ABSTRACT
In Egypt, little is known about the genetic background of Escherichia coli isolates harboring extended-spectrum ß-lactamase (ESBL). Five hundred twenty Enterobacteriaceae were prospectively collected (May 2007-August 2008) at the Theodor Bilharz Research Institute (Cairo). Among the collected Enterobacteriaceae, 56% (n=291) were E. coli and 32% (n=165) Klebsiella pneumoniae. A total of 16% (n=3) of all isolates were ESBL, 19% (n=55) of the E. coli and 14% (n=23) of the K. pneumoniae. The proportion of E. coli ESBL producers did not differ significantly between in and outpatients (20% vs. 17%) but was significantly different for non-E. coli ESBL producers (18.5% vs. 1.2%: p=0.0001). The majority of E. coli ESBL producers (75%) was isolated from urine. All the ESBL-producing Enterobacteriaceae available for molecular study (n=74) produced CTX-M-15. Among the CTX-M-15-producing E. coli isolates; 40% belonged to phylogenetic group A, 32% to D, and 26% to B2. ERIC-2 PCR profiles were obtained for all these E. coli isolates and multilocus sequence typing for those belonging to group B2. Genotyping analyses showed strain diversity; however, some clusters had profiles indistinguishable from that of previously published clones. Multilocus sequence typing showed that 75% of E. coli group B2 belonged to clone ST131. This indicates that a new country in Africa is adversely affected by clones of E. coli-producing CTX-M-15.
Subject(s)
Escherichia coli/isolation & purification , Klebsiella pneumoniae/isolation & purification , beta-Lactamases/biosynthesis , Egypt/epidemiology , Escherichia coli/genetics , Escherichia coli Infections/epidemiology , Escherichia coli Infections/microbiology , Female , Genotype , Humans , Klebsiella Infections/epidemiology , Klebsiella Infections/microbiology , Klebsiella pneumoniae/genetics , Male , Middle Aged , Molecular Epidemiology , Multilocus Sequence Typing , Polymerase Chain Reaction/methods , Population Surveillance , Prospective StudiesABSTRACT
The present study was designed to investigate the prevalence of herpes simplex virus type-2 (HSV-2) in Egyptian patients with bladder cancer or cystitis and to evaluate the performance of different diagnostic HSV-2 assays. The study included 50 patients: 27 with bladder cancer (group I), 23 with cystitis (group II) and 20 subjects as controls (group III). HSV-2 DNA was detected using polymerase chain reaction (PCR) on bladder tissue and buffy coat cells (BCC). Electron microscopic studies (EMS) on BCC and ELISAs for IgM, IgG and specific glycoprotein G-2 (gG-2) IgG were performed. HSV-2 DNA was detected by PCR on bladder tissue biopsies in 29.6% and 21.7% of group I and II respectively and it was also detected by PCR on BCC in 22.2% and 21.7% of group I and II respectively. EMS revealed HSV like particles in 16.6% of cases. IgG, specific gG-2 IgG and IgM were detected in 30%, 16% and 6% of cases respectively. The different assays were evaluated in relation to PCR on bladder tissue biopsies. The gG-2-based ELISA and EMS on BCC were found to be highly specific (97.3% and 100% respectively), with similar low sensitivity of approximately 54%. PCR on BCC was the most sensitive assay. The association of HSV-2 with bladder cancer is suggested especially in schistosomal patients.
