Emergence of vancomycin-intermediate resistant Staphylococcus aureus in north of Palestine

Objective:This study was conducted to update the prevalence of methicillin-resistant Staphylococcus aureus(MRSA) isolates among human clinical S.aureus isolates recovered from Northern Palestine,to evaluate the possible presence of vancomycin-Resistant S.aureus(VRSA) and vancomycin- intermediate resistant S.aureus strains(VISA) and to determine the antimicrobial susceptibilities of these clinical isolates.Methods:The in vitro activities of 11 antibiotics against 204 non-duplicate S.aureus isolates from clinical samples in North of Palestine were determined by the diskdiffusion method.These samples were isolated between June 2006 and December 2007.The minimum inhibitory concentration (MIC) of vancomycin for 115 methicillin resistant Staphylococcus aureus(MRSA) strains was carried out using the agar dilution method.Results:One hundred and fifteen(56.4%) of these isolates were MRSA and according to their antibiotic profile these are multidrug resistant(resistant to three or more non-p-lactam antibiotics). Ninety nine(43.6%) isolates were methicillin sensitive S.aureus(MSSA),forty four of MSSA isolates(44.4%) were multidrug resistant,while forty five(45.6%) were non multidrug resistant.Our results showed that the most common resistance(95.6%) was to penicillin.Two strains of MRSA have shown to be vancomycin- intermediate resistant,had MIC of 4μg/rnL and 8μg/mL and these vancomycin- intermediate resistant S.aureus strains(VISA) are resistant to all antibiotics tested.Conclusion:According to our information this is the first study report about VISA in Palestine.

The AL-SENSE Test is Reliable for Detection of Second Trimester Amniotic Fluid

Objective: To validate the reliability and stability of the AL-SENSE panty-liner for detection of amniotic fluid in the second trimester. Study design: Amniotic fluid drawn during amniocentesis between 16 to 23 weeks of gestation was used for the study.100 μl and 400 μl of amniotic fluid, were dripped onto two panty liners, respectively. After 5 minutes the indicator strip was removed from the AL-SENSE, dried and examined. The color was recorded at time 0 and 5 minutes, and then every 10 minutes for the first 30 minutes, then at 1, 2, 6 and 12 hours. Results: 50 women were enrolled and 49 completed the study. 100% of both volume samples changed color from yellow to blue during the first 5 minutes and remained stable after twelve hours of follow-up. In the 100 μl subgroup, seven of the 49 samples (14.3%) had a delayed color change and in the 400 μl subgroup one of 49 (2.04%) had a delay in change of color. Conclusion: Amniotic fluid drawn during amniocentesis at weeks 16 - 23 of gestation have a positive, stable staining effect on the AL-SENSE panty liner. Hence, AL-SENSE may be reliable for detection of amniotic fluid leakage during the second trimester.