Abstract Introduction: Extended-spectrum β-lactamases (ESBLs), AmpC type, carbapenem resistant Enterobacteriaceae (CRE), are important mechanisms of resistance among Enterobacteriaceae. The aim of this study was to investigate the prevalence of ESBL, AmpC and CRE among Enterobacteriaceae isolates recovered from pediatric patients in Tripoli, Libya. Methods: This cross-sectional study was carried out in Tripoli Children Hospital (TCH), a total of 915 Gram negative bacteria isolates were evaluated for susceptibility to a panel of antimicrobials and were analyzed phenotypically for the ESBL, AmpC type and CRE using chromagen media, E-test and combination disc test. Results: The predominant organisms were Escherichia coli (56.8%) and Klebsiella spp. (21.4%). The overall prevalence of ESBL producing Enterobacteriaceae was 24.5% (224/915). Out of 224, Enterobacteriaceae proved ESBL producer, Klebsiella spp. (54%) and E. coli (34.4%) were the leading ESBL producers. ESBL-producers were more often resistant to major classes of antibiotics compared with non-ESBL producers, significantly high resistance rates (P < 0.001) were observed for ceftriaxone, cefepime, and ceftazidime (87.5 - 95.9%) among ESBL producers compared to non-ESBL producers (7.2 - 13.5%). MDR was documented for 50/224 (22.3%) of ESBL producers and was significantly higher (P < 0.0001) among ESBLs compared with non-ESBL producer isolates. Phenotypic detection of AmpC revealed 60/915 (6.6%) isolates as potential AmpC β-lactamase producers, E. coli exhibited a lower level of AmpC (8.3%) compared with Klebsiella spp. (56.6%). The overall prevalence of CRE was 9% (83/915). Carbapenemase-producing organisms in this study were as follows: Klebsiella spp. (44.6%); Acinetobacter spp. (24%); Pseudomonas spp. (9.6%). Conclusion: This study revealed that the prevalence of ESBL, AmpC, CRE and MDR Enterobacteriaceae isolates in Children hospital was within acceptable frequency. arabic 11 English 91
Abdulaziz Zorgani, Abdulla Bashein, (1-2017)

Mutations in the TAL1 (T-cell acute leukemia 1) gene were recently described in patients with T-cell acute lymphoblastic leukaemia (T-ALL) and in those with lymphoblastic T-cell non-Hodgkin’s lymphoma (T-NHL). The purpose of this pilot study was to assess the prevalence of mutations in TAL1 gene in T-ALL and TNHL. DNA samples from 15 unrelated healthy controls, 20 T-ALL patients, and 10 T-NHL patients were analyzed using DNA-PCR and direct DNA sequencing to identify sequence genetic variations in TAL1 gene (exons 2 and 3). TAL1 exon 2 mutations were identified in 7.7% adult and 12.5% adolescent T-ALL patients analyzed. TAL1 exon 2 mutations were detected in 16.7% of the adult TNHL patients analyzed. Sequencing of TAL1 exon 3 showed no sequence variation for the T-ALL and T-NHL cancer patients analyzed. No sex difference where observed in the incidences of TAL1 exons 2 mutations between T-ALL and T-NHL patients with and without TAL1 mutations. TAL1 exon 2 missense and frame-shift mutations were present in 44.4% (4/9) and 55.6% (5/9) of T-ALL patients, respectively. However, the frame-shift and missense mutations in the T-NHL patients accounted for, where respectively, 60% (3/5) and 40% (4/5) of all TAL1 exon 2 mutations. Comparing the clinical features showed that there are no differences in PLT and WBC counts as well as the average age between T-ALL and T-NHL patients with and without TAL1 mutations. Overall, these findings indicate that TAL1 mutations are too rare to be of clinical relevance, and do not seem to be significantly associated with the increased T-ALL and T-NHL susceptibility, implying different pathways with respect to TAL1 genetic polymorphisms as a risk factor for T-ALL and T-NHL at least in this population of Libyans.
Amal E. Elarifi, Othman A. El-Ansari, Mohamed A. Al-Griw(12-2016)

Alkaline phosphatase (ALP) enzyme level, which is routinely measured at clinical laboratories, increases in end-stage renal disease (ESRD) and hepatitis patients. This study investigated the difference in ALP level among ESRD and hepatitis patients. ALP level was measured in sera of patients suffering from ESRD, HCV and HBV infections, as well as patients suffering from comorbidity of these diseases, then the obtained values of ALP level were statistically compared to a control group. The results of three-Way ANOVA revealed that the mean of ALP level increased significantly (P-value< 0.05) in all types of diseases compared to the control group, with the highest increase in case of ESRD patients infected with Hepatitis B and C. Also, it was found that the interaction of group-gender significantly (P-value< 0.05) altered ALP level in patients suffering from HCV or HBV infections, while the interaction of group-age, gender-age, group-gender-age were found not to significantly alter it. In conclusion, ESRD patients with HBV/HCV coinfection may have a higher risk of liver-related morbidity and mortality than ESRD or HBV or HCV patients. arabic 25 English 103
HA Alemam, A Bashein(1-2020)