Circulating microRNAs as predictors of response to sofosbuvir + daclatasvir + ribavirin in in HCV genotype-4 Egyptian patients.

BACKGROUND: MicroRNAs (miRNAs) play an important role in various diseases, including HCV infection, the aim of the current study was to evaluate the potential use of serum miRNAs as biomarkers for diagnosis, prognosis, and prediction of responses to direct acting antivirals (sofosbuvir + daclatasvir + ribavirin) in HCV-4 patients. METHODS: The serum expression profiles of four liver-associated miRNAs (miRNA-122, 155, 196 and 29) were assessed in 160 HCV-4 patients and 50 healthy controls using real-time PCR prior to therapy. RESULTS: miR-122 and miR-155 showed upregulation in HCV-4 patients compared to healthy controls while miR-196 and miR-29 showed downregulation in HCV-4 patients. ROC curve analyses revealed that the four-studied miRNAs could be valuable biomarkers for predicting response to DAAs with AUC 0.973 for miR-122, 0.878 for miR-155, 0.808 for miR-29 and 0.874 for miR-196 respectively. Univariate logistic regression analysis revealed that miR-196 level is positive predictor for SVR, whereas miR-122,155 levels are negative predictors of response. Multivariate logistic regression analysis revealed that miR-196 is the most significant in predicting response to treatment (p value = 0.011). CONCLUSION: To the best of our knowledge, the current study provided the first clinical evidence of the potential use of circulating miRNAs (miR; 122, 155, 196 and 29) as biomarkers of CHC in HCV-4 patients receiving the new DAA regimen (SOF/DAV + RIB), which is a strong motivator for further studies.

First detection of vanB phenotype-vanA genotype vancomycin-resistant enterococci in Egypt.

INTRODUCTION: Enterococci have emerged in last two decades as serious hospital acquired pathogens particularly vancomycin resistant strains (VRE). The study aimed to identify the prevalence of enterococcal isolation from hospital infections and colonization as well as determine vancomycin resistance phenotypes and genotypes. METHODS: Sixty enterococcus isolates were isolated from patients, health care workers and hospital environment, identified and tested for antimicrobial susceptibility. Enterococcus species were identified by Real-time PCR and vancomycin resistance was assessed by agar dilution method and Real-time PCR. RESULTS: out of 300 samples (20%) were enterococci (53.3% were E. faecium, 31.7% E. faecalis and 10% other enterococci). Among of them 40/60 (66, 6%) were isolated from infections and 33.3% were isolated from colonization. multiple drug resistance was reported in (100%) of isolates, while (95%) and (45%) of isolates were resistant to vancomycin and ticoplanin respectively. VanA phenotype, vanA genotype was identified in (47.4%) of isolates, while vanB phenotype, vanA genotype was identified in (33.3%) of vancomycin resistant isolates. CONCLUSION: VanB phenotype-vanA genotype was identified in (33.3%) of vancomycin resistant enterococcal isolates. To our knowledge it is the first identified incidence of such strains in Egypt and Africa.