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Background: Diabetic foot infection (DFI) is considered the most common cause of diabetes-related hospitalization. Diabetic foot ulcers are subjected to bacterial colonization with biofilm forming organisms which are difficult to eradicate. The aim of this study was to identify the spectrum of bacteria associated with DFI and their ability to form biofilm, to evaluate differences in antibiotic susceptibility pattern between planktonic and biofilm phases, and to determine the antibiotics which are active on the organism in the biofilm phase. Methods: The study comprised 50 patients with DFI. A deep swab was collected from each patient and cultured. All isolates were identified and screened for biofilm formation. Biofilm forming isolates were further subjected to minimum biofilm eradication concentration (MBEC) assays to determine resistance to different antimicrobials while in the biofilm phase. Results: Seventy-one isolates were identified, (14.1%) were Gram positive cocci, (83.1%) were Gram negative bacilli, and (2.8%) were Candida species. The most frequently isolated organism was Klebsiella spp. (18/71, 25.4%), followed by Proteus spp. (14/71, 19.7%). The prevalence of biofilm forming isolates was 38%. All the studied isolates showed MBEC higher than the MIC for all tested antimicrobials. Conclusions: The substantial discrepancy between MIC and MBEC results observed in this study emphasizes the lack of reliability of the routine antimicrobial susceptibility testing in case of biofilm formation. Among all tested antimicrobials; cefoperazone/sulbactam, gentamicin, and vancomycin demonstrated activity against bacteria in the biofilm phase.

Background: Hepatitis C virus is a hepatotropic and lymphotropic virus that has been associated with various diseases and syndromes. Autoimmune hepatitis is a chronic disease of unknown etiology, marked by the continuous inflammation of hepatocytes and necrosis and has a tendency to advance to cirrhosis. Objective: A comparative study between cases of chronic HCV infection and AIH cases regarding different parameters including their genetic association with HLA class II alleles: DRB1*01* -DRB1*15* Methodology:The study included Eighty subjects, Group I: 30 chronic HCV, Group II: 30 AIH, Group III: 20 healthy controls. HLA Typing was performed using a line probe assay. Results: HLA DRB1 * 07, DRB1 * 11 were highly associated with HCV clinical cases. DRB1*3 and DRB1*5 were the predominant alleles in AIH (representing 66.7% and 53.3% respectively). Conclusion: Certain HLA alleles of class II could be linked to hepatitis cases (either caused by HCV or autoimmune) and can predict clinical course and outcome of the disease.

Background: Carbapenemase producing K. pneumoniae poses severe clinical problems. The accurate phenotypic detection and differentiation of the carbapenemase types in clinical laboratories is now of utmost importance for the determination of appropriate therapeutic schemes and the implementation of infection control measures. Objective: to identify the prevalent carbapenemases among carbapenem non-susceptible K. pneumoniae isolated from AMUH, to evaluate the ability of Carba NP version II test to detect carbapenemase production and identify their Ambler classes compared to PCR as a gold standard, in addition to comparing the Carba NP version II test with MHT and inhibitor-based phenotypic tests regarding sensitivity, specificity, turnaround time and cost effectiveness. Methodology: This study was carried out on 96 non-duplicate carbapenem non-susceptible K. pneumoniae isolates carrying one or more of carbapenemase genes. phenotypic screening methods included: Carba NP II test, MHT, meropenem/PBA CDT and meropenem/EDTA CDT. Results: Carbapenemase class B was the most prevalent (94.8%). Carba NP II showed the highest sensitivity in detecting class B (72.5%) with PPV (95.7%). Increase in the number of class B genes in a given isolate, improved the sensitivity from 55.6% to 80%. The Carba NP II test was found to be 15% sensitive and 91.7% specific in detecting class D and it could not detect class A in any of the 19 isolates that harbored KPC gene. Conclusion: The main advantages of Carba NP II test over CDT and MHT are; the rapidity of the test and its relatively higher sensitivity in detecting class B carbapenemases.

Background:The genes that encode the human leukocyte antigens (HLA) molecules are the most polymorphic in the human genome and have been considered as possible genetic risk factor in the development of acute and chronic leukemias. Objective: This study aimed at evaluating the role of HLA DRB1 alleles as markers for selection of the line of therapy in Acute myeloid leukemia (AML) and Chronic myeloid leukemia (CML) patients. Methodology: The study was conducted on: 20 AML, 20 CML cases and 20 healthy controls. Typing was done by the sequence-specific primer (PCR-SSP). Results: There was a highly statistical significance association between response to treatment and HLA DRB1 alleles as markers (MCP= .0001) in AML and CML patients. The HLA-DRB1 04*04 allele was found to be associated with good response to therapy in AML patients while, HLA-DRB1 07*15 allele was associated with bad response. In CML patients, HLA-DRB1 03*11 allele was found to be associated with good response to therapy while, HLA-DRB1 alleles 03*04 and 11*15 alleles were equally associated with bad response. Conclusion: Future researches are mandatory especially on larger scale to confirm whether these alleles are protective or even risk alleles regarding both AML and CML.