Jundishapur Journal of Microbiology
Volume:10 Issue: 2, Feb 2017

Cryptosporidiosis has been reported in both immunocompetent and immunocompromised patients from over 40 countries in six continents..
This study was carried out to determine the prevalence of Cryptosporidium spp. in immunocompromised patients by methods of modified acid fast staining, ELISA and Cassette Kit, and to also compare the three methods..
The patients in different age groups admitted to Bitlis state hospital between June 23, 2011 and January 13, 2015 were enrolled. The study group was composed of 300 immunocompromised volunteer patients and the control group of 100 volunteers with normal immune system. In the study group, patients with hemodialysis, chronic renal failure, diabetes mellitus, diabetes insipidus, and cancer were enrolled. Formalin-ethyl acetate, modified acid fast staining and native-lugol were used for all stool samples; they were also investigated for Cryptosporidium antigens by the ELISA and Cassette Kit..
The highest prevalence rate of Cryptosporidium spp. is found to be 11.3%, which is obtained by ELISA and the lowest (0.7%) by Cassette Kit in the study group. All patients with cryptosporidiosis had diarrhea. The highest prevalence rate (20%) was observed in patients with diabetes insipidus and the second highest in patients with chronic renal failure (11.5%) by ELISA. The sensitivities and specificities of Cassette Kit and modified acid fast staining were 5.9%, 100%; and 50%, 100%, respectively..
It is concluded that Cryptosporidium spp. should be considered in immunocompromised diarrheal patients and ELISA must be chosen for detection of this parasite. Modified acid fast staining and Cassette Kit techniques could be performed if ELISA is not available. The single use of the Cassette Kit will be inadequate for the diagnosis of cryptosporidiosis..

Transmission of Helicobacter pylori occurs within families. It is known that elimination of H. pylori may reduce the risk of peptic ulcer disease (PUD) and gastric cancer (GC) and increase the risk of gastro-esophageal reflux (GERD), Barrett’s esophagus, and esophageal adenocarcinoma..
The present study aimed to determine gastric cancer-related strains of H. Pylori by precise diagnostic methods in patients with gastritis and PUD in East Azerbaijan, Iran, where the incidence of GC and esophageal cancer is high..
The PCR assay was performed on the same biopsy samples used for Campylobacte-like organism test (CLO test), using the vacA d region (a gene predictor of gastric adenocarcinoma and peptic ulcer disease) and 16S rDNA gene in patients referring to the department of endoscopy at Imam Reza hospital in Tabriz, Iran. This study was conducted on individuals who had not received non-steroidal anti-inflammatory drugs or any anti-Helicobacter therapy at least for 3 months prior to endoscopy. The collected data were analyzed using SPSS version 19..
The rate of false negative results by CLO test was 8.3%. However, no false-positive results were found by CLO test. Among those patients infected with H. pylori, vacA d1 -positive strains, one case had a history of gastric cancer and another one had a history of gastric ulcer in first-degree relatives. However, no family history of gastric cancer or gastric ulcer was found in the patients with strains carrying the vacA d2 genotype..
This study suggests that the vacA PCR can be very useful in diagnosis, treatment, and follow-up of patients with gastritis and PUD. The PCR assay and CLO test can complement and confirm each other in identification and eradication of cancer-related strains of H. pylori. The exclusion of patients with suspected achlorhydria from the study is likely a reason for the lack of false positive results in CLO test..

Methicillin resistant Staphylococcus aureus (MRSA) is an increasingly common hospital pathogen in burn patients, which is known to cause over 50% of burn related deaths. One of the serious threats associated with clinical isolates of MRSA is multi-drug resistance, which is associated with integrons..
The aim of this study was to determine the distribution and molecular types of MRSA in burn patients and their carriage of integrons..
During a 7-month period, 106 MRSA isolates were collected from burn wounds of patients admitted to a referral burn hospital in Tehran. Antimicrobial susceptibility testing (AST) was performed for 12 antimicrobial agents. Polymerase chain reaction (PCR) was used to detect nucA, mecA, pvl and tsst-1 genes, and class 1 and 2 integrons. Multiplex PCR technique was used to determine the Staphylococcal cassette chromosome mec (SCCmec) types of MRSA strains. All isolates were genotyped by staphylococcal protein A (spa) typing..
AST showed the lowest rate of resistance to quinupristin-dalfopristin (19.8%), mupirocin (31.3%), and rifampicin (37.7%). All isolates were susceptible to vancomycin, teicoplanin, and linezolid. Multi-drug resistance was observed in 97% of isolates. The most SCCmec type was SCCmec type III (98.1%) while only 2 (1.9%) MRSA isolates harbored SCCmec type IV. SCCmec types I, II, and V were not detected. The study revealed the presence of class 1 integron in 58 (54.7%) isolates and class 2 integron in 3.8% of isolates. Six different spa types of t030 (66%), t037 (14.2%), t065 (9.4%), t1358 (4.7%), t937 (3.8%), and t084 (1.9%) were identified amongst the isolates..
The study revealed a high prevalence of multi-drug resistance (MDR), class 1 integron, SCCmec type III, and spa type t030 amongst MRSA associated with burn wounds in an Iranian hospital. The existence of SCCmec type III in burn patients emphasizes the nosocomial origin of these strains..

Occult hepatitis B infection (OBI) is determined by finding hepatitis B virus (HBV) DNA in the liver cells of the patients with negative tests for HBV surface antigen. It is more common in patients with hepatitis C virus (HCV) infection which can be transmitted by blood transfusion and is frequently seen in hemophilia and thalassemia patients..
The aim of this study was to assess the prevalence of OBI among Iranian patients with hematological disorders (thalassemia, hemophilia and other coagulation factor deficiencies) infected with chronic hepatitis C (CHC)..
In this descriptive cross-sectional study, all patients with hematological disorders (thalassemia, hemophilia or other coagulation factor deficiencies) who had simultaneous CHC infection and were referred to the Tehran hepatitis center between 2009 and 2010 were enrolled. Occult hepatitis B infection identification was based on serum HBV-DNA tests. Data analysis was performed with SPSS software..
All patients were HBsAg-negative and HCV RNA-positive. Only 145 patients were evaluated for HBV DNA (126 male and 19 female patients). The mean age (SD) was 28.12 (8.6) years. Thirty-five patients had thalassemia, 95 patients had hemophilia, and 15 patients had coagulation factor deficiencies. Serum HBV-DNA was negative for all cases..
Based on our results, it seems that there were no cases of OBI among chronic HCV-infected patients with thalassemia and bleeding disorders, particularly hemophilia. However, to improve decisions concerning OBI screening, especially in transfusion centers, and concerning the use of comprehensive screening methods, more original studies with more precise laboratory techniques and larger sample sizes are needed..

Uropathogenic Escherichia coli is one of the most prevalent infectious agents in humans, but its resistance to commonly used antibiotics is growing rapidly..
The aim of this cross sectional study was to investigate the prevalence of tetracycline resistance determinants in urinary E. coli isolates obtained from patients in Iran..
A total of 50 E. coli isolates from human urinary infections were characterized by cultural, biochemical, and molecular tests from 2014 to 2015. Isolates were tested for resistance to tetracycline by disc diffusion method. Then, the prevalence of tetracycline efflux genes (tetA, tetB, tetC, tetD, tetE, tetG, tetH and tetZ) was detected by means of molecular polymerase chain reaction method (PCR)..
Of the 50 E. coli isolates tested, tetracycline resistance was identified in 62% of the strains. PCR analysis revealed that 36% of these isolates contained tetB gene, followed by tetA determinant with 32% frequency. The prevalence of tetG, tetZ, tetC, tetE, tetH, and tetD were 16%, 14%, 12%, 12%, 11%, and 8% among the isolates..
Tetracycline resistance is widespread among uropathogenic E. coli isolates from human infections. Moreover, the distribution of tetracycline resistance determinants among the studied E. coli was very similar to the findings of the international sourced gallery of clinical E. coli Strains..

Candida species are known as the most common fungal pathogens isolated from clinical specimens that can develop complications ranging from cutaneous to systemic diseases..
The present study was conducted to evaluate the diversity and distribution of Candida species in various kinds of cutaneous candidiasis in Tehran, Iran. In addition, the critical effects of several predisposing factors on the induction and progression of the disease were considered..
A total of 3000 samples were taken from March 2014 to 2015. The samples were examined using direct microscopy and culturing method. The polymorphism analysis was performed by using polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) technique. The internal spacer region (ITS) of the fungal rRNA genes was recruited for PCR amplification of target sequences and Msp1 enzyme was employed to digest PCR amplicons..
Out of 3000 samples, yeast was recovered in 290 (9.67%) cases. Onychomycosis was observed predominantly in 164 nail samples (56.5%). The majority of patients were within the age range of 51 - 60 years (22.14%). Women working at home (housewives) showed the highest percentage of people at risk (n = 135, 46.5%). Among patients with underlying diseases, diabetic patients with 46 cases (14.2 %) had the highest susceptibility to candidiasis. Genotypic identification showed that Candida albicans is the most common species (n = 132, 45.5 %) recovered from clinical samples, followed by C. parapsilosis (n = 77, 26.5%), C. glabrata (n = 22, 7.5 %), C. krusei (n = 16, 5.5 %), C. tropicalis (n = 37, 12.7 %), and C. guilliermondii (n = 6, 2%)..
The results of the present study, compared to the previous studies, showed a significantly lower prevalence of cutaneous candidiasis. Among Candida species, C. albicans was still the most common infectious agent isolated from clinical samples. Shifting toward non-albicans Candida species was not confirmed in this study. In addition, our study revealed that there is a direct correlation between some predisposing factors including age of patients, and existence of some non-infectious diseases (e.g. metabolic disorder) and occurrence of Candida infection..

Brain abscess is a rare life-threatening focal intracerebral infection. The etiology of brain abscess depends on trauma, surgical intervention, and infection type. In this report, we present a case with brain abscess caused by Prevotella denticola after chronic otitis media infection..
A 27-year-old male patient presented a history of yellowish green ear drainage coloring his pillow for 10 years. One month before admission, he began to suffer from increased headache. He was first admitted to another hospital and treated with ceftriaxone for otitis media. He was referred to our hospital when a brain abscess was detected in cerebral magnetic resonance imaging (MRI). Meropenem and vancomycin treatment was stated empirically because of failure of the previous antibiotic therapy. The abscess was drained through a burr hole on the second day of admission. The aerobic culture of the pus resulted negative; however, black pigmented colonies were detected on anaerobic culture plates. The organism was identified as P. denticola via molecular typing targeting the 16S RNA gene. The postoperative period was complicated by left temporal hematoma that required surgical intervention; left transverse and sigmoid sinuses thrombosis were treated with enoxaparine. Because of the critical condition of the patient, de-escalation was not considered, and the patient received meropenem plus vancomycin for 6 weeks until discharge with complete cure..
In conclusion, in spite of usually benign features, chronic otitis media may lead to serious complications such as brain abscess. Every effort should be made for microbiological diagnosis of the causative pathogen(s) for appropriate antibiotic treatment..