Mycoplasma pneumoniae is increasingly recognized as a common and an important pathogen in community-acquired respiratory tract infections (RTIs) and pneumonia, particularly in school-age children and young adults. To determine the incidence and antibiotic susceptibility of M. pneumoniae at the main hospitals in Riyadh, Saudi Arabia, we studied 552 respiratory samples from patients diagnosed with different clinical diagnosis. The isolation, identification, enumeration and antibiotic resistance test for M. pneumoniae were performed using Pneumofast kit. There were 194 patients (35.1%) with current M. pneumoniae infection, mostly among younger age groups, with pneumonia the most common underlying clinical condition. All tested isolates were susceptible to four antibiotics included in the Pneumofast kit, doxycycline, minocycline, ciprofloxacine and erythromycin. The findings suggest that M. pneumonia infection in Saudi Arabia is more common among younger age groups, and pneumonia is the most common underlying clinical condition among patients with M. pneumoniae infection, that cannot be distinguished from other respiratory infections on the basis of clinical and radiographic diagnosis alone.
Anti-Bacterial Agents ; Child ; Ciprofloxacin ; Doxycycline ; Drug Resistance, Microbial ; Erythromycin ; Humans ; Incidence ; Minocycline ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory Tract Infections ; Saudi Arabia ; Young Adult

There are no generally accepted regimens for the treatment of H. pylori infection in patients with gastritis or duodenal ulcers. However, metronidazole based regimens have been reported to be among the most successful. Resistance to metronidazole, clarithromycin, and amoxicillin was determined for 46 clinical isolates of Helicobacter pylori in Saudi Arabia and tested by E test. Of these isolates, 69.5% was resistant to metronidazole (MIC > 8 mg/l), 21% to clarithromycin (MIC > 1 mg/l) and 11% were multiresistant. No resistance to amoxicillin was observed. Resistance to metronidazole was more common in isolates from females than in those form males. In conclusion, the present study demonstrates high metronidazole resistance rate of H. pylori isolates in Saudi Arabia. Regimens containing metronidazole are best avoided. Trials to test other antimicrobial combinations are recommended.
Amoxicillin ; Clarithromycin ; Duodenal Ulcer ; Female ; Gastritis ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Metronidazole ; Saudi Arabia

The role of atypical bacterial infection in the pathogenesis of asthma is a subject of continuing debate. There is an increasing body of literature concerning the association between the atypical bacteria such as Mycoplasma pneumoniae (M. pneumoniae) and asthma pathogenesis. Moreover, many studies investigating such a link have been uncontrolled and have provided conflicting evidence, in part due to the difficulty in accurately diagnosing infection with these atypical pathogens. This manuscript will review the relationship between M. pneumoniae infection and asthma pathogenesis.
Aluminum Hydroxide ; Asthma ; Bacteria ; Bacterial Infections ; Carbonates ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma

Helicobacter pylori has been strongly associated with gastritis, gastric and duodenal ulcers, and it is a risk factor for gastric cancer. Two major virulence factors of H. pylori have been described: the cytotoxin-associated gene product (cagA) and the vacuolating toxin (vacA). Since considerable geographic diversity in the prevalence of H. pylori virulence factors has been reported, the aim of this work was to determine if there is a significant correlation between different H. pylori virulence genes (cagA and vacA) in 68 patients, from Saudi Arabia, and gastric clinical outcomes. H. pylor was recognized in cultures of gastric biopsies. vacA and cagA genes were detected by polymerase chain reaction (PCR). The cagA gene was obtained with 42 isolates (61.8%). The vacA s- and m- region genotypes were determined in all strains studied. Three genotypes were found: s1/m1 (28%), s1/m2 (40%) and s2/m2 (26%). The s2/m1 genotype was not found in this study. The relation of the presence of cagA and the development of cases to gastritis and ulcer was statistically significant (P < 0.05). The study showed a significant correlation between the vacA s1/m2 genotype and gastritis cases, and a significant correlation between vacA s1/m1 genotype and peptic ulcer cases. The results of this study might be used for the identification of high-risk patients who are infected by vacA s1/m1 genotype of H. pylori strains. In conclusion, H. pylori strains of vacA type s1 and the combination of s1/m1 were associated with peptic ulceration and the presence of cagA gene.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, Bacterial/*genetics ; Bacterial Proteins/*genetics ; DNA, Bacterial/genetics ; Female ; Gastritis/genetics/microbiology/pathology ; Genotype ; Helicobacter Infections/*epidemiology/*microbiology/pathology ; Helicobacter pylori/*genetics/isolation & purification ; Humans ; Male ; Middle Aged ; Peptic Ulcer/genetics/microbiology/pathology ; Polymerase Chain Reaction ; Saudi Arabia ; Virulence Factors/genetics ; Young Adult

BACKGROUND/AIMS: Helicobacter pylori is present worldwide but few large population studies exist on the epidemiology of the infection in Saudi Arabia. This is an urban based study which was undertaken to determine the prevalence of H. pylori infection among outpatients suffering from gastrointestinal symptoms attending large hospital in Riyadh, Saudi Arabia. METHODS: A validated enzyme-linked immunosorbent assay (ELISA) was used for this study with 5782 samples collected from the outpatients population suffering from gastrointestinal (dyspeptic) symptoms, aged 2 to 82 years. RESULTS: H. pylori seroprevalence was 67% increasing with age. Female shows higher prevalence of H. pylori infection than male. H. pylori infection was more common in patients suffering from epigastric pain. CONCLUSIONS: The seroprevalence rate was higher in female than male. This study shows a high prevalence of H. pylori infection in a large series of patients in an urban area of Saudi Arabia
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Bacterial/blood ; Child ; Child, Preschool ; Female ; Helicobacter Infections/diagnosis/*epidemiology ; *Helicobacter pylori ; Humans ; Immunoglobulin G/blood ; Male ; Middle Aged ; Saudi Arabia/epidemiology ; Seroepidemiologic Studies ; *Urban Population

BACKGROUND/AIMS: The role of Helicobacter pylori in gastric carcinogenesis is unclear, but H. pylori infection is thought to predispose carriers to gastric cancer. The aim of this study was to investigate the relationship between the extent of DNA damage in normal gastric epithelial cells and H. pylori-positive and -negative gastritis according to histological diagnosis. We also compared the percentage of cometed cells on the surface of the gastric epithelial cells to the percentage beneath the gastric mucosal cells using serial incubations times. METHODS: The comet assay is a rapid, efficient and reproducible measure of DNA damage in single cell and it was used in this study. DNA damage was evaluated in 52 cases using alkaline single cell gel electrophoresis (comet assay). Comparisons were made between 19 normal individuals, 19 patients with H. pylori-positive and -negative gastritis and 14 mixed cases with different histology gradings to determine if there was a relationship between histological diagnosis and DNA damage (comet percentage). RESULTS: The comet percentages in specimens from cases with normal histology were significantly higher than the comet percentages in specimens from cases with H. pylori-positive gastritis. In addition, there was a significant increase in the percentage of cometed cells on the surface of gastric epithelial cells in both normal and H. pylori-infected cells compared to the subsequent gastric cell layers of the same specimen. CONCLUSIONS: A relationship between the comet percentage and the histological diagnosis was observed.
Comet Assay ; DNA ; DNA Damage ; Electrophoresis ; Epithelial Cells ; Gastritis ; Helicobacter ; Helicobacter pylori ; Humans ; Stomach Neoplasms

BACKGROUND: Streptococcus pneumoniae causes life-threatening infections such as meningitis, pneumonia, and febrile bacteremia, particularly in young children. The increasing number of drug-resistant isolates has highlighted the necessity for intervening and controlling disease. To achieve this, information is needed on serotype distribution and patterns of antibiotic resistance in children. METHODS: All cases of invasive pneumococcal disease (IPD) in children aged less than 15 yr recorded at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, were reviewed for serotyping and antibiotic susceptibility. Isolates were collected from 78 consecutive patients with IPD between 2009 and 2012. All collected isolates were subjected to serotyping by co-agglutination, sequential multiplex PCR, and single PCR sequetyping as previously described. RESULTS: The most frequently isolated IPD serotypes were 23F, 6B, 19F, 18C, 4, 14, and 19A, which are listed in decreasing order and cover 77% of total isolates. The serotype coverage for the pneumococcal conjugate vaccine (PCV)7, PCV10, and PCV13 was 77%, 81%, and 90%, respectively. Results from sequential multiplex PCR agreed with co-agglutination results. All serotypes could not be correctly identified using single PCR sequetyping. Minimum inhibitory concentration showed that 50 (64%) isolates were susceptible to penicillin, whereas 70 (90%) isolates were susceptible to cefotaxime. CONCLUSIONS: The most common pneumococcal serotypes occur with frequencies similar to those found in countries where the PCV has been introduced. The most common serotypes in this study are included in the PCVs. Addition of 23A and 15 to the vaccine would improve the PCV performance in IPD prevention.
Adolescent ; Anti-Bacterial Agents/*pharmacology ; Bacterial Proteins/genetics ; Cefotaxime/pharmacology ; Child ; Child, Preschool ; DNA, Bacterial/analysis ; Humans ; Infant ; Meningitis/*diagnosis/microbiology ; Microbial Sensitivity Tests ; Multiplex Polymerase Chain Reaction ; Penicillins/pharmacology ; Pneumococcal Vaccines/immunology ; Pneumonia/*diagnosis/microbiology ; Protein Tyrosine Phosphatases/genetics ; Retrospective Studies ; Saudi Arabia ; Serotyping ; Streptococcus pneumoniae/*drug effects/genetics