Archives of Clinical Infectious Diseases
Volume:14 Issue: 4, Aug 2019

This study aimed to design the prevalence maps of toxocariasis in different provinces of Iran. Moreover, the effects of three climatic parameters were explored on Toxocara egg maturation in various provinces using geographical information system (GIS). A review was conducted to examine the studies of the prevalence of human and animal toxocariasis and the contamination of public places with Toxocara eggs. Climatic data were converted into raster layers in ArcGIS 10.3 software and subjected to spatial analysis. A climate-based risk map was drawn for the whole country. Iran was classified into four different classes. Golestan, Mazandaran, Guilan, Khuzestan, Fars, Hormozgan, and Lorestan provinces were located in class four with the highest possibility of parasitic egg development due to proper humidity and temperature. Further, the results showed a high prevalence of human toxocariasis antibody titer in Khuzestan and Fars provinces and high prevalence of infection among carnivores in East Azerbaijan, Tehran, Razavi Khorasan, and Mazandaran provinces. Given the high prevalence of anti-Toxocara antibody titer reported in various studies and the high risk of infection in children, the results of the present study can be helpful for physicians and healthcare staff in high-risk provinces.

Nanobacteria-like structures (NLSs) or calcifying nanoscale particles (CNPs) are novel ambiguous entities. As their names imply, they are tiny creatures (100 to 500 nanometers). Compared to ordinary bacteria, they can exhibit some unbelievable properties such as resistance to conventional antibacterial procedures. Form a scale point of view, these microorganisms are much smaller than ordinary bacteria and are preserved from the outer environment by their rigid apatite shell. The above-mentioned protective properties of nanobacteria are responsible for a dangerous in vivo calcification procedure causing pathological infectious diseases.

The main goal of this study was to identify and isolate the nanobacteria from patients with atherosclerosis.

Human vascular tissues were assessed for the presence of NLSs in atherosclerotic plaques at Sina Hospital, Tehran, Iran. All 40 samples obtained from patients as the wastes of surgery showed crystallization in vitro after about 10 days. Crystallization was seen also in filtered media. The precipitates of media were investigated by scanning electron microscopy (SEM).

NLSs were seen in all samples by SEM. After confirming the NLSs presence, they were characterized by TEM, XRD, and SEM/EDAX.

The NLSs are observed in patients with atherosclerosis.

Scorpions have evermore received considerable attention in Iran due to their medical importance, richness, and frequency. In order to the study scorpions’ behavior and bio-ecology, it is important to use the propermethod for scorpion catching. The collection and maintenance of the specimens are among the most important parts of every study.

This article investigated different techniques suitable for capturing scorpions in residential and non-residential areas of Khuzestan province, Southwestern Iran.

Various scorpion species were captured from rural and urban areas of six counties of this province during 26 sampling sessions, using five methods, namely the black light, rock-rolling, scorpion nest digging, old mud walls destruction, and demolition dry mud wall on the edge of channels. Information pertaining to the number of captured samples in each hunting session, geographical locations under investigation and their specifications, number of sampling sessions and hunting site was recorded.

In total, 391 scorpions of different species were captured. In this study, six different species were collected using different techniques: rock-rolling (53.7%), destruction dry mud wall on the edge of channels (19.7%), old mud walls destruction (13.6%), black light (11.5%), and scorpion nest digging (1.5%). The most frequent species were Hemiscorpius lepturus (60.4%) and Mesobuthus phillipsi (21.5%).

The rock-rolling and black light techniques are respectively, recommended for collecting scorpions during the day and at night from both residential and non-residential areas. The combination of these two methods in different areas improves efficiency.

Diarrhea is one of the most significant diseases in children, causing morbidity and mortality worldwide. Diarrhea is caused by viruses, bacteria, and parasites. There are several viruses that can cause diarrhea, including some groups of enteroviruses that have a significant role in acute diarrhea in children.

This study was conducted to evaluate the presence of enteroviruses in the stool of children with diarrhea.

We collected 85 stool samples including 50 (58.82%) from males and 35 (41.17%) from females with acute diarrhea. All the stool samples proved negative for bacterial and parasitic pathogens. The RNA was extracted from the stool samples and cDNA was prepared. The semi-nested PCR was carried out for the detection of the 5’-UTR region of enteroviruses. To determine the enterovirus serotypes, the sequences of semi-nested PCR product was performed using conserved primers for the 5’-UTR region.

Overall, 21/85 (24.7%) patients including 12/50 (24%) males and 9/35 (25.71%) females showed positive results for enteroviruses (P = 0.3). Based on the results of sequencing, one of the isolated serotypes was identified as coxsackievirus A6 and the other isolated serotype was echovirus 9.

Overall, 21/85 (24.7%) children with acute diarrhea were infected with enteroviruses. The distribution of enteroviruses was not significantly different between male and female patients. The results of sequencing indicated that one of the isolated serotypes was coxsackievirus A6 and the other isolated serotype was echovirus 9. The remaining 64/85(75.29%) isolates were negative for enteroviruses. The role of other viral gastroenteritis agents including rotaviruses, noroviruses, calicivirus, astrovirus, and adenoviruses was not explored that needs further investigation.

Methicillin-resistant Staphylococcus aureus (MRSA) is often the cause of a wide broad of infections ranging fromminor skin infections to serious infections such as toxic shock syndrome (TSS) in hospital and community settings. Toxic shock syndrome toxin 1 (TSST-1) superantigen is the main cause of TSS.

The current study aimed to determine the frequency of MRSA carriage and TSST-1 virulence factor among high school students.

A total of 400 nasal swab samples were randomly collected from male and female students of six different high schools in Tabriz, Iran. After confirmation of S. aureus strains by standard biochemical tests, the antibiotic sensitivity pattern of the isolates was determined by the disk diffusion method. The presence of mecA and TSST-1 genes was examined by PCR.

From 400 students, 15% (n = 60) were positive for S. aureus. Antimicrobial susceptibility testing was performed using 12 antibiotic disks. Based on the results, 100% of the isolates were resistant to ampicillin while all of them were sensitive to vancomycin. Moreover, 18.34% of the S. aureus isolates were resistant to cefoxitin and 11.67% were resistant to oxacillin. The presence of the mecA gene was confirmed in 54.54% of the cases. These results indicated oxacillin-susceptible mecA-positive S. aureus (OS-MRSA) colonization among students. Based on the PCR results, only one of the MRSA isolates belonging to a female student was positive for the TSST-1 gene.

Our findings highlight the spread of OS-MRSA among the healthy population in Tabriz, Northwest of Iran. Nevertheless, a combination of genetic and phenotypic tests is needed to accurately detect MRSA.

Acinetobacter baumannii is one of the most important opportunistic and biofilms-forming microorganisms. Its biofilm structure provides an effective barrier against the antimicrobial penetration and increases the drug resistance of Acinetobacter baumannii by 1000× compared with plankton cells. However, nanoparticles have recently reported as suitable tools to prevent biofilm formation.

The aim of this study was to investigate the effect of curcumin nanoparticles on biofilm gene expression inAcinetobacter baumannii strains in vitro.

Seventy clinical isolates of Acinetobacter baumannii were collected from different specimens and all specimens were diagnosed biochemically. Antibiotic resistance pattern was detected by disc diffusion method. Isolates of high biofilm producers were selected to investigate the effect of curcumin nanoparticles. The antibiofilm activity of curcumin nanoparticles was studied using Real-time PCR technique in the molecular level.

This bacterium showed high resistance to most antibiotics, except for polymyxin B. Twenty-five strains had high biofilm formation capacity. MIC for curcumin was 128µg/mL in all 25 strains. The expression results showed that CsuE gene was downregulated to 0.31 fold in curcumin-treated samples compared to untreated samples.

The study findings suggest that curcumin nanoparticles can be helpful as a candidate for inhibiting the formation of Acinetobacter biofilms.

Integrons are known as mobile genetic elements (MGEs) with their own effects on transferring antibiotic resistance genes among bacteria.

The main purpose of this study was to determine the frequency of class I and II integrons in methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) isolates in the city of Kermanshah, Iran.

In this descriptive cross-sectional study, 86 isolates of S. aureuswere collected and verified using specific biochemical tests, and then examined for antibiotic susceptibility by the Kirby-Bauer disc diffusion method. The frequency of class I and II integrons was also determined by polymerase chain reaction (PCR) and specific primers.

The frequency percentages of class I and II integrons were 47.7% (n = 41 isolates) and 17.4% (n = 15 isolates), respectively. A statistically significant relationship was observed between the frequency of class I and II integrons and resistance to some antibiotics (P < 0.05). In the MRSA isolates, the most antibiotic resistance was to penicillin (100%) and gentamicin (80%) and the most antibiotic sensitivity was to vancomycin (100%) and linezolid (96.5%).

Due to the frequency of the integrons in resistant strains of S. aureus, as well as the possibility of rapid transfer of these agents among the isolates, we are in dire need of continuous monitoring of resistance patterns and selection of appropriate antibiotics using the phenotypic and genotypic resistance measurements taken by hospital laboratories to reduce and control antibiotic resistance.

Strongyloides stercoralis, a soil transmitted helminth, is well known as a potentially fatal parasite in immunosuppressed patients.

The current study aimed to evaluate the prevalence of strongyloidiasis in diabetic patients, in the central parts of Mazandaran province, Iran, using coprological examination and enzyme-linked immunosorbent assay (ELISA).

Fresh stool and serum samples were obtained from diabetic patients. The stool samples were examined using direct smear and formalin-ether concentration methods. The serum samples were tested for the existence of Strongyloides sp. antibodies using a commercial diagnostic kit (Strongyloides - ELISA).

The overall prevalence rates were 13.3% (4/30) and 25.6% (46/180) using parasitological and ELISA methods, respectively. The sensitivity and specificity of ELISA compared with stool examination were 100% and 84.6%, respectively. The seroprevalence rate of this infection was higher in females (27.3%) than males (19.5%), and among participants living in rural regions (31%) compared with urban areas (20%). The prevalence rate of Strongyloides sp. infection was higher in patients with diabetic foot (39.1%) compared with cases with non-diabetic foot (23.6%). It also was higher in insulin dependent patients (29.9%) compared with non-insulin dependent subjects (23%). However, these differences were not statistically significant which may have resulted from the small sample size.

Our findings demonstrated a high seroprevalence of Strongyloides sp. infection in diabetic patients. Furthermore, this is the first seroprevalence study of strongyloidiasis in diabetic patients from Iran. It seems that the ELISA technique can be used for the diagnosis of individual cases and is a good screening assay to rule out strongyloidiasis in diabetic patients.

Cytokines, as key regulators of immune responses, are imbalanced in tuberculosis (TB) which may reflect the status of the disease. Therefore, cytokines could be introduced as potential diagnostic and prognostic TB biomarkers.

Here, we examined the plasma levels of IL-17, IL-6, and TGF-β among newly diagnosed patients with TB in comparison to normal subjects and analyzed the diagnostic utility of each cytokine to introduce a novel TB biomarker.

A total of 105 smear-positive, including 78 newly diagnosed (ND) and 27 under treatment (UT) patients with pulmonary TB and 111 age- and sex-matched healthy subjects were recruited. ELISA cytokine assay was used to determine the plasma levels of IL-17, IL-6, and TGF-β.

IL-6 plasma level was higher in the ND patients than healthy subjects (P = 0.002) and the UT patients (P < 0.0001). Also, IL-17 and TGF-β were significantly overexpressed among both groups of patients with TB compared with healthy subjects. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic utility of the evaluated cytokines. Area under the curve (AUC) for IL-6 was 0.5598 (P = 0.129). Regarding the diagnostic value of IL-6 to distinguish between the ND and UT patients, AUC for IL-6 was 0.8139 (P < 0.0001). Setting the optimal cut-off value at 23.75 gave a sensitivity of 77.78% and a specificity of 74.36%. AUC for IL-17 was 0.9148 (P < 0.0001), while AUC for TGF-β was 0.8877 (P < 0.0001). Setting the optimal cut-off value at 14.05 for IL-17 gave a sensitivity of 81.90% and a specificity of 79.28%, while setting the optimal cut-off value at 51.20 for TGF-β resulted in a sensitivity of 82.69% and a specificity of 72.73%.

All evaluated cytokines were overexpressed in newly diagnosed TB patients with different diagnostic utilities. IL-6 is more convenient in distinguishing the ND from UT patients. IL-17 is more specific in distinguishing TB infection and TGF-β represented a higher sensitivity. It is suggested that multiple cytokine assay should be conducted to have a better diagnostic performance rather than individual cytokine evaluation.

Papulonecrotic tuberculid (PNT) is a relatively rare subtype of cutaneous tuberculosis believed to represent a hypersensitivity reaction to tuberculosis antigens. Yet, the simultaneous occurrence of PNT and Erythema Induratum (EI) is even more uncommon. Here, we present a case of concomitant PNT and EI in a 53-year-old woman without any previous history of Mycobacterium tuberculosis infection who was successfully treated with anti-tuberculosis agents without recurrence in a subsequent follow-up.