Egyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210701Evaluation of toll-like receptor 4 polymorphism in patients with hepatitis c virus-induced hepatocellular carcinoma18186763ENFatma OmarKhalilAssistant Professor of Clinical Microbiology and Immunology Department – National Liver Institute- Menoufia University, Menoufia Egypt0000-0002-3157-5232Journal Article20210221<strong><em>Background: </em></strong><em>Liver related pathologies including Hepatocellular Carcinoma (HCC) is a universal problem. Innate immunity receptorswere accused in the etiopathogenesis of HCC with many conflicts. TLR4 is one of pathogen recognition receptors involved in the pathogenesis of many diseases and malignancies. TLR4 receptor polymorphisms were investigated in HCV related morbidities along with inconclusive results<strong> Objectives: </strong>to study the role of TLR4 rs 2149356 and rs 1927914 genotypes polymorphisms in HCV related HCC development. <strong>Methodology:</strong> 200 Chronically infected HCV patients were enrolled in this study. they were divided according to lab and clinical data into 100 CHCgroup and 100 HCC patients who were compared to health individual<strong>. </strong>The blood samples obtained were further proceed to full lab and<strong> TLR4 genotyping </strong>byRFLP-PCRtechnique<strong> Results: </strong> GT genotype and T allele of TLR4 rs 2149356 at 95% CI of 0.38 (0.21-0.70) was significantly increased in control group than in HCC and CHC groups. At 0.32(0.17-0.63)TLR4 rs 1927914 C allele and CT genotype was significantly increased in Controls than diseased groups while T allele is significantly increased in HCC than control group. <strong>Conclusions: </strong>TLR4 genotypes may play a protective role against HCC development among chronic HCV patients.</em>https://ejmm.journals.ekb.eg/article_186763_73f2056f0171fb171496c618dc676126.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711The impact of the nucleotide-binding oligomerization domain 1 (NOD 1) gene polymorphism on Helicobacter Pylori induced chronic gastritis in hepatic patients919187001ENEmanHassanAssistant Lecturer of Clinical Microbiology and Immunology, National Liver Institute, Menoufia University Menoufia, EgyptJournal Article20210309<strong><em>Background</em></strong><em>:Chronic infection with <em>Helicobacter pylori</em> (<em>H.pylori</em> ) causes atrophic and even gastric metaplastic changes, and it has a well-known link to peptic ulceration. Nucleotide-binding oligomerization domain-containing protein 1 (NOD1) is a </em><em>protein</em><em> receptor that is presented by the NOD1 </em><em>gene</em><em>. It distinguishes<em> H.pylori</em> bacterial molecules and enhances an immune response <strong>Objectives: </strong>to describe the relation between the NOD1 gene (rs2075820) polymorphism and H.pylori infection in hepatic and non hepatic patients with chronic gastritis, study its impact on the degree of chronic gastritis in H.pylori positive individuals, and to examine the effect of<em> H. pylori</em> on clinical, endoscopic and histopathological findings and child paugh scoring in hepatic patients. <strong>Methodology: </strong>Gastric tissue samples were taken from selected 200 patients with chronic gastritis, either hepatic or non hepatic. Rapid urease test and pathological findings classified them into H.pylori infected and non infected patients. Genotyping of NOD 1 was studied using polymerase chain reaction /restriction fragment length polymorphism (PCR–RFLP) method. <strong>Results: </strong>A significant higher frequency of AA genotype, and the A allele of NOD1 gene in H.pylori +ve patients, either hepatic; (58%)-(73%) or non hepatic;(62%)-(78%) as compared to H.pylori –ve patients,(P <0.001). A highly significant relation between NOD1 genotypes and endoscopic findings, where most of H.pylori infected patients with AAgenotype had more peptic ulcer, antral erosion, gastric prolapse, esophageal varices and esophageal hiatus hernia compared to patients with GA and GG genotypes, (P<0.001). No significant impact of<em> H.pylori</em> on signs of liver affection and child paugh scoring in hepatic patients. <strong> Conclusions: </strong>In NOD1 gene polymorphism, AA genotype and A allele have significantly implicated in H.pylori infection susceptibility and progression. While GG genotype and G allele have a protective effect against H.pylori infection.</em>https://ejmm.journals.ekb.eg/article_187001_92df456b0c58f0159a1f5f51a457e65a.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Relationship between Hepcidin and Iron Deficiency Anemia in Helicobacter pylori Infected Patients2127187002ENEmadMoradLecturer of Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, EgyptJournal Article20210324<strong><em>Background:</em></strong><em> Helicobacter pylori may be associated with unexplained iron-deficiency anemia (IDA). Hepcidin is an acute-phase reactant but its relation to H. pylori and IDA has not been elucidated. Objective: to investigate serum hepcidin in H. pylori infected patients and its role in IDA.<strong> Methodology:</strong> This study was performed on 70 patients infected by Helicobacter pylori. They were divided into two groups, group A: 35 H. pylori infected patients without iron deficiency anemia and group B: 35 H. pylori infected patients with iron deficiency anemia. Serum hepcidin was measured by ELISA in both groups while iron, ferritin and total iron binding capacity were estimated in group B.<strong> Results: </strong>Serum hepcidin was significantly higher in patients with H. pylori infection and iron deficiency anemia. However, non-significant correlation between hepcidin and both iron and ferritin were found.<strong> Conclusion:</strong> Helicobacter pylori could modulate serum hepcidin level in patients with iron deficiency anemia.</em>https://ejmm.journals.ekb.eg/article_187002_c13e52eac1a3428b00f89dc053b346d4.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Healthcare Workers’ Mobile Phones as a Possible Vehicle of Nosocomial Pathogens and the Role of Different Disinfectants in their Decontamination2936187508ENRana EhabElgabeeryDemonstrator of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, EgyptJournal Article20210313<strong><em>Background:</em></strong><em> As Mobile Phones (MPs) aren’t cleaned routinely and have been touched during patient’s examination, they may become contaminated with hospital pathogens. <strong>Objectives:</strong> Screen MPs of Health care workers (HCWs) for pathogens and verify the effect of disinfectants in their decontamination. <strong>Methods:</strong> A questionnaire was submitted by 160 HCWs in Tanta University Hospitals. Samples were taken from their MPs and subjected to pour plate counting before and after disinfection. Standard identification and antibiotic susceptibility of isolates were done. <strong>Results:</strong> Colony count was greater in MPs used while caring for patients or inside restroom, and was less in regularly cleaned MPs. All tested disinfectants reduced the colony count significantly. Pathogens were isolated from 84.38% of samples and 36.25% of them were Multi-Drug Resistant Organisms (MDROs). <strong>Conclusion:</strong> Using MPs at critical care areas and restroom may contribute to their contamination with pathogens. Regular disinfection of MPs can reduce this contamination.</em>https://ejmm.journals.ekb.eg/article_187508_ac127a6e48d23ca8eb9752cc2dbf6fb3.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711The association between allergic rhinitis and Polymorphism of Toll like receptors 2 & 4 genes3742188057ENAbdelhakim F.GhallabDepartment of Otorhinolaryngology, Faculty of Medicine, Benha UniversityJournal Article20210313<strong><em>Background:</em></strong><em> Allergic rhinitis is atopic disorder, 10% to 25% of the population worldwide are suffering from it, The prevalence is increasing during the last 10 years.<strong> Objectives: </strong>To study the relationship among polymorphism of single nucleotide in TLR2 and TLR4 genes and the risk of allergic rhinitis disease.<strong> Methodology: </strong>This study was done on 60 patients suffering from allergic rhinitis and 30 healthy subjects as a control group from April 2019 to March 2020. The patients were collected from Otorhinolaryngology Department of Benha University Hospital. Test of Skin prick (SPT)was done to assess atopic state. Blood samples were collected to detect TLR gene polymorphism by Polymerase chain reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). <strong>Results:</strong> The genotypic frequencies of TLR2 Arg753Gln showed increased frequency of the homozygous (GG) genotype among the controls (80%) more than the allergic rhinitis patients (30%). The heterozygous (AG) genotype was increased among the allergic rhinitis patients (62.5%) more than in the healthy group (15%) with OR =9.4, 95% CI (2.4-37.7) and significant P-value. Also, the homozygous mutant (AA) genotype has more trend in the patients (7.5%) than in the control subjects (5%), with OR = 0. 6, 95% CI (0.1-6.7) and non-significant P-value. The genotypic frequencies Statistical data in TLR4 Asp299Gly revealed that the homozygous (AA) genotype has more frequency in the controls (70%) than the allergic rhinitis patients (20%). The heterozygous (AG) genotype was more prevalent among the allergic rhinitis patients (65%) than the controls (30%) with OR =4.3, 95% CI (1.4-13.8) and significant P-value. <strong>Conclusion</strong>: GG genotype of TLR2 and AA genotype of TLR4 are least affected by allergic rhinitis disease and the major allele in both gene is protective against the disease.</em>https://ejmm.journals.ekb.eg/article_188057_6a807a54d737414ee8355c9ff0ac3f72.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711SFO-1 and DHA-1 genes Detection in β-lactamases-producing Klebsiella pneumoniae Causing Blood Stream Infections Acquired in Intensive Care Units in Mansoura University Hospitals4351188059ENGhadaBarakatDepartment of Medical Microbiology & Immunology, Faculty of Medicine, Mansoura University, EgyptJournal Article20210325<strong><em>Objectives: </em></strong><em>The study aimed to detect SFO-1 and DHA-1 genes and to differentiate AmpC with overlapped ESBL isolates. Also, it identified the risk factors aiding in emergence the ESBL producing K.pneumoniae causing blood stream infections in ICUs of Mansoura University Hospitals (MUHs). <strong>Methodology:</strong> This is a prospective study that enrolled 520 blood samples. Double disk synergy test (DDST) and Modified three-dimensional test were performed. Genotypic detection of SFO-1, Class A ESBL, and DHA-1, AmpC β-lactamase was done. <strong>Results:</strong> 520 septicemic patients were enrolled with significant correlation for adults’ acquisition of infection. The main bacteria isolates causing nosocomial infection in septicemic patients admitted to ICU were S. aureus, E. coli and K. pneumoniae. A significant difference in distribution of ESBL and AmpC β-lactamases was detected with significant association between impenem resistance and prevalence of ESBL in those patients. There was a low-occurrence of ESBL SFO-1 and DHA-1 detected in clinical samples. Surgical intervention and CVC were the significant risk factors for presence of ESBL but previous antibiotics and hospital stay were non-significant effectors for presence of ESBL. <strong>Conclusion:</strong> Though SFO-1 is a low-prevalence ESBL, it has been taken by a plasmid with many other multiple resistance determinants including many related genes, and go together with by a large DHA-1- plasmid. </em>https://ejmm.journals.ekb.eg/article_188059_b9fe5e183f7fd51e4e94f28d3dddff9d.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Investigation and management of Klebsiella Pneumoniae Outbreak in Intensive Care Unit of Tanta University Emergency Hospital5358188063ENSara YoussefMaxwellDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Egypt0000-0002-7886-4744Journal Article20210228<strong><em>Background:</em></strong><em> Klebsiella pneumoniae infection is responsible for a wide range of infections including pneumonia, bacteremia, wound infections, and urinary tract infections. <strong>Objective: </strong>To investigate and manage the occurrence of multi-drug resistant Klebsiella pneumoniae outbreak in Intensive Care Unit of Tanta University Emergency Hospital. <strong>Methodology: </strong>The investigation of the outbreak included isolates identification and typingwhile management included implementation of infection prevention and control precautions; establishment of an Outbreak Control Team; epidemiological investigations; and decontamination of environment. <strong>Results: </strong>During September 2020, five patients in the Intensive Care Unit in Emergency Hospital of Tanta University had multi drug-resistant Klebsiella pneumoniae identified in samples obtained from a variety of specimens. The fifth case was identified 10 days following confirmation of the first case. The Microbiology laboratory confirmed the five cases had identical Klebsiella pneumoniae strains. This suggests that there was a patient-to- patient spread of multi-drug resistant Klebsiella pneumoniae.<strong> Conclusion: </strong>This investigation revealed the importance of proactive recognition of a possible outbreak, screening of patients transferred from other hospitals, early identification of any unusual microorganisms and implementation of early infection control interventions.</em>https://ejmm.journals.ekb.eg/article_188063_cd2bc75a30609e5174a4c6eee670ec06.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Correlation between serum IL-23 and serum total IgE levels in allergic rhinitis patients5963188069ENAya M.EL-AidyMedical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig 44519, EgyptJournal Article20210324<strong><em>Background:</em></strong><em> Allergic rhinitis (AR) is an immunoglobulin E (IgE) mediated inflammatory chronic disorder of the nasal mucosa caused by contact to allergens which affects a significant percentage of population. Th17 cells might be involved in the acute phase of the allergic reaction. Th17 cells are regulated by IL-23, which is a member of the IL-12 cytokine family. IL-23 was suggested to be a pivotal cytokine involved in the pathogenesis of AR and may become a novel target in the treatment of AR. <strong>Objective:</strong> Here we investigate the role of serum IL-23 and its correlation with serum total IgE level in AR. <strong>Methodology:</strong> This case control study included the investigation of 48subjects. Blood samples were collected for measuring serum IL-23 and total IgE levels by ELISA. <strong>Results</strong>: positive correlation was found between IL-23 and total IgE serum level in AR patients. <strong>Conclusion:</strong> Positive correlation was found between serum IL-23 and serum total IgE levels in allergic rhinitis patients. </em>https://ejmm.journals.ekb.eg/article_188069_5cce396b7c4e6b3a11c4df0e2adba1e9.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210701The Identification of Microbial Pathogens Using Matrix Assisted Laser Desorption Ionization Time of Flight in Medical Intensive Care Unit Beni-Suef University Hospital6569188073ENMarwa NabilMohamedGeneral Directorate of Infection Control, Ministry of Health and PopulationJournal Article20210807<strong><em>Background:</em></strong><em> Matrix Assisted Laser Desorption Ionization Time of Flight (MALDI-TOF) is a novel technique for identification of microbes. This new method led to a new era in microbial identification because of its rapid, accurate, valid, simple and relatively decreased cost. <strong>Objectives:</strong> The aim of this study was identification of predominant pathogens by MALDI-TOF technique. <strong>Methodology:</strong> Pathogens were identified by both conventional methods and MALDI-TOF. <strong>Results:</strong> From July till December 2018, predominant pathogens were Klebsiella pneumoniae (21%), Pseudomonas aeroguinosa and Candida each constitutes (17%), E-coli (10%), Staph. aureus (9%), Acinetobacter (9%). Identification of isolates (from September to December 2018) by MALDI-TOF revealed a total agreement of (94.1%) with conventional method at genus level, (88.2%) at level of species. Kappa agreement revealed almost perfect correlation between both techniques. <strong>Conclusion:</strong> The MALDI-TOF results might suggest that its’ usage may be dependable for microbiological identification.</em>https://ejmm.journals.ekb.eg/article_188073_0aa3c87016337d3f988a10ccf64fce2b.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Heteroresistance Screening of Pseudomonas aeruginosa Specimens from Hospitalized Inpatients in Cairo, Egypt7179188074ENDalia MohsenHamedQuality Control Department, VACSERA, Giza, EgyptJournal Article20210323<strong><em>Background:</em></strong><em> Heteroresistance described infections with bacterial strains which causes infections with different levels of resistance to an antibiotic and differs with age and gender. <strong>Objectives:</strong> This work determined the variations in the heteroresistance pattern for the age, gender and site of infection and the statistical analysis was done using (SPSS version 20.0) for test of significance. <strong>Methodology:</strong> Out of two hundred and fifty clinical specimens isolated from different sites from Inpatients admitted to Kasr Al-Aini hospital and Al-Demerdash hospital from different genders with different ages in the period from February 2016 to December 2017, Egypt, one hundred and forty five specimens revealed P.aeruginosa after passing several conventional microbiological methods, the antimicrobial susceptibility testing and the screening of nht4heteroresistant specimens were performed. <strong>Results:</strong> The obtained results showed that the hetesroresistance was very high in the urine specimens and very high in males more than females. <strong>Conclusion:</strong> From the statistical analysis we recommend the use of imipenem, levofloxacin and ciprofloxacin in the treatment of heteroresistant P.aeruginosa, since they were the highly significant, effective antibiotics.</em>https://ejmm.journals.ekb.eg/article_188074_bed9b432f6a0ad56d9b8b608f218dcc7.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Cytomegalovirus in Liver Transplant Patients8188188075ENDoaa TawfikMasallatAssociate Professor of Medical Microbiology & Immunology Department, Faculty of Medicine, Mansoura UniversityJournal Article20210323<strong><em>Background:</em></strong><em> Graft survival in liver transplant recipients is significantly lower in patients with a history of CMV infection compared to those without. In the absence of any preventive therapy 75% of recipients develop CMV infection post liver transplant. <strong>Objectives:</strong> This study detected the incidence of cytomegalovirus in liver transplant patients and evaluated post-transplant risk factors for HCMV and its complications<strong>. Methodology:</strong> A prospective study was conducted from the September 2018 till March 2020. Sixty subjects were involved; 30 patients were admitted for liver transplantation at the Gastroenterology Surgery Center (GISC), Mansoura university, and 30 donors. MELD score was calculated, blood samples were taken, CMV antibodies and CMV DNA were detected. Post transplantation follow up for 6 months and complications were reported. <strong>Results:</strong> HCMV viremia was detected in 46.6% recipients and in 10% donors by PCR. One recipient was positive for IgM and the rest were IgG positive and all donors were IgG positive. The most common reported complication after liver transplantation was bacterial infections (46.4%). <strong>Conclusions:</strong> Half of patients developed CMV infection after transplantation. The commonest risk factors for post-transplant CMV infection were seropositive donor or recipient >60 AU/mL, HCV patients, body mass index >25 and DM. Patients with positive HCMV infection had significantly higher MELD score than those reported negative HCMV.</em>https://ejmm.journals.ekb.eg/article_188075_bb7cede38f0b9957060b27789f683b12.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Phenotypic Methods and Molecular Metallo-β-lactamases Genes Detection in Different Clinical Carbapenems Resistant Acinetobacters Isolates from Tanta University Hospitals8995188076ENKareman AhmedEshraMedical Microbiology and Immunology Department, Faculty of Medicine, Tanta UniversityJournal Article20210308<strong><em>Background: </em></strong><em>Acinetobacter species are very common in hospital acquired infections; Carbapenems resistant species become common in hospital and represent a major health problem.<strong> Methodology: </strong>Our study was carried on 150 patients from ICU; we compared different phenotypic methods and PCR for detection of carbapenems resistance in Acinetobacters.<strong> Results: </strong>88.9% of resistant Acinetobacters were detected by Kirby Bauer Disk diffusion method, 54.2%</em><em>by Modified Hodge test, 70.8 % by EDTA disc synergy, 85.4% by Amp C disk test, 33.3% by PCR bla-IMP and 12.5% by PCR bla-VIM.<strong> Conclusion: </strong>We recommended for detection of carbapenems resistance in Acinetobacters the phenotypic methods as they are rapid, accurate methods and less costly than PCR.</em>
<em> </em>
<strong><em><span style="text-decoration: underline;">Note</span></em></strong><strong><em>:</em></strong><strong> </strong><strong><em>bla-IMP</em></strong> gene (NCBI GenBank Nucleotide accession # LC103138.1);
<strong><em>bla-VIM gene </em></strong>(NCBI GenBank Nucleotide accession # MT185944.1<strong> </strong>
GenBank accession number S71932https://ejmm.journals.ekb.eg/article_188076_0b48905c6da92f4974a0b9c564723f94.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Detection of β-lactamase genes (blaTEM, bla CTX-M and bla SHV) in uropathogens isolated from patients with UTI97103188920ENHazem HamedSalehMedical analysis fellow, Urology & Nephrology Center, Mansoura University0000-0003-1890-2005Journal Article20210328<strong><em>Background: </em></strong><em>The problem of antibiotic resistance has become worldwide health issue among hospitalized patients in developing countries, where the inappropriate usage of antibiotics is common. The widespread occurrence of multidrug resistant strains (MDRS) of Escherichia coli (E. coli) and klebsiella pneumoniae (K. pneumoniae) is currently considered avital medical challenge. The identification of ESβL genes and their MDRS in widely isolated uropathogens may provide a helpful tool for choosing effective antibiotic therapy and clinical improvement.<strong> Objective: </strong>The aim of this study is to determine the prevalence of (bla.TEM, bla.CTX-M, and bla.SHV) β-lactamase DNAs in E. coli and K. pneumoniae, and MDRS of uropathogens E. coli and k. pneumoniae isolated from patients urine UTI diagnosed who were admitted to the Urology & Nephrology Center.<strong> Methodology: </strong>Clinical E. coli and K. pneumoniae isolates were isolated from urine specimens of UTI diagnosed patients. Microbiological techniques were utilised to identify the isolates. Antibiotics susceptibility analysis was done utilising the Vitek2 system (bioMérieux, Marcy l’Etoile, France). The double disc diffusion technique (DDDT) was used for detecting phenotypic ESBL in isolates. Using the traditional PCR technique, the ESBL genes were identified.<strong> Results: </strong>Antibiotic resistance of E. coli’s isolates to commonly used antibiotics was high (88.2% resistant to Amoxicillin/clavulanate, 83.5 % were resistant to Trimethoprim-sulfamethoxazole) while minimum resistance appeared against Amikacin (AK) 10.5% and Imipenem (IP) 14%. For isolates of K. pneumoniae, the resistance was higher for nitrofurantoin, ceftazidime, cefotaxime, ciprofloxacin 96.6%, 83.3 %,83.3%, 80% respectively .In our study, out of 115 isolates, E. coli and K. pneumoniae isolates, 81 (70.43%) were phenotypically positive for ESβL by Combination Disc Test (CDT). The most commonly molecularly detected ESBL genes were TEM 80% of K. pneumoniae isolates and 77.6% of E. coli isolates .followed by SHV 70% of K. pneumoniae isolates and 34.1% of E. coli isolates and finally, CTXM 67% of isolates of E. coli and 63.3% of isolates of K. pneumoniae. <strong>Conclusions: </strong>The current study concluded that a high rate of resistance has been developed in uropathogens with empiric antibiotic treatment. It emphasized the alarming role of β-lactamases, especially ESßLs in antibiotic</em>https://ejmm.journals.ekb.eg/article_188920_e0f553c0ee05717ece05b435f6544539.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Nursing Knowledge Level, Are There Room for Improvement in Hepatitis Prevention at Suez Canal Area?105110188921ENNermineEl MaraghyMedical Microbiology & Immunology Department, Faculty of Medicine, Suez Canal University; Ismailia, EgyptJournal Article20210318<strong><em>Background:</em></strong><em> Healthcare workers are at increased risk of contracting and spreading hepatitis C virus (HCV), and HBV to others. <strong>Objective</strong>: The aim of study is to evaluate nursing staff and paramedics knowledge, concerning HCV, HBV and its relationship to institutional infection control facilities. <strong>Methodology</strong>: A self- administered questionnaire was distributed at fever hospital, infectious diseases hospital, Suez Canal university hospital, blood center, primary health care centers and hospitals affiliated to ministry of health, with a convenient sample of 479 nursing staff and paramedics in Suez Canal region. A knowledge score was developed about hepatitis B, C source of infections and different domains of infection control facilities and procedures, with a maximum of 17. <strong>Results</strong>: The mean age of the participating nursing staff and paramedics was 29.55 <span style="text-decoration: underline;">+</span> 8. 31. Knowledge score about mode of transmission of hepatitis, reveals that the highest level was among the student nurse which was 17.07. Concerning exposure including blood contact, blood spills and needle stick, the nurse was 61 %, while mainly head nurse to be 83% stated receiving training about infection control and care of sharp. <strong>Conclusion:</strong> We can prevent the transmission of infection at the occupational level through standard precautions.</em>https://ejmm.journals.ekb.eg/article_188921_2b54a3738ee29aec12c8ae99dee81dbe.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210701Evaluation of the Role of Immunotherapy in Allergic Fungal Rhinosinusitis111117188924ENMarian AsaadGergesMedical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityJournal Article20210410<strong><em>Background: </em></strong><em>Allergic fungal rhinosinusitis (AFRS) is a distinct form of chronic rhinosinusitis. Type I hypersensitivity to inhaled fungal allergens has been implicated as key pathogenesis. Immunotherapy as one of the therapeutic options is still controversial. <strong>Objective:</strong> to evaluate the role of immunotherapy in the management of AFRS patients not responding to medical treatment 3 months following endoscopic surgery. <strong>Methodology:</strong> A total of 35 patients diagnosed as resistant AFRS were included in this prospective study. Patients were diagnosed following clinical, radiological, and endoscopic examination of nose and paranasal sinuses. Specimens were collected during endoscopy and subjected to microscopic examination and fungal culture. Skin prick test and assessment of total IgE level were performed for all patients. Sublingual immunotherapy (SLIT) was initiated for all patients for 6 months. Clinical efficacy of SLIT was assessed using the 20-item sino-nasal outcome test (SNOT-20) score. <strong>Results:</strong> Aspergillus spp. was the most frequent fungus isolated (74.3%) from patients. All patients were sensitized to mixed fungi. Elevated total IgE (> 100 IU/mL) was found in all patients with 40% of them had peripheral eosinophilia. A significant improvement (p < 0.001) was recorded in the SNOT-20 score of examined patients recording a mean of 1.2 ± 0.3, 6 months after SLIT compared to 1.93 ± 0.44 before immunotherapy initiation. <strong>Conclusion: </strong>Immunotherapy appears to be a good adjunctive therapy for the management of resistant cases of AFRS.</em>https://ejmm.journals.ekb.eg/article_188924_a70c2873a8b31aa327b724e2bc5e6ca6.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711The role of T helper 17 cells in Helicobacter pylori associated chronic gastritis119126188925ENSafaa M.EL-AgeeryMedical Microbiology & Immunology Department, Faculty of Medicine, Mansoura UniversityJournal Article20210410<strong><em>Background:</em></strong><em> T helper 17 (Th-17) cell, a proinflammatory subset of CD4 T cells, have an essential role in immunity against Helicobacter pylori (H. pylori) infection.<strong> Objectives: </strong>This study aimed to evaluate expression of selected Th-17 cells associated cytokines (IL-17, IL-21, IL-22, IL-23, IL-26 and TNF-α) in H. pylori-infected patients and to recognize their responsibility in H. pylori associated chronic gastritis with different severity. <strong>Methodology:</strong> This study is a case control study. The case group included 25 H. pylori-positive patients suffering from chronic gastritis. The control group included 25 age and sex-matched healthy individuals without any dyspeptic symptoms and negative for H. pylori. Infection with H. pylori in all participants was determined by detection of H. pylori stool antigen by enzyme-linked immunosorbent assay (ELISA) kit. Certain cytokines expression (IL-17, IL-21, IL-22, IL-23, IL-26 and TNF-α) in serum samples from all participants were tested using ELISA. <strong>Results:</strong> Comparing the serum cytokines expression in cases and controls, IL-17, IL-21 IL-23 and TNF-α were significantly higher in cases while IL-22 and IL-26 were higher in cases but not statistically significant. Both serum IL-17 and TNF-α expressions were statistically significant higher in cases with moderate or severe forms of chronic gastritis than in cases with mild form of chronic gastritis. However, the levels of IL-21, IL-22, IL-23 and IL-26 showed insignificant variation regarding chronic gastritis severity. <strong>Conclusion:</strong> Th-17 cells are responsible for the pathogenesis of H. pylori infection and the severity of gastritis. So, down regulation of Th-17 cells associated cytokines offers a promising therapy to diminish H. pylori associated gastritis.</em>https://ejmm.journals.ekb.eg/article_188925_07176e8653b98712ec1f9e90bc0d1e4e.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Identification and in Vitro Susceptibility Pattern of Fungal Pathogens in Immunocompromised Patients with invasive Fungal Infections127134188926ENShaimaa Abd El- AzeemSalemDemonstrator of Clinical Pathology, Faculty of medicine – Assiut UniversityJournal Article20210405<strong><em>Background</em></strong><em>: In intensive care units, invasive fungal infections have become more common, particularly among immunocompromised patients. Early identification and starting the treatment of those patients with antifungal therapy is critical for preventing unnecessary use of toxic antifungal agents. <strong>Objective: </strong>The aim of this research is to determine which common fungi cause invasive fungal infection in immunocompromised patients, as well as their antifungal susceptibility patterns in vitro, in Assiut University Hospitals. <strong>Methodology:</strong> This was a hospital based descriptive study conducted on 120 patients with clinical suspicion of having fungal infections admitted at different Intensive Care Units (ICUs) at Assiut University Hospitals. Direct microscopic examination and inoculation on Sabouraud Dextrose Agar (SDA) were performed on the collected specimens. Isolated yeasts were classified using phenotypic methods such as chromogenic media (Brilliance Candida agar), germ tube examination, and the Vitek 2 system for certain isolates, while the identification of mould isolates was primarily based on macroscopic and microscopic characteristics. Moulds were tested in vitro for antifungal susceptibility using the disc diffusion, and yeast were tested using Vitek 2 device cards. <strong>Results:</strong> In this study, 100 out of 120 (83.3%) of the samples were positive for fungal infection. Candida and Aspergillus species were the most commonly isolated fungal pathogens. The isolates had the highest sensitivity to Amphotericin B (95 %), followed by Micafungin (94 %) in an in vitro sensitivity survey. <strong>Conclusion:</strong> Invasive fungal infections are a leading cause of morbidity and mortality in immunocompromised patients, with Candida albicans being the most frequently isolated yeast from various clinical specimens; however, the rise in resistance, especially to azoles, is a major concern.</em>https://ejmm.journals.ekb.eg/article_188926_35d869c2aa14512452d36b6a279556c0.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Expression Profile of Long Non Coding RNA PVT1 in Patients with Ulcerative Colitis135141188927ENShymaa E.AyoupDepartment of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Fayoum University, Al Fayoum, EgyptJournal Article20210416<em>Background: Ulcerative colitis (UC) is a chronic progressive inflammatory bowel disease, many long non coding RNA (lncRNAs) have been studied to have a role in the pathogenesis of Ulcerative colitis. Objective: is to evaluate expression level of long noncoding RNA PVT1 in ulcerative colitis and its association with the severity of the disease. Methodology: Sixty ulcerative colitis patients and 60 subjects were enrolled as controls. LNCRNA PVT1 relative expression level was tested using miScript SYBR Green PCR Kit. Results: Results showed significant differences between the patients with ulcerative colitis and controls as regard the median of the relative expression level of LNC PVT1 (P<0.0001). Also, there were positive significant correlations between the expression level of LNC PVT1 and AST(r=0.398, p=0.002), WBC(r=0.473, p < 0.0001) in UC patients. The ROC curve analysis of LNC PVT1 revealed; LNC PVT1; AUC=0.784, P<0.0001, cut off point 1.06, sensitivity 73.3%, specificity 83.3%. Conclusion: Serum Lnc PVT1 could be used as a potential biomarker for UC diagnosis and prognosis</em>https://ejmm.journals.ekb.eg/article_188927_aa29c57aa2bafac1395e6a6d38db133e.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210701Prevalence of Multidrug-Resistant Tuberculosis Using Phenotypic Drug Susceptibility Testing and GeneXpert MTB/RIF with Characterization of Non-tuberculous Mycobacteria Using MALDI-TOF143151188928ENNoha SalahSolimanLecturer of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Egypt.Journal Article20210416<strong><em>Background</em></strong><em>: Multidrug-resistant tuberculosis (MDR-TB) and infections by non-tuberculous mycobacteria (NTM) are diseases of major public health concern. <strong>Objective</strong>: The aim of the present work is to study the prevalence and patterns of MDR-TB as well as the characterization of isolated NTM species. <strong>Methodology</strong>: All samples (1069) were subjected to smear microscopy, culture on Lowenstein-Jensen (LJ) media, and phenotypic drug susceptibility testing (DST) of MTB to isoniazid (INH), rifampin (RF), streptomycin (S), and ethambutol (E). GeneXpert was used for direct detection of MTB and RF resistance. Matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry (MS) was utilized for characterizing isolated NTM species. <strong>Results</strong>: M.tuberculosis (MTB) was isolated at a rate of 95.3% (1019/1069). MDR-TB was detected at rate of 7.16% with significant patterns for INH + RF + S + E (46.5%) and INR + RF (24.6%) (P-value <0.001). RF resistance was detected at a rate of 27.2% by GeneXpert. Seven NTM species (0.6%) were isolated in culture of which M.porcinum and M.fortuitum had confident identification by MALDI-TOF (score ≥1.8). <strong>Conclusion</strong>: MDR-TB rate was found to be 7.16% with significant dominance for INH + RF + S + E and INR + RF resistance patterns, while NTM rate was 0.6%.</em>https://ejmm.journals.ekb.eg/article_188928_3228a964139184771db0892ac4065939.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Bacterial Pattern of Community acquired Urinary Tract Infections: A Challenge for Antimicrobial Resistance153162188929ENRaniaKishkMicrobiology and Immunology Department, Faculty of Medicine, Suez Canal University, Ismailia, EgyptJournal Article20210416<strong><em>Background</em></strong><em>: Urinary tract infection (UTI) is considered one of the most common bacterial infections seen in health care. To our knowledge, there is no available antimicrobial resistance surveillance system for monitoring of community-acquired UTIs (CA- UTIs) in our country. <strong>Objectives</strong>: we aimed to discuss the bacterial pattern and resistance profile of CA-UTIs in Ismailia, Egypt. <strong>Methods:</strong> This cross-sectional study included 400 patients suffering from symptoms of acute UTIs.Urine specimens were collected by clean-catch mid-stream method, examined microscopically and inoculated immediately on blood agar and MacConkey's agar plates. Colony counting, isolation and identification of the urinary pathogens were performed by the conventional biochemical tests according to the isolated organism. Antibiotic susceptibility testing was performed by Kirby Bauer disk diffusion method. Interpretation was performed according to Clinical Laboratory Standard Institute (CLSI) guidelines<strong>. Results: </strong>out of 400 specimens, 136 of them revealed no bacterial growth or insignificant bacteriuria. Most of participants with UTI were females (81.8%) (p=0.008) and 54.5% of them were married (P=0.1). Gram negative bacteria were more common than Gram positive representing 66 % and 34% respectively. E. coli was the most common isolated organism (39%) followed by S. aureus (32%), K. Pneumoniae and Pseudomonas (10.5% for each), Proteus (6%) and Enterococci (2%).E. coli isolates showed the highest susceptibility to imipenem, meropenem, amikacin, nitrofurantoin, levofloxacin and ciprofloxacin. Most of our patients were diabetics (64.8%) (p=0.004). The mean ± SD of HbA1c was 6.4±2.0 with 4 to 12.6 range, S.E was 0.1 and 95% C.I was 6.2- 6.7. The highest mean ± SD of HbA1c was in S. aureus infections. <strong>Conclusion:</strong> Gram negative bacteria were most common than Gram positivewith predominance of E. coli with significant relation to the presence of diabetes. </em>https://ejmm.journals.ekb.eg/article_188929_4f108611d8f291ea0d36fe92011828d7.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Knowledge, Practice, and Perception of Barriers Regarding COVID‑19 among Egyptian Health care Workers163171188930ENMohamed A.SakrDepartment of Medical Microbiology & Immunology, Faculty of Medicine, Suez University, EgyptJournal Article20210504<strong><em>Background: </em></strong><em>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was characterized as the etiology for a cluster of pneumonia cases that spread rapidly, causing considerable morbidity and mortality worldwide. By April 2021, more than 2,996,791 deaths were reported globally. Proper updated infection control protocol for Coronavirus disease 2019 (COVID-19) must be provided to every health care facility.<strong> Objectives:</strong> To evaluate the knowledge, attitude, perception of barriers, and practices among Egyptian health care workers (HCWs) regarding COVID-19 disease.<strong> Methodology:</strong> A cross-sectional study using an online questionnaire through a link shared on social networking sites was conducted on 480 HCWs from different regions in Egypt.<strong> Results:</strong> This assessment included a sample of 480 HCWs. The total knowledge score was (19.95±2.4). Satisfactory knowledge was reported among 60%. Total attitude score was (18.1±3.7) with positive attitude being reported among 23.3%. Total practice score was (10.6±1.1) and good practice was reported among 89.2%. <strong>Conclusion:</strong> There were satisfactory knowledge and practice with a low positive attitude regarding COVID-19 which requires more efforts to improve precautionary measures and training programs in hospitals.</em>https://ejmm.journals.ekb.eg/article_188930_dbeda471ba6b736430bf51c6e73220d5.pdfEgyptian Society for Medical Microbiology (ESMM)Egyptian Journal of Medical Microbiology1110-217930320210711Immune profile of peripheral blood T-lymphocyte subpopulations in chronic hepatitis B173178188931ENSafaa M.EL-AgeeryMedical Microbiology & Immunology Department, Faculty of Medicine, Mansoura UniversityJournal Article20210523<strong><em>Background: </em></strong><em>The role of immune response to chronic hepatitis B virus (HBV) infection is complex; and the specific T-cell response to this infection can determine the duration and the extent of liver disease. <strong>Objective: </strong>This study aimed at assessing the profile of T-lymphocyte subpopulations in chronic hepatitis B (CHB) patients and its association with HBV replication. <strong>Methodology:</strong> The case group included 50 CHB patients with normal liver function tests (LFTs); and the control group included 50 age and sex-matched healthy individuals. The HBV markers, LFTs and serum viral load were measured in cases. Blood CD4 and CD8 T-lymphocyte subpopulations and the CD4/CD8 ratio were assessed in both groups by flow cytometry. <strong>Results:</strong> Our results showed significantly higher CD8 T-cells; significantly lower CD3 and CD4 T-cells; markedly reduced CD4/CD8 ratio in the cases as compared to the controls (P<0.001, for all). This T-cell impairment was also significantly linked to HBeAg positivity and elevated level of viraemia. The increased level of CD8 T-cells was significantly linked to both the HBeAg positivity (P<0.001) and the elevated level of viraemia (P=0.005), whereas the decreased levels of CD3, CD4 T-cells and CD4/CD8 ratio were significantly linked to both HBeAg positivity (P<0.001, in all) and the elevated level of viraemia (P<0.001, P=0.001& P=0.007, respectively).<strong> Conclusion:</strong> T-lymphocyte subpopulations imbalance could be expected by measuring the serum HBVeAg and the viraemia level in CHB patients exhibiting normal LFTs. These parameters are recommended to be measured regularly for the cellular immune function assessment.</em>https://ejmm.journals.ekb.eg/article_188931_bcb8871f7e7015beffc6a676130b6ce7.pdf