Egypt was among the first 10 countries in Africa that experienced COVID-19 cases. The sudden surge in the number of cases is overwhelming the capacity of the national healthcare system, particularly in developing countries. Central to the containment of the ongoing pandemic is the availability of rapid and accurate diagnostic tests that could pinpoint patients at early disease stages. In the current study, we aimed to (1) Evaluate the diagnostic performance of the rapid antigen test (RAT) “Standard™ Q COVID-19 Ag” against reverse transcriptase quantitative real-time PCR (RT-qPCR) in eighty-three swabs collected from COVID-19 suspected individuals showing various demographic features, clinical and radiological findings. (2) Test whether measuring laboratory parameters in participant’s blood would enhance the predictive accuracy of RAT. (3) Identify the most important features that determine the results of both RAT and RT-qPCR. Diagnostic measurements (e.g. sensitivity, specificity, etc.) and receiver operating characteristic curve was used to assess the clinical performance of “Standard™ Q COVID-19 Ag”. We used the support vector machine (SVM) model to investigate whether measuring laboratory indices would enhance the accuracy of RAT. Moreover, a random forest classification model was used to determine the most important determinants of the results of RAT and RT-qPCR for COVID-19 diagnosis. The sensitivity, specificity, and accuracy of RAT were 78.2, 64.2, and 75.9%, respectively. Samples with high viral load and those that were collected within one-week post-symptoms showed the highest sensitivity and accuracy. The SVM modeling showed that measuring laboratory indices did not enhance the predictive accuracy of RAT. “Standard™ Q COVID-19 Ag” should not be used alone for COVID-19 diagnosis due to its low diagnostic performance relative to the RT-qPCR. RAT is best used at the early disease stage and in patients with high viral load.

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) emergence and dissemination, is an important healthcare concern due to its limited therapeutic options. Ceftazidime/avibactam (CAZ/AVI) is a recently approved antibiotic combination that may be effective in treating these resistant infections. The current study aimed to determine the prevalence of CRKP among clinical isolates from the neonatal intensive care unit (NICU) and to evaluate the in-vitro activity of CAZ/AVI against them. Methods: A total of 255 clinical samples were collected from neonates with suspected sepsis. All Klebsiella pneumoniae isolates were identified by standard methods. Antibiotic susceptibility testing, screening for Extended-spectrum β lactamase (ESBL) production, Carbapenem resistance, carbapenemase production, and susceptibility to CAZ/AVI were done according to the CLSI guidelines. Results: Of the 255 neonates clinically suspected as neonatal sepsis, only 136 (53.3%) had positive culture results, out of the 136 culture-proven cases, 72 (52.9%) were positive for Klebsiella pneumoniae, of them ESBL producers were 92% (n=66) and CRKP was 32% of isolates (n=23). All of the CRKP were Carbapenamase producers (39% serine-type and 61% MBL type). Serine Carbapenamase and MBL producers showed high resistance against CAZ/AVI with a percentage of 77.8% and 100% respectively. Conclusion: The prevalence of CRKP is alarming in our NICU especially in the presence of neonatal risk factors like; neutropenia, central line fixation, and premature rupture of membranes. CAZ/AVI is an unsuitable option for the treatment of this type of resistant bacteria because of its high resistance.

Background: The clinical presentations of coronavirus disease 2019 (COVID-19) exhibit significant variation, ranging from asymptomatic cases to mortality resulting from severe pneumonia. Host genetics can partially explain this variation. Objective: This study evaluated possible associations between severity and outcome of COVID-19 and single nucleotide polymorphism (SNP) rs2285666 in the ACE2 gene and SNP rs2070788 in the TMPRSS2 gene. Methods: The study included a sample of 100 consecutive adult patients admitted to the COVID-19 Isolation and Intensive Care Units of the Zagazig University Hospitals, Zagazig, Egypt from July 2021 to November 2021. For rs2285666, polymerase chain reaction-restriction fragment length polymorphism was carried out. For rs2070788, real-time polymerase chain reaction was performed. Results: For rs2285666, the GA genotype was the most frequent among female patients (39% [16/41]) and the A genotype was more prevalent among male patients (54.2% [32/59]). For rs2070788, the AA genotype was the most frequent among all patients (46% [46/100]). No rs2285666 or rs2070788 genotypes or allele frequencies had significant associations with either severity or outcomes of patients. Conclusion: This study found no significant associations of COVID-19 severity or outcomes of patients with genotypes or allele frequencies of the rs2285666 SNP in the ACE2 gene or the rs2070788 SNP of the TMPRSS2 gene. The search for other genetic associations with COVID-19 infection is still required. What this study adds: The study reveals that host genetics explain the variation observed in the disease. Specific genetic variants can confer either increased susceptibility or resistance to the disease.

Background. Recent studies have revealed that antibiotics are yielding unsatisfactory outcomes in certain patients with acne. Therefore, attention was drawn to antibiotic resistance as a rapidly growing problem that might lead to treatment failure. Objective. The study aims to assess the antibiotic susceptibility patterns of Cutibacterium acne isolates in a sample of Egyptian patients to the antibiotics most frequently prescribed for acne vulgaris. Methods. A total of 155 patients with moderate to severe acne were included in the study. Skin swab samples were collected and inoculated. Cutibacterium acnes was identified based on colonial morphology, Gram stain, and biochemical reactions and further confirmed by VITEK 2 automated systems. Antibiotic susceptibility tests were performed using minimum inhibitory concentrations determined by the Epsilometer test. Results. Cutibacterium acnes was detected in 50 samples (32.2%), alone in 17 (10.9%), and in combination with Staphylococci in 33 (21.3%) cases. The results of the antibiotic susceptibility testing revealed high resistance to erythromycin, followed by clindamycin, tetracycline, trimethoprim/sulfamethoxazole, and doxycycline. Conclusion. Cutibacterium acnes showed high resistance rates to most antibiotics used in the clinical treatment of acne vulgaris.

Background: Understanding the profile of antibody responses following acute COVID-19 infection is required. Aim: to describe the pattern of IgG anti-COVID-19 antibody production in patients with acute infection using the LABScreen COVID Plus assay. Results: The overall seropositivity was 69/73(94.5%). Anti-Spike, Spike 1 and spike S2 subunit were positive in 78.1%, while anti spike Receptor binding domain (RBD) was detected in 68.4% and anti nucleocapsid protein in 61.6%. The overall positivity of the assay reached 100.0% during the second week post symptoms. The mean fluorescent intensities (MFI) of anti-Spike S1 was higher in the second week than the first week, P=0.03. MFI of anti-Spike S2 was significantly higher in PCR positive patients in comparison with the negative ones, p=0.006. When compared to the RT-PCR results; the overall antibodies positivity, anti-Spike, and anti-Spike2 antibodies had sensitivities (100% and 84.7%) and specificities (28.6% and 50.0%) and accuracies (86.3% and 78.1%). Patients' outcome correlated significantly with the time of hospital admission, P=0.001. Conclusions: COVID-19 IgG antibodies are detectable with considerable frequencies during the first two weeks post infection. Anti S2 antibodies correlates well with the RT-PCR results. The LABScreen COVID Plus is a sensitive assay for the detection of post-acute COVID-19 infection antibody responses.