Background and Objectives: This study aims to identify risk factors associated with MDRO infections and assess their impact on patient outcomes in Egyptian ICUs. Materials and Methods: The widespread overuse of antimicrobials has led to antibiotic multidrug resistance, posing significant challenges in intensive care units (ICUs) and leading to increased morbidity, mortality, and healthcare costs. A prospective observational study was conducted over 12 months, including 113 adult patients admitted to the ICU with confirmed bacterial infections. Comprehensive medical assessments and routine investigations were performed, including multisource cultures based on clinical suspicion. Patient histories, underlying conditions, and disease progression were documented. Patients were classified into two groups: those infected with MDROs and those without MDRO infections. Results: Significant differences were observed between patients with and without MDRO infections regarding temperature, pH, PaO₂, HCO₃, serum creatinine levels, high-dose inotropes, and inotrope dependence (p-values: 0.01, 0.028, 0.036, 0.008, <0.001, 0.013, 0.029, 0.039, <0.001, and 0.003, respectively). Additionally, cerebrovascular stroke and renal failure were significantly more frequent in MDRO-infected patients (p-values: 0.048 and 0.007, respectively). MDROs accounted for 42% of infections. The most commonly detected MDRO was Klebsiella spp. (52%). Patients with MDRO infections showed significantly higher mortality (42.6%), increased incidence of ARDS, invasive ventilation, and longer ventilation durations. Independent risk factors included prior antibiotic use (OR: 3.2; 95% CI: 1.5–6.8) and invasive device presence (OR: 2.7; 95% CI: 1.2–5.9). Conclusions: Cerebrovascular stroke and renal failure appear to be risk factors for MDRO infections. MDRO infections in ICUs are associated with poor clinical outcomes and increased complications. Improved antimicrobial stewardship and targeted prevention strategies are urgently required.

Background: Catheter-associated urinary tract infections (CAUTIs) are prevalent among intensive care unit (ICU) patients and pose significant health risks. The causative agent, Escherichia coli, is commonly associated with these infections. Objectives: The primary objective of our study was to evaluate various risk factors associated with CAUTIs. Additionally, we investigated the capacity of E. coli to form biofilms and the presence of virulence genes in these infections. Methods: We conducted a prospective study involving 204 patients admitted to ICUs with indwelling urinary catheters who subsequently developed CAUTIs. The isolated pathogen in all cases was E. coli. We subjected the isolated E. coli strains to microbiological analyses, including biofilm formation assays and polymerase chain reaction (PCR) for detecting virulence genes (pap-C, fim-H, sfa, afa, hylA, and cnf1). Results: Our findings revealed that 111 out of 204 isolated E. coli strains (54.4%) could form biofilms in vitro. Among the detected virulence genes, fim-H was the most frequently observed (32.4%), followed by pap-C (14.2%), sfa (12.3%), and afa1 (11.3%). The least frequently detected genes were cnf1 (3.9%) and hylA (2.5%). Notably, there was a significant association between the presence of fim-H, pap-C, afa1, and hylA genes and the ability of E. coli to form biofilms (P = 0.001, P = 0.001, P = 0.04, P = 0.046, respectively). Regarding the timing of CAUTIs, most cases occurred 7 - 10 days after catheter insertion (48.53%), followed by 3 - 6 days after insertion (45.59%). The least frequent occurrence was after 10 days from catheter insertion (5.86%). Early presence of CAUTIs (within 3 - 6 days) was significantly associated with diabetes mellitus (DM) and post-operative complications (both with P = 0.046). Furthermore, we observed a significant increase in the presence of the cnf1 gene in cases of early CAUTIs (3 - 6 days after catheter insertion, P = 0.001). Conclusions: Our study highlights the importance of understanding the risk factors, virulence genes, and biofilm formation capacity in E. coli-related CAUTIs. These findings may guide preventive strategies and improve patient outcomes.

Objective/Aim: Dental pulp inflammation is a critical condition in endodontics. Traditional diagnostic methods, such as patient pain history and percussion tests, often lack accuracy in reflecting the true status of pulp inflammation. This study explores the feasibility of using a rapid C-reactive protein (CRP) chairside point-of-care (POC) test as a potential adjunctive tool for detecting dental pulp inflammation. The findings provide preliminary insights to inform future larger-scale validation studies. Materials and methods: This pilot cross-sectional observational study included 20 patients with deep carious lesions. Blood samples were collected from exposed pulp tissue under sterile conditions and analyzed using the CRP rapid POC test (index test). Patient pain history (clinical reference test) and percussion test outcomes were documented. The study assessed feasibility and preliminary diagnostic trends based on test performance and associations with clinical indicators. Results: The CRP rapid POC test yielded positive results in 55% of cases. Preliminary findings suggest a potential association between CRP levels and percussion test results (p < 0.001), while no significant correlation was observed between CRP levels and patient pain history. The test demonstrated an observed sensitivity of 94.3%, specificity of 87.1%, positive predictive value (PPV) of 90.7%, and negative predictive value (NPV) of 91.9%. However, given the small sample size, these estimates should be interpreted with caution, and further research with larger cohorts is necessary for validation. Conclusion: This pilot study suggests that the CRP rapid POC test may have potential as a diagnostic aid for detecting dental pulp inflammation. However, these findings are preliminary, and further validation through larger studies and gold-standard comparisons is necessary before clinical implementation can be considered.

Aim: The present study aimed to detect Human bocavirus (HBoV) in stool samples from young children below 5 years complaining of acute gastroenteritis (GE) in addition to detection of rotavirus, norovirus, and astrovirus. Methods: The study included 90 children below 5 years with acute GE with excluded bacterial pathogens. The determination of the presence of HBoV was performed by nested polymerase chain reaction (PCR) beside determination of astrovirus and norovirus by multiplex PCR and rotavirus antigen by enzyme-linked immunosorbent assay (ELISA). Results: The most prevalent virus among the studied viruses was rotavirus (33.3%) detected by ELISA for antigen in the stool. The other three viruses detected by molecular methods were bocavirus (14.4%), astrovirus (13.3%), and norovirus (10%). Mixed viral infection with two or more viruses was detected in 16 children (17.8%). The most common was bocavirus and rotavirus in 6 patients (37.5%). In the study of demographic and clinical presentations of the children with HBoV, the affected children were mainly females, i.e., 10 (76.9%), from rural residence i.e., 11 (84.6%) with the mild classification of GE in 7 children (53.8%) and moderate GE in 6 children (46.2%) and none of them had severe GE. Fever was the most common presenting sign in those children (53.8%) followed by vomiting (46.2%). Conclusion: The study highlights the existence of HBoV in children with acute GE under the age of five. The infection associated with this virus was either mild or moderate in severity. The combined viral infection was common especially associated with rotavirus. There is a need for further additional study to identify the type of the circulated strain of bocavirus and the confections with other pathogens.

Background: Rotavirus-associated gastroenteritis is a common health problem in children, different variations of rotavirus genotypes differ according to geographic locations and the practice of wide-scale vaccination. Therefore, the present study aimed to detect both the G and P genotypes of rotavirus in children ≤ 5 years old in one center in Egypt as a cross-sectional study, to correlate the genotypes with various demographic and clinical data in infected children and to evaluate the common mixed genotypes G and P in infected children. Method: The cross-sectional study included children with acute gastroenteritis ≤ 5 years old from January 2023 till March 2024 recruited from Mansoura University Children’s Hospital, Egypt based upon laboratory diagnosis by exclusion of bacterial and protozoa pathogens. The stool samples were obtained from each child and subjected to detection of rotavirus antigen by enzyme-linked immunosorbent assay (ELISA) followed by genotypes identification of G and P genotypes by nested polymerase chain reaction (PCR). Result: A nested PCR study for rotavirus genotypes revealed that G1 was the most common genotype (24.7%) followed by G2 (21.1%), G3 (20%), G9 (20%), and G4 (14.1%). The genotyping of the P genotype revealed that P9 was the commonest genotype (24.7%), followed by P4 (21.2%), P10 (20%), P8 (17.6%) and P6 (16.5%). The commonest combined genotypes of G and P were G1P4 (85.7%), G3P8(88.2%), followed by G2P6 (77.8%) and G9P9(76.5%) and G4P9 (66.7%) followed by G4P10 (33.3%), G9P10(23.5%), G2P10(22.2%), G1P10 (14.3%), G3P10(11.8%). The distribution was significant (P = 0.001). The positive rotavirus antigen was more frequently detected in females (55.3%) than males (44.7%, Odd ratio 0.2, 95% CI 0.22–0.71, P = 0.001). There was a significant association between the summer season and positive rotavirus antigen (P = 0.001) and rural residence of the patients (Odd ratio 6,9 95%CI 3,5-13.5, P = 0.001). The significant associated clinical sign with positive rotavirus antigen was fever (Odd ratio 3,3, 95%CI 1,8-6.05, P = 0.001). The genotypes G and P were significantly associated with positive rotavirus antigen as all cases positive by antigen had been detected by nested PCR with the commonest genotypes G4 (24.7%, P = 0.001) and genotype P9 (24.7%, P = 0.001). Conclusion: The present study highlights the common genotypes of rotavirus at one center in Egypt, G1, G2, and G3 were the commonest G genotypes. As regard genotype P the commonest genotypes were P9, P4, and P10. The commonest combined genotypes were G1P4, G3P8, G2P6. There was no effect of the practice of rotavirus vaccination at limited rates at private health sections as the rotavirus is still a major pathogen of acute gastroenteritis in children. There is a need for the inclusion of rotavirus vaccination in the national program of children vaccination in Egypt.