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The emergence of hypervirulent and carbapenem-resistant Klebsiella pneumoniae poses a significant threat to the public health of both cats and their owners. Therefore, conducting molecular characterization and phylogenetic analysis of K. pneumoniae strains in both cats and humans in Egypt is crucial. 108 feline and 101 human urine samples were collected and subjected to routine microbiological isolation and molecular identification of K. pneumoniae . Subsequently, phenotypic antimicrobial sensitivity patterns and molecular identification of classical virulence, hypervirulence, and carbapenem resistance genes were examined. A total of 46 K. pneumoniae isolates were recovered, comprising 43.4% (23 out of 53) from diseased humans, 4.17% (2 out of 48) from healthy humans, 22.95% (14 out of 61) from diseased felines, and 14.89% (7 out of 47) from healthy felines. The detection rates for narrow drug-resistant (NDR), multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan drug-resistant (PDR) strains were 41.30%, 54.35%, 2.17%, and 2.17%, respectively. The distribution rates for mrKD , entB , K2 , Kfu , and MagA genes were 76.1%, 82.6%, 8.7%, 13.0%, and 0%, respectively. In addition, the distribution of hypervirulence genes was 41.3%, 36.9%, 13.0%, 10.9%, and 17.4% for iucA , iroB , Peg344 , rmPA , and rmPA2 , respectively, and 43.5%, 30.4%, 19.6%, and 52.2% for NDM , OXA-48 , VIM , and KPC resistance genes, respectively. Phylogenetic analysis of the entB gene from four recovered strains revealed a relationship between feline strains and other human strains. In conclusion, this study focused on the molecular characterization and phylogenetic analysis of hypervirulent and carbapenem-resistant K. pneumoniae in companion cats and humans in Egypt.

Timely diagnosis is essential for managing feline panleukopenia (FPL), a devastating disease of cats caused by feline parvovirus (FPV) or canine parvovirus variants (CPV-2a, -2b, -2c). To support swift clinical decisions, point-of-care (PoC) antigen kits offer frontline tools. Given their cost and availability advantages, CPV-specific kits are often used off-label in cats; however, their interchangeability with manufacturer-matched FPV-specific kits remains unverified. This study assessed the diagnostic agreement between paired canine- and feline-specific PoC parvovirus antigen tests from two manufacturers. Fifty cats (30 with acute gastroenteritis, 20 healthy) were tested using all test formats. All cats underwent PCR and sequencing for parvovirus typing. Tests from the same manufacturer showed near-perfect or perfect agreement for result interpretation (Cohen's κ: 0.919 and 1.000). This strong inter-kit concordance also extended to test line intensity (  = 0.908 and 1.000). Antigen-positive results were limited to diseased cats, mirroring the distribution of PCR positives. The latter included all the 30 cases, and were typed by sequencing as follows: 28 FPV, 1 CPV-2a, and 1 CPV-2c. All kit types detected FPV and CPV variants, and agreement within each manufacturer's paired kits was consistent across detected viral types. This preliminary evidence suggests that for two manufacturers, CPV antigen tests were non-inferior to their FPV counterparts, supporting flexible, cost-effective FPL diagnosis in cats, regardless of implicated parvovirus types.

Background Feline parvovirus (FPV) causes feline panleukopenia (FPL) and cerebellar ataxia (CA) in cats. to date, only two complete Egyptian VP2 sequences have been available in GenBank. To investigate FPV diversity And evolution in Egypt, we generated 24 complete VP2 sequences from diseased cats during two FPV activity peaks in 2023 (January-February and November-December). Egyptian sequences were Analyzed with 967 global references to assess selection pressure and phylogenetic relationships. In silico predictions of VP2 Antigenic sites, 3D structure, and phosphorylation potential were performed to evaluate the impact of identified mutations. Results Egyptian sequences showed 99.3–100% nt And 99.8–100% aa identity among themselves, And 98.6–100% nt And 98.4–100% aa identity with global references. The overall dN/dS ratio was 0.121, with codon 101 under positive selection. Compared to the prototype FPV-b strain (M38246), Egyptian strains had 32 mutations (3 nonsynonymous: Ala5Thr, Ile101Thr, and Thr390Ala; 29 synonymous), forming 19 nt And 3 aa sequence types. Notably, Thr390Ala was unique to Egyptian sequences and absent from all global references. Phylogenetically, Egyptian strains formed two subclades: one composed solely of sequences carrying Thr390Ala ( n  = 13), And Another including the remaining 11 sequences clustering with 19 global strains sharing the synonymous mutation C135T in addition to A927G and/or A1236G. The Thr390Ala variant predominated in the first peak (11/17, 64.7%) but declined in the second (2/7, 28.6%). Residue 390 lies within an epitope-rich region (aa 350–450) and was predicted to be a phosphorylation site. Thr390Ala caused a modest drop in epitope score, disrupted local hydrogen bonding, and abolished predicted phosphorylation. Conclusions Beyond expanding the global dataset with the largest number of Egyptian full-length VP2 sequences to date, this study highlights the Thr390Ala mutant as a classic example of evolutionary trade-off: it emerged and predominate during the first peak, potentially as an immune escape variant, but declined in the second peak, likely due to structural constraints and competition with fitter variants. Despite strong purifying selection, this case illustrates that FPV evolution is not entirely static. This underscores the need for continuous genetic monitoring to capture viral evolution in real time and inform effective control strategies.

The main objective of this study is to investigate the antibacterial activity of silver nanoparticles (AgNPs) against multidrug-resistant  isolates recovered from diarrheic  sheep and goats. This study used chemical reduction synthesis of AgNPs to evaluate their antimicrobial effects by estimation of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for each isolate using the microplate dilution method and tetrazolium salt reduction test to detect the viability percentage. In vivo treatment efficacy was assessed in mice by determining the viable count of Enteritidis recovered from feces and by hematologic, biochemical and histopathologic examinations to confirm that use of AgNPs has no toxic or pathologic effects and to evaluate its ability in tissue regeneration following treatment. All recovered strains were identified as MDR with a prevalence of 4% and 3.6% in sheep and goats, respectively. The results of TEM, DLS, Zeta potential, and FTIR revealed typical characteristics of the synthesized AgNPs. Silver nanoparticles showed antibacterial activity against all recovered strains with MIC of ≤0.02-0.313 μg/mL (mean average 0.085±0.126 μg/mL) and MBC of 0.078-1.250 μg/mL (average 0.508±0.315 μg/mL). In vivo efficacy of AgNPs was observed by a reduction in the number of viable . Enteritidis recovered from feces in an . Enteritidis infected mouse model, with complete shedding stopping between treatment days 4 and 6. Hematologic, serum biochemical, and histopathologic analyses proved the ability of AgNPs to suppress inflammatory reaction caused by . Enteritidis infection. The study proved the effective ability of AgNPs to fight MDR spp. in vitro and in vivo without adverse effects.

ABSTRACT A cross sectional survey study aimed to: 1) Identify the management factors associated with the occurrence of salmonellosis in some diarrheic sheep and goats belonging to mixed reared flocks in Giza governorate, Egypt, 2) Investigate the presence of enterotoxin (stn) gene in the recovered Salmonella spp. strains, and 3) Build a phylogenetic tree for the partial codon sequence of stn gene of some recovered strains in order to provide a scientific basis for the implementation of practical preventive measures. A total number of 518 diarrheic sheep and goats belonging to 7 mixed flocks of sheep and goats were enrolled and from which rectal swabs were collected and subjected to culture for Salmonella spp. Enterotoxin (stn) gene was detected using polymerase chain reaction assay (PCR), and the PCR amplicons of nine randomly selected strains were purified, sequenced and deposited in the GenBank. The obtained data about disease occurrence were statistically analyzed using Chi-square test in order to identify disease-associated factors. The overall prevalence of salmonellosis among diarrheic sheep and goats was 3.86%, and the disease prevalence per each flock ranged from 0% to 7.55%. The factors that were found to be associated with disease occurrence included, absence of isolation of newly-purchased animals and isolation pen for sick animals, over the counter use of antimicrobials, lack of disinfection of feeding utensils and water troughs, and presence of rodents in feed storage area. Enterotoxin (stn) gene was detected in all recovered salmonellae, and the phylogenic analysis of stn gene of the selected strains and the retrieved sequences from GenBank showed the relatedness of the isolated strains to the other strains isolated from different sources. Accordingly, the analysis of disease associated factors and the robust phylogeny findings provide valuable data that will be useful for implementation of preventive measures for salmonellosis in small ruminants.

The emergence of multidrug-resistant (MDR) Salmonella spp. has increased the need for investigation of antimicrobial alternatives. Ethanolic extract of propolis (EEP) has been identified to have wide-ranging medical applications related to its antimicrobial activity. The current study aimed to identify the major chemical components of EEP with antibacterial effects, evaluate the antibacterial efficacy of EEP against MDR Salmonella spp. isolates, and further examine the therapeutic efficacy of EEP against MDR S. Enteritidis infected mouse model. Bulgarian propolis EEP was prepared by using ethanol based extraction method. The chemical composition of EEP was characterized using the gas chromatography-mass spectroscopy (GC-MS). The in-vitro antibacterial activity of EEP against 20 isolates of MDR Salmonella spp. was investigated. Furthermore, the minimum inhibitory concentration (MIC) and minimum bactericidal concentrations (MBC) of EEP were determined along with in vivo therapeutic efficacy with reference to hematobiochemical and histological analyses. The main identified compounds belonged to flavonoids, aromatic acids, and esters which may be attributable to its antibacterial activity. Antimicrobial efficacy of EEP was detected against all isolates with variable bactericidal to bacteriostatic efficacy and with an MIC of <0.012-6.250 mg/ mL (mean 1.294 ± 1.557) and an MBC of 1.563-12.50 mg/mL (mean 4.531 ± 2.678). A therapeutic efficacy against S. Enteritidis was also determined. Statistical analyses for hematological and serum biochemical tests have showed a significant increase due to infection effect in band neutrophil counts, eosinophil counts and serum alanine aminotransferase (ALT) levels in comparing two infected groups with two non-infected groups; simultaneously, there was no significant difference in between both infected groups and in between both non infected groups whereas the results were significant at (p value<0.05). As well as, there was no any evidence of significance regarding neither treatment nor infection·treatment interaction effects. In infected groups, histological examination of the liver revealed degenerative changes in hepatocytes; these changes had almost disappeared in the EEP-treated group. The current study demonstrated a potential therapeutic effect of Bulgarian propolis ethanolic extract on clinically recovered antibiotic-resistant S. Enteritidis from diarrheic goat, and the results herald a promising supplementary therapy of EEP during resistant Salmonella infection.

BackgroundIn Egypt, chronic hepatitis C virus (HCV) is the most prevalent cause of hepatocellular carcinoma (HCC). The study aims to evaluate the percutaneous radiofrequency ablation (RFA) efficacy as monotherapy in intermediate versus early-stage treatment of HCC.MethodsThe present study was a single-center, prospective non-randomized, controlled clinical trial in the Interventional Ultrasonography Unit, Tropical Medicine Department, Beni-Suef University Hospitals, between October 2018 and August 2021. Abdominal ultrasonography and triphasic computerized tomography (CT) abdomen were used to diagnose HCC. The abdominal ultrasonography and a dynamic CT scan were performed six weeks following the ablation to assess treatment efficacy.ResultsWe have enrolled 120 participants in our clinical trial, 72 (60%) had the intermediate-stage-HCC, and 48 (40%) had the early-stage-HCC. The majority of the participants were males, 78 (65%). The early-stage-HCC patients had only Child-Pugh Score A (n = 48), while the intermediate-stage-HCC patients had both Child-Pugh Score A (n = 56) and B (n = 16). HCC stages, age, the total size of the tumour, number of tumours, serum albumin, platelets count, Platelet-Albumin-Bilirubin (PALBI) score, pre, and post-treatment alpha-fetoprotein (AFP) were the significant predictors of treatment response (p-value ≤ 0.05). The odds ratio for pre and post-treatment AFP were less than one [OR = 0.99, 95% CI (0.995–0.999)] and [OR = 0.99, 95% CI (0.991–0.998)], respectively, meaning that the lower pre-treatment AFP, the higher the chance of getting a better response to RFA.ConclusionsRFA is an effective and safe monotherapy in treating intermediate-stage as well as early-stage hepatocellular carcinoma.

Background The association between cognitive decline and Helicobacter pylori (H. pylori) infection remains controversial, with some evidence suggesting that H. pylori eradication may slow the progression of the disease. This meta-analysis aims to investigate the bidirectional relationship between H. pylori and cognitive decline. Methods We searched PubMed, Web of Science, the Cochrane Library, and Scopus for double-arm studies that reported either the prevalence of cognitive decline in individuals with H. pylori-positive status or the prevalence of H. pylori infection in patients with cognitive decline. A random-effects meta-analysis was conducted using Comprehensive Meta-Analysis software to pool the odds ratios from the included studies. Study quality was assessed using the Newcastle–Ottawa Scale. Results Our search identified 1,240 records, with 16 studies meeting the inclusion criteria. Meta-analysis showed that patients with H. pylori had a significantly higher risk of cognitive decline (OR = 1.338, 95% CI 1.046–1.713), with the strongest association seen in studies grouping cognitive dysfunction and dementia (OR: 3.190, 95% CI 1.853–5.490). However, the risk of Alzheimer’s disease was insignificant. Cognitive decline cohorts showed a significantly higher prevalence of H. pylori (OR = 1.5, 95% CI 1.131–1.989), with a significant association with Alzheimer’s disease (OR: 1.630, 95% CI 1.064–2.497), but not with dementia or cognitive dysfunction. The association varied across study designs, with cross-sectional studies showing no association in both analyses. Heterogeneity was substantial ( I 2  > 70% in most analyses), highlighting variability in the findings. Conclusion This meta-analysis indicates a bidirectional association between H. pylori and cognitive decline. While H. pylori infection increased the overall risk of cognitive decline, no significant link was found with Alzheimer's disease. Conversely, Alzheimer’s disease patients had a higher prevalence of H. pylori infection. High heterogeneity underscores the need for further well-designed studies to clarify this relationship.

This work was aiming to design novel bio-composite (BC) materials based on microwave-prepared AuNPs-loaded Zeolite-A (ZA-Au) and nano-hydroxyapatite (HA). Ciprofloxacin drug was uploaded onto the BC entities to provide a potential treatment for osteomyelitis. The prepared BCs containing the lowest and highest (10 and 40%) active weight ratios of ZA-Au were prepared and coded as ZA-Au-10 and ZA-Au-40, respectively. The XRD, FTIR, TEM, and SEM supported with EDX technique were used for samples characterization. Both bio-mixtures were able to induce hydroxyapatite layer after immersion into SBF for 15 days. Cytotoxic evaluation of all prepared materials indicated their safe and nontoxic nature. Both BCs showed significant improvement in their drug release profiles and rates, compared to either parent constituents (HA or ZA-Au). The total cumulative amounts of released antibiotic from ZA-Au-10 and ZA-Au-40 were 1.324 ± 0.21 and 1.218 ± 0.13 mg, respectively. The application of the Higuchi square root model on the drug release profiles for both BCs specified the diffusion-controlled manner for the drug elution. This novel BC will combine the high bioactivity of the nano-HA with the given strength and defined porosity of the zeolite structure, to help effectively in delivering the drug in a regular and prolonged manner. Overall, the formed novel bio-composites are cost-effective and proved to be highly efficient as a controlled drug delivery system for ciprofloxacin.

Postoperative delirium is common in elderly patients after orthopedic surgery. While pharmacological interventions often prove ineffective and are associated with significant adverse effects, non-pharmacological strategies targeting modifiable risk factors show promise. This systematic review evaluates perioperative non-pharmacological interventions for preventing postoperative delirium in elderly adults undergoing total knee or hip arthroplasty. This systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Five electronic databases were searched for randomized controlled trials and observational studies examining non-pharmacological interventions to prevent postoperative delirium in patients aged 60 years or older undergoing total knee or hip arthroplasty. Two independent reviewers performed study selection, data extraction, and quality assessment using the Cochrane Risk of Bias tool (RoB 2) for randomized trials and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomized studies. Eleven studies comprising 15,761 patients were included. Postoperative delirium incidence ranged from 0% to 34% across interventions. The fast-track methodology achieved the lowest incidence at 0%, while maintaining 10-20% below baseline showed the highest incidence at 34%. Tourniquet use was associated with higher delirium rates (19.1% vs 9.6%; 15.22% vs 5.43%) and increased pain scores. Comprehensive care protocols reduced delirium incidence (15.9% vs 30.8%) and duration (2.06 vs 3.42 days) compared to conventional care. Fresh frozen plasma transfusion demonstrated a 5.96-fold increased delirium risk. Transcranial direct current stimulation reduced the incidence of delirium from 19.7% to 4.9%. Hospital length of stay ranged from 2.6 days with fast-track methodology to 15 days with suboptimal blood pressure management.  Multimodal non-pharmacological interventions can significantly reduce postoperative delirium in elderly orthopedic surgery patients. Evidence-based strategies include maintaining adequate intraoperative blood pressure, implementing fast-track care pathways, avoiding unnecessary fresh frozen plasma transfusions, and adopting comprehensive care bundles. Standardized delirium prevention protocols should be prioritized in clinical practice to improve outcomes in this vulnerable population.