ABSTRACT
Candiduria is a common and high risk event in patients with uropathies and cancer. In this study we investigated the distribution of 3 virulence factors namely: biofilm formation [BF], secreted aspartyl proteinase [SAP] and phospholipase activity [PLA] among different Candida species isolated from inpatients with candiduria. The susceptibility patterns of Candida isolates to antifungal agents, including the new voriconazole, were evaluated in vitro and the association of these virulence factors with resistance was studied. Urine specimens from 250 patients divided into 3 groups were examined: Group1 [n=50] cancer bladder; Group2 [n=100] obstructive uropathy and Group 3 [n=100] simple recurrent urinary tract infection [UTI]. Candida isolates were identified by CHROM-agar, and by Candifast Es Twin test. Susceptibility testing to antifungal agents was evaluated by disc diffusion test using fluconazole [FCZ] 30microg discs and E test strips for Minimum inhibitory concentration [MIC] determination of FCZ, voriconazole [VCZ] and Amphotericin B [AMB]. Assessment of BF was performed by tube and spectrophotometric plate adherence methods and quantitated by crystal violet staining and XTT reduction assays. PLA was screened using Sabouraud egg yolk agar and SAP was detected using bovine serum albumin agar [BSA]. The overall prevalence of candiduria was 24% with highest incidence among obstructive uropathy patients [67.2%]. Isolation rate of Candida [C]. nonalbicans species [C. tropicalis ,C. krusei and C. glabrata] was significantly higher than C. albicans [73.1% versus 26.8%; p256microg/ml]. Voriconazole, the new triazole antifungal agent, was active against all isolated Candida species with a sensitivity rate of 82%-100% and low MIC values [0.064-1microg/ml] except in C. glabrata species [22%]. All isolated Candida species were more sensitive to VCZ compared to FCZ; particularly C. krusei isolates [90% versus 9%]. AMB remained to be an effective drug with absolute sensitivity and low MIC
ABSTRACT
Recent epidemiological studies have implicated Cytomegalovirus [CMV] infection in the etiology of cancer bladder. The present study was designed to estimate the performance characteristics of different assays, used for identification of CMV infection in schistosomal patients. The study was conducted on sixty cancer bladder patients; thirty five with schistosomiasis [group I] and twenty five without [group II], and twenty control subjects were included [group III]. PCR technique for detection of CMV DNA was performed on bladder tissue, serum, buffy coat and urine. ELISA for detection of IgG and IgM in sera and Antigenemia test and electron miscroscopic studies [EMS] on buffy coat were performed. CMV DNA was significantly detected in group I versus group II by PCR on bladder tissue, buffy coat, and serum respectively. None of the urine samples were positive for CMV DNA. The results of different assays were evaluated in relation to PCR results on tissue biopsies. Antigenemia test showed significant difference between group I versus group II. The EMS was found to increase the sensitivity of PCR on bladder tissue. Both PCR on serum and antigenemia test showed similar sensitivity of 56%, but a specificity of 100% and 81% respectively. In conclusion, the significant association of CMV infection with cancer bladder in Egyptian patients, suggest that the virus may be implicated in the development of such malignant transformation especially in cases with schistosomal affection. Both pp65 antigenemia assay and PCR on serum are two major assays available for diagnosis and monitoring of CMV infections. The EMS could increase the sensitivity and accuracy of PCR on bladder tissue and on buffy coat. Further investigation on a larger number of patients are required in immunodeficient schistosomal cancer bladder patients in order to clarify the role played by CMV in bladder cancer
ABSTRACT
SEN virus [SENV] has been tentatively linked to transfusion-associated non A-E hepatitis. The aim of the present study was to determine the prevalence of SENV among Egyptian patients with HCV-related chronic liver disease [CLD] and haemodialysis [HD] patients and to assess the clinical effect of SENV infection on coexistent hepatitis C either in the severity or the probability of developing hepatocellular carcinoma [HCC]. Polymerase chain reaction [PCR] was used to detect SENV-D and SENV-H DNA in serum samples of 74 HCV-related CLD patients, 45 uraemic patients on maintenance HD and 28 healthy controls. SENV DNA was detected in 13.5%, 11.1%, and 7.1% of CLD, HD patients and healthy controls respectively with no significant differences between patients and control group. No statistically significant differences were demonstrated between SENV infected and non infected CLD or haemodialysis patients regarding the clinical and biochemical parameters. SENV infection was significantly higher in CLD patients with HCC [33.3%] than without [8.5%] [p<0.05]. In conclusion, SENV does not seem to be a common infection in Egyptian patients. It has no apparent influence on the severity of co-existent HCV related CLD but it could be a risk factor for developing HCC in these patients. Further studies are needed to define the aetiopathogenic role of SENV infection in HCC development