Fecal contamination of drinking water is a major health problem which accounts for many cases of diarrhea mainly in infants and foreigners. This contamination is a complex interaction of many parameters. Antibiotic resistance among bacterial isolates complicates the problem. The study was done to identify fecal contamination of drinking water by Diarrheagenic Antibiotic-ResistantEscherichia coliin Zagazig city and to trace reasons for such contamination, three hundred potable water samples were investigated forE. coliexistence. Locations ofE. colipositive samples were investigated in relation to population density, water source, and type of water pipe. SixteenE. colistrains were isolated. Antibiotic sensitivity was done and enterotoxigenic, enteropathogenic, and enterohaemorrhagic virulence genes were investigated by PCR. Probability of fecal contamination correlated with higher population density, with increased distance from Zagazig water plant, and with asbestos cement water pipes. Resistance to at least one antimicrobial drug was found in all isolates. Virulence genes were detected in a rate of 26.27%, 13.13%, 20%, 6.67%, and 33.33% for LT, ST, stx1, stx2, and eae genes, respectively. This relatively high frequency of fecal contamination points towards the high risk of developing diarrhea by antibiotic resistant DEC in low socioeconomic communities particularly with old fashion distribution systems.

Carbapenem-resistant Gram-negative bacilli resulting fromβ-lactamases have been reported to be an important cause of nosocomial infections and are a critical therapeutic problem worldwide. This study aimed to describe the prevalence of imipenem-resistant Gram-negative bacilli isolates and detection ofblaVIM,blaTEM,blaSHV,blaCTX-M-1, andblaCTX-M-9genes in these clinical isolates in Egyptian hospitals. The isolates were collected from various clinical samples, identified by conventional methods and confirmed by API 20E. Antibiotic susceptibility testing was determined by Kirby-Bauer technique and interpreted according to CLSI. Production ofblaVIM,blaTEM,blaSHV, andblaCTX-Mgenes was done by polymerase chain reaction (PCR). Direct sequencing from PCR products was subsequently carried out to identify and confirm theseβ-lactamases genes. Out of 65 isolates, (46.1%) Escherichia coli, (26.2%) Klebsiella pneumoniae, and (10.7%) Pseudomonas aeruginosa were identified as the commonest Gram-negative bacilli. 33(50.8%) were imipenem-resistant isolates. 22 isolates (66.7%) carriedblaVIM, 24(72.7%) hadblaTEM, and 5(15%) showedblaSHV, while 12(36%), 6(18.2%), and 0(0.00%) harboredblaCTX-M-1,blaCTX-M-9, andblaCTX-M-8/25, respectively. There is a high occurrence ofβ-lactamase genes in clinical isolates and sequence analysis of amplified genes showed differences between multiple SNPs (single nucleotide polymorphism) sites in the same gene among local isolates in relation to published sequences.

Background: Chronic hepatitis C virus infection and its sequela are major health problems facing the Egyptian community. The high prevalence and spread rates of the disease require serious actions to stop or decrease these rates. Determination of HCV genotypes and subgenotypes adds significant knowledge about the epidemiology of the disease, and provides an added value in the decision making process of what strategy to follow and what therapy response to expect. The molecular epidemiology and genetic variability of HCV variants circulating in Egypt still need further analysis. Objectives: The study was held to evaluate the genotype and subgenotype of the hepatitis c virus circulating in Sharkia as one of the large governorates of Egypt, which was not included in any study for genotyping of the virus before. Patients and Methods: The HCV molecular epidemiology in Sharkia governorate was studied using direct sequencing and further phylogenetic analysis of a partial NS5B region of the HCV genome from 63 patients. HCV genotype and subtype were successfully determined in 62 out of 63 patients. Results: The highest prevalent genotype was genotype 4a, which was found in 57 patients (92%) followed by 2 isolates (3%) with genotype 4o, 2 strains (3%) with genotype 1g and one isolate (2%) with genotype 4n. Conclusions: This molecular epidemiology study revealed high prevalence of HCV genotype 4, subtype 4a among Egyptian patients residing in Sharkia governorate, Egypt. Keywords: Hepatits C Virus, Genotype; Egypt; Multilocus Sequence Typing

Background: Hospital-acquired infection in hospitals especially in developing countries is a challenging health problem with a great burden on patients and national economy. The incidence and risk factors varies from place to another and from time to time which necessitates continuous updating to combat the problem. Objectives: A prospective cross-sectional surveillance study was done over two-year duration at Al-Ahrar hospital, Zagazig to estimate the incidence of hospital acquired infection (HAI) and highlight the risk factors associated, to determine the antibacterial susceptibility, and to generate a modified antibiotic policy against emergence of new resistant strains. Methodology: Samples were collected from different hospital wards. Isolation and identification of bacteria, antibacterial susceptibility testing was determined. Double disc synergy test and E- test ESBL were done for MIC determination. Results: The overall incidence of HAI in the hospital was 20.6%. Burn unit was the most affected (82.4%) followed by internal medicine and ICU with incidence of (57.10% and 29.40%) respectively. The most predominant organism was Pseudomonas spp. followed by E. coli and Staphylococcus aureus. Prolonged hospital stay, medical devices such as urine catheter, ventilator, CVC and some co-morbidities act as risk factors of HAI. The highest susceptibility was to imipenem, amikacin and vancomycin while all isolates were resistant to cephalosporins. All S. aureus isolates were MRSA and 18.2% were VRSA. Ten isolates (20.8%) were confirmed as ESBL by double disc synergy test and E-test ESBL. Conclusion: The relative high incidence of HAI and resistance among the studied isolates necessitates the implementation of strict infection control practice and antibiotic policies in our hospitals.