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JCDR. 2021; 12(6): 49-60

Relation between Chlamydia - Like Microorganism 'SimkaniaNegevensis' and Patients Undergoing Hemodialysis

George Emad Shaker, Rehab Ahmed Rabie, Ahmed Abo El Makarem Hosny, HebaShafeakAbd El Khalik.


Background:Chronic kidney disease (CKD) has been recognized worldwide public health
problem, and the associated morbidity and mortality in patients reaching end-stage renal disease
(ESRD) is constantly increasing. Despite the significant improvements and advanced dialysis
technologyInfection is a common complication of hemodialytic treatment. Many of these
infections are due to sepsis, primarily arising from the vascular access site. Simkanianegevensis
(S. negevensis) is an obligate intracellular bacterium belonging to the family Simkaniaceae in the
Chlamydial order, able to survive and grow as an amoeba resisting microorganism in
trophozoites and cysts of Acanthamoeba and other free-living protozoa, which probably represent
its natural reservoirs S. Negevensiswas first defined in 1993. The aimwas to assess diagnosis
ofSimkaniaNegevensis infection in hemodialysis patients. Methods:This cross-sectional study
was performed on 78 hemodialysis patients, and they were treated with regular
hemodialysis.Patients were subjected to the following: complete history taking, full clinical
assessment, laboratory investigation, (complete blood count, Measurement of serum IgG
antibody against S.negevensisin hemodialysis patients and Water samples were collected from
hemodialysis circuits for detection the occurrence of S. Negevensisinfection. Results: Total of 8
water samples were collected from HD tap water in different occasions after the specific
treatment of disinfection from March to November 2020. In the first 4 months of our study when
the water samples were negative for Simkania, 39 patients were selected randomly, IgG
antibodies were measured in their serum and the routine laboratory investigations were
established for these patients. When the negative water samples turned positive, we measured the
serum IgG for all the patients included in our study (78 patients), and the routine laboratory
investigations were also established for all patients. Regarding age and sex distribution among
studied group. Mean Age was 50 years distributed as (46.71±10.61 SD) with minimum 23 years
and maximum 67 years, regarding sex distribution, most cases were males with 88.5% and
females were 11.5 There was no difference in the significance of age and gender between the
patients undergoing hemodialysis with negative water samples for Simkania compared to
hemodialysis with positive water for S.Negevensis. Regarding HTN and DM distribution among
studied groups, there was no significant difference between the patients undergoing hemodialysis
with negative water samples for Simkania compared to hemodialysis with positive water for
S.Negevensis. There was no significance in our study regarding hemoglobin between patients
who were undergoing hemodialysis with positive and negative water samples for Simkania,
Conclusion: Our study detected the occurrence of S.negevensis in hemodialysis patients. When
the patients were undergoing hemodialysis with positive water for Simkania.

Key words: Serological Study- SimkaniaNegevensis- Hemodialysis

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