Diabetes mellitus (DM) and coronavirus disease 2019 (COVID-19) are public health issues worldwide, and their comorbidities trigger the progress to severe disease and even death in such patients. Globally, DM has affected an estimated 9.3% adults, and as of April 18, 2021, the World Health Organization (WHO) has confirmed 141,727,940 COVID-19 confirmed cases. The virus is spread via droplets, aerosols, and direct touch with others. Numerous predictive factors have been linked to COVID-19 severity, including impaired immune response and increased inflammatory response, among others. Angiotensin receptor blockers and angiotensin converting enzyme 2 have also been identified as playing a boosting role in both susceptibility and severity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Specifically, in DM patients, both their control and management during this pandemic is herculean as the restriction periods have markedly hampered the maintenance of means to control glycemia, hypertension, and neuroendocrine and kidney diseases. In addition, as a result of the underlyin cardio-metabolic and immunological disorders, DM patients are at a higher risk of developing the severe form of COVID-19 despite other comorbidities, such as hypertension, also potentially boosting the development of higher COVID-19 severity. However, even in non-DM patients, SARS-CoV-2 may also cause transient hyperglycemia through induction of insulin resistance and/or pancreatic β-cell injury. Therefore, a strict glucose monitoring of DM patients with COVID-19 is mandatory to prevent life-threatening complications.

Background and aim: Recently, the extensive use of quinolones led to increased resistance to these antimicrobial agents, with different rates according to the organism and the geographical region. The aim of this study was to detect the resistance rate of Klebsiella pneumoniae Iraqi isolates toward quinolone antimicrobial agents, to determine genetic mutations in gyrA and parC, to screen for efflux-pump activity, and to screen the presence of plasmid-mediated quinolone resistance (PMQR) genes.

Methods: Forty-three K. pneumoniae isolates were confirmed phenotypically and genotypically by Vitek 2 system and species specific primers by PCR using the targeting rpo gene followed by sequencing. Antibiotic susceptibility test was carried out using disc diffusion method. Quinolone resistant isolates were subjected to ciprofloxacin MIC testing, and cartwheel method to screen for efflux pump activity. The presence of the plasmid mediated quinolone resistance genes qepA, qnrB, qnrS, and aac(6)Ib was tested by PCR. Sequencing of gyrA and parC was performed.

Results: We observed a high rate of resistance to ceftriaxone, gentamicin ciprofloxacin, and levofloxacin. Low rate of resistance was detected against amikacin and azithromycin. Ciprofloxacin MIC results revealed that 96.1% of the isolates had MICs >256 µg/mL, 83.4% had MICs >512 µg/mL while 34.6% had MIC >1024 µg/mL. Testing of isolates against ciprofloxacin mixed with EtBr at various concentrations resulted in decreased resistant. Sequencing results showed that Ser83Leu was the most common mutation in gyrA that was observed in all quinolone resistant isolates, followed by Asp87Asn. Ser80Ile mutation in parC was observed in 77.7% of the tested isolates. The prevalence of PMQR genes was 92.5% aac (6)-Ib, 51.8% qnrB, 40.7% qepA, and 37% qnrS.

Conclusion: Quinolone resistance is common in K. pneumoniae isolates in Baghdad. The frequent mutation in gyrA and parC, and the presence of PMQR genes is alarming.

Background and aim: The poultry meat and its products are considered ideal media for bacterial growth and spoilage, as they are highly nutritive with a favorable pH. The food industry has focused its attention on a great diversity of plant species as food preservatives. The aim of this study was to investigate the presence of Staphylococcus aureus, Escherichia coli O157: H7, and Klebsiella pneumonia in food samples and to evaluate of the antibacterial activity of some medicinal plant extracts against these bacteria.

Methods: Raw and processed meat samples (n = 60) were collected from abattoirs and local markets. S. aureus, E. coli O157: H7, and K. pneumonia were isolated, identified by phenotypic methods, and then confirmed by 16S rRNA gene sequencing. The antibacterial activity and spectrum of essential oils and spices powder of cumin, black seeds, cloves, cinnamon, and marjoram was determined against the isolated strains in this study by microbial count and well-diffusion techniques.

Results: A total of 33 isolates have been identified as S. aureus, 30 isolates were identified as E. coli O157: H7, and 15 isolates were identified as K. pneumonia. S. aureus, E. coli O157: H7, and K. pneumonia could be detected in both fresh and processed food with higher prevalence in the processed meat. There was a significant decrease in microbial count in treated samples either with the spices powder or essential oils of the tested medicinal plants compared to control samples during storage time period. Furthermore, while the microbial count increased in the control samples, the microbial count decreased to reach zero in almost all treated samples with essential oils after 15 days of storage.

Conclusion: S. aureus, E. coli O157: H7, and K. pneumonia are associated with food from animal sources, in either fresh or processed meat samples. The prevalence of them was higher in the processed meat than in fresh meat. The essential oils and spices powder of cumin, black seeds, cloves, cinnamon, and marjoram have an in vitro wide spectrum antibacterial activity with the highest antibacterial activity for the black seeds.

Acinetobacter baumannii is a Gram-negative coccobacillus responsible for severe hospital-acquired infections, particularly in intensive care units (ICUs). The current study was designed to characterize the virulence traits of biofilm-forming carbapenem-resistant A. baumannii causing pneumonia in ICU patients using a Galleria mellonella model. Two hundred and thirty patients with hospital-acquired or ventilator-associated pneumonia were included in our study. Among the total isolates, A. baumannii was the most frequently isolated etiological agent in ICU patients with pneumonia (54/165, 32.7%). All A. baumannii isolates were subjected to antimicrobial susceptibility testing by the Kirby-Bauer disk diffusion method, while the minimum inhibitory concentrations of imipenem and colistin were estimated using the broth microdilution technique. The biofilm formation activity of the isolates was tested using the microtiter plate technique. Biofilm quantification showed that 61.1% (33/54) of the isolates were strong biofilm producers, while 27.7% (15/54) and 11.1% (6/54) showed moderate or weak biofilm production. By studying the prevalence of carbapenemases-encoding genes among isolates, bla_OXA-23-_like was positive in 88.9% of the isolates (48/54). The Bla_NDM gene was found in 27.7% of the isolates (15/54 isolates). Bla_OXA-23-_like and bla_NDM genes coexisted in 25.9% (14/54 isolates). Bap and bla_PER-1 genes, the biofilm-associated genes, coexisted in 5.6% (3/54) of the isolates. For in vivo assessment of A. baumannii pathogenicity, a Galleria mellonella survival assay was used. G. mellonella survival was statistically different between moderate and poor biofilm producers (p < 0.0001). The killing effect of the strong biofilm-producing group was significantly higher than that of the moderate and poor biofilm producers (p < 0.0001 for each comparison). These findings highlight the role of biofilm formation as a powerful virulence factor for carbapenem-resistant A. baumannii that causes pneumonia in the ICU.

Medicinal plants are highly used in the ethnoveterinary practice as considerable livestock resources in remote areas. The aim of the present study is to explore the ethnoveterinary medicinal practices in three different communities and discuss the cross-cultural consensus on the usage of medicinal plants for the treatment of animals. The field survey was conducted by the animal healers of the area during the different seasons of plant growth. A total of 83 informants were interviewed through Semi-structured interview involving experts of traditional knowledge in 21 localities of the three regions (Zhob, D. I. Khan and Mianwali) were conducted. Findings of the study were quantitatively analyzed through the informant consensus factors to identify the homogeneity information provided by the informants. Furthermore, cross-culture consensuses were analyzed and recorded data were represented in a tabulated and Venn diagrams. In particularly, 59 species of plants were documented in the comparative analysis. Among them, 32 plant species were recorded in Pashto community, while Punjabi and Sarakai communities exhibited nine and four plant species, respectively. Whereas cross-cultural analysis showed 14 medicinal plants that were commonly utilized by three different ethnic communities, that indicated low interregional consensus in regard to ethnoveterinary practices of medicinal plants. The current study showed that different communities and ethnic groups sharing some traditional knowledge and cross-culturally approaches have been reported from traditional uses of plants against livestock's diseases. Therefore, current findings are the opportunities to scrutinize the plants for the discovery of new drug sources for humans and animals.

Background: NS5B polymerase inhibitors represent the cornerstone of the present treatment of Hepatitis C virus infection (HCV). Naturally occurring substitution mutations to NS5B inhibitors have been recorded. The current study intended to demonstrate possible natural direct acting antiviral (DAA)-mutations of the HCV NS5B region in HCV patients in Minia governorate, Egypt.

Methods: Samples were collected from 27 treatment-naïve HCV patients and 8 non-responders. Out of 27 treatment-naïve patients, 17 NS5B sequences (amino acids 221-345) from treatment-naïve patients and one sample of non-responders were successfully amplified. Nucleotide sequences have been aligned, translated into amino acids, and compared to drug resistance mutations reported in the literature.

Results: NS5B amino acid sequence analysis ensures several novel NS5B mutations existence (more than 40 substitution mutations) that have not been previously documented to be correlated with a resistant phenotype. It was found that K304R (82.4%), E327D and P300T (76.5% each) substitutions were the most distributed in the tested samples, respectively. S282T, the major resistance mutation that induces high sofosbuvir-resistance level in addition to other reported mutations (L320F/C) and (C316Y/N) were not recognized. Q309R mutation is a ribavirin-associated resistance, which was recognized in one strain (5.9%) of genotype 1g sequences. Besides, one substitution mutation (E237G) was identified in the successfully amplified non-responder sample.

Conclusion: Our study showed various combinations of mutations in the analyzed NS5B genes which could enhance the possibility of therapy failure in patients administered regimens including multiple DAA.

Background: Avian tuberculosis is a chronic and zoonotic disease that affects a wide variety of birds, mammals, and humans. This study aimed to estimate the frequency of Mycobacterium avium subsp. avium in some domestic birds based on molecular diagnosis, antibiogram profile, and PCR-based detection of inhA, rpoB, rpsL, and otrB antibiotic resistance-related genes.

Methods: A total of 120 fecal samples were collected from small flocks of house-reared domestic birds at Ismailia Governorate, Egypt. The collected samples were processed and subjected to the bacteriological examination. The antimicrobial susceptibility testing of the recovered isolates was performed using the broth microdilution method for the detection of minimum inhibitory concentrations (MICs). The genetic detection of the IS901confirmatory gene, inhA, rpoB, rpsL, and otrB genes was carried out using PCR.

Results: The frequency of M. avium subsp. avium was 4.1% (5/120); 10% (4/40) in ducks, and 2.5% (1/10) in geese. The identification of the recovered isolates was confirmed using PCR, where all the tested isolates were positive for IS901confirmatory gene. The results of the broth microdilution method revealed that most of the recovered isolates exhibited multidrug resistance (MDR) to isoniazid, rifampicin, streptomycin, oxytetracycline, and doxycycline, and harbored the inhA, rpoB, rpsL, and otrB genes.

Conclusion: In brief, to the best of our knowledge this is the first report that emphasized the emergence of avian tuberculosis in house-reared domestic birds in Egypt. The emergence of MDR- M. avium subsp. avium is considered a public health threat. Emerging MDR-M. avium subsp. avium in domestic birds are commonly harbored the IS901, inhA, rpoB, rpsL, and otrB genes. Azithromycin and clofazimine revealed a promising in-vitro antibacterial activity against M. avium subsp. avium.

Background: Meat-products are considered an enriched media for mycotoxins. This study aimed to investigate the prevalence of toxigenic Aspergillus species in processed meat samples, HPLC-quantitative measurement of aflatoxin B₁ and ochratoxin A residues, and molecular sequencing of aflR1 and pks genes. One hundred and twenty processed beef meat specimens (basterma, sausage, and minced meat; n = 40 for each) were collected from Ismailia Province, Egypt. Samples were prepared for total mold count, isolation, and identification of Aspergillus species. All samples were analyzed for the production of both Aflatoxin B₁ and Ochratoxin A mycotoxins by HPLC. Molecular identification of Aspergillus flavus and Aspergillus ochraceus was performed using PCR amplification of the internal transcribed spacer (ITS) region; furthermore, the aflR1 and pks genes were sequenced.

Results: The total mold count obtained from sausage samples was the highest one, followed by minced meat samples. The prevalence of A. flavus was (15%), (7.5%), and (10%), while the prevalence of A. ochraceus was (2.5%), (10%), and (0%) in the examined basterma, sausage, and minced meat samples, respectively. Using PCR, the ITS region was successfully amplified in all the tested A. flavus and A. ochraceus strains. Aflatoxin B₁ was detected in six basterma samples (15%). Moreover, the ochratoxin A was detected only in four sausage samples (10%). The aflR1 and pks genes were amplified and sequenced successfully and deposited in the GenBank with accession numbers MF694264 and MF694264, respectively.

Conclusions: To the best of our knowledge, this is the first report concerning the HPLC-Molecular-based approaches for the detection of aflatoxin B₁ and ochratoxin A in processed beef meat in Egypt. The production of aflatoxin B₁ and ochratoxin A in processed meat constitutes a public health threat. Aflatoxin B₁ is commonly associated with basterma samples. Moreover, ochratoxin A was detected frequently in sausage samples. The routine inspection of mycotoxins in processed meat products is essential to protect human consumers.

The need for a reliable risk map in the control of soil-transmitted helminths (STHs) in Kogi East, North Central Nigeria is very important. This study was carried out to determine the effect of environmental risk factors on geospatial distribution of STHs. Epidemiological data were obtained from a district-wide survey conducted in 2018 in Kogi East. Edaphic and climatic factors were downloaded as spatial layers from international recognised health data resources centres. A total of 24 environmental factors were used in determining the risk map of STHs using MaxEnt tool. The predicted high-risk areas of A. lumbricoides, hookworms and S. stercoralis were the central part of Kogi East covering parts of Dekina, Ofu, Igalamela-Odolu, Olamaboro and Omala LGAs with probability of 0.8 to 1.00. Among the factors investigated; Temperature [mean diurnal temperature range (BIO2), temperature annual range (BIO7) and maximum temperature of the warmest month (BIO5)], precipitation [precipitation of the wettest quarter (BIO16)], and soil clay contents were the five factors that exerted most significant influence on the geospatial distribution of STHs in Kogi East, Nigeria. Public health control programmes on STHs should target high-risk areas by including them in mass drug administration, health education as well as provision of water, sanitation and hygiene infrastructures.

Radiotherapy-induced dermatitis (RID) is an inflammatory cutaneous disorder that is acquired as an adverse effect of undergoing radiotherapy. Skin microbiome dysbiosis has been linked to the outcomes of several dermatological diseases. To explore the skin microbiota of RID and deduce their underlying impact on the outcome of RID, cutaneous microbiomes of 78 RID patients and 20 healthy subjects were characterized by sequencing V1-V3 regions of 16S rRNA gene. In total, a significantly apparent reduction in bacterial diversity was detected in microbiomes of RID in comparison to controls. Overall, the raised Proteobacteria/ Firmicutes ratio was significantly linked to delayed recovery or tendency toward the permanence of RID (Kruskal Wallis: P = 2.66 × 10^-4). Moreover, applying enterotyping on our samples stratified microbiomes into A, B, and C dermotypes. Dermotype C included overrepresentation of Pseudomonas, Staphylococcus and Stenotrophomonas and was markedly associated with delayed healing of RID. Strikingly, coexistence of diabetes mellitus and RID was remarkably correlated with a significant overrepresentation of Klebsiella or Pseudomonas and Staphylococcus. Metabolic abilities of skin microbiome could support their potential roles in the pathogenesis of RID. Cutaneous microbiome profiling at the early stages of RID could be indicative of prospective clinical outcomes and maybe a helpful guide for personalized therapy.