Objectives. To assess the level of awareness, prevalence and risk factors of Needle-stick and sharps injuries (NSSIs) in Tanta university hospitals (TUHs), Egypt to develop a well stablished preventive strategy. Methods. A total of 662 healthcare workers (HCWs) including nurses and physicians, who attended at work during the last six months of 2019. Data were collected on a structured questionnaire distributed during their working time. Results. Of 662 participated HCWs, 486 were nurses and 176 were physicians. Good awareness (86.1% and 83.1%) of the participants about the safe injection policy and sharp disposal after use was observed. Nurses showed significantly higher percentage of poor awareness score (79.1%) than physicians (20.9%). NSSIs in our hospitals reached 60.4%. Nurses (67.9%) had higher risk of NSSIs than physicians (39.8%), p<0.001. NSSIs were significantly less likely to occur in HCWs who were aware of safe injection and sharp disposal policies. NSSIs were frequent with specimen collection (16.4%), injections (15.5%) and sharp disposal (14.6%). Only 110 (27.5%) have reported their injuries. Conclusion. A comprehensive program that addresses institutional, behavioral and device-related factors that contribute to the occurrence of NSSIs and reporting systems are needed.

Antibiotic resistance and biofilm formation complicate Staphylococcus aureus infections, raising concerns for global health. Understanding antimicrobial resistance and biofilm formation in these pathogens is essential for effective infection management. The current research aimed to assess antibiotic resistance patterns, biofilm formation, and the occurrence of integron classes 1, 2, and 3 in clinical S. aureus isolates. The disc diffusion method tested antibiotic susceptibility. MRSA strains were identified by cefoxitin disc diffusion, and the mecA gene by PCR. The D-test also assessed macrolide–lincosamide–streptogramin B. A microtiter plate assay assessed biofilm formation. By PCR, integron classes were examined. Of the 63 S. aureus isolates, 25 were MSSA and 38 were MRSA. Pus (39.5%) was the most prevalent clinical source of MRSA isolates, while blood (24%) was the predominant source of MSSA isolates. MRSA isolates were more resistant to clindamycin, ciprofloxacin, ofloxacin, levofloxacin, tetracycline, and doxycycline than MSSA isolates. In total, 76.2% of the isolates produced biofilm. Biofilm-producing isolates were more resistant to cefoxitin and clindamycin. The isolates had 33.3% cMLSB resistance. The intI1 gene was found in 21 S. aureus isolates (33.3%), whereas the intI2 or intI3 genes were not detected. Our findings demonstrate the need for strict infection control to prevent the spread of resistant bacteria.

Background: Pseudomonas aeruginosa can cause several ocular infections that are associated with adverse outcomes, owing to the production of different virulence factors that are regulated by quorum-sensing (QS) mechanisms. The current study aims to detect different QS dependent virulence factors, antibiotic resistance patterns in P. aeruginosa associated with ocular infections to correlate them with QS genes and to assess their impact on visual outcome. Methods: several ocular specimens were collected for isolation of P. aeruginosa. Antibiotic susceptibility was evaluated. The presence of QS genes (rhlR and lasR) was identified by PCR. The isolates were assessed for their capability to produce virulence factors such as pyocyanin, protease, twitching motility, exopolysaccharides, and biofilm. Results: Out of 55 P. aeruginosa isolates, 38.2% were MDR, 29.1% were XDR, and 12.7% were PDR. The highest sensitivity was to meropenem 67.3% while the lowest sensitivity was to ceftazidime18.2%. The frequency of studied virulence factors, exopolysaccharides production, biofilm formation, twitching motility, protease, and pyocyanin production was 94.5%, 89.1%, 83.6%, 81.8%, and 78.2% respectively. QS genes lasR and rhlR were identified in 89% and 81.8% of the isolates respectively. The assessed virulence factors and antibiotic resistance pattern were significantly correlated with the presence of QS system. Conclusion: This study emphasized the importance of the QS system in regulating the formation of virulence factors and antimicrobial resistance in P. aeruginosa. Consequently, anti-QS and anti-virulence therapy can be a promising substitute to antibiotic therapy currently available.

Background: Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has been proven to be an escalating public health challenge in Egypt owing to its high mortality rate and raised health care costs. Purpose: Detection of carbapenem-resistant gram-negative bacilli among VAP patients, genotypic identification of carbapenemase genes in the isolated strains with evaluation of their impact on patient outcome and detection of carbapenemase-producing enterobacterales by MASTDISCS combi Carba plus disc system. Methods: Broncho-alveolar lavage fluid (BALF) and endotracheal aspirate were collected aseptically from clinically suspected VAP patients. Pathogen identification and antibiotic sensitivity testing were done. Carbapenemase-encoding genes (bla_KPC, bla_NDM, and bla_OXA-48) were tested by PCR in all carbapenem-resistant gram-negative isolates. Performance of MASTDISCS combi Carba plus in isolated Enterobacterales was assessed in relation to the PCR results. Results: Eighty-three carbapenem-resistant gram-negative isolates were detected. The most frequent pathogens were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa representing 34.9%, 20.5% and 18.1%, respectively. bla_KPC was the predominant gene. Patients with persistent mechanical ventilation less than 15 days and Pseudomonas aeruginosa infection were significantly associated with a higher death rate. MAST-Carba plus had the highest sensitivity, specificity, positive and negative predictive values for detecting OXA-48 carbapenemases representing 81.8%, 92.5%, 75% and 94.9%, respectively. Conclusion: Worse outcome in VAP patients was associated with carbapenem-resistant gram-negative bacilli. MASTDISCS combi Carba plus is an efficient simple method for identification of different carbapenemases among enterobacterales.

Statement of problem: The 3D-printed denture base resin needed reinforcement. Purpose: To evaluate the effects of adding nano ZrO2 and nano TiO2 on microbial colonization and patient satisfaction with 3D-printed maxillary complete dentures. Materials and methods: Twenty-four patients who needed complete dentures were randomly distributed into three equal groups. Group I: Patients used maxillary complete dentures 3D printed without the addition of any additives. Group II: Patients used maxillary complete dentures 3D after reinforcement by Nano-ZrO₂ (0.4%) by weight. Group III: Patients used maxillary complete dentures 3D printed after reinforcement by Nano-TiO₂ (0.4%) by weight. For microbial evaluation, a cotton swab was taken from the mucosa of the palate and the intaglio surface of maxillary dentures, and microbial colonization was evaluated by calculating the number of colony-forming units of S. aureus on mannitol salt agar plates and C. albicans on Sabouraud’s dextrose agar plates after 48 h of incubation at insertion, 6 months, 12 months and 18 months. Patient satisfaction was evaluated 15 days after insertion and at 6, 12, and 18 months. The values of microbial colonization and patient satisfaction were analyzed via repeated-measures ANOVA followed by Tukey’s multiple comparison test. Results: No significant differences in microbial colonization were detected among the three groups concerning Staphylococcus aureus in the palatal mucosa. There was a significant difference between Group I, the lowest antimicrobial group, and the other groups, while between Groups II and III, there was no significant difference in the number of S. aureus on the fitting surface of the denture. There were significant differences between Group II, the highest antifungal group, and the other groups at 12 and 18 months concerning Candida albicans in the palate and in the dentures. There was a significant difference in patient satisfaction between Group I, the lowest, and the other groups, whereas there was no significant difference between Groups II and III. Conclusion: Compared with the other groups, the nano-ZrO₂ group presented greater antimicrobial effects until 18 months, whereas the nano-TiO2 group presented antibacterial effects until 18 months and antifungal effects until 6 months. The addition of nano-ZrO₂ and nano-TiO₂ to 3D-printed denture base resin improved the aesthetic, speech, masticatory efficiency, hygiene, and comfort of patients. Trial registration: The trial was registered in the Clinical Trials Registry under the number NCT06921577 on 10/04/2025 (retrospective registration).