Recent Approach in Microbial Pathogen Complications in Patients with Cystic Fibrosis

Cystic fibrosis (CF) is a multisystem genetic disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Microbial infection is the defined characteristics of cystic fibrosis airway disease. This infection is caused by bacteria, fungi, and viruses which increase complications leading to patient death. Additionally, bacterial pathogens including Haemophilus influenza, Staphylococcus aureus, Pseudomonas aeruginosa, nontuberculous mycobacterium (NTM) species, and MRSA are attributed to pulmonary infections. Subsequently, fungal pathogens such as Candida sp. and filamentous fungi such as Aspergillus fumigatus can also lead to pulmonary infections. On the other hand, Pseudomonas aeruginosa is the most common bacterial pathogen leading to complications in CF distal airways disease. Also, Aspergillus fumigatus can lead to aspergillus lung diseases including allergic bronchopulmonary aspergillosis and aspergilloma formation. Control of pathogenic microorganisms associated with cystic fibrosis may prevent pulmonary complications and has the potential to improve the prognosis of this life-limiting disease

Modern Trends in Uses of Different Wastes to Produce Nanoparticles and Their Environmental Applications

Wastes are produced at large amounts all over the world. These wastes cause a variety of problems to the ecosystem, plants, animals, and humans. In this chapter, we discuss the wastes, types of wastes, sources of wastes, and problems related to wastes, especially health-related problems. Then we discuss agricultural wastes and how we can synthesize different nanoparticles from them. Also, we discuss industrial wastes and different nanoparticles synthesized from them. Additionally, we discuss fruit wastes and production of different nanoparticles and also food wastes and their uses in nanoparticle syntheses. Also, we can use other wastes to produce nanoparticles. In applications section, we discuss the use of different nanoparticles produced in agriculture, removal of heavy metals and pollutants from environment, industry and finally medical applications. We will finish our chapter with the topic of healthy and safe synthesis of nanoparticles produced by different wastes and then conclusion

The Effect of Thickness And Accelerated Aging on Opalescence of Different Ceramic Materials

Purpose: The objective of the study was to evaluate the effect of ceramic material type and thickness on opalescence before and after accelerated aging. Materials and methods: 180 all-ceramic slices were divided into three groups (n=60) according to the ceramic material (InCoris TZI, Empress CAD HT, and Empress CAD LT). Each group was further subdivided into four subgroups (n = 15) according to their thickness (0.5 mm, 0.8 mm, 1 mm and 1.2 mm).). CIE Lab coordinates were measured for each slice against black and white backgrounds using intraoral spectrophotometer and OP was calculated. All specimens were subjected to accelerated aging using autoclave (134 ºC, 0.2 MPa for 5 h) and OP was calculated after accelerated aging. Repeated ANOVA combined with a Tukey-post hoc test were used to analyze the data obtained (P ≤ 0.05). Results: The results showed that ceramic material type and thickness have significant effect on opalescence with OP values (from 4.4±1.2 to 7.1±1.7) for InCoris TZI, (from 4.1±0.28 to 5.7±0.36) for CAD HT, and (from 5.9±0.7 to 8.7±4.6) for CAD LT, while the effect of accelerated aging was not statistically significant. Conclusion: The dental ceramic type affected the opalescence with Empress CAD HT showing the highest OP values. Increasing the thickness caused an increase in the opalescence of leucite reinforced glass ceramic, while it decreased the opalescence of zirconia. Therefore, manufactures should develop all-ceramic materials that can simulate the opalescence of natural teeth especially in esthetic ceramic restoration with lower thickness

Trends in the assessment of multidrug efficiency against identified bacterial strains isolated from wounds at El-Demerdash Hospital, Egypt

Multidrug-resistant (MDR) bacteria is a severe problem for universal public health which increases morbidity and mortality rate. These resistant bacteria lead to ineffective treatment of drugs resulting in the spreading and persistence of infections. So, the major target of this study is to estimate the competence of multidrug antibacterial agents against bacterial strains isolated from wound samples and then identify the most potent Multidrug-resistant (MDR) bacteria. Fifty wound swab specimens were gathered from various wounds and several patients from the Central Microbiology Laboratory of El-Demerdash Hospital, Cairo, Egypt. Eighty- nine bacterial isolates were isolated from fifty wound samples then cultured on different media and tested for their susceptibility to different thirty antibiotic discs using the agar disc diffusion method. After recording the results of the susceptibility test, the post potent resistant bacterial isolates recorded 3 bacterial isolates which resistant to 30 different antibiotic types. These resistant bacterial isolates were identified using morphological, biochemical, and molecular techniques. The results recorded that the post potent resistant bacterial isolates identified as Klebsiella oxytoca, Pseudomonas aeruginosa, and Escherichia coli. This study concluded that with the increase in the random use of antibiotic drugs resulted in the presence of multi-antibacterial resistant strains. There are bacterial strains that were isolated from wounds in patients at El-Demerdash Hospital, Egypt, and identified. They can resist about thirty different antibiotic discs. Abbreviation: Multiple antibiotic resistance (MAR)

Effect of accelerated aging on translucency of monolithic zirconia

Purpose: The objective of the study was to evaluate the translucency of different thickness of a translucent zirconia before and after accelerated aging. Materials and methods: Sixty slices of translucent zirconia were obtained by cutting InCoris TZI blocks into slices using Micracut precision cutting machine. The slices were divide into four groups (n ¼ 15) according to their thickness (0.5 mm, 0.8 mm, 1 mm and 1.2 mm). CIE lab coordinates were measured for each slice against black and white backgrounds using vita easy shade and TP was calculated. All specimens were subjected to accelerated aging using autoclave (134 ºC, 0.2 MPa) and TP was calculated after accelerated aging. One way analysis of variance combined with a Tukey-post hoc test was used to analyze the data obtained (P ¼ 0.05). Results: Results of the present study showed that thickness of zirconia has determinal effect on its translucency as there was no statistically significant difference in TP between 0.5 mm and 0.8 mm thicknesses while there were statistically significant differences in TP between 0.8 mm, 1.0 mm, 1.2 mm. Effect of aging was significant on 0.5 mm thickness. Conclusion: Thickness of zirconia has significant effect on translucency. Aging has significant effect on thinner sections of zirconia. More research is required on zirconia towards making the material more translucent for its potential use as esthetic monolithic restoration. © 2016 Faculty of Oral & Dental Medicine, Future University. Productio

First Emergence of NDM-5 and OqxAB Efflux Pumps Among Multidrug-Resistant Klebsiella pneumoniae Isolated from Pediatric Patients in Assiut, Egypt

Eman R Abdelbary,1 Ashraf M Elsaghier,2 Rehab M Abd El-Baky,3,4 Nancy GFM Waly,3 Mohammed Ramadan,1 Fatma S Abd- Elsamea,5 Mohamed E Ali,1 Hayat A Alzahrani,6 Mohammed Salah7 1Microbiology and Immunology Department, Faculty of Pharmacy, Al-Azhar University-Assiut Branch, Assiut, 11651, Egypt; 2Gastroenterology and Hepatology Unit, University Children Hospital, Faculty of Medicine, Assiut University, Assiut, 11651, Egypt; 3Microbiology and Immunology Department, Faculty of Pharmacy, Minia University, Minia, 61519, Egypt; 4Microbiology and Immunology Department, Faculty of Pharmacy, Deraya University, Minia, 11566, Egypt; 5Medical Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut, 11651, Egypt; 6Department of Medical Laboratory Technology, Faculty of Applied Medical Science, Northern Border University, Arar, 91431, Saudi Arabia; 7Microbiology and Immunology Department, Faculty of Pharmacy, Port Said University, Port Said City, 42526, EgyptCorrespondence: Rehab M Abd El-Baky, Email [email protected]: New Delhi metallo-β-lactamase (NDM)-producing K. pneumoniae poses a high risk, especially among Egyptian pediatric patients who consume carbapenems antibiotics very widely and without adequate diagnostic sources. In addition, presence of efflux pump genes such as OqxAB increases resistance against many groups of antimicrobials which exacerbates the problem faced for human health. This study aimed to determine NDM variants among K. pneumoniae strains isolated from pediatric patients in Egypt, analyze the presence of OqxAB genes, and molecular characterization of blaNDM-5-positive K. pneumoniae.Methods: Fifty-six K. pneumoniae isolates were recovered from pediatric patients, and tested for carbapenemase by modified carbapenem inactivation methods (mCIM) test. Minimum inhibitory concentrations of meropenem and colistin were determined by meropenem E-test strips and broth microdilution, respectively. PCR was used for the detection of the resistant genes (ESBL gene (blaCTX-M), carbapenemase genes (blaNDM, blaKPC) colistin resistant (mcr1, mcr2)) and genes for efflux pump (oqxA and oqxB). BlaNDM was sequenced. The effect of efflux pump in NDM-5-producing isolates was assessed by measuring MIC of ciprofloxacin and meropenem before and after exposure to the carbonyl cyanide 3-chlorophenylhydrazone (CCCP). The horizontal gene transfer ability of blaNDM-5 was determined using liquid mating assay and PCR-based replicon typing (PBRT) was done to determine the major plasmid incompatibility group.Results: Twenty-nine isolates were positive for blaNDM-1, nine isolates were positive for blaNDM-5, and 15 isolates were positive for blaKPC. There is a significant increase of meropenem MIC of NDM-5-positive isolates compared with NDM-1-positive isolates. In addition, 38 isolates were positive for CTX-M, and 15 isolates were positive for mcr1. Both OqxA and OqxB were detected in 26 isolates and 13 isolates were positive for OqxA while 11 isolates were positive for OqxB only. All NDM-5-producing isolates except one isolate could transfer their plasmids by conjugation to their corresponding transconjugants (E. coli J53). Plasmid replicon typing showed that FII was predominant in NDM-5-producing K. pneumoniae. Similar strains were found between the three isolates and similarity was also detected between the two isolates.Conclusion: The highly resistant K. pneumoniae producing blaNDM-5 type was firstly isolated from pediatric patients. The association of efflux pump genes such as OqxAB is involved in resistance to ciprofloxacin. This highlighted the severity risk of blaNDM-5-positive K. pneumonia as it could transfer blaNDM-5 to other bacteria and has more resistance against carbapenems. This underlines the importance of continuous monitoring of infection control guidelines, and the urgent need for a national antimicrobial stewardship plan in Egyptian hospitals.Keywords: blaNDM-5, OqxAB, carbapenem resistant K. pneumoniae, efflux pump

Implications of the medication regimen complexity index score on hospital readmissions in elderly patients with heart failure: a retrospective cohort study

Abstract Background The likelihood of elderly patients with heart failure (HF) being readmitted to the hospital is higher if they have a higher medication regimen complexity index (MRCI) compared to those with a lower MRCI. The objective of this study was to investigate whether there is a correlation between the MRCI score and the frequency of hospital readmissions (30-day, 90-day, and 1-year) among elderly patients with HF. Methods In this single-center retrospective cohort study, MRCI scores were calculated using a well-established tool. Patients were categorized into high (≥ 15) or low (< 15) MRCI score groups. The primary outcome examined the association between MRCI scores and 30-day hospital readmission rates. Secondary outcomes included the relationships between MRCI scores and 90-day readmission, one-year readmission, and mortality rates. Multivariate logistic regression was employed to assess the 30- and 90-day readmission rates, while Kaplan-Meier analysis was utilized to plot mortality. Results A total of 150 patients were included. The mean MRCI score for all patients was 33.43. 90% of patients had a high score. There was no link between a high MCRI score and a high 30-day readmission rate (OR 1.02; 95% CI 0.99–1.05; p < 0.13). A high MCRI score was associated with an initial significant increase in the 90-day readmission rate (odd ratio, 1.03; 95% CI, 1.00-1.07; p < 0.022), but not after adjusting for independent factors (odd ratio, 0.99; 95% CI, 0.95–1.03; p < 0.487). There was no significant difference between high and low MRCI scores in their one-year readmission rate. Conclusion The study’s results indicate that there is no correlation between a higher MRCI score and the rates of hospital readmission or mortality among elderly patients with HF. Therefore, it can be concluded that the medication regimen complexity index does not appear to be a significant predictor of hospital readmission or mortality in this population

Bacterial Compositional Shifts of Gut Microbiomes in Patients with Rheumatoid Arthritis in Association with Disease Activity

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disabling autoimmune disorder. Little is known regarding the association between the gut microbiome and etiopathogenesis of RA. We aimed to dissect the differences in gut microbiomes associated with RA in comparison to healthy individuals and, in addition, to identify the shifts in the bacterial community in association with disease activity; Methods: In order to identify compositional shifts in gut microbiomes of RA patients, V3-V4 hypervariable regions of 16S rRNA were sequenced using Illumina MiSeq. In total, sixty stool samples were collected from 45 patients with RA besides 15 matched healthy subjects; Results: Notably, RA microbiomes were significantly associated with diverse bacterial communities compared with healthy individuals. Likewise, a direct association between bacterial diversity and disease activity was detected in RA patients (Kruskal Wallis; p = 0.00047). In general, genus-level analysis revealed a positive coexistence between RA and Megasphaera, Adlercreutzia, Ruminococcus, Bacteroides, Collinsella, and Acidaminococcus. Furthermore, Spearman correlation analysis significantly stratified the most dominant genera into distinct clusters that were mainly based on disease activity (r ≥ 0.6; p ≤ 0.05). The predictive metabolic profile of bacterial communities associated with RA could support the potential impact of gut microbiomes in either the development or recovery of RA; Conclusions: The overall shifts in bacterial composition at different disease statuses could confirm the cross-linking of certain genera either to causation or progression of RA

An Eco-Friendly Approach to the Control of Pathogenic Microbes and Anopheles stephensi Malarial Vector Using Magnesium Oxide Nanoparticles (Mg-NPs) Fabricated by Penicillium chrysogenum

The discovery of eco-friendly, rapid, and cost-effective compounds to control diseases caused by microbes and insects are the main challenges. Herein, the magnesium oxide nanoparticles (MgO-NPs) are successfully fabricated by harnessing the metabolites secreted by Penicillium chrysogenum. The fabricated MgO-NPs were characterized using UV-Vis, XRD, TEM, DLS, EDX, FT-IR, and XPS analyses. Data showed the successful formation of crystallographic, spherical, well-dispersed MgO-NPs with sizes of 7–40 nm at a maximum wavelength of 250 nm. The EDX analysis confirms the presence of Mg and O ions as the main components with weight percentages of 13.62% and 7.76%, respectively. The activity of MgO-NPs as an antimicrobial agent was investigated against pathogens Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans, and exhibited zone of inhibitions of 12.0 ± 0.0, 12.7 ± 0.9, 23.3 ± 0.8, 17.7 ± 1.6, and 14.7 ± 0.6 mm respectively, at 200 µg mL−1. The activity is decreased by decreasing the MgO-NPs concentration. The biogenic MgO-NPs exhibit high efficacy against different larvae instar and pupa of Anopheles stephensi, with LC50 values of 12.5–15.5 ppm for I–IV larvae instar and 16.5 ppm for the pupa. Additionally, 5 mg/cm2 of MgO-NPs showed the highest protection percentages against adults of Anopheles stephensi, with values of 100% for 150 min and 67.6% ± 1.4% for 210 min