Detection of phylogrouping, adhesin, and extended spectrum ß-lactamases genes in hospital acquired uropathogenic Escherichia coli isolates.

BACKGROUND: It has been interesting to compare the levels of antimicrobial resistance and the virulence characteristics of uropathogenic Escherichia coli (UPEC) strains of certain phylogenetic groups. The purpose of this study was to identify the frequency of phylogenetic groups, adhesin genes, antibiotic sensitivity patterns, and extended spectrum-lactamases (ESBLs) genes in hospital-acquired UPEC. METHODS: After UPEC isolation, the disc diffusion method was used to assess its susceptibility to antibiotics. Combination disc testing confirmed the existence of ESBL producers. Polymerase chain reaction (PCR) was used to detect genes for adhesin and ESBLs. RESULTS: One hundred and twenty-eight E. coli were isolated which had the highest resistance to tetracycline (96%) followed by cefoxitin (93%), cefepime (92%), ceftazidime (79%), aztreonam (77%) and sulfamethoxazole -trimethoprim (75%). About 57% of isolates were phenotypically ESBLs positive and they were confirmed by PCR. B2 phylogroup (41%) was the most frequent in E. coli isolates then group D (30%), group A (18%), and lastly group B1 (11%). ESBLs genes were more significantly prevalent in phylogroups B2 and D than other phylogroups (P < 0.001). Regarding adhesin genes, both fim H and afa were more significantly associated with group B2 than other groups (P < 0.009, < 0.032), respectively. In ESBL-positive isolates, both genes were more significantly detected compared to negative ones (P < 0.001). CONCLUSION: Phylogroups B2 and D of UPEC are important reservoirs of antimicrobial resistance and adhesion genes. Detection of ESBL-producing E. coli is important for appropriate treatment as well as for effective infection control in hospitals.

Interleukin-17 Genotypes in Egyptian Asthmatic Children at Zagazig University Hospitals.

Bronchial asthma (BA) is increasing among Egyptian children. It is affected by multiple factors including genetic ones. In the current study, we assessed the relationship between interleukin-17 (IL-17) genotypes and the occurrence of BA among Egyptian children. This case-control study included 100 participants. Group I (the control group) comprised 50 healthy subjects. Group II (the asthmatic group) comprised 50 subjects diagnosed with atopic asthma according to the Global Initiative for Asthma. Measurement of serum Ig E and eosinophilic count was performed. Detection of single nucleotide polymorphism rs2275913 of IL-17 gene by restriction fragment length polymorphism-polymerase chain reaction was conducted. GA and AA genotypes were more frequent in the asthmatic group compared to the control group (P = 0.03 and 0.01, respectively). Subjects carrying GA and AA genotypes were more susceptible to have asthma [odds ratio (OR) = 2.21, 95% confidence interval (CI) = 1.14-9.94, P = 0.03; OR = 7.78, 95% CI = 1.59-38.3, P = 0.01, respectively]. The A allele was higher in the asthmatic group (33%) compared to the control group (10%). A allele carriers were more susceptible to have asthma (OR = 4.43, 95% CI = 2.04-9.82 and P < 0.001). Immunoglobulin E (IgE) levels and eosinophil percentages were higher among the carriers of GA and AA genotypes when compared with the GG genotype. All pulmonary function tests were significantly lower among carriers of AA genotype compared with GG genotype. An A allele carrier, AA genotype, increased IgE level, and eosinophil level were significant predictors for occurrence of asthma (P = 0.01, 0.02, 0.004, and 0.01). In conclusion, AA genotype carriers and A allele carriers of the IL-17 gene are more likely to have asthma compared with controls.

Human leukocyte antigen - B27 and antibodies to Klebsiella pneumoniae in Ankylosing Spondylitis: associations and clinical outcome.

Ankylosing spondylitis (AS) is a chronic disabling rheumatic disease with indefinite etiology. Human leukocyte antigen-B27 (HLA-B27) carriage and Klebsiella pneumoniae (K. pneumoniae) infections may contribute to the etiopathogenesis of AS. The objective of this study was to determine the association of HLA-B27 carriage, serum immunoglobulin G (IgG) to K. pneumoniae with AS, and its clinical outcome. In a case-control study, HLA-B27 carriage was detected by polymerase chain reaction, serum IgG to K. pneumoniae was measured by ELISA, and K. pneumoniae was isolated from the stool of 40 AS patients who were compared to age and sex-matched 40 normal individuals. Clinical findings, disease activity, and functional ability were evaluated for all AS patients. HLA-B27, serum IgG to K. pneumoniae, and fecal carriage of Klebsiella were significantly higher in AS patients when compared to controls (p < 0.001 for all). Disease activity and functional score categories were significantly higher in HLA-B27 positive AS patients with an elevated titer of K. pneumoniae IgG than in HLA-B27 negative patients with low titer of K. pneumoniae IgG (p < 0.012 and p < 0.001, respectively). In conclusion, HLA-B27 carriage and K. pneumoniae infections could play a significant role in the development and clinical outcome of AS patients.

Evaluation of CDCP1 (CD318) and endoglin (CD105) expression as prognostic markers in acute myeloid leukemia.

BACKGROUND: The most commonly used prognostic factors in acute myeloid leukemia (AML) are cytogenetic, molecular, and morphological markers. However, AML prognosis is still unfavorable particularly in adults. So, further reliable markers are urgently needed to improve the risk stratification and treatment decisions. CUB domain-containing protein 1 (CDCP1; CD318) and endoglin (CD105) are new markers correlated with poor prognosis in different solid tumors, but their role in AML prognosis is not fully evaluated. OBJECTIVES: This work aimed to evaluate the prognostic role of CD318 and CD105 in AML and their impact on the outcomes. METHODS: Sixty-five newly diagnosed AML patients were included in this study. CD318 and CD105 expression was assessed by quantitative real-time polymerase chain reaction. Patients were followed up for ∼ 2 years to evaluate the prognostic impact of gene expression on the outcomes. RESULTS: Patients with high CD318 and CD105 showed higher white blood cell (WBC) count, M2 subtype, poor cytogenetic risk, reduced complete remission, and a greater number of deaths compared to low CD318 and CD105. CD318 was correlated with CD105, and both were correlated with WBC count, bone marrow blasts, and peripheral blood blasts. After a follow-up period of up to 24 months, relapse-free survival for high CD318 and CD105 was significantly different (42.1% and 52.6% vs. 64.5% and 58.1% for low CD318 and CD105, respectively). Survival was worse in patients with high CD318 and CD105, as the mean survival time was 13.9 and 13.3 months compared to 24 and 22.7 months in low CD318 and CD105, respectively. CONCLUSIONS: CD318 and CD105 are upregulated in AML patients. Their overexpression was associated with poor response to treatment and poor outcomes. Therefore, CD318 and CD105 can be useful prognostic markers in AML.

Interleukin 10 -1082 G/A Gene Polymorphism and Susceptibility to Bronchial Asthma in Children: A Single-Center Study.

Interleukin-10 (IL-10) is the key regulator of immune responses preventing the undesirable exaggerated ones. Genetic variation in the promoter region of IL-10 may influence its serum level and contribute to susceptibility to bronchial asthma in children. This is a case-control study including 100 patients and 100 healthy control children who had undergone skin prick test, estimation of total IgE and serum level of IL-10 by enzyme-linked immunosorbent assay, and polymerase chain reaction-restriction fragment length polymorphism for IL-10 gene polymorphism. A significant association between IL-10 polymorphism and susceptibility to pediatric asthma was found. AA genotype represented (66%) of the patient group compared to (6%) only of the control group, while AG genotype was detected in 20% of patients and 4% of control. In contrast, wild genotype GG was found in 14% of patients and 90% of control with a highly statistically significant difference among both groups (P < 0.001). The serum level of IL-10 was significantly elevated in the GG genotype in comparison to other genotypes (P < 0.001), and it was negatively correlated with the severity of asthma among the studied pediatric asthmatic group (P < 0.001). In conclusion, IL-10 polymorphism may play an important role in the development of bronchial asthma in children.

Serum Procalcitonin as A Diagnostic and Prognostic Marker for Bacterial Community - Acquired Pneumonia.

For community acquired pneumonia (CAP), the discrimination between typical and atypical bacterial causes could influence antibiotic choice and outcome of patients. Objective of this study was to evaluate the utility of serum procalcitonin (PCT) level as a diagnostic and prognostic marker for CAP. Typical bacteria were isolated and identified by conventional methods. An indirect immunoflourescence assay was used to diagnose atypical bacteria. Serum level of PCT was measured by ELISA and clinical outcome was evaluated. Out of 240 enrolled CAP patients, 95 (39.6%) had bacterial etiology (30.8 % typical bacterial pneumonia and 8.8% atypical pneumonia). Ninety five bacterial CAP patients were divided into 3 groups; group 1 (mortality, 20.1%), group 2 (complications, 52.6 %) and group 3 (discharge, 26.3 %). Group 1 patients had the highest PCT level in serum compared to other groups with a statistically significant difference (P < 0.001). A statistically significant higher serum level of PCT was detected in typical than atypical pneumonia (P < 0.001). In conclusion, serum PCT level may serve as a diagnostic and prognostic marker in CAP.

Serum Level of IL 10 is Significantly Increased in Allergic Rhinitis Patients on Subcutaneous Immunotherapy and Vitamin D Supplementation.

For allergic rhinitis (AR), subcutaneous immunotherapy (SCIT) is proved to be effective in improving symptoms and outcome. It increases IL-10 production which helps in inducing peripheral tolerance to allergens. The role of vitamin D supplementation as an adjuvant to SCIT in patients with allergic rhinitis should be investigated. Objective of this study was to assess role of Vitamin D supplementation with SCIT in inducing tolerance to pollen, increasing IL10 and improving symptoms in AR patients. 48 AR patients were included. Skin prick test was done then baseline and final nasal symptoms scores rating, serum level of IL 10 and specific IgE were measured in two groups of patients; group 1 on SCIT and group 2 on SCIT and vitamin D supplementation. A statistically significant decrease of total nasal symptoms scores in group 2 when compared with group 1 (P < 0.001). IL 10 was increased in group 2 than group 1 with a statistically significant difference (P < 0.001) while, specific IgE was decreased in group 2 than group 1 with a statistically significant difference (P =0.01).There was a significant negative correlation between serum level of IL 10 and both nasal symptoms scoring and specific IgE (P < 0.001 and 0.028, respectively). In conclusion, serum level of IL 10 is significantly increased in AR patients on SCIT and Vitamin D supplementation.

Correlation between Relative Expression of IL 17 and PERP in Rheumatoid Arthritis Patients and Disease Activity.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder. Decreased apoptosis is considered an important leading cause of autoimmune diseases. As IL17 and PERP can affect apoptosis process, they may contribute the pathogenesis and activity of RA. Objectives of this study were to investigate the possible correlation of IL 17 and PERP levels with RA pathogenesis and activity. Peripheral blood mononuclear cells (PBMCs) were isolated from fifty RA patients and fifty healthy subjects, RNA was extracted and subjected to real time PCR to detect the relative expression of IL17 and PERP. Results were correlated with RA disease activity parameters. Increased IL17 and decreased PERP mRNA expression levels were detected in patients as compared to the healthy controls (P˂0.001) and they were positively and inversely correlated with disease activity score for 28 joints (DAS28), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and rheumatoid factor (RF). A significant negative correlation between PERP and IL-17 mRNA expression levels was found (P ˂0.001). In conclusion, increased level of IL 17 and decreased level of PERP may constitute two major factors in the pathogenesis and activity of RA.

Serum Level and Genetic Polymorphism of Mannose-Binding Lectin in Infants with Neonatal Sepsis at Zagazig University Hospitals.

Immature immune system in neonates is considered a risk factor for neonatal infections and sepsis. Mannose-binding lectin (MBL) is one of the innate immune system components that could recognize a wide variety of pathogens and initiate an immune response against them. Objectives of this study were to assess the correlation between serum level of MBL and MBL2 gene polymorphism and incidence of neonatal sepsis. Isolation of bacteria from neonatal blood culture was carried out by conventional methods then, serum level of MBL was measured by ELISA and MBL2 gene polymorphism was determined by PCR-RFLP. Out of 50 neonates with sepsis enrolled in this study, 44 (88%) neonates had MBL deficiency and 6 (12%) had normal serum level with a very high statistically significant difference (P=0.00001). Genotype BB was more frequent in neonatal sepsis (56%) followed by genotype AB (32%) then genotype AA (12%) and it was more prevalent in preterm (63.2%) than in full term (33.3%) with a high statistically significant difference (P=0.001). Patients with BB genotype had the lowest MBL level in serum compared to other genotypes with a very high significant difference (P=0.001). In conclusion, low serum level of MBL and genotype BB might be significantly associated with development of sepsis among neonates.

Diagnostic performance of direct latex agglutination, post-enrichment latex agglutination and culture methods in screening of group B streptococci in late pregnancy: a comparative study.

BACKGROUND: Group B streptococcus (GBS) is one of the main causes of neonatal sepsis. PURPOSE: Evaluation of the diagnostic performance of direct latex agglutination test (DLA), post-enrichment latex agglutination (LA) test, and direct culture on chromogenic media in rapid identification of GBS carrier in pregnant women in comparison with the conventional post-enrichment CDC-recommended culture method and further to estimate GBS carriage prevalence and its antimicrobial susceptibility. METHODS: Two hundred pregnant women at gestational age (35-37 weeks) were enrolled. Three low vaginal swabs were obtained from each participant. One swab was directly inoculated into Strep B Select (SBS) agar. The second swab was inoculated in enrichment Lim broth for immunological antigen detection by post-enrichment latex agglutination (5 h and 24 h) and subculture for bacteriological detection. The third swab was used for immunological detection of GBS antigen by direct latex agglutination. The isolated GBS was subjected to antimicrobial susceptibility testing. RESULTS: Among 200 pregnant women, 47 (23.5%) were GBS carriers. Considering post-enrichment subculture on SBS medium as a gold standard, the sensitivities for post-enrichment 5 h and 24 h LA were 66% and 95.7%, respectively. However, direct cultivation of the vaginal swabs on SBS medium and DLA recorded 83% and 4.3%, respectively, for sensitivity. All GBS isolates (100%) were sensitive to penicillin G, ampicillin, ceftriaxone, and vancomycin. In contrast, 21.3% and 12.8% of isolated GBS were resistant to erythromycin and clindamycin, respectively. CONCLUSION: Group B streptococcal antigen detection by latex agglutination after 5 h enrichment is a reliable, easy, and relatively rapid method for screening of GBS carriage in pregnant woman not in labor. Latex agglutination after 18-24 h enrichment can be used alternative to standard subculture method for screening GBS carriage.