ABSTRACT
Tuberculosis [TB] is the most common opportunistic infection and leading cause of death in persons infected with human immunodeficiency virus [HIV] worldwide. HIV pandemic is one of the greatest challenges facing TB control program. Immune suppression by HIV- infection increases the risk of reactivation of latent TB infection and rapid progression of either recent or latent TB infection to active TB disease. Multidrug resistant- TB [MDR -TB] has been associated with inadequate and poor adherence to treatment regimens, poorly managed TB- control programs, as well as HIV- infection. Comparing the anti- tuberculous drug resistance patterns of Mycobacterium tuberculosis complex [MBTC] isolates from HIV-seropositive and HIV- seronegative TB patients attending King Abdulaziz University Hospital [KAAU], Jeddah, KSA, from January 2011 till January 2013. A total of [132] TB patients were included, they were divided into 31[23.48%] patients with HIV- infection [51.60% males and 48.40% females]and 101[76.52%] patients without HIV- infection [40.60% males and 59.40% females]
All resistance detected in our study was primary resistance except one case with secondary resistance. Our results showed that, the percentage of any resistance to rifampicin was higher in TB patients with HIV- infection than those without HIV- infection [19.4% vs 3%] with high significant difference. While the percentage of any resistance to streptomycin was higher in TB patients with HIV- infection than those without HIV-infection [9.7% vs 0.0%] with significant difference. The percentage of monoresistance to rifampicin was higher in TB patients with HIV- infection than those without HIV- infection [9.7% vs 2%] with significant difference. The percentage of one drug resistance was higher in TB patients with HIV-infection than those without HIV- infection [19.4% vs 3%] with high significant difference. Moreover, the percentage of MDR -TB [resistance to rifampcin and isoniazid] was higher in TB patients with HIV- infection than those without HIV- infection [9.7% vs 2%] with significant difference. Also, there was one patient [3.2%] had 4 drug resistance and also one patient [3.2%] had 5 drug resistance in TB patients with HIV-infection
Conclusion: Our study showed significant associations between any resistance to rifampicin and streptomycin, monoresistance to rifampcin and MDR strains with HIV- seropositive than HIV-seronegative TB patients
Recommendations: HIV testing of TB patients and susceptibility testing ofM. tuberculosis isolates from HIV- infected patients should be routinely done for early detection of resistant strains
ABSTRACT
Background: The emergence of drug resistant strains of Mycobacterium tuberculosis is of growing concern. Multi-drug resistance [MDR-TB] where the strain is resistant to both rifampicin [RIF] and isoniazid [INH], has been reported in all regions of the world. Early choice, and rapid determination of drug resistance can allow a customized approach to treatment early in the course of the disease and can potentially reduce morbidity, mortality and infectiousness. It would be helpful for low-resource countries to have simple and inexpensive tests which can rapidly detect resistance to RIF .The excellent performance of the BACTEC MGIT 960 for rapid detection of resistance to first- and second-line anti-TB drugs can be accomplished in days rather than weeks, although still constrained by high cost equipments and consumables. FASTPlaque-Response is a phage amplification-based test for detection of RIF resistance and has been developed for direct use on sputum specimens
Aim: The present study was undertaken to compare between BACTEC MGIT 960 method and FASTPlaque-Response method for the time, specificity and sensitivity determination of RIF susceptibility in sputum of both positive [+ve] and negative [-ve] AFB-smear of Mycobacterium tuberculosis patients
Results: In this study, a total of 60 specimens were collected and divided according to Z-N staining into two groups : group[1] which was Z.N [+ve]comprising 47 specimens ranged from+1 to +3 positivity, and group[2] which was Z.N -[-ve] comprising 13 specimens. The turnaround-time [TAT] of group[1] by BACTEC MGIT 960 ranged from 8 to 39.2 days with Mean +/- SD 13.9 +/- 3.4 days for positivity and ranged from 4 to 12.96 days with Mean +/- SD[8.02 +/- 1.98] days for susceptibility pattern, while in group[2] the TAT ranged from 8.2 to 41.75 days with Mean +/- SD[15 +/- 5.2] days for positivity and ranged from 4.04 to 13 days with Mean +/- SD [8. 6 +/- 2.2] days for susceptibility pattern ,In contrast to BACTEC MGIT960, FASTPlaque-Response susceptibility pattern was completed in just 48 hours. Susceptibility pattern of RIF by BACTEC MGIT 960 and FASTPlaque-Response showed the same results in 35 out of 60 specimens [58%] which were [26,6 and 3] Sensitive, resistant, and contaminant respectively, While the other 25 specimens [42%] showed discrepant results. In group [1]: 34 out of the 47 specimens [72 %] showed the same results by FASTPlaque- Response and BACTEC MGIT 960, while discrepancy occurred in the other 13 specimens [28 %], in which 12 specimens were RIF sensitive by the BACTEC MGIT 960 and showed different results by FASTPlaque- Response [6,2 and 4 were resistant ,contaminant and no growth respectively],while the 13th specimen which was resistant by BACTEC MGIT960 became sensitive with FASTPlaque- Response .In group[2] the results by the two methods were the same in only one out of 13 specimens [8 %], whereas the discrepancy was in the other 12 specimens [92 %] in which 8 specimens were sensitive with the BACTEC MGIT 960, 7of them showed no growth and the 8th was contaminant by FASTPlaque-Response, while 3 specimens were resistant by BACTEC MGIT 960, 2 of them were contaminant and 1 showed no growth by FASTPlaqueTB- Response, whereas, the 12th specimen was contaminant by BACTEC MGIT 960,but showed no growth with FASTPlaqueTB-Response . In group[1]; 4 out 47 specimens[8.5%] were contaminants and 4 specimens[8.5%] showed no growth by FASTPlaque- Response ,while,2 specimens[4.2%] were contaminants and no specimens showed no growth by BACTEC MGIT 960. In group[2];5 specimens out of 13 [38.5%] were contaminants and 8 specimens [61.5%] showed no growth by FASTPlaque- Response ,while,2 specimens[15.3%] were contaminants and no specimens showed no growth by BACTEC MGIT 960
Recommendation: Standardization of phage method to minimize the number of contaminated or incorrect results is necessary before this diagnostic tool can be implemented widely, and improvement needed to become highly sensitive and specific in that cases to become routinely used
ABSTRACT
Patients with chronic hepatitis C virus [HCV] infection may suffer from some autoimmune disorders. The pathogenesis of autoimmunity in those patients remains unclear but may reflect the host's genetic predispositions. Human leukocyte antigen [HLA] may play a predominant role in this aspect. The aims of this study were to assess the production of autoantibodies in chronic HCV patients and to investigate for the presence of a possible link between the HLA-DRB1 alleles and production of autoantibodies in chronic HCV patients
Methods: This study included 60 HCV infected patients who were previously diagnosed as having chronic HCV infection. These patients were investigated for the presence of autoantibodies [ANA by ELISA, ASMA by indirect immunofluorescent technique, anti-ds-DNA by latex agglutination method, and LKM-1 by ELISA]. Also, they were investigated for HLA-DRB1 by PCR technique and reverse dot-blot hybridization. The studied individuals were divided according to the presence or absence of autoantibodies into two main groups: group I [HCV infected patients with autoimmunity], group II [Pathological control group, HCV infected patients without autoimmunity]. The results of this study showed that the most prevalent HLA-DRB1 broad types in group I were HLA-DRB1 *03, *04 and *16. Moreover, these three types were significantly higher in group I compared to group II [P < 0.05]. The most prevalent HLA-DRB1 broad types in group II were HLA-DRB1 *7 and *8 and the prevalence of each was higher in group II compared to group I and the difference was highly significant [P < 0.01]. The frequencies of the alleles 030101, 030501, 040702, 160101 and 160102 were significantly higher in group I than group II, while the alleles 0812 and 110103 were significantly lower in group I than in group II. In conclusion, the results of this study suggested that some HLA-DRB1 broad types and alleles may predispose to or protect from HCV-induced autoimmunity in Egyptian patients who suffer from chronic HCV infection. These findings may allow better selection of management strategies for these patients after detection of HLA-DRB1 types which may be helpful to predict those who are susceptible to HCV-induced autoimmunity
ABSTRACT
Background: Elevated Interleukin-6 [IL-6] Levels have been described in bronchial asthma, where they appear to orchestrate a variety of inflammatory responses. It has been suggested that control of many of these IL6-mediated events is regulated via soluble Interleukin-6 receptor [sIL-6R]. Consequently, when considering the role of IL-6 in asthmatic patients, it is equally important to consider how sIL-6R affects its function
Objective: This Study was carried out to assess serum levels of IL-6 and sIL-6R in bronchial asthma patients during exacerbation and remission, stressing upon their relationships with airway obstruction, atopic status and allergy-related parameters
Methods: Thirty-two consecutive asthmatic patients and 16 control subjects were submitted to full medical history taking, clinical examination, measurement of peak expiratory flow rate [PEFR], skin testing, complete blood counting and estimation of serum concentration of IL-6, sIL-6R and total immunoglobulin E [IgE] by enzyme-linked immunoassay [ELI- SA]. In asthmatic patients, all these procedures were done during acute exacerbation and repeated after 4 weeks during remission
Results: Mean serum levels of IL-6 and sIL-6R were significantly higher in asthmatic patients as compared with control subjects, and in acute asthma exacerbation as compared with its remission. There was no statistically significant difference between atopic and non-atopic patients regarding their levels. Serum IL-6 and sIL-6R correlated positively with each other with stronger correlation in asthma exacerbation. Also they orrelated positively with peripheral blood eosinophilic count [PBEC] and serum total IgE, and con-elated negatively with PEFR during exacerbation and remission
Conclusion: In bronchial asthma, serum IL-6 and sIL-6R are likely involved together in an immunoinflammatory response particularly during acute exacerbation. They are not influenced by atopy. Their increased levels are associated with greater bronchoconstriction suggesting possible roles for them in airway obstruction and in the pathophysiology of bronchial asthma