An-Najah Staff

Background: Community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a major global problem. This study attempted to investigate the prevalence of nasal carriage of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) strains among 360 healthy university students at An-Najah National University, Palestine. For the purpose of comparing the staphylococcal cassette chromosome methicillin resistant determinant (SCCmec) type of MRSA, 46 clinical MRSA isolates were also included in this study.
Methods: Susceptibility testing was performed by the disc diffusion method. The genetic association of MRSA isolates was investigated by SCCmec typing. A selected number of isolates were also used to amplify and sequence mecA. Results  Nasal carriage of S aureus was found in 86 of 360 students (24%). MRSA accounted for 9% of S aureus isolates. All 86 strains of S aureus were sensitive to vancomycin. Resistance to penicillin G, amoxicillin/clavulanic acid, ciprofloxacin, erythromycin, and clindamycin was found in 98%, 93%, 33%, 23%, and 12% of the isolates, respectively. Resistance rates of the MRSA isolates were as follows: 100% resistant to penicillin G and amoxicillin/clavulanic acid, 96% to ethromycin, 52% to clindamycin, and 48% to ciprofloxacin. No vancomycin-resistant isolates were identified. In our study, nearly half (52%) of the MRSA isolates belonged to SCCmec types IVa and V. However, SCCmec types II and III are represented by 48%, whereas SCCmec type I was completely absent.
Conclusion: The findings of this study indicate the existence of SCCmec type IVa in both student nasal carriers and health care settings. This emphasizes the need for implementation of a revised set of control measures in both settings. Moreover, the rational prescription of appropriate antibiotics should also be considered.

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 disk-diffusion 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-β-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 4 µg/mL and 8 µg/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 antibacterial effects of single and combined plant extracts of water, ethanol and methanol for two nutraceuticals utilized in Palestine were studied against multiple drug resistances Pseudomonas aeruginosa using well diffusion method. These plants are Rhus coriaria and Thymus vulgaris. Combinations of these extracts showed an additive action against this pathogen.

This study has been carried out to evaluate the possible In vitro interaction between ethanolic extracts of Rus coriaria (seed), Sacropoterium spinosum (seed) and Rosa damascena (flower) and certain known antimicrobial drugs including oxytetracycline HCl, penicillin G, cephalexin, sulfadimethoxine as sodium and enrofloxacin. Synergy testing of these extracts and antibiotics was carried out against 3 multidrug-resistant Pseudomonas aeruginosa strains using microdilution method. Results of this study showed that there is a decrease in the MIC in case of combination between ethanolic plant extracts and test antimicrobial agents. The most interesting result that the combination between R. coriaria and these antibiotics, which showed a high decrease in MIC and a strong bactericidal activity against these strains. These results may indicate that combinations between R. coriaria extract and these antibiotics could be useful in fighting emerging drug-resistance P. aeruginosa, this may due to that R. coriaria extract contain natural inhibitors working by different mechanisms or inhibiting efflux pumps. Now we have experiments underway leading to the identification of the active molecules present in R. coriaria. Further, in vivo experiments are needed to confirm Pseudomonal protection.

Nine medicinal plants growing in Palestine were screened in vitro for potential antibacterial activity against 6 bacterial strains by well diffusion and micro-dilution techniques. Both aqueous and organic solvents were used. The dried extracts of Sacropoterium spinosum (Rosaceae) (seed), Ruta chalepensis L (Rutaceae) (leaf), Cassia senna (Ligumenosa) (leaf), Lawsonia inermis (Lythraceae) (leaf), Psidium guajava (Myrtaceae) (Leaf), Carataegus  azerullus (Rosaceae) (Leaf), Ranunclus asiaticus(Ranunculaceae) (Flowers), Calendula officinalis (Composita) (Flowers),and Salvia syriaca (Labiatae) (leaf) were screened. The bacterial strains tested were; Methicillin-resistant Staphylococcus aureus (MRSA); three strains (1, 2 & 3), multidrug resistant Pseudomonas aeruginosa, Proteus vulgaris and Klebsiella pneumonia. The average diameter of inhibition zones ranged from 9 to 30 mm and 11 to 28 mm for aqueous and ethanol extract, respectively. Methicillin-resistant Staphylococcus aureus (MRSA) was the most inhibited microorganism. Sacropoterium spinosum extract was the most active against Methicillinresistant Staphylococcus aureus (MRSA) and multidrug resistant  Pseudomonas aeruginosa. The MIC value of ethanol extract was 0.781 mg/ml  against MRSA while 0.390 mg/ml against Pseudomonas aeruginosa. The  combination effect of ethanol extracts of (Sacropoterium spinosum with  Lawsonia Inermis) on bacterial species tested exhibited a higher effect than  that of any individual extract.  Such results lead to an interesting promise for further investigation to design  potentially active antibacterial augmentative agents of natural sources. 

Objectives: Staphylococcus aureus is an important pathogen associated with diseases in a variety of hosts including humans. It produces several toxins and virulence factors that contribute to its pathogenic potential such as staphylococcal enterotoxins (SEs). This study was conducted to determine enterotoxigenicity of S. aureus associated with chronic urogenital tract infection by detecting enterotoxin genes. Setting: This study was done in The Microbiology laboratory, An-Najah N. University, Palestine. Methodology: A total of 90 S. aureus isolates recovered from clinical samples from patients suffering from chronic urogenital tract infection in the North of Palestine were used to detect the presence of staphylococcal enterotoxin genes sea , seb , sec, sed and see by polymerase chain reaction (PCR) assay. Results: Out of 90 S. aureus isolates tested, it was found that 57 (63.3%) of these isolates harboured one or more enterotoxin genes. Up to 78.9% of the enterotoxigenic isolates possessed one SE gene. The majority of these enterotoxigenic strains (61.4%) isolated from both semen and urine samples harbored sec gene either alone or in combination with other genes. Also the prevalence of genes in combination was significantly more common in S. aureus isolates derived from urine 9/33 (27.3%), as compared to those derived from semen 3/24 (12.5%). Conclusions: The role of enterotoxin genes in the pathogenesis of urogenital tract infection is still unknown. However, it is evident that urogenital infection can be caused by S. aureus strains which lack these genes. Other newly detected genes may play a role in pathogenesis.

Objective To evaluate the possible in vitro interaction between ethanolic extracts of Rhus coriaria (R. coriaria) (seed), Sacropoterium spinosum (S. spinosum) (seed), Rosa damascena (R. damascene) (flower) and certain known antimicrobial drugs including oxytetracycline HCl, penicillin G, cephalexin, sulfadimethoxine as sodium, and enrofloxacin. This synergy study was carried out against 3 clinical strains of multidrug-resistant Pseudomonas aeruginosa (P. aeruginosa). Methods Evaluation of synergy interaction between plant extracts and antimicrobial agents was carried out using microdilution method. Results The results of this study showed that there is a decrease in the MIC in case of combination of ethanolic plant extracts and test antimicrobial agents. The most interesting result was that the combination between R. coriaria and these antibiotics, showed a high decrease in minimum inhibitory concentration (MIC), and a strong bactericidal activity against these strains. Conclusions these results may indicate that combinations between R. coriaria extract and these antibiotics could be useful in fighting emerging drug-resistance P. aeruginosa, which may due to that R. coriaria extract contain natural inhibitors working by different mechanisms or inhibiting efflux pumps. Now we have experiments underway leading to the identification of the active molecules present in R. coriaria. Further, in vivo experiments are needed to confirm pseudomonal protection.

Disk diffusion and micro-dilution techniques were used to determine the antibacterial activity of water, ethanolic and methanolic extracts of Rhus coriaria ripe berries against five clinical bacterial strains (Methicillin-resistant Staphylococcus aureus (MRSA), multi-drug resistant Pseudomonas aeruginosa, enterohemorrhagic Escherichia coli O157 (EHEC), Proteus vulgaris and Klebsiella pneumoniae). Bacillus subtilis ATCC6633 was used as a reference strain. The zone of inhibition varies depending on bacterial species and type of extract. The average diameter of inhibition zones ranges from 0 to 19 mm, 15 to 25 mm and 15 to 22 mm for water, ethanolic and methanolic extract, respectively. The MIC value of ethanolic extract was 1.25 mg/ml against MRSA, EHEC, P. aeruginosa and Proteus vulgaris, while 0.156 mg/ml against B. subtilis. In general these results showed that the antibacterial activity of R. coriaria ripe berries extracts was more effective against Gram-positive bacteria than Gram-negative.

Enterotoxin genes ( sea-see ) in Staphylococcus aureus isolates recovered from milk of clinically healthy sheep and cows in the north of Palestine were determined using a polymerase chain reaction (PCR). Thirty-seven (37%) out of 100 S. aureus isolates were toxin gene positive. Four strains (10.8%) were sea-positive, 20 (54.1%) were seb-positive, 4 (10.8%) were sec-positive, 6 (16.2%) were sed-positive and 3 (8.1%) were see-positive. None of these enterotoxigenic isolates carried more than one toxin gene. This study indicates that the presence of enterotoxigenic S. aureus in raw milk can contribute to the sources of staphylococcal food poisoning in Palestine.

Abstract In Palestine (the occupied Palestinian territories - oPt) there are a number of challenges in the field of Disaster Risk Reduction (DRR), notably natural hazards such as earth¬quakes, floods, desertification and droughts. Seismological studies show that there is a high probability of damaging earthquakes occurring in the region. At the same time, engineering studies show that seismic vulnerability of common buildings and infrastructures in the oPt is high. Major events triggered by climate changes and seismic activ¬ities may become trans-boundary. The objectives of this paper are to help establish a profile of DRR in the oPt and further help identify the needs of the oPt in the field of disaster risk reduction and management. In addition to the risk assessment, a review of existing legislation, capacities and shortages in various areas of needs, strengths and weaknesses in all elements of DRR plus institutional mechanisms towards disaster preparedness and prevention has been carried out. National and international initiatives toward DRR and case studies of (best) practices in the oPt were also reviewed. Historic data on recorded disaster related incidents pertaining to the number of people killed, the number of people affected and the economic loss incurred provides the main criteria for the risk assessment. The recommendations include regional cooperation, improvement/formulation of legislation toward disaster preparedness and prevention, linking policies and operations, coordination of central and local governments, political resolution, awareness and training, integration of DRR and management into national development, and developing a risk management database. Key words: Palestine, Hazards, Risk, Vulnerability, Capacity, Risk, Disaster Management, Risk reduction, Earthquakes, Floods, Need Assessment. .

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