Objectives Multidrug resistance (MDR) and emergence of extended-spectrum β-lactamases (ESBLs) among uropathogenic Escherichia coli have been reported worldwide, but there was no information on the detection of blaCTX-M-15 in major teaching hospitals in Libya. The aim of the study was to investigate the occurrence of CTX-M-15 β-lactamases producers isolated from five teaching hospitals in Tripoli, Libya. Methods A total of 346 urine samples were collected from hospitalized patients in five teaching hospitals with a diagnosis of urinary tract infection (UTI). Phenotypic confirmation of ESBLs was confirmed by E-test strip; all ESBL-producing E. coli isolates were screened for the blaCTX-M-15 gene. Results The distribution of ESBL-producing E. coli varied among the five hospitals. The highest proportion was identified in Tripoli Medical Centre (67.6%). There were extremely high proportions of isolates resistant to ceftriaxone, cefepime, and ceftazidime (93.0–100.0%) among ESBL producers compared to non-ESBL producers (2.2–4.7%). MDR was detected in 22.2% of isolates. The majority of isolates (85.9%) in which blaCTX-M-15 was identified were ESBL producers. There was a correlation (p < 0.001) between expression of CTX-M-15 and resistance to ceftazidime. Conclusions The isolation of MDR ESBL-producing uropathogens expressing the CTX-M-15 gene will limit the choices clinicians have to treat their patients with UTIs. Continued surveillance and implementation of efficient infection control measures are required. arabic 17 English 94
Abdulaziz Zorgani, Abdulla Bashein(1-2017)

Background: Phenylketonuria (PKU) is one of the most common inborn errors of amino acids metabolism. It is an autosomal recessive disease that is caused by mutations in phenylalanine hydroxylase (PAH) gene. In the North Africa and Eastern Mediterranean region, E280K missense mutation and c.1055del.G frameshift mutation in PAH gene are one of the most common pathogenic mutations seen in PKU patients. Materials and Methods: In this study, we developed molecular protocols for rapid screening of the PKU patients for these two mutations. These protocols are based on hydrolysis probe real-time polymerase chain reaction technique using allele-specific probes labeled with 6-carboxyfluorescein (FAM) for wild-type (WT) and hexachloro-6-carboxyfluorescein (HEX) for mutant genotypes and Black Hole Quencher 1 as a quencher and high-resolution melting analysis using EvaGreen saturating dye. Results: There was complete accordance between the developed protocols in differentiating genotypes and they proved to be rapid, sensitive, and efficient for the detection and differentiation between WT, mutant, and heterozygous genotypes of the E280K and c.1055del.G mutations. Conclusions: These protocols allow easy molecular screening of the mutations studied among the families of affected people, especially for premarital screening. arabic 27 English 170
Abdulla Bashein(1-2017)

Despite the relative abundance of sunny weather, surprisingly, there is increasing evidence that vitamin D deficiency is extremely prevalent in females of reproductive age in Middle East countries. There is also increasing interest in the non-classical roles of vitamin in health and disease including its relation to incidence of gestational diabetes, its impact on glycaemic control in diabetes mellitus, and its association with some complications of pregnancy like preeclampsia. The objective of this study was to estimate the prevalence of Vitamin D deficiency in pregnant diabetic patients in west Libya and analyse potential links to socioeconomic and cultural factors. This is a cross sectional observational study. Random plasma was collected form expected mothers attending the Antenatal Diabetes Clinic at Tripoli’s Main Maternity Hospital. Demographics and socioeconomic and cultural factors were recorded at the same time. Samples were analysed for vitamin D level and biochemical screening panel. Vitamin D level was obtained from 160 patients (mean age 35 years). Over all 95 % of the study population had vitamin D levels below normal (defined as vitamin D level of < 20 ng/mL). Results were subcategorised into severe deficiency ( 30 ng/ml, only 1.3%, 2 patients). All patients were taking daily vitamin D Supplements at a dose of 400 IU as per hospital policy. Vitamin D deficiency is extremely prevalent in pregnant diabetic patients in Libya. There is no clear association with socioeconomic risk factors like employment, type of accommodation or geographic distribution. However, most of the study population had life style characterized by minimal exposure to direct sun arabic 11 English 70
G Murad, A Bashein(1-2019)