To study the utility of Galactomannan (GM) antigen as a screening marker for diagnosing invasive pulmonary aspergillosis (IPA) in coronavirus disease 2019 (COVID-19) patients.The serum samples from patients with severe COVID-19 diseases admitted to the Critical Care Unit were collected on the 5th day of admission for GM screening. The samples were analysed by enzyme linked immune sorbent assay (ELISA) and GM index of more than 1 was considered as positive. All GM positive patients were serially followed until discharge or death.The GM was raised in serum of 12 out of 38 patients, indicating an incidence of possible COVID-19 associated IPA (CAPA) in 31.57% of patients. The median age of these CAPA patients was 56.5 years, males were significantly more affected than females. The inflammatory marker serum ferritin was raised in all 12 patients (median value of 713.74 ng/ml), while IL-6 was raised in 9 patients (median value of 54.13 ng/ml). None of these patients received antifungals. Their median length of hospital stay was 20 days (IQR: 12, 34 days). All these patients succumbed to the illness.The serum GM appears to be sensitive diagnostic tool to identify early IPA in COVID-19 patients and pre-emptive antifungal therapy could play a role in salvaging these patients.
To determine Clostridium difficile (C. difficile) prevalence on retail surfaces and shoppers plastic bags.From 20 June to 10 August 2011, in a cross-sectional epidemiological study, 17 supermarkets from 2 cities, Albaha and Altaif, Saudi Arabia were sampled. A total of 800 samples, which comprised 200 samples per surveyed surface, were studied. These included baskets, trolleys, conveyer belts, and outgoing shoppers' plastic bags. Clostridium difficile strains were isolated. The isolates were characterized using ribotyping and polymerase chain reaction for the detection of toxin A (tcdA), toxin B (tcdB), binary toxin (cdtB), and toxin C (tcdC) genes. Susceptibility to antibiotics was determined on a Muller-Hinton agar with 5% sheep blood agar using E-tests.Overall, the C. difficile prevalence on sampled surfaces was 0.75%. The highest prevalence was found on retail baskets and trolleys, followed by plastic bags. A total of 5 different ribotypes were identified. Alterations in tcdC were detected in ribotype 027 and BT1. All the identified isolates were susceptible to vancomycin, but resistant to levofloxacin.In this study, C. difficile was present at a rate of 0.75% on supermarket surfaces. Spore disinfection of implicated surfaces may be necessary to control any community-acquired infections caused by this pathogen.
Abstract Preliminary studies have indicated that the recently described bacterium Atopobium vaginae may have an association with bacterial vaginosis (BV). Fifty‐five women attending the gynaecology out‐patient's clinic were tested for the presence of this micro‐organism, Gardnerella vaginalis , Mobiluncus and Bacteroides species by polymerase chain reaction (PCR)‐based assays. The frequency of detection was 40%. PCR detection of Gardnerella vaginalis with A. vaginae , occurred in 50% of A. vaginae ‐positive cases. Due to the high detection rate of A. vaginae we believe that it is important to determine whether this and other hard‐to‐culture microorganisms have a role in gynaecological disorders.
Abstract The Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has gained research attention worldwide, given the current pandemic. Nevertheless, a previous zoonotic and highly pathogenic coronavirus, the Middle East Respiratory Syndrome coronavirus (MERS-CoV), is still causing concern, especially in Saudi Arabia and neighbour countries. The MERS-CoV has been reported from respiratory samples in more than 27 countries, and around 2500 cases have been reported with an approximate fatality rate of 35%. After its emergence in 2012 intermittent, sporadic cases, nosocomial infections and many community clusters of MERS continued to occur in many countries. Human-to-human transmission resulted in the large outbreaks in Saudi Arabia. The inherent genetic variability among various clads of the MERS-CoV might have probably paved the events of cross-species transmission along with changes in the inter-species and intra-species tropism. The current review is drafted using an extensive review of literature on various databases, selecting of publications irrespective of favouring or opposing, assessing the merit of study, the abstraction of data and analysing data. The genome of MERS-CoV contains around thirty thousand nucleotides having seven predicted open reading frames. Spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins are the four main structural proteins. The surface located spike protein (S) of betacoronaviruses has been established to be one of the significant factors in their zoonotic transmission through virus-receptor recognition mediation and subsequent initiation of viral infection. Three regions in Saudi Arabia (KSA), Eastern Province, Riyadh and Makkah were affected severely. The epidemic progression had been the highest in 2014 in Makkah and Riyadh and Eastern Province in 2013. With a lurking epidemic scare, there is a crucial need for effective therapeutic and immunological remedies constructed on sound molecular investigations.
Tobacco smoking remains a worldwide health issue, and the use of flavored varieties (maassel) embedded in glycerine, molasses, and fruit essence via shisha paraphernalia (waterpipe) is growing globally. 16S rRNA gene pyrosequencing was conducted on 18 different varieties representing 16 flavors and three brands in order to study the microbiota of maassel and find whether it contains pathogenic bacteria.The samples were selected randomly from the most utilized brands within Albaha, Saudi Arabia as determined through a questionnaire of 253 smokers. In addition, ten-fold serially diluted samples were inoculated on blood agar, MacConkey agar, half-strength trypticase soy agar and malt agar for the enumeration of mesophilic microorganisms, coliforms, Bacillus, thermophilic bacteria, and fungi.A core microbiota was recognized consisting of three phyla (Firmicutes, Proteobacteria and Actinobacteria) and a total of 571 different species were identified including many pathogens, such as Mycobacterium riyadhense, M. chelonae, Shigella sonnei, S. flesneri, Klebsiella pneumoniae, Salmonella bongori, Coxiella burnetii, Acinetobacter spp., Staphylococcus haemolyticus, Streptococcus pseudopneumoniae, and Streptococcus sanguinis, showing the contamination of maassel.The present study suggests that flavored tobaccos are potentially infectious. However, further risk assessment is required to determine transmission occurrence.
Background: Non-sterile latex disposable gloves (NSLDGs) can prevent infections, but may also cause them if improperly used.Aim: To study NSLDGs bacterial contamination and the effect of hand hygiene reminder notices.Methods: A controlled interventional study was conducted through a quantitative bacterial sampling of NSLDGs (n = 160 gloves) obtained from boxes immediately after they were opened (baseline contamination) and 48 hours afterwards (per-intervention), and after hand hygiene reminder notices were placed (post-intervention).Bacteria were isolated and identified by 16S rRNA gene sequencing and antibiotic sensitivity testing.Findings: Pre-intervention contamination was found to be 90% and 65% for skin commensals and pathogens, respectively.Post-intervention contamination by skin commensals and pathogens declined to 70% and 15%, respectively, representing a significant reduction in the prevalence of pathogens (p = 0.0006244).The average number of colony-forming units per glove pair was also reduced, from 57.05 to 4.95 (p = 1.5 × 10 -5 ) and from 16.1 to 0.65 (p = 0.003374), for skin commensals and pathogenic bacteria, respectively.Discussion: NSLDGs are potential pathogen transmission vehicles.Hand hygiene reminder notices placed on glove boxes can lead to reductions in bacterial contamination levels.
Aim Tissue inhibitor of metalloproteinase (TIMP2) is involved in the regulation of matrix metalloproteinase 2 (MMP2) and shown to implicate in cancer development and progression. The results from the published studies based on the association between TIMP2 -418 G>C polymorphism and cancer risk are inconsistent. In this meta-analysis, we aimed to evaluate the potential association between TIMP2 -418 G>C polymorphism and cancer risk. Methodology We searched PubMed (Medline) and EMBASE web databases to cover all studies based on relationship of TIMP2 -418 G>C polymorphism and risk of cancer until October 2013. The meta-analysis was performed for selected case-control studies and pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for all genetic models. Results A total of 2225 cancer cases and 2532 controls were included from ten eligible case-control studies. Results from overall pooled analysis suggested no evidence of significant risk between TIMP2 -418 G>C polymorphism and cancer risk in any of the genetic models, such as, allele (C vs. G: OR = 1.293, 95% CI = 0.882 to 1.894, p = 0.188), homozygous (CC vs. GG: OR = 0.940, 95% CI = 0.434 to 2.039, p = 0.876), heterozygous (GC vs. GG: OR = 1.397, 95% CI = 0.888 to 2.198, p = 0.148), dominant (CC+GC vs. GG: OR = 1.387, 95% CI = 0.880 to 2.187, p = 0.159) and recessive (CC vs. GG+GC: OR = 0.901, 95% CI = 0.442 to 1.838, p = 0.774) models. No evidence of publication bias was detected during the analysis. Conclusions The present meta-analysis suggests that the TIMP2 -418 G>C polymorphism may not be involved in predisposing risk factor for cancer in overall population. However, future larger studies with group of populations are needed to analyze the possible correlation.
Summary The dlt operon of Gram‐positive bacteria encodes proteins required for the incorporation of d ‐alanine esters into cell wall‐associated teichoic acids (TA). d ‐Alanylation of TA has been shown to be important for acid tolerance, resistance to antimicrobial peptides, adhesion, biofilm formation, and virulence of a variety of pathogenic organisms. The aim of this study was to determine the importance of d ‐alanylation for colonization of the gastrointestinal tract by Lactobacillus reuteri 100‐23. Insertional inactivation of the dltA gene resulted in complete depletion of d ‐alanine substitution of lipoteichoic acids. The dlt mutant had similar growth characteristics as the wild type under standard in vitro conditions, but formed lower population sizes in the gastrointestinal tract of ex‐ Lactobacillus ‐free mice, and was almost eliminated from the habitat in competition experiments with the parental strain. In contrast to the wild type, the dlt mutant was unable to form a biofilm on the forestomach epithelium during gut colonization. Transmission electron microscope observations showed evidence of cell wall damage of mutant bacteria present in the forestomach. The dlt mutant had impaired growth under acidic culture conditions and increased susceptibility to the cationic peptide nisin relative to the wild type. Ex vivo adherence of the dlt mutant to the forestomach epithelium was not impaired. This study showed that d ‐alanylation is an important cell function of L. reuteri that seems to protect this commensal organism against the hostile conditions prevailing in the murine forestomach.
Most studies of the vaginal microflora have been based on culture or on qualitative molecular techniques. Here we applied existing real-time PCR formats for Lactobacillus crispatus, L. gasseri and Gardnerella vaginalis and developed new formats for Atopobium vaginae, L. iners and L. jensenii to obtain a quantitative non culture-based determination of these species in 71 vaginal samples from 32 pregnant and 28 non-pregnant women aged between 18 and 45 years.The 71 vaginal microflora samples of these women were categorized, using the Ison and Hay criteria, as refined by Verhelst et al. (2005), as follows: grade Ia: 8 samples, grade Iab: 10, grade Ib: 13, grade I-like: 10, grade II: 11, grade III: 12 and grade IV: 7.L. crispatus was found in all but 5 samples and was the most frequent Lactobacillus species detected. A significantly lower concentration of L. crispatus was found in grades II (p < 0.0001) and III (p = 0.002) compared to grade I. L. jensenii was found in all grades but showed higher concentration in grade Iab than in grade Ia (p = 0.024). A. vaginae and G. vaginalis were present in high concentrations in grade III, with log10 median concentrations (log10 MC), respectively of 9.0 and 9.2 cells/ml. Twenty (38.5%) of the 52 G. vaginalis positive samples were also positive for A. vaginae. In grade II we found almost no L. iners (log10 MC: 0/ml) but a high concentration of L. gasseri (log10 MC: 8.7/ml). By contrast, in grade III we found a high concentration of L. iners (log10 MC: 8.3/ml) and a low concentration of L. gasseri (log10 MC: 0/ml). These results show a negative association between L. gasseri and L. iners (r = -0.397, p = 0.001) and between L. gasseri and A. vaginae (r = -0.408, p < 0.0001).In our study we found a clear negative association between L. iners and L. gasseri and between A. vaginae and L. gasseri. Our results do not provide support for the generally held proposition that grade II is an intermediate stage between grades I and III, because L. gasseri, abundant in grade II is not predominant in grade III, whereas L. iners, abundant in grade III is present only in low numbers in grade II samples.
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