Neopterin in pulmonary tuberculosis and lung cancer patients

Neopterin is produced and released by human macrophages in response to stimulation with interferon-gamma, and changes in neopterin concentrations indicate cellular immune activation. To assess the usefulness of serum, urine and pleural fluid neopterin levels as an index of disease activity in patients with pulmonary tuberculosis and lung cancer. Serum, urine and pleural fluid neopterin levels were evaluated in 30 patients with pulmonary tuberculosis and 30 patients with lung cancer while serum and urine neopterin levels were evaluated in 20 healthy controls by enzyme linked imunosorbent assay [ELISA] technique. The neopterin levels [mean +/- SD] in the serum and urine of 30 tuberculous patients [54 +/- 13.9 n mol/L, 675 +/- 230.7 n mol/mol criatinine respectively] were significantly higher when compared with those in lung cancer patients [29 +/- 5 n moUL, 312 +/- 74.5 n mol/ mol criatnine respectively, P < 0.001] and when compared with those in control subjects [6 +/- 2 n mol/L, 128 +/- 39.8 u mol/mol criatinine respectively]. In tuberculosis patients with faradvanced disease pleural fluid, serum and urine neopterin levels were significantly higher when compared with those in patients with moderately and minimally advanced disease [p < 0.001]. In lung cancer group serum and urine neopterin levels were significantly higher [p < 0.001] in adenocarcinoma, squanous cell carcinoma, and small cell carcinoma than that in the control group. But there was no significant difference between the serum, urine and pleural fluid neopterin from one cell type to another. Serum urine and pleural fluid neopterin levels may reflect the degree of activity in pulmonary tuberculosis before exact diagnosis of the disease by culture results. In addition serum, urine and pleural fluid neopterin levels are elevated in patients with lung cancer whatever the cell type

Beta - Lactamase and Mex - R gene mutation in a nosocomial outbreak of carbapenem - resistant pseudomonas

Antimicrobial resistance in bacteria has become a worldwide problem. Some organisms have developed resistance not only to commonly used antibiotics, but also to virtually all known antimicrobials. The emergence of multi-drug-resistant Pseudomonas aeroginosa in nosocomial infections is increasingly recognized This had included imipenem and meropenem which were used to treat a variety of serious infections when an organism is resistant to the primary agent of choice. The aim of this study was to identify the causative agent of an outbreak in an ICU of a university hospital over 14 weeks-period [from 15/06/2002 to 30/09/2002,] prospectively. Most patients were mechanically ventilated and had respiratory infections. Laboratory diagnosis was based on culture on basic and selective media as well as full identification of bacterial strains using automated microscan system. Test for beta-lactamase production was done and mex-R gene mutation was assessed by PGR - sequencer. This outbreak had cleared up after revision of disinfection policy, isolation measures and better compliance of nursing staff for hand washing

DNA Sequencing and bacieriophage based technique for rapid detection of rifampicin resistant mycobacterium tuberculosis

The drug resistant Mycobacterium tuberculosis [M TB] is an emerging problem of great importance to public health worldwide. This has stressed the need for development of more rapid techniques to accurately identify mycobacteria and drug resistant strains This study was done in an attempt to find a rapid and reliable method for identification of M. TB, and to study the genetic mutation in rifampicin resistance. Thirty sputum samples were subjected to identification of M. TB using conventional methods including Ziehli-Neelsen [ZN] stain and Lowenstein Jensen [LJ culture in comparison to the new rapid FAST plaque TB [bacteriophage based assay] which was used also to detect rifampicin resistance. The rifampicin resistant M. TB were subjected to PCR implication of rpoB gene followed by automated DNA sequencing. The phage technique identified 14/30 [46.7%] and when compared to LJ culture which was able to detect 19/30 [63.3%], the sensitivity was 73.7% and the specificity was 100%. Z.N. stain detected acid fast bacilli [AFB] in 10/30 ['33.3%]. Among the 20 smear negative samples the phage technique was able to detect 4 out of 9 cases identified by LJ culture with 44.4% sensitivity and 100% specificity. Among the rifampicin resistant M. TB, the highest percentage of point mutation was detected at codon 531[40%] and codon 526 [40%] followed by codon 516 [20%]. In conclusion the phage technique could be used in conjunction with sputum smear microscopy to detect additional cases which would be missed with smear alone. Rifampicin resistant M. TB is mostly associated with rpoB gene mutations

Plasma glutathione reductase, total antioxidants and neuropeptide Y among children with bronchial asthma

Though bronchial asthma is a common chronic disorder in children, its pathogenesis is far from being simple. The diagnosis of bronchial asthma is mainly based on clinical picture and laboratory diagnosis. Measurement of plasma concentration of antioxidants like glutathione [GSH] reductase is considered a new diagnostic procedure for bronchial asthma and may play a role in preventing bronchial asthma. Neuropeptide Y [NP-Y], a pro-inflammatory mediator, has a wide distribution and physiological effects on the lung and small bronchioles suggest that it may be involved in the exacerbation of asthma. The aim of the study was to evaluate the role of GSH reductase, total antioxidants and NP-Y in the diagnosis of bronchial asthma in children. This study consisted of two closely related parts. The first part included 30 patients with asthma and 20 healthy children as controls. The plasma samples were assayed for GSH reductase activity and total antioxidants concentrations. GSH reductase activity was significantly lower in patients than in control group [P <0.001], however, total antioxidants showed no significant difference between both groups [P >0.05]. There were no significant differences in GSH reductase or total antioxidants concentrations between patients with respiratory infections and those without. Patients treated with bronchodilators and steroids had a significant lower level of GSH reductase concentration as compared with those treated with bronchodilators only, however, the difference in total antioxidants concentration between both groups was statistically insignificant. In the second part of the study, plasma samples were obtained from 30 patients attending the emergency ward with exacerbations of asthma and from 20 healthy controls. All samples were assessed for NP-Y before and after treatment. The mean plasma level of NP-Y was higher in patients [10.02 +/- 4.6 ng/ml] than in controls [0.13 +/- 0.05 ng/ml], p <0.001. There was no significant difference between the level of NP-Y before and after treatment. No relation was observed between the severity of asthma and plasma level of NP-Y since hospitalized patients had almost the same results of NP-Y as other patients with mild or moderate asthma and left the hospital within the same day. In conclusion, GSH reductase could help as a laboratory marker in the diagnosis and prognosis of bronchial asthma in children On the other hand, plasma NP-Y could be a useful diagnostic tool but can not be employed as a predictor of responsiveness to therapy