Background: Hepatocellular carcinoma (HCC) is the most dangerous complication of chronic liver disease. It is a multifactorial complicated disease. Hepatitis C and hepatitis B viruses (HCV and HBV, respectively) represent the main causes of HCC in Egypt. Early diagnosis is very important to aid in early intervention. Objectives: The goal of this research is to evaluate the metabolic role of different amino acids as non-invasive biomarkers over the course of HCC. Methods: This study included 302 participants with 97 diagnosed, untreated HCC patients, 81 chronic HCV patients, 56 chronic HBV patients, 18 co-infected patients, and a control group of 50 normal age and gender-matched individuals. All participants provided complete medical histories and underwent complete clinical examinations, abdominal ultrasonography and/or computed tomography, routine laboratory investigations, estimation of serum α-fetoprotein, and determination of amino acid levels using ultra-performance liquid chromatography (UPLC MS/MS). Results: This work revealed a decline in branched chain amino acids (BCAA) and increase in aromatic amino acids (AAA) among infected groups (HCC, HBV, HCV, and co-infected patients) compared to control subjects and a marked change in Fisher’s and the BCAAs/tyrosine molar concentration ratios (BTR) between controls and infected groups. Conclusion: Different amino acids could be used as non-invasive markers to discriminate and follow chronic hepatitis patients to predict the course of HCC.

Background: Enterococci are the 3rd cause of HAIs. E. faecalis and E. faecium are the commonest enterococcal species, showed resistance to vancomycin due to resistance genes (vanA, vanB and vanC). Linezolid is considered a good substitute. The virulence factors like asa1, gelE, cylA, esp, and hyl may interfere with antibiotic susceptibility. Objectives: Determine linezolid resistance in VR E. faecalis and E. faecium in relation to virulence factors. Methodology: Enterococcus spp. identified by colony morphology, Gram stain, biochemical reactions and by the VITEK 2 system. Antibiotic susceptibility was done through VITEK 2 system, AST-GP72 card. Vancomycin and linezolid MIC were done according to CLSI. Multiplex PCR for ddl E. faecalis , ddl E. faecium . vanA and vanB detection. Other for asa1, gelE, cylA, esp, and hyl virulence genes determination then conventional PCR for cfr and optrA genes were done. Results: A total of 65 enterococci CIs. (45 E. faecalis & 20 E. faecium) were isolated from different samples. E. faecalis and E. faecium were resistant to vancomycin by 11,1% and 35% and to linezolid by 4.4% and 10% respectively. The vanA, vanB, cfr and optrA genes were present in 100% of VR E. faecalis like E. faecium except that, the cfr was not detected. The gelE was frequently detected in E. faecalis followed by asa1, esp, hyl and finally cylA. And for E. faecium, the most frequent one was asa1followed by gelE. esp, and finally cylA and hyl. Conclusions: LZD resistant enterococci were increasingly detected, with no significant relation between linezolid resistance and vancomycin resistance. And with different impact of virulence genes.

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