ABSTRACT
Background: Burns represent major threat, they result in a loss of the normal skin barrier, making burned patients highly susceptible to different bacterial pathogens. Pseudomonas aeruginosa is the most important, resistant and dangerous organism in burn wound infections. Tissue damage produced during P. aeruginosa infections is due to the production of several extracellular and cell-associated virulence factors including exotoxinA [ETA], elastases, type III secretion proteins, pyocyanin and alginate
Objective: The aim of this study was to compare quantitative culture of wound biopsies and surface swabs in detecting different bacterial pathogens, to study ETA as a major virulent factor of P. aeruginosa and the impact of toxigenic strains of P. aeruginosa on wound healing. Study Design: Seventy nine patients showing signs of local wound burn infections were studied. Wound biopsies and surface swabs were taken on post burn day 10 and quantitavely cultured. When their count exceeded 105 /gram of tissue, blood culture was done. Antibiotic sensitivity and PCR were done for P. aeruginosa isolates
Results: Pseudomonas aeruginosa was the most common isolate 47 [48.4%] and the comparative study between wound biopsies and surface swabs revealed that, only 78[80.4%] of isolates were detected by swabs, while all of them [100%] were detected by biopsies. P aeruginosa isolates were mostly sensitive to imipenem [95.7%], followed by amikacin [87.2%], then ciprofloxacin [80.8%], tobramycin [78.7%] and aztreonam [70.2%]. Thirty seven cases showed bacterial count more than 105 /gram of tissue and showed signs of bacteraemia. Out of the 37 cases, p.aeruginosa was the commonest bacterial isolate 21 [56.7%]. ToxA gene was detected in 42 [89%] of p. aeruginosa isolates by PCR [toxigenic strains]. Out of them, 38 isolates were associated with retardation of wound healing, while all the non toxigenic strains showed normal wound healing. The difference was statistically significant [P < 0.001]
Conclusion: Pseudomonas aeruginosa is the commonest and dangerous organism in burn wound infections. ETA is the most virulent factor among other factors produced by P. aeruginosa. The toxigenic strains of P. aeruginosa as diagnosed by PCR retard wound healing
ABSTRACT
Background: Environmental factors, including virus infection, may play a role in the activation and/or exacerbation of pemphigus. However, it is still unclear whether human herpesvirus [HHV-8] is involved in pathogenesis of pemphigus or not
Objective: This study was undertaken to investigate the possible association of pemphigus with HHV-8
Methods: Polymerase chain reaction assay [PCR] was used for detection of HHV-8 DNA in lesional and nonlesional skin biopsy specimens of pemphigus patients. Restriction fragment length polymorphism was done on positive cases to confirm the PCR results. Twenty patients with pemphigus [14 with pemphigus vulgaris and 6 with pemphigus foliaceus] and ten control subjects were included in this study
Results: HHV-8 DNA was detected in lesional skin biopsy specimens of 8 out of 20 pemphigus patients [40%]. Biopsy specimens of non-lesional skin of the patients and of control subjects were all negative for HHV-8 DNA. There was no significant difference in HHV-8 prevalence among different types of pemphigus
Conclusion: Our results support the association of HHV-8 and pemphigus. HHV-8 infection might be a contributing factor in the development of pemphigus
ABSTRACT
Background: The inflammatory cascade in sepsis is characterised by co-ordinated expression of proinflammatory cytokines as Tumour Necrosis Factor-alpha [TNF-alpha] and chemokines RANTES [Regulated upon Activation, Normal Tcell Expressed and Secreted], which are essential for host defence against microbial infection. This cascade and the use of newly discovered inflammatory mediators are focused upon for diagnosis of neonatal sepsis and outcome prediction
Objective: The aim of this study was to measure serum levels of TNF-alpha and RANTES in neonatal sepsis as diagnostic markers and to determine whether early and late onset neonatal sepsis were associated with differences in their concentrations
Study Design: Fifteen preterm and term infants showing clinical signs suggestive of an early-onset, or lateonset infection were studied. TNF-alpha and RANTES were determined in the serum at the first suspicion of sepsis and prior to commencement of antibiotic therapy. Fifteen healthy neonates were included as control group
Results: Serum TNF-alpha, WBC count and CRP concentrations were significantly higher in septic than non septic neonates. On the other hand, RANTES levels were significantly lower in the septic group compared to the non septic one while platelets count didn't show any significant difference between the two groups. There was no significant difference in the RANTES or TNF-alpha levels between infants suffering from early-onset or late-onset sepsis. Premature neonates like term neonates, responded to infection with an increased production of TNF-alpha and a decreased production of RANTES but no statistical difference was detected between the RANTES and TNF-alpha levels measured in the serum of premature and term neonates. Correlation analysis revealed a significant negative correlation between serum levels of TNF-alpha and RANTES and a significant positive correlation between serum levels of CRP and TNF-alpha in septic neonates. No significant correlation existed between CRP and TNF-alpha or between either TNF-alpha or RANTES and gestational age
Conclusion: C-C chemokines, RANTES and TNF- alpha are of value as early markers in diagnosis of neonatal sepsis. In this study, TNF-alpha is found to be the best diagnostic test for detection of neonatal sepsis followed by CRP when evaluated at first suspicion of sepsis