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Nanotechnology has been manufactured from medicinal plants to develop safe, and effective antischistosmal alternatives to replace today's therapies. The aim of the study is to evaluate the prophylactic effect of ginger-derived nanoparticles (GNPs), and the therapeutic effect of ginger aqueous extract, and GNPs on Schistosoma mansoni (S. mansoni) infected mice compared to praziquantel (PZQ), and mefloquine (MFQ). Eighty four mice, divided into nine different groups, were sacrificed at 6th, 8th, and 10th week post-infection (PI), with assessment of parasitological, histopathological, and oxidative stress parameters, and scanning the worms by electron microscope. As a prophylactic drug, GNPs showed slight reduction in worm burden, egg density, and granuloma size and number. As a therapeutic drug, GNPs significantly reduced worm burden (59.9%), tissue egg load (64.9%), granuloma size, and number at 10th week PI, and altered adult worm tegumental architecture, added to antioxidant effect. Interestingly, combination of GNPs with PZQ or MFQ gave almost similar or sometimes better curative effects as obtained with each drug separately. The highest therapeutic effect was obtained when ½ dose GNPs combined with ½ dose MFQ which achieved 100% reduction in both the total worm burden, and ova tissue density as early as the 6th week PI, with absence of detected eggs or tissue granuloma, and preservation of liver architecture. GNPs have a schistosomicidal, antioxidant, and hepatoprotective role. GNPs have a strong synergistic effect when combined with etiological treatments (PZQ or MFQ), and significantly reduced therapeutic doses by 50%, which may mitigate side effects and resistance to etiological drugs, a hypothesis requiring further research. We recommend extending this study to humans.

In developing countries, the prevalence of intestinal parasitic infection is still significant, particularly due to geographical and socioeconomic variables. The objective of this study was to map the distribution pattern of intestinal parasitic infection in a cohort of the Egyptian population, as well as to assess associated risk factors. A cross-sectional hospital-based study was conducted on 386 patients. A single fecal specimen was collected from the study individual and examined microscopically for the detection of parasitic infection. DNA was extracted from all samples and utilized to amplify Entamoeba histolytica complex species , Cryptosporidium species, Giardia intestinalis assemblages, and Blastocystis species using PCRs. Typing of Cryptosporidium species and Giardia intestinalis assemblages was performed using restriction enzymes RasI and HaeIII respectively. While Blastocystis spp. subtypes (ST) were identified through sequencing of PCR products and phylogenetic analysis. 59.6% (230/386) of the study patients were infected with one or more intestinal parasites, 87.4%; 201/230 of patients had mono-parasitic infections, and 12.6%; 29/230 had multiple-parasitic infections ( P  < 0.0001). The predominant protozoa were Blastocystis , followed by Entamoeba histolytica complex, and Giardia intestinalis both as mono-parasites and as part of multiple parasites. Molecular assays showed that Blastocystis ST3, Entamoeba dispar , Giardia intestinalis assemblage B, and Cryptosporidium hominis were the most prevalent species. Intestinal parasitic infection was significantly associated with age, gender, residence, and water source. Multi-parasitism showed that residency in a rural area was a risk factor (OR 4.49; 95% CI 1.51–13.37; P  = 0.007). Egyptians residing in rural areas have a high prevalence of intestinal multi-parasitism. Therefore, to lessen the prevalence and effects of these infections in this group, effective and sustainable control methods, providing health education focusing on good personal hygiene habits, and providing a safe drinking water supply should be implemented.

The biocompatible hybrid Zeolitic imidazolate framework-8 (ZIF-8)/structured silica nanocomposite can be loaded with antioxidants such as curcumin and resveratrol to offer multiple advantages of drug functionalization and structural stability. blastocystosis, an enteric parasite, has various outcomes and its treatment includes drugs which have side effects and do not result in a full cure. We aimed to design novel biocompatible nanocomposites containing natural antioxidant, resveratrol or curcumin and ZIF-8/mesoporous silica. We also assessed their anti- blastocystosis activities as bioactive novel nanocomposites. The nano-silica (MCM-41 and KIT-6) was synthesized using a hydrothermal technique and made composite with ZIF-8 using an ultrasonic technique. The antioxidants, curcumin and resveratrol, were loaded over ZIF-8/MCM-41 and ZIF-8/KIT-6 using a rotary evaporator technique to form novel nanocomposites with bioactive properties. The formulated nanocomposites were characterized. To test their biological activity, suspension of cultured blastocystosis cysts (subtype 3) were exposed to increasing concentrations of nanocomposites and the minimal lethal concentration of each nanocomposite was calculated. The bioactive nanocomposites (ZIF-8/KIT-6, ZIF-8/KIT-6/Resveratrol and ZIF-8/MCM-41/Curcumin) were formulated. Anti- blastocystosis activity of the tested nanocomposites was both dose and time dependent. ZIF-8/KIT-6/Resveratol showed the maximum percentage of growth inhibition (~ 100%) at a concentration of 500 µg/ml after 5 h of exposure. More than 90% of blastocystosis cysts’ growth was significantly inhibited at all concentrations of ZIF-8/MCM-41/Curcumin, with different times of exposure, while it occurred only at the highest concentration of ZIF-8/KIT-6 (800 µg/ml). Using cheap, simple, reproducible and scalable techniques, we nano-formulated innovative bioactive nanocomposites, by incorporating the bioactive ZIF-8 (Zn 2+ with imidazole), structured mesosilica and natural antioxidant compounds, curcumin or resveratrol, to generate multifunctional modalities. These eco-friendly, naturally based, safe, economical, biocompatible, and bioavailable nanocomposites are potential nanotherapeutics. The anti- blastocystosis results of these three nanocomposites indicate their potentially promising innovative and safe use as alternative Blastocystosis therapies.

During the coronavirus disease 2019 lockdown period, a surge in sandflies and cutaneous leishmaniasis (CL) cases was observed in Al-Ahsa, Saudi Arabia. Skin punch biopsies were obtained from 100 patients clinically diagnosed with CL in Al-Ahsa who had no travel history in the last 6 months. Impression smears were used following a three-step polymerase chain reaction (PCR) protocol using genus-specific primers targeting kDNA and ITS1. Leishmania speciation was determined by ITS1 PCR/nested PCR-restriction fragment length polymorphism and sequencing. A phylogenetic tree was constructed. The associated patient characteristics were analyzed. Using internal transcribed spacer one (ITS1)-PCR/nested PCR, 98 cases were considered true-positive CL. Leishmania major was the predominant species, and Leishmania tropica was identified in three cases. Microscopy had poor sensitivity and perfect specificity. Direct ITS1-PCR missed nine cases. Sex, residence, and treatment outcome were significantly associated with the occurrence of Leishmania ; distribution of skin lesion(s) and treatment outcome were significantly associated with Leishmania genotype. This is the first time that L. tropica was identified as a cause of CL in human in Al-Ahsa, in addition to the predominant zoonotic species, L. major . We recommend using ITS1-nested PCR for negative cases by ITS1-PCR. Further exploration of Leishmania transmission dynamics in vectors and reservoir animals is essential for designing effective preventive measures.

Background and Objectives: Catheter-associated urinary tract infections (CAUTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing and carbapenem-resistant Enterobacterales (CRE) significantly contribute to global rates of UTI. This study aimed to compare the prevalence and trends of ESBL-producing Enterobacterales and CRE in patients with CAUTIs and non-CAUTIs. Materials and Methods: A retrospective review of 4262 UTI-positive urine cultures was conducted at King Fahad Hospital of the University, Al Khobar, Saudi Arabia (January 2022–November 2023). Demographic, clinical, and microbiological data were obtained from hospital records. Antimicrobial susceptibility was tested using the Vitek® System; ESBL and CRE were identified using Ezy MIC™ strips and Xpert® Carba-R assay, respectively. Results: ESBL-producing Enterobacterales accounted for 11.3% of cases; CRE comprised 1.8%. ESBL was significantly more prevalent in non-catheterized patients and those in emergency care. CRE was significantly associated with catheterized patients and inpatient settings. Escherichia coli and Klebsiella pneumoniae were the predominant ESBL-producing and CRE isolates, respectively. bla-OXA-48 was the most frequently detected carbapenemase gene (66.7%). ESBL was prevalent in younger, non-catheterized females, suggesting increasing community transmission. Conversely, CRE were primarily observed in older, catheterized inpatients, emphasizing the role of invasive devices in resistance spread. Conclusions: These findings highlight the importance of targeted infection control and early catheter removal to mitigate resistance trends.

Blastocystis is a unicellular eukaryote found in the gastrointestinal tract of both human and other animal hosts. The clinical significance of colonic Blastocystis colonization remains obscure. In this study, we used metabarcoding and bioinformatics analyses to identify differences in stool microbiota diversity between Blastocystis-positive and Blastocystis-negative individuals (n = 1285). Alpha diversity was significantly higher in Blastocystis carriers. At phylum level, Firmicutes and Bacteroidetes were enriched in carriers, while Proteobacteria were enriched in non-carriers. The genera Prevotella, Faecalibacterium, Flavonifracter, Clostridium, Succinivibrio, and Oscillibacter were enriched in carriers, whereas Escherichia, Bacteroides, Klebsiella, and Pseudomonas were enriched in non-carriers. No difference in beta diversity was observed. Individuals with Blastocystis-positive stools appear to have gut microbiomes associated with eubiosis unlike those with Blastocystis-negative stools, whose gut microbiomes are similar to those associated with dysbiosis. The role of Blastocystis as an indicator organism and potential modulator of the gut microbiota warrants further scrutiny.

Travel-associated malaria is a health hazard, even in non-malaria endemic regions. This is a hospital-based retrospective study of 12,931 febrile patients who presented at King Fahad Hospital of the University (KFHU) from January 2009 to December 2019. Patients either returning from malaria endemic countries and/or for whom malaria was suspected, had blood films microscopically screened for malaria parasites. Malaria prevalence was very low in febrile patients attending KFHU. Out of the 12,931 febrile patients, 0.63% (n = 81) were malaria positive, all travel-related, except for one case of transfusion malaria. Indian nationals were the most infected (29.6%, n = 24), followed by Sudanese nationals (24.7%, n = 20). P. falciparum (47%, n = 38) and P. vivax (42%, n = 24) were the predominant species. The majority of P. falciparum (64.5%, n = 20) cases were from African nationals and the majority of P. vivax (72.7%, n = 24) cases were from Asia. The highest percentage of malaria patients were adult (90%, n = 73), males (85.2%, n = 69), ages ranged from 6 to 65, with a mean of 34.6 years. Most of the malaria cases presented at the emergency room (ER), only 3 required critical care. Only sex, hospitalized in-patient (IP) and attendance at ER were statistically associated with malaria. In the presence of a potential vector, travel-associated malaria in non-malaria endemic areas should be monitored to guide control strategies. Author summary: Malaria is a neglected potentially fatal tropical mosquito-born disease. Travel-associated malaria is a health hazard, even in non-malaria endemic regions. In spite of previous efforts to estimate malaria prevalence, morbidity and mortality in Saudi Arabia in the last decade, there have been no studies that determine the prevalence of malaria in Al-Khobar, Eastern Province of Saudi Arabia. Malaria prevalence was very low in febrile patients (81/12,931) attending King Fahad Hospital of the University over a decade. Cases were all travel-related, except for one case of transfusion malaria. Indian nationals were the most infected (29.6%), followed by Sudanese nationals (24.7%). P. falciparum (47%) and P. vivax (42%) were the predominant species. The majority of P. falciparum (64.5%) cases were from Africa and the majority of P. vivax (72.7%) cases were from Asia. No patient factors predicted malaria in febrile travelers. In non-malaria endemic areas, in the presence of a potential vector, patients with acute fever coming from endemic areas or having received blood transfusion, should be screened for travel-associated malaria to guide control strategies.

Background and Objectives: Despite extensive research on the sources and transmission pathways of Hospital-Acquired Infections (HAIs), the role of cleaning staff as potential vectors has been under-explored. This study addresses the gap by examining the cleaning staff’s role in nosocomial infection transmission, focusing on pathogenic bacteria and fungi colonization. Identifying potential pathogens harbored by cleaning staff that carry the risk of causing HAIs, especially methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae. Materials and Methods: This current cross-sectional study was conducted on 96 cleaning staff at King Fahad Hospital of the University and Family and Community Medicine-Centre, Eastern Province, Saudi Arabia. Sample collection targeted hands and nostrils using cotton swabs, followed by laboratory testing, including MALDI-TOF mass spectrometry for bacterial identification, and the cefoxitin disc diffusion test for the screening of MRSA. Results: In total, the occurrence of MRSA colonization was 9.4% while Enterobacteriaceae colonization was 15.6%. No significant correlation was found for MRSA among departments or between day and night shifts. Alternatively, individuals working in the ICU and the operating room showed higher chances of being colonized by Enterobacteriaceae, and a notable connection was identified between Enterobacteriaceae and day shifts. Ultimately, the frequency of handwashing reduced the chances of being colonized by MRSA and Enterobacteriaceae, underscoring the significance of good hygiene practices. Conclusions: The study highlights the potential role of cleaning staff in transmitting HAIs, indicating a need for further research and consideration of enhanced hygiene protocols in hospital settings.

The genus Acanthamoeba is a free-living amoeba widely distributed in various aquatic environments. It is an etiologic cause of amoebic encephalitis and keratitis particularly for immunocompromised individuals. The purpose of the present study was to investigate Acanthamoeba species prevalence in household and hospital potable water in Beni-Suef governorate, Egypt, and to employ sequencing methods to identify positive Acanthamoeba species isolates and their potential health risks. Sixty tap water samples (30 household and 30 governmental and private hospital settings) collected from Beni-Suef governorate, Egypt were filtered, cultured on non-nutrient agar, identified by morphotyping keys after staining with Giemsa stain and then confirmed by PCR using Acanthamoeba specific primers. Twenty positive samples were successfully genetically characterized and phylogenetically analyzed to identify Acanthamoeba species. The total detection rate for Acanthamoeba was 48/60 (80%); Acanthamoeba contamination in water collected from domestic houses was higher than in hospitals; 27/30 (90%) versus 21/30 (70%) with statistical significant value (P value = 0.05). Sequencing of 20 positive isolates revealed Acanthamoeba T4 in 65% and T2 in 35%. To our knowledge, this is the first research that documents the occurrence and phylogeny of Acanthamoeba species in Beni-Suef, Egypt. The presence of a higher percentage of Acanthamoeba species in tap water, in particular T4, highlights the potential health hazards for immunocompromised individuals and emphasizes the urgent need for the implementation of effective filtration and disinfection measures.

Background Diagnosis of schistosomiasis depends mainly on stool or urine microscopy for Schistosoma egg detection as well as immunoassays. The low sensitivity of these conventional tests makes molecular detection the diagnostic method of choice. The study aimed to detect the molecular prevalence of urine schistosomiasis and evaluate microscopic examination vs. PCR technique for detection of Schistosoma haematobium ( S. haematobium ) in urine of patients with suggestive symptoms or previous history of urine schistosomiasis coming from endemic regions. Results This cross-sectional study was performed on eighty patients attending the urology clinic of Sohag University Teaching Hospital from August 2016 to July 2018. Socio-demographic data and clinical data were collected. Urine samples from all study individuals were collected and examined microscopically for S. haematobium eggs as well as detection of S. haematobium DNA of using PCR assay . Microscopic examination and PCR were positive among (68.8%) and (87.5%) of cases, respectively. There was 60% agreement between microscopy and molecular assay. Microscopy was a good test to rule in cases of urine schistosomiasis, with 100% specificity and 100% PPV, but was of limited sensitivity (NPV = 40%) and missed 12.5% of positive cases. Among studied patient variables, only hematuria showed association with urine schistosomiasis with statistical significance. Conclusion Urine schistosomiasis was highly prevalent in studied population. Considering the high sensitivity and specificity of PCR, it should be implemented as the test of choice, especially in chronic urinary schistosomiasis with low infection setting. In our study population, patients presenting hematuria were likely to have S. haematobium .