Emerging infection: streptococcal toxic shock-like syndrome caused by group B Streptococcus (GBS), Streptococcus agalactiae

ABSTRACT Streptococcus agalactiae or Group B Streptococcus (GBS) infections are commonly associated with infections in neonates and pregnant women. However, there has been a rising incidence in nonpregnant adults. The risk of GBS infection in nonpregnant adults is increased for patients of advanced age and those with underlying medical conditions such as diabetes mellitus and cancer. We present a 77-year-old female with type-2 diabetes mellitus, hypertension, and bilateral foot ulcers that presented in probable septic shock with necrotic foot ulcers and necrotizing fasciitis and underwent bilateral lower limb amputations. The patient fulfilled the Streptococcal Toxic Shock Syndrome (STSS) criteria as defined by The Working Group on Severe Streptococcal Infections. These criteria were created for group A Streptococcus (Streptococcus pyogenes). Our patient fulfilled the Working Group's criteria, except that the blood culture was positive for group B Streptococcus (Streptococcus agalactiae). Numerous studies demonstrate the importance of early detection and antibiotic treatment for GBS infections in general and early surgical management for necrotizing soft tissue infections (NSTIs) such as necrotizing fasciitis.

Biochemical Characterization, 16S rRNA Sequence Analysis and Multiple Sequence Alignment of Bacteria Isolated from Fermented and Unfermented Coconut.

Coconut (Cocos nucifera L.) is a tropical and subtropical plant which has great versatility due to many benefits of its different parts. Appropriate methods such as biochemical, morphological, serological, physiological and molecular techniques are required to clearly differentiate beneficial from harmful bacteria that are found in coconut. The objectives of this research were to characterize bacterial diversity in coconut based on biochemical tests and molecular techniques, to study the evolutionary relationship among the bacteria isolates based on 16S rRNA BLAST analysis and Multiple Sequence Alignment. Eight bacteria isolates, 3 from fermented and 5 from non-fermented coconut were identified. Biochemical characterization, polymerase chain reaction amplification of 16S rRNA using universal primers (63f-1387r), BLAST analysis and multiple sequence analysis were performed. The result indicated that the bacteria were detected as Klebsiella pneumonia, Enterobacter aggromerans, Pseudomonas, Ralstonia pickettii and Burkholderia. The first two were carbohydrate fermenting while the last three were non-fermenting bacteria. All these species are related to human pathogenicity. This can be related to hygiene in food process and handling procedures. Therefore, to favour the selective growth of beneficial bacteria, appropriate environmental hygiene is required.

Study of the association between the human leukocyte antigen class I molecules and remitting relapsing multiple sclerosis MS

The aim of this work is to study the frequencies of different HL4 class I subtypes in Egyptian patients with remitting relapsing MS in order to find out genetic determinants to disease susceptibility among this genetic group. The study was carried out on twenty patients having Ms according to McDonald's criteria, excluding those with clinical courses other than the remitting-relapsing one. All patients subjected to complete history taking, full physical and neurological examination, routine lab investigations, MRI of the brain and/or spinal cord, also HLA class I typing using the complement dependent microlymphocytotoxicity test. The result of HLA typing were compared to twenty healthy controls matched for age. The study revealed the following results. o The most frequent HLA class I subtypes in our study group were: HLA-A1 [40%], A2 [30%], B7 [25%], A28 [15%], and Cw6 [15%]. o Among those subtypes only HLA-B7 showed a statistically significant association with the MS patients suggesting a role of this HLA class I subtype in modulating susceptibility to the disease. o The HIA-Cw4 subtype showed a tendency toward an association with the control group approaching but not reaching a statistical significance suggesting a role of this subtype as a protective factor against MS. However further confirmation is required to support this finding. o The HLA-B7 subtype was significantly associated with the presence of emotional disturbance in the MS patients suggesting a role of this subtype in modulating the clinical picture of the disease. o The HLA-A2 subtype was significantly associated with the absence of sphincteric disturbance in the MS patients suggesting a protective role of this subtype against this particular clinical defect. This subtype may also have a similar protective role against developing emotional disturbance although this finding was only near significant. The above mentioned results agreed with a few reports from some parts of the world and disagreed with many others suggesting a considerable difference in genetic determinants of MS between different populations