Salwa Bdour

Risk of perinatal transmission of hepatitis B virus in Jordan.

OBJECTIVES: To determine the risk of perinatal transmission of hepatitis B virus (HBV) in Jordan. METHODS: Plasma samples from 1000 pregnant Jordanian women were screened by ELISA for HBV markers (HBsAg, HBeAg, anti-HBe, anti-HBc and anti-HBs). RESULTS: HBsAg and HBeAg were detected in 4.3% and 0.1% of the pregnant women, respectively. The overall prevalence of antibodies was 6%, 11.1% and 7.5% for anti-HBe, anti-HBc and anti-HBs, respectively. Women were assigned to four groups according to the serological patterns of HBV markers: susceptible (85.9%), with acute infection (2.9%), with chronic infection (1.4%) and previously infected (9.8%). Most women were at the third trimester of pregnancy, therefore women with acute and chronic hepatitis at this gestational age were at risk of transmitting HBV infection to their newborns. Women who belonged to the low socio-economic class were at higher risk of HBV infection. CONCLUSIONS: Based on the results, we recommend screening women for HBV during pregnancy in order to identify HBV carriers. All newborns born to carriers should be vaccinated immediately after birth, both passively and actively. Also vaccination of HBV seronegative pregnant women is recommended.

Isolation and characterization of methicillin-resistantStaphylococcus aureus from livestock and poultry meat

Meat samples from sheep, bovine, camel and poultry were collected from Amman area and were processed and tested for the presence of methicillin (oxacillin) resistantStaphylococcus aureus (MRSA). Identity ofS. aureus was ensured by Gram-staining and a battery of biochemical tests. From 1260 meat samples, 157S. aureus positive isolates were identified. Of the 157 isolates, 30 were resistant to methicillin levels greater than 2 μg/ml and only 15 weremecA-positive MRSA originating mainly from sheep and chicken. Subjecting themecA-positive MRSA to antibiotic susceptibility testing revealed that all isolates were resistant to β-lactam antibiotics (ampicillin, penicillin, and oxacillin) and were sensitive to vancomycin, trimethoprim, chloramphenicol and cephalothin. Randomamplified polymorphic DNA (RAPD) analysis ofmecA-positive animal isolates generated six different patterns. Comparing these results with results of isolates of human origin of our laboratory there is some molecular epidemiological relatedness between both and could be a possible source of infections through consuming contaminated meat products, direct contact or meat processing.

Respiratory syncytial virus subgroup A in hospitalized children in Zarqa, Jordan

Summary The epidemiology of RSV infection was investigated in 271 children aged less than 2 years admitted to the Zarqa Government Hospital, Jordan with bronchiolitis or bronchopneumonia. Nasopharyngeal washings were cultured and RSV antigen was detected by the direct immunofluorescence technique. Of the 271 specimens, 69 (25.46%) were positive for RSV, representing 50.36% of the respiratory viruses. All RSV isolates were typed as subgroup A by monoclonal antibody and confirmed by RT-PCR. RSV was prevalent in the hospitalised children in the coldest months of the year. The epidemics began in January or February, peaked in spring and then disappeared in summer. This study supports the idea that RSV subgroup A is a major contributor to winter outbreaks of respiratory tract disease in children, and health care workers in Jordan should consider the diagnosis during January-May each year.

Isolation of plasmids present in thermophilic strains from hot springs in Jordan

The plasmid profile of two thermophilic bacterial strains isolated from recreation thermal springs in Jordan has been investigated. These strains are Streptococcus thermophilus and Bacillus sp1, which have been isolated from Zerka – Maeen and Himma hot springs respectively. Supercoiled and circular plasmid forms were detected, explaining the effect of DNA conformation on the mobility of the plasmid in the agarose gel electrophoresis. Two plasmids have been isolated and characterized by restriction endonucleases to facilitate their use as cloning vectors in thermophilic strains. The sizes of the plasmids were approximately 3 kb (from Streptococcus thermophilus) and 7 kb (from Bacillus spl). These plasmids were then digested with three different restriction enzymes (EcoRI, Bam HI, and HindIII), one of which was found to possess a single site for both plasmids, this enzyme is EcoRI.

Mumps: immune status of adults and epidemiology as a necessary background for choice of vaccination strategy in Jordan

The prevalence of antibodies against mumps in 333 students at Jordan University was assessed using the ELISA technique. Most of the students (93.7%) were seropositive for mumps. About 50% of unvaccinated students and students vaccinated using the optional single‐dose MMR vaccine had mumps. The incidence rate of mumps in different age groups and sexes, the geographic distribution and the seasonality of mumps infection prior to the adoption of compulsory MMR vaccination were investigated during the period from 1988 to 2000. Mumps occurred in all age groups in both sexes and the incidence rate was higher in children aged 5–14 years than in adults. There was a higher frequency in winter and spring with epidemic peaks in 1988, 1993 and 2000. Southern Jordan had the highest incidence rate due to low vaccination coverage by the private clinics. The data support the introduction of compulsory MMR vaccination in Jordan for all susceptible individuals. Evaluation of the effectiveness of the compulsory single‐dose vaccine and, based on the outcome, a second dose of this vaccine is also recommended in order to achieve and maintain a high level of immunization.

Present anti-measles immunity in Jordan

The immunity of adults and the prevalence of measles was determined in order to evaluate the adequacy of current measles vaccination policy in Jordan. A total of 307 sera, collected from adults aged 18--40 years, were tested for anti-measles antibodies by ELISA technique. The overall prevalence of anti-measles antibodies was 94.8% and there was no significant difference in the seropositivity rate between males (95.7%) and females (94%). Of the tested adults, 71% were vaccinated and 29% escaped vaccination. In Jordan, measles outbreaks occur periodically and predominantly attack children aged 5--14 years. Our data support introducing the compulsory MMR vaccine in the year 2000 to improve the vaccination coverage of measles; since the optional single dose vaccination has not interrupted the circulation of the measles virus. A second dose of MMR vaccine could be offered to Jordanians either at school entry or at the age of 11--12 years, based on the outcome of the compulsory single dose of MMR vaccine.

PCR amplification of four genes coding for aminoglycoside-modifying enzymes in bacteria of clinical isolates from Jordan University Hospital

Three species of Gram-negative G(−) bacteria were chosen for this study: Escherichia spp. (29 isolates), Pseudomonas spp. (16 isolates) andEnterobacter spp. (17 isolates), utilizing colony PCR to detect genes coding for aminoglycoside-modifying enzymes. The 62 isolates were purified and cultured on nutrient broth media supplemented with 50 μg kanamycin/ml. Only 17 out of the 62 isolates were resistant to kanamycin and were subjected to colony PCR protocol using 20 μl cell lysate and eight sets of primers with each isolate. Sizing of the amplified fragments was carried out in order to determine the specificity of PCR. The 17 isolates were shown to carry the rrs, aacC2, aacA-aphD and aphA3 genes.

Emerging OP354-Like P[8] Rotaviruses Have Rapidly Dispersed from Asia to Other Continents

The majority of human group A rotaviruses possess the P[8] VP4 genotype. Recently, a genetically distinct subtype of the P[8] genotype, also known as OP354-like P[8] or lineage P[8]-4, emerged in several countries. However, it is unclear for how long the OP354-like P[8] gene has been circulating in humans and how it has spread. In a global collaborative effort 98 (near-)complete OP354-like P[8] VP4 sequences were obtained and used for phylogeographic analysis to determine the viral migration patterns. During the sampling period, 1988-2012, we found that South and East Asia acted as a source from which strains with the OP354-like P[8] gene were seeded to Africa, Europe, and North America. The time to the most recent common ancestor (TMRCA) of all OP354-like P[8] genes was estimated at 1987. However, most OP354-like P[8] strains were found in three main clusters with TMRCAs estimated between 1996 and 2001. The VP7 gene segment of OP354-like P[8] strains showed evidence of frequent reassortment, even in localized epidemics, suggesting that OP354-like P[8] genes behave in a similar manner on the evolutionary level as other P[8] subtypes. The results of this study suggest that OP354-like P[8] strains have been able to disperse globally in a relatively short time period. This, in combination with a relatively large genetic distance to other P[8] subtypes, might result in a lower vaccine effectiveness, underscoring the need for a continued surveillance of OP354-like P[8] strains, especially in countries where rotavirus vaccination programs are in place.