Iman E. Wali

Combined activity of garlic and nitrofurantoin against Escherichia coli and Enterococcus species recovered from urinary tract infections

Nitrofurantoin represents an attractive choice for empirical treatment of acute uncomplicated cystitis, and for long term prophylaxis against recurrent urinary tract infections. However, rather rare but severe adverse effects related to cumulative drug doses may occur. Bioactive compounds of plant origin combined with antibiotics can increase the sensitivity of microbial cells to such antibiotics. Garlic has antimicrobial effects against a wide range of microorganisms. The minimum inhibitory concentrations (MICs) of each of nitrofurantoin and garlic alone, and in combination were determined against 17 extended spectrum β-lactamase (ESBL) producing Escherichia coli and 24 Enterococcus spp. urinary isolates. When grown as planktonic cells, none of the E. coli isolates demonstrated resistance towards nitrofurantoin, whereas only one (4.2%) Enterococcus isolate was resistant. Garlic showed an inhibitory effect on planktonically grown ESBL producing E. coli and Enterococcus spp. with varying MICs. Each of nitrofurantoin and garlic tested alone showed an increase in the MICs for biofilm grown isolates compared to their planktonic counterparts. However, the combination of both agents led to significant decline of the MICs, whether for planktonic or biofilm forms, resulting in either synergy or addition. In conclusion, garlic enhanced the antibacterial activity of nitrofurantoin towards the tested urinary isolates. Key words: Antimicrobial combination, biofilm, checkerboard assay, Enterococcus spp., extended spectrum β-lactamase (ESBL)-producing Escherichia coli, garlic extract, nitrofurantoin.

Isolation of Lactobacilli and Bifidobacteria Species from Human Breast Milk

Background: Bacterial colonization of the infant gut is a gradual process that exerts a strong influence on the health status of the host. The source of bacterial diversity in breast fed babies remains unclear. For many decades, breast milk has been regarded as a sterile body fluid which exerts its influence on the infants microbiota environment via presenting only some growth factors and optimal conditions for helping the growth of bacteria. However, in recent years, breast milk has been hypothesized to be a source of commensal bacteria for the infant gut. Objective: This study aimed at searching for bacteria in breast milk to assess the role of breast milk as their probable source. Methodology: Samples of breast milk were obtained from 50 lactating women and were tested for the presence of different bacteria, using specific media and specific biochemical reactions. Results: Culture of the 50 breast milk specimens showed growth of different species of lactobacilli in 100% of the specimens and bifidobacteria in the milk of 14 mothers (28%). Conclusion: breast milk can be a source of lactobacilli and bifidobacteria for the infants

Anti-C1q in chronic hepatitis C Virus genotype IV infection: association with autoimmune rheumatologic manifestations

A growing body of evidence suggests that anti-complement-1q (anti-C1q) antibodies are elevated in a variety of autoimmune disease. Therefore, we investigated their prevalence and clinical significance in plasma of patients with hepatitis C virus (HCV) genotype IV in the presence and absence of autoimmune extra hepatic manifestations in comparison to normal healthy individuals. Plasma Anti-C1q Abs levels were assessed by an Enzyme Linked Immunosorbant Assay in 91 chronic HCV-infected patients (51 with and 40 without autoimmune rheumatic manifestations) and 40 healthy volunteers matched for age and gender. Epidemiological, clinical, immunochemical and virological data were prospectively collected. Positive Anti-C1q antibodies were more frequent among HCV patients with extra-hepatic autoimmune involvement, than those without and healthy control subjects. No significant correlations were found between Anti-C1q levels with either the liver activity or the fibrosis scores. In HCV-patients with autoimmune involvements, plasma Anti-C1q levels were significantly higher in patients with positive cryoglobulin, and in those with lymphoma than in those without. These results were confirmed by multivariate analysis. Further large scale longitudinal studies are required to assess and clarify the significance and the pathogenic role of anti-C1q antibodies among HCV infected patients with positive cryoglobulinaemia and lymphoma.

Medically Graded Honey Supplementation Formula to Preterm Infants as a Prebiotic: A Randomized Controlled Trial

Objectives: The aim of the study was to assess the effect of medically graded enteral honey supplementation on the intestinal microbiota, immune response, and somatic growth of preterm infants. Methods: A prospective randomized controlled trial was conducted on preterm infants with gestational age ⩽34 weeks and postnatal age >3 days. After reaching 1/2 goal enteral feeds, medically graded bee honey was added to milk at a dose of 5, 10, 15, and 0 g/day for 2 weeks in groups A, B, C, and D, respectively. Anthropometric measurements, CD4 and CD8 cytokines, stool cultures, and stool polymerase chain reaction assays for molecular detection of microbiomes were performed at 0, 7, and 14 days of intervention. Analysis of variance test was used to detect differences among the 4 groups. Results: A total of 40 subjects were enrolled; 10 in each arm of the study. Compared with group D, all 3 intervention groups demonstrated significant increase in weight (P < 0.0001). Head circumference increased in groups B and C (P = 0.0056). There were no changes in CD4 or CD8 cytokines (P = 0.24 and P = 0.11, respectively). Enterobacter stool colonization decreased in groups A and B (P = 0.002), whereas Bifidobacterium bifidum colony counts increased in groups A, B, and C (P = 0.002) and lactobacilli colony counts increased in group B (P < 0.0001). Applying real-time polymerase chain reaction, B bifidum and lactobacilli increased in group C (P < 0.0001). Conclusions: Supplementation of milk formula with medically graded honey was associated with changes in physical growth and colonic microbiota of preterm infants. Further studies are needed to examine the sustainability of these effects and associated long-term outcomes.

Detection of the Emerging Human Metapneumovirus and Its Comparison with the Respiratory Syncytial Virus among Children with Acute Respiratory Tract Infections

Background: Respiratory syncytial virus and human metapneumovirus are respiratory pathogens that circulate worldwide. RSV is the most common cause of respiratory tract disease in children; where children < 3 years of age are usually affected. Objectives: The aim of the present study was to determine the frequency of hMPV and RSV infections among children with acute respiratory tract infection and to compare their occurrence in children suffering from acute respiratory tract infection. Methodology: This was a cross sectional study carried out on 50 patients diagnosed as having acute respiratory infections. The included patients were children up to 6 years of age selected from hospitalized patients in Abo El-Reesh hospital. Throat swabs were obtained. The collected specimens were subjected to viral RNA extraction and tested for the presence of hMPV and RSV by real time PCR. Results: RSV was detected in 4 out of 50 (8%) of the studied cases, while hMPV virus was not detected among our studied patients. All detected cases were less than two years old (median age 6 months) with a statistically significant association between detection of the RSV and age ofpatients (P<0.05).There was no significant difference regarding the gender and the detection of the virus. Conclusion: Although hMPV is known as a cause of ARTI, it was not detected among our studied patients. RSV was detected in 8% of pediatric patients aged less than two years with ARTI

Detection of the Human Metapneumovirus and Its Comparison with the Respiratory Syncytial Virus in malignant pediatric patients with Acute Respiratory Tract Infections

Background: Acute viral respiratory tract infections are a leading cause of illness in both children and adults. RSV is the most common cause of respiratory tract disease in children also hMPV was first isolated from children suffering from acute respiratory tract disease. The disease is more severe (sometimes lethal) in immunocompromised hosts Objective:The aim of the present study was to study the frequency of hMPV and RSV infections in children suffering from different types of malignancy with acute respiratory tract infection and to compare their occurrence in the studied patients. Methodology: This is a cross sectional study carried out on 50 malignant patients diagnosed as having acute respiratory infections. The included patients were children up to 6 years of age selected from hospitalized patients in National Cancer Institute. Throat swabs were obtained. The collected specimens were tested for the presence of hMPV and RSV by real time PCR. Results: RSV was detected in 6 out of 50 (12%) of the studied cases, while hMPV virus was not detected among our studied patients. All detected cases were less than two years old (median age 16 months) with a highly statistical significant association between detection of the RSV and age of patients (P<0.01). There was a statistically significant association betweenpatients with pneumonia and detection of RSV in the studied cases. Conclusion:RSV was detected in 12% of pediatricmalignant patients aged less than two years with ARTI, pneumonia was the most common presentation of ARTI in RSV infected cases.

Relation between probiotic properties of isolates isolated from breast milk and infants’ stools

Purpose Breast milk has been hypothesized to be a source of bacteria for the infant gut. This paper aims to search for probiotic bacteria among 415 isolates belonging to the Enterococcus, Lactobacillus, Streptococcus and Bifidobacterium genera recovered from breast milk of 50 lactating mothers and their respective infant stools, and then, determine whether their levels in stools vary with different modalities of breast feeding. Design/methodology/approach To prove that the isolates were probable probiotics, subtractive screening was done using three major selection criteria, namely, resistance to low pH, tolerance against bile salts and testing for their antimicrobial activity. Findings The three criteria were fulfilled by 31.7 and 31 per cent of the isolates recovered from mothers’ breast milk and infants’ stool specimens, respectively. The majority of probiotic strains, isolated from milk and infants’ stools were phenotypically identical, suggesting breast milk as their probable source. Moreover, there was a positive correlation between exclusive breast milk feeding and the number of probiotics in the infants’ stools. Originality/value Viable bacteria could be retrieved from breast milk of healthy women, not suffering from mastitis, by using different types of media and different cultivation conditions. Up to five different species belonging to the same genus could be isolated in the same specimen of whether milk or stools. Breast milk could be a source of probiotic bacteria for intestinal microflora of infants, which help improvement of infants’ gut and growth.

Isolation of Enterococci and Streptococci Species from Human Breast Milk

Background: Bacterial colonization of the infant gut is a gradual process that exerts a strong influence on the health status of the host. The source of bacterial diversity in breast fed babies remains unclear. For many decades, breast milk has been regarded as a sterile body fluid which exerts its influence on the infants microbiota environment via presenting only some growth factors and optimal conditions for helping the growth of bacteria. However, in recent years, breast milk has been hypothesized to be a source of commensal bacteria for the infant gut. Objective: This study aimed at searching for bacteria in breast milk to assess the role of breast milk as their probable source. Methodology: Samples of breast milk were obtained from 50 lactating women and were tested for the presence of different bacteria, using specific media and specific biochemical reactions. Results: Culture of the 50 breast milk specimens showed growth of different species of enterococci and streptococci in 60% and 84% of the specimens; respectively. Conclusion: breast milk can be a source of enterococci and streptococci for the infants.