International Journal of Infection
Volume:4 Issue: 3, Jul 2017

Context: The number of quinolone-resistant Vibrio cholerae strains reported in various clinical studies is growing steadily since the 1990s. Important biological conditions such as alterations of DNA topoisomerases, perturbations in regard to drug entry and efflux and plasmids transferability between bacteria, are conditions that lead to the acquisition of certain power to resist quinolones during therapy. The current article aimed to review the evolution of quinolone-resistant strains of V. cholerae, the basis for quinolone mode of action against DNA topoisomerases and the recent advances in the understanding of the mechanisms by which V. cholerae strains are resistant to quinolones, including chromosomal mediated resistance involving mutations in topoisomerases, chromosomal mediated resistance resulted in response to reduced expression and/or overexpression of proteins synthesis for porins and cellular efflux pumps, respectively and plasmid mediated resistance.
Evidence Acquisition: This systematic review utilized the research results of clinical trials.gov database, the cochrane database of systematic reviews, Medline, PubMed, Google and other databases to select about 67 publications on cholera and fluoroquinolones resistance mechanisms in V. cholerae. Relevant publications were reviewed; findings were synthesized using a narrative method to illustrate how the treatment of cholera with quinolones as adjunct is evolved.
Through the thorough literature review, it was found that despite the progress made in the development of effective fluoroquinolones against various enteric pathogens including V. cholerae, new concerns emerged which include the constant reports on reduced susceptibility of these drugs against V. cholerae strains endorsed with the emergence of various mechanisms of resistance.
The current systematic review emphasized on the importance of surveying the emergence of V. cholerae resistance to quinolones that may occur during adjunct treatment of cholera and also the importance of determining the genetic basis of the resistance mechanisms for future development of more promising quinolones.

Crimean-Congo hemorrhagic fever (CCHF) is an acute viral hemorrhagic disease, and it is currently endemic in Southeastern Iran. The present study aimed at comparing the effect of ribavirin alone and in combination with dexamethasone on clinical outcome of patients with severe form of Crimean-Congo hemorrhagic fever.
In this clinical trial study, we studied 30 patients with severe form of Crimean-Congo hemorrhagic fever (2 groups with 14 controls and 16 cases), who were admitted to Boo Ali hospital in Zahedan (Southeast of Iran) from July 2015 to April 2016. Patients were selected randomly for each group. The intervention group received dexamethasone and ribavirin, and the control group was treated only with ribavirin. Then, the rate of recovery, mortality rate, blood products used, and duration of hospitalization in both groups were recorded and compared. The distribution of samples and comparison of quantitative variables were evaluated by Kolmogorov Smirnov test, t test, and Man-Whitney test. The comparison of qualitative variables was performed by Chi-square and McNamara’s test.
Of 30 patients, 24 (80%) and 6 (20%) were male and female, respectively. A few patients required transfusion of blood products in the intervention group compared to controls, but there was no statistically significant difference between the 2 groups (P It seems that high-dose dexamethasone is effective in the treatment of patients with severe form of CCHF. Blood products requirement for severe CCHF patients was reduced after receiving high-dose dexamethasone. Further investigations are necessary to determine the efficacy of corticosteroid and its effect on outcome.

Approximately, one-third of the worlds population are in the influence of intestinal parasite infections (IPIs). The infections can cause a whole range of clinical symptoms such as watery or mucoid diarrhea, dehydration, vomiting and nausea, abdominal pains, as well as a fever.
The aim of this study was to evaluate IPIs in Shush County, southwest Iran, during 2014 - 2016.
In this descriptive cross-sectional survey, 15132 stool samples were collected during 2014 - 2016. The stool samples were evaluated microscopically for the presence of parasite trophozoites, cysts, and eggs using direct and formalin-ether concentration methods. The data were analyzed by SPSS version 21 and statistical Chi-square test.
Of the 15132 stool samples, 778 (5.14%) were positive for IPIs, where 429 (55.14%) were female and 349 (44.85%) were males, respectively. Entamoeba histolitica/dispar was detected as the most common parasite in 313 (2.06%) specimens (172 females, 141 males). Other parasites were included, 158 (1.04%) Giardia lamblia (83 females, 75 males), 150 (0.99%) Blastocystis hominis (84 females, 66 males), and 155 (1.02%) Entamoeba coli (90 females, 65 males). Furthermore, 2 (.0.013%) Trichuris trichiura were detected only in males.
The results show that a relatively high prevalence of intestinal parasite infections were observed among individuals. Since the parasitic infections can cause malabsorption, severe diarrhea, paralytic ileum, intestinal obstruction, cholecystitis, liver inflammation, pulmonary, as well as renal complications, the health authorities of Shush County must pay more attention to control and prevent the transmission of intestinal parasites to individuals.

Cholera is an infectious disease caused by a gram negative bacteria, Vibrio cholerae. It was found for the first time in Niger during year 1970 and continues to occur as an issue of major public health importance.
This study aimed at more accurately defining the burden of cholera in Niger.
Cholera surveillance data from the direction of epidemy surveillance and response reported to the Niger ministry of public health and the world health organization were reviewed and analyzed to determine trends in cholera disease.
Of Niger’s 8 regions or states, 7 were very active in reporting cases each year between 1991 and 2015. Globally, cholera cases and deaths were 26,835 and 1,430, respectively (CFR = 5.3%).
Taken together, the epidemiological trends of cholera in Niger showed annual increase in frequency and length of outbreaks during the 21 years under review. To successfully reduce the burden of cholera outbreaks in Niger, concerted efforts by the government and non-government organizations as development partners through longterm investments are urgently needed to strengthen preventive measures for early detection and confirmation of cases, followed by a well-coordinated, timely, and effective response.

Helicobacter pylori (H. pylori) bacterium has contaminated over 80% of the population of developing countries. H. pylori has a major role in developing gastric ulcer, duodenal ulcer, chronic gastritis, as well as gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma (MALT). To eradicate H. pylori infection, information about regional antibiotic resistance is necessary. Therefore, this study was conducted to compare the success rate of quadruple and triple antibiotic therapy in eradicating H. pylori infection in southwest of Iran (Yasuj).
This was a randomized clinical trial, in which 60 patients aged 15 to 80 years, who referred with dyspepsia and peptic ulcer symptoms to the outpatient clinic of Shahid Mofatteh, Yasuj, Iran, in 2014, enrolled after confirmation of H. pylori infection. All participants provided written informed consent. Then, they were randomly allocated to quadruple (amoxicillin, metronidazole, bismuth subcitrate, and pantoprazole) and triple (amoxicillin, clarithromycin, and pantoprazole) antibiotic therapy regimens for 2 weeks. H. pylori stool antigen test was performed for all patients 6 weeks after the end of the treatment. SPSS17 software was used for data analysis.
From 60 patients, 29 (48.3%) and 31 (51.7%) received quadruple and triple antibiotic therapy regimens, respectively. H. pylori stool antigen test was negative in 23 (79.3%) and 16 (51.6%) treated patients with quadruple and triple antibiotic therapy regimens, respectively (P = 0.023).
The success rate of quadruple therapy was considerably higher than triple antibiotic therapy, and this might be due to clarithromycin resistance.

Bacteriocins are antimicrobial proteins or peptides secreted in the culture medium during the growth of bacteria. Bacteriocin production is influenced by various physical parameters such as pH, temperature, NaCl concentration, and carbon source.
The current study aimed at optimizing the culture conditions for higher growth and production of bacteriocins by the soil isolates, Pediococcus pentosaceus LB44, and Weissella confusa LM85.
Growth of LB44 and LM85 isolates was measured spectrophotometrically at OD600 and bacteriocin production was determined in terms of growth inhibition zone using agar well diffusion assay (AWDA) at different pH (3.0 to 10.0), temperatures (30 to 50°C), NaCl concentrations (2% to 10%), and different concentrations (10 to 40 g/L) of carbon sources, glucose, and lactose.
Pediococcus pentosaceus LB44 could demonstrate similar growth and activity at pH 5.0 to 8.0; whereas Weissella confusa LM85 could grow and show activity at pH 5.0 to 10.0, but higher growth was recorded at pH 6.0 to 9.0. The growth and activity of P. pentosaceus LB44 was at 30 to 42°C, whereas W. confusa LM85 was able to grow and demonstrate activity at 30 to 50°C. Both isolates could grow up in 6% NaCl, but growth and activity was higher in the absence of NaCl. The isolates showed optimum growth and activity in the presence of 20 g/L glucose and 40 g/L lactose. In comparison to glucose, the growth and activity were less in the presence of lactose.
P. pentosaceus LB44 and W. confusa LM85 could grow and produce bacteriocin under acidic and alkaline conditions at 37°C in the medium without NaCl. These isolates utilized glucose better in comparison with lactose. The optimized conditions are helpful to recover maximum yield of bacteriocin for industrial applications.

The aim of this study was to investigate the effect of ethanol extract of green tea on biofilm formation of Staphylococcus aureus.
Staphylococcus aureus samples were obtained from hospital sources and plant extracts; green tea was made using the rotary. The minimum inhibitory concentration was determined using the microdilution method. Inhibition of biofilm formation was determined by using a microplate.
The results of this study showed that the greatest resistance was to the antibiotics penicillin (88.2%) and erythromycin (82.4%) and the least resistance to the antibiotic Amikacin (76/11%), respectively. The results of the effect of green tea extract showed the lowest inhibitory concentration (MIC) is equal to 0.3 milligrams per milliliter, which is a strain on the inhibitory concentration, and the highest concentration (MBC) MBC resistant Staphylococcus aureus equal to 20 milligrams per milliliter, which is controlled unidirectional. The results of green tea extract effects on biofilm showed that with increasing concentrations of less biofilm formation the biofilm formation has been much lower concentration of the extract.
The results of this study indicate good effects of green tea extract to inhibit biofilm formation of Staphylococcus aureus, which can be used to treat infections caused by these bacteria’s.

Coxiella burnetii (C. burnetii) is the causative agent of Q fever, a zoonotic disease that is prevalent worldwide. Domestic and companion animals are the main reservoirs of infection. Humans mainly acquire the infection through inhalation of contaminated aerosols.
This study was carried out to detect the prevalence of C. burnetii antibodies in dairy cattle sera samples collected in nine states and in camel sera samples in four states in Sudan during May 2015 - March 2016.
A total of 244 cattle sera and 76 camel sera samples were collected and screened for anti- C. burnetii IgG antibodies, using a commercial Q fever antibody ELISA test kit (IDEXX).
In dairy cattle, the results indicated an overall 29.92% prevalence of C. burnetii antibodies whereas an overall 64.5% prevalence rate was detected in dairy camel.
Our data indicate that C. burnetii is widespread in dairy cattle and camel in Sudan. Both animal and human health workers in Sudan should be aware of the possibility of Q fever infection in animals and humans.

Toxoplasma gondii (T. gondii) infections are widely prevalent in human beings and animals worldwide. Humans become infected post-natally by ingesting tissue cysts from undercooked meat, consuming food or drink contaminated with oocysts or by accidentally ingesting oocysts from the environment.
The present study was conducted to determine the seroprevalence of T. gondii infections in chickens in Sudan, during the period between December 2015 and January 2016.
Sera were separated from blood samples, which were collected from the wing vein of chickens (n = 58). Commercial serum agglutination kits (toxoplasmosis latex test kit) for Toxoplasma antibodies detection, using diluted blood serum samples (1/2, 1/4, 1/8, 1/16, 1/32, 1/64), were used.
Twenty-five, seventeen and sixteen chicken sera from river Nile, Khartoum and Sennar states, were positive, respectively. These represented a seroprevalence of 100% in all states with different titers.
Toxoplasma gondii infection is prevalent in chickens of Sudan. Therefore, further investigations on the parasite in other States of Sudan is important.

Leishmaniasis is a protozoal disease transmitted by sand-fly. The term leishmaniasis encompasses multiple clinical syndromes.
A 24-year-old male native of Yazd, Iran, was referred from the dental and subsequently to the infectious clinic with complaints of ulcer and swelling over his lower lip for three months. The lesion progressively increased in size over a few weeks and there was no history of fever or other complaints. The lesion had response to treatment with multiple antibiotics by various medical practitioners.
The case was interesting according to the rare location of the lesion since it can be confused with other infectious diseases.

Hepatitis C virus (HCV) infection is a major public health problem and may lead to liver failure and cancer. New direct-acting antiviral medications (DAAs) are potent with shorter course of treatment and less side effects. However, the cost of these medications and the limited experience are the main obstacles for their use.
Here, a sustained virological response (SVR) was achieved in a patient, who received interferon, ribavirin and sofosbuvir for six weeks. Medications were stopped at the sixth week of treatment due to severe depression and reduction in albumin levels.
This report highlighted the importance of further studies to determine the safety and optimum duration of treatment with DAAs.