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Distribution of petroleum hydrocarbon in sediment from coastal area receiving industrial effluents in Kuwait.

Sediment samples from the coastal area facing Shuaiba industrial area (15 x 1.5 km(2)) were examined for contamination with petroleum hydrocarbons. Aliphatic hydrocarbons in sediment extracts were characterized largely by unresolved complex mixture from nC(22)-nC(33). The sediment samples from the upstream area facing Mina Al-Ahmadi refinery to Shuaiba Harbor were heavily polluted with polycyclic aromatic hydrocarbons (PAHs) possibly due to the higher depth in the area created for a navigational channel to the harbor. PAHs at these locations exceeded the probable effect levels with reference to sediment quality guidelines.

Environmental Monitoring↗

Estimation of optimum requirements for indoor air quality and energy consumption in some residences in Kuwait.

Contrasting effects of the dilution of indoor generated pollutants and the energy efficiency of heating and ventilating air conditioning systems (HVAC) for indoor air quality (IAQ) and thermal comfort were studied for 10 Kuwaiti residences. The levels of volatile organic compounds (VOCs) and the calculated cooling load of the HVAC systems were used as indicators for the IAQ and for the energy consumption, respectively. Air exchange rates and VOCs levels (both indoor and outdoor) were measured. It was found that the outdoor VOC concentrations were always less than the indoor values. Therefore reduction of indoor VOC levels can be accomplished either by increasing the ratio of the makeup air to the recirculation air of the HVAC system or by increasing the infiltration airflow rate through openings. A single compartment IAQ model, modified by the authors, was used to test for the variation in the above two dilution modes and to test the performance sensitivity. Hence, the optimum parameters in terms of IAQ and energy consumption were determined. The results indicated that it was necessary to increase the ratio of the makeup air to the recirculation air from its typical design value of 0.5 to a range of 0.7-1.3 in order to reduce indoor VOC to acceptable levels.

Air Conditioning↗

Septicaemia in a teaching hospital in Kuwait--I: Incidence and aetiology.

During a period of 18 months of study, blood cultures were performed on 3845 patients in hospital with clinical signs of infection. Among these, 214 (5.6%) episodes of septicaemia were diagnosed which correspond to 10.9/1000 hospital admissions. About 80% of the episodes were due to Gram-negative organisms, most common of which were Escherichia coli (19.6%), Salmonella spp (16.5%) and Klebsiella spp (15.1%). Gram-positive organisms implicated in 20% of episodes were mainly Staphylococcus aureus (9.3%) and enterococci (4.9%). Of all the septicaemias 62.0% were community-acquired with Salmonella spp. being the organism most commonly implicated. Hospital-acquired infections were mainly due to Serratia spp, Pseudomonas spp and Flavobacterium spp. The antibiotic resistance pattern of the organisms showed that hospital-acquired organisms had relatively high resistance to most antibiotics as compared with community-acquired organisms.

Cross Infection↗

The concurrent associations of group A streptococcal serotypes in children with acute rheumatic fever or pharyngitis-associated glomerulonephritis and their families in Kuwait.

A group of 146 children with acute rheumatic fever and 256 members from their families, and a group of 125 children with post-streptococcal glomerulonephritis and 199 family members, together with a group of 145 children with non-complicated group A streptococcal pharyngitis were examined over a period of three years. The purpose of the study was to explore the concurrent association and distribution of group A streptococcal serotypes among the three groups. Strains isolated from the children with non-complicated group A streptococcal pharyngitis represented the prevalent strains of group streptococci in the childhood community during the period of study. Rheumatic fever was encountered in a non epidemic situation. As expected, the recovery of group A streptococci was low. The strains however belonged mainly to two patterns, namely type M1 and M non-typable strains. Nephritis was pharyngitis-associated and occured also sporadically throughout the year. Types M12 and 49 accounted for the majority of the isolates. Type M12 accounted for 34.4% of the group A isolates from family members of children with nephritis and was totally absent in family members of children with rheumatic fever (p less than 0.001). The T pattern 8/25/Imp. 19 accounted for 40% of the group A isolates from family members of rheumatic patients compared to 3.3% from family members of nephritis patients (p less than 0.005). Data from this study show that the group A streptococcal serotypes, concurrently isolated from children with acute rheumatic fever and their families are disparately different from those of children with pharyngitis-associated glomerulonephritis and their families in the same population. These findings support the concept of "nephritogenicity" and "rheumatogenicity" and indicated the important role of the biological characteristics of the streptococcal serotypes in the aetiology of acute rheumatic fever and acute poststreptococcal glomerulonephritis.

Acute Disease↗

Otoscopic findings in a group of schoolchildren in Kuwait.

Middle ear diseases are the most common cause of hearing impairment in children. Therefore, we found it important to conduct a study to reveal the frequency of different middle ear conditions. Using an otoscope with a magnifying lens 826 children in their second grade of primary school were examined. Various kinds of ear canal and middle ear pathology were found. An extremely high percentage (41%) of the 1,652 examined ears did show significant pathology. The different findings will be presented and comparison with other similar studies will be done.

Child↗

Antibiotic resistance of enterococci isolated at a teaching hospital in Kuwait.

Enterococci isolated in a teaching hospital were studied for their resistance to different antibiotics. Minimum inhibitory concentrations to high-level aminoglycosides and glycopeptide antibiotics were determined by agar dilution and E-test methods respectively. Genes encoding aminoglycoside-modifying enzymes were detected by the polymerase chain reaction (PCR). 195 enterococci were isolated from urines (54.3%), wounds (16.4%), blood (10.2%), and miscellaneous sources (18.9%). They consisted of E. faecalis (88.7%), E. faecium (9.2%), E. casseliflavus (1.5%) and E. bovis (0.5%). None of the enterococci produced penicillinase but 3.5% of them were resistant to ampicillin. They were also resistant to high-level gentamicin (15.9%), kanamycin (22.0%), streptomycin (21.0%), tetracycline (65.1%), erythromycin (62.6%), ciprofloxacin (36.1%), chloramphenicol (26.1%), vancomycin (3.0%) and teicoplanin (2.0%). Most of the high-level aminoglycoside-resistant isolates contained genes coding the bifunctional aminoglycoside modifying enzymes AAC(6')-APH(2"), APH(3') and ANT(6') but not the ANT(4') enzyme. The results demonstrated a low prevalence of vancomycin resistance among Enterococci in this hospital.

Academic Medical Centers↗

Characterization of rpoB mutations in rifampin-resistant clinical Mycobacterium tuberculosis isolates from Kuwait and Dubai.

Mutations conferring resistance to rifampin in rifampin-resistant clinical Mycobacterium tuberculosis isolates occur mostly in the 81 bp rifampin-resistance-determining region (RRDR) of the rpoB gene. In this study, 29 rifampin-resistant and 12 -susceptible clinical M. tuberculosis isolates were tested for characterization of mutations in the rpoB gene by line probe (INNO-LiPA Rif. TB) assay and the results were confirmed and extended by DNA sequencing of the PCR amplified target DNA. The line probe assay identified all 12 susceptible strains as rifampin-sensitive and the DNA sequence of RRDR in the amplified rpoB gene from two isolates matched perfectly with the wild-type sequence. The line probe assay identified 28 resistant isolates as rifampin-resistant with specific detection of mutation in 22 isolates including one isolate that exhibited hetro-resistance containing both the wild-type pattern as well as a specific mutation within RRDR while one of the rifampin-resistant strain was identified as rifampin-susceptible. DNA sequencing confirmed these results and, in addition, led to the specific detection of mutations in 5 rifampin-resistant isolates in which specific base changes within RRDR could not be determined by the line probe assay. These analyses identified 8 different mutations within RRDR of the rpoB gene including one novel mutation (S522W) that has not been reported so far. The genotyping performed on the isolates carrying similar mutations showed that majority of these isolates were unique as they exhibited varying DNA banding patterns. Correlating the ethnic origin of the infected TB patients with the occurrence of specific mutations at three main codon positions (516, 526 and 531) in the rpoB gene showed that most patients (11 of 15) from South Asian region contained mutations at codon 526 while majority of isolates from patients (6 of 11) of Middle Eastern origin contained mutations at codon 531.

Antibiotics, Antitubercular↗

Surface ultrastructure of Stictodora tridactyla (Trematoda: Heterophyidae) from Kuwait Bay.

The surface morphology of Stictodora tridactyla recovered from a kitten that was fed the killifish, Aphanius dispar, naturally infected with the metacercariae was studied using scanning electron microscopy. The body comprised a rounded head, elongate neck, and widely pyriform hind-body. The head bore a circular oral sucker on the ventral side, and concentric rows of peg-like cephalic spines on the dorsal side. The oral sucker was armed with pre-oral spines similar in shape and size to the cephalic spines. The neck and hind-body were densely covered with scale-like multipointed spines, the size and density of which decreased from anterior to posterior parts of the body. Ciliated dome-shaped papillae were found solitarily or as conjugated groups on the head apex and lips of the oral sucker. Non-ciliated dome-shaped papillae were restricted to the lower lip of the oral sucker. The body was devoid of a ventral sucker. The genital opening appeared as a round depression of the tegument at about the anterior third of the body. This is the first record of the occurrence of S. tridactyla in the Arabian Gulf region and A. dispar is a new second intermediate host.

Animals↗