Helicobacter pylori cagA Gene in Egyptian sewage workers

A comparative cross-sectional study was conducted on 60 sewage workers and 30 matched unexposed referents from Mansoura city; Egypt; to estimate the prevalence and risk factors of Helicobacter pylori (H. pylori). Stool culture and detection of H. pylori antigen were done. In addition; the polymerase chain reaction (PCR) amplification of cytotoxin-associated gene A (cagA) gene in H. pylori in stool samples was carried out. The prevalence of H. pylori in sewage workers was 56.7% compared to 16.7% in the comparison group with a highly statistically significant difference between both groups. H. pylori cagA gene was present in 64.7% of H. pylori-infected sewage workers compared with 40% of controls. cagA gene was associated with more dyspeptic symptoms (77.3%) in infected workers compared to those of noninfected ones (33.3%) (P = .041). The risk of H. pylori was significantly higher among workers with poor compliance with personal protective equipment (PPE) (OR = 3.00); with duration of work 20 years (OR = 4.71); older than 45 years (OR = 4.27); and of low education level (OR = 11.2). We concluded that H. pylori infection and heartburn with or without epigastric pain are significant health problems in the studied sewage workers. Low education and poor compliance with PPE were the only predictors of H. pylori infection in sewage workers

Susceptibility tests of oropharyngeal Candida albicans from Egyptian patients to fluconazole determined by three methods

Candida albicans frequently cause oropharyngeal candidiasis in immunocompromised patients. As some of these isolates show resistance against azoles, the clinician is wary of initiating therapy with fluconazole (FZ) until a final susceptibility report is generated. We aimed to evaluate the efficacy of rapid flow cytometry (FCM) and disc diffusion (DD) methods in comparison to reference microdilution (MD) of Clinical and Laboratory Standards Institute (CLSI) method for FZ. Thirty seven Candida albicans isolates were tested by the three methods. By both MD and FCM, 26/37 (70.3%) were sensitive with minimal inhibitory concentration (MIC) ¡Ü 8¦Ìg/ml, 5/37 (13.5%) were susceptible dose dependant (S-DD) with MIC 16-32 ¦Ìg/ml and 6/37 (16.2%) were resistant with MIC ¡Ý64¦Ìg/ml. More than 92% of isolates susceptible to FZ by the MD were susceptible by the DD methods with good agreement (81.08%, P = 0.000). However, 4/5 isolates diagnosed as S-DD by MD were resistant by DD. Interestingly, the MIC by FCM at 4 h showed excellent agreement (95.59%, P = 0.000) to that obtained by MD method at 24 h. Overall, FCM antifungal susceptibility testing provided rapid, reproducible results that are valuable alternative to MD. The DD test is recommended as a simple and reliable screening test for the detection of susceptible Candida albicans isolates to FZ.

Diagnostic performance of an immunoassay for simultaneous detection of HCV core antigen and antibodies among haemodialysis patients

Nosocomial transmission of HCV is a concern in haemodialysis (HD) units worldwide. Diagnosis of HCV infection among dialysis patients is currently based on the detection of anti HCV antibodies by ELISA, and is confirmed by HCV RNA. The average window period between HCV infection and seroconversion with new generations of HCV antibody tests remains approximately 70 days with more prolonged period among dialysis patients. In this study we assessed the diagnostic performance of an immunoassay designed for simultaneous detection of anti HCV antibodies and core antigen in one step in comparison to qualitative RT-PCR and anti HCV antibodies detection test among Egyptian haemodialysis patients. The studied patients were 39 chronic renal failure patients on maintenance haemodialysis. The results obtained in the present study revealed HCV infection of 56.4 percent. Combined Ag/Ab test detected 3 out of the 4 anti-HCV negative viraemic patients who were in the window period. The sensitivity, specificity and accuracy of the test were higher than that of anti HCV antibodies detection test (95.45 percent, 94.1 percent and 94.87 percent versus 81.8 percent, 88.23 percent and 84.6 percent) and they were raised to 100 percent on combining its positivity with liver enzymes elevation results. Therefore, this simple combined Ag/Ab test can be applied for early detection of HCV infection during window period among HD patients as an alternative to HCV RNA detection.