RESUMO
Infections with Pseudomonas aeruginosa (P. aeruginosa) have become a real fear in hospital-acquired infections, especially in critically ill and immunocompromised patients. Thus, advance of novel anti-infectives is currently pursued. The aim of the present study was to evaluate the antibacterial effect of each of citrus honey and fosfomycin in comparison to the combined effect of both of them on multidrug resistant (MDR) P. aeruginosa. 50 MDR P. aeruginosa isolates were tested for the antibacterial effect of citrus honey. Screening for potential synergistic activity of fosfomycin and honey combinations by E test. Molecular detection of the virulent exoenzyme U (exoU) genotype by conventional PCR was done. The present study found that 50 % (v/v) concentration of citrus honey was sufficient to inhibit the growth of most isolates (33/50, 66%). Minimal inhibitory concentration (MIC) for fosfomycin tested by E test was found to be >128 µg/mL in 50(100%) of MDR P. aeruginosa isolates but after repeating E test with Mueller-Hinton agar (MHA) containing sublethal concentration of citrus honey (29/50,58%) isolates were sensitive. Also, there was a significant correlation between the presence of exoU gene and positive synergy of citrus honey-fosfomycin combination. This study showed that citrus honey has antibacterial effect and synergy with fosfomycin antibiotic against MDR P. aeruginosa isolates. Also, exoU positive genotype is associated with MDR phenotype. In conclusion, our results revealed that the citrus honey-fosfomycin combination showed highly statistically significant effect on MDR P. aeruginosa fosfomycin susceptibility pattern. exoU positive P. aeruginosa isolates were detected mostly in burn unit and ICUs. Also, there was a statistically significant correlation between the presence of exoU gene and positive result of honey-fosfomycin combination E test.
RESUMO
Neonatal sepsis remains a major cause of mortality and morbidity in neonates, Traditional methods for diagnosis like blood culture has a low sensitivity and delayed results in neonates. This study aimed to measure the level of interleukin-27 (IL-27) in sera of patients with neonatal sepsis to determine its potential role as a biomarker for diagnosis of bacterial sepsis. This prospective study included 90 neonates with suspected neonatal sepsis. Plasma levels of IL-27 were measured using an ELISA; blood culture, 16s r DNA and C-reactive protein (CRP) level were done to diagnose sepsis. The ROC curve analysis was performed to evaluate the predictive ability of IL 27 and CRP individually and in combination to identify bacterial sepsis in neonates. The Studied neonates were divided into 45 patients with neonatal sepsis and 45 uninfected systemic inflammatory response syndrome (SIRS) patients as controls. 30 neonates in the infected group were identified by positive blood culture results (66.6%) and 15 patients were identified by being positive for 16s r DNA (33.3%). For IL- 27, the ROC area under the curve (AUC) was 0.991 and a cut-off point of > 485.56 with sensitivity of 95.56% and a specificity of 100%. For CRP, the AUC value was 0.933 and a cut-off point of > 32 with sensitivity of 88.89% and a specificity of 82.22%. In conclusion, our results indicated that elevated IL-27 correlated well with bacterial sepsis among neonatal patients with bloodstream infections and may provide additional diagnostic value along with other available biomarkers.
