Implementation of a sustainable surveillance system in a resource-limited country was possible following a stepwise approach with continuous evaluation. Enhancing infection prevention and control programs should be an infection control priority in Egypt.

Background. Methicillin-resistant Staphylococcus aureus (MRSA) has created significant epidemiological, infection-control, and therapeutic management challenges during the past three decades. Aim. To analyze the pattern of resistance of healthcare- and community-associated MRSA in Egypt and the trend of resistance of HA-MRSA over time (2005–2013). Methods. MRSA isolates were recovered from healthcare-associated (HA) and community-associated (CA) Staphylococcus aureus (S. aureus) infections. They were tested against 11 antimicrobial discs and the minimal inhibitory concentration (MIC) of vancomycin was determined. Inducible clindamycin resistance (iMLSB) was also screened using D-test. Findings. Of 631 S. aureus, MRSA was identified in 343 (76.6%) and 21 (11.5%) of HA and CA S. aureus isolates, respectively. The proportion of HA-MRSA increased significantly from 48.6% in 2005 to 86.8% in 2013 (p value < 0.001). Multidrug resistance (MDR) was observed in 85.8% of HA-MRSA and 48.6% of CA-MRSA. Vancomycin intermediate resistant S. aureus (VISA) was detected in 1.2% of HA-MRSA and none was detected in CA-MRSA. Among HA-MRSA strains, 5.3% showed iMLSB compared to 9.5% among CA-MRSA. Conclusion. The upsurge of the prevalence rates of HA-MRSA over time is alarming and urges for an effective infection control strategy and continuous monitoring of antimicrobial use.

This study shows the insufficient effectiveness of HBsAg screening in protecting blood recipients from HBV infection. Inclusion of anti-HBc testing should be considered in the screening of blood donors.

With more classrooms within higher education mobilizing strategies for internationalization, collaborative online international learning (COIL), also referred to as virtual exchange, is an effective approach at offering intercultural competence through experiential learning. This strategy provides students who face barriers to international travel the opportunity to engage with students from other countries in meaningful ways, while enhancing and reinforcing course content. Grounded in the transformative learning theory, this study evaluates the effectiveness of a virtual exchange that was implemented within an undergraduate global public health course. The virtual exchange connected students from the University of Florida (within the US) with medical students in a microbiology course at Ain Shams University in Cairo, Egypt. Using adapted reflection prompts, we assessed the students' knowledge and learning before, during, and after the virtual exchange. This was coupled with a final paper to capture how personal backgrounds and experiences may contribute to their perception of the virtual exchange, as well as if they felt their global perspective had changed or shifted during the experience. Using directed content analysis for each of the measurements, two researchers coded the data independently to then present agreed upon salient themes to the larger group. Of the 28 randomly sampled students who participated in the virtual exchange, seven major themes emerged from the data: Connectedness; Openness; Acquisition of Knowledge and Skills; Communication; Cultural Identity; Anticipation of Options for New Roles, Relationships, and Actions; and Absence of Change. Through this evaluation it was clear there was a variance of different perspectives with many sampled students having diverse lived experiences that influenced their worldview prior to the virtual exchange. Despite course-related barriers, students acknowledged several facilitating factors that improved their intercultural competence and knowledge of course content. The integration of a virtual exchange within the classroom, with careful design and implementation, can provide a unique experience for students and an inclusive approach to learning.

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Background:The use of fetal membranes as a graft has gained a lot of attention since 1910 and ever since it has been used in clinical practice notably in ocular surgeries and in the treatment of burns and skin ulcerations. Amnion graft should be sterile, free of contamination, easily obtained and can be stored for long periods of time without affecting graft integrity. Methods currently used to preserve amnion graft include hypothermic (fresh) storage, freezing, freeze drying and gamma irradiation. For any storage method selected assessing any potential bacterial or fungal contamination is profoundly important to ensure the safety of the stored graft. Objectives: In this study, five different preservative media commonly used in Egypt for storing amnion graft hypothermally were evaluated microbiologically to select the optimum preservation method. Methodology: A total of 40 amnion grafts were obtained from consented women delivered by elective caesarean section. The graft of each donor was split into 7 pieces, two pieces from each donor were cultured immediately after collection to exclude contaminated grafts. The remaining 5 pieces of non-contaminated grafts were stored in five preservative media at 4°C for three weeks: Sodium hypochlorite 0.025% , Glycerol 85%, Gentamycin (0.32 mg/ml) in 100% Phosphate-buffered saline (PBS), Penicillin G (50,000 IU/ 100 ml), and a mixture solution comprised of Streptomycin (50mg/ml), Penicillin (50 mg/ml), and Amphotericin B (2.5 mg/ml) were used for preservation. By the end of each week the pieces were cultured onto aerobic and anaerobic media and the recovered colonies were identified. Results: 25 grafts out of 40 were included in the study. The findings of the study revealed that the contamination was observed in three preservative media, the highest of which was Penicillin G followed by Garamycin and the least contamination proportion was identified in the mixture solution (96% 88% and 44% respectively). The contaminants were mainly Filamentous fungi (69.3%) and Candida albicans (4%) while Staphylococcus aureus was only recovered in two specimens (2.6%). Glycerol 85% and Sodium hypochlorite were free from contamination all over the storage period. Conclusion: The preservation of amnion graft in glycerol 85% and sodium hypochlorite 0.025% were proved to be the optimum media for preservation up to three weeks from a microbiological perspective.

Background Coronavirus disease 2019 (COVID-19) is a devastating pandemic-causing disease with a variable severity among populations. Genetic studies have pinpointed angiotensin-converting enzyme 2 (ACE2), a key enzyme for viral entry, for its possible linkage to the disease progression. The present study aimed to investigate the potential association between single nucleotide polymorphisms (SNPs) of human ACE2 gene with the severity and outcomes of COVID-19 for better patient management. Methods In this observational cross-sectional study, COVID-19 confirmed patients were classified into moderate and severe cases according to the “Ain Shams University Hospitals Pocket Guide for COVID-19 Diagnosis.” Genetic analysis of ACE2 SNP rs2048683 was carried out using a TaqMan assay with the real-time polymerase chain reaction (PCR) technique. Results Among 90 confirmed COVID-19 patients, 78.9% (71/90) were classified as severe, and 21.1% (19/90) were classified as moderate. Laboratory biomarkers were significantly (P = 0.000) higher in the severe group than in the moderate group. Similarly, associated comorbidities such as hypertension were significant (P = 0.000) in the severe group, whereas asthma and deep venous thrombosis were significant in the moderate group (P = 0.007 and 0.006, respectively). Elevated serum ferritin level (odds ratio (OR) 162.589, 95% confidence interval (CI) 8.108–3260.293) and ACE2 rs2048683 genotype GG/G (OR 5.852, 95% CI 1.586–21.591) were both considered independent risk factors for severe disease. Conclusion The findings of the present study provide preliminary evidence of an association between ACE2 rs2048683 SNPs and COVID-19 severity in the Egyptian population, which may inform the need for targeted management.