Chronic spontaneous urticaria (CSU) is considered as an autoimmune disorder in around 30-50% of cases and referred to as chronic autoimmune urticaria. T regulatory cells (Tregs) may be involved in the pathogenesis of CSU. However, their exact role has not yet been fully defined in those patients. This study aimed to investigate the possible role of Tregs cells subsets in CSU patients. In a case-control study, conducted at dermatology clinics, Suez- Canal University Hospitals, Ismailia, Egypt; 25 CSU patients and 25 apparently healthy control blood donors with matched age and gender were recruited. CSU patients were subjected to history taking, physical examination, assessment of urticaria activity score (UAS) and autologous serum skin test (ASST). Blood samples were obtained from both groups to estimate the number of Tregs cells by flow cytometric analysis. The mean values of CD4+ Fox P3+ and CD4+ FoxP3+ CD25+ Tregs in the study cases were increased significantly compared to the controls (Mean ± SD, ]73.51±26.63[ vs ]4.68±2.98[; P= 0.001 and ]0.97±0.59[ vs ]0.56±0.36 [; P =0.003), respectively. However, the mean values of CD4+ CD25+ Tregs were decreased significantly in CSU patients compared to the controls (0.27±0.38 vs 3.63±1.44, P= 0.001). Mean levels of CD4+CD25+ and CD4+ CD25+ FoxP3+ Tregs cells decreased in positive ASST group in comparison to the ASST negative group, but this decrease did not reach statistical insignificance. In conclusion, our data indicated that CSU was associated with alterations in circulating Tregs cells subsets supporting the autoimmune theory.
Background: Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) can be eradicated by topical mupirocin application. Mupirocin resistance, on the other hand, is becoming more widespread. Objective: The present work aims to compare conventional and molecular approaches to detect the prevalence of mupirocin resistance in MRSA isolates from clinical and nasal samples, as well as to investigate their susceptibility to other antibiotics. Methodology: Our study included 60 MRSA nonduplicate isolates, 14 from surgical wounds, 16 from urinary tract infections from patients hospitalized to Suez-Canal University Hospital in Ismailia, Egypt, and 30 nasal swabs from health care workers. The minimum inhibitory concentrations (MICs) for MRSA isolates to mupirocin were determined using the E-test method, and PCR targeting the mupA gene was performed. Results: Six isolates out of 60 MRSA isolates (10%) showed high-level mupirocin resistance, while just one strain (1.6%) showed lowlevel mupirocin resistance. Four of the six MRSA isolates with high levels of mupirocin resistance carried the mupA gene. All seven mupirocin-resistant isolates (11.6%) were isolated from nasal swabs. MRSA strains resistant to mupirocin were more resistant to tetracycline, chloramphenicol, gentamycin, ciprofloxacin, and trimethoprimsulfamethoxazole than mupirocin-susceptible ones. Conclusion: The high prevalence of mupirocin resistance in MRSA strains at our hospital is alarming. As a result, frequent testing of MRSA for mupirocin resistance is recommended even in settings where mupirocin is not used prophylactically.
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