Diversity of clonal complex 22 methicillin-resistant isolates in Kuwait hospitals.

CC22-MRSA is a major MRSA lineage that is widely reported globally. To characterize CC22-MRSA for trends in antibiotic resistance and emergence of variants, a total of 636 CC22 isolates identified by DNA microarray in 2016 ( = 195), 2017 ( = 227) and 2018 ( = 214) were investigated further using staphylococcal protein A () typing and multilocus sequence typing. The isolates belonged to 109 types dominated by t223 ( = 160), t032 ( = 60), t852 ( = 59), t005 ( = 56) and t309 ( = 30) and 10 sequence types (STs) dominated by ST22 (85.

Resurgence of Chloramphenicol Resistance in Methicillin-Resistant Due to the Acquisition of a Variant Florfenicol Exporter ()-Mediated Chloramphenicol Resistance in Kuwait Hospitals.

Following a surge in the prevalence of chloramphenicol-resistant methicillin-resistant (MRSA) in Kuwait hospitals, this study investigated the genotypes and antibiotic resistance of the chloramphenicol-resistant isolates to ascertain whether they represented new or a resurgence of sporadic endemic clones. Fifty-four chloramphenicol-resistant MRSA isolates obtained in 2014-2015 were investigated. Antibiotic resistance was tested by disk diffusion and MIC determination.

Fusidic Acid Resistance Determinants in Methicillin-Resistant Staphylococcus aureus Isolated in Kuwait Hospitals.

Objective: The aim of this study was to investigate the genetic determinants of fusidic acid (FA) resistance in MRSA isolated from patients in Kuwait hospitals.

Methods: The minimum inhibitory concentration (MIC) of FA was tested with E-test strips. Genetic determinants of FA were determined by PCR and DNA microarray.

Randomised controlled trial to investigate the effectiveness of local oestrogen treatment in postmenopausal women undergoing pelvic organ prolapse surgery (LOTUS): a pilot study to assess feasibility of a large multicentre trial.

Objective: To evaluate the feasibility of a multicentre randomised controlled trial (RCT) comparing oestrogen treatment with no oestrogen supplementation in women undergoing pelvic organ prolapse (POP) surgery.

Design And Setting: A randomised, parallel, open, external pilot trial involving six UK urogynaecology centres (July 2015-August 2016).

Participants: Postmenopausal women with POP opting for surgery, unless involving mesh or for recurrent POP in same compartment.

Willingness of postmenopausal women to participate in a study involving local vaginal oestrogen treatment as an adjunct to pelvic organ prolapse surgery: a qualitative study.

Background: Pelvic organ prolapse (POP) negatively affects many women's quality of life. The ability to develop improved therapeutic approaches for POP patients is hampered by low patient recruitment and retention rates in clinical trials.

Objective: Our objective was to explore the motivational factors and barriers to recruitment and participation in clinical trials among postmenopausal women with POP who are intending to have surgical management.

Emergence of Methicillin-Resistant Belonging to Clonal Complex 15 (CC15-MRSA) in Kuwait Hospitals.

Purpose: Methicillin-resistant . (MRSA) belonging to clonal complex 15 (CC15-MRSA) is rare among clinical isolates with few reports from retail camel meat and human patients. This study investigated the genetic relatedness of CC15-MRSA isolated for the first time from patients in Kuwait hospitals.

Livestock-Associated Methicillin-Resistant in Patients Admitted to Kuwait Hospitals in 2016-2017.

Livestock-associated methicillin-resistant (LA-MRSA) has been reported to colonize and cause infections in animals as well as in humans. LA-MRSA isolates have only recently been identified in patients admitted to Kuwait hospitals. This study was conducted to characterize LA-MRSA isolates obtained from patients admitted to Kuwait hospitals.

Emerging variants of methicillin-resistant Staphylococcus aureus genotypes in Kuwait hospitals.

Background: Frequent changes in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) occurring worldwide demand regular surveillance to study their composition and distribution in healthcare facilities. We investigated the genotypic characteristics of MRSA obtained in Kuwait hospitals to better understand their clonal distribution.

Materials And Methods: A total of 1,327 MRSA isolates obtained from clinical samples in 13 Kuwait hospitals from 1 January to 31 December 2016 were investigated using antibiogram, SCCmec typing, spa typing and DNA microarray.

The impact of urodynamics on treatment and outcomes in women with an overactive bladder: a longitudinal prospective follow-up study.

Introduction And Hypothesis: The aim of this study was to establish if the management of women with overactive bladder (OAB) and patient-reported outcomes differed based on the findings of urodynamics (UDS).

Methods: A prospective, longitudinal observational study conducted in urogynaecology clinics in 22 UK hospitals participating in the Diagnostic Accuracy of Bladder Ultrasound Study (BUS). A total of 687 women with OAB symptoms or urgency-predominant mixed urinary incontinence were recruited into a diagnostic study that used UDS as the reference standard.

Characterization of a CC1153 PVL-producing community-acquired methicillin-resistant Staphylococcus aureus from a dog bite wound.

The isolation of a rare community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) strain from an infected dog bite wound is here reported. A 27-year old man presented with a deep open wound on his right hand caused by his dog's bite at the outpatient clinic of Infectious Disease Hospital (IDH), Kuwait. A wound swab was obtained for bacteriological culture and susceptibility testing.

Testing and Treating Women after Unsuccessful Conservative Treatments for Overactive Bladder or Mixed Urinary Incontinence: A Model-Based Economic Evaluation Based on the BUS Study.

Objective: To compare the cost-effectiveness of bladder ultrasonography, clinical history, and urodynamic testing in guiding treatment decisions in a secondary care setting for women failing first line conservative treatment for overactive bladder or urgency-predominant mixed urinary incontinence.

Design: Model-based economic evaluation from a UK National Health Service (NHS) perspective using data from the Bladder Ultrasound Study (BUS) and secondary sources.

Methods: Cost-effectiveness analysis using a decision tree and a 5-year time horizon based on the outcomes of cost per woman successfully treated and cost per Quality-Adjusted Life-Year (QALY).

Obstetric anal sphincter injuries after episiotomy: systematic review and meta-analysis.

Introduction: There is conflicting evidence on whether mediolateral episiotomy (MLE) reduces the risk of obstetric anal sphincter injuries (OASI) in spontaneous vaginal deliveries (SVD).

Objectives: A systematic review was undertaken to compare rates of OASI amongst women who had undergone mediolateral episiotomy versus those who did not.

Search Strategy: Electronic searches were performed in literature databases: CINAHL, Cochrane, EMBASE, Medline and MIDIRS from database inception to July 2015.

Bladder ultrasonography for diagnosing detrusor overactivity: test accuracy study and economic evaluation.

Background: Urodynamics (UDS) has been considered the gold standard test for detrusor overactivity (DO) in women with an overactive bladder (OAB). Bladder ultrasonography to measure bladder wall thickness (BWT) is less invasive and has been proposed as an alternative test.

Objectives: To estimate the reliability, reproducibility, accuracy and acceptability of BWT in women with OAB, measured by ultrasonography, in the diagnosis of DO; to explore the role of UDS and its impact on treatment outcomes; and to conduct an economic evaluation of alternative care pathways.

Complementary therapies for bladder pain syndrome: a systematic review.

Introduction And Hypothesis: Bladder pain syndrome is a difficult condition to treat. The purpose of this systematic review is to assess the effectiveness of various complementary therapies available for treatment.

Methods: This review was conducted in adherence with Preferred Reporting Items for Systematic Reviews.

Does vaginal estrogen treatment with support pessaries in vaginal prolapse reduce complications?

Objective: Pelvic organ prolapse is often co-existant with atrophy of the genital tract in older women who tend to prefer vaginal pessaries for prolapse. Vaginal estrogen therapy is used by some along with a support pessary for prolapse with no robust evidence to back this practice. We aimed to evaluate differences in complications of support pessaries for vaginal prolapse in postmenopausal women, with and without vaginal estrogen use.

Recent status of the treatment of stress urinary incontinence.

The therapeutic options for management of stress urinary incontinence can be conservative, pharmacological or surgical. The treatment of patients with stress urinary incontinence should be tailored to the individual to optimize care. A multitude of surgical techniques have emerged to treat this condition in recent years.

Miscarriages following caesarean section-induced extra-uterine adhesions.

A Caucasian lady in her 30s presented with repeated miscarriages following a previous caesarean section. Following ongoing pain and bleeding, and inconclusive imaging, a scan undertaken after her second miscarriage suggested a possible communication through the uterine wall. Subsequent laparoscopy revealed a dense band of adhesions starting from lower segment of uterus and extending all the way to anterior fundus adherent to the anterior abdominal wall.

An interesting case of intramyometrial pregnancy.

A 27-year-old woman, gravida 3, para 1, at 9 weeks gestation, initially presented with clinical and ultrasonographic features suggestive of a missed spontaneous abortion for which surgical evacuation was performed. A diagnosis of ectopic pregnancy was made as on histological review no fetal or chorionic tissue was seen. Medical management for an ectopic pregnancy was initiated.

Comparative evaluation of anoxomat and conventional anaerobic GasPak jar systems for the isolation of anaerobic bacteria.

Objectives: To evaluate the performance of the Anoxomat, in comparison with the conventional anaerobic GasPak jar system, for the isolation of obligate anaerobes.

Method: Anoxomat, model WS800, and anaerobic GasPak jar system (Oxoid) were evaluated. Anoxomat system utilized a gas mixture of 80% N(2), 10% CO(2) and 10% H(2), while the GasPak used a gas mixture of 90% H(2) and 10% CO(2).

In vitro activity of 15 antimicrobial agents against clinical isolates of Clostridium difficile in Kuwait.

A total of 73 clinical isolates of Clostridium difficile isolated from stool/rectal swabs of patients admitted to the intensive care units at Mubarak Hospital, Ibn Sina Hospital Burn unit and Haematology wards at the Kuwait Cancer Control Centre, were investigated for their susceptibility to 15 antibiotics using the Etest. Amoxycillin-clavulanic acid, ampicillin, meropenem, metronidazole, penicillin, piperacillin, piperacillin/tazobactam, teicoplanin and vancomycin had excellent activities with MIC(90)s of 0.38, 0.