Promising Antioxidant and Antimicrobial Potencies of Chemically-Profiled Extract from Withania aristata (Aiton) Pauquy against Clinically-Pathogenic Microbial Strains.

Withania aristata (Aiton) Pauquy, a medicinal plant endemic to North African Sahara, is widely employed in traditional herbal pharmacotherapy. In the present study, the chemical composition, antioxidant, antibacterial, and antifungal potencies of extract from the roots of Withania aristata (Aiton) Pauquy (RWA) against drug-resistant microbes were investigated. Briefly, RWA was obtained by maceration with hydro-ethanol and its compounds were identified by use of high-performance liquid chromatography (HPLC). The antioxidant activity of RWA was determined by use of ferric-reducing antioxidant power (FRAP), 1,1-diphenyl-2-picrylhydrazyl (DPPH), and total antioxidant capacity (TAC). The evaluation of the antimicrobial potential of RWA was performed against drug-resistant pathogenic microbial strains of clinical importance by use of the disc diffusion agar and microdilution assays. Seven compounds were identified in RWA according to HPLC analysis, including cichoric acid, caffeic acid, apigenin, epicatechin, luteolin, quercetin, and p-catechic acid. RWA had excellent antioxidant potency with calculated values of 14.0 ± 0.8 µg/mL (DPPH), 0.37 ± 0.08 mg/mL (FRAP), 760 ± 10 mg AAE/g (TAC), and 81.4% (ß-carotene). RWA demonstrated good antibacterial potential against both Gram-negative and Gram-positive bacteria, with inhibition zone diameters ranging from 15.24 ± 1.31 to 19.51 ± 0.74 mm, while all antibiotics used as drug references were infective, except for Oxacillin against S. aureus. Results of the minimum inhibitory concentration (MIC) assay against bacteria showed that RWA had MIC values ranging from 2.13 to 4.83 mg/mL compared to drug references, which had values ranging from 0.031 ± 0.003 to 0.064 ± 0.009 mg/mL. Similarly, respectable antifungal potency was recorded against the fungal strains with inhibition zone diameters ranging from 25.65 ± 1.14 to 29.00 ± 1.51 mm compared to Fluconazole, used as a drug reference, which had values ranging from 31.69 ± 1.92 to 37.74 ± 1.34 mg/mL. Results of MIC assays against fungi showed that RWA had MIC values ranging from 2.84 ± 0.61 to 5.71 ± 0.54 mg/mL compared to drug references, which had values ranging from 2.52 ± 0.03 to 3.21 ± 0.04 mg/mL. According to these outcomes, RWA is considered a promising source of chemical compounds with potent biological properties that can be beneficial as natural antioxidants and formulate a valuable weapon in the fight against a broad spectrum of pathogenic microbes.

Induced Pluripotent Stem Cells (iPSCs)-Roles in Regenerative Therapies, Disease Modelling and Drug Screening.

The discovery of induced pluripotent stem cells (iPSCs) has made an invaluable contribution to the field of regenerative medicine, paving way for identifying the true potential of human embryonic stem cells (ESCs). Since the controversy around ethicality of ESCs continue to be debated, iPSCs have been used to circumvent the process around destruction of the human embryo. The use of iPSCs have transformed biological research, wherein increasing number of studies are documenting nuclear reprogramming strategies to make them beneficial models for drug screening as well as disease modelling. The flexibility around the use of iPSCs include compatibility to non-invasive harvesting, and ability to source from patients with rare diseases. iPSCs have been widely used in cardiac disease modelling, studying inherited arrhythmias, neural disorders including Alzheimer's disease, liver disease, and spinal cord injury. Extensive research around identifying factors that are involved in maintaining the identity of ESCs during induction of pluripotency in somatic cells is undertaken. The focus of the current review is to detail all the clinical translation research around iPSCs and the strength of its ever-growing potential in the clinical space.

Potent antioxidant and anticancer activities of the methanolic extract of Calligonum comosum (L'Her) fruit hairs against human hepatocarcinoma cells.

Cancer is a devastating and aggressive disease that is globally ranked as the second-leading cause of deaths despite the relentless efforts being directed towards the discovery of novel chemotherapeutic drugs. Plants naturally produce a plethora of secondary metabolites that play a crucial role as effective therapeutic agents. Cancer treatment rely primarily on chemo- and radio-therapeutic strategies that suffers from known side effects. Recently, the strategy of controlling cancer progression by use of plant-derived natural products have extensively attracted research interests. In this study, the antioxidant and anticancer activities of the methanolic extract of Calligonum comosum (MeCc) fruit hairs were investigated. According to DPPH and ABTS assays, MeCc exhibited potent antioxidant capacity as it displayed significant free-radical scavenging activity. Results of the MTT cytotoxicity assay revealed that the MeCc exhibited potent anti-proliferation activity (IC50 = 10.4 µg/ml) that is specific against human hepatocarcinoma cells (HepG2), as only marginally harmful effect against non-cancerous control BJ-1 cells was detected. Results of the RT-qPCR gene expression analyses indicated that MeCc resulted in significant overexpression of mRNA transcript levels of the pro-apoptotic genes p53, caspase-3 and Bax, while downregulating the level of Bcl-2, an anti-apoptotic marker gene. Immunoblotting of the protein expression levels for the same markers showed similar pattern to that observed in RT-qPCR profiling. While the levels of p53, caspase-3 and Bax proteins exhibited significant increase, the protein level of Bcl-2 was significantly reduced. In conclusion, it is proposed that the observed specific anticancer activity of MeCc against HepG2 cells takes place via the engagement of apoptosis. This highlights the value of C. comosum as a source of potent natural anticancer agents and warrants further investigation to identify the active principals involved.

Quantitative proteomics analysis reveals unique but overlapping protein signatures in HIV infections.

BACKGROUND: Human immunodeficiency virus-1 (HIV-1) exploits human host factors to complete its life cycle. Hence, discovery of HIV-regulated host proteins markers would better our understanding of the virus life-cycle and its contribution to pathogenesis and discovery of objective diagnostic and prognostic molecules. METHODS: We conducted holistic total proteomics analysis of three closely related study populations including patients with HIV type-1 (HIV-1) and HIV type-2 (HIV-2) as well as HIV-1 elite controllers (HIV-1-EC). Peripheral blood plasma (PBP) samples were subjected to label-free quantitative liquid-chromatography tandem mass-spectrometry (LC-MS/MS). RESULTS: Over 314 unique PBP protein species were identified of which 100 (approx. 32%) were significantly differentially expressed (≥2 to ∞ - fold-change; p < 0.05) between the three sample cohorts. Of the 100 proteins, 91 were significantly changed between pairs of HIV-1 versus HIV-1-EC, while 83 of the 100 proteins differed significantly between HIV-2 and HIV-1-EC. Interestingly, 76 proteins (87.5%) overlap between the two data sets indicating that majority of these proteins share similar expression changes between HIV-1 and HIV-2 sample groups. Two of the identified proteins, XRCC5 and PSME1, were implicated in the early phase of the pathway network for HIV life cycle, while others were involved in infectious disease and disease of signal transduction. Among them were MAP2K1, RPL23A, RPS3, CALR, PRDX1, SOD2, LMNB1, PHB, and FGB. Despite the high degree of similarity in protein profiles of HIV-1 and HIV-2, six proteins differed significantly including ETFB, PHB2, S100A9, LMO2, PPP3R1 and Vif, a fragment of virion infectivity factor of HIV-1. Additionally, 15 proteins were uniquely expressed, and one of them (LSP1) is present only in HIV-1-EC but absent in HIV1 and HIV-2 and vice versa for the rest 14 proteins. CONCLUSIONS: Altogether, we have identified HIV-specific/related protein expression changes that might potentially be capable of early diagnosis and prognosis of HIV diseases and other related infectious diseases.

Prevalence and Diversity of Haplotypes of Sickle Cell Disease in the Eastern Province of Saudi Arabia.

Hb F modulates sickle cell disease. Five major haplotypes of the ß-globin gene cluster are associated with sickle cell disease. In the Eastern Province of Saudi Arabia, the Arab-Indian (AI) is most common. Single nucleotide polymorphism (SNP) genotyping (rs3834466, rs28440105, rs10128556, and rs968857) was carried out by nuclease allelic discrimination assay with target-specific forward and reverse primers, TaqMan probes, labeled with VIC and FAM. In 778 patients with sickle cell disease from the Eastern Province, a haplotype was assigned to 90.9% of all samples; 9.1% were classified as compound heterozygotes for the AI and an atypical haplotype. The distribution of haplotypes for 746 Hb S (HBB: c.20A > T) homozygotes was: 614 AI/AI, nine SEN/SEN (Senegal), 42 SEN/AI, nine CAM/CAM (Cameroon), one CAR (Central African Republic)/BEN (Benin), 71 AI/atypical. In Hb S/ß-thalassemia (Hb S/ß-thal), the distribution of Hb S haplotypes was: 22 AI/AI, one CAM/CAM, four AI/SEN, five AI/atypical. Mean Hb F in the haplotypes was: AI/AI 16.6 ± 7.5%, CAM/CAM 8.0 ± 4.1%, SEN/SEN 11.0 ± 5.1%, SEN/AI 15.1 ± 4.6%, AI/atypical 16.2 ± 6.5%. The presence of the SEN and CAM haplotypes was unexpected due to the apparent homogeneity of the population of the Eastern Province. We have successfully classified sickle cell disease haplotypes using the relatively inexpensive TaqMan assay for the first time. In addition, we have previously shown that children with AI haplotype have Hb F of 30.0% and mild disease, while in our cohort of adult AI patients, which might be the largest yet reported, Hb F was about 16.6%.

Existence of HbF Enhancer Haplotypes at HBS1L-MYB Intergenic Region in Transfusion-Dependent Saudi ß-Thalassemia Patients.

Background and Objectives. ß-Thalassemia and sickle cell disease are genetic disorders characterized by reduced and abnormal ß-globin chain production, respectively. The elevation of fetal hemoglobin (HbF) can ameliorate the severity of these disorders. In sickle cell disease patients, the HbF level elevation is associated with three quantitative trait loci (QTLs), BCL11A, HBG2 promoter, and HBS1L-MYB intergenic region. This study elucidates the existence of the variants in these three QTLs to determine their association with HbF levels of transfusion-dependent Saudi ß-thalassemia patients. Materials and Methods. A total of 174 transfusion-dependent ß-thalassemia patients and 164 healthy controls from Eastern Province of Saudi Arabia were genotyped for fourteen single nucleotide polymorphisms (SNPs) from the three QTL regions using TaqMan assay on real-time PCR. Results. Genotype analysis revealed that six alleles of HBS1L-MYB QTL (rs9376090C p = 0.0009, rs9399137C p = 0.008, rs4895441G p = 0.004, rs9389269C p = 0.008, rs9402686A p = 0.008, and rs9494142C p = 0.002) were predominantly associated with ß-thalassemia. In addition, haplotype analysis revealed that haplotypes of HBS1L-MYB (GCCGCAC p = 0.022) and HBG2 (GTT p = 0.009) were also predominantly associated with ß-thalassemia. Furthermore, the HBS1L-MYB region also exhibited association with the high HbF cohort. Conclusion. The stimulation of HbF gene expression may provide alternative therapies for the amelioration of the disease severity of ß-thalassemia.

Exome-Wide Association Analysis of Coronary Artery Disease in the Kingdom of Saudi Arabia Population.

Coronary Artery Disease (CAD) remains the leading cause of mortality worldwide. Mortality rates associated with CAD have shown an exceptional increase particularly in fast developing economies like the Kingdom of Saudi Arabia (KSA). Over the past twenty years, CAD has become the leading cause of death in KSA and has reached epidemic proportions. This rise is undoubtedly caused by fast urbanization that is associated with a life-style that promotes CAD. However, the question remains whether genetics play a significant role and whether genetic susceptibility is increased in KSA compared to the well-studied Western European populations. Therefore, we performed an Exome-wide association study (EWAS) in 832 patients and 1,076 controls of Saudi Arabian origin to test whether population specific, strong genetic risk factors for CAD exist, or whether the polygenic risk score for known genetic risk factors for CAD, lipids, and Type 2 Diabetes show evidence for an enriched genetic burden. Our results do not show significant associations for a single genetic locus. However, the heritability estimate for CAD for this population was high (h(2) = 0.53, S.E. = 0.1, p = 4e(-12)) and we observed a significant association of the polygenic risk score for CAD that demonstrates that the population of KSA, at least in part, shares the genetic risk associated to CAD in Western populations.

A prospective evaluation of synergistic effect of sulbactam and tazobactam combination with meropenem or colistin against multidrug resistant Acinetobacter baumannii.

The present study evaluates the synergistic effect of sulbactam/tazobactam in combination with meropenem or colistin against multidrug resistant (MDR) Acinetobacter baumannii isolated from hospitalized patients from a tertiary care hospital in Saudi Arabia. During the study period, 54 multidrug and carbapenem-resistant isolates of A. baumannii isolates were collected from blood and respiratory samples of patients with ventilator-associated pneumonia or bacteremia. Microbroth checkerboard assay (CBA) and E-test were performed to look for synergistic interface of sulbactam and tazobactam with meropenem or colistin. All 54 MDR isolates of A. baumannii were resistant to carbapenem. Minimum inhibitory concentration [50/90] value against sulbactam, tazobactam, meropenem, colistin was found to be 64/128, 64/128, 64/256, and 0.5/1.0 respectively. Synergy was detected in more isolates with CBA compared to E-test. All four combinations showed significant synergistic bactericidal activity. However, the combination with colistin showed greater synergistic effect than combination with meropenem. Antagonism was not detected with any of the combinations and any method, but indifference was seen in tazobactam and colistin combination alone. A significant bactericidal effect was seen with sulbactam combination with meropenem or colistin in both methods. A combination therapy can be a choice of treatment. As colistin is known to exhibit nephrotoxicity, the combination of sulbactam and meropenem might be considered as an alternative antibiotic treatment for such multi- and extremely resistant bacteria. Yet, sample size is small in our study, so further well-designed in vitro and clinical studies on large scale should confirm our findings.

Concept and design of a genome-wide association genotyping array tailored for transplantation-specific studies.

BACKGROUND: In addition to HLA genetic incompatibility, non-HLA difference between donor and recipients of transplantation leading to allograft rejection are now becoming evident. We aimed to create a unique genome-wide platform to facilitate genomic research studies in transplant-related studies. We designed a genome-wide genotyping tool based on the most recent human genomic reference datasets, and included customization for known and potentially relevant metabolic and pharmacological loci relevant to transplantation. METHODS: We describe here the design and implementation of a customized genome-wide genotyping array, the 'TxArray', comprising approximately 782,000 markers with tailored content for deeper capture of variants across HLA, KIR, pharmacogenomic, and metabolic loci important in transplantation. To test concordance and genotyping quality, we genotyped 85 HapMap samples on the array, including eight trios. RESULTS: We show low Mendelian error rates and high concordance rates for HapMap samples (average parent-parent-child heritability of 0.997, and concordance of 0.996). We performed genotype imputation across autosomal regions, masking directly genotyped SNPs to assess imputation accuracy and report an accuracy of >0.962 for directly genotyped SNPs. We demonstrate much higher capture of the natural killer cell immunoglobulin-like receptor (KIR) region versus comparable platforms. Overall, we show that the genotyping quality and coverage of the TxArray is very high when compared to reference samples and to other genome-wide genotyping platforms. CONCLUSIONS: We have designed a comprehensive genome-wide genotyping tool which enables accurate association testing and imputation of ungenotyped SNPs, facilitating powerful and cost-effective large-scale genotyping of transplant-related studies.

Clinical description of human bocavirus viremia in children with LRTI, Eastern Province, Saudi Arabia.

Human bocavirus (HBoV) is a major etiology of lower respiratory tract infection (LRTI) in young children. We tested 149 patients admitted to King Fahd Hospital of the University with diagnosis of LRTI. Viremia caused by the different studied viruses was detected in 31.5% of the total cases by Real-time Polymerase chain reaction. We report five patients who were positive for HBoV in serum samples. Clinical presentation ranged from mild to severe disease as one of them required admission to intensive care unit. Wheezing was a striking feature in most of our patients, but fever was not a consistent finding.

Detection of extended spectrum beta-lactamases-producing isolates and effect of AmpC overlapping.

INTRODUCTION: Few reports about the prevalence and genetic basis of extended spectrum beta-lactamases (ESBLs) are available from Saudi Arabia. We sought to determine the prevalence of ESBL-producing Enterobacteriaceae in a university hospital in eastern Saudi Arabia and to characterize the ESBLs produced by these isolates at the molecular level. METHODOLOGY: All clinical isolates of Escherichia coli, Klebsiella spp., and Proteus spp. collected over two years were evaluated for susceptibility to a panel of antimicrobials and were analyzed for the ESBL phenotype using screening and confirmatory tests. ESBL-positive isolates were then screened for the presence of genes encoding CTX-M, SHV, and TEM beta-lactamases by PCR. RESULTS AND CONCLUSIONS: The overall prevalence of ESBL-producing isolates was 4.8% (253/5256). Most isolates (80%) were from the inpatient department. The ESBL phenotype was more frequently detected in K. pneumonia. CTX-M genes were the most prevalent ESBL genes, detected in 82% of the studied isolates. The ESBL producers demonstrated a high multidrug resistance rate (96.6%). In transconjugation assay, the same ESBL gene pattern was transmitted from 29.7% of K. pneumoniae donors to the recipient strain, and the latter exhibited concomitant decreased aminoglycosides and co-trimoxazole susceptibility. We observed the presence of ESBL screen-positive but confirmatory-negative isolates (8.9%). Phenotypic tests for the production of AmpC ß-lactamase tested positive in 52% of these isolates. Further studies are needed for appropriate detection of concomitant ESBL and AmpC enzyme production among such isolates. Continued surveillance and judicious antibiotic usage together with the implementation of efficient infection control measures are absolutely required.

Burn-injury affects gut-associated lymphoid tissues derived CD4+ T cells.

After scald burn-injury, the intestinal immune system responds to maintain immune balance. In this regard CD4+T cells in Gut-Associated Lymphoid Tissues (GALT), like mesenteric lymph nodes (MLN) and Peyer's patches (PP) respond to avoid immune suppression following major injury such as burn. Therefore, we hypothesized that the gut CD4+T cells become dysfunctional and turn the immune homeostasis towards depression of CD4+ T cell-mediated adaptive immune responses. In the current study we show down regulation of mucosal CD4+ T cell proliferation, IL-2 production and cell surface marker expression of mucosal CD4+ T cells moving towards suppressive-type. Acute burn-injury lead to up-regulation of regulatory marker (CD25+), down regulation of adhesion (CD62L, CD11a) and homing receptor (CD49d) expression, and up-regulation of negative co-stimulatory (CTLA-4) molecule. Moreover, CD4+CD25+ T cells of intestinal origin showed resistance to spontaneous as well as induced apoptosis that may contribute to suppression of effector CD4+ T cells. Furthermore, gut CD4+CD25+ T cells obtained from burn-injured animals were able to down-regulate naïve CD4+ T cell proliferation following adoptive transfer of burn-injured CD4+CD25+ T cells into sham control animals, without any significant effect on cell surface activation markers. Together, these data demonstrate that the intestinal CD4+ T cells evolve a strategy to promote suppressive CD4+ T cell effector responses, as evidenced by enhanced CD4+CD25+ T cells, up-regulated CTLA-4 expression, reduced IL-2 production, tendency towards diminished apoptosis of suppressive CD4+ T cells, and thus lose their natural ability to regulate immune homeostasis following acute burn-injury and prevent immune paralysis.

Morphology and antifungal effect of nano-ZnO and nano-Pd-doped nano-ZnO against Aspergillus and Candida.

The present work was aimed to study the activity of nano-particulated ZnO and nano Pd doped nano-ZnO against Aspergillus and Candida species, commonly contaminating the water supply systems. Micro-ZnO was purchased from the market (Aldrich, USA) while nano ZnO were synthesized using sole gel and precipitation methods and their morphology was determined using XRD and TEM techniques. The average grain size of nano-ZnO estimated by these techniques was 30 nm and 20 nm, respectively. The doping of nano-ZnO with 5 % Pd was achieved by a thermal decomposition method and its morphology; as characterized by XRD, TEM and FESEM techniques; gave an average grain size of 35 nm. Serial dilutions of nano-ZnO doped with 5 % Pd, pure nano-ZnO and micro-ZnO (as a control) were prepared from 10 mg/mL stock solution of each in dermasel agar (OXOID), inoculated with standard strains of Candida albicans and Aspergillus niger and incubated at 37°C for 24 and 48 hours, respectively. Their antimicrobial effect was compared by the minimal inhibitory concentration (MIC), determined as the dilution giving a negligible growth of microorganism. Nano-ZnO doped with 5 % nano-Pd, pure nano-ZnO and micro-ZnO, showed antifungal activity against Aspergilus niger with an MIC of 1.25, 2.5 and 5mg/mL, respectively. However, Candida albicans yeasts were relatively resistant to these compounds, with an MIC of 2.5, 5 and 10 mg/mL for Pd doped nano-ZnO, nano-ZnO and micro-ZnO, respectively. Thus nano-ZnO was twice as potent in killing Aspergillus, as compared to its non-nano-counterpart and loading of nano-ZnO with 5 % nano-Pd further increased its activity, four times that of micro-ZnO. Further investigations are needed to confirm the potential use of nano-ZnO and its doping with nano-Pd in the treatment of water supply systems and food preservation.

Analysis of chemokines and soluble adhesion molecules in cytomegalovirus-positive renal transplant recipients.

BACKGROUND: The relationship among cytomegalovirus (CMV) infection and the serum level of chemokines and soluble adhesion molecules is not well studied. This study aimed to assess chemokines and soluble adhesion molecules in CMV-positive Saudi renal transplant recipients. METHODOLOGY: The study was conducted in a tertiary hospital in Eastern Saudi Arabia over a 12-month period. All kidney transplant recipients who regularly attended the nephrology clinics were included (n = 150). Randomly selected age- and sex-matched individuals served as a control group (n = 158). CMV antibodies (IgG and IgM), chemokines and soluble adhesion molecules were measured using standard enzyme-linked immunosorbent assay (ELISA). CMV viral DNA was detected using real time polymerase chain reaction (PCR). RESULTS: Of the 150 patients studied, 149 (n = 150) had detectable levels of Anti-CMV IgG antibodies (99.3%). In the control group, 113 (n = 158), blood donors had anti-CMV IgG antibodies (71.5%). Forty-one (n = 150) kidney transplant recipients were positive for anti-CMV IgM antibodies (27.3%), whereas only one (n = 158) blood donor had detectable anti-CMV IgM antibodies. All IgM positive samples contained CMV viral DNA. MCP-1, IL-8, ICAM-1, and VCAM-1 levels were measured using ELISA. Of those, only MCP-1 and IL-8 were detectable. Eighteen kidney transplant recipients were positive for MCP-1 (12%). All MCP-1 patients were also anti-CMV IgM positive, while 5 patients had detectable levels of IL-8 (3.3%). All these patients were CMV IgM-positive. CONCLUSIONS: The increase in chemokine levels during CMV infection may reflect a possible role for these molecules in the immunopathogenesis of CMV infection in this study population.

Screening of pregnant women attending the antenatal care clinic of a tertiary hospital in eastern Saudi Arabia for Chlamydia trachomatis and Neisseria gonorrhoeae infections.

INRODUCTION: Of the "top ten" sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoeae are ranked second and fifth, respectively, worldwide. AIM: The aim of this study was to screen the pregnant women for C. trachomatis and N. gonorrhoeae infections and to detect antimicrobial resistance pattern of N. gonorrhoeae. MATERIALS AND METHODS: This study was a prospective, hospital-based analysis of a random sample of pregnant women visiting the antenatal clinic of a tertiary hospital in eastern Saudi Arabia. Endocervical and high vaginal swabs were collected both from pregnant women and female patients attending gynecology clinic with lower genital tract infection (control group). C. trachomatis antigen was detected using enzyme-linked immunosorbent assay (ELISA). N. gonorrhoeae was detected by culture and identification of isolates, and antimicrobial susceptibility testing was performed. Statistical Package for Social Sciences (SPSS) version 13.0 and Chi-square test were used for statistical analysis. RESULTS: C. trachomatis antigen was detected in 10.5% (10/95) and 34.4% (35/102) of pregnant women and control group, respectively (P < 0.001). The isolation rate of N. gonorrhoeae among pregnant women was 0.0% compared to 7.8% (8/102) among the control group (P < 0.01). N. gonorrhoeae were resistant to penicillin (62.5%), tetracycline (50%), ampicillin (25%), amoxycillin-clavulinic acid (25%) and ciprofloxacin (37.5%), while they were susceptible to cefepime, ceftriaxone, ceftazidime, spectinomycin, and cefuroxime. CONCLUSION: Screening of pregnant women for C. trachomatis infection should be included in the antenatal care in this area. The detection rate of both organisms among the control group highlights the importance of preventive strategies. Certain antibiotics previously used in treating gonorrhea are no longer effective.

Detection of Hepatitis C virus and Human immunodeficiency virus in expatriates in Saudi Arabia by antigen-antibody combination assays.

BACKGROUND: The simultaneous detection of antigen and antibody was originally described for the early detection of the human immunodeficiency virus (HIV). The same approach was applied to detect the hepatitis C virus (HCV). The aim of this work was to use the antigen and antibody combination assay for the detection of HCV and HIV infections in expatriates in Eastern Saudi Arabia. METHODOLOGY: The study group (N = 875) included expatriate workers of both sexes who were undergoing mandatory pre-employment testing. Detection of anti-HCV antibodies, HCV core antigen, HCV viral RNA, HIV antigens and antibodies was conducted using commercially available kits. RESULTS: Of the 875 samples that were screened for HCV-specific antibodies, four (0.46%) tested positive (two from Pakistan, one from India, and one from the Philippines) and two (0.23%) were equivocal (one from Egypt and one from Nepal). All four samples that were positive for HCV-specific antibodies also tested positive using HCV RNA assay and the HCV antigen-antibody combination assay. The two samples that were equivocal tested positive using the HCV RNA assay and the HCV antigen-antibody combination assay. Of the 875 samples that were tested for HIV antibodies, only one (0.11%) sample gave repeatedly positive results. The same sample also tested repeatedly positive using the HIV combination assay. These results were subsequently confirmed by HIV western blot assay. CONCLUSIONS: Our study indicates that the addition of antigen detection to the screening of HCV and HIV may lower the risk of transmission of these viruses in the host country and contribute to the overall control of HCV and HIV in Saudi Arabia.

Molecular detection of hepatitis B, hepatitis C, and torque teno viruses in drug users in Saudi Arabia.

Injecting drug users are at increased risk of infection with hepatitis viruses and blood-borne pathogens. The aim of this study was to examine HBV, HCV, HDV, and TTV infections in Saudi drug users (N = 344). Extraction of nucleic acid from serum, reverse-transcription, amplification of viral nucleic acids, and HBV and HCV genotyping were done using established techniques. Of the analyzed samples, 41 (12%) contained detectable HBV DNA, 131 (38%) contained detectable HCV RNA, and 174 (51%) had detectable TTV DNA. The predominant HBV genotype was found to be genotype D and the predominant HCV genotype was found to be genotype 1b. All the samples were negative for HDV. Twelve samples (3.5%) were found to contain mixed HBV and HCV genomes, 24 samples (7%) were found to contain mixed HBV and TTV genomes, 82 samples (24%) were found to contain mixed HCV and TTV genomes, and 9 samples (2.6%) were found to contain mixed HBV, HCV, and TTV genomes. Identification of various infections in drug users will help the control of these infections in this group as well as in the community.

In vitro ciprofloxacin resistance patterns of gram-positive bacteria isolated from clinical specimens in a teaching hospital in Saudi Arabia.

BACKGROUND: Over the last few decades the ever-increasing level of bacterial resistance to antimicrobials has been a cause of worldwide concern. Fluoroquinolones, particularly ciprofloxacin has been used indiscriminately for both gram-positive and gram-negative bacterial infections. The increased use of ciprofloxacin has led to a progressive loss of bacterial susceptibility to this antibiotic. Therefore it is necessary to have update knowledge of resistance pattern of bacteria to this antibiotic so that alternate appropriate antibiotics can be used for ciprofloxacin-resistant bacterial infections. OBJECTIVE: To evaluate the trends of ciprofloxacin resistance pattern in commonly isolated gram-positive bacteria over time in a Saudi Arabian teaching hospital. METHODS: A retrospective analysis was carried out for ciprofloxacin susceptibility patterns of 5534 isolates of gram-positive bacteria isolated from clinical specimens submitted to microbiology laboratories at King Fahd Hospital of the University (KFHU), Al-Khobar, Saudi Arabia during the period from January 2002 to August 2005. RESULTS: Increase in ciprofloxacin resistance rates with some fluctuations, among these isolates, were observed. For Staphylococcus aureus, it varied from 4.62, 1.83, 7.01 and 3.98%, methicillin resistant Staphylococcus aureus (MRSA) 97.92, 97.75, 87.01 and 88.26%, Streptococcus pyogenes 5.35, 4.47, 14.44 and 3.53% during the years 2002, 2003, 2004 and 2005 respectively. Cirprofloxacin resistance during the years 2002, 2004 and 2005 for other isolates was as follows: Streptococcus pneumoniae, 30.23, 23.02 and 26.47%; enterococcus group D, 43.05, 20.68 and 57.03% and non-enterococcus group D, 62.96, 76.92 and 87.50% respectively. CONCLUSION: Ciprofloxacin resistance in gram-positive bacterial clinical isolates particularly Staphylococcus aureus, methicillin resistant Staphylococcus aureus (MRSA) enterococcus group D, and non-enterococcus group D, has greatly increased and ciprofloxacin no more remains the drug of choice for these infections.