ABSTRACT
Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) infections resist nearly most available antimicrobials, resulting in poor clinical outcomes. Saudi Arabia has a relatively high CRE prevalence. This study aims to evaluate the sensitivity of Rapidec Carba NP test and GeneXpert Carba-R assay compared with conventional manners for detection of carbapenemase-producing Enterobacteriaceae. Methods: This is a cross-sectional study including a total of 90 CRE isolates examined at two tertiary hospitals in KSA from October 2020 to December 2021. Gram-negative Enterobacteriaceae were identified by using Vitek 2 system and were furtherly tested for imipenem and meropenem susceptibility by E- test strips, followed by Rapidec Carba NP test and the Xpert™Carba-R assay. Results: Carbapenem-resistant K. pneumoniae (78.9%) and carbapenem-resistant E. coli (14.4%) were the two most common isolates species. Colistin (98.9%) and tigecycline (88.9%) were the most effective antibiotics against CRE isolates, followed by amikacin (52.2%), gentamicin (33.3%), cotrimoxazole (15.6%), and ciprofloxacin (8.9%). blaOXA-48 was the predominant carbapenemase gene (44.4%), followed by blaNDM (32.2%). blaKPC gene was not detected. The Rapidec Carba NP and the Xpert™Carba-R demonstrated an overall sensitivity of 69.3% and 88%, respectively, in comparison to gold standard detection of meropenem and imipenem resistance by Vitek 2 system and E- test strips. Discussion: RAPIDEC® CARBA NP may be a beneficial screening test for detecting CRE, but for confirmation of the results, Xpert Carba-R assay is more sensitive, significantly lowering the turnaround time compared to reference traditional methods. The information on carbapenemase genes may be used for epidemiologic purposes and outbreak management.
ABSTRACT
Psoriasis is a chronic autoimmune disease affecting the skin and joints, IL- 17 family has been shown to be the major effector cytokine in its pathogenesis. This study aimed to investigate genetic polymorphism of IL-17F (rs763780) and evaluate the impact of this polymorphism on circulating levels of IL-17F as a potential risk locus for psoriasis. 60 patients suffering from chronic plaque psoriasis and 60 healthy controls were genotyped for the IL-17F (rs763780) using an Amplification Refractory Mutation System -PCR (ARMS-PCR) method. Measurement of serum IL-17F was also done by ELISA. There was a significant difference in frequency between TT and TC genotypes (OR= 2.74, 95%CI=1.04 -7.4, P=0.04) and TT and CC genotypes (OR=10.9, 95%CI=1.3-91.3, P=0.007). Moreover, the TC and CC genotypes were associated with increased risk of psoriasis in comparison with the TT genotype. (OR= 3.8, 95% CI: 1.5- 9.4, P= 0.003). The mutant allele, C, was significantly associated with an increased risk of psoriasis compared to that with the wild T allele, T (OR= 4.1, 95% CI: 1.9- 9.1, P= 0.0002). Serum level of IL-17F was higher among psoriasis patients ( 25.7±3.8pg/ml) than healthy controls ((15.1±2.1 pg/ mL). In conclusion, IL17F polymorphism (rs763780) is associated with increased risk of psoriasis and may influence the level of production of IL-17F with subsequent effects on the pathogenesis of psoriasis.
