BACKGROUNDInterferon gamma release assays (IGRA) is highly specific for Mycobacterium tuberculosis and is the preferred test in BCG-vaccinated individuals. The few studies that have screened health care workers (HCWs) in Saudi Arabia for latent tuberculosis infection (LTBI) using IGRA have varied in agreement with the traditional tuberculin skin test (TST).OBJECTIVEAssess the prevalence of LTBI among HCWs working in the Hajj pilgrimage using IGRA and TST and measuring their agreement.DESIGNCross-sectional prospective.SETTINGMultiple non-tertiary care hospitals.PATIENTS AND METHODSHCWs who worked during the Hajj pilgrimage in Saudi Arabia in December 2015. Data was collected by standardized questionnaire. Samples were drawn and analyzed by standard methods.MAIN OUTCOME MEASURESThe prevalence of LTBI among HCW and the agreement by kappa statistic between QFT-GIT and TST.SAMPLE SIZE520 subjects.RESULTSThe sample included 30.7% nurses and 19.2% physicians. The majority were BCG vaccinated (98.5%). There were a total of 56 positive by QFT-GIT and the LTBI rate was 10.8%. In 50 QFT positive/476 TST negative the LTBI rate was 10.5% in discordant tests, and in 6 QFT positive/44 TST positive it was 13.6% in concordant tests. The overall agreement between both tests was poor—83% and kappa was 0.02. LTBI prevalence was associated with longer employment (13.1 [9.2] years). The QFT-GIT positive test was significantly higher in physicians (P=.02) and in HCWs working in chest hospitals 16/76 (21.05%) (P=.001).CONCLUSIONAgreement between the tests was poor. QFT-GIT detected LTBI when TST was negative in HCWs who had a history of close contact with TB patients.LIMITATIONSA second step TST was not feasible within 2–3 weeks.

This work was carried out in collaboration between all authors. Author SAMA designed the study, performed the laboratory work, managed the literature searches, managed the analyses of the results and wrote the first draft of the manuscript. Author ZZA wrote the protocol, participated in the designing of the study, participated in the performing the laboratory work and reviewed of the manuscript. Author HAY participated in the designing of the study, recruited the cases, performed the statistical analysis and reviewed of the manuscript. Author AMA managed the literature searches, recruited the cases, shared in analyses of the results and reviewed of the manuscript. All authors read and approved the final manuscript.

BackgroundLivin gene and Yes-Associated Protein 1 (YAP1 (play a pivotal role in organ size control and tumorigenesis.AimIn the present pilot study, we investigate the expression of Livin gene and YAP1 in hepatitis C virus (HCV) associated hepatocellular carcinoma (HCC) compared to other HCV patients and controls.Methods: the studied patients were divided into three groups 30 patients in each group in addition to 30 healthy subjects as a control group. Relative quantification of Livin gene and YAP-1 were assessed by quantitative Real Time RT-PCR (qPCR) in all studied patients and healthy controls. other laboratory investigations were done including complete blood count (CBC),international normalized ratio (INR) as well as liver function tests and tumor markers.ResultsSignificant overexpression of Livin gene and YAP-1 was detected in HCC group followed by Hepatitis C Virus (HCV) untreated group then HCV treated group. The relative quantitation (RQ) of both genes showed positive correlation to the carcinoembryonic antigen (CEA) level and a significant relation was found between higher level of Livin and YAP1 genes and tumor size. The overall survival rate was low in those patients with high levels of Livin and YAP 1 genes so they were considered as indicators of a bad prognosis.ConclusionThere is overexpression of Livin gene and YAP1 in hepatocellular carcinoma patients. They can be used as indicators of bad prognosis of the disease pathway together with low survival rate.

Background: Neonatal sepsis (NS) due to K. pneumoniae is a major cause of morbidity and mortality in neonates. This study aimed to study the risk factors of NS caused by K.pneumoniae in NICU in Menoufia University Hospitals and to detect rmpA and magA virulence genes and CTX-M antibiotic resistance gene. Correlation between compliance of infection control measures and occurrence of NS and its outcome were also evaluated. Methods: Klebsiella pneumoniae were isolated from blood of neonates with sepsis and studied for hypermucovicosity by string test and detection of rmpA and magA genes. ESβL production was studied by cephalosporin/clavulanate combination disks and expression of CTX-M gene groups. Hand hygiene and other infection control measures compliance were evaluated by observational and practical methods. Results: Klebsiella pneumoniae was the most frequently isolated organism (31.6%) among neonates with confirmed sepsis. Hypermucoviscous phenotype was detected by string test in 39.6% of isolates while rmpA and magA genes were found in 47.9% and 8.3% respectively. ESβL production was confirmed in 75% (by cephalosporin/clavulanate combination disk). The CTX-M gene was found among 77.8% of ESβL-producing K. pneumoniae isolates. There was a negative correlation between hand hygiene and other infection control measures compliance and occurrence of NS. Conclusion: Virulence and antimicrobial resistance genes are common among K. pneumoniae isolated from neonates with sepsis in our locality. Implementation of infection control measures and proper antimicrobial stewardship programs may be helpful to overcome this problem..

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