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1.  A review of community-acquired methicillin-resistant Staphylococcus aureus for primary care physicians 
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections among young people without healthcare-associated risk factors have emerged during the past decade. Reported prevalence rates of CA-MRSA vary widely among studies, largely because of the different definitions employed and different settings in which the studies have been performed. Although the majority of CA-MRSA infections are mild skin and soft tissue infections, severe life-threatening cases have been reported. CA-MRSA infections have mostly been associated with staphylococcal strains bearing the staphylococcal cassette chromosome mec type IV element and Panton-Valentine leukocidin genes. These strains are more frequently susceptible to a variety of non-beta-lactam antibiotics. Clinicians must be aware of the wide spectrum of disease caused by CA-MRSA. Continued emergence of MRSA in the community is a public health problem, and therefore warrants increased vigilance in the diagnosis and management of suspected and confirmed staphylococcal infections.
PMCID: PMC3045103  PMID: 21359021
Clindamycin; methicillin; Saudi Arabia; Staphylococcus aureus
Breast infection in lactating mothers is a common entity which in the majority of cases can be explained by ascending infections. However, it has been noticed that the number of non lactating women presenting with breast abscesses is rising. This study attempts to explore the sensitivity pattern of organisms and underlying cause of breast infections in non-lactating women.
Materials and Methods:
This review was undertaken at King Fahd of the University, Alkhobar, Saudi Arabia between 1991-2003. All patients presenting with breast infections were included. Medical records, operative notes, cultures, histopathology reports and outcome were reviewed.
The number of patients presenting with breast infections accounted for 179(3.5%) out of the total number of patients 6314 with variable breast complaints. Infection occurred in 136(76%) lactating women (Group I) ,while Non lactating (Group II) breast infections accounted for 43(24%). Age ranged from 24 years to 52 years. Underlying clinical conditions were found in 26 patients(60%) in Group II namely granulomatous mastitis13(50%), duct ectasia4 (15.3%), pregnancy3(11.5%), fat necrosis1(3.8%), diabetes3 (11.5%) and breast cancer 2(7.6%). The pattern of culture results was different in the two groups, from differing causative organisms namely staphylococcus aureus as the commonest organism in both groups, in comparison to such uncommon organisms as Klebsiella pneumonae, Peptococcus magnus, Streptococcus group B, Entro-bacter cloacae, Methicillin resistant staphylococcus aureus (MRSA) and Mycobacterium tuberculosis occurring in group II only. Fortunately, all organisms were sensitive to antimicrobial therapy.
Breast infection in non-lactating women is an infrequent but recognized clinical entity that deserves special attention. An underlying clinical condition should always be sought and treated. Indeed, in addition to cultures, radiological modalities such as ultrasonographic imaging may provide specific diagnosis and aid the management.
PMCID: PMC3410108  PMID: 23012091
Breast infections; non-lactating; mastitis
A stethoscope, an essential tool of the medical profession, can become a source of nosocomial infection.
To determine the frequency of bacterial contamination of stethoscopes as well as the practices used for cleaning them.
Cultures were taken from 100 stethoscopes used by different medical personnel in different hospital services. The stethoscopes were collected while the staff filled in a questionnaire.
Thirty (30%) out of the 100 stethoscopes surveyed were contaminated with microorganisms. The majority of organisms isolated were gram-positive bacteria (gram positive bacilli 12%, gram-negative bacteria 9%, gram-positive cocci 9%). None of the stethoscopes grew methicillin-resistant staphylococcus aureus. Overall, 21% of the health personnel cleaned their stethoscopes daily, 47% weekly, and 32% yearly. None of the health care workers cleaned their stethoscopes after every patient. Nurses cleaned their stethoscopes more often than physicians and medical students.
Stethoscopes may be important in the spread of infectious agents. Their regular disinfection after use on each patient should be considered, particularly in such areas of the hospital, as the critical care units, and oncology units which house many patients with antibiotic-resistant organisms.
PMCID: PMC3410102  PMID: 23012043
Stethoscope; Contamination; Saudi Arabia

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