MicroRNA-146a expression as a potential biomarker for rheumatoid arthritis in Egypt

Background: MicroRNAs [miRNAs] are small non-coding RNAs, whose role in regulating diverse immune functions, suggests they might play a role as biomarkers for immune medi-ated disorders. Studies showed that miRNA-146a [miR-146a] expression is increased by proinflammatory cytokines and is an important modulator of differentiation and function of cells of innate and adaptive immunity

Aim of the work: The current study aimed to evaluate the expression of miR-146a as a potential biomarker for diagnosis of rheumatoid arthritis [RA] and to explore its association with disease activity

Subjects and methods: The study enrolled 50 Egyptian subjects divided into a patient group, which comprised 25 RA patients, and a control group which comprised 25 healthy individuals

The disease activity for the patients' group was determined by simplified disease activity index. Relative quantification of miR-146a expression in whole blood was determined using reverse tran-scriptase quantitative real time polymerase chain reaction

Results: There were highly significant statistical differences between patients and healthy controls as regards miR-146a relative expression, erythrocyte sedimentation rate [ESR] and anti-cyclic citrullinated peptide [anti-CCP] [p < 0.001]. Highly significant statistical differences [p < 0.001] were also found between different patients' subgroups as regards miR-146a relative expression and ESR. rm'R-146a levels correlated positively with those of ESR, C-reactive protein and anti-CCP [p < 0.001]

miR-146a illustrated best performance in diagnosing RA, showing the highest sensitivity and specificity [96% and 100%, respectively] [AUC: 0.992 at a cut off value of >/=2.16] compared to anti-CCP [sensitivity: 68%, specificity: 100% and AUC: 0.87 at a cut off value of >/= 22 U/ml] and RF [sensitivity: 56%, specificity: 80% and AUC: 0.992 at a cut off value of >/=13 U/ml]

Conclusion: This study demonstrated that miR-146a expression was highly significantly elevated in whole blood of patients with RA. Its diagnostic performance was better than anti-CCP and RF and its level of expression correlates with disease activity

Device- associated infections and antimicrobial resistance patterns of isolated pathogens in surgical intensive care unit at Ain Sham University Hospital

Device associated infections [DAIs] are considered the principal threat to patient safety in the ICU, and among the main causes of patient morbidity and mortality. To determine the DAI rates, as well as to identify the infectious agents isolated and their antimicrobial resistance patterns in the surgical ICU of Ain Sham University Hospital. The numbers of total patient days, ventilator days, urinary catheter days, and central catheter days in the ICUs were recorded during the period from June to November 2013. DAI rates and device utilization ratios were calculated. Clinical specimens were obtained from infected patients, cultured onto suitable media and isolates were identified using conventional methods. Antimicrobial susceptibilities of the isolates were investigated according to the standards of the Clinical and Laboratory Standards Institute. Totally 152DAIs were determined with a rate of 24.43/1, 000device days. The device utilization ratios were as follows: [0.75] for urinary catheter, [0.54] for mechanical ventilator, and [0.41] for central line. Ventilator associated pneumonia rate was 26.07/1, 000 ventilator days and most common microorganism was K.pneumoniae. Catheter associated urinary infection rate was 25.3/1, 000 urinary catheter days and the most common pathogen was E.coli. Central catheter associated blood stream infection rate was 19.84/1, 000 central catheter days and the most common infecting organism was S.aureus. Among Staphylococcus spp., 60.52% of S.aureus isolates and 50% of coagulase negative Staphylococci were methicillin resistant. ESBL production rates were 27.77% in E.coli, 27.6% in P.aeuroginosa, and 20.83% in K.pneumoniae isolates. The high rates of DAIs, device utilization ratios, and levels of antimicrobial resistance of pathogens identified in this study, highlight the importance of establishing antimicrobial stewardship and an active surveillance program, developing a comprehensive education program on evidence-based approaches for all health care workers, decreasing device utilization and the implementation of care bundles

Fast plaque assay technique for detection of mycobacterium tuberculosis in sputum samples of newly diagnosed cases of pulmonary tuberculosis

Tuberculosis [TB] is a serious public health problem that especially prevalent in developing countries. An essential element in the control of TB is the rapid, sensitive and specific identification of the causative agent. Mycobacteriophages constitute a potentially useful approach for detecting viable Mycobacterium tuberculosis bacilli as well as for susceptibility studies. The aim of this study is to evaluate the diagnostic value of the Phage Tek MB kit for pulmonary tuberculosis in comparison with standard Lowenstein-Jensen [LJ] media and staining techniques for respiratory specimens. Sputum specimens submitted for diagnosis of mycobacterial disease at Ain Shams University hospital from August to November 2004 were included in the study. Specimens were studied using both of the conventional methods [direct microscopic examination and culture in LJ medium] and the Phage Tek MB assay. The sensitivity, specificity, positive and negative predictive value for the FAST Plaque TB assay relative to that of culture were 65.52, 100, 100 and 52.38%, respectively. The sensitivity was much higher in smear positive samples in comparison to smear negative ones [73.91% and 33.33%, respectively]. FAST Plaque TB proved to be specific, and rapid. It is able to detect M. tuberculosis in clinical samples within 1 day with 100% specificity, long before culture results]. Also it is cheap technology in comparison to PCR and would be suitable for use by routine microbiology laboratories, especially in developing countries