Ultrastructure and types of fimbriae in uropathogenic E-coli among bilharzial patients

The aim of this work was to study the association of different types of fimbriae of urinary E coli isolates with different disease entities. We collected a total of 57 urinary E. coli isolates from 3 groups of bilharrzial patients: group 1: with cystitis [21 isolates]; group 2: with pyelonephritis [18 isolates] and group 3: with urinary bladder carcinoma [18 isolates]. Each isolate was studied for: I. Fimbrial expression and type determination by haemagglutination [HA] of human and guinea pig erythrocytes. II. Electron microscopic [E/M] structure using negative staining, standard transmission and scanning electron microscopy. It was found that infection with mannose sensitive type 1 fimbriated E. coli dominated in group 1 and 3 [80.95% and 77.78% respectively]. In group2 [55.56%] were caused by mannose resistant P fimbriated E. coli. Although there was a perfect correlation between HA and the presence of fimbiriae by E/M [P< 0.01], yet E/M detected other types of fimibriae which could-have been missed by HA alone. Negative staining was the best technique in electron microscopy. We concluded that detection of P flimbriae in urinay E. coli strains may justify a vigorous antibiotic treatment to prevent development of pyelonephritis. Although type 1 fimbriae was associated with simple cystitis, yet follow up and complete investigations are recommended to detect an associated carcinoma

Ultrastructure and types of fimbriae in uropathogenic E-coli among bilharzial patients

The aim of this work was to study the association of different types of fimbriae of urinary E coli isolates with different disease entities. We collected a total of 57 urinary E. coli isolates from 3 groups of bilharzial patients: group 1: with cystitis [21 isolates]: group 2: with pyelonephritis [18 isolates] and group 3: with urinary bladder carcinoma [18 isolates]. Each isolate was studied for: I-fimbrial expression and type determination by haemagglutination [HA] of human and guinea pig erythrocytes, II- Electron microscopic [E/M] structure using negative staining, standard transmission and scanning electron microscopy. It was found that infection with mannose-resistant type I fimbriated Ecoli dominated in group 1 and 3 [80.95% and 77.78% respectively]. In group 2. 55.56% were caused by man- nose resistant P fimbriated Ecoli. Although there was a perfect correlation between HA and the presence of fimbriae by E/M [p< 0.01], yet E/M detected other byres of fimbriae which could have, been missed by HA alone. Negative staining was the best technique in electron microscopy. We concluded that detection of P fimbriae in urinay Ecoli strains may justify a vigorous antibiotic treatment to prevent development of pyelonephritis. Although type I fimbriae was associated with simple cystitis, yet follow up and complete investigations are recommended to detect an .associated carcinoma

Gamma interferon as a diagnostic marker for tuberculous pleural effusion

This study was performed on 74 patients [45 males and 29 females] suffering from pleural effusion due to different etiologies to evaluate the use of gamma interferon [IFN-gamma] as a diagnostic marker for tuberculous pleural effusion. The patients were classified into five groups according to one or more of the following criteria: Clinical examination, tuberculin intradermal test, histopathological and microbiological examination of both sputum and pleural fluid by ZN stains and culture on Bactec-460 [Becton Dickinson]. The five groups were tuberculous effusion group [30 patients], malignant effusion group [11 patients], empyemic effusion group [10 patients] and nonspecific effusion group [14 patients]. For each pleural effusion, glucose, total protein and albumin were estimated calorimetrically and IFN-gamma was evaluated by radio-immunoassay technique

Role of preoperative antibiotics prophylaxis in reducing bacteraemia after open and closed heart surgery

In a trial to find out how effective is the currently used regimen of administration of prophylactic antibiotics before cardiac surgery, this study was conducted on 3 groups of patients undergoing cardiac operations. The first group included 15 patients undergoing closed heart surgery and receiving no preoperative antibiotic prophylaxis. The second included 15 patients also undergoing closed heart surgery but receiving preoperative antibiotic prophylaxis. The third group included 30 patients undergoing open heart surgery and receiving preoperative antibiotic prophylaxis. Postoperative aerobic and anaerobic blood cultures were done to all patients, the incidence of postoperative bacteremia and the type of isolated microorganisms were used for evaluation of antibiotic efficacy. The study showed a significant difference in the incidence of postoperative bacteremia between patients with closed heart surgery who did not receive and those who received antibiotic prophylaxis [P <0.0005]. Postoperative bacteremia in open heart surgery was significantly higher than in closed heart surgery when all patients received prophylactic antibiotics [P <0.001]

Rheumatic fever activity in patients on regular penicillin prophylaxis

During the follow up of 740 rheumatic patients whose main clinical presentation to the Cardiology Clinic of the Pediatric Hospital, Cairo University was arthritis, 250 patients compliant to regular prophylaxis with benzyl penicillin G [BPG], 12 or more injections in one year, were studied for rheumatic fever [RF] recurrence. Clinical RF activity was detected in 28 patients [11.2%], 16 males and 12 females whose ages ranged 4-12 years. RF activity in the form of arthritis was detected in 14/28 cases [50%], carditis by auscultating new murmurs was detected in 9/28 cases [32.14%] and 5/28 cases [17.85] had chorea. Serum penicillin level was measured for all patients who showed clinical RF activity at the end of 3rd and 4th weeks after giving penicillin, by the agar-diffusion microbiological assay. Serum penicillin levels were below minimal therapeutic level [0.03 ug/ml] in 4/28 patients [14.28%] at the end of the 3rd week, 3 with carditis and one with arthritis. Two more cases with carditis in addition to the previous 4 cases showed low serum penicillin levels by the end of the 4th week, 6/28 cases [21.42%], both had carditis. None of the chorea patients had low serum penicillin levels at the end of 3rd or 4th week. Acute phase reactants and ASLO titers were not correlated with the presence of RF activity or low serum penicillin levels. It is concluded that RF recurrence occurs among patients on strict BPG prophylaxis, but with no evidence of streptococcal infection, other factors such as concomitant viruses or bacteria, or host factors may be responsible and needs further investigations

Bacteriological study of urine in children suffering from urinary schistosomiasis

To clarify the association between urinary tract infection [UTI] and urinary schistosomiasis, 100 children [9-12 years] having urinary schistosomiasis and 100 age and sex matched normal children were randomly selected. Urine samples were cultured and viable bacterial counts were determined. Out of the 100 bilharzial children, 11% showed significant bacteriuria [> 10[5]/ml] the isolated bacterial pathogens were E.coli [4 cases] coagulase negative staph [3 cases], Klebsiella [l case], proteus [l case] staph aureus [l case] and one case with mixed infection by E. coli and non-haemolytic streptococci. In the control group only 3 cases showed significant bacteriuria. The isolated bacteria were E. coli, Klebsiella and coagulase negative staphylococci [each from one sample]