Comparative study of different methods of diagnosis of invasive fungal infection in immunocompromised patients

Fungal infection is still a major cause of morbidity and mortality in cancer patients. Our study was conducted on 50 patients attending Al-Hussein university hospital complaining from different types of cancer were suffering from low grade fever, night sweat, weight loss, lassitude and easy fatigability. The cases were matched with 10 healthy controls of the same age and sex. Blood samples were collected and cultured to isolate fungal pathogens using conventional methods and BACTEC system. Positive cases were subcultured on Sabouraud dextrose Agar [SDA]. We describe a multiplex polymerase chain reaction [PCR] based approach to the detection and identification of pathogenic fungi which has potential for the diagnosis of invasive mycoses. PCR allowed the detection [universal PCR] and identification [species-specific PCR] of a fungal pathogen within 6 h from blood samples. Fungal isolates detected and identified using conventional and confirmatory methods were 7 cases [14%], while fungal isolates detected using PCR were 8 cases [18%]. Sensitivity and specificity of conventional methods in relation to PCR was; sensitivity [87.5%] and specificity [98.1%]. In our study Candida species were the only fungal pathogens with different frequency; Candida albicans [4 isolates], Candida tropicalis [2 isolates], Candida glabrata [1 isolate] and Candida parapsilosis [1 isolate]

T lymphocyte subpopulation and function in children with shigellosis

This study was carried on sixty-two children aged from 12 to 60 months, attending TABARAK pediatric hospital with acute dysentery [visible blood in the stool and the presence or absence of fever]. Of the 62 children enrolled in this study, 43 had shigella dysentery 1 [S, dysentery] infection and 19 children matched for age and without any infection as control group, [NI; n= 19]. Children with S. dysentery were divided into 3 groups: those who had HUS or leukomoid reactions [complicated shigellosis, CS; n=25], those who developed complications following enrollment [subsequently complicated shigeliosis, SCS; n=6], and those who had no complication [uncomplicated shigellosis, US; n=12]. T lymphocyte subpopulation and function was evaluated for these children

RESULTS showed that children with SCS differed from other groups in as follows: [i] the number of CD3 and CD4 was lower compared to NI children [P<0.05]. [ii] CD4/CD8 ratio was lower compared to US children [PO.05] and NI children [PO.05]. [iii] The level of DTH response was lower than this in children with US [PO.05]. Three to five days after enrollment, the number of CD4 cells increased in children with SCS, The results showed that T lymphocyte phenotypes and function were altered prior to development ofcomplication in children with shigellosis, and once complications develop, the pattern of alteration changes. Whether these alterations have a role in predicting complications or whether they reflect events underlying the development of complications remains to be elucidated

Evaluation of urinary leukocyte esterase and nitrite tests for diagnosis of bacterial urinary tract infections in the pediatric intensive care unit

This study included 100 infants and children with some urinary tract symptoms who were selected from the pediatric intensive care unit of Al-Hussein University Hospital. The aim of this work is to evaluate the diagnostic performance of the urinary leukocyte esterase and nitrite tests on random urine samples. Also, microscopic urinalysis and urine culture were done to patients with some urinary troubles in the pediatric ICU to provide guidelines for its use. The results showed that the urinary leukocyte esterase test had a sensitivity of 80.36% in detecting leukocyturia [> 10 leukocytes/mm3].The urinary nitrite test had a specifity of 98.01% in detecting bacteriuria. The combination of the urinary leukocyte esterase, nitrite tests and microscopic urinalysis for bacteriuria had a sensitivity of 100%, a specifity of 99.23% and a negative predictive value of 100%. We conclude that, the urinary leukocyte esterase and nitrite tests are rapid screening tests for diagnosis of bacterial urinary tract infections in the pediatric intensive care unit