Background Cutaneous warts are the commonest benign lesion produced by human papillomavirus. Lesions often regress spontaneously yet have a high rate of recurrence. They impair patients' quality of life and carry the potential risk of cancer. Nowadays, Candida antigen immunotherapy has become an encouraging therapeutic modality for warts. We tried to assess the role of the complement pathway and T helper 1 immune response in clinical response to Candida antigen immunotherapy via complement component 3c (C3c) and tumor necrosis factor (TNF)-α, respectively. Methods A total of 44 patients with cutaneous warts were enrolled in the study. Patients were injected with Candida antigen at 2week interval until complete clearance of the lesion or for a maximum of 5 sessions. Blood samples were collected before initiation and after completion of immunotherapy. C3 and C4 were measured using an automated turbidimetric method. Mannose-binding lectin (MBL), C3c, and TNF-α were measured using enzyme-linked immune sorbent assay. Results A total of 56.4%, 17.9%, and 25.7% of the patients showed complete, partial, and no response to immunotherapy, respectively. Lesions on the dorsum of the foot and sole showed significant clearance (p value = 0.037). All patients had no deficient C3, C4, and MBL serum levels. C3c and TNF-α serum levels were significantly higher in non-responder group (p value < 0.001 and < 0.001, respectively). C3c and TNF-α serum levels were strongly correlated in all the studied patients (r = 0.8, p value < 0.001). Conclusions Candida antigen immunotherapy is an effective therapeutic modality for cutaneous warts. C3c and TNF-α serum levels were higher in patients who failed to respond to immunotherapy. Clinical trial registry number NCT04399577, May 2020 "retrospectively registered"

Background: Acinetobacter baumannii (A. baumannii) is a Gram-negative, aerobic coccobacillus. It causes life-threatening nosocomial infections, particularly in immunocompromised patients. Carbapenem-resistant A. baumannii are prevalent worldwide mostly caused by carbapenemase synthesis. Metallo β-lactamases (MBLs) include imipenemase (IMP), New Delhi metallo-β-lactamases (NDM) and Verona integrin metallo-β-lactamase (VIM). We aimed to investigate the prevalence of MBLs genes expression in carbapenem-resistant A. baumannii isolated from ICU patients as a reliable method for reducing the morbidity & mortality of these patients. Methods: Using conventional methods, 87 A. baumannii isolates were identified from 103 ICU patient specimens. Metallo β-lactamases were detected phenotypically in imipenem-resistant strains using a combined disc test (CDT). Real-time PCR was used to quantitate the expression of the blaIPM, blaNDM & blaVIM genes. Results: Imipenem resistance was identified in 82.8% of patients. Combined disc test was positive in 44.4% of imipenemresistant isolates. For metallo-lactamases gene expression, blaVIM had a higher median value than blaNDM and blaIPM (0.5, 0.1 and 0 respectively). Combined disc test was found to have a statistically significant relationship with both NDM and VIM gene expression, which was considerably higher in isolates with positive CDT. Both NDM and VIM gene expression had a statistically non-significant correlation with CDT value, but their expression had a statistically significant negative correlation with CD zone of inhibition value. Conclusion: The expression of blaVIM and blaNDM genes is directly correlated with the level of MBLs production and the level of these enzymes can be detected phenotypically depending on its negative correlation with the CD zone of inhibition diameter.