Background: The Gram-negative bacterium, Acinetobacter baumannii (A. baumannii) has emerged as a significant threat in healthcare settings, causing severe opportunistic infections. This research aimed to identify plasmid-mediated quinolone resistance (PMQR) genes in A. baumannii clinical isolates in Suez Canal University Hospitals (SCUHs). Methods: A. baumannii isolates were collected and identified by conventional methods. The minimum inhibitory concentration index of ciprofloxacin was determined using the agar dilution method, and efflux pump activity was detected after the addition of carbonyl cyanide 3-chlorphenhydrazone (CCCP) efflux inhibitor. The PMQR genes were detected using conventional PCR. Results: The study included 44 A. baumannii isolates collected from 650 patients at a rate of 6.7%. The highest isolation was from the intensive care unit (56.8%) and respiratory specimens (52.3%). The highest antibiotic resistance was to ceftazidime and cefepime (95.5% and 86.4% respectively), and fluoroquinolones (FQs) (82%), and the lowest resistance was to doxycycline and tetracycline (45.5% and 54.5% respectively). After using efflux inhibitor, thirteen strains (36%) of quinolone-resistant isolates showed efflux pump activity. Using conventional PCR, the aac (6’)-Ib-cr gene showed the highest frequency (89 %), oqxB gene (53 %), qepA gene (47 %) and oqxA gene (30.5%). Conclusion: Most PMQR genes were detected at unforeseen high levels. Strict adherence to infection control measures is important to restrain the horizontal spread of these genes. The addition of the newest arsenal of antibiotics to the Egyptian market becomes a national demand, that may partially solve this critical situation.

Background: Escherichia coli (E. coli) is a Gram-negative bacterium that is facultative anaerobic in nature. E. coli strains causing urinary tract infection (UTI) are called uropathogenic E. coli (UPEC). UPEC makes up to 70-95% of UTIs. UTI is a serious health problem concerning antibiotic resistance and biofilms formation. Biofilm can restrict the diffusion of antimicrobials. Aim: To detect E. coli biofilm producers to improve prognosis and treatment and reduce morbidity and mortality rates due to UTI. Methods: Forty-seven clinical isolates of non-duplicated UPEC were collected from clinically suspected cases of UTI in Suez Canal University Hospitals (SCUHs). Isolates were identified as E. coli by colony morphology, Gram staining and biochemical reactions. Antimicrobial susceptibility testing was performed by Kirby–Bauer disc diffusion method on Muller–Hinton agar plate. The detection of biofilm was carried out by Congo red agar (CRA) method and modified tissue culture plate (MTCP) method. Results: The CRA method detected 63.8% of E. coli isolates as biofilm producers while the MTCP method detected 40.4% of them as biofilm producers. The sensitivity, specificity and accuracy of CRA method in comparison to MTCP method were 100%, 60.7% and 76.6% respectively. All biofilm producers and non-producers were resistant to amoxicillin-clavulanate and ceftazidime. The maximum sensitivity was seen for imipenem (91.49 %), followed by nitrofurantoin (78.72%) and then gentamicin (63.83%). Biofilm producers showed significant resistance (73.68%) to norfloxacin when compared to nonbiofilm producers (25%) (P=0.003). Conclusion: The prevalence of biofilm production among UPEC in SCUHs is 40.4%. Imipenem is the drug of choice for treating biofilm producing UPEC.

Background: Diabetic nephropathy, a chronic kidney disease resulting from diabetes mellitus microvascular complications, is thought to be the primary cause of end-stage renal failure. Gene mutations affecting the TNF gene can impact the generation of tumor necrosis factor-α (TNF-α), which has been associated with worse clinical outcomes in patients with diabetic nephropathy who are in severe condition. Objective: The purpose of this study was to assess the relationship between diabetic nephropathy and TNFα -308 G/A gene polymorphism in individuals with diabetes. Methodology: 50 diabetic individuals were recruited in this case-control research and were split into two groups: 25 patients with nephropathy and 25 patients without nephropathy. As a typical control group, a third set of blood donors (n = 25) appeared to be in good condition. Patients' information was gathered through the use of an interview questionnaire. The test for gene polymorphism was PCR. The TNF α308 G/A gene's A allele has a positive, statistically significant correlation (P-value ~0.05) with DN. Results: The prevalence of DN among the study participants may be predicted by the presence of an A allele in the TNF α308 G/A gene with a statistically significant P-value (P-value < 0.05). The study participants' TNF α308 G/A gene patterns and albumin/creatinine ratio did not exhibit a statistically significant relationship. Conclusion: According to this study, having an A allele in the TNF α308 G/A gene may contribute to the pathophysiology of diabetic nephropathy and be a predictor of nephropathy in diabetic populations.

The vitamin D binding protein (DBP) plays a critical role in both innate and adaptive immune systems, participating in several clinical conditions, including coronavirus disease 2019 infection severity, and mortality rate. The study aimed to investigate the correlation between rs7041 and rs4588 polymorphisms in the DBP gene and Coronavirus Disease-2019 (COVID-19) severity and mortality, in patients of Suez Canal University Hospitals in Ismailia, Egypt. A case-control study enrolled 220 individuals; 140 COVID-19 patients and 80 healthy controls. Serum 25(OH) vitamin D levels were determined by the enzyme-linked immunosorbent assay (ELISA), and rs7041 and rs4588 polymorphisms of the DBP gene were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The study found that both groups had vitamin D deficiency, which was considerably lower in the COVID-19 patients group compared to controls. Among COVID-19 patients, there was a significant difference in vitamin D levels according to the disease severity indicating that vitamin D levels can be used as predictors of COVID-19 severity. Negative significant correlations between genetic variants rs4588 CA genotype and genetic variants rs7041 TT genotype and COVID-19 prevalence (p = 0.006 and 0.009 respectively) were proved. No significant correlations between all the genetic variants of both rs4588 and rs7041 and COVID-19 severity (p > 0.05). Positive significant correlations between both genetic variants rs4588 CA genotype and genetic variants rs7041 TG genotype and COVID-19 mortality (p = 0.029 and 0.031 respectively). vitamin D deficiency increased the severity of COVID-19. The DBP polymorphism correlated with vitamin COVID-19 prevalence and mortality.

Background: Health care workers lack knowledge about human Mpox, and most are not confident in their abilities to identify and manage cases. The study's objectives are to improve healthcare workers ' knowledge and attitudes regarding Mpox infections and to help them become confident in diagnosis and management. Methods: This study was carried out in two stages. The first phase involved a cross-sectional survey of 206 healthcare workers, utilizing the snowball sampling approach, to evaluate their knowledge and attitudes regarding Mpox using a self-administered questionnaire. The second phase was a pre-posttest study with stratified random sampling method to improve the participants’ knowledge and attitude towards Mpox among health care workers. Results: In phase one, 7.3% of the 206 participants had good knowledge with a mean knowledge score of 6.2 ± 8.3., and 89.3% had a positive attitude. In phase two, there was significant improvement in the score of knowledge post intervention immediately [28.6 ± 1.7] and after one month [28.5 ± 1.4] compared with before. The improvement in knowledge level was from 5.7% before to 100% after the intervention. The positive attitude frequency also increased from 42.9% to 100% [p < 0.001]. Conclusion: In conclusion the knowledge and attitude level towards human Mpox infection in our study were considered low. After giving the educational training program, the participants’ knowledge and attitude towards Mpox among health care workers was improved.

Background Variation in host immune responses to SARS-CoV-2 is regulated by multiple genes involved in innate viral response and cytokine storm emergence like IL-10 and TNFa gene polymorphisms. We hypothesize that IL-10 ; -592 C > A and − 1082 A > G and TNFa-308 G > A are associated with the risk of SARS-COV2 infections and clinical outcome. Methods Genotyping, laboratory and radiological investigations were done to 110 COVID-19 patients and 110 healthy subjects, in Ismailia, Egypt. Results A significant association between the − 592 A allele, A containing genotypes under all models ( p < 0.0001), and TNFa A allele with risk to infection was observed but not with the G allele of the − 1082. The − 592 /-1082 CG and the − 592 /-1082/ -308 CGG haplotypes showed higher odds in COVID-19 patients. Severe lung affection was negatively associated with − 592, while positive association was observed with − 1082. Higher D-dimer levels were strongly associated with the − 1082 GG genotype. Survival outcomes were strongly associated with the GA genotype of TNFa . -308 as well as AGG and AAA haplotypes. Conclusion IL-10 and TNFa polymorphisms should be considered for clinical and epidemiological evaluation of COVID-19 patients.

Acidic exopolysaccharide (EPS) was produced by a marine actinobacterium Streptomyces vinaceusdrappus strain AMG31 with the highest yield of 10.6 g/l. The synthesized EPS has an average molecular weight of 5.1 x 104 g/ mol and contains arabinose, glucose, galacturonic acid (0.5:2:2 M ratio), with 39.77 % uronic acid residues and 18.8 % sulfate detected. EPS exhibited antioxidant activities with 93.8 % DPPH radical scavenging and 344.7 mu g/ mg total antioxidant capacity. It displayed anti-inflammatory effects by inhibiting 5-LOX and COX-2. Regarding the cytotoxic activity, the IC50 values are 301.6 + 11.8, 260.8 + 12.2, 29.4 + 13.5, 351.3 + 11.2, 254.1 + 9.8, and 266.5 + 10.4 mu g/ml for PC-3, HEP-2, MCF-7, HCT-116, A-549, HepG-2 respectively, which indicate that the produced EPS does not have strong cytotoxic activities. Moreover, the EPS showed anti-Alzheimer activity via inhibition of the Butyrylcholinesterase enzyme, with the highest percentage of 84.5 % at 100 mu g/ml. Interestingly, the EPS showed superior anti-obesity activity by inhibiting lipase enzyme with a rate of 95.3 % compared to orlistat as a positive control (96.8 %) at a concentration of 1000 mu g/ml. Additionally, the produced EPS displayed the highest anti-diabetic properties by inhibiting a-amylase (IC50 31.49 mu g/ml) and a-glucosidase (IC50 6.48 mu g/ml), suggesting antidiabetic potential analogous to acarbose. EPS exhibited promising antibacterial and antibiofilm activity against a wide range of Gram-positive and Gram-negative pathogenic bacteria.

Background: World Health Organization has documented the exaggerated use of broad-spectrum antibiotics during the COVID-19 pandemic raising warnings of increasing antimicrobial resistance. Aim: This is an observational cross-sectional comparative study that was done to describe the pattern of antibiotics resistance before and during the COVID-19 era to explain if this pattern is affected with using different antibiotics in COVID-19 era. Methods: Various clinical specimens from patients admitted in the urology, internal medicine, surgery inwards, intensive care unit and neonatal ICU in Suez Canal University Hospital in the pre-COVID-19 period (January 2019 to January 2020) and during COVID-19 pandemic (January 2020 to January 2021) were included. 627 patients,349 (55.6%) patients in the pre-COVID-19 era and 278 (44.4%) patients during the COVID-19 era. Results: Most samples were Gram-negative organisms (86%), while gram-positive represent 14% only. The most common Gram-negative isolates include Escherichia coli (E. coli) (30.9%). The most common Gram-positive is Staphylococcus species (11.8%). The study found a statistically significant increase in the resistance for cefazoline (p=0.002), nitrofurantoin (p=<0.001), aztreonam (p=<0.001) and tobramycin (p=<0.001) during the COVID-19 era compared with the pre-COVID-19 era. Among the Gram-negative pathogens, there is a significant increase in the resistance for ampicillin (p=0.023), ciprofloxacin (p=0.013), nitrofurantoin (p=<0.001), aztreonam (p=<0.001), tobramycin (p=0.035), trimethoprim -sulphamethoxazole (p=0.029), cefazoline (p=0.011), aztreonam (p<0.001), tigecyclin (p=0.048), and amikacin (p=0.043) during the COVID-19 compared with before, but the susceptibility pattern for the Gram-positive pathogens did not vary in both periods. Conclusion: COVID-19 pandemic led to the uncontrolled use of broad-spectrum antimicrobials, causing an increase in the antimicrobials resistance (AMR). Strict adherence to antimicrobial stewardship is essential.

Streptococcus agalactiae (S. agalactiae), group B Streptococcus (GBS), a major cause of infection in a wide variety of diseases, have been compared in different human and animal sources. We aimed to compare the bacterial proteome and metabolome profiles of human and animal S. agalactiae strains to delineate biological interactions relevant to infection. With the innovative advancement in mass spectrometry, a comparative result between both strains provided a solid impression of different responses to the host. For instance, stress-related proteins (Asp23/Gls24 family envelope stress response protein and heat shock protein 70), which play a role in the survival of GBS under extreme environmental conditions or during treatment, are highly expressed in human and animal strains. One human strain contains ꞵ-lactamase (serine hydrolase) and biofilm regulatory protein (lytR), which are important virulence regulators and potential targets for the design of novel antimicrobials. Another human strain contains the aminoglycosides-resistance bifunctional AAC/APH (A0A0U2QMQ5) protein, which confers resistance to almost all clinically used aminoglycosides. Fifteen different metabolites were annotated between the two groups. L-aspartic acid, ureidopropionic acid, adenosine monophosphate, L-tryptophan, and guanosine monophosphate were annotated at higher levels in human strains. Butyric acid, fumaric acid, isoleucine, leucine, and hippuric acid have been found in both human and animal strains. Certain metabolites were uniquely expressed in animal strains, with fold changes greater than 2. For example, putrescine modulates biofilm formation. Overall, this study provides biological insights into the substantial possible bacterial response reflected in its macromolecular production, either at the proteomic or metabolomic level.

Background: Hepatitis B infection is a potentially severe liver infection caused by the hepatitis B virus and is a significant global health issue. The likelihood of health care professionals contracting hepatitis B is high. Vaccination is the most effective and feasible method for avoiding hepatitis B virus infection. Hepatitis B virus (HBV) prevention requires adequate knowledge, attitudes, and practices regarding hepatitis B infection and immunization. Aim of work: To study the level of knowledge, attitudes, and practice towards HBV infection among health care workers in Suez Canal University Hospital. Materials and methods: A descriptive cross-sectional study was conducted on 305 health care employees at Suez Canal University Hospital, including physicians and nurses. A self-administered questionnaire with sociodemographic, knowledge, attitude, and practice-related questions was established. Results: Among the 305 HCWs of the study, 55.5% have adequate understanding of HBV transmission, even though 80% of health care workers (HCWs) were vaccinated against HBV, only 7.5% had immunity test after immunization. About 50% of physicians and 38.7% of nurses sustained 2 to 5 needle stick / sharp injury incidents during their working careers. Nearly, 16.2% of physicians and 19.0% of nurses reported using post-exposure prophylaxis, including hepatitis B vaccination. Conclusion: The majority of HCWs at Suez Canal University Hospital have proper knowledge, attitudes, and practices regarding HBV transmission and immunization. The health care authorities should provide training courses on hepatitis B infection and vaccination for HCWs to reduce the risks of acquiring hepatitis C virus infection.

The pandemic of COVID-19 is a traumatic event with distressing implications for mental health and several aspects of life. This study aimed to assess Post-traumatic Stress Disorder (PTSD) and Health-Related Quality of Life (HRQoL) among patients who experienced mild-to-moderate COVID-19 and their household contacts. This cross-sectional descriptive study was conducted between May 2020 and November 2020, in Ismailia and Suez governorates. A convenient sampling method was used. The sample size was calculated according to the prevalence of PTSD in COVID-19 patients to be 200 adult participants from both sexes, 100 patients with history of recent COVID-19 infection (up to 2 months after recovery) and their close family. COVID-19 was confirmed by a nasal swab sample tested by PCR in addition to suggestive symptoms and/or positive computed tomography lung findings. Data was collected by using the Arabic version of the Post-Traumatic Stress disorder checklist 5 (PCL5-PTSD) and the Arabic version of Health-Related Quality of Life (HRQoL). The questionnaire was collected through interviews at the Endemic and Infectious diseases and Family medicine outpatient clinics. Of the 200 studied participants, evidence of PTSD was found in 112 (56%) participants; all COVID-19 cases and 12 of their close-contact relatives. Impaired HRQoL was evident in 107 (53.5%) participants; all the COVID-19 cases and 7 contacts. The mean values total scores of the PTSD and HRQoL and its domains were significantly higher among cases compared to their contacts. The most frequently impaired domain was social (55%), psychological (54.5%), impairment (53.5%) followed by physical (48.5%) and the least was health perception (33.5%). The mean values of PTSD, HRQoL and their domains were significantly higher among participants who recalled respiratory symptoms and who had comorbid illness. The odds ratio of PTSD and HRQoL was 0.27 (95% CI: 0.2-0.36) and 0.3 (95% CI: 0.23-0.39) in participants who had more than a case of COVID-19 within their families. All the studied COVID-19 participants showed PTSD and impaired HRQoL, compared to 12% and 7% of their contacts, respectively. Past COVID-19 was associated with impairment of all domains of HRQoL and the most affected were the physical, psychological and impairment domains.

Antimicrobial resistance (AMR) is considered as a global health and development threat. During COVID-19 pandemic, there has been an increase in antimicrobial resistance. Health care providers (HCPs) play the main role in facing antibiotic resistance because they have the authority to prescribe antibiotics during clinical practice as well as in promoting patients' compliance with therapies and avoid self-medication. So, this study will serve as an important source of information in context with Covid19 pandemic in Egypt. The data was collected using a validated standardized self-administered online questionnaire compromised of four sections: socio-demographic data of the HCPs, the general knowledge on antibiotics and AMR, the HCP attitude towards antibiotic prescription and AMR and the practice in applying the appropriate antibiotic prescription. Most of HCPs (93.7%) recorded good knowledge level about antibiotic prescription and antimicrobial resistance with mean score of knowledge13.21 ± 1.83. About 79% of HCPs recorded a positive attitude towards proper antibiotic prescription with mean score of attitudes 63.02 ± 7.68. Fifty four percent of HCPs demonstrated a good level of practice with mean score of practice 9.75 ± 2.17. In conclusion, HCPs in our study have a good level of knowledge and attitude about antibiotics. However lower level of proper practice towards the problem of AMR in COVID19 era was noticed. Implementation of effective policies and guidelines is crucial to evaluate the antimicrobial use especially in the COVID-19 era to reduce the unintended consequences of the misuse of antibiotics and its impact on AMR.

Background: Worldwide, the prevalence of hepatitis B virus (HBV) infection is decreasing particularly in the vaccinated population. However, there are foci of increased transmission particularly in localized communities and within families. Objective: This study aimed at identifying HBV infection status among family members (FMs) of a cohort of HBsAg positive index cases (ICs) living in a village near Ismailia City, North-East Egypt. Design and participants: The study targeted ICs with chronic hepatitis B and their FMs. All were inquired for socio-demographic data, previous vaccination, kinship, and risk factors. All were tested for hepatitis markers and in HBcAb positive sera, HBV DNA and ALT were added. Results: The study included 96 participants including 14 ICs, 51 (53.1%) were females and 73 (76%) self-reported receiving hepatitis B vaccine after birth. Among 82 FMs, HBcAb was found in 49 (59.76%) of whom overt and occult HBV were diagnosed in 24 (49%) and 18 (36.7%). HBs Ag and HBcAb were more frequent in unvaccinated compared to vaccinated FMs; being 60.9% vs. 32.9% for HBsAg (p < /em>=0.017) and 91.3% vs. 57.5% for HBcAb (p < /em>=0.003). Among the FMs, active HBV were more related to male than female ICs (54.9% vs. 45.2%, p < /em>=0.73) while among children, it is more related to females more than male ICs (38.9% vs. 25%, p < /em>=0.33). In all HBsAg positive participants, HBeAg was negative and HBV DNA load was higher among female than male ICs (median 3500 vs. 2594.5 IU/mL, p < /em>=0.82). Conclusion: The study shows a high rate of HBV transmission among FMs of HBsAg carriers living in a remote area in North-East Egypt. Both overt and occult HBV infections were frequent despite previous vaccination

Background: End-stage renal disease (ESRD) is an increasing health problem worldwide.Older age, diabetes mellitus and hypertension, acute kidney damage are among some of the factors that play a role in ESRD.This study aims at exploring liver morbidity (LM) among Egyptian hemodialysis (HD) patients.Methods: The study included 142 patients free from overt hepatitis B virus (HBV) or hepatitis C virus (HCV); their data were retrieved from files and all were clinically assessed and tested for liver functions, serological markers and viremia of HCV and HBV.Results: Of 142 eligible HD patients, two seroconverted to overt HCV, and five showed occult HCV.According to the laboratory and ultrasonography (US) data, three patterns of LM were found in 62 (43.7%), non-alcoholic fatty liver disease (NAFLD) in 30 (48.4%), liver fibrosis in 19 (30.6%), and hepatitis in 13 (21%).The mean durations of renal impairment (7.6 ± 5.91), hemodialysis (9 ± 6.1269), and total dialysis sessions (976.26 ± 683.69) were significantly higher in patients with LM compared to others (6.78 ± 4.82, 5.38 ± 3.69, and 699.4 ± 467.1).Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels were elevated in 14 (22.6%) and 13 (21%) of patients with LM.However, the ROC curve revealed ALT and AST cut-off points of 16.5 and 25.5 IU/L to discriminate LM.Conclusion: LM is common among EDRD patients undergoing hemodialysis despite the low levels of ALT and AST.The use of the US and the new lower levels of ALT and AST could improve the screening approach of LM.

Background Coronavirus disease 2019 vaccine acceptance among healthcare workers (HCWs) plays a fundamental role in combating the COVID-19 pandemic. Vaccination acceptance depends on perceptions of competence and motives of the providers, producers, health professionals, and policymakers. This study aimed to identify the frequency and determinants of COVID-19 vaccine uptake acceptance, hesitancy, and barriers among HCWs. Methods A total of 500 HCWs from 3 different hospital affiliations in Ismailia Governorate, Egypt, were included in this mixed methods study. The study was conducted between March and April 2021 through two phases. Phase 1 included a cross-sectional study using a self-administered questionnaire with inquiries about different determinants of vaccine acceptance, hesitancy, and barriers, which was completed either electronically in a Google form or a hard printed copy. Phase 2 included four focus group discussions to explore the determinants in depth. Results The mean age of participants was 33.9 ± 7.9 years, 70% were females, 51.2% were nurses, and 28.6% were physicians. Of the 500 HCWs, only 27.8% accepted taking the vaccine immediately, 49.2% refused, and 23% were hesitant. Vaccine safety was the highest associated factor with vaccine acceptance (odds ratio (OR) = 6.3, 95% confidence interval (CI) 3.132–12.619), followed by previous uptake of influenza vaccine (OR = 3.3, 95% CI 2.048–5.217) and vaccine effectiveness (OR = 2.6, 95% CI 1.282–5.262). The main barriers to vaccine acceptance were mistrust in governmental policies during the pandemic or in the healthcare facility they work in. Hesitancy was common among females and nurses and was attributed to three prominent factors, including safety concerns, negative stories, and personal knowledge. Conclusions The vaccine acceptance frequency among HCWs was considered low, as the majority either refused or was hesitant about taking the vaccine. Concerns about vaccine safety and effectiveness were significant determinants of vaccine acceptance. Factors related to trust were the main barriers to vaccine uptake. The health authority should establish a surveillance system for side effects of the COVID-19 vaccine and communicate this information between HCWs to decrease their worries about safety and increase vaccine uptake.

Background. COVID-19 infection is more likely to be acquired and transmitted by healthcare workers (HCWs). Furthermore, they serve as role models for communities in terms of COVID-19 vaccination attitudes. As a result, HCWs’ reluctance to vaccinate could have a significant impact on pandemic containment efforts. Aim. To characterize the current COVID-19 vaccine approval situation among healthcare workers and to determine the most likely reason for agreement or disagreement with COVID-19 vaccination. Methods. This cross-sectional design included 451 HCWs from COVID-19 treatment institutions, with COVID-19 exposure risk changing depending on job function and working location. Results. The study recruited 156 physicians and 295 nurses, of whom 58.1% were female and 41.9% were male. Physicians had a significantly higher rate of participation in COVID-19 pandemic prevention and control, with a rate of 69.9% versus 55.3% of nurses. Acceptance of COVID-19 vaccination was reported by 40.8% of HCWs. The rate of acceptance was significantly higher among physicians (55.1%) than among nurses (33.2%) (p<0.001). Most HCWs (67.8%) believed the vaccine was not effective. Physicians showed more significant trust in the effectiveness of the vaccine than nurses (41% and 27.5, respectively) (p=0.003). Concerning vaccine safety, only 32.8% of HCWs believed it was safe. This was significantly higher in physicians (41.7%) than in nurses (28.1%) (p=0.004). Conclusion. Vaccination uncertainty is common among healthcare personnel in Egypt, and this could be a significant barrier to vaccine uptake among the public. Campaigns to raise vaccine knowledge are critically needed.

In Egypt, antibiotic sensitivity analysis for Helicobacter pylori is not routinely performed. We aimed to identify the clarithromycin and metronidazole resistance directly from gastric biopsies for better guide treatment regimens. This cross-sectional descriptive study included 75 adult dyspeptic patients referred to the upper endoscopy unit in Suez Canal University Hospital, Ismailia, Egypt. Gastric biopsies were taken for rapid urease test (RUT) and cultured on brucella agar with antibiotic supplements. Genomic DNA was extracted directly from the specimen, and PCR was performed for direct detection of H. pylori. Also, to explore clarithromycin and metronidazole resistance, mutations in the 23S rRNA gene and the rdxA gene were investigated. We found that 60 samples were positive to RUT (80%), and only 4 samples were positive by culture. UreC gene was detected in 45 specimens. Meanwhile, 26 isolates were contained mutations at positions 2142 and 2143. Amplification of the metronidazole rdx gene was performed by conventional PCR. Out of 45 isolates, DNA sequence analysis of PCR product showed the wild type (ACA) in 9 isolates, while the mutant type (ATA) was detected in 28 isolates. We found a significant proportion of clarithromycin and metronidazole resistance among H. pylori infected patients in our region.

INTRODUCTION:The severe acute respiratory syndrome coronavirus 2 (SARS CoV2-CoV-2) viral outbreak in Wuhan (China) caused thousands of confirmed cases and deaths around the world. Severe viral pneumonia with respiratory failure and death are the ultimate consequence of infection.AIM:This study aimed to evaluate the regularly performed standard laboratory parameters that can assist in COVID-19 case identification and establish an effective approach to help care and management of (COVID-19) patients.METHODOLOGY:COVID-19 (n = 129) patients were hospitalized in the Suez Canal University Hospital and were retrospectively examined. Laboratory parameters were gathered from patients upon admission (n = 129) during the period from the 20th of June to 15th of August 2020. SARS-CoV-2 cases were diagnosed clinically and radiologically by chest Computed Tomography (CT) and confirmed by RT-PCR.RESULTS:The results showed that COVID-19 survivors exhibited lower hemoglobin (Hb) and hematocrit (HCT), while showed higher Red Cell Distribution Width (RDW), neutrophil lymphocyte ratio (NLR), and lymphocytes. Logistic regression analysis showed that age greater than 60 years old, neutrophilia and high NLR were associated with more deaths.CONCLUSION:Monitoring of lymphopenia, neutrophilia and NLR may help categorizing patients who may need Intensive care.

Background: Acinetobacter baumannii is an opportunistic pathogen that rapidly develops antibiotic resistance against commonly prescribed antimicrobial agents in hospitalized patients worldwide. Aminoglycosides are commonly used in the treatment of A. baumannii health care-associated infections (HAIs). Aminoglycosides resistance mechanisms are varied and commonly involve production of aminoglycoside-modifying enzymes (AME) and efflux systems. Aim: This study aimed to provide an insight into the frequency of genes encoding AME in A. baumannii strains isolated from different clinical specimens in intensive care units (ICU). Methodology: A total of 52 multidrug-resistant (MDR) A. baumannii strains were isolated from ICU, Suez Canal University Hospitals. Species identification and antibiotics susceptibility testing were done by the automated system VITEK 2. The genes encoding AME were detected by PCR. Results: Aminoglycosides resistance (amikacin, gentamicin and tobramycin) was observed in 35 isolates (67.3%). We found that aacC1 gene was the predominant AME resistance gene among A. baumannii isolates, detected in 14 isolates (40%), aphA6 in 11 isolates (31.4%) and addA1 in 5 isolates (14.2%). We found 5 isolates containing 2 AME genes, 3 of them with aacC1 and aphA6 and the remaining 2 with both aacC1 and aadA1 genes. Nearly, 5 isolates (14.2%) were negative for all AME resistance genes. Conclusion: Our study indicated that AME encoding genes are predominant in A. baumannii strains in our region which stressed on the importance of preventive measures to control spreading of resistance genes.