Superantigen gene profile of Staphylococcus aureus colonizing Egyptian pediatric patients with atopic dermatitis: relationship to disease severity and multi-drug resistance

Background: Eczematous skin of atopic dermatitis [AD] is highly susceptible to infection and colonization by Staphylococcus aureus and the superantigen toxins can worsen the condition

Objectives: To assess the colonization of Egyptian pediatric AD patients with S. aureus and to characterize the superantigen gene profile of isolates in relation to severity and to presence of multiple drug resistant [MDR] strains

Methodology: The study included 53 AD pediatric patients and 45 controls. Severity of AD was assessed by scoring atopic dermatitis [SCORAD] index. Swabs were collected to isolate S. aureus. Isolates were subjected to multiplex PCR reactions for detection of six superantigen genes and to antimicrobial susceptibility tests by disc diffusion method

Results: Colonization with S. aureus was significantly higher [P < 0.0001] in AD children compared to controls and was significantly associated [P= 0.001] with severity. Superantigen genes were detected in 30.1% of isolates. The most prevalent genes were sea [64.5%], seb [32.3%], sec [6.5%] and tsst-1 [3.2%]. Multidrug resistance was found in 63.1% of strains. Severity of AD was significantly higher with strains harboring superantigen genes [P=0.04] and with MDR strains [P=0.0002]. Among methicillin resistant S. aureus [MRSA], seb was the most prevalent superantigen gene [37.5%], while sea was most prevalent in methicillin-susceptible S. aureus [MSSA] [20%], MDR [23.1%] and non MDR isolates [13.2%]

Conclusion: Superantigen genes and multidrug resistance are common in S. aureus colonizing AD patients and are associated with severity. More attention should be paid at performing antimicrobial susceptibility testing before antibiotic therapy

Prevalence of hepatitis C virus in an elderly population in rural areas of Sharkia governorate, Egypt

Background and aim: Egypt has the highest prevalence of hepatitis C virus [HCV] infection in the world. At an older age, infected patients usually have lower rates of HCV clearance as well as higher rates of cirrhosis. The aim of this work was to study the actual prevalence, characteristics, and risk factors of HCV infection in elderly Egyptian individuals [>60 years] living in rural areas of Sharkia governorate and to assess the role of associated diseases [e.g. diabetes mellitus and hypertension] that are common in this age group

Patients and methods: A total of 115 male and 99 female nonhospitalized elderly individuals [mean age 64.37 +/- 4.74 years] were enrolled in this study. They were recruited from rural areas in Sharkia by a systemic 1: 4 sampling procedure. A questionnaire on sociodemographic characteristics was conducted, and information on risk factors for HCV infection and history of other comorbid diseases was recorded. Serodiagnosis of HCV infection was performed and for the positive cases, abdominal ultrasonography and liver function tests were performed

Results: The prevalence of HCV was 28% among the group studied. No association was found between sociodemographic data and HCV prevalence. Among the risk factors, a history of schistosomiasis treatment, blood transfusion, previous use of glass syringes, previous surgery, previous endoscopic intervention, repeated dental manipulations, and the presence of other infected members in the family were all significant factors [P<0.05]. History of previous liver disease and renal dialysis were significantly [P<0.05] associated with the prevalence of HCV, whereas diabetes mellitus and a history of ischemic heart disease were not

Conclusion: There is a high prevalence of HCV among elderly individuals living in rural areas in Sharkia, with many risk factors suspected to be the cause