Impaired renal functions have been reported with Hepatitis E virus (HEV) infections, especially with genotypes 3 and 4. These complications were reported during the acute and chronic phases of infection. HEV genotype 1 causes acute infection, and the effect of HEV-1 infections on renal functions is not known. We examined the kidney function parameters in the serum of HEV-1 patients (AHE, n = 31) during the acute phase of infection. All of the included patients developed an acute self-limiting course of infection, without progression to fulminant hepatic failure. We compared the demographic, laboratory, and clinical data between AHE patients with normal kidney function parameters and those with abnormal renal parameters. Out of 31 AHE patients, 5 (16%) had abnormal kidney function tests (KFTs) during the acute phase of infection. Three patients had abnormal serum urea and creatinine, and two patients had either abnormal urea or creatinine. Four out of five patients had an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m². AHE patients with abnormal KFTs were older and had a lower level of albumin, but a slightly elevated alanine transaminase (ALT) compared to AHE patients with normal KFTs. There were no significant differences between the two groups in terms of age, sex, liver transaminase levels, and the viral load. Similarly, the clinical presentations were comparable in both groups. Interestingly, these KFTs in patients with abnormal renal parameters returned to normal levels at the recovery. The serum creatinine level was not correlated with patients’ age or liver transaminase levels, but it was significantly negatively correlated with albumin level. In conclusion, this study is the first report that evaluated KFTs in patients during the acute phase of HEV-1 infections. Impaired KFTs in some AHE patients resolved at convalescence. KFTs and renal complications should be monitored during HEV-1 infections.

Methicillin resistance in Staphylococcus aureus has become prevalent globally. Moreover, biofilm-formation makes it more difficult to eradicate bacteria by antibiotics. The mazEF toxin-antitoxin system encodes for mazF, which acts as an endoribonuclease that cleaves cellular mRNAs at specific sequence motifs (ACA), and mazE, which opposes the mazF action. Our goal was to detect mazEF expression in methicillin-resistant S. aureus (MRSA) isolates compared with methicillin-sensitive S. aureus (MSSA) isolates and determine its relation to methicillin susceptibility as well as biofilm-formation. According to their susceptibility to cefoxitin disks, 100 S. aureus isolates obtained from patients admitted to Cairo University Hospitals were categorized into 50 MSSA and 50 MRSA according to their susceptibility to cefoxitin disks (30 µg). Antimicrobial susceptibility and biofilm-formation were investigated using the disk diffusion method and tissue culture plate method, respectively. Finally, using real-time PCR, mazEF expression was estimated and correlated to methicillin susceptibility and biofilm formation. Both MRSA and MSSA isolates showed the best sensitivity results with linezolid and gentamicin, where about 88% of MRSA isolates and 96% of MSSA isolates were sensitive to linezolid while 76% of MRSA isolates and 84% of MSSA isolates were sensitive to gentamicin. MRSA isolates were significantly more able to form biofilm than MSSA isolates (p-value = 0.037). The mazEF expression was significantly correlated to methicillin resistance in S. aureus (p-value < 0.001), but not to biofilm-formation.

Quality management system implementation in clinical laboratories is becoming mandatory. A reasonable easy to practice approach is a key element for success. Clinical and Laboratory Standards Institute (CLSI) QMS01-A4 has provided a detailed practical approach that focuses on twelve main items; named quality essentials. Incorporating these essentials in daily practice in the microbiology laboratory mandates creating an environment that practices ‘quality’ by default. This review provides a step-by-step approach to facilitate the implementation of the twelve essentials of the CLSI QMS while keeping an eye on the ISO 15189 requirements. The twelve quality essentials delineated namely are: Organization, Customer focus, Facilities and Safety Management, Personnel Management, Purchasing and Inventory Management, Equipment, Process Management, Documents and Records, Information Management, Nonconforming events Management, Assessments and Continual Improvement. These essentials are designed to cover the whole testing process. Whenever applicable, real-life examples from the daily practice are added to make the picture clearer.

Background: Campylobacter is one of the leading pathogens which causes bacterial gastroenteritis among children worldwide, especially in developing countries. Several laboratory methods have been used to diagnose campylobacteriosis including culture, ELISA, and PCR. Objectives: The aim of this study was to compare PCR and antigen detection by ELISA with culture for the detection of Campylobacter. Methodology: The present study was conducted on 160 stool samples that were collected from pediatric patients complaining of acute gastroenteritis. All samples were cultured on Modified Charcoal Cefoperazone Deoxycholate Agar (mCCDA) and suspected colonies were consequently identified. Detection of Campylobacter antigen (PEB1) in stools was done by ELISA. Molecular detection of virulence genes: cadF, hipO, and asp in stools was done by multiplex PCR. Results: Thirty-five samples (21.9%) were found to be positive for Campylobacter by culture. Campylobacter antigen was detected in 50 samples (31.3%) by ELISA. cadF gene was detected in 47 samples (29.4%) by PCR, 39 of which were positive for hipO gene and thus identified as Campylobacter jejuni, while asp gene was not detected in any sample. Conclusion: Alternative diagnostic tests for campylobacteriosis that do not rely on culture have become increasingly important. Nucleic acid-based techniques can detect the presence of Campylobacter infection and even distinguish between different Campylobacter species.

Background: Disinfectants play an important role in the control of nosocomial infections. Appearance of MRSA resistant to disinfectants used in hospitals is alarming. Objectives: We aimed to detect cross resistance between antibiotics and disinfectants among MRSA and MSSA, and to compare the efficacy of three disinfectants; (Clorox®, ULTRASOL AF ®0.25%, Virusolve +® 0.5%) against MRSA and MSSA. Methodology: Twenty-five MSSA and 25 MRSA isolates were collected from Cairo University Hospital laboratories Antimicrobial susceptibility pattern was compared, and susceptibility to the three mentioned disinfectants was carried out. Results: With Clorox, 44% of MRSA isolates versus 68% of MSSA isolates showed no growth. With Ultrasol AF and Virosulve+ 36% of MRSA isolates showed no growth with both agents in comparison to 56% and 44% of MSSA isolates respectively. Conclusions: No relationship between antibiotic resistance and non-susceptibility to disinfectants was found. Both hypochlorite and QACs couldn’t completely eradicate MRSA and MSSA isolates tested.

Background: Vaccines may be thought of as a reliable intervention to prevent SARS-CoV-2 infection. Prophylactic drugs may be a sound alternative. We aimed to assess the use of folic acid to protect against COVID-19 infection. Methods: This randomized controlled study was conducted in an isolation hospital at Cairo University Hospitals on three groups of nurses caring for COVID-19 patients: group I; the control group, group II whose participants received 500 micrograms of folic acid daily, and group III whose participants received 1000 micrograms daily. PCR conversion was tested for the three groups as a primary endpoint. Results: In total, 526 nurse were included. Group I comprised 139 nurse, group II comprised 163 nurse, and group III comprised 224 nurses. The rates of PCR conversion from negative to positive were 4.9% (8/163) in group II and 1.8% in group III (4/224) compared with 14.4% in the control group I (20/139). Statistically significant (p < 0.005) and highly statistically significant (p < 0.001) differences respectively were found. Conclusions: Prescribing folic acid daily may significantly decrease the risk of COVID-19 infection among exposed healthcare workers.