Objective: Pseudomonas aeruginosa uses type 3 secretion system (T3SS) to directly inject four toxins into host cells. The aim of the study was to determine the prevalence of the toxins-encoding genes among P. aeruginosa isolates collected from nosocomial infections and environmental sources.Methods: Clonal relatedness of the studied P. aeruginosa isolates (n=85) was studied by RAPD typing. Multiplex PCR was performed on the 85 P. aeruginosa isolates (68 nosocomial isolates obtained from hospitalized patients present in different wards and departments, and 17 environmental isolates including 2 isolates from health-care worker hands from ICU) to detect the secretion toxins-encoding genes.Results: RAPD fingerprinting demonstrated that most strains were of distinct genotypes and determined the presence of 54 RAPD patterns. The prevalence of the genes among all isolates was as follows; exoT-100%, exoS-40%, exoY-83.5% and exoU-62.4%. No significant differences in the prevalence of these genes were observed between nosocomial and environmental isolates or between isolates cultured from different sites of infection. The part of P. aeruginosa strains harboring either exoS (37.6%) or exoU (60%) gene was significantly higher (P<0.001) than that contained both genes (2.4%). Conclusion:ExoT was present in all isolates and exoS, exoY and exoU are variable traits with exoU gene was the third in prevalence after exoT and exoY. No significant differences in exoS, exoY and exoU prevalence were observed between nosocomial and environmental isolates or between isolates from different sites of infection. ExoS and exoU genes were mutually exclusive that almost all isolates contain either exoS without exoU or exoU without exoS. Yöntemler: Çalışılan P. aeruginosa izolatlarının klonal yakınlığı RAPD tiplendirme metodu ile bakılmıştır. Sekretuar toksin kodlayan genleri saptamak için 85 P. aeruginosa izolatında (farklı klinik ve bölümlerde yatan hastalardan izole edilen 68 hastane kaynaklı izolatı ve ikisi yoğun bakım ünitesindeki sağlık çalışanının ellerinden izole edilen 17 çevresel izolat) multiplex PCR çalışıldı.Bulgular: RAPD fingerprint analizi ile varlığı tespit edilen 54 RAPD paterninin varlığı suşların çoğunun uzak genotiplere sahip olduğunu gösterdi. Tüm izolatlarda saptanan genlerin prevalansı sırasıyla exoT (% 100), exoS (% 40), exoY (% 83,5) ve exoU (% 62,4) şeklindeydi. Farklı enfeksiyon bölgelerinden üretilen izolatlar arasında yada hastane ve çevresel kaynaklardan elde edilen izolatlar arasında bu genlerin prevalansı açısından anlamlı bir fark yoktu. P. aeruginosa suşla-rından exoS (% 37,6) veya exoU (% 60) genlerinden birini taşıyanlar her iki geni taşıyanlardan (% 2,4) anlamlı olarak daha fazlaydı (p<0.001). Sonuç:ExoT tüm izolatlarda bulunurken exoS, exoY ve exoU genlerinin varlığı değişkenlik gösteriyordu. ExoU geni exoT ve exoY geninden sonra üçüncü sıklıkta görülmekteydi. exoS, ExoY ve exoU görülme prevalansı hastane kaynaklı ve çev-re kaynaklı suşlar arasında veya değişik bölge veya enfeksiyonlar arasında an...

Background: Sepsis is a global, life-threatening health priority. Blood culture is the gold standard of diagnosis of sepsis, however, it requires several days, which delays the diagnosis of the sepsis. Biomarkers could play a pivotal role in diagnosis, grading and predicting the outcome of sepsis. Objectives: To assess the potential role of C-reactive protein (CRP), procalcitonin (PCT) and presepsin for diagnosis, grading and predicting the prognosis of sepsis. Methods: The study included 28 patients diagnosed with sepsis, and 28 intensive care unit (ICU) patients presented by different presentations but with no sepsis. For patients with sepsis, APACHE II score was calculated, blood culture was done using BacT/Alert system, and Vitek 2 to identify bacterial isolates. For all subjects included in the study, quantitative measurement of CRP, PCT and presepsin were done using PA54 Specific Protein Analyzer, VIDAS ® immune-analyzer, and PATHFAST fully automated immunoassay analyzer, respectively. Results: APACHE II score positively correlated with PCT (p=0.026) and presepsin (p=0.034), but not CRP (p=0.291). Differences between cases and control group for the three biomarkers' levels were statistically significant (P value <0.001). For sepsis severity, there were significant increase in PCT and presepsin on admission (P value <0.001) among septic shock compared to sepsis cases. Procalcitonin was slightly superior than presepsin. Procalcitonin and presepsin showed statistically significant increase (P <0.001 & p=0.02 respectively) among died compared to survived subgroups. Conclusion: PCT and presepsin are reliable biomarkers for early diagnosis, grading and predicting of the prognosis of sepsis.

Human Leucocyte Antigens (HLA) class II appears to play an important role in the individual's immune response to viral infection. The present study was aimed at assessment of the relationship between HLA DRB1 alleles and the response to HCV combined therapy in Chronic Hepatitis C patients (CHC). We enrolled a total of 44 chronically infected HCV patients without Hepatitis B Virus (HBV) or Human Immunodeficiency Virus (HIV). Their mean age was 36.45±11.18 years (21-63). HLA-DRB1 typing was done by real time Polymerase Chain Reaction (PCR). ALT and Hemoglobin (Hb) levels were assessed as well as viral genotype was taken from patients' reports (HCV genotypes were 1, 2, 3 and 4 representing 13.6, 13.6, 4.5 and 68.18%, respectively). The most frequent alleles demonstrated among patients were DRB1*13 and DRB1*07 (31.8 and 36.4%, respectively). Analysis of DRB1 frequency between sustained responders and non responders revealed that DRB1*13 allele was significantly higher among sustained responders (p<0.001), while DRB1*07 allele was significantly higher among non responders (p<0.01). Female sex, HCV genotype 2 and pretreatment low serum HCV RNA level were associated with Sustained Virological Response (SVR). Also, elevated Alanine aminotransferase (ALT) level at the 1st week of therapy followed by return to baseline level at the 4th week and a decrease of the mean hemoglobin concentration at 4th week and 12th week of therapy were significantly associated with SVR. We concluded that the virological and special HLA patterns may possibly predict the response to combination therapy in CHC patients.

Background: Cancer immunotherapy became a promising alternative to old therapeutic options in hepatocellular carcinoma. DC-DRibbles vaccine has clinical applications across a broad range of malignancies. Objective: To compare the efficacy of subcutaneous and intranodal routes of injection of Dendritic Cells-DRibbles immunotherapy in HCC induced mice. Methodology: This experimental study was conducted on 24 BALB/c mice. Healthy as negative control and cancer induced. The later was subdivided into two groups: positive control group and vaccinated groups (A and B) according to route of administration. Results: The mean of percentage of tumor volume reduction was 92.76% in DC+ Dribbles intranodal group (B), which was better than mean of percentage of change in subcutaneous group (A) which was 90.87%. Conclusion: DC-Dribbles vaccine was effective as HCC immunotherapy, both subcutaneous and intra nodal routes had comparable results. This study recommends subcutaneous route over intranodal route immunotherapy; it is simple, less invasive and effective.

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