role of Staphylococcus aureus super antigensin pediatric atopic dermatitis

Background: Atopic dermatitis [AD] is a chronic inflammatory skin disease prevalent in children with a rate of 60–90% of superantigen producing staphylococcal colonisation that may play a role in its pathogenesis

Objective: This study aims to investigate the role of superantigen in the pathogenesis of atopic dermatitis by identifying enterotoxins producing S. aureus on the skin and nose of the patients using reverse passive latex agglutination test

Methodology: This study comprised 44 cases with atopic dermatitis attending the Outpatient Clinic of Dermatology and Paediatric Departments of Tanta University Hospital from December 2016 to the end of November 2017. Twenty healthy control volunteers were included

Results: Bacteriological skin cultures of patients revealed colonization with staph. aureus in[72.2]%, whereas, only 6 normal subjects [30%] showed positive cultures. This difference was statistically significant. Culture of nasal swabs revealed colonization with S. aureus in 21 atopic patients[47.2%] and only 8 subjects of control group [40%] with a statistically non significant difference. Wet lesions [in 23 patients] showed highly statistically significant colonization with S. aureus in comparison to dry lesions [in 6 patients]. Out of the [32] positive staph. cultures from the skin of patients,[18] isolates were enterotoxin producers;[3] isolates produced enterotoxin A,[4] produced enterotoxin B,[9] produced enterotoxin C and[2] produced enterotoxin D. In control group, only [2] positive skin cultures were enterotoxins producers; [1] produced enterotoxin B and [1] produced enterotoxin C., the statistical difference was significant. Out of[21] nasal positive Staphylococcal cultures, 6 isolates were enterotoxins producers. Four of them produced enterotoxin B and two produced enterotoxin C. In control group, only 2 positive nasal cultures were enterotoxins producers; one produced enterotoxin B and one produced enterotoxin C. After treatment, skin lesions were clinically improved and the number of positive cultures were reduced from 18 to 8 [6 of them were still superantigen producing]. This difference was significant

Conclusion: It is concluded that daily skin care, use of topical steroids and systemic anti-Staphylococcal antibiotics, are necessary to reduce skin inflammation

study on the aetiology of pneumonia in Cairo and Tanta university hospitals: a bacteriologic approach

One hundred and sixty cases of "pneumonia" with proved clinical and radiological evidence from the Chest Departments in Cairo and Tanta University Hospitals during the year 2007, were the subjects of a conventional bacteriologic study having in mind the empirical approach in the antibiotic therapy. They represented 4.06% of the yearly admissions. The major age incidence was 16 year with more sex predilection. 92.5% belonged to CAP [community acquired pneumonia] and only 7.5% to HAP [hospital acquired pneumonia], VAP [ventilator associated pneumonia] being excluded. 80.6% were primary; with no antedating pathology in the patients, while 19.4% were secondary with co-morbidity in such patients; out which malignancy and COPD were the main associations in older age groups and foreign body in younger ages. The causative organisms were bacteriologically identified only in 53.7% of cases. The main organism in the causation of CAP was Streptococcus pneumoniae in 51.7% of the cases, followed by Hemophilus influenzae in 15.5%, while in HAP, 2 major organisms were responsible for the disease; namely Streptococcus pneumoniae and Klebsiella pneumoniae; 33.3% for each, followed by Hemophilus influenzae and Streptococcus pyogenes; 11.1% for each, but the number of cases in HAP is too small to draw valid conclusions. The organism detected, in primary pneumonia was also essentially Streptococcus pneumoniae 57.6%, while in secondary pneumonia the same organism was encountered in only 33.3% of the cases. Concerning the lobar and lobular distribution of the disease the S. pneumoniae was overwhelming in the lobar type: 84.2%, while in the lobular bronchopneumonic type the main organisms, besides S. pneumoniae which was responsible for 22.2% of the cases were S. pyogenes was responsible for one quarter of the cases and H. influenzae which was encountered in 22.2%. Figures for other organisms are detailed in the text with their relation to other parameters of the study

Is there a relationship between chlamydia trachomatis-associated tubal pathology and different chlamydial genes in infertile women?

Background and Aim: Chlamydia [C.] trachomatis infections in females are a major cause of tubal factor infertility and ectopic pregnancy. However, the precise pathogenesis of C. trachomatis infections remains to be elucidated. Not all women who have undergone a C. trachomatis infection will develop tubal pathology. Variations, like single nucleotide polymorphisms [SNPs], in immunologically important host genes are assumed to play a role in the course and outcome of a C. trachomatis infection. We studied whether genetic traits [carrying multiple SNPs in different genes] in the bacterial sensing system are associated with an aberrant immune response and subsequently with tubal pathology following a C. trachomatis infection. The genes studied all encode for pattern recognition receptors [PRRs] involved in sensing bacterial components

Methods: Of 259 subfertile women, serum was available for C. trachomatis IgG antibody testing and genotyping [common versus rare allele] of the PRR genes TLR9, TLR4, CD14 and CARD15/NOD2. In all women, a laparoscopy was performed to assess the grade of tubal pathology. Tubal pathology was defined as extensive peri-adnexal adhesions and/or distal occlusion of at least one tube

Results: Following a C. trachomatis infection [i.e. C. trachomatis IgG positive], infertile women carrying two or more SNPs in C. trachomatis PRR genes were at increased risk of tubal pathology compared to women carrying less than two SNPs [73% vs 33% risk]. The differences were not statistically significant [P = 0.15], but a trend was observed

Conclusion: Carrying multiple SNPs in C. trachomatis PRR genes tends to result in an aberrant immune response and a higher risk of tubal pathology following a C. trachomatis infection. Larger studies are needed to confirm our preliminary findings

Topical clindamycin or metronidazole for treatment of bacterial vaginosis: microbiologic-clinical study

Aim: To compare the frequencies, concentrations, and antimicrobial susceptibilities of vaginal microbes isolated from women with bacterial vaginosis [BV] before and after therapy with intra-vaginal clindamycin or metronidazole

Design: Prospective randomized controlled study

Patients and Methods: 119 non-pregnant women aged 20 - 45 with clinical and Gram stain evidence ofBV were randomized to receive intra-vaginal clindamycin or metronidazole. Vaginal swabs were collected at baseline and 7 to 12 days, 35 to 45 days, and 70 to 90 days following therapy for quantitative vaginal culture. For the 99 women completing all four visits, statistical analyses were performed comparing differences in vaginal microflora between the two treatment arms and between visits in the same treatment group. Antimicrobial susceptibility testing using the agar dilution method was performed for anaerobic gram-negative rods

Results: Although both therapies resulted in decreased colonization by Gardnerella vaginalis and Mycoplasma hominis, only metronidazole treatment resulted in a significant decrease in the frequency and concentration of Prevotella bivia and black-pigmented Prevotella species. Of the 865 anaerobic gram-negative rods evaluated for susceptibility, only 3 [0.3%] were resistant to metronidazole, whereas clindamycin resistance increased significantly for P. bivia and black-pigmented anaerobic gram-negative rods persisting following clindamycin therapy. Clindamycin-resistant subpopulations of P. bivia and black-pigmented Prevotella species emerged 7 to 12 days after therapy even among women colonized initially by clindamycinsusceptible strains. These resistant subpopulations persisted at high frequencies [42 to 50%] 70 to 90 days following therapy

Conclusion: The two topical agents for treatment of BV have differing microbiologic effects on the vaginal microflora. The emergence of clindamycin-resistant anaerobic gram-negative rods following therapy is of concern