Abdel-Gaber, H. M., A. M. Said, H. E. E. Gomaa, R. N. Yousef, R. M. Elmessiery, and M. A. Gad, "TMPRSS2 rs2070788 and rs383510 polymorphisms and laboratory markers as predictors for severity and mortality among COVID-19 patients: A single center study", Microbes and Infectious Diseases, vol. 6, issue 3, pp. 1044-1059, 2025.
Saleh, M. H., M. A. Gad, A. A. El-Kholy, L. Saleh, Z. M. Mostafa, and S. H. Abd-El-Aziz, "Co-Infection with respiratory viruses among critically-ill SARS-CoV2 patients in a tertiary hospital in Egypt: Incidence and effect on patients outcome", Microbes and Infectious Diseases, vol. 5, issue 2, pp. 441-450, 2024.
Soliman, M. S., N. S. Soliman, A. M. Abbas, M. A. Gad, S. M. Khairat, and A. A. El-Kholy, "Drug resistance trends of Mycobacterium tuberculosis before and after the COVID-19 pandemic in an Egyptian Cairo University tertiary-care hospital", Microbes and Infectious Diseases, vol. 5, issue 3, pp. 939-947, 2024.
Soliman, M. S., C. H. Hansen, M. Hanafy, S. Shawky, H. Rashed, M. Abdullah, N. S. Soliman, M. A. Gad, sahar khairat, A. El-Kholy, et al., "Drug resistance and genomic variations among Mycobacterium tuberculosis isolates from The Nile Delta, Egypt.", Scientific reports, vol. 14, issue 1, pp. 20401, 2024. Abstract

Tuberculosis is a global public health concern. Earlier reports suggested the emergence of high rates of drug resistant tuberculosis in Egypt. This study included 102 isolates of Mycobacterium tuberculosis collected from two reference laboratories in Cairo and Alexandria. All clinical isolates were sub-cultured on Löwenstein-Jensen medium and analyzed using both BD BACTEC MGIT 960 SIRE Kit and standard diffusion disk assays to identify the antibiotic sensitivity profile. Extracted genomic DNA was subjected to whole genome sequencing (WGS) using Illumina platform. Isolates that belong to lineage 4 represented > 80%, while lineage 3 represented only 11% of the isolates. The percentage of drug resistance for the streptomycin, isoniazid, rifampicin and ethambutol were 31.0, 17.2, 19.5 and 20.7, respectively. Nearly 47.1% of the isolates were sensitive to the four anti-tuberculous drugs, while only one isolate was resistant to all four drugs. In addition, several new and known mutations were identified by WGS. High rates of drug resistance and new mutations were identified in our isolates. Tuberculosis control measures should focus on the spread of mono (S, I, R, E)- and double (S, E)-drug resistant strains present at higher rates throughout the whole Nile Delta, Egypt.

Gad, M. A., A. A. El-Kholy, and O. M. A. Taher, "Diagnostic role of FilmArray Pneumonia Panel compared to routine microbiological methods to identify pneumonia pathogens.", Microbes and Infectious Diseases,, vol. 4, issue 2, pp. 477– 486, 2023.
Akl, Y. M. K., Y. M. A. Soliman, H. H. Assal, A. G. M. M. A. Abdullah, and et al, "Factors affecting bronchoalveolar lavage cellularity in patients with hypersensitivity pneumonitis.", International Journal of Health Sciences,, vol. 6, issue S7, pp. 1030–1040, 2022.
El-Sokkary, R., S. Uysal, H. Erdem, R. Kullar, A. U. Pekok, F. Amer, S. Grgić, B. Carevic, A. El-Kholy, A. Liskova, et al., "Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: an international ID-IRI survey.", European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, vol. 40, issue 11, pp. 2323-2334, 2021. Abstract

Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile of multidrug-resistant organisms (MDROs) among hospitalized patients with bacteremia in intensive care units (ICUs) in a large geographical area. This is a 1-month cross-sectional survey for blood-borne pathogens in 57 ICUs from 24 countries with different income levels: lower-middle-income (LMI), upper-middle-income (UMI), and high-income (HI) countries. Multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant isolates were searched. Logistic regression analysis determined resistance predictors among MDROs. Community-acquired infections were comparable to hospital-acquired infections particularly in LMI (94/202; 46.5% vs 108/202; 53.5%). Although MDR (65.1%; 502/771) and XDR (4.9%; 38/771) were common, no pan-drug-resistant isolate was recovered. In total, 32.1% of MDR were Klebsiella pneumoniae, and 55.3% of XDR were Acinetobacter baumannii. The highest MDR and XDR rates were in UMI and LMI, respectively, with no XDR revealed from HI. Predictors of MDR acquisition were male gender (OR, 12.11; 95% CI, 3.025-15.585) and the hospital-acquired origin of bacteremia (OR, 2.643; 95%CI, 1.462-3.894), and XDR acquisition was due to bacteremia in UMI (OR, 3.344; 95%CI, 1.189-5.626) and admission to medical-surgical ICUs (OR, 1.481; 95% CI, 1.076-2.037). We confirm the urgent need to expand stewardship activities to community settings especially in LMI, with more paid attention to the drugs with a higher potential for resistance. Empowering microbiology laboratories and reports to direct prescribing decisions should be prioritized. Supporting stewardship in ICUs, the mixed medical-surgical ones in particular, is warranted.

El-Sokkary, R., H. Erdem, R. Kullar, A. U. Pekok, F. Amer, S. Grgić, B. Carevic, A. El-Kholy, A. Liskova, M. Özdemir, et al., "Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey.", Journal of infection and public health, vol. 15, issue 9, pp. 950-954, 2022. Abstract

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases-International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (~5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%-90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs' implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted.

Devrim, I., H. Erdem, A. El-Kholy, A. Almohaizeie, M. Logar, B. A. Rahimi, F. Amer, S. Alkan-Ceviker, M. C. Sonmezer, M. Belitova, et al., "Analyzing central-line associated bloodstream infection prevention bundles in 22 countries: The results of ID-IRI survey.", American journal of infection control, vol. 50, issue 12, pp. 1327-1332, 2022. Abstract

BACKGROUND: Because central line-associated bloodstream infections (CLABSIs) are a significant complication of central venous access, it is critical to prevent CLABSIs through the use of central line bundles. The purpose of this study was to take a snapshot of central venous access bundles in various countries.

METHODS: The participants in intensive care units (ICUs) completed a questionnaire that included information about the health center, infection control procedures, and central line maintenance. The countries were divided into 2 groups: those with a low or low-middle income and those with an upper-middle or high income.

RESULTS: Forty-three participants from 22 countries (46 hospitals, 85 ICUs) responded to the survey. Eight (17.4%) hospitals had no surveillance system for CLABSI. Approximately 7.1 % (n = 6) ICUs had no CLABSI bundle. Twenty ICUs (23.5%) had no dedicated checklist. The percentage of using ultrasonography during catheter insertion, transparent semi-permeable dressings, needleless connectors and single-use sterile pre-filled ready to use 0.9% NaCl were significantly higher in countries with higher and middle-higher income (P < .05).

CONCLUSIONS: Our study demonstrated that there are significant differences in the central line bundles between low/low-middle income countries and upper-middle/high-income countries. Additional measures should be taken to address inequity in the management of vascular access in resource-limited countries.

Elbendary, A., R. Youssef, Abdel-Halim, M. Gad, and M. F. Elmasry, "Role of streptococcal infection in the etiopathogenesis of pityriasis lichenoides chronica and the therapeutic efficacy of azithromycin: a randomized controlled trial.", Archives of Dermatological Research,, vol. 315, issue 3, pp. 521-530 , 2022.
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