thanaa shamaulddin abbas alturaihi

Background: The emergence of antibiotic resistance among pathogenic bacteria has become a serious problem worldwide. Integrons are useful marker of antibiotic resistance dissemination among Enterobacteriaceae. The purpose of current study was to compare the existence of the intI1andintI2 gene and its associations with the resistant to antibiotic of Escherichia coli isolated from patients with suspected with UTIs. Methods: For the period of the study about of 1300 urine specimens were collected from patients suspected with UTIs, Kirby-Bauer disk diffusion method 28 antimicrobial agents used to determine the antibiotic susceptibility of E coli isolates. The isolates had be subjected to polymerase chain reactions (PCR) for detection of class 1 and 2 integron and antibiotic resistance genes. Results: From 1300 urine specimens E. coli isolates had represented in 111(41.3%). The antimicrobial sensitivity profile of 111 E. coli isolates were studied 104(93.3%) were multidrug resistant (MDR) and five (4.4%) isolates were susceptible to all antibiotics. The PCR data of integrons genes revealed that 89 (85.6%) of MDR E. coli isolates had integrons genes, intI1 was detected in 82.7% of isolates, while intI2 was found only in 6.7% of them. Detect the bouth of intI1 and intI2 had detected in 3.8% of the isolates. The qacE∆1 gene were found in 65.1%, sul1 gene were detected in 8.1% ,and variable region in a different size products were detected in 89.5% of class I integron, at the same time as for variable regions of class II integron were detected in 57.1%. Conclusions: The study is show that the high frequency of class I integron in Uropathogenic Escherichia coli (UPEC) isolates conferring resistance to some classes of antibiotic. Keywords: Uropathogenic Escherichia coli, classI and classII intgrons, antibiotic resistance Correspondence: *Hashim Ali Abdualmeer Al-sherees Department of Microbiology / Faculty of Medicine / University of Kufa

Summary Staphylococcus aureus is a representative constituted pathogen related with the major community and hospital acquired sickness and has been taken into consideration for a long time as a major problem of Public Health,Several virulence factors engaged in the pathogenesis of S. aureus strains Perhaps the most notable virulence factors associated with this microorganism are the heat-stable enterotoxins that cause the sporadic food-poisoning syndrome or foodborne outbreaks (Martin et al.,2003). Hypothesis: The pathogenesis of Allergic rhinitis(AR) has been a hot subject , recent studies had suggested that Staphylococcus aureus excretes exotoxins that may act as superantigens and can influence the activity of both immune modulatory and pro inflammatory effector cell type and therefore, may have a potentially important role in the pathogenesis of chronic inflammatory disease or lead to exacerbation of upper airway disease Methodology A case –control study has been conducted to determine the prevalence of enterotoxin producing Staphylococcus aureus in the nasal cavities of patients with allergic rhinitis during the period from March 2014 to November 2014, 100 patients with Allergic rhinitis and 100 control subjects, the patients attended Al-Sadder Medical City, outpatient clinic of ENT in Najaf city. For isolation of S. aureus, a nasal swab was taken from each of the 100 patients and 100 controls by using a sterile cotton swab. Isolates were identified by a conventional test and then confirmed by Biomerieux Vitek 2 Compact Automated Microbial Identification. The super antigen genes (SEA, SEB,SEC,SED,SEE,and TSST) were detected by using conventional PCR on the isolate then an enzyme immune assay RIDASCREEN ® SET A, B,C,D,Epreformed on broth culture of these isolates in order to identify the enterotoxins production or libration. Result: Nasal S. aureus carriage was significantly more frequent in patients with allergic rhinitis than in non-allergic controls (P < 0.001),(Odds=3.4306 CI=1.8-6.26).The distribution of toxigenic S. aureus that recover from allergic rhinitis patients by PCR test was (63.16%) and (26.32%) from control groups and the difference was non-significant P= 0.434.The most frequently detected enterotoxin was staphylococcal enterotoxin B (SEB).ELISA test seem to be more sensitive for (SED, SEC, and SEE) and less sensitive for (SEA and SEB), however the specificity of ELISA is better in (SEB, SEC, SED, SEE than SEA Conclusion: We have demonstrated that the rate of nasal carriage of Staphylococcus aureus in allergic rhinitis patients was significantly higher than that of control subject,-Staphylococcus aureus isolated from allergic rhinitis patients have a probably a relationship with the disease and their superantigen have been a role in triggering and exacerbation of the disease

This study was carried out to evaluate the relation between the causative agents of otitis media and the parameter related to the patients (e.g., gender, age) the criteria of causative agents include type of bacteria, growth conditions, susceptibility to antibiotics, and the ability to produce ß-lactamase enzymes. A total of 50 ear swabs were obtained from outpatients infected with otitis media.The results showed that Staphylococcus epidermidis (30%) was the predominant pathogens followed by Staphylococcus aureus (20%), Pseudomonas aeruginosa (18%), Proteus mirabilis (8%), and Proteus vulgaris (4%). The antimicrobial susceptibility pattern showed that all bacteria were resistant to cephalothin and moderate resistant to other antibiotics.For detection of ß-lactamase producing bacteria, results showed that Ps. aeruginosa was recorded a high percentage in producing of ß-lactamase enzymes (55.6 %) in comparison with the other bacteria.

Abstract: This study was performed between May 2006 and May 2007 to identify patients who had nosocomial bacteramia and identify the pathogen responsible and its resisitance to antibiotics. Of 550 patients in various wards, 115 (20.9%) had positive blood cultures. Gram-positive cocci were recognized in 46.9% patients; these included coagulase-negative staphylococci, Staphylococcus aureus 16.5%, Streptococcus pneumoniae 6.95% and other Gram-positive cocci. Gram-negative bacilli were responsible 53.04% of isolates. However, Pseudomonas aeruginosa 21.73% was the predominant isolate. Patterns of drug resistance varied according to species of bacteria but were generally quite high.

Background:Rheumatoid arthritis (RA): Chronic inflammatory polyarthritis, an autoimmune response targeting citrullinated antigens, due to destructive synovial joint inflammation. Porphyromonas gingivalis, a gram-negative bacterium residing in the subgingival tissues of the oral cavity, has been implicated in the association with RA, mainly due to the identification of a bacterial enzyme known as peptidyl arginine deaminase (PAD). The presence of this enzyme in P. gingivalis suggests its potential role in RA development by generating citrullinated antigens. Aims: The association between P. gingivalis and the development of anticitrullinated peptide antibody (ACPA) and if its role as an environmental risk factor of RA. Methods: This case-control study involved a total 140 participants, collection of blood and gingival crevicular fluid (GCF) samples from the participants, various tests were conducted, Specific PCR primers targeting fimA genotypes of P. gingivalis were utilized to amplify the relevant genetic regions,statistical analysis used: Statistical Package for the Social Sciences (SPSS) version 26, a T-test and Chi-square (?^2) test were utilized. Results: The p-values for ESR, ACCP, and IL-17 were 0.0001, 0.02, and 0.0001, respectively, indicating strong statistical significance for RA patients. Among the RA patients with P. gingivalis infection and the RA patients without P. gingivalis infection the analysis did not reveal a statistically significant difference in mean of ACCP and all biomarkers between the two groups (p-value=1.000). Conclusions: No association between P. gingivalis and the development of ACPA, the rise in ESR levels as disease severity escalates underscores the potential practicality of using ESR as an indicator to evaluate disease activity in RA, a trend towards a higher occurrence of gum problems among RA patients especially in category of patients developed gum problems before the onset of RA. Keywords: Anti-cyclic Citrullinated Peptide, Disease Activity Score-28 (DAS28), Interleukin- 17, Porphyromonas gingivalis, Rheumatoid arthritis.

Summary Rheumatoid arthritis (RA) is the most common type of chronic inflammatory polyarthritis, characterized by an autoimmune response against citrullinated antigens and the subsequent destruction of synovial joints. higher prevalence among females compared to males. The risk of developing RA increases with age . Porphyromonas gingivalis is a gram-negative bacterium found in the subgingival tissues of the oral cavity, it is characterized by its black pigmentation and can survive in the oxygen-deprived environment of periodontal pockets, despite being asaccharolytic (not fermenting sugars), it is able to adapt and thrive in these low-oxygen conditions. This a case-control study investigate the connection between P. gingivalis and the development of anticitrullinated peptide antibody (ACPA) and its function as an environmental risk factor for rheumatoid arthritis (RA). The study included participants from Iraq who were diagnosed with rheumatoid arthritis (RA) at Al-Sadr Medical City in Najaf, as well as healthy residents of Najaf. A total of 140 participants were enrolled, with 70 individuals having confirmed RA based on specific criteria and serological testing, while the remaining 70 served as healthy controls. The study involved the collection of blood samples and gingival cervicular fluid samples. Various measurements and tests were performed, including the assessment of disease activity using the Disease Activity Score (DAS28-ESR) and erythrocyte sedimentation rate (ESR), detection of rheumatoid factors (RF) through latex agglutination, measurement of anti-cyclic citrullinated peptide (ACCP) and interleukin-17 (IL-17) levels using ELISA,and determination of the frequency of fimA genotypes (Gene Type Ib fimA & Gene Type II fimA) of Porphyromonas gingivalis in both RA patients and the control group. was used the PCR method to analyze the presence of P. gingivalis genotypes and their association with RA. According to the findings of this study, there is a significant difference in the occurrence of rheumatoid arthritis (RA) between males and females ,resulting in a female-to-male ratio of 11.3:1. RA patients exhibited significantly higher values for erythrocyte sedimentation rate (ESR), rheumatoid factor (RF) titer, anti-cyclic citrullinated peptide (ACCP), and interleukin-17 (IL-17) compared to the control group. The p-value for ESR was 0.0001, indicating a strong statistical significance. The p-value for ACCP was 0.02, Similarly, the IL-17 parameter had a p-value of 0.0001, indicating a strong statistical significance. In terms of gum problems, 20.0% of patients experienced these issues before the onset of RA, while 27.1% experienced them after RA onset. An additional 14.3% of patients had gum problems, but it was unknown whether they occurred before or after the onset of RA. Furthermore, the distribution of percentages revealed that 80% of patients who experienced tooth loss were in the younger age group, while the remaining 20% were in the older age group. Interestingly, none of the RA patients without gum problems experienced tooth loss.Regarding P. gingivalis infection, the study suggests that the presence of specific gene types (Ib fimA and II fimA) does not significantly affect disease activity as measured by the Disease Activity Score 28 (DAS 28). Additionally, there were no significant differences observed in RF, ACCP, and IL-17 levels between RA patients with and without P. gingivalis infection.

Summary RA is an autoimmune, systemic, inflammatory disease that affects both small and large synovial joints in a symmetric manner. The skin, the eyes, the heart, the kidneys and the lungs ultimately. Bone and cartilage are often damaged, tendons and ligaments are weakened, and chronic inflammation leads to joint deformity and bone degeneration in the following years. RA-related systemic effects contribute to increased mortality and morbidity. This study is designed to assess the serum levels of B cell chemokine (CXCL-13), Anti-carbamylated antibody, and to evaluate their relationships with diagnosis and severity of disease. This case-control study obtained from Rheumatology Unit of Al-Sadr Medical City in Najaf and Al-Hussaynia General Hospital in Karbala during the period from November - 2021 to March-2022 . Sixty patients with RA who were fulfilled four or more of the 2010 American College of Rheumatology (ACR) and European League against Rheumatism (EULAR) classification criteria for RA and sixty individuals classified as control groups. Disease activity score (DAS28-ESR), (CDAI) and Erythrocyte Sedimentation Rate(ESR) were measured, as well as rheumatoid factors (RF) were detected by latex agglutination in all participants. Anti- cyclic citrullinated peptide (ACCP), CXCL13 and Anti-CarP in the human serum samples were measured by enzyme-linked immunosorbent assay (ELISA). Age group included in this study was 20-70. RA found high in individuals of age group <=40 years old of 45 patients at a percentage 75.0%. The mean age was 45.3±1.3 years. The results of this study showed that the RA disease is more frequent in female 46 (76.7%) than in males 14(23.3%). Female to male ratio was 3.2:1. CXCL13, Anti-CarP, Anti-CCP, and RF levels with high significantly differ among RA patients and healthy groups at p value =0.0001.CXCL13 demonstrated good specificity (83%) and high sensitivity (93%) for RA patients , while the AUC for CXCL13 was 0.88,while Anti-CarP antibodies demonstrated low sensitivity(39%) and high specificity(98%) for diagnosis of RA. On the other hand, the AUC for anti-CarP antibodies was 0.67. Patients with RA have positive for RF; Anti-CarP were 71.7% and 36.7% respectively, while healthy group have positive for RF and Anti-CarP were 11.7% and 1.7% respectively. The mean of ACCP antibodies level in patients was higher 95.8±32.3 in male than in female. The serum level of CXCL13 shows no a significant difference (P =0.7) between male and female with means 1.02±0.15 and 0.8±0.03 respectively, while there is no significant difference in anti-CarP or RF between male and female (P value= 0.9; 0.8) respectively. In addition, there was no significant difference at P value=0.4; 0.7 respectively in both biomarkers concentrations (CXCL13, anti-CarP) among age groups. There were significant differences between CXCL13 and disease duration (P value=0.05), while there were no significant differences between anti-CarP and disease duration (P value=0.2). There were no significant differences of concentration of ACCP, CXCL13 and anti-CarP according to DAS-ESR, at P value=0.2; 0.2 and 0.1 respectively. There were no significant differences between CXCL13 and anti-CarP in regard to CDAI, the means of CXCL13 in mild was 0.893±0.14, moderate 0.874±0.4and sever 0.963.1±0.9 at (P value =0.4), while The overall number of positive Anti-Carp patients is 22, with mild 5(22.7%), moderate 9(40.9%), and severe 8(36.4%) cases at p value=0.8 . There were no significant differences among study parameters (CXCL13 and ACCP) in regard to treatment response, the means CXCL13 of good 0.899.5±0.60 and poor 0.940±0.1 at (P value =0.7).The means ACCP of good 73.8±9.2 and poor 73.6±15.2 at( P value =0.7). In conclusion, the study has shown that the more common of RA patients were females.CXCL13, Anti-CarP, Anti-CCP, and RF levels with high significantly differ among rheumatoid arthritis patients and healthy groups.CXCL13 demonstrated good specificity and high sensitivity, while the AUC for CXCL13 was 0.88, these results suggest a superior role of CXCL13 positivity in diagnosis of RA. Anti-CarP antibodies demonstrated low sensitivity and high specificity. On the other hand, the AUC for anti-CarP antibodies was 0.67; these results suggest an additional role of anti-CarP positivity in the diagnosis of RA. There was a non-significant correlation between serum level of ACCP, CXCL13, Anti-CarP with DAS28-ESR and CDAI, so these biomarkers not usefulness in prediction of disease-severity. The serum levels of ACCP, CXCL13, Anti-CarP, did not significantly correlate with CDAI or DAS28-ESR, indicating that these biomarkers were not effective in predicting the severity of the disease

Background: Rheumatoid arthritis is a persistent, immune-mediated disorder that causes pain, edema, and inflammation in the joints. A genetic history that is high in risk, when paired with genomic markers and environmental exposures, triggers a series of actions that not only results in synovitis and arthritis, but also affects a great number of organs that are not related to the joints. The identification of novel autoantibodies playing key roles in different stages of disease remains an issue of interest for RA. Therefore, autoantibodies are necessary to assist in making a diagnosis and prediction more quickly in RA. Anti-Carbamylated Protein antibodies are a different class of anti- transformed protein antibody that is often found in the blood of RA patients. Objective: Rheumatoid arthritis has a recently discovered biomarker, which is an antibody called anticarbamylated protein (CarP). Our aim is to evaluate the usefulness of anti-CarP as a diagnostic tool for RA. Participants and methods: The study conducted on 60 people diagnosed with RA as well as 60 people who served as healthy controls. Both the disease activity score (DAS28) and the health assessment questionnaire (HAQ) were evaluated. Estimates were made based on laboratory examinations such as ESR and rheumatoid factor (RF). Anti-CarP and Anti-CCP antibodies were measured by enzyme-linked immune-sorbent assay. Results:Anti-CarP levels were considerably higher in the patients with RA compared to the group that provided as a control (p > 0.000). Therefore, the sensitivity and specificity for anti-CarP antibodies were 39% and 98% respectively, while the sensitivity and specificity for anti-CCP antibodies were 83% and 95% respectively, and for RF were 68% and 83% respectively. The area under the curve (AUC) for anti-CarP antibodies was 0.67. Conclusions: Anti-CarP antibodies had comparatively lower sensitivity and slightly higher specificity than AntiCCP.These findings suggest that anti-CarP antibodies works as an additional role in the diagnosis of RA. Keywords: Rheumatoid Arthritis, Anti-Carbamylated Protein, Anti-Citrullinated Peptide, Rheumatoid Factor.