We aimed to isolate Acinetobacter baumannii (A. baumannii) from wound infections, determine their resistance and virulence profile, and assess the impact of Silver nanoparticles (AgNPs) on the bacterial growth, virulence and biofilm-related gene expression. AgNPs were synthesized and characterized using TEM, XRD and FTIR spectroscopy. A. baumannii (n = 200) were isolated and identified. Resistance pattern was determined and virulence genes (afa/draBC, cnf1, cnf2, csgA, cvaC, fimH, fyuA, ibeA, iutA, kpsMT II, PAI, papC, PapG II, III, sfa/focDE and traT) were screened using PCR. Biofilm formation was evaluated using Microtiter plate method. Then, the antimicrobial activity of AgNPs was evaluated by the well-diffusion method, growth kinetics and MIC determination. Inhibition of biofilm formation and the ability to disperse biofilms in exposure to AgNPs were evaluated. The effect of AgNPs on the expression of virulence and biofilm-related genes (bap, OmpA, abaI, csuA/B, A1S_2091, A1S_1510, A1S_0690, A1S_0114) were estimated using QRT-PCR. In vitro infection model for analyzing the antibacterial activity of AgNPs was done using a co-culture infection model of A. baumannii with human fibroblast skin cell line HFF-1 or Vero cell lines. A. baumannii had high level of resistance to antibiotics. Most of the isolates harbored the fimH, afa/draBC, cnf1, csgA and cnf2, and the majority of A. baumannii produced strong biofilms. AgNPs inhibited the growth of A. baumannii efficiently with MIC ranging from 4 to 25 µg/ml. A. baumannii showed a reduced growth rate in the presence of AgNPs. The inhibitory activity and the anti-biofilm activity of AgNPs were more pronounced against the weak biofilm producers. Moreover, AgNPs decreased the expression of kpsMII , afa/draBC,bap, OmpA, and csuA/B genes. The in vitro infection model revealed a significant antibacterial activity of AgNPs against extracellular and intracellular A. baumannii. AgNPs highly interrupted bacterial multiplication and biofilm formation. AgNPs downregulated the transcription level of important virulence and biofilm-related genes. Our findings provide an additional step towards understanding the mechanisms by which sliver nanoparticles interfere with the microbial spread and persistence.

Background and Objectives: Urinary tract infections are common health problem affecting millions worldwide. Antibiotic resistance among uropathogens (Ups) is prevalent in many countries. In the absence of any available data in the region, this hospital-based study investigated the pattern, frequency and susceptibility of Ups at Prince Mutaib Bin Abdulaziz Hospital, Aljouf Region, Saudi Arabia. Materials and Methods: A retrospective assessment of UPs and their antibiotics susceptibility was conducted from January 2017 to December 2017 using the fully automated Vitek2 system (BioMérieux, France). Results: Among the 415 uropathogens isolates, the most prevalent bacteria were Gram-negatives comprising 137 (51%) E. coli; 46 (17.2%) Klebsiella spp.; 30 (11.2%) Pseudomonas spp.; 25 (9.3%) Proteus spp.; 14 (5.2%) Acinetobacter baumanii and 16 (5.9%) others. On the other hand, Enterococcus spp. were predominant among Gram-positive isolates representing 54 (36.7%), 47 (32.0%) Staphylococcus spp., 22 (15.1%) Streptococcus spp., and 13 (8.8%) S. aureus, and 11 (7.5%) others. Gram-negative Ups showed multidrug resistance towards the majority of the tested antimicrobials (ampicillins, cephalospo- rins, fluoroquinolones, trimethoprim-sulfamethoxazole, fosfomycin, aztreonam, and nitrofurantoin). While high resistance patterns by Gram-positives was also seen against cephalosporins, penicillins, amoxicillin-clavulanic acid, trimethoprim-sul- famethoxazole, clindamycin, erythromycin and tetracycline. Conclusion: The observed widespread multidrug resistance clearly warrant implementing stricter control measures, local guidelines of antimicrobials usage, and continuous epidemiological surveys at hospitals and communities.

Croton macrostachyus is an important plant in traditional African medicine, widely utilized to treat a variety of diseases. In Kenya, HIV-infected patients use leaf and root decoctions of the plant as a cure for cough, back pain, bleeding, skin diseases, warts, pneumonia, and wounds. This study aimed to evaluate the anti-HIV activities and cytotoxic effects of extracts and chemical constituents isolated from C. macrostachyus. In our previous study we demonstrated that the hexane, CH2Cl2, ethyl acetate and methanol soluble fractions of a 1:1 v/v/ CH2Cl2/MeOH crude extracts of the leaves and stem bark of C. macrostachyus exhibited potent anti-HIV activities against HIV-1 with IC50 values ranging from 0.02–8.1 μg/mL and cytotoxicity effects against MT-4 cells ranging from IC50 = 0.58–174 μg/mL. Hence, hexane soluble extract of 1:1 v/v/ CH2Cl2/MeOH crude extract of the leaves of C. macrostachyus, that was more potent against HIV-1 at IC50 = 0.02 μg/mL was subjected to column chromatography leading to the isolation of 2-methoxy benzyl benzoate (1), lupenone (2), lupeol acetate (3), betulin (4), lupeol (5), sitosterol (6) and stigmasterol (7). Lupenone (2), lupeol acetate (3) and betulin (4) exhibited anti-HIV-1 inhibition at IC50 = 4.7 nM, 4.3 and 4.5 μg/mL respectively. The results obtained from this study support the potential of C. macrostachyus, as a source of anti-HIV constituents.

Introduction: Saudi Arabia can be considered a hot spot for Methicillin-resistant Staphylococcus aureus (MRSA) infections with significant regional variations. As far as we know, this is the first study to evaluate the prevalence of MRSA in clinical samples obtained from Turaif general hospital (TGH), Northern Area-Saudi Arabia, and screening the resistance profile to the most regularly used antimicrobials as an indicator for evaluation of the implemented infection control measures. Methodology: Totally, 410 Samples were collected from patients in TGH with clinically suspected nosocomial infections. MRSA isolates were identified by the classical bacteriological, biochemical, and cefoxitin-based methods as recommended by the Clinical Laboratory Standard Institute. Confirmation of isolates and testing of their antimicrobial susceptibilities were performed by the automated Vitek 2 compact system. Results: Totally, 130 nosocomial isolates were detected. Staphylococcus aureus (29.23%) was the most frequently isolated Gram-positive pathogen. MRSA represented 39.47% of Staphylococcus aureus and 11.54% of all isolates. MRSA-causing surgical site infections were the most predominant type of MRSA nosocomial infections representing (25.00%). Recent antibiotic therapy, prolonged hospital stays, and indwelling devices were significant risk factors for the development of MRSA infections. Although all MRSA isolates were sensitive to vancomycin, teicoplanin, linezolid, Fosfomycin, and tigecycline, many isolates were resistant to other tested antimicrobials. Conclusions: Hospital administrators should strengthen the ideal use of antibiotics according to the local hospital policy to control the selective drug pressure on Staphylococcus aureus strains with minimizing exposure to the risk factors by implementing the proper infection control policies.

Background:In 2019, the coronavirus pandemic emerged, resulting in the highest mortality and morbidity rate globally. It has a prevailing transmission rate and continues to be a global burden. There is a paucity of data regarding the role of long non-coding RNAs (lncRNAs) in COVID-19. Therefore, the current study aimed to investigate lncRNAs, particularly NEAT1 and TUG1, and their association with IL-6, CCL2, and TNF-α in COVID-19 patients with moderate and severe disease. Methods: The study was conducted on 80 COVID-19 patients (35 with severe and 45 with moderate infection) and 40 control subjects. Complete blood count (CBC), D-dimer assay, serum ferritin, and CRP were assayed. qRT-PCR was used to measure RNAs and lncRNAs. Results: NEAT1 and TUG1 expression levels were higher in COVID-19 patients compared with controls (P<0.001). Furthermore, CCL2, IL-6, and TNF-α expressions were higher in COVID-19 patients compared to controls (P<0.001). CCL2 and IL-6 expression levels were significantly higher in patients with severe compared to those with moderate COVID-19 infection (P<0.001). IL-6 had the highest accuracy in distinguishing COVID-19 patients (AUC=1, P<0.001 at a cutoff of 0.359), followed by TUG1 (AUC=0.999, P<0.001 at a cutoff of 2.28). NEAT1 and TUG1 had significant correlations with the measured cytokines, and based on the multivariate regression analysis, NEAT1 is the independent predictor for survival in COVID-19 patients (P=0.02). Conclusion:In COVID-19 patients, significant overexpression of NEAT1 and TUG1 was observed, consistent with cytokine storm. TUG1 could be an efficient diagnostic biomarker, whereas NEAT1 was an independent predictor for overall survival.

Introduction: Efforts have been made to contain COVID-19. Human behavior, affected by knowledge and perceptions, may influence the course of disease. Methodology: A structured questionnaire was used to collect data from 422 participants. It consisted of 28 questions in four sections; seven questions about sociodemographic characteristics of participants, 12 questions to estimate level of knowledge about COVID-19, six questions to evaluate attitudes toward disease, and three questions to assess practices to prevent disease transmission. Results: Their overall understanding of COVID-19 was satisfactory. 69% of the participants had satisfactory levels of knowledge, and the main sources of information were social media platforms (79.70%) and television (70.90%). There was a significant difference in knowledge as a function of gender (p = 0.50), occupation (p = 0.012), and smoking (p = 0.041). The participants held optimistic attitudes and adopted appropriate protective measures. Most participants agreed that COVID-19 can cause death (64.7%), poses greater risks to elderly (93.4%) and those with chronic diseases (96.7%), it is mandatory to quarantine infected individuals (98.1%), preventive health measures are important (97.6%), and health authorities will succeed in controlling the pandemic (67.5%). There was a statistically significant association between satisfactory levels of knowledge and the practice of wearing masks and the adoption of protective measures (avoiding crowded places, frequent hand washing). Conclusions: Residents of Al-Jouf region in Saudi Arabia have satisfactory levels of knowledge, optimistic attitudes, and good practice during the rapid rise period of the pandemic. Awareness campaigns will improve any misbeliefs and risky behaviors.

This work was carried out in collaboration between all authors. All authors planned and designed the study, wrote the protocol, collected the samples, performed the practical laboratory activities, participated in the interpretation of the results and analysis, drafted and critically revised the manuscript. All authors read and approved the final manuscript.

Systemic lupus erythematosus (SLE) is a chronic autoimmune illness with a growing prevalence in many populations. Few studies have examined genetic predisposition to SLE, so we aimed to examine the clinical impact of the genetic polymorphisms MECP2 rs2734647and TIRAP rs8177374 on the outcomes and therapeutic precision of SLE with and without nephritis. This study included 110 SLE patients—divided into 63 with lupus nephritis (LN), and 47 without nephritis—and 100 controls. Laboratory measurements including CRP, ESR, ACR, CBC, anti-ds-DNA, vitamin A, C3, and C4 were carried out, along with genotyping of MECP2 rs2734647and TIRAP rs8177374 by real-time PCR and sequencing. Treg %, vitamin A, C3, and C4 were lower, whereas Th17 % was higher, in patients vs. controls (p < 0.001). The T allele of MECP2 rs2734647 was higher in LN than in non-nephritis and control subjects. Moreover, the T allele of TIRAP rs8177374 was higher in LN than in non-nephritis and control subjects. The MECP2 and TIRAP genes could play a role in predisposition to SLE, and can also predict disease progress to nephritis, helping to personalize medicine.