Background: Enterococci are intrinsically resistant to clinically achievable concentrations of aminoglycosides. However, high-level resistance to aminoglycosides (HLAR) is primarily due to the acquisition of genes encoding aminoglycoside-modifying enzymes (AMEs). Aminoglycosides along with cell wall inhibitors are given clinically for treating enterococcal infections. The current study was conducted to investigate the rate of HLAR and to determine aminoglycoside resistance encoding genes profile in enterococcal isolates from different clinical specimens. Results: From 120 Enterococcus species, 50 (41.7%) enterococcal isolates were proven to have HLAR, 78% (39/50) have high-level gentamicin resistance (HLGR), and 74% (37/50) were high-level streptomycin-resistant (HLSR). HLGR isolates carried aminoglycoside modifying gene aac (6′)-Ie-aph (2′)-Ia in 26/39 (66.7%) of isolates, whereas 32/37 (86.5%) of HLSR carried aph (3′)-IIIa gene and were observed in E. faecalis, E. faecium, E. gallinarum, and E. casseliflavus. The aph (2′)-Ib, aph (2′)-Ic, and aph (2′)-Id that encode HLGR could not be detected. Conclusions: The high detection rate of HLAR among the studied Enterococcus species and the coexistence of HLGR and HLSR strains provide crucial insights to the necessity of routine testing for HLAR in the microbiology lab. The main AME genes among HLGR and HLSR enterococci were aac (6′)-Ie-aph (2″)-Ia and aph (3′)-IIIa, respectively.
Helicobacter pylori, PCR, rapid urease test, stool antigen. was revealed in 27(45%) and 10 (16.7%) had peptic ulcer disease (PUD). Conclusions: H. pylori infection rate in Egyptian patients with dyspepsia was high and gastritis was the most revealed finding upon endoscopy. No risk factors were associated with H. pylori infection among the studied adult patients. Combined rapid urease and stool antigen tests can be relied upon for detecting H. pylori infection.
The present study was designed to investigate the prevalence of herpes simplex virus type-2 (HSV-2) in Egyptian patients with bladder cancer or cystitis and to evaluate the performance of different diagnostic HSV-2 assays. The study included 50 patients: 27 with bladder cancer (group I), 23 with cystitis (group II) and 20 subjects as controls (group III). HSV-2 DNA was detected using polymerase chain reaction (PCR) on bladder tissue and buffy coat cells (BCC). Electron microscopic studies (EMS) on BCC and ELISAs for IgM, IgG and specific glycoprotein G-2 (gG-2) IgG were performed. HSV-2 DNA was detected by PCR on bladder tissue biopsies in 29.6% and 21.7% of group I and II respectively and it was also detected by PCR on BCC in 22.2% and 21.7% of group I and II respectively. EMS revealed HSV like particles in 16.6% of cases. IgG, specific gG-2 IgG and IgM were detected in 30%, 16% and 6% of cases respectively. The different assays were evaluated in relation to PCR on bladder tissue biopsies. The gG-2-based ELISA and EMS on BCC were found to be highly specific (97.3% and 100% respectively), with similar low sensitivity of approximately 54%. PCR on BCC was the most sensitive assay. The association of HSV-2 with bladder cancer is suggested especially in schistosomal patients.
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.
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