Role of cytokines IL-6, and TNF-alpha levels and c-reactive protein in early diagnosis and management of neonatal sepsis N.M.

To determine serum IL-6, and TNF-alpha and C-reactive protein levels in neonatal sepsis at the time of diagnosis and after therapy, and to show the meaningful on the follow up. This prospective study was performed on newborns who were hospitalized for neonatal sepsis and who were classified as, cultureproven sepsis [n=15], culture-negative sepsis [n=15], healthy newborns [n=15]. At the time of diagnosis, serum IL-6 and TNF-alpha and C-reactive protein levels of culture-proven sepsis were significantly higher than those of the control groups [P<.05]. At the time of diagnosis, IL-6 and TNF-alpha levels of cultureproven sepsis and culture-negative sepsis were significantly higher than levels at the seventh day after antibiotic treatment. Serum IL-6, and TNF-alpha are mediators of inflammation and can be used at the diagnosis and at the evaluation of the therapeutic efficiency in neonatal sepsis

Genotypic versus phenotypic methods for detection of [methicillin resistant staphylococcus aureus] MRSA isolates from Tanta University Hospital

Methicillin-resistant Staphylococcus aureus [MRSA] has emerged worldwide as a nosocomial pathogen of major importance, and the incidence of infections caused by MRSA continues to increase. Infections with MRSA are known to be associated with considerable morbidity and mortality. "Mortality was three times higher in patients with MRSA than those with MSSA infection in ICU. We aimed in this study to apply rapid and accurate detection method for identification of MRSA and prevent its spread in Tanta University Hospital. Our study was carried out on 110 different clinical specimens and we evaluate three different methods which are two phenotypic methods and one genotypic method for identification of MRSA .The genotypic method was Real time PCR for mec A gene and the phenotypic methods were oxacillin disc diffusion method using 1ug and 5ug OX and latex agglutination using PBP2a. Conventional PCR for 533bp mecA gene product was utilized as a golden standard test. Our study showed that disc diffusion method using OX1ug and 5ug yield 90.9% and 90.1 sensitivity and 94.1% and 76.5% specificity respectively while latex PBP2a and real time PCR yielded 100%sensitivity and 100% specificity. We recommendPBP2a latex agglutination test as a phenotypic method and Real time PCR as a genotypic method for rapid detection of MRSA. The use of these rapid assays should help to reduce the work load associated with MRSA surveillance programs and the spread of MRSA in clinical settings

Microbiological identification versus clinical impression in diagnosis of infective corneal ulcers

Infective corneal ulcer is a leading cause of blindness in Egypt It is the most common serious ocular infection and appears to be increasing in incidence. To identify the specific microorganisms responsible for infective keratitis and to correlate the clinical and microbiological profile of corneal ulcers to determine to what extent the presence of certain clinical features may be used to provide a presumptive diagnosis of infective keratitis. This study included consecutive patients suffering from infective corneal ulcers, attending the outpatient clinic of Ophthalmology Department. Tanta University Hospital, during the period between January 2012 and March 2013. Every cases was subjected to full clinical ophthalmologic evaluation and microbiological evaluation of the corneal ulcers. Risk factors, fate and complications of the corneal ulcers were recorded. Fifty eyes of fifty patients were included in this study. Dry eye of mild to moderate degree and ocular trauma were the most common risk factors. Cases associated with trauma as a risk factor, especially that of plant origin, revealed higher frequency of fungal isolation [10 out of 22 [45%]]. Microbiological evaluation reveled that pure fungal growth had the highest frequency [20 out of 50 cases [40%]] followed by pure bacterial growth [18 out of 50 cases [36%]], mixed growth [fungi and bacteria] [2 out of 50 cases [4%]] and acanthamoeba growth [2 out of 50 cases [4%]]. Negative growth was present in 8 cases [16%]. Elevated corneal ulcers with larger stromal infiltrates and congulated hypopyon were characteristic signs in corneal ulcers with pure fungal isolation with a statistical significant difference [p. value= 0.018, 0.022 and 0.019 respectively] between corneal ulcers with pure fungal isolation and ulcers with pure bacterial isolation. Microbiological evaluation of the cases diagnosed clinically as fungal keratitis [38 cases] revealed fungal growth in only 19 cases [50%] with a statistical significant difference [p value < 0.001]. Fungal keratitis should be put into consideration in corneal ulcers caused by trauma with objects of plant origin. Elevated corneal ulcers with larger stromal infiltrates and coagulated Hypopyon are characteristic signs in corneal ulcers with pure fungal isolation. Treatment should be given according to both clinical and microbiological evaluation of the corneal ulcers.Dry eye of mild to moderate degree is an important risk factor in corneal ulcer development

Molecular characterization of ciprofloxacin resistant e. coli in community acquired urinary tract infection

Widespread use of ciprofloxacin in treatment of urinary tract infection [UTI] led to increased level of resistance in clinical isolates of E. coli. The aim of this study was to investigate the molecular characterization of ciprofloxacin resistant E.coli isolates from community acquired urinary tract infections.. E-coli strains were isolated from urine samples [E. coli represented 70% of isolates [21/30] and minimal inhibitory concentration [MIC] of Ciprofloxacin [CFX] of E. coli was measured [Resistant strains of E. coli had MICs of ciprofloxacin ranging from 4 to >32 mg per liter]. CFX resistant E. coli strains were subjected to PCR to amplify gyrA and parC genes of Quinolones resistance determining region of E. coli. DNA sequencing of amplified product was carried out and the molecular characterization of E. coli resistant to CFX were analysed [All resistant E. coli isolates contained Ser83+/-Leu and Asn87+/-Asp mutations in gyrA and a Ser83-+/-Ile mutation in parC; two isolates also contained a Glu84+/-Val mutation in parC.