Papers by Nagwa Mostafa El-Sayed
Understanding clinical outcomes and factors influencing mortality in intensive care unit patients with COVID‐19‐associated candidemia
Mycoses, Dec 31, 2023
Background: During the COVID pandemic, research has shown an increase in candidemia cases followi... more Background: During the COVID pandemic, research has shown an increase in candidemia cases following severe COVID infection and the identification of risk factors associated with candidemia. However, there is a lack of studies that specifically explore clinical outcomes and mortality rates related to candidemia after COVID infection. Objectives: The aim of this international study was to evaluate the clinical outcomes and identify factors influencing mortality in patients who developed candidemia during their COVID infection. Patients/Methods: This study included adult patients (18 years of age or older) admitted to the intensive care unit (ICU) and diagnosed with COVID-associated candidemia (CAC). The research was conducted through ID-IRI network and in collaboration with 34 medical centres across 18 countries retrospectively, spanning from the beginning of the COVID pandemic until December 2021. Results: A total of 293 patients diagnosed with CAC were included. The median age of the patients was 67, and 63% of them were male. The most common Candida species detected was C. albicans. The crude 30-day mortality rate was recorded at 62.4%. The This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Anti-infective agents, Jul 5, 2019
Background: As natural herbs and medicinal plants extracts are widely used as alternative treatme... more Background: As natural herbs and medicinal plants extracts are widely used as alternative treatments for different parasitic diseases, some have been tested on Cryptosporidium either in vitro or in vivo. This study assessed the prophylactic and therapeutic treatments' effect of Moringa oleifera (M. oleifera) leaves methanol extract on immunosuppressed-Cryptosporidium infected mice. Methods: The evaluation was carried out by Cryptosporidium oocysts count in fecal samples, histopathological changes in the intestinal tissues, determination of IFN-γ level in mice sera and measuring the antioxidant activity in the intestinal tissues. Results: Prophylactic treatment by M. oleifera extract lowered Cryptosporidium oocysts shedding from immunosuppressed-infected mice although there was no complete elimination of the parasite. However, therapeutic treatment induced a significant reduction in Cryptosporidium oocysts counts by 91.8% higher than that of the drug control (nitazoxanide) group (77.2%). Histopathologically, the intestinal tissues from immunosuppressed-Cryptosporidium infected mice showed loss of brush border with severe villous atrophy and extensive necrosis. M. oleifera prophylactic treatment induced a moderate improvement of the pathological changes. However, the villi in M. oleifera therapeutic treated mice retained their normal appearance with minimal inflammatory cells. It was observed that M. oleifera extract induced a significant upregulation of IFN-γ in both prophylactic and therapeutic treated groups compared to that of the infected untreated group. In addition, M. oleifera leaves extract exhibited a significant antioxidant activity by reducing the levels of Nitric Oxide (NO) and Malondialdehyde (MDA) and increasing Superoxide Dismutase (SOD) level in the intestinal tissues compared to those of the infected and drug controls. Conclusion: M. oleifera leaves extract has potent prophylactic and therapeutic activities against infection with Cryptosporidium.
Phytomedicine, 2018
Chemical analysis of aqueous extracts of Origanum majorana and Foeniculum vulgare and their effic... more Chemical analysis of aqueous extracts of Origanum majorana and Foeniculum vulgare and their efficacy on Blastocystis spp.
Role of Nanomedicine in Ocular Parasitic Infections
BENTHAM SCIENCE PUBLISHERS eBooks, Jun 14, 2023
European Journal of Clinical Microbiology & Infectious Diseases
Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study... more Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/ followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6%; n = 407), neoplasms (11.4%, n = 90), collagen vascular disorders (9.3%, n = 73), undiagnosed (20.1%, n = 158), miscellaneous diseases (7.7%, n = 60). The most common infections were tuberculosis (n = 45, 5.7%), brucellosis (n = 39, 4.9%), rickettsiosis (n = 23, 2.9%), HIV infection (n = 20, 2.5%), and typhoid fever (n = 13, 1.6%). Cardiovascular infections (n = 56, 7.1%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95% CI: 1.19-3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95% CI; 0.87 (0.65-1.15)), death attributed to FUO (RR = 0.87, 95% CI: 0.65-1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients.
Medicinal plants as natural anti-parasitic agents against Blastocystis species
Recent Advances in Anti-Infective Drug Discovery
Background: Blastocystis species (sp.) are enteric parasites that live in both humans' and an... more Background: Blastocystis species (sp.) are enteric parasites that live in both humans' and animals' gastrointestinal tracts. Blastocystis hominis (B. hominis) is the recognizable human isolates in clinical and diagnostic specimens. Human infection occurs via the oro-fecal route, particularly in developing areas due to a lack of sanitation and hygienic facilities. B. hominis can exist in the large intestine for weeks to years until treated appropriately. Metronidazole is the drug of choice for the treatment of Blastocystis infection. However, it induces intolerable side effects and has been shown to have teratogenic and carcinogenic potential. Several medicinal plant extracts have been experimentally tested against Blastocystis infection in comparison to currently available treatments. Objective: Based on in vitro and in vivo studies, this article reviewed the anti-Blastocystis activity of some medicinal plants. Method: To conduct the research for this review, Google Scholar ...
Anti-Toxoplasma gondii Activity of Some Medicinal Plants
Medicinal Plants As Anti-Parasitic Agents
The Journal of Infection in Developing Countries
Introduction: Although vaccines are the safest and most effective means to prevent and control in... more Introduction: Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale. Methodology: In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents’ attitudes towards vaccination of their children. Results: Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher ...
Acanthamoeba keratitis: a growing problem in Egypt
Toxocariasis in Children: An Update on Clinical Manifestations, Diagnosis, and Treatment
Journal of Pediatric Infectious Diseases, 2017
Toxocariasis, a parasitic infection, carries a major health risk in children, especially in the d... more Toxocariasis, a parasitic infection, carries a major health risk in children, especially in the developing countries. Children are the most infected group because of their undeveloped immune system, their higher exposure to infection, and the frequency of reinfections depending on the factors related to their hygienic and behavioral habits. Many human infections are asymptomatic, with only eosinophilia and positive serology. However, several complications were associated with this neglected disease. These complications depend on the organs invaded by migrating Toxocara larvae, the degree of the larvae burden, and the strength of the host immune response. This review aims at giving an update on clinical manifestations, diagnosis, and treatment of toxocariasis in children. The pediatricians should merge this information into their clinical diagnosis to defeat this neglected disease by establishing the correct diagnosis and treatment.
Role of Exosomes in Biological Communication Systems, 2020
Blood protozoan parasites are single-cell organisms that can be found in the bloodstream of the i... more Blood protozoan parasites are single-cell organisms that can be found in the bloodstream of the infected individuals or spread to others through exposure to infected blood as in blood transfusion. The medically important blood protozoa are Plasmodium spp., Leishmania spp., and Trypanosoma spp. Infection by these parasites is naturally transmitted by insects (vectors). They cause life-threatening diseases that are among the most widespread and lethal all over the world with high prevalence in developing countries. Research studies showed that extracellular vesicles (EVs) released from these blood protozoa or infected host cells play a significant role in the pathogenesis of parasitic diseases and have an effective role on the host immune responses. Blood protozoa-released EVs transfer genetic materials among parasites and different cells in the host leading to the dissemination of parasitic infections. More importantly, EVs provide a new direction in the management of blood protozoan parasitic diseases as well as may be candidates for immune prevention of these parasitic diseases. This chapter summarizes the implications of extracellular vesicles in blood protozoan parasitic diseases, mainly focusing on trypanosomiasis, leishmaniasis, and malaria.
Since thousands of years natural products have played a very important role in health care and in... more Since thousands of years natural products have played a very important role in health care and in prevention of disease. To evaluate the anti-microbial & antidiabetic activities of leaf extracts (chloroform and methanol) of ixora chinensis. A complete literature survey of ixora chinensis revealed that most of the activities reported on leaves and flowers were anti-oxidants, anticancer, anti-microbial activities. For preliminary phytochemical screening of the extracts, we performed tests for alkaloids, carbohydrates, flavanoids, tannins, glycosides, saponins, proteins and steroids. From this study, we can conclusively state that methanol, chloroform leaf extracts of Ixora chinensis has anti-hyperglycemic activity, anti-microbial activity. These results support the use of the plant in folk medicine to manage microbial infections, diabetics and other related diseases.
Tropical Medicine and Infectious Disease, 2016
Toxoplasmosis may present as a severe disease among some Egyptian patients with chronic liver dis... more Toxoplasmosis may present as a severe disease among some Egyptian patients with chronic liver disease (CLD) due to their impaired immune system, changing the course of the disease. The classical diagnosis of toxoplasmosis by serological tests is inadequate for such patients. This study was performed to highlight the role of real-time quantitative PCR (qrtPCR) test in the accurate diagnosis of toxoplasmosis among Egyptian patients with CLD. Seventy patients with CLD and 50 healthy controls were enrolled in this study. All were subjected to full clinical examinations, abdominal ultrasonography, and biochemical analysis of liver enzymes and they were investigated for markers of hepatitis B virus (HBV) and hepatitis C virus (HCV). In addition, Toxoplasma gondii (T. gondii) parasitemia was determined using qrtPCR. The results showed that T. gondii parasitemia was positive in 30% of CLD patients with highly statistically significant (p < 0.001) compared with the control group (6%). Co-infection in both T. gondii/HBV and T. gondii/HCV was 33.3% and 31.4%, respectively, with a highly significant association between T. gondii parasitemia and HCV viral load. Moreover, the results showed a significant increase of liver enzymes in the serum of patients positive for T. gondii compared with negative patients. An association between T. gondii infection and CLD was observed, and further studies will be needed to define the mechanism of this association.
Asian Pacific Journal of Tropical Disease, 2016
Informed written consent was obtained from all participants. The journal implements double-blind ... more Informed written consent was obtained from all participants. The journal implements double-blind peer review practiced by specially invited international editorial board members. Objective: To ascertain a relationship between Toxoplasma gondii (T. gondii) infection and rheumatoid arthritis (RA) disease among Egyptian patients. Methods: One hundred RA patients and 50 healthy subjects participated in this study. The patients were classified into three groups, namely GI, G2 and G3. Patients in G1 were recently diagnosed with RA with the disease duration of less than one year (prior treatment); G2 included RA patients receiving anti-tumor necrosis factor agents and RA patients in G3 received disease modifying anti-rheumatic drugs (methotrexate, antimalarial, corticosteroids). Serum samples of all participants were examined for the presence of anti-Toxoplasma immunoglobulin G (IgG) antibodies and positive samples were further analyzed for anti-Toxoplasma IgM antibodies to detect the possibility of reactivation of latent toxoplasmosis. Also, the association between Toxoplasma seropositivity and clinical, laboratory and radiological features of these patients were determined. Results: There was a significantly higher percentage of T. gondii IgG positivity in RA patients (54%) than in the controls (32%). At the same time, 20.40% of T. gondii IgG positive patients had anti-T. gondii IgM antibodies with a statistically significant difference as comparing to T. gondii IgG positive controls. Out of T. gondii seropositive patients, 20.37% had a lower IgG level with a mean titer of (65.3 ± 17.7) IU/mL, 46.29% had moderate level with a mean titer of (184.2 ± 60.0) IU/mL and 33.33% had higher level with a mean titer of (404.3 ± 50.0) IU/ mL. A positive correlation was found between disease activity and Toxoplasma seropositivity. T. gondii seropositive RA patients had longer disease duration, longer time morning stiffness, higher numbers of tender and swollen joints and also increase in disease severity markers (erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, anti-cyclic citrullinated peptide anti-bodies, rheumatoid factor) than T. gondii seronegative patients. As regards radiological findings, Larsen score was found significantly higher in T. gondii seropositive RA patients. Conclusions: The positive correlation between T. gondii infection and RA disease among Egyptian patients indicated the need to improve awareness of this parasitic infection and its management in this risk group.
Asian Pacific Journal of Tropical Disease, 2016
The study protocol was performed according to the Helsinki declaration and approved by Research E... more The study protocol was performed according to the Helsinki declaration and approved by Research Ethics Committee of the Faculty of Medicine, Benha University, Egypt. All donors included in the study were informed of the study objectives and a written signed consent was taken from each one of them. The journal implements double-blind peer review practiced by specially invited international editorial board members. Objective: To determine the value of voluntary blood donors screening in diagnosing asymptomatic toxoplasmosis in an attempt to reduce the risk of this infection in Egyptian immunocompromised recipients. Methods: Serum samples from 300 healthy voluntary blood donors were analyzed for anti-Toxoplasma antibodies [immunoglobulin G (IgG) and immunoglobulin M (IgM)] using ELISA and detection of Toxoplasma gondii (T. gondii) parasitemia was done by real-time quantitative PCR (qrtPCR). Results: Frequency of T. gondii infection in 300 healthy blood donors was 101 (33.67%), 10 (3.33%), 18 (6.00%) by ELISA IgG, IgM and qrtPCR, respectively. It was found that 8 of 18 (44.4%) donor samples positive by qrtPCR contained IgM anti-T. gondii, conversely 8 of 10 (80%) IgM-positive samples were positive for T. gondii DNA. There was a highly significant increase in detection of recent Toxoplasma infection using PCR over IgM ELISA by 55.6%. At the same time, T. gondii parasitemia was detected in 11 of 101 (10.90%) donor samples positive by IgG ELISA and in 7 of 199 (3.50%) negative donor samples for anti-T. gondii IgG antibodies. On the other hand, the negative results obtained by both qrtPCR and ELISA in 192 (64%) subjects ruled out the infection in those donors. Conclusions: It might be appropriate to include the screening of blood and blood products for T. gondii in the pre-transfusion blood testing schedule in Egypt. Also, molecular screening should be carried out on the blood being transfused to immunocompromised patients.
Indian journal of ophthalmology, 2015
Ocular lesions are frequently associated with different parasitic infections. The classes of infe... more Ocular lesions are frequently associated with different parasitic infections. The classes of infection include protozoa, nematodes, cestodes, and ectoparasites. Ocular parasitic infections can manifest in any part of the eye; the disease manifestations are frequently characterized as either posterior or anterior eye disease. Parasite-induced lesions may be due to damage directly caused by the parasite, indirect pathology caused by toxic products or the immune response initiated by infectious parasitism. This review characterized the parasite-induced lesions in the posterior segment of the eye. Prompt diagnosis and early treatment of these lesions can reduce ocular morbidity. The method of the literature search was conducted on PubMed, Elsevier Scopus database, and Google Scholar with no limitation on the year of publication databases. It was limited to English articles published for ocular lesions in clinical studies and was focused on parasitic infections of the eye.
Schistosomiasis: An Association with Autoimmunity
ABSTRACT
Journal of Parasitic Diseases, 2015
Toxoplasma gondii (T. gondii), an intracellular parasite, establishes a chronic infection by form... more Toxoplasma gondii (T. gondii), an intracellular parasite, establishes a chronic infection by forming cysts preferentially in the brain. TNF-a plays an important role in controlling the infection caused by this protozoan. Thus, the blockade of TNF-a could cause reactivation of latent toxoplasmosis infection as well as increase the risk of acute toxoplasmosis. This study evaluated the effect of etanercept, a TNF-a antagonist in reactivation of latent toxoplasmosis compared to the therapeutic effect of sulfadiazine and pyrimethamine in combination on the progress of the disease. A total of 40 laboratory-bred Swiss albino mice were infected with Me49 strain of T. gondii and divided into four groups: infected control group; treated group with sulfadiazine and pyrimethamine; treated group with etanercept and treated group with both etanercept and sulfadiazine and pyrimethamine. The mean number and size of tissue cysts in brain smears of mice of each group were determined and also, serum levels of TNF-a were assessed in different study groups by an enzyme linked immunosorbent assay. The results showed that the mean TNF-a level was significantly different in the treated groups compared to that in infected control group. The highest level of TNF-a was found in the infected controls. After treatment with etanercept alone or combined with sulfadiazine and pyrimethamine, it was significantly decreased. In this study, reactivation of latent toxoplasmosis was observed by a significant increase in the mean number and sizes of Toxoplasma tissue cysts in brains of mice with established chronic toxoplasmosis after treatment with etanercept alone or combined with conventional treatment compared to both untreated chronically infected controls and infected mice treated with sulfadiazine and pyrimethamine. It was concluded that etanercept, a TNF-a antagonist may play a role in reactivation of latent toxoplasmosis. So, serological screening for toxoplasmosis might offer a valuable aid for patients treated with this drug.
Uploads
Papers by Nagwa Mostafa El-Sayed
Toxocara spp. are amongst foodborne parasites which are prevalent in developing
countries. These parasites do not multiply in foods, but they may survive in foods
for months and are not routinely controlled in food causing major health problem.
Toxoplasma gondii infection occurs by ingesting oocysts (from contaminated raw
fruits, vegetables and water with cat feces) or Toxoplasma cysts from contaminated
raw or improperly cooked meat. Toxoplasmosis is usually asymptomatic in immunocompetent individuals while in immunocompromised subjects, causes serious
complications with particularly, encephalitis, myocarditis, and pneumonitis with
high death-rate. Toxocariasis occurs by the ingestion of contaminated raw vegetables or water with embryonated Toxocara eggs and, by eating raw or improperly
cooked infected meat containing viable Toxocara larvae. Infection with Toxocara
organism induces visceral, ocular or neurological manifestations. Involvement of
the eye may lead to loss of vision and, central nervous system involvement in the
form of meningitis and encephalitis may be fatal. This chapter discussed the occurrence and persistence of Toxoplasma and Toxocara parasites in relevant foods, current detecting methods in foods and possible control measures
in the feces of an infected cat, blood transfusion, placental transmission or organ transplantation. Toxoplasmosis is the most common opportunistic infection in the pregnant women and the immunocompromised individuals resulting in severe
complications as encephalitis, pneumonitis and myocarditis with high mortalities. Unfortunately, few effective drug therapies for this disease are available, their aim being the decrease of the parasite replication rate to prevent more pathological changes in organs involved as well as to avoid the serious complications. The recommended therapy for treatment or prophylaxis of toxoplasmosis is the combination of
pyrimethamine and sulfadiazine, in spite of this combination is so effective against acute toxoplasmosis but being unsuccessful in the treatment of toxoplasmic chorioretinitis, encephalitis, and congenital toxoplasmosis. Anti-Toxoplasmic drugs need to be effective against the all stages and strains of Toxoplasma parasite with a higher penetration into the cerebral, ocular and placental tissues and have no side
effects as fetal toxicity and teratogenic effects. Up till now, there is no available drug has all these advantages. The occurrence of side effects, the development of resistant strains and the lack of effectiveness against Toxoplasma tissue cyst are the main disadvantages of the current drug therapies. The discovery of drug therapies with a
lower toxicity and able to prevent and treat toxoplasmosis would represent a novel era in the treatment of this infectious disease, especially in immunosuppressed patients. Therefore, the researches technology with regard to the parasite’s proteomics and functional genomics are needed for the development of new and safer drug agents.
Currently, an increase orientation of the pharmacological action of natural agents and medicinal plants are usually considered to be safer than synthetic drugs. The value of these plants as sources of natural product bioactive molecules to medicine related to their chemotherapeutic effect and considered as template molecules for the manufacture of new drug agents. Recently, most of the researches in the drug development for toxoplasmosis focus on the use of nanotechnology for improving the pharmacokinetic profile of drugs. The combination of nanoparticles and plant extracts to give rise broad spectrum of drugs may be a greater chance for defeating Toxoplasma infection. This chapter aimed at giving an update on the current progress
in the development of new drugs for the treatment of toxoplasmosis.