Asymptomatic bacteriuria in haemodialysis patients

This study was designed to assess the frequency significance and possible pathogenic factors of asymptomatic bacteriuria in chronic haemodialysis patients. A hundred patients suffering from endstage renal failure under regular haemodialysis treatment [divided into 3 groups according to the underlying cause of renal failure whether primary glomerulonephritis [forty cases] tubulointerstitial nephritis [thirty cases] or diabetic nephropathy [thirty cases] were randomely selected from the dialysis unit of Ain Shams University Hospital, El Sahil Teaching Hospital and Cairo Kidney Centre. None of these patients suffered symptoms nor signs suggestive of urinary tract infection and all were subjected to full history and clinical examination, clean catch midstream urine analysis with culture [aerobic and anaerobic]. Bacterial isolates were identified by bacteriological methods and sensitivity [when needed] in addition to microscopic examination for pus cells. Also, assessment of blood urea and serum creatinine were done. A subgroup of patients [proved to have asymptomatic bacteriuria 10 cases] as well as an equal subgroup of those having no significant bacteriuria were further studied by assessment of residual kidney function, total and differential WBCs counts, serum Ig[G], Ig[A] level, urinary Ig[A] level, opsonophagocytic function and migration inhibition test. Though we had high prevalence of significant bacteriuria in our patients [50%]. Pyuria was detected in only 14% of cases, all except one were associated with significant bacteriuria and the most prevalent organism was Staphylococcus aureus followed by Staph. saprophyticus. We didn't detect any significant correlation between significant bacteriuria and either age of the patients, duration, frequency of dialysis, blood urea or serum creatinine but female patients and chronic interstitial nephritis were associated with significant high prevalence of assymptomatic bacteriuria. In the two subgroups studied no correlation was detected between significant bacteriuria and either W.B.Cs count, residual kidney function, macrophage migration inhibition test, opsonophagocytic activity, Ig[A] or Ig[M] level. Though low Ig[G] level was associated with higher prevalence of asymptomatic bacteriuria. It is conducted that local factors may be more important than systemic factors in the pathogenesis of asymptomatic bacteriuria in haemodialysis patients and that routine urine analysis should be regularly performed in these patients to detect and possibly treat such cases especially female patients and cases of chronic interstitial nephritis

Assessment of a rapid method of pneumococcal antigen detection in routine sputum bacteriology

Sputum samples were obtained from 60 outpatients and inpatients admitted to Ain Shams University Hospitals with chest troubles as pneumonia, bronchopneumonia, acute bronchitis, asthmatic bronchitis and chronic bronchitis. Some of them [29] were collected before administration of treatment for at least 7 days before admission the other [31] were collected after initiation of treatment. Each group included different ages and sexes and examined thoroughly clinically and radiologically. Sputa of each group were examined by three method for detection of Streptococcus pneumoniae which is the cause of the most fatal chest diseases. These methods were Gram film, culture and latex agglutination test for pneumococcal antigen detection. In the first group the highest positive results were obtained by Gram film 69% while culture and antigen detection were apparently equal% 55In the second group the highest positive results were obtained by antigen detection latex agglutination test 80.6%, Gram film was positive in 51.6% and culture was positive in only 32.2%. As regard susceptibility of pneumococci to different penicillin generations we found that it is still the drug of choice for the treatment of pneumococcal infections

Measurement of non-specific antibodies in renal transplant patients and the incidence of certain postoperative viral infections

In this study we assess the level and incidence of panel reactive antibodies which are the main cause of hyperacute rejection in renal transplant. The patients sera were tested against the lymphocytes of standard individuals. The lymphocytes panel had adequate representation of most of known antigens. 11 out of 20 patients [55%] gave positive standard panel test utilizing the microlymphocytotoxic assay. The positivity was recorded at 20°C suggesting that those patients were sensitized. When the recipient sera were treated with Dithiothreitol [DTT] 2 cases showed false cytotoxic antibodies as shown in thee-negative panel obtained after the DTT treatment. The other nine positive cases showed true cytotoxic by not reacting with DTT. 80% of active CMV infections occurred concomitantly to acute rejection episodes and/or its treatment suggest a chronologic, possibly causal link between rejection and CMV infection