Archives of Clinical Infectious Diseases
Volume:10 Issue: 4, Oct 2015

Chitotriosidase (CHIT1), the major chitinase in human airways, is expressed by pulmonary macrophage. Variation in the coding region with 24 bp duplication allele results in reduced CHIT1 activity.. The present study was designed to assess the impact of 24 bp duplication in exon 10 of human CHIT1 gene on pulmonary tuberculosis (PTB) risk..Patients and This case-control study was performed on 173 PTB patients and 164 healthy subjects in Zahedan, southeast Iran. Polymerase chain reaction (PCR) was used to detect the variant.. Homozygous wild type, heterozygous and homozygous mutant frequencies of CHIT1 24 bp duplication polymorphism were 43.9%, 43.9% and 12.2% in controls and 42.8%, 45.1% and 12.1% in PTB patients. We found the mutant allele frequency of 34.2% and 34.7% in controls and cases, respectively. Chi-square comparison of PTB and control subjects and logistic regression analysis revealed no association between CHIT1 24 bp duplication and PTB.. In conclusion, CHIT1 24 bp duplication might not be a candidate gene for susceptibility to PTB. Larger studies are necessary to confirm these findings in various populations..

Over recent decades, halitosis has become a priority in oral hygiene maintenance. Bad breath is one of the primary reasons for referral to dentists in Iran. Although halitosis is mainly caused by endogenous factors such as microbial metabolism, it is a multifactorial condition.. This study aimed to identify the probable relationship of the presence of Fusobacterium species in periodontal pockets with halitosis and determine the risk factors for this condition..Patients and This case–control study included patients referred to a polyclinic in Shiraz, which is located in Fars province in the southwest of Iran. In total, 50 patients with halitosis confirmed by an organoleptic test and 50 patients without oral malodor were recruited. Samples were obtained from their periodontal pockets using absorbent paper points and cultured for characterization by biochemical tests.. In total, 26% (n = 13) and 8% (n = 4) samples were positive for Fusobacterium species in the halitosis and control groups, respectively, with F. nucleatum present in the greatest proportion in both groups. Halitophobia was significantly more frequent in the halitosis group than in the control group (P < 0.001). Sinusitis was the most common systemic disease. Moreover, the halitosis group patients exhibited a greater tendency to include curry powder, chili, and sausage in their diet compared with the control subjects (P < 0.05).. The results of the present study suggest that the presence of Fusobacterium species in periodontal pockets is an important risk factor for halitosis..

Staphylococcus aureus (S. aureus) isolates have emerged in healthcare and community, and cause a wide spectrum of clinical signs. On the other hand, methicilin-resistant S. aureus (MRSA) isolates can resist a wide range of antibiotics, which can make treatment of infections much more difficult.. The current study aimed to determine S. aureus characteristics isolated from wounds.. This definitive and cross-sectional study was conducted in Tehran, Iran. A total of 15 S. aureus isolates were collected from wound samples with sterile swabs and were identified by the conventional diagnostic tests. The antibiotic susceptibility pattern was performed according to the Clinical and Laboratory Standards Institute (CLSI, 2012) protocol. The mecA gene, Staphylococcal Cassette Chromosome mec (SCCmec) types, agr specific groups and biofilm related genes were detected by Polymerase Chain Reaction (PCR) assay.. The majority of the isolates were resistant to amoxicillin, tetracycline and erythromycin, but all were susceptible to vancomycin and linezolid. Eight (40%) isolates were methicillin resistant and the mecA gene was detected in these isolates. The majority of (90%) of MRSA harbored SCCmec type III, and two isolates harbored type V. The majority (70%, n = 14) of the isolates belonged to agr I, followed by agr II (15%, n = 3), agr IV (10%, n = 2) and agr III (5%, n = 1). The frequencies of clfAB, fnbAB, fib, eno, cna, ebps and bbp genes were 100%, 100%, 65% (n = 13), 55% (n = 11), 70% (n = 14), 70% (n = 14), 55% (n = 11), 0% and 0%, respectively.. Half of the isolates were MRSA, the majority of which harbored SCCmec type III. Moreover, most of S. aureus isolates belonged to agrI. The frequency of icaAD, clfAB, fib and eno genes were high in S. aureus species isolated from wounds..

Staphylococci are some of the most common causes of infections in birds. Worldwide, the dramatic increase in the prevalence of antimicrobial-resistant Staphylococcus aureus (S. aureus) is receiving widespread attention, due to multi-resistant strains, diminishing the usefulness of antibiotics in human medicine and, thereby limiting therapeutic options.. In this study, we characterized the distribution and antibiotic resistance patterns of methicillin resistant S. aureus (MRSA) strains, isolated from lying hen farms in Karaj, Iran. The pulsed field gel electrophoresis patterns and the staphylococcus cassette chromosome mec (SCCmec) types were also determined.. Over a period of 90 days (collected at days: 0, 45, 90) during 2013, nine samplings, consisting of swab samples and litter collection, were done from three poultry farms (three each) and a total of 55 MRSA isolates were isolated from chromogenic MRSA selective agar. The clonality of MRSA strains was determined using pulsed field gel electrophoresis (PFGE) and the diversity in the structure of SCCmec elements and also different ccr types was studied. Susceptibility to seventeen antibiotics was determined, using disc diffusion method, according to Clinical and Laboratory Standards Institute recommendation.. Out of the 55 MRSA strains, all isolates were at least resistant to penicillin, 58% showed resistance to erythromycin and 55% were resistant to ciprofloxacin. On the other hand, all isolates showed susceptibility to vancomycin, quinuprostin-dalfopristin, linezolid, fusidic acid, nitrofurantoin and minocycline. The results of PFGE showed diverse pulsotypes, consisting of 13 common types and 18 single types, with seven common PFGE types, which were found among the MRSA strains, isolated from different farms, suggestive of an epidemiological link. Moreover, 67% of MRSA isolates shared SCCmec type III and showed type 3 ccr, indicating the hospital origin of the strains.. The results of this study illustrated the persistence of resistant bacteria in the environment, and highlight the reservoir of resistance, associated with use of antibiotics, as feed additive in poultry production..

Hydatid disease can involve various body organs, but it is less common for it to involve multiple organs simultaneously. Hydatid cysts present unique manifestations in each organ. Some of these manifestations are rarely reported. In this report, we discuss a case of hydatid disease of the liver and omentum. Although most of the abdominal hydatid cysts are considered to be asymptomatic, our patient presented with symptoms of acute abdomen due to a torted peritoneal cyst, which is a very rare presentation.. A 40-year-old man was referred to the emergency department with dull and intermittent periumbilical pain in the left and right lower quadrant regions accompanied by moderate tenderness and rebound with involuntary guarding over the entire lower half of the abdomen. As the patient’s condition and abdominal pain were worsening rapidly, an open laparotomy was scheduled with the primary suspicion of peritonitis. During the surgery, five omental cysts were observed within different parts of the abdomen. One of the cysts was torted. Two simple cysts were also detected on post-operative abdominal computed tomography.. It is important to keep in mind that even peritoneal involvement may be seen despite intact hepatic cysts. Careful excision of these cysts is the treatment of choice..

Crimean-congo hemorrhagic fever (CCHF) is a tick-borne zoonotic disease caused by Nairovirus of the Bunyaviridae family. It affects multiple systems and case fatality rate may vary between 5% - 30%. It also causes several complications. Here we presented a pararenal abscess case complicating CCHF, never reported before.. A 49-year-old male dealing with livestock husbandry was admitted to Ankara Training and Research Hospital with three days of complaints including fever, malaise, headache, myalgia, nausea, vomiting, diarrhoea and hematuria. Laboratory findings (thrombocytopenia and elevated alanine transaminase (ALT) and aspartate transaminase (AST)) were suggesting CCHF and he was hospitalized. The diagnosis was confirmed by CCHF reverse transcriptase-polymerase chain reaction (RT-PCR) and IgM positivity. Although his clinical condition was improving, he developed right flank pain on the fourth day. The computerized tomography showed abscess (pararenal 44 mm × 17 mm). With appropriate antibiotherapy and percutaneous drainage, his clinical and laboratory findings regressed.. Unexpected complications may be seen during the course of CCHF. Patients must be closely followed up..

Tuberculosis is a chronic bacterial infection that is caused by Mycobacterium tuberculosis. This chronic infection is amongst important of reasons for morbidity and mortality in the world. Cutaneous tuberculosis is a rare form of extra pulmonary involvement.. The case was a 42-year-old female, a known case of rheumatoid arthritis that was receiving prednisolone, and presented multi-lobulated soft tissue abscess in the forearm. Smear of the drained pus had 3+ Acid Fast Bacilli (AFB) and culture of the drained material confirmed Mycobacterium tuberculosis.. The detection of Mycobacterium tuberculosis is always an important differential diagnosis for skin and soft tissue involvement in endemic areas. The cold abscess is an uncommon form of cutaneous tuberculosis that can be single or multiple and with or without fistula..

Tuberculosis is now more frequently observed in older individuals, often with underlying illnesses or conditions that may confuse diagnosis. Rapid diagnosis is mandatory. However, treatment should be initiated immediately based on strong clinical suspicion, because mortality from tuberculosis is most often due to delays in treatment.. A 68-year-old male was admitted to our hospital with fever. He had splenomegaly, ascites and right-sided psoas abscess. Chest X-ray was normal. Although the vertebral column was intact, he had asymptomatic sacroiliitis. Bony changes of the right sacroiliac joint seemed to be chronic on computerized tomography (CT) scan. Lack of associated clinical symptoms strengthened this assumption. However, signal alterations of respective areas on magnetic resonance imaging (MRI) suggested active inflammation. Analysis of aspirated pus was positive for acid-fast bacilli and the culture depicted mycobacterial growth. The patient was not cirrhotic yet he had high serum-ascites albumin gradient ascites. He had two hypodense lesions in his liver with a cholestatic pattern in the liver test. He had pancytopenia. Biopsy from his liver and bone marrow showed multiple granulomas. Treatment was started with an anti-tuberculosis regimen of four drugs. He responded well to our therapeutic protocol.. Tuberculosis is still a diagnostic challenge, especially when the presentation is atypical and extra-pulmonary..