ABSTRACT
Background: The spread of carbapenem resistance among Enterobacteriaceae have become a problem for healthcare facilities worldwide. Community and hospital-acquired infections caused by these bacteria have been associated with significant morbidity and mortality with limited treatment options. Rapid detection of carbapenem resistant Enterobacteriaceae [CRE] is important for infection control
Objectives: To detect the prevalence of carbapenem resistant Enterobacteriaceae [CRE] species and determine their antimicrobial susceptibility profile using the Vitek 2 system and the presence of carbapenemases genes using Multiplex PCR
Methodology: Various clinical samples were collected from 469 patients from Sohag University Hospitals in the period between August 2016 and April 2018, CRE isolates were identified by conventional methods and antimicrobial susceptibility testing using disc diffusion method and also performed by Vitek 2 automated system, Multiplex PCR was used for detection of carbapenemases genes as blaKPC, blaVIM, blaIMP, blaNDM-1 and blaOXA-48
Results: The prevalence of carbapenem resistant Enterobacteriaceae [CRE] species was 19.9%, Klebsiella pneumoniae was the most common species [51.4%], Escherichia coli [28.6%], Enterobacter aerogenes[8.6%] and Acinetobacter baumannii [5.7%]. Vitek 2 system identified CRE isolates with 82.7% sensitivity, 98.6 % specificity and 90.6% diagnostic accuracy 25.7% of CRE strains were isolated from the internal ICU and 20 % from Chest Department, and mostly isolated from urine[40%] and from endotracheal tubes swabs[28.6 %] 77.1 % of CRE isolates contained carbapenemases genes, 62.1 % were blaKPC positive, 20.7 % were blaVIM-positive, 3.4 % were blaNDM-positive, 13.8 % were blaOXA-48-positive and none was blaIMP-positive
Conclusion: Conventional methods supported by Vitek 2 system is a valuable method for identification of CRE species, the detected carbapenemases genes in this study indicate that carbapenem resistance is spreading in Egypt and support the use of molecular methods for the rapid detection of CRE for successful implementation of infection control measures. We recommend routine testing to determine carbapenem resistance in Enterobacteriaceae in health facilities in Egypt
ABSTRACT
Introduction: Helicobacter Pylori is a common bacteria found in the stomach that can cause ulcers and more rarely gastric cancer. There are multiple diagnostic tests that are currently available to detect this microorganism possibly making it difficult for providers to choose the most accurate or inexpensive test. It is important to diagnosis H. pylori in symptomatic patients due to the potential of eliciting a series of pathologic consequences in the extra-gastric regions. These consequences have been studied at length and can include cardiovascular and autoimmune disorders as well as certain digestive disorders such as liver disease
The Aim of this Study: the aim of this study was to evaluate molecular evidence of the presence of Helicobacter pylori in gastric biopsy samples, based on analysis of urease A [ureA] gene by real-time polymerase chain reaction [PCR], with the other diagnostic methods including culture, histopathology and rapid urease test [RUT] as invasive tests and serology as a non-invasive test in Sohag University Hospitals
Material and Methods: patients complaining of symptoms of upper gastrointestinal disturbance, at the Sohag University hospital from gastroenterology clinic that were already scheduled for upper endoscopy were eligible for enrollment in the study. At the time of endoscopy, 4 biopsies were collected and used for rapid urease, histology, and culture, PCR respectively, urea breath test performed, Stool and serum samples were tested for the presence of H pylori by using commercially available enzyme-inked immunosorbent assay-based technology [ELISA]
Results: positive result for both histopathology and RUT was used as a gold standard for diagnosis against which, sensitivity and specificity of all performed diagnostic tests were calculated. Sensitivity and specificity of PCR were 96.4% and 95.5% respectively with performance index [accuracy] of 96 % which is comparable to that of histopathology [98%] and higher than those of culture [86%], RUT [88%] and serology [70%]
Conclusion: the PCR based molecular method were apparently high sensitive direct method for detection of H. pylori infection from gastric biopsy specimens when compared to standard histologic examination and rapid urease test
ABSTRACT
Introduction: fungal infections continue to cause major complications in cancer patients. The prognosis of these infections is poor unless they are diagnosed early and treated promptly particularly in neutropenic cancer patients. Traditional diagnosis of Candida infections is slow and complicated. The sensitivity of the traditional diagnostic procedure based on blood culture is variable, and it usually takes 2 to 4 days before growth of Candida species is detected. The ability to diagnose and identify candidiasis may be enhanced by the use of molecular techniques, such as PCR
The aim of the study: is to evaluate real-time PCR approach in comparison with standard culture for rapid diagnosis of fungamia and pulmonary fungal injections in cancer patients
Methods: 80 patients with different malignancies in Sohag University Hospital and 20 healthy individuals included as a control. All were investigated for the presence of fungal infections by blood culture, Sputum culture on Sabourads dextrose with cyclohexamide and detection of candid by real-time PCR
Results: in the present report we evaluated a real-time PCR approach in comparison with standard blood culture [BC] diagnostics for rapid diagnosis of candidaemia in patients with various forms of malignancies. Blood culture is positive in 16/80 [20%]. Twelve out of sixteen BC-proven cases [75%] are positive by germ tube test .8/12[66.7%] of candidaemia were positive by the Candida-specific PCR. A positive PCR result was also obtained for 7/68 BC-negative samples. Sensitivity, specificity, positive predictive value and negative predictive value for PCR are 66.7%, 90%, 53.3% and 94% respectively. PCR is more sensitive than blood culture, since [7/68] of the patients at risk for invasive yeast infection, whose blood cultures were all negative for Candida, tested positive in the PCR amplification
Conclusion: the Candida specific-PCR approach facilitates rapid detection of Candida DNA in blood samples of patients at risk of candidaemia within a few hours
ABSTRACT
Background: wheezing is very common in children and more than 50% of children wheeze at some time during the first 6 years of their lives most of these infants will suffer from a single episode of wheezing, some of them showing recurrent and/or persistent wheezy chest. The differential diagnosis of recurrent/persistent wheeze is broad use of Flexible fiberoptic bronchoscopy [FFB] and bronchoalveolar lavage [BAL] are two promising new techniques .for diagnosing the etiology of recurrent/persistent wheezing
Aim of work: aim of this study is to assess the utility of FFB and BAL for diagnostic evaluation of young children with recurrent/persistent wheeze, not in acute attack, and to study the microbiological diagnostic yield of BAL and study the pattern of airway inflammation occurring in such children in Sohag University Hospital
Patients and methods: the study was conducted on 40 infants and children with recurrent/ persistent wheezy chest attending Sohag Faculty of Medicine - pediatric department and clinic and who are not in acute exacerbation or on antibiotic therapy, aged from > I month to < 60 months compared with10 children who are of similar ages as those in the patient group and who need FFB for indications other than recurrent /persistent wheezing which included as control group
Results: the BAZ cell profile of young children with wheezing typically includes a significantly higher cell count [mean, 701.50+/-423.46x 10[3]/ml],a significantly higher neutrophil count [55.43+/-60.09 p value 0.001], as compared with control subjects. Bacteriological culture findings were positive in 16 of the 30 children with wheezing [53.3%] and negative in 14 children [46.7%]. Wheezy children had measured higher level of LLMI, serum IgE and BAL [LTC4/D4/E4] when compared to controls [p=0.001]
Conclusion: FFB and BAL is safe and valuable diagnostic and therapeutic too1 for the management of preschool children with recurrent wheezing poorly responsive to treatement. A neutrophil mediated inflammation seems to characterize this young group of preschool wheezers