Tarek Goda

Publications (5)8.59 Total impact

• Source

  Available from: jidc.org

  Article: Clinico-pathological study of atypical pathogens in community-acquired pneumonia: a prospective study.

  Maysaa El Sayed Zaki, Tarek Goda
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  ABSTRACT: Atypical respiratory pathogens such as Mycoplasma pneumoniae, Legionella species, and Chlamydia pneumoniae are isolated with increasing frequency from community-acquired pneumonia (CAP). This study highlights the importance of organisms responsible for CAP. One hundred consecutive patients with clinically and radiographically diagnosed CAP were evaluated from October 2005 to October 2006. Sputum, bronchoalveolar lavage, and blood samples were collected for microbiological culture. Determination was performed for specific immunoglobulin M (IgM) for Chlamydia pneumoniae, Mycoplasma pneumoniae, Legionella pneumophila, Coxiella burnettii, adenovirus, and influenza virus. The most common isolated bacteria was Streptococcus pneumoniae (22%) followed by Haemophilus influenzae (18%). Mycoplasma pneumoniae was isolated from 5% and Legionella pneumophila was isolated from 5% of patients. The most common positive serological reaction was for Chlamydia pneumoniae (30%) and Adenovirus (30%). In the study of accuracy of determination of specific IgM for Mycoplasma pneumoniae and Legionella pneumophila compared to culture, the sensitivity was 60% and 80% respectively, specificity was 93.7 %, and 98.9 % respectively, and accuracy was 92 % and 97 % respectively. This study highlights the prominence of mixed bacterial/viral infections in lower respiratory tract infection diagnosis. Our data showed that at least 30% of our patients had concurrent infections. This observation raises two important questions: 1) whether sequential or concurrent viral and bacterial infections have a synergistic impact on the evolution of disease in children; and 2) should diagnostic batteries for any patient with CAP include methods for detecting both the typical and atypical bacterial or viral pathogens.
  The Journal of Infection in Developing Countries 01/2009; 3(3):199-205. · 1.19 Impact Factor
• Article: Rapid phenotypic assay of antimycobacterial susceptibility pattern by direct mycobacteria growth indicator tube and phage amplified biological assay compared to BACTEC 460 TB.

  Maysaa El-Sayed Zaki, Tarek Goda
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  ABSTRACT: The performance of antimycobacterial susceptibility testing for the first line drugs (isoniazid, streptomycine, rifampicin and ethambutol) with mycobacteria growth indicator tube (MGIT) and by bacteriophage amplified biological assay by FAST-plaque TB-MDR were compared to automated radiometric BACTEC 460 TB system. This study was carried on 84 sputum samples of positive Zhiel-Neelsen (ZN) smears. Sputum samples were subjected to culture and antimycobacterial susceptibility testing by BACTEC 460 TB. Samples were also tested by direct susceptibility tests for isoniazid (INH), ethambutol, rifampicin (RIF) and streptomycine by MGIT. Sensitive and resistant isolates for RIF were further studied by FAST-plaque TB-MDR for RIF resistance. The commonest resistance pattern by BACTEC 460 TB was for INH (32%) followed by RIF (24%) either alone or in combination with other drugs. Multiple drugs resistance was 20%. The agreement between BACTEC 460 TB and direct MGIT for resistant strains was 100% for INH and ethambutol, 91.7% for rifampicin, 80% for streptomycine and was 90% for MDR. FAST-plaque TB-MDR detected correctly all RIF resistant strains and 97.2% of the sensitive strains. For majority of strains direct susceptibility tests were available within 6.34-6.404 days (95% confidence interval) with direct mycobacteria growth tube, while results for FAST-plaque TB-MDR appear within 10.5-11.5 days from the time that the sputum was received in the laboratory (95% confidence interval). From this study, we could conclude that direct MGIT AST is the quickest method for screening antimycobacterial susceptibility pattern for the drugs commonly used (INH, RIF, etambutol, streptomycin) as results were available within 6.34-6.404 days. Also FAST-plaque TB-MDR method is accurate for detection of rifampicin resistance after primary culture which can be used as a surrogate marker for presence of MDR strains and the results were available within 10.5-11.5 days.
  Tuberculosis 04/2007; 87(2):102-8. · 3.47 Impact Factor
• Article: STUDY OF PHENOTYPIC AND MOLECULAR CHARACTERIZATION OF MYCOBACTERIUM TUBERCULOSIS ISOLATES RESISTANT TO BOTH ISONIAZID AND ETHAMBUTOL

  MAYSAA EL-SAYED ZAKI, TAREK GODA
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  ABSTRACT: In the present study, we performed radiometric susceptibility testing, and we analyzed the genetic regions associated with resistance to isoniazid (INH) and ethambutol (EMB) in 100 selected isolates of Mycobacterium tuberculosis by polymerase chain reaction (PCR). The studied codons of M. tuberculosis were amino acid Ser315 of katG for INH resistance and embB Met306 and Gly406 for EMB resistance. The goal of the study was to determine (1) how often these common mutations occurred in the targeted genes in isolates displaying resistance in the phenotypic assays, (2) whether the particular INH-resistance-associated mutation occurred with the studied particular EMB-resistance-associated mutation and (3) the value of PCR to these regions as a rapid screening tool to identify multidrug-resistant (MDR) M. tuberculosis. The percentage of isolates resistant to INH, rifampicin (RIF), EMB and streptomycin (STR) was 70, 20, 100 and 70%, respectively. All resistant strains of M. tuberculosis to INH, RIF and STR were resistant to EMB. Sixty strains (85.7%) with phenotypic resistance to INH displayed mutation in amino acid Ser315 of katG sequence. All strains resistant (100%) to EMB had mutations in amino acids Met306 and Gly406 of embB sequence. In conclusion, both mutations in amino acid Ser315 of katG for INH resistance and embB Met306 and Gly406 for EMB resistance are common findings in MDR-M. tuberculosis. Moreover, the study of embB Met306 and Gly406 for EMB resistance by PCR can be used as a rapid screening test for identifying MDR-M. tuberculosis.
  Journal of Rapid Methods & Automation in Microbiology 01/2007; 14(4):377 - 388. · 0.58 Impact Factor
• Article: Soluble VEGF/sFLt1 ratio is an independent predictor of AML patient out come.

  Salah Aref, Mamdouh El Sherbiny, Tarek Goda, Manal Fouda, Hassan Al Askalany, Doaa Abdalla
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  ABSTRACT: Angiogenesis is the formation of new blood vessels and is controlled by a balance between positive and negative angiogenic regulatory factors. Soluble vascular endothelial growth factor receptors 1,2 (Flt-1, KDR) are the negative counterpoint to the vascular endothelial growth factor (VEGF) signaling pathway, which has been characterized as one of the most important endothelial regulator in human angiogenesis. In the present work, we tested the differential prognostic relevance of soluble vascular endothelial growth factor (VEGF), their receptors 1 (Flt-1), 2 (KDR), and the ratio between sVEGF/sFlt-1 in 43 patients with acute myeloid leukemia (AML). sVEGF and its soluble receptors were assessed using an ELISA. Soluble VEGF, sFLT-1 and sKDR concentration levels were significantly higher in AML patients at diagnosis when compared to the levels in normal controls. sVEGF, sFlt1 and the sVEGF/sFlt1 ratio were significantly higher in non responders when compared to responders (P < 0.001 for all). However, there was no significant difference regarding sKDR levels (P > 0.05). sVEGF, the sVEGF/sFlt1 ratio but not sFlt1 and sKDR levels were significantly elevated in those who did not survive, when compared to survivors. sVEGF, sFlt1 levels were significantly correlated to WBC counts (R = 0.93, P = 0.000, R = 0.56, P = 0.000, respectively); bone marrow blast cell counts (R = 0.92, P = 0.000; R = 56, P = 0.000, respectively); peripheral blood blast cell counts (R = 0.91, P = 0.000; R = 0.52, P = 0.000, respectively); sKDR was only correlated to peripheral blood blast cell counts(R=0.37,P=0.014). Cox regression analysis results with sVEGF, sFlt1, sKDR, sVEGF/sFlt1 ratio suggest that the most important predictor for AML outcome is the sVEGF/sFlt1 ratio. In conclusion, sVEGF/sVEGF ratio is independent predictor of AML patient out come, and its significance should be assessed when considering antiangiogenic therapy.
  Hematology 04/2005; 10(2):131-4. · 1.49 Impact Factor
• Article: Accelerated neutrophil apoptosis in neutropenic patients with hepatosplenic schistosomiasis is induced by serum Fas ligand.

  Salah Aref, Mohamed El Refaei, Tarek Goda, Medhat Sakrana, Hosam El-Nemre
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  ABSTRACT: Neutropenia in patients with hepatosplenic (HS) schistosomiasis may stem from enhanced neutrophil apoptosis. However, the molecular mechanism of neutrophil apoptosis has not been clearly defined. Neutrophils harvested from neutropenic patients with HS schistosomiasis (n = 25), non-neutropenic patients with hepatointestinal (HI) schistosomiasis (n = 10), and age- and sex-matched healthy control subjects (n = 10) were examined for the degree of apoptosis after incubation with autologous sera. Neutrophil apoptosis was quantified by flow cytometry through determination of propidium iodide nuclear staining and confirmed by DNA gel electrophoresis at 0 time (fresh neutrophil), 4 and 24 h culture. Neutrophils from healthy subjects were also incubated with either 10% heterologous normal or neutropenic serum, with and without anti-Fas ligand antibody. Serum Fas ligand levels were assessed in sera of patient groups and healthy controls by ELISA. Compared with normal controls and HI, HS group demonstrated greater neutrophil apoptosis in the presence of autologous serum (P < 0.01, < 0.05, respectively). Furthermore, compared with normal neutrophils exposed to heterologous normal serum, those exposed to heterologous neutropenic serum exhibited higher apoptosis rates (P < 0.01). The apoptotic effect of neutropenic sera is attenuated by anti-Fas ligand. Fas expression was significantly higher in HS group as compared to both HI and normal healthy controls (P < 0.05). Serum Fas ligand levels were significantly higher among HS group as compared to both HI and control groups (P < 0.01 for both). Neutrophil apoptosis was not correlated to the size of spleen in HS group. In conclusion, the rate of neutrophil apoptosis is accelerated in neutropenic HS schistosomiasis. These findings suggest that enhanced neutrophil apoptosis demonstrated in HS patients is triggered by soluble Fas ligand, which is mostly derived from spleen.
  The Hematology Journal 01/2004; 5(5):434-9. · 1.86 Impact Factor