Background: Neonatal septicemia is a serious life-threatening condition with high mortality. The accurate diagnosis of sepsis is one of the main challenges in emergency medicine. A great effort to reduce the neonatal mortality rate is put into looking for new reliable biomarkers. Among biomarkers, presepsin could be one of the most promising and reliable biomarker for early diagnosis of sepsis. Objective: We aimed to evaluate the diagnostic value of presepsin in the early diagnosis of neonatal sepsis. Methodology: By chemiluminescent enzyme immunoassay (CLEIA), the level of presepsin was assessed in 40 full term neonates with suspected sepsis (Proven sepsis group: 23 patients with +ve blood culture & Probable sepsis group: 17 patients with-ve blood culture) and15 healthy full term neonates. Results: Presepsin level was found to be significantly higher in patient group than control group as well as in proven sepsis group than probable sepsis group. The cut off value for presepsin was 875pg/ml at which the sensitivity and specificity of presepsin were (95.7%, 87.5%) respectively. Presepsin level was found to be significantly higher in females than males. There was no significant difference in the presepsin level as regard mode of delivery nor onset of sepsis. Conclusion: Presepsin is a novel biomarker with high sensitivity and good specificity for sepsis and its measurement can be useful for early diagnosis of neonatal sepsis.

Background: Human bocavirus (HBoV) infection possibly plays a role in gastroenteritis because of the frequent manifestation of gastrointestinal symptoms. Objectives: Detect human bocavirus (HBoV) and assess its prevelance among gastroenteritis associated viral agents in infants with gastroenteritis in Benha University Hospital. Methodology: The study was carried out on 100 stool samples collected from 100 infants with acute gastroenteritis for detection of Rotavirus (RV), Norovirus (NoV) & Astrovirus (AstV) by multiplex reverse transciptase polymerase chain reaction and detection of Adenovirus(AdV) & HBoV by multiplex polymerase chain reaction. Results: Viral agents were detected in 57 (57%) samples; 51 (51%) samples show mono-infection while 6 (6%) samples show co-infection. Rotavirus, Norovirus, Adenovirus and astrovirus were detected in 37%, 14%, 7.0%, and 3% of the study population, respectively; HBoV was detected in 2%. Conclusion: This percentage of HBoV suggests that it might play a minor role in gastroenteritis.

Background: CD26 has a role in the pathogenesis of inflammation and participates in degrading interferon-γ-induced chemokine and inflammatory cytokines which have a role in Systemic lupusErythematosus (SLE) pathogenesis. Objectives: This work was carried out to evaluate the level of CD26 mRNA expression in the peripheral blood leucocytes of SLE patients by quantitative RT-PCR and correlates this level with the disease activity and lupus nephritis. Methodology: thirty SLE patients' blood samples were obtained, leucocytes were isolated and the level of CD26 mRNA expression was evaluated by RT-PCR. Twenty healthy subjects matched for age and sex were chosen as a control group. All cases were subjected to full history taking, thorough clinical exanimation and laboratory investigations. The disease activity was evaluated with systemic lupus erythematosus disease activity index (SLEDAI).. Patients were subdivided into: 12 SLE patients with lupus nephritis and 18 SLE patients without lupus nephritis. Results: CD26 mRNA expression increased 1.28 fold in SLE patients compared to the controls (p<0.05) with no significant correlation between CD26 mRNA expression and SLEDAI score. No significant difference (p>0.05) was found among patients with and those without lupus nephritis. Conclusion: Our results support the hypothesis that CD26 mRNA plays a role in the pathogenesis of SLE; however it is not a good predictor of SLE disease activity or lupus nephritis.

Background: Antimicrobial resistance is one of the most serious public health threats of the twenty-first century, Uropathogenic Escherichia coli (UPEC) are one of the main bacteria causing urinary tract infections (UTIs). The rate of UPEC with high resistance towards antibiotics has increased dramatically in recent years. Objectives: This study aimed to assess the antibiotic resistance pattern of UPEC and to detect the relationship of antibiotic resistance with the presence of efflux pump genes (AcrA-AcrB-TolC). Methodology: This study included 50 UPEC strains, Identification of E.coli by Gram stain, culture and biochemical reactions was done, Antibiotic susceptibility for isolated E.coli strains by vitek system and detection of AcrA-AcrB-TolC genes by conventional PCR among isolated strains were also performed. Results: the prevalence of MDR was 70%,UPEC isolates showed high level of resistance to : ampicillin(94%), nalidixic acid (84%), ticacillin (82%), ciprofloxacin (76%) and trimethoprim/sulfamethoxazole (76%), low level of resistance of UPEC to:gentamicin (34%), amoxicillin/clavulinic acid (28%), ceftazidime (21%), cefoxitin (16%), piperacillin/ tazobactam (8%), tobramycin(2%) and ertapenem (2%) but no resistance to amikacin , imipenem and nitrofurantoin. 50%, 66% and 68% of isolates had genes acrA, acrB and tolC respectively. there was a significant correlation between tol C gene and MDR phenotype. Conclusion: the rate of MDR UPEC is rising, efflux pumps play an important role in mediating antibiotic efflux and increase the rate of antibiotic rasistance. The frequency of tol C gene was significantly higher in MDR than non MDR, while the acr A B level showed non significant variation among MDR and non MDR.

Background: Cathelicidin (LL-37) comprises one of several types of antimicrobial peptides that have a vital role in the innate defense against the urinary tract infection (UTI). Objectives: Is to evaluate the diagnostic role of LL-37 in UTI. Methodology: Urine specimens were collected from 70 patients with clinically suspected UTI and from 20 healthy controls. Culture of urine and sensitivity to antimicrobials were tested. LL-37 urinary levels were measured in all participants using an enzyme-linked immunosorbent assay (ELISA). Results: Based on the results of urine culture, the patient group were classified into: 50 patients with culture positive urine (proven UTI) and 20 patients with culture negative urine (suspected UTI). Urine from all control subjects were culture negative. There is significant rise in the level of LL-37 among proven UTI group in comparison with suspected UTI and control groups (p<0.001), while, there is nonsignificant increase in the LL-37 level among suspected UTI group when compared with control group. There is a significant positive correlation between LL-37 level and bacterial count among proven UTI group (rho=0.442, P=0.003). ROC curve showing excellent ability of LL-37 to differentiate between proven and suspected UTI (AUC=0.982, P=<0.001). The uropathogenic Escherichia coli was the predominant isolate, n = 22 (44%). 67% of the isolates were multidrug resistant (MDR). There is nonsignificant relation between LL-37 levels and type of organisms isolated from urine (p=0.54). Conclusion: LL-37 can be considered as a good diagnostic marker for UTI.