Multidrug resistant (MDR) P.aeruginosa had emerged in Egypt and seen mainly in nosocomial infections due to the selective pressure by overusage of antibiotics. This study was planned to delineate prevalence of MDR P.aeruginosa in nosocomial infection patients, and to screen for ESβLs producing P.aeruginosa with typing of P.aeruginosa isolates in Menofia University Hospitals (MUH), Egypt. Our study included 287 inpatients admitted to Menoufia University Hospital and having different nosocomial infections. Samples from medical staff and from hospital environment were collected. Antibiotyping of P. aeruginosa isolates were determined. MDR and ESBLs P. aeruginosa were detected. Plasmid DNA analysis and pyocin typing were done. In our study, a total of 57 P. aeruginosa strains were isolated. P. aeruginosa and its MDR phenoype accounted for 19 % and 9.5% respectively of nosocomial infections. MDR and ESβLs producer P. aeruginosa infections were commonly isolated from burn wound specimens followed by urinary tract, respiratory tract and wound infections. We detected high rates of MDR P. aeruginosa (52%) and of ESβLs producer strains (45.6%) and those ESBLs strains were all MDR. Amikacin and imipenem were the most effective drugs against P. aeruginosa. 23 different resistance patterns were identified, profiles from (1 -8) were prevalent. The most prevalent antibiotype (2) included 12 MDR isolates, 9 clinical and 3 environmental isolates having same patterns. 61.5% of ESβLs isolates harbor plasmids. Five groups could be demonstrated among our P. aeruginosa isolates. Each had the same antibiotype and plasmid profile. In conclusions, our results clarified that threats of MDR and ESBLs P. aeruginosa become of major concern in our hospital and implementation of infection control strategies are major concerns to avoid the spread of this threat. Eenvironmental sources may have a significant role in spread of MDR P. aeruginosa among hospitalized patients. Combination of Journal of Virology & Microbiology 2 simple typing methods as antibiotyping with plasmid profiling may be the cheapest and effective method for tracing source of infection.

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Background: Advanced glycation end products (AGEs) have biological properties that may contribute to the mortality of children on hemodialysis (HD). This study examines the relationship of LMW fluorescence AGEs, oxidized LDL (ox-LDL), soluble receptor AGE (sRAGE) as markers of oxidative stress in children with end stage renal disease (ESRD) undergoing HD. Method: Thirty children with ESRD undergoing HD, and 30 healthy, age-and sex-matched children were included. Serum levels of LMW fluorescence AGEs, sRAGE, oxidized LDL (ox-LDL), pre-and post-dialysis urea, high-sensitivity C-reactive protein (hs-CRP), hemoglobin (Hb) and serum albumin (ALB), were measured. Results: Abnormal serum inflammatory changes: elevated levels of LMW AGEs, sRAGE, oxLDL, CRP and urea were exhibited in HD children compared with healthy controls; more so in anemic when compared to non-anemic patients. Significant positive correlation was found between serum levels of AGEs and sRAGE. Conclusion: The low molecular weight form of AGEs is associated with oxidative stress in children receiving chronic HD, and may be important in the mechanisms leading to atherosclerosis and inflammation in such patients. LMW AGEs levels showed a negative correlation with sRAGE and both exhibit a significant negative relation to seum urea.

Background: Evaluation of renal microstructure is pivotal for diagnosing and monitoring chronic renal disease. DWI has been proved to be practicable and reliable examination for the assessment of renal function and parenchymal damage in some renal diseases. Our aim is to appraise DWI sequence and ADC measurement as a potential tool of renal function assessment as well as establishing a possible relationship between the different CKD stages and the renal parenchymal ADC values changes. Results: Regarding the cause of CKD, nine patients (45%) had glomerulonephritis, 5 patients (25%) had hemolytic uremic syndrome, 2 patients (10%) had lupus nephritis, 2 patients (10%) had nepheronophthisis, and 1 patient (1.5%) had infantile nepherosis, whereas the cause of CKD was unknown in 1 patient (1.5%). The stages of CKD were classified according to KIDGO guidelines: 6 patients (30%) were stage 1, 4 patients (20%) were stage 2, 3 patients (15%) were stage 3, 2 patients (10%) were stage 4, and 5 patients (25%) were stage 5. The patients' group (group A) had a mean ADC value (1.85 × 10 −3 ± 0.24) which was significantly lower than that of the control group (group B) (2.21 × 10 −3 ± 0.12). As for the correlation between stage of CKD and ADC, we found it to be a moderate negative one with r' value of − .655 and a significant p value of < 0.001. Conclusion: DWI is recognized as a promising imaging tool that can take part in the assessment of the morphological and functional changes in diffuse renal parenchymal disease, hence playing an important role in the early diagnosis and staging of chronic kidney disease.

Introduction: Hearing impairment is frequent in patients with end-stage renal disease (ESRD). We aimed to assess the prevalence of hearing impairment in children on regular hemodialysis and renal transplantation. Materials and Methods: Transient-evoked otoacoustic emissions (TEOAEs) has been done for 80 children on regular hemodialysis and 40 with renal transplant.Results: In hemodialysis group, TEOAEs showed that 53.8% children had hearing affection, it was significantly related to dialysis duration, dialysis adequacy, vascular access infection, hepatitis C virus (HCV) infection, and ototoxic drugs (p = 0.001, 0.037, 0.011, 0.004, 0.030, 0.007, and 0.044, respectively). In renal transplant group hearing impairment was 25%. There was significant relation with period of dialysis before transplantation and biopsy proved rejection (p = 0.008, <0.001, respectively). Conclusion:Hearing impairment is a common finding in ESRD patients.