Regulatory B cells (Bregs) are unique subpopulations of B cells with immune-regulating or immune-suppressing properties and play a role in peripheral tolerance. Due to the current limitations of human Breg studies among periodontal diseases, in the present study, we tried to analyze the change in circulating Bregs, pro-inflammatory, and anti-inflammatory cytokines in patients with periodontitis. Peripheral blood from 55 patients with stage 2 periodontitis and 20 healthy controls was analyzed using flow cytometry to evaluate the frequency of CD19⁺CD24⁺CD38⁺ Breg cells. ELISA was used to assess the serum levels of the pro-inflammatory cytokines, including interleukins (IL)-1β, IL-6, TNF-α, and anti-inflammatory cytokines including IL-10, IL-35, and TGF-β. Increased proportions of Breg cells were observed in patients with stage 2 periodontitis compared to controls. Serum levels of cytokines were significantly higher in patients with periodontitis compared to controls. A significant positive correlation was observed between the frequencies of Breg cells and IL35 levels, IL10 levels, and TGF-β. In conclusion, our results suggest that the increase in peripheral Breg cells and serum cytokine levels among periodontitis patients seems to be closely associated with disease progression, a possible link between periodontitis, and systemic inflammatory process.

Carbapenem-resistant Gram-negative bacilli (CR-GNB) has become a global threat. In hospital settings, the association of CR-GNB with ventilator-associated pneumonia (VAP) is a critical public health concern owing to their high resistance rate to most antibiotics. The present study aims to identify the frequency of carbapenem-resistance and to determine the rate of multidrug resistance (MDR), extensive drug resistance (XDR) and pan-drug resistance (PDR) among CR-GNB infections in VAP. Antimicrobial susceptibility testing was carried out using the disk diffusion method and the detection of carbapenemases was screened using the imipenem-E test and the modified carbapenem-inactivation method (mCIM). The isolates were verified by polymerase chain reaction (PCR) for the presence of bla_NDM, bla_SPM, bla_VIM, bla_IMP and bla_GIM genes. 89.5%, 14%, 17.5%, 10.5%, 3.5% of isolates exhibited the presence of bla_NDM, bla_VIM, bla_SPM, bla_IMP and bla_GIM, respectively. 76%, 17% and 7% of isolates were PDR, XDR, and MDR, respectively. Carbapenem-resistance genes were identified in a significant percentage and bla_NDM was the most predominant gene. All isolates were highly resistant to most antibiotics. This health concern has proven to be a big challenge in developing countries such as Egypt, as it is associated with high morbidity, high mortality, and raised healthcare costs.

Regulatory T cells (Tregs) play a fundamental role in maintaining immune homeostasis to balance between the tissue-damaging and protective effects of the immune response. There are strong evidences that Treg cells and their cytokines may play an important role in the induction of tolerance in the liver and progression of HCV infection. Herein, we investigated the frequency of Treg cells and interleukin 35 (IL-35) level in blood and their potential relationship to the various chronic hepatitis C (CHC) complications and outcomes. A total of 36 HCV infected patients subdivided into, CHC complicated with cirrhosis (HCV LC; n = 18), CHC complicated with hepatocellular carcinoma (HCV- HCC; n=18) and apparently healthy control group (n=18) were enrolled in this study. Treg cells percentages were determined by flow cytometric analysis and ELISA was used to measure IL35 serum levels. A significant increase in the frequency of peripheral Tregs and serum IL35 level was found in HCV HCC, and HCV LC groups compared with the control group. The frequency of peripheral Tregs and plasma (IL-35) levels were significantly positively correlated with viral load along with disease progression. We conclude that the higher percentage of Tregs and IL35 level in peripheral blood of HCV HCC and HCV LC groups compared to the control group may suggest their contribution to viral persistence and progression of HCV infection.

Background: The genus Acinetobacter is one of the main fears of hospital-acquired infection (HAI) wide-reaching mostly in ICUs. Objectives: This study aimed to identify the incidence of carbapenem-resistant Acinetobacter (CRA) HAI in Assiut University Hospitals ICU and determine their antimicrobial susceptibility profile. Methodology: The study included 1204 clinical samples from 928 patients with HAI and 625 environmental samples. Carbapenemase production was detected phenotypically by MIC determination using imipenem, meropenem and doripenem E-test, modified Hodge test, combined disc test and double disc synergy test (DDST). OXA genes (blaOXA-51, blaOXA-23, blaOXA-24, and blaOXA-58) and MβL genes (blaSIM-1, blaVIM, and blaIMP-1) were investigated genotypically by PCR. Results: Out of total 60 Acinetobacter isolates, 55 (91.7%) were extensively drug-resistant (XDR) and 5 (8.3%) were multi-drug resistant (MDR). 93.3% of Acinetobacter isolates were resistant to imipenem and meropenem, and 90% were resistant to doripenem. The prevalence of bla genes in isolates were blaOXA-51 (93.3%), blaOXA-23 (68.3%), blaOXA-24 (23.3%), blaOXA-58 (10%), blaSIM-1 (46.7%), and blaVIM (8.3%). blaIMP-1 was not detected in any isolate. Conclusion: CRA infections were considerable in our ICUs. The high prevalence of XDR Acinetobacter spp. observed in our study was very alarming and requires critical intervention.