ABSTRACT
Background: E.coli is the most common cause of urinary tract infection [UTI] both in the community and hospital settings. UropathogenicE.coli [UPEC] possesses a number of virulence factors that allow it to colonize and persist in the urinary tract. Of particular interest are the P pili and biofilm formation. The emergence of drug resistant E.coli is a global threat to the public health
Objectives: To determine the biofilm producing ability, antimicrobial susceptibility pattern, ESBL production and the presence of the adhesive pap gene [pyelonephritis associated pili] in E-coli strains isolated from Outpatients and Inpatients diagnosed with UTI
Methodology:The study was conducted on 40 Inpatients and 40 Outpatients diagnosed with UTI attending Ain Shams University Hospitals. E. coli Isolates were tested for antimicrobial susceptibility using disk diffusion method, ESBL production by ESBL detection discs, in vitro formation of biofilm on Congo red media, and detection of Pap gene using conventional PCR technique
Results: The prevalence of antibiotic resistance was significantly higher in E.coli isolates from inpatients group than those from the outpatients group. The prevalence of ESBL production, biofilm formation and pap gene among E. coli isolates was 55%, 82.5% and 40% respectively. ESBL production and biofilm formation were significantly higher in the inpatients with upper UTI than in patients with lower UTI [90-38.5%] and [100-61.5%] respectively. There was no statistically significant difference between the 2 groups as regards the prevalence of pap gene
Conclusion: The prevalence of biofilm producing, ESBL producing and antibiotic resistant E.coli strains is more in the inpatients population particularly those with upper UTI. Special concern should be addressed to the spread of ESBL producing E.coli in the community. Pap gene is expressed equally in the outpatients and inpatients groups which highlights its importance in the establishment of UTI
ABSTRACT
Background: Helicobacter pylori [H.pylori] is a cause of chronic-active gastritis and a majority of cases of peptic ulcer disease. It is also associated with the development of gastric adenocarcinoma, the fourth most common malignancy in the world
Aim of the study: The study aims to detect the level of interferon gamma expression and the percentage of CD4+ CD25+ T regulatory cells in patients with gastritis and their relation to the pathological grading
Methods: Gastric biopsy specimens were taken from the antrum of 30 patiens using upper GIT endoscopy. Rapid urease test [RUT], immunohistochemistry [IHC], and Hematoxylin and Eosin [H and E] stains were used to determine H.pylori status. Evaluation of the histologic features was done using H and E. IFN-gamma mRNA expression in the gastric biopsies was measured using Real-Time PCR. Flowcytometry was used for measuring the percentage of CD4+CD25+regulatory T-ells [T regs] in the peripheral blood of all the patients. The results were compared to 15 healthy control subjects
Results: H.pylori was detected in 56.7% of all patients by RUT and in 93.3% patients by H and E and in 83.3% by IHC,out of them 88% had active gastritis and all of them had chronic gastritis. There was a statistically significant positive correlation between H.pylori positive infection and the pathological grading of active gastritis [p=0.015]. However, there was no statistically significant correlation between H.pylori infection [by IHC] and the pathological grading of chronic gastritis [p=0.334]. No statistically significant difference in the levels of IFN-gamma mRNA expression between H.pylori positive and negative patients was detected. No correlation was found between the levels of IFN-gamma mRNA expression and the severity of either active or chronic gastritis. Similarly, no correlation between the percentage of CD4+ CD25+ T regulatory cells and the severity of either active or chronic gastritis was detected
Conclusion: H.pylori plays an important role in active gastritis lesion. The correlation between IFN-gamma mRNA expression and the severity of active or chronic gastritis was overshadowed by the prevalence of helminthic infection among Egyptian patients. Meanwhile, low levels of T regulatory cells among H.pylori positive and negative gastritis than controls suggests an important role of T regulatory cells in regulating the gastric mucosal inflammatory response