A high rate of contamination can be expected during autograft preparation for ACL reconstruction. Soaking the hamstring autograft in either bacitracin or 4 % chlorhexidine solution is effective for decontamination, particulary if graft is dropped on the floor.

Gut microbiota is mainly composed of four phyla; however, the human gut microbiota is dominated by only 2 of them and most of them are uncultivable. Psoriasis is an inflammatory skin disorder with associated inflammation of internal organs and musculoskeletal system. This study aimed to, identify numerically abundant bacteria phyla in fecal samples of patients with psoriasis, evaluate whether differences in fecal microbiota correlate with the occurrence of psoriasis and understand the possible pathogenesis behind psoriasis-related bacterial targets. From April, 2015 to 2016, 90 adults were selected prospectively to allocate 2 equal groups: Gr1 (45 cases) patients with psoriasis, and Gr2 (45 cases) healthy controls. Psoriasis Area and Severity Index (PASI) for each psoriasis patient was detected. All subjects were subjected to history taking, clinical examination, and fecal real time polymerase chain reaction (PCR) testing for the Firmicutes, Bacteroidetes, and Actinobacterial phyla. In both groups, Firmicutes were the most common detected phylum followed by Bacteroidetes and finally Actinobacterial phyla. High statistically significant difference was reported for the Firmicutes/ Bacteroidetes ratio between the psoriasis patients and the control group and showed statistically significant positive correlations with PASI. Actinobacterial count was significantly higher in the control group than in psoriasis patients and showed statistically significant negative correlations with PASI. It is believed that, there are fractions of the gut microbiota with the ability to counteract inflammation (Bacteroidetes and Actinobacterial), and others that are more prone to induce inflammation (Firmicutes) and the disturbed microbiome ratio may be the cause for inducing psoriasis.

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Vancomycin resistant Enterococcus faecium (VREF) ia an emerging and challenging nosocomial pathogen. This study aimed to determine the prevalence, risk factors and clonal relationships between different VREF isolates in the intensive care units (ICUs) of the university hospitals in our geographic location. This prospective study was conducted from July, 2012 until September, 2013 on 781 patients who were admitted to the ICUs of the Mansoura University Hospitals (MUHs), and fulfilled the healthcare-associated infection (HAI) criteria. Susceptibility testing was determined using the disk diffusion method. The clonal relationships were evaluated with pulsed field gel electrophoresis (PFGE). Out of 52 E. faecium isolates, 12 (23.1%) were vancomycin resistant. The significant risk factors for the VREF infections were: transfer to the ICU from a ward, renal failure, an extended ICU stay and use of third-generation cephalosporins, gentamicin, or ciprofloxacin. PFGE with the 12 isolates showed 9 different patterns; 3 belonged to the same pulsotype and another 2 carried a second pulsotypes. The similar pulsotypes isolates were isolated from ICUs of one hospital (EICUs); however, all of the isolates from the other ICUs had different patterns. Infection control policy, in conjunction with antibiotic stewardship, is important to combat VREF transmission in these high-risk patients.

Earlier and accurate diagnosis of the fungal infection in the cornea is necessary for effective treatment. In developing countries, microscopical evaluation is the most valuable and rapid diagnostic tool. Therefore we aimed to investigate the efficacy of methylene blue (MB) staining in comparison with potassium hydroxide (KOH) and calcofluor white (CW) stain. Corneal scraping from 48 cases with suspected fungal keratitis were included in the study from January 2014 to December 2014. The specimens were subjected to direct examination by MB, 10% KOH and CW stain. The staining results were confirmed with fungal culture and strain identification. Topical amphotericin B was started for all positive fungal cases; 39 (81.25%) were proven fungal cases. Positive rate of calcofluor white, MB and 10% KOH staining were 79.2%, 75% and 68.75% respectively. CW showed higher sensitivity and specificity (99.44% and 90.91% respectively), followed by MB (92.31% and 80.0% respectively) and lastly KOH 10% (84.62% and 71.43% respectively). 71.8% of cases had healed scars and only 4 patients (10.3%) required keratoplasty (PK). Direct microscopic detection of fungal structures by MB staining in corneal scrapes is a fast and effective method for the early diagnosis of fungal keratitis.