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medhat khafagy, A. Mayla, A. Khafagy, M. Gadalla, A. Orabi, W. A. Gawad, N. Baraya, G. Emira, and M. El-Dweik, Drop of post-operative infection after pre-operative vaccination with anaerobic toxoids (a clinical study of 445 patients)., , 2016/04/01. Abstract

Background: After a successful experiment in rats with anaerobic vaccine in combating peritonitis in the model of ceacal ligation and puncture to prevent sudden death, it was decided to undergo a clinical study. Material and methods: 445 patients who underwent major and semimajor operations were vaccinated each with 0.25 mL of covexin 10 before operation. Results: Infection of the wounds occurred in 24 of 445 patients (5.4 %). Infection occurred in 7 of 202 who underwent breast operations, mostly for breast cancer including axillary dissection (3.5 %). Infection occurred in 2 of 50 who underwent major operation for colorectal cancer (4%). 3 of 43 patients who underwent major operation for urinary bladder cancer developed wound infection (7.0%). Other operations for other sites were associated with a low incidence of wound infection compared to historical control. Although, it was a large series of major operations, not a single case developed multiple organ failure syndrome. Discussion: Because of success of anaerobic vaccination in combating post-operative wound infection, we recommend that researchers in this field to start similar clinical trials. Because multiple organ dysfunction syndrome was not encountered in this series, a possible etiology of the syndrome may be due to toxins released from anaerobic sepsis in small bowl. Conclusion: Vaccination with anaerobic vaccine was successful in reducing post-operative wound infection to about half of historical control. Key words: wound infection, anaerobic vaccine, and anaerobic infection. No. S19/P4, page 90, Microbiology Society Annual Conference 2016, Liverpool, UK.

medhat khafagy, A. Mayla, M. Elberry, M. Gadalla, W. Gawad, and M. El-Dweik, SGM Annual Conference 2015 Abstract Book.148, , 2016/03/10. Abstract
medhat khafagy, A. Mayla, A. Khafagy, N. Baraya, G. Emira, M. El-Dweik, W. A. Gawad, M. Gadalla, M. Moneer, M. Elberry, et al., Postoperative anaerobic sepsis could be combated by prophylactic vaccination, , vol. 8, 2016/03/01. Abstract

Postoperative sepsis is the leading cause of morbidity and mortality after major surgery, resulting in hefty financial costs in hospitals all over the world. 40 Fischer rats were injected intra-peritoneally with 0.05 ml Covexin 10 which contains toxoids from different Clostridial species, 2 weeks prior to caecal ligation and puncture. Another 40 Fischer rats, as a control, underwent caecal ligation and puncture without vaccination. 16 of 40 vaccinated rats died (40%), peritoneal fluid cultures from the dead rats grew E. coli only, and 36 of 40 control rats died (90%), peritoneal fluid cultures from the dead rats were: 19 grew E. coli and C. perfringens; 12 grew E. coli,C. perfringens, and enterococci; 3 grew E. coli only; 1 grew E. coli, and enterocci; and 1 grew no organisms. Prophylactic vaccination with clostridial toxoids proved effectiveness in preventing anaerobic infection, and reduce mortality in rats that underwent caecal ligation and puncture; the gold standard model for polymicrobial sepsis. Currently, a pilot study is underway in which human patients who will undergo major surgery are prophylactically vaccinated with clostridial toxoids, in an attempt to eradicate postoperative anaerobic sepsis. © 2016, Journal of Chemical and Pharmaceutical Research. All Right Reserved.