Urine Samples Of Patients Research Articles

The potential of Leishmania donovani Aurora kinase in the diagnosis of Indian and Brazilian visceral leishmaniasis patients.

Visceral leishmaniasis (VL), caused by Leishmania donovani or Leishmania infantum, is prevalent in India and Brazil. Post-kala-azar dermal leishmaniasis (PKDL), a cutaneous form, can occur in patients who seem to have recovered from VL. The rK39 test, which detects circulating antibodies, shows high sensitivity and specificity for VL diagnosis in India, but its performance varies in other endemic regions, with a significant limitation being the inability to distinguish active disease from past infection. Herein, we investigated Aurora Kinase (LdAIRK), a conserved virulence factor across Leishmania species with a major role in cell division, for VL diagnosis. We analyzed serum samples from parasitologically confirmed symptomatic VL patients (n = 79), PKDL patients (n = 16), healthy controls, and other diseases (n = 53) from India, along with VL patients (n = 40) and healthy endemic controls (n = 19) from Brazil, using enzyme-linked immunosorbent assay with rLdAIRK. The sensitivity of rLdAIRK was 98.73% (95% CI: 93.17-99.94) for Indian patients and 97.5% (86.84-99.94) for Brazilian patients. It also demonstrated a sensitivity of 93.75% (71.67-99.68) for Indian PKDL sera. Specificity ranged from 94.33% to 94.74% for Indian samples and 84.21% for Brazilian samples. Notably, LdAIRK showed low reactivity (8.3%) with follow-up patient samples compared with rK39 rapid diagnostic tests, indicating its potential as a test-of-cure tool. These findings were supported by dipstick and lateral flow tests (LFTs), which are user-friendly and suitable for field settings. We recommend incorporating recombinant antigen Ldairk in serological assays for the diagnosis of VL.IMPORTANCEAn early detection and treatment of VL is essential in the control of this potentially fatal disease. Since signs and clinical symptoms of VL are non-specific, diagnosis is confirmed with serological tests. Rapid diagnostic tests (RDTs) against VL that detect antibodies are simple and field adaptable. rK39 antigen-based RDTs are in use, but their sensitivities vary in the different VL-endemic regions. Moreover, since the antibodies persist long after cure in healthy individuals, these RDTs cannot diagnose relapse of the disease. Here, we have identified a Ldairk as a new marker for the diagnosis of VL. We found that Indian VL and PKDL as well as Brazilian patient sera reacted to this protein consistently. Sensitivity was also maintained in the patient's urine samples. Low reactivity with antibodies after cure with Ldairk can help distinguish previously treated cases from active and relapsed ones.

Revisiting fosfomycin to treat urinary tract infections in the era of rising carbapenem resistance

Background: Most of the studies on antibiotic resistance are pre-judiced over the use of last-resort antibiotics for Multidrug resistant organisms (MDRO) and fail to acknowledge the effectiveness of older antibiotics. There is a dearth of information regarding the susceptibility of fosfomycin and nitrofurantoin, which are oral alternatives for such infections. Aims and Objectives: To study the antibiotic susceptibility profile of uropathogenic Escherichia coli and infer whether fosfomycin can be used as an efficient oral option for the management of uncomplicated urinary tract infection (UTI), especially in carbapenem-resistant cases. Materials and Methods: Clean catch midstream urine samples from cases clinically suspected of UTI received for culture were processed using standard guidelines for microbiological procedures. Antimicrobial sensitivity was performed through the Kirby Bauer disc diffusion method. Discrepant results were confirmed with VITEK 2. Results: This study reports antimicrobial susceptibility pattern of 100 E. coli isolated from urine samples of patients with signs and symptoms suggestive of UTI. There was a female predominance in the study population and the most affected age group was 20–40 years (52%). Most specimens were received from the obstetrics and gynecology department (32%) followed by General medicine (28%). Higher sensitivity was observed for fosfomycin (97%), amikacin (80%), and meropenem (79%). Conclusion: Fosfomycin is an oral, safe, and efficient antibiotic for UTI. It is a valuable alternative for outpatient treatment of MDROs causing UTI. Thus, decreasing hospitalization and consequently reducing the financial burden of treatment for the patients.

Targeted and untargeted urinary metabolomics of alkaptonuria patients using ultra high-performance liquid chromatography-tandem mass spectrometry.

Alkaptonuria (AKU) is a rare autosomal-recessive disease which is characterized through black urine and ochronosis. It is caused by deficiency of the enzyme Homogentisate 1,2-dioxygenase in the Phenylalanine/Tyrosine degradation pathway which leads to the accumulation of Homogentisic acid (HGA). Urine was provided by AKU patients and healthy controls. Several different methods were developed in this study each with a specific goal.Firstly, a simple and inexpensive RP-UHPLC-UV method for routine monitoring of HGA as a key metabolite employing a Phenylhexyl stationary phase chemistry. Validation was performed in accordance to FDA guidelines and method selectivity was further evaluated via on-line high-resolution sampling 2D-LC-QToF-MS, coupling the Phenylhexyl phase in the first dimension with a C18 phase in the second dimension. Secondly, a targeted and accurate RP-UHPLC-MRM-QTRAP assay, providing quantitative analysis of the relevant pathway metabolites based on a Phenylhexyl stationary phase, and lastly an untargeted HILIC-UHPLC-QToF-MS/MS method with SWATH (sequential window acquisition of all theoretical mass spectra) acquisition employing a sulfobetaine-type HILIC-Z superficially porous particle column, with the aim of uncovering more details about the metabolic profile of this genetic disorder. By untargeted analysis 204 metabolites could be detected and annotated in positive and negative ESI mode in total. Two separate LC methods were employed, differing in their conditions depending on the ionization mode (20 mM ammonium formate as buffer additive adjusted to a pH = 3.5 with formic acid in ESI+ mode and 20 mM ammonium acetate adjusted to a pH = 7.5 with acetic acid in ESI- mode). By effectively combining the aforementioned methods, a comprehensive workflow was developed, allowing the effective analysis of both patient and control urine samples.

Bacteriological Profile Isolated from Patients with Viral Hepatitis Diseases

Background: Three types of bacterial liver infections may be distinguished: granulomatous liver disease caused by bacteria, bacterial liver abscesses, and acute bacterial hepatitis. Numerous types of hepatic infections have been linked to a wide range of bacteria, and the liver is impacted by the infection process of numerous systemic bacterial diseases. Clinical manifestations, etiological agents, and treatment modalities substantially intersect. The majority of liver-damaging bacterial infections only manifest clinically and laboratory as secondary hepatitis. Aims of the study: To show the bacterial profile in viral hepatitis patients as a preliminary investigation at Diyala province. Methodology: Cross-sectional study Included (40) patients with clinically diagnosed viral hepatitis with in a period of 1st November 2023 to 30th March 2024. Those subjects were in patients at Baaquba Teaching Hospital in Diyala province, Blood and urine samples were collected from each subject. Results: All blood and urine samples obtained from individuals with viral hepatitis yielded positive findings at percentage 26 (65%) when subjected to bacterial culture. Regarding blood culture, 19 cases were positive bacterial culture. The predominant bacterium of Gram positive was Staphylococcus haemolyticus, and for Gram-negative was Pseudomonas aeroginosa. bacterial cultures were detected in 26 cases for urine culture Also, Staphylococcus haemolyticus was the predominant Gram-positive bacterial type in urine samples of viral hepatitis patients and E. coli was the predominant type for Gram negative bacteria. Conclusion: Bacterial infections were detected in viral hepatitis patients. Bacterial cultures were detected in 26 cases for urine culture Also, Staphylococcus haemolyticus was the predominant Gram-positive bacterial type in urine samples of viral hepatitis patients and E. coli was the predominant type for Gram negative bacteria.

Searching for sexually transmitted infections by midstream urine pooling after exclusion of urinary tract infection: A cost-effectiveness analysis.

Searching for sexually transmitted infections by midstream urine pooling after exclusion of urinary tract infection: A cost-effectiveness analysis.

Analysis of the Distribution Characteristics and Changes of Drug Resistance of Pathogens in Patients with Urinary Tract Infection Across Southwest China From 2019 to 2023.

To analyze the changes in the distribution and drug resistance of pathogenic bacteria causing urinary tract infections in Southwest China from 2019 to 2023, and to provide an accurate scientific basis for empirical clinical use. The identification results and drug susceptibility tests of non-duplicate pathogens isolated from urine samples of patients in Sichuan region from 2019 to 2023 were retrospectively analyzed. The results obtained were interpreted with reference to CLSI M100-33th and analyzed with WHONET 5.6 software. A total of 247295 strains of pathogens were detected, including 188551 gram-negative strains (76.2%). The positive rate of female patients (56.8%) was significantly higher than that of male patients (43.2%). The top five most common urinary pathogens were Escherichia coli (50.5%), Enterococcus faecium (11.5%), Klebsiella pneumoniae (8.5%), Enterococcus faecalis (6.5%), and Proteus mirabilis (2.9%). The resistance rate of E.coli to levofloxacin, cefotaxime and ceftriaxone was higher (>50%) and had a certain upward trend. The resistance rates of Klebsiella pneumoniae to imipenem and meropenem increased from 7.8% and 9.6% in 2019 to 11.6% and 13.2% in 2023, respectively, much higher than the resistance rates of E. coli to carbapenem antibiotics (<2%). E. coli, K. pneumoniae and E. cloacae still maintained high activity against tigecycline and polymyxin B. The drug resistance rate of Acinetobacter baumannii to imipenem and meropenem was more than 27.4%. The resistance rates of Enterococcus faecium and Enterococcus faecalis to vancomycin, teicoplanin and linezolid were lower than 3.4%. There was an increasing trend in the detection of CRE-KPN among multidrug-resistant bacteria, and a slight decreasing trend in CRPA and CRAB. The main pathogens of urinary tract infections were E. coli, E. faecium and K. pneumoniae. The drug resistance rates of main clinically isolated bacteria in urine samples showed a diverse trend. Antibiotics should be rationally selected based on the resistance patterns of the pathogens. At the same time, with the continuous detection of multi-drug resistant bacteria VRE and CRE, we have a long way to go in future drug resistance monitoring.

Electrochemical detection of creatinine at picomolar scale with an extended linear dynamic range in human body fluids for diagnosis of kidney dysfunction.

Electrochemical detection of creatinine at picomolar scale with an extended linear dynamic range in human body fluids for diagnosis of kidney dysfunction.

Selective determination of 3,5-dihydroxycinnamic acid in urine samples as gluten intake biomarker: high-performance thin-layer chromatography combined with colorimetric detection

The determination of biomarkers is a significant field of analytical chemistry research under continuous evolution that contributes to enhance diagnostics and enable more personalized medicine. Celiac disease is a systemic autoimmune disorder caused by the ingestion of gluten (Glu) proteins found in various cereals. Currently, the only effective way to prevent and manage potential complications is through a strict gluten-free diet (GFD). However, both intentional and unintentional dietary transgressions can occur, often leading to persistent symptoms and ineffective treatment. In this scenario, the development of analytical strategies to detect biomarkers of gluten intake and monitor adherence to a GFD is of significant interest. Herein, we present an analytical strategy based on high-performance thin-layer chromatography (HPTLC) combined with colorimetric detection to estimate 3,5-dihydroxycinnamic acid (3,5-DHCA) as selective biomarker of Glu intake in urine. The approach combined Fast Blue (FB)-doped polydimethylsiloxane (PDMS) membrane with colorimetric HPTLC (RP-C18) giving rise to a selective method to isolate 3,5-DHCA response in urine samples. Detection by visual inspection, image analysis, and spectroscopic response was evaluated and compared. Analytical parameters were estimated showing a good sensitivity (limit of detection (LOD) ≤ 0.8 mg L−1) and precision, relative standard deviation (RSD) values < 7%. Analysis of urine samples of celiac patients and control patients was performed, and recovery studies showed satisfactory values (R > 80%). The preliminary results indicated correlation between Glu intake and positive 3,5-DHCA responses. This study demonstrated that FB-doped PDMS membranes-HPTLC is a promising tool for detecting dietary transgressions to the GFD by visual inspection, and subsequent quantitative analysis by image analysis and spectroscopic techniques. Hence, the proposed analytical method contributes to the advance of knowledge about celiac disease, which still remains an important challenge to our society.Graphical abstract

In-silico and in-vitro Antibacterial Activity and GC-MS Analysis of Anogeissus acuminata Leaf Extract with Host Toxicity Testing

Background: Anogeissus acuminata leaf extract is utilized in the different purposes. Objective: Antibacterial activity of organic solvent fractions of crude leaf extract of Anogeissus acuminata was used against multidrug-resistant strains of 9 pathogenic bacteria isolated from urine samples of patients with urinary tract infections. Methodology: The n-butanol fraction revealed effective control over pathogens, and the zone size was 21 mm as a measure of antibacterial activity against Proteus mirabilis. The gas chromatography-mass spectroscopy analysis indicated the presence of 15 phyto-compounds with docking score values -5 to -7 kcal/mol in a molecular docking attempt against β-lactamase of Pseudomonas aeruginosa. Results: The isolated chemicals, conocarpan and dihydrodehydrodiconiferyl alcohol, had comparatively effective docking scores, -10.908 and -10.081 kcal/mol, respectively. In toxicity testing, the experimental minimum inhibitory concentration value was 600 mg/L, and the computed lethal concentration25 value was 1698.24 mg/L during cytotoxicity assay; it was observed that comet was not found in the cells treated leaf extract. Conclusion: The isolated compounds conocarpan and dihydrodehydrodiconiferyl alcohol achieved successful docking scores against -lactamase in the molecular docking attempt. When the leaf extract was seen using lymphocytes grown from UCB, it was determined that it had no host toxicity. Bangladesh Journal of Infectious Diseases, December 2024;11(2):93-101

Characterizing metabolomic and proteomic changes in depression: a systematic analysis.

Despite the widespread use of metabolomics and proteomics to explore the molecular landscape of depression, there is a lack of consensus regarding dysregulated molecules with replicable evidence. Thus, this study aimed to identify robust metabolomic and proteomic features in depression by integrating evidence from large-scale studies. In this study, a knowledge base-mining approach was adopted to compile a list of dysregulated molecules derived from metabolomic and proteomic studies. A vote-counting approach was performed to identify consistently altered molecules in the blood and urine samples of patients with depression. A total of 2398 molecular entries were selected, comprising 857 unique metabolites and 468 unique proteins from 143 metabolomic and 23 proteomic studies in depression. The results of vote-counting analyses revealed that 11 metabolites in blood and 5 metabolites in urine exhibited consistent disturbances across studies. Circulating levels of glutamic acid and phosphatidylcholine (32:0) were elevated in depressive patients, whereas the levels of tryptophan, kynurenic acid, kynurenine, acetylcarnitine, serotonin, creatinine, inosine, phenylalanine, and valine were lower. Urinary levels of isobutyric acid, alanine, and nicotinic acid were higher, whereas the levels of N-methylnicotinamide and tyrosine were lower. Moreover, analysis of the proteomic dataset identified only one circulating protein, ceruloplasmin, that was consistently dysregulated. Convergence comparison prioritized tryptophan as the top-ranked circulating metabolite, followed by kynurenic acid, acetylcarnitine, creatinine, serotonin, and valine. Collectively, robust evidence of metabolomic changes was observed in patients with depression, pointing to a role as potential biomarkers. Further investigation of consensus proteomic features for depression is necessitated.

The metabolomic profile features of some bio logical fluids in serous ovarian adenocarcinoma patients.

The search for effective biomarkers for ovarian cancer (OC) early diagnosis is an urgent task of modern oncogynecology. Metabolic profiling by ultra-high performance liquid chromatography and mass spectrometry (UHPLC-MS) provides information on the totality of all low molecular weight metabolites of patient's biological fluids sample, reflecting the processes occurring in the body. The aim of the study was to research blood plasma and urine metabolomic profile of patients with serous ovarian adenocarcinoma by UHPLC-MS. To perform metabolomic analysis, 60 blood plasma samples and 60 urine samples of patients diagnosed with serous ovarian carcinoma and 20 samples of apparently healthy volunteers were taken. Chromatographic separation was performed on a Vanquish Flex UHPLC System chromatograph (Thermo Scientific, Germany). Mass spectrometric analysis was performed on an Orbitrap Exploris 480 (Thermo Scientific, Germany) equipped with an electrospray ionization source. Bioinformatic analysis was performed using Compound Discoverer Software (Thermo Fisher Scientific, USA), statistical data analysis was performed in the Python programming language using the SciPy library. Using UHPLC-MS, 1,049 metabolites of various classes were identified in blood plasma. In patients with OC, 8 metabolites had a significantly lower concentration (P &lt; 0.01) compared with conditionally healthy donors, while the content of 19 compounds, on the contrary, increased (P &lt; 0.01). During the metabolomic profiling of urine samples, 417 metabolites were identified: 12 compounds had a significantly lower concentration compared to apparently healthy individuals, the content of 14 compounds increased (P &lt; 0.01). In patients with ovary serous adenocarcinoma, a significant change in the metabolome of blood plasma and urine was found, expressed in abnormal concentrations of lipids and their derivatives, fatty acids and their derivatives, acylcarnitines, phospholipids, amino acids and their derivatives, derivatives of nitrogenous bases and steroids. At the same time, kynurenine, myristic acid, lysophosphatidylcholine and L-octanoylcarnitine are the most promising markers of this disease. The revealed changes in the metabolome can become the basis for improving approaches to the diagnosis of serous ovarian adenocarcinoma.

Endoglin promotes podocyte injury and apoptosis through the autophagy-lysosomal pathway in lupus nephritis.

Endoglin promotes podocyte injury and apoptosis through the autophagy-lysosomal pathway in lupus nephritis.

The Prevalence of Xylazine in Patient Urine Samples That Were Positive for Fentanyl in Western New York.

Xylazine, a veterinary sedative, is increasingly being discovered in the illegal drug supply across the United States and is associated with overdose fatalities. Not approved for human use, xylazine poses life-threatening risks, particularly when used in conjunction with opioids such as fentanyl. This study evaluates the prevalence of xylazine in urine samples that screened positive for fentanyl. The evaluation involved measuring the parent drug xylazine and its metabolites, xylazine glucuronide and hydroxy-xylazine, as well as finding their correlation with fentanyl and norfentanyl concentrations in patient samples. Samples were collected over a one-month period. Urine samples were analyzed for fentanyl, norfentanyl, and 3 xylazine-specific analytes (i.e., xylazine, xylazine glucuronide, and hydroxy-xylazine). Briefly, reverse-phase chromatographic separation was performed on a Bonshell Phenyl-Hexyl column utilizing a binary mobile phase gradient. The eluents were detected through positive electrospray ionization and multiple reaction monitoring analysis on a triple quadrupole mass spectrometer. Out of a total of 230 urine samples, 184 were confirmed positive for fentanyl. Xylazine was detected in 56 out of the 184 fentanyl-positive samples, accounting for 30% of the fentanyl-positive confirmatory test. Xylazine (or its metabolites) was not observed in fentanyl-negative samples. Furthermore, the parent xylazine drug was detected in all 56 samples, whereas the metabolite glucuronide and hydroxy forms were only detected in 28 and 6 samples, respectively. This study estimated a xylazine prevalence of 30% in fentanyl-positive urine samples within our local Western New York population. This study represents the first report within our clinical population.

Verification of the analytical performance of the urinary creatinine assay on Abbott Architect ci8200

The urinary creatinine assay is a pivotal diagnostic tool for assessing kidney function, hydration status, and muscle metabolism. This study evaluated the analytical performance of the urinary creatinine assay method using an Abbott kit on the Architect ci8200® automated system in the biochemistry laboratory of CHU Mohammed VI, Oujda. Method verification was conducted in two phases: intermediate fidelity testing using internal quality controls and repeatability testing on patient urine samples across low and high creatinine concentration levels. The results demonstrated excellent analytical performance, with coefficients of variation (CV) for intermediate fidelity (CV1 = 1,95% and CV2 = 1.46%) and repeatability (CV1 = 0.78% and CV2 = 0.87%) well within the limits established by the French Society of Clinical Biology (SFBC). Levey-Jennings charts illustrated consistent and robust performance. This method also underwent a comparative analysis using the Bland-Altman diagram, which confirmed its accuracy and precision relative to established standards. These findings underscore the reliability of the urinary creatinine assay method, ensuring high-quality diagnostic outcomes.

P0045 Serologic levels of fatty acids as promising biomarkers for the severity of Inflammatory Bowel Disease

Abstract Background Inflammatory Bowel Disease (IBD) is a chronic and autoimmune disease which affects the gastrointestinal tract. Several changes in the metabolomic profile have been described in urine, blood and feces samples of IBD patients. However, little is known regarding the relationship between these metabolic changes and the severity of IBD. Therefore, we aim to characterize the metabolomic profile, specifically the fatty acid profile, in serum from both active and in remission IBD patients. Methods Blood samples from UC active patients (n=20), UC patients in remission (n=20), CD active patients (n=21), CD patients in remission (n=21) and non-IBD controls (n=21) were obtained. UC and CD patients were classified in active or remission according to the Mayo-score and Harvey-Bradshaw Index, respectively. Serum was obtained after centrifugation of the fresh blood. Metabolomic analysis was performed using Liquid Chromatography High-Resolution Mass Spectrometry. Data were expressed as mean±SEM (μg/mL) and compared by a t-test or ANOVA. A p-value&amp;lt;0.05 was considered statistically significant. Results A total of 42 fatty acids were quantified and results are shown in Table 1. 23 of them showed significant differences, either Control vs UC, Control vs CD, or CD vs UC. In addition, 9 fatty acids showed significant differences between active CD vs remission CD patients (FA 15:0, FA 16:1n10, FA 17:0, FA 18:0, FA 18:1n12 + FA 18:1n13 + FA 18:1n9trans, FA 20:0, FA 20:3n9, FA 20:4n6, FA 22:4n6). In case of UC, 24 fatty acids showed significant differences in active vs remission patients, especially those with large and very large chain (FA 14:0, FA 15:0, FA 16:1n10, FA 16:1n9, FA 17:0, FA 18:1n12 + FA 18:1n13 + FA 18:1n9trans, FA 18:1n7trans, FA 18:1n9, FA 18:2n6trans, FA 18:3n6, FA 19:0, FA 20:0, FA 20:1n9, FA 20:2n6, FA 20:3n3 + FA 20:3n6, FA 20:3n9, FA 20:4n6, FA 22:0, FA 22:1n9, FA 22:2n6, FA 22:3n3 + FA 22:3n6 + FA 22:3n9, FA 22:4n6, FA 22:5n6 and FA 24:1n9). Moreover, 4 fatty acids, specifically FA 20:0, FA 22:0, FA 22:1n9 and FA 22:4n6, showed areas under the curve higher than 0.8 in the ROC curves (0.87, 0.84, 0.89 and 0.81 respectively). Conclusion Differences in serum levels of fatty acids were detected between active and remission patients of both CD and UC. The ROC curves of some of them point these fatty acids as potential biomarkers indicating the severity of IBD in these patients. Table 1. Levels of the fatty acids in serum of both non-IBD and IBD patients.

ANTIBIOTIC SUSCEPTIBILITY PATTERN OF E. COLI ISOLATED FROM THE URINE SAMPLES OF PATIENTS VISITED CIVIL HOSPITAL MADYAN SWAT

Background: Antibiotic resistance is a global challenge, particularly in urinary tract infections (UTIs) caused by Escherichia coli (E. coli), which is a leading pathogen in both nosocomial and community-acquired infections. Regular monitoring of antibiotic susceptibility profiles is essential due to the rising prevalence of drug-resistant bacteria. This study focused on evaluating the antibiotic susceptibility pattern of E. coli isolated from urine samples of patients attending Civil Hospital Madyan, Swat, to guide effective empirical therapy. Objective: To determine the antibiotic susceptibility profile of E. coli isolated from urine samples of UTI patients visiting Civil Hospital Madyan, Swat. Methods: A cross-sectional study was conducted from December 2022 to July 2023 in the Department of Microbiology, Government Degree College Madyan, Swat. A total of 450 mid-stream urine samples were collected from patients with suspected UTIs. The samples were cultured on MacConkey agar and incubated at 37°C for 24–48 hours under aerobic conditions. Isolated bacterial colonies were identified using gram staining, microscopy, and biochemical tests. Antibiotic susceptibility testing was performed on Mueller-Hinton agar using the Kirby-Bauer disc diffusion method with multiple antibiotic discs. The bacterial isolates were categorized into resistant (R), sensitive (S), or intermediate (I) groups by measuring inhibition zone diameters. Data were statistically analyzed and presented in figures and tables. Results: Out of 450 urine samples, 125 (27.0%) were culture-positive, with E. coli being the most frequently isolated bacterium (60%). Culture positivity was higher in females (70%) than males (30%). Among hospital areas, samples from the outpatient department (70%) showed the highest culture positivity, followed by wards (25%) and the emergency department (5%). Antibiotic susceptibility testing revealed that E. coli exhibited the highest resistance to ampicillin (97.1%), ceftriaxone (92%), moxifloxacin (88.2%), cefixime (86%), and ceftazidime (80.1%). Conversely, the highest sensitivity was observed to fosfomycin (95.3%), sulzone (85.2%), imipenem (85.0%), and amikacin (78%). Conclusion: This study confirmed that E. coli is the predominant pathogen causing UTIs and displayed significant resistance to commonly used antibiotics such as ampicillin, ceftriaxone, moxifloxacin, cefixime, and ceftazidime. However, fosfomycin, imipenem, and amikacin were found to be the most effective antibiotics against E. coli. These findings underscore the importance of conducting antibiotic susceptibility testing to guide effective therapy and combat antimicrobial resistance.

Urine miRNA signature as potential non-invasive diagnostic biomarker for Hirschsprung's disease.

Hirschsprung's disease (HSCR) is characterized by congenital absence of ganglion cells in the gastrointestinal tract, which leads to impaired defecation, constipation and intestinal obstruction. The current diagnosis of HSCR is based on Rectal Suction Biopsies (RSBs), which could be complex in newborns. Occasionally, there is a delay in diagnosis that can increase the risk of clinical complications. Consequently, there is room for new non-invasive diagnostic methods that are objective, more logistically feasible and also deliver a far earlier base for a potential surgical intervention. In recent years, microRNA (miRNA) has come into the focus as a relevant early marker that could provide more insights into the etiology and progression of diseases. Therefore, in the search of a non-invasive HSCR biomarker, we analyzed miRNA expression in urine samples of HSCR patients. Results from 5 HSCR patients using microarrays, revealed hsa-miR-378 h, hsa-miR-210-5p, hsa-miR-6876-3p, hsa-miR-634 and hsa-miR-6883-3p as the most upregulated miRNAs; while hsa-miR-4443, hsa-miR-22-3p, hsa-miR-4732-5p, hsa-miR-3187-5p, and hsa-miR-371b-5p where the most downregulated miRNAs. Further search in miRNAwalk and miRDB databases showed that certainly most of these dysregulated miRNAs identified target HSCR associated genes, such as RET, GDNF, BDNF, EDN3, EDNRB, ERBB, NRG1, SOX10; and other genes implied in neuronal migration and neurogenesis. Finally, we could also validate some of these miRNA changes in HSCR urine by RT-qPCR. Altogether, our analyzed HSCR cohort presents a dysregulated miRNA expression presents that can be detected in urine. Our findings open the possibility of using specific urine miRNA signatures as non-invasive HSCR diagnosis method in the future.

Isolation and Characterization of Klebsiella pneumoniae from Urinary Tract Infections: A Comparative Study of Diagnostic Methods

Background: Urinary tract infections (UTIs) are a significant public health concern, and Klebsiella pneumoniae is a common cause of these infections. The rise of antibiotic resistance among K. pneumoniae strains necessitates accurate and timely identification for effective treatment. Aim: This study aimed to isolate and identify K. pneumoniae from urine samples of patients with UTIs. It also sought to evaluate the effectiveness of different diagnostic methods, including phenotypic, biochemical, Vitek 2, and molecular techniques. Method: The study was conducted between August 2023 and November 2024 in Babylon province, Iraq, encompassing both public and private healthcare facilities. A total of 100 urine samples were collected from patients with UTIs, covering a diverse range of age groups and both sexes. The study employed a combination of diagnostic approaches. Phenotypic and biochemical tests were performed for initial identification. The Vitek 2 automated system provided rapid and accurate identification. Molecular identification was carried out using PCR amplification of the 16S rRNA gene. Results: K. pneumoniae was isolated from 12% of the urine samples. The highest prevalence was observed in the 10-30-year age group, and females had a higher incidence compared to males. All isolates were successfully identified using all diagnostic methods employed in the study. Conclusion: The study demonstrated the significant role of K. pneumoniae in causing UTIs in the studied population. The findings highlight the importance of utilizing a combination of diagnostic approaches for accurate and timely identification of this pathogen, which is crucial for effective treatment and infection control.

Distribution and antifungal susceptibility of Candida species causing vulvovaginal candidiasis and urinary tract infection in Medlatec healthcare system, Ha Noi city, Vietnam in 2023.

Vulvovaginal candidiasis and urinary tract infections caused by Candida are common diseases. While the most common causative agent is C. albicans, other species, such as non-C. albicans, can also be responsible. Susceptibility to antifungal drugs varies among Candida species, but there is very limited information available from Vietnam. To determine the species distribution and antifungal susceptibility patterns of Candida isolated from urine and vaginal samples of patients tested at the Medlatec healthcare system in 2023. Cross-sectional study. The study describes a cross-sectional analysis of over 102 Candida isolates obtained from urine and vaginal samples of patients using the testing services at Vietnam Medlatec healthcare system from January to December 2023. Species identification of Candida isolates was performed using germ tube test and Vitek® 2 systems. Antifungal susceptibility testing was carried out using the VITEK® 2 card for yeast fungi. Minimum inhibitory concentrations for these isolates were classified according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27M44S-ED3). In this investigation, five different Candida species were identified. Among these isolates, C. albicans (78.43%) was the most frequent, followed by C. tropicalis (11.76%), C. glabrata (4.91%), C. parapsilosis (1.96%), and C. krusei (0.98%). The resistance rates to fluconazole, voriconazole, caspofungin, micafungin, and amphotericin B were 7.7%, 4.2%, 4.0%, 1.0% and 1.0%, respectively. The most common species found in this population was C. albicans. Our findings also showed a high frequency of non-albicans Candida species causing fungal urinary tract infections. The resistance rates of isolated Candida strains to echinocandins and amphotericin B were low, while some strains were found to be resistant to fluconazole and voriconazole.

Prognostic Correlation of Basic Fibroblast Growth Factor and Vascular Endothelial Growth Factor with Radiological Tumor Size in Pediatric Nephroblastoma and Neuroblastoma: A Prospective Study.

Angiogenesis plays an important role in the growth, progression, and metastasis of solid tumors. Basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF); both are potent angiogenic factors implicated with the growth and metastasis of solid tumors mostly in adult studies. Rapidly growing and large-size tumors have a positive correlation with these factors which are measured in serum and urine samples of patients. There is little literature available for pediatric patients that compare the computed tomography findings (size) of pediatric solid tumors with serum VEGF and serum/urinary bFGF.This prospective study aims to determine the correlation of serum VEGF and serum/urinary bFGF with the size of common pediatric solid tumors (nephroblastoma and neuroblastoma [NB]) to determine its diagnostic and prognostic significance. A prospective case-control study was done for 3 years (December 2020 to November 2023) at our institute. All children aged 1 day to 18 years admitted with the diagnosis of NB and nephroblastoma (Wilms' tumor [WT]) were included after parental consent. The control group includes children of varying ages without any malignancy. Blood and urinary samples were collected at admission before or a week after the biopsy and the level of bFGF and VEGF was analyzed with the ELISA method. Triple-phase computed tomographies along with recommended evaluation were performed according to the tumor as per international standard protocols. Appropriate statistical analyses were done. A total of 30 patients were included in the cohort, of which 13 patients were with the diagnosis of WT. Only 7 patients had metastatic disease. All the patients were treated with neoadjuvant chemotherapy, surgery, and radiotherapy according to their presentation and tumor stage. Both the growth factors, i.e., VEGF (median value - 314.38 pg/mL) and bFGF (median value - 18.96 pg/mL), are elevated in all the tumor patients in comparison with the controls (median VEGF - 100.51 pg/mL and bFGF - 15.6 pg/mL). When compared with the tumor size, no significant associations are found (with VEGF P - 0.40 and with bFGF P - 0.44). Although no satistically significant correlations were found between serum/urinary levels of bFGF and VEGF with tumor size, this study showed the raised median serum value of bFGF and VEGF in patients with NB and WT in comparison to controls and provided the rationale to explore this issue on a larger group of patients.