ABSTRACT
Introduction:-Systemic lupus erythematosus is an autoimmune disease characterized by inflammation of many different systems. Epidemiological studies showed an increase of cardio and cerebrovascular events in patients suffering from systemic autoimmune diseases, and autoptic investigations pointed out that an accelerated atherosclerotic process is largely responsible for such manifestations. Both symptomatic as MI [myocardial infarction] and asymptomatic as atherosclerotic [carotid plaque] diseases are more prevalent in SLE patients than in the general population. There were positive correlations between CD69 [one of type I IFN-regulated genes in platelets] level and cardio vascular complications in these patients
Objective:-To determine the level of CD69 andC3 in patients with systemic lupus erthematosus and to find the relationship between CD69 andC3 levels and cardio vascular complications in these patients
Methods:-Twenty systemic lupus erthromatosis patients were included in this study were selected from internal medicine in and out-patient clinics of Al-Zahraa university hospital, ten patients suffering of SLE with no cardio vascular disease [Group1] and ten patients suffering of SLE with cardio vascular disease [Group 2], Ten healthy individuals of matched age and sex were selected as control group. All systemic lupus patients were subjected to full history taking, clinical examination, ECG, complete blood picture, liver function, renal function, ANA, dDNA, serum complement 3, and CD69 on platelets were done
Results:-The expression ofCD69 on platelets was significantly higher in patient of SLE with cardiovascular complication group than control group[p0.0071],and there was a significant increases in the serum level of C3 of SLE with cardiovascular complication group than in patient of SLE without cardiovascular complication group [p=0.000005]. Also we found that the serum level of C3 lower in patient of SLA group with and without cardiovascular complication than control group [p=0.009] [0.00009]
Conclusion:-These finding suggest that Platelets with CD69 expression seem to more activated and may contribute to development of vascular complication in patients of SLE so CD69 expression on platelets may serve as predictive marker of CVD complication in patients with SLE
ABSTRACT
Antimicrobial resistance is a major public health concern in human medicine both in the community and in medical institutions. Knowledge on local antimicrobial resistance among urinary isolates is important in guiding the recommendations in empirical antibiotic treatment of UTI. Production of Extended Spectrum Beta-Lactamases [ESBL] is the most common amongst the mechanisms of antimicrobial resistance. ESBLs have been found in a wide range of Gram-negative rods. However, the vast majority of strains expressing these enzymes belong to the family Enterobacteriaceae. In this study we evaluate the methods for detection of extended spectrum beta lactamases to determine the magnitude and pattern of antimicrobial resistance among gram -ve bacilli [E. coli and Klebsiella Pneumoniae] isolated from urine specimens as well as providing a better delineation of the clinical patterns associated with the carriage of ESBL-producing urine isolates that may allow the identification of at risk patients more rapidly
Methods: eighty four patients with UTI collected over a 11-month period were obtained. Microbiological cultures were carried out by standard laboratory methods ESBL production was detected by the double disk synergy testand phenotypic confirmatory double disc diffusion test and genes encoding ESBLs [blaTEM, blaCTX-M, blaSHV] were detected by polymerase chain reaction [PCR]
Results: 84% of the total isolated bacteria were Enterobacteriaceae. Among Enterobacteriaceae, E.coli was [57.8%] and Klebsiella Pneumoniae were [26.3 %]. However, 33.3% of E. coli was ESBL producer and 53.3% of Klebsiella Pneumoniae was ESBL producer by PCDDT. ESBL producer bacteria were higher among isolates from female [46.2%], from patients in ICU [80%], from outpatient clinic [33.3%], from catheterized patients [71.4%] and those with co morbidities. There was highly significant occurrence of ESBL in those with increased weight and BMI. ESBL- producing E. coli strains showed/00% resistance to Amoxicillin-clavulanic acid, Ciprofloxacin, Norfloxacin, Piperacillin-tazobactam. E.coli showed less rate of resistance to Gentamicin [54.5%], Cefoxitin [36.3%], Amikacin [27.2%], and Nitrofurantoin [18.1%] and no resistance for imipenem. However ESBL- producing K. pneumoniae strains showed high resistance to Ciprofloxacin [75%], Gentamicin and Norfloxacin [62.5%], Nitrofurantoin [50%]. K. pneumoniae isolates were showed less rate of resistance to Cefoxitin [25%], and no resistance was found to Amikacin and imipenem
Conclusion: routine detection of ESBL-producing microorganisms is required to be done by each laboratory by the standard detection methods so as to control the spread of these infections and also to institute proper therapeutic strategies. PCPDT was found to be better than DDST in the detection of ESBLs. Amikacin and imipenem were the most effective and drugs of choices in the treatment of UTI caused by ESBL producing E. coli and Klebsiella pneumoniae. High BMI appears as a new risk factor for acquisition of ESBL-producing E coli and k pneumonia. The genotypic methods provided an efficient and rapid differentiation of ESBLs