Detection of gram negative bacilli and endotoxin in water and dialysate of haemodialysis unit in a university hospital

This study aimed to detect Gram negative bacilli by different microbiological methods and to detect the endotoxin by The Limulus Amebocyte Lysate [LAL] assay in water and dialysate of haemodialysis unit in Zagazig University Hospitals. Two hundred eighty one water samples, 50 concentrate and 100 dialyste samples were collected. All tested samples were cultured on four media using membrane filtration technique, M- Endo at 37 degree C for 24 hours [selective for total coliform], M- FC medium at 45 degreeC for 48 hours [selective for faecal coliform], Reasoner's 2 agar [R2A] at 22 degreeC for 7 days [for isolation of heterotrophs] and Cetermide medium at 37 degree C for 24 hours [selective for Pseudomonas auroginosa].Forty samples were tested for endotoxin by gel clot method LAL assay along with bacterial count on R2A medium. Fifty dilaysate samples were tested for free short segments of DNA .The same samples were directly tested by PCR for the presence of Gram negative bacilli 16S t RNA universal gene. No water samples showed coliform or faecal coliform growth while concentrate and dialysate samples showed 12% and10 % coliform growth and 6% and 5% faecal coliform growth respectively. 9.7 % of all tested samples showed growth of Pseudomonas aurginosa. On R2A 28.9% of all tested samples showed growth. Forty percent of treated water, 60% of treated water after distribution and 70 % dialyste samples had endotoxin level > 0.25 EU/ml. 82% of dialysate samples showed short DNA fragment with molecular weight below 100 bp.62% of samples showed positive results for the presence 16S t RNA gene with bands that lie in the area between 123-246 bp .The quality of water and fluids used in the heamodialysis unit under study necessitates revision of to elevate the quality of haemodialysis service with better outcome for patients

Urinary leukotriene level in patients with bronchial asthma

Cysteinyl leukotriene is considered an important mediator in airway inflammation in asthma. So this work was conducted to measure urinary leukotriene E4 levels in patients with bronchial asthma in comparison to control subjects and to define a potential role of Cys LT in patients with bronchial asthma. This study was done on 50 asthmatic patients, 25 males and 25 females with age range from 6 to 45 years in addition to 15 apparently healthy subjects, of matched age and sex. Urine and blood samples were collected to estimate urinary LTE4, total serum IgE by ELISA respectively and CBC, after full clinical examination, skin test, urine and stool analysis were done. Pollen was the most common allergen causing positive skin test in patients [63.41% of cases].The mean values of blood eosinophilic percentage, urinary LTE4 and total IgE level of patients were significantly higher than that of control group, and in atopic patient than that of non-atopics. There were positive significant correlations between blood eosinophilic percentage, urinary LTE4 and total IgE level of patients. There were no correlations between either age of patients or duration of illness with blood eosinophilic percentage, urinary LTE4 and total IgE level. In conclusion, the measurement of LTE4 in urine sample, which is safe and easily available method of estimating the synthesis and release of the mediator, would be useful in understanding the pathogenesis of bronchial asthma

Urinary leukotriene level in patients with bronchial asthma

Cysteinyl leukotriene is considered an important mediator in airway inflammation in asthma. So this work was conducted to measure urinary leukotriene E4 levels in patients with bronchial asthma in comparison to control subjects and to define a potential role of Cys LT in patients with bronchial asthma. This study was done on 50 asthmatic patients, 25 males and 25 females with age range from 6 to 45 years in addition to 15 apparently healthy subjects, of matched age and sex. Urine and blood samples were collected to estimate urinary LTE4, total serum IgE by ELISA respectively and CBC, after full clinical examination, skin test, urine and stool analysis were done. Pollen was the most common allergen causing positive skin test in patients [63.41% of cases].The mean values of blood eosinophilic percentage, urinary LTE4 and total IgE level of patients were significantly higher than that of control group, and in atopic patient than that of non-atopics. There were positive significant correlations between blood eosinophilic percentage, urinary LTE4 and total IgE level of patients. There were no correlations between either age of patients or duration of illness with blood eosinophilic percentage, urinary LTE4 and total IgE level. In conclusion, the measurement of LTE4 in urine sample, which is safe and easily available method of estimating the synthesis and release of the mediator, would be useful in understanding the pathogenesis of bronchial asthma

Circulating levels of interleukin-6 and its soluble receptor in asthma exacerbation and remission

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

relation between HLA [Class I] and bronchial asthma

This study included forty eight patients suffering from allergic bronchial asthma in addition to 24 normal persons as a control group who were completely chest free. All individuals were subjected to full history taking, prick and intradermal skin tests for common allergens [house dust mites, mixed fungi, mixed pollens, hay dust, wool, cat hair and dog hair] and HLA [class I] typing by Micro lympnocyto-toxicity. It was found that the most prevalent allergens causing bronchial asthma were house dust mites [45.8%] and mixed fungi [20.8%]. The most common HLA [class I] associated with allergic asthma were HLA-A[1], B[8], Cw[4] and these results were statistically significant [P = < 0.01]. The asthmatic patients with house dust mites were mostly associated with HLA-A[1], B[8], Cw[6] while to mixed fungi was HLA- A[1], A[30], B[8], Cw[4]. So persons with HLA-A[1], B[8] are more susceptible to develop bronchial asthma, so we must kept him away from sources of external allergens

Oral defensive mechanisms in normal subjects and in patients with periodontal diseases

This study was done on 48 cases of periodontal diseases, and 48 normal subjects as controls. Determination of IgA, C3c and fibronectin concentration in saliva samples from patients and controls was done by radial immunodiffusion. The role of buccal epithelial cells [BEC] as a defensive mechanism was determined by the inhibition of bacterial growth rate on Mueller Hinton agar plates. There was statistically significant increase in the concentration of IgA and C3c and nonsignificant increase in the concentration of fibronectin in saliva samples from patients with periodontal diseases compared to controls. Adherence of Strept. viridans to BEC was markedly increased in patients with periodontal diseases compared to controls and this was statistically significant. The antibacterial activity of BEC was markedly obvious in normal subjects compared to those with periodontal diseases and this result was statistically highly significant

Effect of subminimal inhibitory concentration of Aminoglycosides on some Gram-Negative Bacilli

The effect of pre-incubation of Ps. aeruginosa and E. coli with subminimal inhibitory concentrations [sub-MICs] of tobramycin and amikacin on the adherence of these organisms was studied. Pre-incubation with sub-MICs of tobramycin or amikacin significantly enhanced the adherence for Ps. aeruginosa and decreased adherence for E. coli. Furthermore, the effect of pre-incubation with sub-MICs of tobramycin or amikacin on polymorphonuclear leukocyte [PMNLs] function against these organism was determined. Filtrates of E. coli pre-incubated with sub-MICs of tobramycin or amikacin promoted PMNL chemotaxis. No effect on chemotaxis was noted with the filtrates of Ps. aeruginosa pre-incubated with tobramycin or amikacin. Phagocytosis and intracellular killing for both organisms were increased after they were pre-incubated with sub-MICs of tobramycin or amikacin

Prevalence of shigella subgroups and their antibiotic susceptibility pattern among recruits

This work was done on 300 samples of stools, 150 samples from diarrheal cases presented at El-Kobba Military Hospital and 150 samples from the control group. Out of the 150 diarrheal samples 15 shigella subgroups were isolated [10%], while 3 strains were isolated from the control group [2%]. Biotyping was done by the conventional methods and API and also serotyping was done. Shigella dysenteriae constituted the majority of shigellae isolated from patients [6.66%], followed by Shigella sonnei [2.66%]. A comparison was done on different culture media used for isolation of shigellae. It was found that Desoxycholate citrate agar [DCA] and Macconkey's agar were highly selective medium for the isolation, while selenite enrichement media inhibits many isolates of shigella strains. This work shows a change in antibiotic resistance pattern of most isolated strains. All the isolated shigella strains were resistant to tetracyclin and streptomycin and 86.66% were resistant to trimethoprim