Objectives: To assess the capability of different orthodontic arch-wires to retain oral biofilm and to correlate the adhesion to surface roughness of the wires. Methods: Four types of orthodontic arch-wires were used for the study, Nickel-titanium (NiTi), Copper nickel-titanium (Cu-NiTi) , Beta Titanium (TMA) & Beta III Titanium (CNA) new arch wires and 4 weeks after intraoral usage, were examined for Surface roughness (SR) using an atomic force microscope (AFM). Adhesion of Streptococcus mutans (MS), Staphylococcus aureus (SA), and Candida albicans (CA) were performed using colony count method. Statistically, the following tests were done: analysis of variance, Pearson correlation coefficient test, post hoc Tukey test. Results: The four wire types showed significant increases in SR (P< 0.05) after 4 weeks of intra-oral usage, TMA wires recorded the highest roughness values while the lowest ones were for NiTi wires. Bacterial adhesion was detected on all wires, ANOVA showed significant differences between the wires concerning MS, SA and CA adhesion. A significant positive correlation (P=.001) was observed between bacterial adhesion and surface roughness after intra-oral exposure. Conclusions: SR of the wires increased after intra-oral use and there was a positive correlation with the biofilm adhesion.

Background Cancer and pulmonary tuberculosis are major global health concerns and are associated with substantial morbidity and mortality. The association between active tuberculosis and subsequent cancer development has been investigated for many years. This study was planned to determine the prevalence of latent tuberculosis infection in patients with recently diagnosed bronchogenic carcinoma. Methods Sixty-four newly diagnosed primary lung cancer patients were enrolled. Diagnosis of latent tuberculosis infection was performed with QuantiFERON-TB Gold In-Tube tests, with exclusion of active tuberculosis. Results Latent tuberculosis infection was detected in 16 (25%) patients, and 8 (12.5%) had indeterminate results of the QuantiFERON-TB Gold In-Tube test. Being a current smoker was associated with a higher prevalence of latent tuberculosis ( p = 0.001). Comorbidities, tumor site, and histopathology were not associated with latent tuberculosis infection. Conclusions There is a considerable risk of concurrent latent tuberculosis in newly diagnosed primary bronchogenic carcinoma. The need for treatment of latent tuberculosis in these patients and its influence on the outcome and prognosis are issues for further investigations.

Background and Aim: Pseudomonas aeruginosa (P. aeruginosa) is an important causative organism of burn infection. Several virulence factors are implicated in P. aeruginosa colonization and invasion, making P. aeruginosa infection's outcome worse. Type III secretion system (T3SS) effector proteins are among these virulence factors. The present study evaluated the frequency of genes encoding T3SS effectors as a virulence determinant in P. aeruginosa isolates from burn patients.Materials and Methods: Wound swabs were collected from burn patients admitted to the Plastic and Reconstructive Surgery Center, Mansoura University, Egypt, and identified by different microbiological testing methods. The modified Kirby Bauer's disc diffusion method was used to test the antibiotic susceptibility of P. aeruginosa isolates against different antibiotics. Prevalence and the presence of exo genes that encode type T3SS proteins (exoS, exoT, exoU, and exoY) in P. aeruginosa isolates were evaluated by the multiplex PCR. Chi-square and Fisher's test were used for statistical analysis.Results: A total of 45 P. aeruginosa isolates were identified from 101 burn patients, including 27 males and 18 females, with a mean age of 15.78±2.65 years old. P. aeruginosa isolates were mostly susceptible to piperacillin/tazobactam and imipenem (73.33 and 62.22%), respectively; while the lowest susceptibility rates were in ceftazidime (4.44%), Tobramycin (4.44%), and ceftriaxone (6.67%). The exoY and exoT genes were detected in 100% of the P. aeruginosa isolates, while 62.22% and 42.22% of clinical isolates harbored exoS and exoU genes, respectively. Conclusion:This study established a correlation between T3SS proteins, particularly exoS and exoU genes and antimicrobial resistance in P. aeruginosa isolates from burn infection.

Background A growing body of evidence suggests that ceftazidime/avibactam (CZA) is a potential therapeutic option for carbapenem-resistant Klebsiella pneumoniae (CRKP) infections; however, resistant strains are increasingly emerged worldwide. Herein, we deemed to investigate the susceptibility profile of CRKP isolates from cancer patients to CZA and to identify the underlying resistance mechanisms. Methods Clinical samples were obtained from adult patients admitted to the Oncology Center of Mansoura University, Mansoura, Egypt. The antibiotic susceptibility pattern of K. pneumonia e isolates to different antibiotics was tested by the modified Kirby Bauer’s disc diffusion method. Minimum inhibitory concentrations of CZA were assessed using broth microdilution method. Screening for carbapenemase-producing strains was achieved by the modified Hodge test. Multiplex polymerase chain reactions (PCRs) were conducted for uncovering of carbapenemase-encoding genes ( bla KPC , bla VIM , bla IMP , bla NDM-1 , and bla OXA-48 ), and outer membrane porin genes ( ompK35 and ompK36 ). Results A total of 12 CZA-resistant isolates were identified out of 47 CRKP isolates (25.5%). The MIC 50 and MIC 90 of CZA against CRKP were 1 and 64 µg/mL, respectively. Risk factors for CZA resistance included chronic kidney disease, mechanical ventilation, longer length of hospital stay, and ICU admission. The multivariate logistic regression demonstrated that longer length of hospital stay ( P =0.03) was the only independent predictor for acquisition of CZA-resistant isolates. The leading mechanism for CZA resistance was sustained by bla KPC (50%), meanwhile 16.7% and 8.3% of the CZA-resistant isolates harbored bla OXA-48 and bla OXA-48 / bla NDM-1 , respectively. The MBL-encoding genes bla NDM-1 and bla IMP were detected in 16.7% and 8.3% of the isolates, respectively. Absence of both ompK35 and ompK36 was observed in 58.3% of the CZA-resistant isolates. Conclusion CZA has displayed superior in vitro activity against CRKP isolates in comparison to other antibiotics; however, thorough molecular characterization of resistant strains is highly recommended in future studies to detect and monitor the emergence of further tackling strains.

T HE RESISTANCE of Candida to antifungal agents is an emerging global health problem, especially with the emergence of new species. Therefore, the focus has shifted to alternative agents like silver nanoparticles (AgNPs), received significant attention. The aim of this study was to evaluate the in vitro antifungal susceptibility of AgNPs against resistant Candida isolates from various clinical specimens. The antifungal effect of AgNPs was assessed by the broth microdilution method using different concentrations (0.062-1µg/ mL). The Minimum Inhibitory Concentration (MIC 50 ) and Minimum Fungicidal Concentration (MFC) of AgNPs were determined. As a result, of 109 recovered Candida isolates, 65.1%, and 34.9% were C. albicans and non-albicans Candida (NAC), respectively. Moreover, 35.8% of the Candida isolates were non-susceptible to conventional antifungal drugs. The MIC 50 of AgNPs against resistant isolates was lower (0.125-1µg/mL) than that of fluconazole (1-64µg/ mL), itraconazole (0.016-4 µg/mL), voriconazole (0.016-4µg/mL), and amphotericin B (0.016-1µg/mL). The scanning electron micrograph revealed that AgNPs treatment altered the cell morphology of Candida. In conclusion, AgNPs exhibited a notable fungicidal effect against resistant Candida isolates and may be an adequate substitute for antifungal agents.

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Background: Onychomycosis is fungal infection of nails. Dermatophytes, Candida species, and non-dermatophyte moulds are the commonest causes of onychomycosis. Objectives: This study assessed the frequency of non-dermatophyte moulds causing onychomycosis and their antifungal susceptibility. Methodology: Our study included106 nail specimens obtained from patients attending Mansoura University Hospital from October 2019 to March 2021. All samples were examined by standard mycological methods. Results: Onychomycosis was detected in 86 nail specimens. Dermatophytes were isolated from 7 cases (6.6%), non-dermatophyte moulds from 62 cases (58.5%), Candida species from 17 cases (16.0%), and the remaining 20 cultures were negative for fungal growth. Among non-dermatophyte moulds the predominant isolates were Aspergillus fumigatus (25.5%), Aspergillus niger (17.9%), Aspergillus flavus (3.8%), Alternaria alternata (2.8%) and Penicillium species (2.8%). The non-dermatophyte moulds were highly sensitive to itraconazole and ketoconazole. Conclusion: Nondermatophyte moulds are a common cause of onychomycosis that cause failure of therapy and should be considered in cases of onychomycosis.

Surgical site infections (SSIs) are still the most prevalent infections in health care facilities. The magnitude of the problem increased with the development of health care associated infections caused by Gram negative bacilli (GNB), which are resistant to Carbapenem antibiotics. This study aimed to assess the performance of various detection methods of carbapenemase-producing GNB; isolated from healthcare associated SSIs at different surgical units, Mansoura University Hospitals, Al-Dakahliya Governorate, Egypt. A total of 186 wound specimens were collected from patients showing symptoms and signs of SSIs; used for isolation of bacteria and then identification of these bacterial isolates according to colony morphology; microscopic examination and biochemical reactions. About 173 specimens were positive for bacterial pathogens; out of them 83 were GNB isolates. The most commonly isolated bacteria were; Klebsiella spp. 31 (37.3%), followed by Escherichia. coli 22 (26.5%), Pseudomonas. aeruginosa 17 (20.5%), Proteus spp. 10 (12.0%) and Enterobacter spp. 3 (3.6%). The antibacterial sensitivity testing of the total 178 bacterial isolates was assessed using the disc diffusion assay. Bacterial pathogens that were carbapenemase producers were tested using phenotypic, rapid colorimetric (Carba NP test) and genotypic methods. Among these isolated bacteria 31 (83.8%), 26 (70.3%) and 28 (75.7%) were carbapenem resistant; confirmed by MHT, Carba NP test and multiplex Polymerase chain reaction (PCR), respectively. Continuous screening of the bacterial antimicrobial susceptibility at local level and rational use of the antibacterial agents; is essential to decrease the emergence and spread of resistant bacterial pathogens.