Evolving Risk of Acute Kidney Injury in COVID-19 Hospitalized Patients: A Single Center Retrospective Study.

Background and Objectives: Within a year, COVID-19 has advanced from an outbreak to a pandemic, spreading rapidly and globally with devastating impact. The pathophysiological link between COVID-19 and acute kidney injury (AKI) is currently being debated among scientists. While some studies have concluded that the mechanisms of AKI in COVID-19 patients are complex and not fully understood, others have claimed that AKI is a rare complication of COVID-19-related disorders. Considering this information gap and its possible influence on COVID-19-associated AKI management, our study aimed to explore the prevalence of AKI and to identify possible risk factors associated with AKI development among COVID-19 hospitalized patients. Materials and Methods: A retrospective cohort study included 83 laboratory-confirmed COVID-19 patients hospitalized at the isolation department in a tertiary hospital in Zagazig City, Egypt between June and August 2020. Patients younger than 18 years of age, those diagnosed with end-stage kidney disease, or those on nephrotoxic medications were excluded. All study participants had a complete blood count, liver and renal function tests, hemostasis parameters examined, inflammatory markers, serum electrolytes, routine urinalysis, arterial blood gas, and non-enhanced chest and abdominal computer tomography (CT) scans. Results: Of the 83 patients, AKI developed in 24 (28.9%) of them, of which 70.8% were in stage 1, 8.3% in stage 2, and 20.8% in stage 3. Patients with AKI were older than patients without AKI, with hypertension and diabetes being the most common comorbidities. Risk factors for AKI include increased age, hypertension, diabetes mellitus, and a higher sequential organ failure assessment (SOFA) score. Conclusions: AKI occurs in a considerable percentage of patients with COVID-19, especially in elderly males, those with hypertension, diabetes, and a higher sequential organ failure assessment (SOFA) score. Hence, the presence of AKI should be taken into account as an important index within the risk spectrum of disease severity for COVID-19 patients.

Effect of Synergistic Action of Bovine Lactoferrin with Antibiotics on Drug Resistant Bacterial Pathogens.

Background and Objectives: The multidrug resistant (MDR) bacterial pathogenic infection is one of the chief worldwide public health threat to humanity. The development of novel antibiotics against MDR Gram negative bacteria has reduced over the last half century. Research is in progress regarding the treatment strategies that could be engaged in combination with antibiotics to extend the duration of these life-saving antibacterial agents. The current study was therefore planned to assess the synergistic effects of bovine lactoferrin (bLF) in combination with different antibiotics that are conventionally used. This synergism would provide a newer therapeutic choice against MDR pathogens. LF is present in mucosal secretions, vastly in milk. LF is considered an important constituent in host defense. In previous reports, LF has been co-administered as a combination antibiotic therapy. Materials and Methods: This study included synergistic (LF + appropriate antibiotic) exposure against 147 locally encountered bacterial pathogens, which were completely characterized strains. The anti-biofilm effects and the outcome of bLF on minimum inhibitory concentrations (MICs) of antibacterials on clinical MDR bacterial pathogens were determined by standard techniques. Results: In our study, synergism of bLF with antibacterial agents were reproducible and found to be significant. LF on its own had an important effect of inhibiting the biofilm production of some significant bacterial pathogens. Conclusion: The results of this study provides useful data on the antibacterial potential of the combination of LF with antibiotics against drug resistant pathogens.

Risk assessment of toxic residues among some freshwater and marine water fish species.

Egypt has several beaches, as well as the Nile River and a few lakes; therefore, it could compensate for the lack of protein in red meat with fish. Fish, however, may become a source of heavy metal exposure in humans. The current study was to assess the level of five toxic metals, lead (Pb), cadmium (Cd), mercury (Hg), arsenic (As), and aluminum (Al), in six species, namely, Oreochromis niloticus (O. niloticus), Mugil cephalus (M. cephalus), Lates niloticus (L. niloticus), Plectropomus leopardus (P. leopardus), Epinephelus tauvina (E. tauvina), and Lethrinus nebulosus (L. nebulosus), collected from the El-Obour fish market in Egypt. The residual concentrations of the tested toxic metals in the examined O. niloticus, M. cephalus, L. niloticus, E. tauvina, P. leopardus, and L. nebulosus species were found to be higher than the European Commission's maximum permissible limits (MPL) for Pb and Cd by 10 and 20%, 15 and 65%, 75 and 15%, 20 and 65%, 15 and 40%, and 25 and 5%. In contrast, 30% of L. niloticus exceeded the MPL for Hg. It was shown that the average estimated daily intake (EDI) and the target hazard quotient (THQ) in fish samples are below safety levels for human consumption and hazard index (HI < 1). From the human health point of view, this study showed that there was no possible health risk to people due to the intake of any studied species under the current consumption rate in the country.

Prevalence of Enterotoxigenic Staphylococcus aureus and Shiga Toxin Producing Escherichia coli in Fish in Egypt: Quality Parameters and Public Health Hazard.

This study investigated the prevalence of Staphylococcus aureus enterotoxin genes and shiga toxin -producing Escherichia coli (STEC) in fish and evaluated quality parameters of examined fish. A total of 150 fish samples belonging to 6 species (25/each species) were cultured on Baird-Parker agar and eosin methylene blue agar. Staphylococcal enterotoxin genes and virulence genes (stx1, stx2, and eaeA genes) in E. coli serotypes were determined by multiplex PCR. Aerobic plate count (APC), Enterobacteriaceae count, coliform count, and Pseudomonas count were performed. Also, levels of total volatile base nitrogen and histamine in fish were determined. The prevalence of S. aureus ranged from 4% to 36% and count from 2 to 4 log10CFU/g. The sed, sea, and seb genes in S. aureus isolates were detected with percentages of 40%, 26.6%, and 20%, respectively. The E. coli serotype O26 carried stx1, stx2, and eaeA. The APCs, Enterobacteriaceae counts, and Pseudomonas counts ranged from 5.1 to 7.2, from 2.01 to 3.9, and from 2.1 to 3.1 log10 CFU/g, respectively. The most probable number (MPN) of coliform ranged from 1.3 to 3.6 log10/g. Levels of total volatile basic nitrogen and histamine ranged from 29.2 to 12.2 and from 0.6 to 4.6 mg/100 g, respectively. Also, the value of thiobarbituric acid was highly significant (1.1 ± 0.084 mg MDA/kg) in Trachurus mediterraneus samples compared with those levels obtained from other fish species. Our findings concluded that those fish species could constitute a public health hazard as fish are reservoirs for enterotoxigenic S. aureus and Shiga toxin producing E. coli strains. This study highlighted the importance of screening of fish for enterotoxigenic S. aureus strains and STEC isolates, and also assessing the quality parameters of fish.