Detection of adenovirus in urine of immunocompromised patients by polymerase chain reaction

Adenovirus [AdV] has been increasingly shown to play a role in the morbidity and mortality of immunosuppressed patients. This work aimed to detect AdV in urine samples of immunocompromised patients of both pediatric and adult oncology units and study some factors that may associate with increased risk of AdV infections and subsequent detection in urine samples. This study was conducted from December 2009 to December 2010 in Medical Micro6iolog]i and Immunology Department Faculty of Medicine Zagazig University. Urine samples were collected from 100 patients in oncology wards of both Pediatric and Internal Medicine Departments [50 from each department] in Zagazig University Hospitals. Each sample was subjected to PCR detection of AdV. The characteristics ofpediatric and adult immunocoinpromised patients in whom AdV was detected in urine were comparecl. Twenty [20%] out of 100 urine samples were positive for AdV by PCR, 15 [30%] out of 50 pediatric and 5 [10%] out of 50 adult immunocompromised patients. The difference was statistically significant [P=0.01]. Pediatric patients diagnosed as cases of leukemia were significantly associated with AdV detection in urine [P=0.01].The use of intmunosuppressive therapy is significantly associated with AdV detection in urine in both pediatric and adult patients [P=0.02 and 0.05 respectively]. In conclusion Adenovirus infection is an important cause of morbidity and mortality in immunocompromised patients, particularly who are receiving immunosuppressive therapy. The need for rapid method of diagnosis and an effective, nontoxic antiviral therapy is apparent

Comparison between polymerase chain reaction and enzyme linked immune-sorbent assay in diagnosis of congenital cytomegalovirus infection

Objectives: this study aimed to compare polymerase chain reaction [PCR] and IgM detection using enzyme linked immune-sorbent assay [ELISA] in diagnosis of congenital cytomegalovirus [CMV] infection

Methods: this study was conducted from May 2009 to December 2010. Urine and blood samples were collected from 94 neonates with suspected congenital CMV infection. Serum and part of urine samples were stored at -20 degreeC freezer, until the serologic and PCR tests were achieved. A 94fiesh urine samples were processed for cell culture. Nineteen [20.2%].out of 94 urine samples were proven positive for CMV infection by viral culture. For comparing PCR and IgM ELISA we used tissue culture technique as a reference, the 19 positive samples on culture [CMV group] and 20 negative samples [control group] were included in the comparison. Some characteristics of CMY and control groups were compared including sex, age, birth weight, gestational age <37 and small for gestational age. Clinical and laboratory abnormalities were also compared in both groups

Results: this study showed that the sensitivity and specificity of PCR in relation to viral culture were 100% and 100% respectively, there was excellent agreement between both tests [Kappa coefficient was I and P=0.000]. On the other hand, the sensitivity of lgM CMV ELISA in relation to viral culture was 63.2% and the specificity was 85%. There was good agreement between both rests [Kappa coefficient was 0.48 and P=0.002]. By comparing CMV and control groups, there were high statistically significant differences between both groups as regard the birth weight, gestational age < 37 and small for gestational age items [P= 0.00, 0.03 and 0.01 respectively]. There were statistically insignificant differences as regarding the clinical and laboratory abnormalities detected for neonates of both groups. In this study jaundice [63%] and hepatosplenomegaly [42%] were the most common clinical signs in both groups

Conclusion: PCR is more sensitive and specific technique for detection of congenital CMV infection than CMV IgM ELISA. Being more cost effective, less cumbersome and less time consuming in relation to viral culture, PCR may be used in detection of congenital CMV infection

Influenza, adenovirus and respiratory syncytial viruses as causes of influenza-like illness in outpatients of Zagazig University Hospitals

Background and objectives: viruses, including, Influenza viruses, Adenoviruses [ADV] and Respiratory syncytial virus [RSV] are a frequent cause of respiratory tract infections. This work aimed to identify Influenza [A and B], ADV and RSV as causes of Influenza- like illness, determination of their epidemiological data and seasonality and identification' of virus's specific clinical syndromes

Methods: a total of 651 nasopharyngeal swabs [NPSs] were collected from patients with influenza like illness [IL1] symptoms visiting Chest, Ear Nose and Throat [ENT] and Pediatric Departments' out patients clinics Zagazig University Hospitals Each sample was subjected to virus isolation in cell culture and typing of the isolates by indirect immunofluorescence. Demographic data of positive cases were studied

Results: out of the total samples collected, 246 [37.8%] were positive for at least one of the three viruses under investigation. As regard the remaining 405 [62.2%] samples, none of these viruses were detected. Children 39.5 degreeC [P =0.000] while other viruses were associated with mild fever. Also adenovirus infections were significantly associated with upper respiratory tract symptoms as tonsillitis and pharyngitis [P<0.001]. However RSV was the most common agent associated with bronchiolitis [P<0.05] compared with bronchiolitis caused by other viruses

In Conclusion: a better understanding of the epidemiology of respiratory viral infections may be used for determining specific antiviral therapy, prophylaxis and vaccination

Detection of helicobacter pylori in gastric biopsy specimens using polymerase chain reaction and determination of their clarithromycin resistance rate

This study was performed over 12 months [April 2008 to April 2009] to diagnose Helicobacter pylori [H. pylori] infection in patients attending Endoscopy Unit serving Zagazig University hospitals, and determine clarithromycin resistance in relation to age and sex. The diagnostic gastric [antral] biopsies were investigated for the presence or absence of H. pylori using culture and PCR assays targeting vacuolating cytotoxin gene [vacA]. Fifty out of 60 patients' samples were positive for H. pylori using traditional culture and 51 out of 60 were positive using PCR assay. Comparison between PCR and culture showed high agreement between these two tests kappa = 0.81 [P value = 0.000]. This PCR-based system was simple to perform and could be completed in 3 to 4 h, thereby overcoming the delays associated with conventional culture methods for H. pylori identification. There were statistically significant differences as regarding the distribution of H. pylori infection in the older than 40 years-old group [P value = 0.02]. Clarithromycin resistance rates of H. pylori isolates were determined from disc diffusion tests on 50 H. pylori isolates. Overall clarithromycin resistance rates were 10 %. No associations between clarithromycin resistance and either the gender or the age of the patients were detected. The need for continued resistance surveillance is indicated to monitor the effects of the used treatment strategy for H. pylori eradication

Virulence factors of Escherichia coli causing bacteriuria during pregnancy in comparison with isolates from community- acquired cystitis

Escherichia coli [E. coli] isolates from women with bacteriuria of pregnancy establish significant bacteriuria without causing symptoms of urinary tract infection [UTI]. In this study Escherichia coli isolates from patients with bacteriuria of pregnancy were compared phenotypically with uropathogenic E. coli [UPEC] from patients with community-acquired cystitis for the presence of established virulence determinants. The asymptomatic bacteriuria [ABU] strains from pregnant women were less likely to express type 1 fimbriae [26, 66%], P-fimbriae [20%] and ?-haemolysin [6.6%] than the other group [66.66% , 40% , and 13.3% respectively]. PCR analysis of the gene producing type 1 fimbria showed that the gene is present in 93.33% among both groups. However, determination of the phase switch orientation by analysis of positive PCR isolates showed that 3 of 14 ABU isolates of pregnant women [21.4%] was detectable in the on orientation compared to [64.2%] in community acquired cystitis patients. These data indicate that type 1 fimbriae are not necessary to maintain the majority of E. coli bacteriuria in pregnant women since there appears to be selection against their expression in this particular group in contrast to the considered role of this adhesion in community-acquired symptomatic infections