Archives of Clinical Infectious Diseases
Volume:15 Issue: 2, Apr 2020

In the healthcare system, Artificial Intelligence (AI) is emerging as a productive tool. There are instances where AI has done marvels in the diagnosis of various health conditions and the interpretation of complex medical disorders. Although AI is far from human intelligence, it can be used as an effective tool to study the SARS-CoV-2 and its capabilities, virulence, and genome. The progress of the pandemic can be tracked, and the patients can be monitored, thereby speeding up the research for the treatment of COVID-19. In this review article, we highlighted the importance of AI and Machine learning (ML) techniques that can speed up the path to the discovery of a possible cure for COVID-19. We also deal with the interactions between viromics and AI, which can hopefully find a solution to this pandemic.

  A review of different articles was conducted using the following databases: MEDLINE/PubMed, SCOPUS, Web of Science, ScienceDirect, and Google Scholar for recent studies regarding the use of AI, seeking the spread of different infectious diseases using relevant MeSH subheadings.

After a thorough screening of different articles, 30 articles were considered, and key information was obtained from them. Finally, the scope was broadened to obtain more information. Our findings indicated that AI/ML is a promising approach to drug development.

The field of AI has enormous potential to predict the changes that may take place in the environment. If this technology is applied to situations of a pandemic such as COVID-19, breakthroughs could potentially pave the way for new vaccines and antiviral drugs.

The COVID-19 (SARS-CoV-2) pandemic originating in Wuhan, China, has continued to escalate, causing millions of infections, over 100 thousand deaths, enormous economic losses, and global social challenges. Containing the rapid spread of the infection and deaths requires a joint local, national, regional, and international collaborative evidence-based implementation of policies. We aimed to identify, extract, summarize, and extrapolate symbiotic strategies and methods of containing pandemic viral diseases for global implementation against COVID-19.

 A literature review was conducted and used to describe and extrapolate strategies and methods used in containing pandemic viral diseases occurring between the years 2000 and 2020. The information was identified, extracted, and summarized from reports from the WHO, the CDC, the National Department of Health websites, and bibliographic databases such as PubMed, Google Scholar, Embase, and Web of Science.

Viral containment was found to be fostered and achieved through rapid behavior modifications, community mobilization, and effective testing and treatment strategies. Educating communities on transmission, symptoms, outcomes, quarantine, and isolation, prevention strategies such as sanitizing and using PPE, when and where to report suspected cases, and where to go for testing, counseling, and treatment that have proven to be effective in managing and mitigating viral pandemics.

COVID-19 is a viral pandemic that can be contained through a behavioral modification approach, where individuals and communities jointly enforce international prevention policies responsibly and consistently

In late December 2019, a new type of coronavirus, called novel coronavirus disease 2019 (COVID-19), caused a major outbreak of severe pneumonia in Wuhan (Huanan seafood market) and then, across China. As of 31 March 2020, COVID-19 has spread in 200 countries, including Iran, and imposed serious health-related threats to the public worldwide. Fever, dry (non-productive) cough, myalgia, and pneumonia seem to be the symptoms of COVID-19 disease. To date, and despite various studies and investigations, except for chloroquine and hydroxychloroquine, which have recently been temporarily approved by FDA, no other vaccines and/or antiviral agents have been clinically endorsed for the treatment of COVID-19 disease. Nevertheless, prevention of the disease and control of the infection is deemed a top priority for the general public. Owing to the characteristics of different dental treatments and settings, the risk of virus transmission can be considered high between patients and dental practitioners. Therefore, the need for strict and tough effective infection control protocols in dental practice is of great importance, namely for the dental centers in the potentially affected areas with COVID-19. This study, based on relevant evidence, aimed to review the basic knowledge of COVID-19 and address the recommended protocols of infection control for the dental practitioners and treatments in hypothetically stricken areas.

Mycobacterium tuberculosis (MTB), which is the causative agent of tuberculosis (TB), is among the most important infectious bacteria with high morbidity and mortality rates worldwide. Bacilli Calmette-Guerin (BCG) vaccine has been discovered for about a century, and it is considered as a major vaccine for humans. However, some factors, such as its attenuated nature and its inefficacy against the latent form of the disease, have led to the use of alternative vaccines. Multi-epitope subunit vaccines are new-generation vaccines that are being developed in clinical trial phases. For the production of a subunit vaccine, the selection of immunodominant antigens and targeted delivery systems to antigen presenting cells (APCs) are considered as basic parameters. In the present study, we designed the novel multi-epitope ESAT-6:Ag85B:Fcγ2a, which was evaluated completely by various online tools as an optimum vaccine against TB. The early secreted antigenic target of 6 kDa (ESAT-6) and antigen 85B (Ag85B) are two immunodominant antigens, and Fcγ2a is a targeted delivery system. This vaccine candidate can be used for future preclinical studies.

Chlamydia psittaci (C. psittaci) is an important zoonotic pathogen in birds and has been reported from urban pigeons (Columba livia) and house sparrows (Passer domesticus) worldwide. Some public areas in Iran, such as parks, have a high density of these birds; thus, they may be regarded as a zoonotic threat to humans. The current study aimed at performing the prevalence assessment as well as the phylogenetic analysis of C. psittaci in cloacal swab samples from these birds. To this aim, a total of 75 specimens of urban pigeon, 75 specimens of the house sparrow, and 30 pharyngeal swabs of humans who work in pet-markets were collected from six different zones of Chaharmal-va-Bakhtiari, a Southwestern Province of Iran. The prevalence of C. psittaci was 25.3% (19 out of 75), 18.6% (14 out of 75), and 10% (3 out of 3) among the pigeon, sparrow and the human samples, respectively. The prevalence of C. psittaci was considerably high in urban pigeons. To determine the genotype of C. psittaci, OmpA gene fragments in positive samples were amplified and sequenced. Phylogenetic analysis revealed that strains from the pigeon and sparrow positive samples belonged to the genotypes B and A, while genotyping was unsuccessful for the positive human samples. Our findings suggest that the prevalence of C. psittaci in pigeons and sparrows is high in Chahrmahal-va-Bakhtiari posing as a potential infection risk to susceptible individuals in public places and parks. Therefore, it is essential to take effective measures for the implementation of proper control programs to prevent the possible infection of people with C. psittaci.

Toxigenic Clostridium difficile is one of the prevalent diarrheagenic pathogens in hospitalized patients.

The study assessed the ability of three diagnostic methods in identifying C. difficile strains. The genotyping of the isolates was done, as well.

Stool samples were subjected to three different diagnostic methods including direct stool culture, glutamate dehydrogenase enzyme immunoassay (GDH-EIA), and direct stool PCR for the detection of the tcdA and tcdB genes. The sensitivity and specificity of the tests were evaluated. The genotyping was done by the PFGE method.

Of 120 samples, 20 (16%) were positive for C. difficile based on PCR, while 15 (12.5%) and 12 (10%) were positive according to GDH-EIA and direct stool culture. Among patients with C. difficile-associated diseases (CDAD), 11 (61%) were more than 65-years-old. The specificity of PCR, GDH-EIA, and direct culture was almost similar and equal to 100%, but their sensitivity was 90%, 70%, and 60%, respectively. The positive predictive value (PPV) was lower for GDH-EIA than for the other two methods, and the highest negative predictive value (NPV) was related to the PCR method. The results showed a high similarity between the isolates, and only were three pulsotypes differentiated among the isolates.

The specificity and sensitivity of the direct stool PCR method were higher than those of the other two methods. Although PCR inhibitors may reduce its ability for the correct diagnosis of negative samples, it seems to be a reliable method for the detection of C. difficile infection. The weakness of the GDH-EIA method was its lower PPV, which can cause false-positive results. Toxin patterns and pulsotypes of C. difficile isolates revealed a high similarity between the strains isolated from the same units.

Recently, a novel coronavirus was reported from Wuhan, Hubei Province, China. The novel coronavirus infection was spread from China to other countries, including Iran.

We report the clinical characteristics, laboratory findings, and chest exams of infected patients.

All patients suspected to the novel coronavirus were hospitalized in a special airborne protection room. We collected and analyzed the characteristics of confirmed patients by data extraction from electronic medical records.

The Computerized Tomography (CT) scan and radiography results showed ground glass in the lung of patients, and real-time PCR confirmed the infection. The myocardial and liver function tests showed abnormalities in infected patients.

Most patients admitted to the Intensive Care Unit (ICU) showed respiratory problems, and their infection was confirmed by virological tests and chest images. The main reason for the patient’s death was the signs of acute heart failure, such as hypotension and cardiac arrhythmia

Nisin is a potent bacteriocin produced by Lactococcus lactis subsp. lactis and anti bacterial peptide. Colorectal cancer (CRC) is considered as one of the most prevalent and mortal cancers throughout the world. Genetic variations and environmental factors are responsible for initiation and development of cancer. Regulation of the apoptosis process plays an important role in the development of crc. bax, bcl2, caspase 3, 6, 8 and 9 genes are involved in induction of apoptosis.

The present study describes cytotoxic effects of nisin and bax, bcl2, caspase 3, 6, 8 and 9 gene expression levels in SW480 cells incubated with nisin at different doses and different incubation times.

The SW480 cells were treated with concentrations of nisin at different doses and different incubation times. The cytotoxic effects of nisin were studied using MTT assay. Expression levels of bax, bcl2, caspase 3, 6, 8 and 9 genes were determined by real-time PCR technique.

Our results showed that treatment with 800,1000,1200 and 1500 μg/mL nisin after 24 hour incubation at 37°C significantly reduced cell viability (P < 0.05). In the in vitro experiment, the mRNA expression level of bax, bax/bcl2 ratios, caspase 3 and caspase 9 were significantly increased (P < 0.05). In contrast, the mRNA expression level of caspases 6, 8 didn’t show any significant increase after 24 h and 48 h incubation (P > 0.05).

Our results confirm that nisin induces mitochondrial dependent apoptosis by up regulation of caspase genes expressions. The results of this study contribute to the use of nisin as a suggested therapeutic factor to reduce the progression of colon cancer

Sepsis is the leading cause of death in critically ill patients in Intensive Care Units (ICUs). Lipid metabolism may change during sepsis.

This study aimed to evaluate the lipid profile in patients with sepsis.

After approval of the local ethics committee, all adult patients admitted to a medical ICU of a tertiary teaching hospital were enrolled for one year in a prospective cross-sectional study. The inclusion criterion was the primary diagnosis of sepsis based on the probable or proved source of infection or positive blood culture. The exclusion criterion was the use of any lipid-reducing medications. The serum levels of triglyceride (TG), cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured for each patient on the first day after ICU admission. Patients were divided into survivors and non-survivors. Quantitative variables were reported as the mean (± SD). The independent samples t-test was used to compare the means between the two groups.

Of 112 patients, 24 were excluded due to the use of lipid-reducing medications. Of 88 enrolled patients, 54.5% were male. The average age was 71.49 ± 11.06 years, and the in-hospital fatality rate was 63.6%. The mean level of TG was significantly higher in survivors than in non-survivors (111.16 ± 37.83 vs. 100.75 ± 21.42 mg/dL, t = 1.429, P = 0.002). Cholesterol, LDL, and HDL levels did not show statistically significant differences between the two groups.

Our study illustrated that a lower TG level is associated with higher mortality in patients with sepsis in the ICU. Triglyceride may be used as a clinical indicator to assess the outcome of patients with sepsis.

Mycobacterium tuberculosis (TB) is a widespread life-threatening infection worldwide. There is an uncertainty in the association between the emergence of autoimmune antibodies and TB.

We hereby aimed to screen anti-tissue transglutaminase (anti-tTG) IgA in patients with TB in an Iranian population.

This was a cross sectional study conducted on smear positive TB patients admitted to the Respiratory Diseases Management Center of the city of Zabol, Sistan and Baluchestan Province of Iran during 2017 - 2018. Anti-tTG IgA level was determined using an ELISA kit (Pars Azmoun, Iran). Statistical analyses were performed in SPSS 19 software.

Overall, 162 patients were evaluated. Females and males constituted 87 (53.7%) and 75 (46.3%) of the patients respectively. The mean age was 51.7 ± 22.3 years (range of 1 - 83). Afghan patients constituted 16 (9.9%) and the remaining were Iranians. The therapy course was successfully completed in 78 (48.1%) patients, and 67 (41.4%) improved following treatments. Overall, 5 patients had active TB with 2 drug-resistant cases. Pulmonary tuberculosis was diagnosed in 127 (78.4%) while 35 (21.6%) had extra-pulmonary disease. The mean titer of anti-tTG IgA was 22.59 ± 107.7 (range of 0.8 - 940). Overall, 19 (11.9%) of the patients showed elevated levels of the antibody. There was no significant association between anti-tTG IgA titer with neither demographic nor clinical variables.

Although anti-tTG IgA antibody test was positive in a relatively high ratio of our patients with TB, the clinical implications of this phenomenon were not significant

Fecal carriage of extended-spectrum β-lactamase (ESBL)-producing bacteria is a potential risk for transmission and infection. Genotypes known to be associated with ESBL-producing Enterobacteriaceae are cefotaximases (CTX-M), temoniera (TEM), and sulfhydryl variable (SHV). Unfortunately, data on ESBL prevalence in Indonesia, especially in South Sulawesi, is still limited, so further research on the community is needed.

This study aimed to investigate the prevalence of fecal carriage of ESBL-producing Enterobacteriaceae among school children in South Sulawesi, Indonesia.

The research was conducted among school-children in South Sulawesi, Indonesia. Detection of ESBL gene using polymerase chain reaction (PCR) methods. A total of 245 stool samples were collected.

The prevalence of fecal carriage of ESBL-producing Enterobacteriaceae among school children was 76.7% (188/245). Genotyping of EBSL-producing Enterobacteriaceae encoding genes using PCR found that TEM genes, 92.6% (174/188), were higher than SHV genes, 38.8% (73/188) and CTX-M genes, 4.3% (8/188). It was also revealed a combination of ESBL-producing genes of Enterobacteriaceae. The most combination genes were found in TEM + SHV genes, including 55 of 188 (29.26%).

The presence of ESBL gene careers suggests that antibiotic resistance has spread in the community, which needs to be of concern since it can be an ESBL gene reservoir that can be transmitted to many pathogenic bacteria.