Characterization of metallo-beta-lactamase producing pseudomonas aeruginosa in Egypt

Pseudomonas aeruginosa is an important nosocomial pathogen, commonly causing infections in immunocompromised patients.This study devoted to investigate the clinical and molecular characteristics of metallo-beta-lactamase [MBL] positive P.aeruginosaisolates recovered from different hospitals belonging to Cairo University, Cairo, Egypt.Antibiotic susceptibility testing and phenotypic screening MBLs were performed on 122 P.aeruginosa isolates collected in the period from January 2011 till March 2012.PCR was used to search for MBL genes in imipenem-non-susceptible isolates.The resistant rate to imipenem was 39.34% [n=48].The resistance rates for clinical P. aeruginosa isolates to cefuroxime, cefoperazone, ceftazidime, aztreonam and piperacillin/tazobactam were 87.7%, 80.3%, 60.6%, 45.1%, and 25.4% respectively.Out of 48 imipenem resistant P. aeruginosa isolates, 67.8% were found to produce MBL upon phenotypic screening for MBLs. VIM-2 was detected in 85% of MBL producingP. aeruginosa.IMP-1 was detected in only oneMBL producingP.aeruginosa

Pseudomonas bacteremia in pediatric cancer patients

Despite availability of potent antimicrobial agents, Pseudomonas aeruginosa [P aeruginosa] continues to be a serious cause of bacteremia, with high rates of morbidity and mortality; but no available data to elucidate if non-aeruginosa strains of Pseudomonas constitute a similar problem or just bystanders. The aim of this study was to identify the relative frequency of Pseudomonas bacteremia, and to define its clinical impact in pediatric cancer patients receiving chemotherapy. Medical charts of pediatric cancer patients with Pseudomonas bacteremia, at National Cancer Institute were retrospectively reviewed during the period from January 1999 to December 2002. Risk factors, manifestations of infection, pattern of antibiotic susceptibility and outcome of cases with P aeruginosa and non- aeruginosa bacteremia were evaluated. Over the period of the study, 72 cases of Pseudomonas bacteremia were recorded. P aeruginosa bacteremia represented 1.9% of the total number of positive blood cultures; whereas non-aeruginosa accounted for 4.5%. It was more common in patients with hematologic malignancies [80.6% versus 19.4% in solid tumors]. The most common concomitant site of infection was the lower respiratory tract. The overall cure rate was 72% with no significant difference in adverse outcome between P aeruginosa and non-aeruginosa cases. The variables that were significantly associated with an unfavorable outcome were related to peripheral blood counts. Only a reduced monocyte count at day one was significantly associated with a bad prognosis, whereas at days 4 and 7 reduced absolute neutrophil count [ANC], monocyte, lymphocyte and platelet counts were all related to an adverse outcome. Pseudomonas sp. bacteremia still poses a great health hazard as regards morbidity and mortality in pediatric cancer patients receiving chemotherapy. Factors that can manipulate prolonged reduced cytopenias during intake of chemotherapy may be helpful to reduce adverse outcome of serious Pseudomonas sp. bacteremia in this population of patients

Pneumocystis carinii in bronchogenic carcinoma compared to other immunocompromised cancer patients using immunofluorescence and immunoperoxidase techniques

Indirect immunofluorescence [IFL] assay was used concomitantly with immunoperoxidase stain for the diagnosis of Pneumocystis carinii in 54 cancer patients with respiratory illness. The specimen analyzed was bronchoalveolar lavage fluid [BALF] in 27 patients complaining mainly of blood-tinged sputum for a period of 3-6 months with cough [group one]. Of these patients, 20 were documented by bronchoscopy and histopathology to be bronchogenic carcinoma [subgroup 1A]. Induced sputum was the test specimen in another 27 cancer patients with cough and expectoration for more than one month during receiving their chemotherapy [group two]. In subgroup 1A, eight BALF specimens showed positivity for P. carinii by both techniques. All positive cases for P. Carinii were belonging to subgroup 1A, i.e. proved bronchogenic carcinoma. The immunoperoxidase technique was slightly more specific and as sensitive as IFL. The IFL gave two false positive results as P. carinii cysts were similar to fungi under the fluorescent microscope. On the other hand, only one patient in group two was positive for P. carinii

Hepatitis delta virus Antigenemia in all children after induction chemotherapy

Hepatitis delta virus [HDV] is a defective virus which requires hepatitis B virus as a helper virus. The present study was carried out on sera of 58 ALL children after induction chemotherapy for the detection of HBV markers and HDV antigen by enzyme linked immunosorbant assay [ELISA] technique. Of the 58 ALL cases, with a mean age of 5.8 years, 34 were positive for one or more of the HBV markers, 22 were positive for HBsAg, 13 were positive for HB anti- core IgM, 10 were positive for anti-HBs and 9 were positive for HbeAg. Of these 34 patients, 7 were found to be positive for HDV antigen. ALL 7 children showed elevated ALT levels, which was statistically significantly different when compared to HDAg negative children. On the other hand, 24 ALL children were negative for all HBV markers and were also negative for HD antigen. Co-infection of HBV and HDV was the prominent pattern of infection in these patients. As these leukemic children had received multiple transfusions during induction therapy, they became liable to acquire both viruses from infected blood

Serum ferritin as a tumor associated marker in malignant lymphomas: Is it influenced by age, serum iron, or C-reactive protein?

Serum ferritin concentration as a tumor associated marker was investigated in 60 patients suffering from malignant lymphomas. The patients were categorized into two age groups: 30 children [2-14 years] and 30 adults [>14 years]. In an attempt to clarify the mechanism of increased serum ferritin, serum iron, total iron binding capacity [TIBC] [with calculation of percent saturation] and C- reactive protein [CRP] were examined. Increased serum ferritin levels were found in 48.3% of the lymphoma patients, while none of the healthy controls showed an elevated serum ferritin. This increased serum ferritin in patients correlated with the stage of the disease as 70.8% of the disseminated lymphoma [DL] group showed increased serum ferritin compared to 33.3% of patients with non-disseminated disease. Furthermore, the mean ferritin levels showed statistically significant higher values in the DL group, the P value being <0.001. The increase in serum ferritin correlated significantly with CRP suggesting that it is a part of the acute phase reaction