EIA the sensitivity of QCC-EIA was 100%, while the specificity was 91%. The Positive Predictive Value was 74%, while the Negative Predictive Value was 100%. Conclusion: The C. difficile infection prevalence rate in the hospital was 14.4%. There was statistical significant difference between patients with peptic ulcers, patients received proton pump inhibitors and patients received broad-spectrum antibiotics. The QCC-EIA can be used as a screening test for the detection of C. difficile toxin in stool samples but should be confirmed with a PCR assay or another confirmatory test Due to its decreased specificity.

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Clinical importance of Clostridium difficile finding in hospitalized patients

Medicinski pregled ◽

10.2298/mpns0812632k ◽

2008 ◽

Vol 61 (11-12) ◽

pp. 632-637 ◽

Cited By ~ 1

Author(s):

Branislava Kocic ◽

Predrag Stojanovic

Keyword(s):

Clostridium Difficile ◽

Antibiotic Treatment ◽

Clinical Importance ◽

Hospitalized Patients ◽

Control Group ◽

Clinical Group ◽

Clinical Center ◽

Significant Difference ◽

Clostridium Difficile Toxin ◽

Stool Samples

Introduction Clostridium difficile infections predominatelly occur among hospitalized patients. The aim of this study was to evaluate the importance of finding the isolate of Clostridium difficile cultured from the stool of hospitalized patients. Material and methods Material consisted of 100 patients with at least one liquid stool samples and control group with form stool. Every patient spent minimum 48h in hospital before the sampling. The material was immediately cultured on mediums for isolation of enteric pathogens, and on selective CCFA medium (Biomedics) for Clostridium difficile in anaerobic condition. Diagnosis of Clostridium difficile toxin in stool samples was achieved by ELISA-RIDASCREEN Clostridium difficile Toxin A/B test (R-Biopharm). Results One-hundred forty one stool samples of patients in Clinical Center Nis were cultivated and examined for C. difficile. The bacteria was isolated in seven patients from the clinical group. In four (57.14%) patients, the presence of C. difficile toxin in stool was established. The bacteria was diagnosed from the stool samples of five patients from the control group, but the toxin was not found in their stool samples. Discussion The results performed at the Institute for Public Health Nis are in accordance with previously published results that all patients with positive findings of Clostridium difficile toxin in stool samples were on antibiotic treatment longer than 14 days. By analyzing the patient's stay in hospital and duration of antibiotic treatment, we observed the statistically significant difference in findings between the patients with CDAD and the patients from the control group with positive bacteria. Conclusion The study confirms the importance of finding Clostridium difficile associated disease in four (4%) hospitalized patients.

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P23 Tolerability of prednisolone and dexamethasone in children in saudi arabia and the united kingdom

Archives of Disease in Childhood ◽

10.1136/archdischild-2017-314585.32 ◽

2018 ◽

Vol 103 (2) ◽

pp. e2.26-e2

Author(s):

Fahad Aljebab ◽

Mofadhi Alanazi ◽

Imti Choonara ◽

Sharon Conroy

Keyword(s):

Saudi Arabia ◽

Abdominal Pain ◽

Sodium Phosphate ◽

Oral Prednisolone ◽

Phosphate Solution ◽

List Type ◽

Dexamethasone Sodium Phosphate ◽

Significant Difference ◽

Sodium Phosphate Solution ◽

The Uk

BackgroundCorticosteroids are used to treat conditions including acute asthma and croup where they are often given in short-courses. This study evaluated the tolerability and palatability of oral prednisolone and dexamethasone in children in Saudi Arabia (SA) and the UK.MethodsA prospective observational/interview study was performed. Palatability was evaluated by asking patient/parent’s opinions of the taste and acceptability of the medication. Children pointed at the appropriate face on a scale depicting: 1 ‘dislike very much’, 2 ‘dislike a little’, 3 ‘not sure’, 4 ‘like a little’ and 5 ‘like very much’.1 Tolerability, in particular nausea, vomiting and abdominal pain was evaluated by direct questioning of the patient/parents after each administration. Data was collected over three months in each centre. Patients aged 2–18 years treated with oral prednisolone or dexamethasone in hospital were approached to participate.ResultsIn SA, 122 patients (89 asthma, 33 croup), aged 2–10 years (mean=4.3) were recruited: 52 received prednisolone base tablets; 37 prednisolone sodium phosphate syrup; 33 dexamethasone elixir. In the UK, of 133 patients (80 asthma, 53 croup) aged 2–16 years (mean=4.9): 38 received prednisolone base tablets; 42 prednisolone sodium phosphate soluble tablets; 53 dexamethasone sodium phosphate oral solution.SA: Day 1 prednisolone base tablet palatability scores: 1 (88.5%); 2 (11.5%). Day 2 scores: 1 (64.4%); 2 (28.9%); 3 (6.7%). Day 1 prednisolone sodium phosphate solution palatability scores: 1 (48.6%); 2 (40.5%); 3 (10.8%). Day 2 scores: 1 (10.8%); 2 (67.6%); 3 (21.6%). Day 1 dexamethasone elixir palatability scores: 1 (27.3%); 2 (48.5%); 3 (24.2%).UK: Day 1 prednisolone base tablet palatability scores: 1 (76.3%); 2 (13.1%); 3 (5.3%); 4 (5.3%). Day 2 scores: 1 (61.3%); 2 (19.4%); 3 (16.1%); 4 (3.2%). Day 1 prednisolone sodium phosphate soluble tablet palatability scores: 1 (35.7%); 2 (26.2%); 3 (23.8%); 4 (11.9%) 5 (2.4%). Day 2 scores: 1 (16.7%); 2 (58.2%); 3 (16.7%); 4 (4.2%); 5 (4.2%). Day 1 dexamethasone sodium phosphate solution palatability scores: 1 (5.7%); 2 (28.3%); 3 (37.7%); 4 (17%); 5 (11.3%).Dexamethasone sodium phosphate solution had the highest palatability scores (P<706;0.0001). The score was lowest for prednisolone base tablets in both centres (P<0.0001).In SA prednisolone base tablets were associated with more cases of nausea (24 vs 7) and vomiting (5 vs 0) than prednisolone sodium phosphate syrup (p=0.008 and p=0.073 respectively). In the UK vomiting occurred significantly more frequently with prednisolone base tablets (8) than prednisolone sodium phosphate soluble tablets (2) (p=0.041).In both centres dexamethasone was associated with less side effects but with no significant difference between the formulations. Vomiting (1 vs 0), nausea (7 vs 3) and abdominal pain (10 vs 8) occurred more with dexamethasone sodium phosphate solution than dexamethasone elixir (p=1, p=0.53 and p=0.55 respectively).ConclusionsDexamethasone sodium phosphate solution was the most palatable preparation. Prednisolone base tablets were rated the least palatable and were also the least well tolerated. Palatability scores seemed to improve with second doses.ReferenceH. Hames H, Seabrook JA, Matsui D, Rieder MJ, Joubert GI. A palatability study of a flavoured dexamethasone preparation versus prednisolone liquid in children. Can. J. Clin. PharmacolJanuary 2008;15(1):e95–8.

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Evaluating Course Syllabus: Basis for Reframing into a Learner-Centered Syllabus for Outcome-Based Nursing Education

European Scientific Journal ESJ ◽

10.19044/esj.2018.v14n10p222 ◽

2018 ◽

Vol 14 (10) ◽

pp. 222

Author(s):

Hamdan Albaqawi ◽

Farhan Alshammari ◽

Eddieson Pasay-an ◽

Mansour Alyami ◽

Sandro Villareal ◽

...

Keyword(s):

Saudi Arabia ◽

Nursing Education ◽

Classroom Environment ◽

Faculty Members ◽

Learning Goals ◽

Learning Assessment ◽

Kingdom Of Saudi Arabia ◽

Learner Centered ◽

Significant Difference ◽

Course Syllabus

The shift from customary content-based pedagogical to learnercentered practice is imperative in the 21st century. This research aims to evaluate the course syllabus developed by the faculty members and if the syllabus meets the criteria for the learner-centered syllabus. The study employed a quantitative –comparative design to properly represent the phenomenon. The study was conducted at the selected universities in the Kingdom of Saudi Arabia. Overall, the respondents of the study consist of 100 faculty members and the 50 students from the participating universities in the Kingdom of Saudi Arabia. The researchers adapted the learning-focused syllabus instrument to gather the data. Results show that the faculty members rated the learning goals and objectives to moderate (1.58), while students rated it low (1.42). Likewise, the learning assessment revealed a moderate result (1.76) for faculty members and low (1.38) for the students; the learning activities have moderate (1.69) result for the faculty and low (1.36) for the students. As regards scheduling, faculty members and students reported moderate results having a 2.06 and 2.09 respectively. The classroom environment revealed moderate results both the faculty members (1.62) and the students (1.52). Statistically, there is no significant difference on the category of syllabi when faculty respondents were grouped according to years of teaching (0.699.05). The findings show that the course syllabus evaluated is in a transitional phase towards learner-centered. As such, the progress of the syllabus is potential to meet the criteria for an outcomebased nursing education. However, the varying results as reported suggest reconciliation of the views of the faculty members and the students.

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Vegetative Clostridium difficile Survives in Room Air on Moist Surfaces and in Gastric Contents with Reduced Acidity: a Potential Mechanism To Explain the Association between Proton Pump Inhibitors and C. difficile-Associated Diarrhea?

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01443-06 ◽

2007 ◽

Vol 51 (8) ◽

pp. 2883-2887 ◽

Cited By ~ 145

Author(s):

Robin L. P. Jump ◽

Michael J. Pultz ◽

Curtis J. Donskey

Keyword(s):

Clostridium Difficile ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Saline Control ◽

Potential Mechanism ◽

Vegetative Cells ◽

Vegetative Form ◽

Gastric Contents ◽

Stool Samples ◽

Phosphate Buffered Saline

ABSTRACT Proton pump inhibitors (PPIs) have been identified as a risk factor for Clostridium difficile-associated diarrhea (CDAD), though the mechanism is unclear because gastric acid does not kill C. difficile spores. We hypothesized that the vegetative form of C. difficile, which is killed by acid, could contribute to disease pathogenesis if it survives in room air and in gastric contents with elevated pH. We compared the numbers of C. difficile spores and vegetative cells in stools of patients prior to and during the treatment of CDAD. We assessed the survival of vegetative cells on moist or dry surfaces in room air versus anaerobic conditions and in human gastric contents, in pH-adjusted gastric contents, and in gastric contents from individuals receiving PPI therapy. Stool samples obtained from patients prior to the initiation of antibiotic treatment for C. difficile contained ∼10-fold more vegetative cells than spores. On dry surfaces, vegetative C. difficile cells died rapidly, whereas they remained viable for up to 6 h on moist surfaces in room air. Vegetative C. difficile cells had only marginal survival in gastric contents at low pH; adjustment to a pH of >5 resulted in survival similar to that in the phosphate-buffered saline control. The survival of vegetative C. difficile in gastric contents obtained from patients receiving PPIs was also increased at a pH of >5. The ability of the vegetative form of C. difficile to survive on moist surfaces and in gastric contents with an elevated pH suggests a potential mechanism by which PPI therapy could increase the risk of acquiring C. difficile.

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Prevalence of Some Human Enteroparasites in Commonly Consumed Raw Vegetables in Tabuk, Saudi Arabia

Journal of Food Protection ◽

10.4315/0362-028x.jfp-15-485 ◽

2016 ◽

Vol 79 (4) ◽

pp. 655-658 ◽

Cited By ~ 7

Author(s):

REFAAT M. GABRE ◽

ABDELAZIM SHAKIR

Keyword(s):

Saudi Arabia ◽

Food Preparation ◽

Personal Hygiene ◽

Kingdom Of Saudi Arabia ◽

Retail Markets ◽

Standard Methods ◽

Helminth Eggs ◽

Fresh Vegetables ◽

Significant Difference ◽

Eggs And Larvae

ABSTRACT The problem of parasitic contamination of food, especially fresh vegetables, is not limited to personal hygiene during food preparation but is also widely dependent on the source of the food and the handling it undergoes before it gets to the consumer. The objective of the present study was to evaluate parasitic contamination in eight common raw vegetables in Tabuk, Kingdom of Saudi Arabia. A total of 400 samples of raw vegetables obtained from wholesale and retail markets were examined for helminth eggs and larvae and for cysts of different parasites, using standard methods. The prevalence of the parasites was 20.65% in cucumber, 15.76% in cabbage, 14.67% in pea, 14.13% in cress, 13.04% in lettuce, 10.33% in carrot, 8.70% in green onion, and 2.72% in tomato. Statistical analysis showed a significant difference (P < 0.05) for Entamoeba spp. cysts, Ascaris lumbricoides eggs, Entamoeba coli cysts, and unknown isolated parasite cysts. Parasites are common in vegetables that are frequently eaten raw and, for this reason, may pose a health risk for consumers in Tabuk.

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The Effect of Pre-Quarantine Physical Activity on Anxiety and Depressive Symptoms during the COVID-19 Lockdown in the Kingdom of Saudi Arabia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157771 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7771

Author(s):

Abdulazeem S. Alotaibi ◽

Boukhemis Boukelia

Keyword(s):

Mental Health ◽

Physical Activity ◽

Saudi Arabia ◽

Depressive Symptoms ◽

Well Being ◽

Activity Level ◽

Self Report ◽

Sample Population ◽

Kingdom Of Saudi Arabia ◽

Significant Difference

The outbreak of COVID-19 and the changes to normal societal function and in particular quarantine has increased mental distress in many nations. A survey of 22,112 COVID-19-negative quarantined participants in the Kingdom of Saudi Arabia (age: 18–40 years, 42.6%; 40–60 years, 53.3%; over 60 years, 4.1%; mass, 78.9 ± 14.8 kg; stature, 167 ± 8.7 cm) were assessed for depressive symptoms using the online Beck Depression Inventory self-report questionnaire. The relationship between pre-quarantine physical activity and mental health and wellbeing during lockdown has been investigated. A significant difference in body mass index (BMI) between active and inactive participants (p = 0.03) was observed; with females also recording a 3% higher BMI than males. All participants showed a decrease in mental health compared to pre-quarantine. However, pre-quarantine inactivity was found to result in a greater negative impact on mental health and well-being than those active pre-quarantine (p < 0.01). The sedentary population had a 4-fold greater incidence of mild-depression than the active population. This suggests that activity level plays an important role in shielding people from anxiety and stress, whilst it builds mental strength in individuals that can be called upon in trying and difficult situations. Nevertheless, pre-quarantine activity levels did not lead to any significant change in levels of extreme depression in the sample population.

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Antibiotic Susceptibility Pattern of Methicillin-Resistant Staphylococcus aureus from the Isolated Wound Culture in the Northwest Region, Kingdom of Saudi Arabia

Asian Journal of Pharmaceutical Research and Health Care ◽

10.18311/ajprhc/0/5972 ◽

2016 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Ibrahim Al Balawi ◽

Palanisamy Amirthalingam ◽

Abdullah Abdul Khalig Alyoussef ◽

Osama Salih Mohammed ◽

Hyder Oman Mirghani ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Saudi Arabia ◽

Fusidic Acid ◽

Antibiotic Susceptibility ◽

Susceptibility Pattern ◽

Kingdom Of Saudi Arabia ◽

Antibiotic Susceptibility Pattern ◽

Methicillin Resistant ◽

Surgical Department ◽

Significant Difference

The present study aimed to investigate the antibiotic susceptibility pattern of Methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) in isolated wound cultures of the patients admitted in King Khalid Hospital, Tabuk, Kingdom of Saudi Arabia. A retrospective cohort study of 54 patients admitted with wound infections in the surgical department. Ethics committee approval was granted by the University of Tabuk and King Khalid Hospital, Kingdom of Saudi Arabia. Fifty-four adult patients (>18 years old) diagnosed with moderate to severe skin and soft tissue infections were included in the study. 26 patients with isolated cultures of MRSA were compared with 28 patients with Methicillin-sensitive <em>Staphylococcus aureus</em> (MSSA) isolated cultures using Graph pad prism 4.0 version statistical databases. Overall, there was no significant difference in sensitivity (P = 0.2445) and resistance (P = 0.4215) between MRSA and MSSA cultures. However, it is interesting findings that Oxacillin and Fusidic acid had higher resistance in MRSA isolated cultures compared MSSA culture, on the other hand, Linezolid, Tigecycline and Nitrofurantoin shows 100% sensitivity in both MRSA and MSSA isolates. No significant difference between male and female regarding the sensitivity (P = 0.0638) and resistance (P = 0.3638). The current study emphasizes that Tigecycline, Nitrofurantoin and Fusidic acid were the best drugs in both MRSA and MSSA isolates. While, oxacillin showed 100% resistance to MRSA; but retain its efficacy on MSSA isolates.

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Prevalence and Genotypes of Nosocomial Clostridium difficile Infections in the Eastern Province of the Kingdom of Saudi Arabia: A Multi-Centre Prospective Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2019/38321.12694 ◽

2019 ◽

Cited By ~ 1

Author(s):

Doha Hudhaiah ◽

Nasreldin Elhadi

Keyword(s):

Saudi Arabia ◽

Clostridium Difficile ◽

Prospective Study ◽

Kingdom Of Saudi Arabia ◽

Eastern Province

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Prevalence of disordered eating attitudes among adolescent girls in Arar City, Kingdom of Saudi Arabia

Health Psychology Research ◽

10.4081/hpr.2018.7444 ◽

2018 ◽

Vol 6 (1) ◽

Cited By ~ 6

Author(s):

Waseem Fatima ◽

Leena M. Ahmad

Keyword(s):

Eating Disorders ◽

Saudi Arabia ◽

Disordered Eating ◽

Adolescent Girls ◽

Eating Habits ◽

Eating Attitudes ◽

Kingdom Of Saudi Arabia ◽

Significant Difference ◽

Eat 26 ◽

Disordered Eating Attitudes

Eating disorders (ED) are one of the most common psychiatric problems faced by todays adolescent girls where the attitude towards weight and shape as well as their perception of body shape are disturbed. The aim of the paper is to assess the prevalence and associated factors of disordered eating attitudes among adolescent girls of Arar city, Kingdom of Saudi Arabia. This is a cross-sectional survey design in which 314 adolescents females (age: 15-19 years) were selected from four schools of Arar city, KSA. Subjects were asked to fill pre-tested questionnaire about socioeconomic status, eating habits and Eating attitude test 26 (EAT 26), there height and weight were measured and BMI was calculated. Disturbed eating behaviors (EAT-26>20) was found in 25.47% participants. The prevalence of disordered eating was more in overweight and obese than normal weight. Vegetarian girls had higher EAT 26 score than non - vegetarian and significant difference was found in total EAT 26 score and subgroup namely oral control and dieting score (P<0.01) but non-significant difference was found between Saudi and non-Saudi adolescent girls in different BMI ranges. Eating disorders prevalent in adolescent girls and were strongly associated with weight status and eating habits. Future prospective and experimental studies are warranted to advance our understanding of the risk factors to enable better preventive program planning.

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