Occurrence of ureaplasma urealyticum and mycoplasma hominis in Egyptian schistosomal patients with urinary tract infections cancer bladder and urinary stones

The present study was done to elucidate the role of Ureaplasma urealyticum [U. urealyticum] and Mycoplasma hominis [M. hominis] in Egyptian schistosomal patients with urinary tract infections [UT1], cancer bladder and urinary stones. Four groups were studied, the first included 40 male patients with simple urinary schistosomiasis, the second and third groups [30 patients each] included schistosomal patients complicated with urinary stones and cancer bladder respectively, while the fourth group included 40 normal subjects as controls. Mid stream urine, bladder urine and stones in the second group were tested for M. hominis and U. urealyticum by culture on A[7] agar, U[9] broth, mycoplasma agar, mycoplasma broth and inoculation into Mycofast All-In. U. urealyticum and M. hominis were isolated from both mid stream and bladder urine samples in patients with urinary. stones in 23.3%. In cancer bladder patients 13.3% were positive, while patients with simple urinary schistosomiasis were positive in 17.5%. Stone culture revealed 20% positivity. In the contorl group only mid stream urine revealed 7.5% positivity. Comparing the results obtained on A[7] agar, U[9] broth and mycoplasma agar and broth [classic ordinary culture media for mycoplasmas] with those obtained by Mycofast All in method, same results were obtained. The current work revealed that mycoplasmas may be regarded as a considerable aetiological agents in urinary tract infections especially in patients complicated with cancer bladder, urinary schistosomiasis and urinary stones which necessitates proper indentification and treatment. The Mycofast All-In test may be used as an alternative rapid and easy method for diagnosis of mycoplasmas

Plasmid-mediated resistance to multiple antibiotics in salmonella typhi in Egypt

Several hundred strains of S. typhi isolates from typhoid patients admitted to different fever hospitals in Cairo, Kaluobiya and Sharkiya governorates during the period from June, 1991 to May, 1992 were studied. The strains were tested for susceptibility to the 3 antimicrobials of choice for typhoid treatment namely chloramphenicol [CM], ampicillin [AP] and trimethoprim - sulphamethoxazole [SXT]. 28 strains were found resistant to one or more of these drugs. Seven were resistant to CM, 22 to AP and 27 to SXT. Out of the 7 strains resistant to CM, 4 were resistant to the 3 drugs, one resistant to CM and AP, 2 resistant to CM and SXT. Plasmid profile analysis of resistant and sensitive strains showed that a specific band at 3. 8 Kbp is characterized in strains resistant to the 3 antimicrobials. Other strains had no such a plasmid band. Another plasmid with a molecular size over 9 kbp was present in both phenotypes. Additional studies are ongoing in our institute for further identification and characterization of resistant strains. In addition, plasmid profile analysis of resistant S. typhi strains are undertaken aiming at using this analysis as a routine test for antimicrobial resistance identification

Doxycycline treatment in mycoplasma and ureaplasma urinary tract infections

Mycoplasma hominis [M. hominis] and Urea plasma urealyticum [U. urealyticum] were documented to play a significant role in recurrent urinary tract infections [UTI] in Egyptian patients especially when associated with urinary schistosomiasis. Doxycycline is the drug of choice used to treat these infections at TBRI [100 mgtwice daily for 2 weeks] and this study was conducted to evaluate its efficacy. Fifty six patients with M. hominis and/or U. urealyticum UTI were included and classified into two groups according to association with urinary schistosomiasis. Cure rates of 39.4% and 34.8% were achieved after one course of treatment in group [I] [schistosomal] and in group [II] [non-schistosomal] patients respectively. Higher rates were achieved after a second course of doxycycline in resistant cases [88% and 91% respectively] Test-of-cure cultures obtained 10-15 days after completion of therapy showed treatment failure in only 6 patients [10.9%], four of them had urinary tract stones and their urine samples grew U. urealyticum, three of these patients were schistosomal. It is concluded that a high cure rate [89%] could be achieved by repeating the doxycycline course. Patients with urinary stones should be managed operatively before successful doxycycline therapy

Enteric fever antigenemia with schistosomiasis

This study aims at evaluating the efficacy of a commercially available ELISA kit for Salmonella O-antigen detection [Kirkegaard and Perry laboratories] as a diagnostic technique in comparison to conventional diagnostic methods. Also, the role of Salmonella organisms as a cause of prolonged intermittent fever frequently encountered with hepatosplenic schistosomiasis was revised. The study was conducted on 4 groups of subjects. Group I, 80 patients with schistosomal hepatosplenomegaly and repeated attacks of fever. Group II, 72 non-schistosomal patients with clinical suspicion of enteric fever. Group III, 26 patients with schistosomal hepatosplenomegaly but with no history of fever and Group IV comprised 26 healthy subjects as controls. ELISA test for Salmonella antigen detection was found positive in 58.8%, 55.6% and 15.4% of Group I, II and III respectively while blood culture was found positive in 7.5%, 41.6% and 3.8% of the same groups. ELISA test was found also positive in 62% of serum samples, 70% of urine samples and 100% of blood broth mixture samples from patients with positive blood cultures for Salmonella. The same samples from patients with positive blood cultures for organisms other than Salmonella gave negative results by ELISA. We concluded that this ELISA test is specific and rather sensitive and could be a useful tool for the early and rapid diagnosis of Salmonella infections. Chronic Salmonella infection is still an important cause of prolonged fever among patients with hepatosplenic schistosomiasis

Brucellosis in Egyptian patients with prolonged fever

This study was conducted on 43 patients [19 males and 24 females, with a mean age of 27.6 +/- 14.18 years], presenting with fever of more than 3 weeks duration, in addition to 20 healthy subjects serving as a control group. Blood cultures for brucella using biphasic medium were done and proved to be negative for all of them. Brucellosis was diagnosed serologically in 7/43 cases [16.3 percent] using the microagglutination technique. Enteric fever was diagnosed in 9/43 cases [20 percent] using Widal lest. Brucellosis was diagnosed more in the risk groups [Farmers and workers in animal farms]. The possible modes of infection were ingestion of raw milk, fresh cheese or contact with animals. The favorable clinical features of brucella cases were fever, drenching sweats, rigors, arthralgia and backache. All brucella cases responded well treatment with tetracycline and streptomycin

Fungal infection in urinary bilharziasis

This study was carried out on 50 patients [40 males, and 10 females] suffering from urinary schistosomiasis with bladder complications. Urine of each patient was collected aseptically, examined microscopically, cultured on nutrient agar, blood agar, MacConkey[s] agar and Sabouraud[s] dextrose agar. Fungal and bacterial growth were identified. Out of the 50 patients, 2 [one male and one female] had Candida albicans with the percentage of 4 percent, and 39 had bacterial infections with the percentage of 58 percent. The bacteria isolated from the 29 patients, in their order of frequency were E. coli, isolated from 16 patients with the percentage of 51.6 percent, Klebsiella isolated from 6 patients with the percentage of 19.4 percent, Proteus species isolated from 5 patients with the percentage of 16 percent. Staphylococcus aureus isolated from 1 patient with the percentage of 3.2 percent and finally one mixed infection [E. coli and Pseudomonas] was isolated with the percentage of 3.2 percent