دو ماهنامه میکروب شناسی پزشکی ایران
سال چهاردهم شماره 2 (فروردین و اردیبهشت 1399)

In the outbreak of infectious diseases, non-pharmacological intervention might be the only available protection tools. The aim of this systematic review is to investigate whether it is or is not necessary to wear masks in new corona virus (COVID-19) outbreaks in the community.

On February, 28, 2020, related databases were searched with the following keywords: "COVID-19"; "COVID 19"; 2019-nCoV; 2019-CoV; coronavirus; mask* and facemask. We updated the search in March 13, 2020. A total of 982 relevant reports were identified after removing duplicates. Of these, 71 references were screened based on titles and abstracts. After excluding unrelated studies, 36 studies were included in the full-text review and were assessed for eligibility. Finally, 3 articles met our inclusion criteria.

In three wards of hospital with more exposure to infected patients, wearing the N95 respirator while using regular disinfectants and hand hygiene, was a better way to prevent COVID-19 transmission from patients to nurses and physicians when compared to non-users of masks. Another study on family members with a history of travelling to Wuhan, showed that those who had worn a surgical mask only during the hospital visit, were infected. However, the 7 years old child of the family who wore a surgical mask, was not found to be infected by COVID-19. Finally, none of eleven healthcare workers who had unprotected exposure with confirmed cases were infected.

Due to the newness of the COVID-19 virus, no clinical trials have been found regarding the use of the masks in the prevention of the disease, and the level of evidence were low.

Tuberculosis is one of the most dangerous infectious diseases in the world and causes nearly two million deaths each year, especially in developing countries. Meanwhile, multidrug resistance tuberculosis (MDR-TB) is due to the resistance of Mycobacterium tuberculosis (Mtb) strains to two effective first-line drugs, isoniazid and rifampin, which is increasing worldwide. MDR-TB strains are mainly caused by inadequate treatment of TB patients. The emergence and spread of these strains is an obstacle to the control and management of tuberculosis as well as a threat to the World Health Organization's goal of eliminating the disease by 2050. Proper management of MDR-TB relies on early recognition of the disease. Recently, phenotypic and genotypic diagnostic methods have been developed to rapidly identify MDR strains in tuberculosis patients. Some of them are also economically suitable to use in developing countries. Proper treatment of patients with drug-resistant TB requires the rapid detection of resistant strains and appropriate drug administration. Regular monitoring of patients' side effects of medications as well as enhancing the quality of bacterial tests is essential to identify resistant strains. Therefore, in this review, we will describe the available phenotypic and genotypic tests for drug-resistant tuberculosis detection and discuss their advantages and limitations.

Leaves of Piper betle are frequently used in South and Southeast Asia for traditional treatment and as a mouth freshener. Our purpose is to compare the phytochemical and antimicrobial properties of betel leaves from Barguna and Moheshkhali against Bacillus cereus, Staphylococcus aureus, and Escherichia coli.

We extracted the betel leaves with acetone and ethanol according to the standard procedure. The extracts were analyzed for the presence of phytochemical properties by a standard procedure, antibacterial susceptibility by agar well diffusion method, minimum inhibitory concentration (MIC) by broth dilution assay and functional groups were obtained by FT-IR spectroscopic analysis.

We found the presence of a good number of phytochemicals in both Barguna and Moheshkhali extracts. Most of the cases, extracts of Moheshkhali leaves showed a greater zone of inhibition than Barguna extracts. Acetonic and ethanolic extracts of Barguna showed the minimum inhibitory concentration (MIC) from 2.12 to 4.25 mg/ml, where Moheshkhali extracts showed between 2.12-8.5 mg/ml. The functional groups obtained by FT-IR spectra analysis were compared for the extracts.

Betel leaves can be utilized to augment the shelf life of foods, treatments and boost up immunity following comprehensive studies.

 Behcet's Disease (BD) is one of the chronic inflammatory diseases with unknown etiology. The relationship between infectious agents and BD has not been clearly identified yet. Human cytomegalovirus (HCMV) causes a primary infection in the first years of life and remains latent in various tissues and cells. This study aimed to find out the frequency of HCMV among BD patients.

 In this cross-sectional study, serum samples from 103 BD patients were analyzed for HCMV by molecular and serological tests. The results were analyzed by IBM SPSS version 20.

 The mean age of BD patients was 38.67±8.82, and 53% (54/103) were male. The mean duration of BD was 18.42±6.12 years. HCMV IgG antibody was found in 96% and 94% of males and females, respectively, and the IgM antibody was positive only in one male patient. HCMV DNA was not detected in the samples.

 Our result showed, there is no evidence of Cytomegalovirus infection among Behcet's patients. Like other studies IgG antibodies against CMV are prominent among the general population.and Behcet patients. While, IgM against HCMV was positive only in one patients. But, no CMV-DNA detected among 103 Behcet patients. However, the absence of the virus genome in a positive IgM person can be due to the Short-term DNAemia or due to rheumatoid factor interference. In addition, there is a time lag between primary infection and IgM antibody production (IgM level can remain undetectable because of delayed seroconversion owing to immunosuppressive agents). IgM antibodies can also persist for a long time after infection in some healthy individuals.

 Disinfectants have important clinical applications. Antibiotic resistance of some hospital pathogens such as Pseudomonas aeruginosa has led to the use of disinfectants. In the present study, the effects of four commercial disinfectants; Hydrocare, Benzalkonium Chloride, Cetrimide-C, and Vico sience on Pseudomonas aeruginosa isolates were investigated.

 The dilutions of four tested disinfectants recommended by the manufacturer were prepared and their effects on twelve Pseudomonas aeruginosa isolates were evaluated at five, ten, fifteen minutes after the bacterial inoculation.

 Hydrocare and Benzalkonium Chloride inhibited the growth of all strains while Cetrimide-C disinfectant did not inhibit the growth of bacterial strains at any time. The Vico sience completely inhibited the growth of bacterial strains at ten and fifteen minutes after the addition of disinfectant. Since the recommended dilutions by the manufacturer were prepared and evaluated in the present study, the inefficiency of some of the disinfectants indicated that the evaluation and dilution assay of the disinfectant is necessary prior to routine use in laboratories or health centers.

On December 31, 2019, pneumonia due to the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2, formerly known as 2019-nCoV) appeared to Wuhan, China, and COVID-19 is an infectious disease caused by SARS. CoV-2. SARS-CoV-2 is a new strain of coronavirus that has not been previously identified in humans. Until April 18, 2020, 2275783 were confirmed and 156104 deaths worldwide reported. This paper presents an overview of the findings that scientists have realized so far. In this study articles indexed in Embase, Elsevier, PubMed, Google Scholar and using keywords SARS-CoV-2, COVID-19, Coronavirus 2019 and nCoV-2019 were used. The World Health Organization and the Centers for Disease Control and Prevention used the world's most reputable websites to obtain the latest COVID-19 disease statistics. In the initial search, 500 articles were extracted and 55 articles were selected after duplication and evaluation of title and abstract. The results show that the mortality rate of the virus in the elderly and people with underlying diseases is significantly higher than in the healthy ones. High-risk groups for the disease include cardiovascular disease, diabetes, chronic respiratory disease, and hypertension, respectively. The novel coronavirus pandemic is more widespread in humans compared to previous coronaviruses, which indicates the extremely high prevalence of the virus. No vaccine or cure has been found for the virus so far, but supportive treatments and early diagnosis are effective in the treatment process, and there are many treatments around the world for the treatment of COVID-19.

Nosocomial infections or healthcare associated infections occur in patients under medical care. Infections acquired in hospitals have existed since the very inception of hospitals themselves, and continue to be an important health problem even in the modern era of antibiotics. Today, they result in high morbidity and mortality, extended hospitalization, greater use of antibiotics, and increased costs. The overuse and inappropriate consumption and application of antibiotics have driven the rapid emergence of multidrug-resistant drugs (MDR) pathogens. Combating MDRs which cause serious life threatening nosocomial infections and appear to be biologically compatible with their environment, are difficult to manage due to the limited treatment options. The worldwide emergence of multidrug resistance (MDR) among Gram negative and Gram-positive bacteria has caused a great threat to fight the bacterial pathogens. It is clear that in the lack of a timely, efficient solution   the challenge of antibiotic resistance becomes alarming and will cause a great challenge in the forthcoming years. In this review article we will discuss the most important MDR nosocomial infection agents, including Staphylococcus aureus, Enterococcus faecium, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa as major threats throughout the world.

The novel Coronavirus (COVID-19), which emerged from the Wuhan City of China was first reported to the World Health Organization on 31December 2019. It has affected 205 countries and territories and infected more than 1,141,425 people worldwide, and claimed over 61,205 lives (1). Amidst this pandemic outbreak, the death of a person from Yunnan province by Hantavirus also became a source of panic for the humankind. Eventually it made us to search literature for global publication of Hantavirus infection using the three databases: Scopus, Web of science (WoS) and PubMed.

In 1978, in South Korea, near the Hantan river, an outbreak of Hemerologic fever occurred. The causative agent was isolated from a small infected field rodent. The virus was named by its birth place as ‘Hanta anvirus’.  Later in 1993 the outbreak in the four corner region of Southwestern United States that caused serious respiratory distress in infected patients was called as hantavirus pulmonary syndrome (HPS). Eventually it led to the discovery of hantavirus genus of more than twenty one species and more than 30 genotypes (2). 

We explored three main biomedical databases globally namely Scopus, Web of Science (WoS) and PubMed. using the search strategy as “Hantavirus” in the title. All the research outputs were downloaded on 27th March 2020 published from 1 Jan 1999 to 27th March 2020 (22 years).   

Globally number of research articles retrieved by the three databases were 1519 (WoS), 1566 (PubMed) and 1348(Scopus). On an average the number of research articles identified by WoS, PubMed and Scopus were 69, 71 and 61 respectively per year. PubMed identified the maximum number of articles. Examining all three databases, the growth pattern of the Hantavirus articles was neither increasing nor decreasing over years (Fig I). The growth was on the increase during the years 2007, 2014 and 2019.

The major five productive countries were from USA, Finland, Germany, China and Sweden (Fig II). Considering WoS, 31.8% from USA, Finland 12.7%, Germany 12.2%, China 4.9% and Sweden 9.5%; followed by PubMed, 18.2% from USA, Finland 9.1%, Germany 8.1%, China 7.9 % and Sweden 5.1; and Scopus, 26.7% from USA, 11.6% Finland, 11% Germany, 9.6%China and 8.8% Sweden.

The reported number of cases of Hantavirus Infection in the United States (1999-2018) through the Nationally Notifiable Disease Surveillance System (NNDSS) (3) is shown in Fig I. Also the European Centre for Disease Prevention and Control (ECDC) surveillance report 2015 (4) shows the number of Hantavirus infection cases for the period 2011-2015 for European countries. The second productive country Finland showed an increased number (2089 cases) during the year 2014.  It can be justified that, whenever more number of cases occur as an outbreak, there appears a growth in the number of research articles.

To conclude based on the three databases, the growth pattern of the Hantavirus research articles

was not steady. The pattern showed some fluctuations, the magnitude of the output got raised followed by an outbreak where in the scientific community became active and it was on lower side until a further outbreak.  The country USA has contributed more publications may be due to the reason of the first outbreak of unknown origin happened and moreover it is a predominant country for scientific research as shown various bibliometric analysis (5-10)

Since from the first outbreak of Hanta pulmonary syndrome (HPS) in May 1993, several Cases of HPS outbreak from related hantaviruses have been documented in various countries like Argentina, Brazil, Canada, Chile etc. (1). Consequently it would have led to more research and as a result many scientific outputs are published. Any scientific research output disseminates one or more of the following: epidemiology of the disease, severity of the disease and its impact, the emergency response required, remedial measures, probable research collaborations, development of medicines and vaccines. Hence Hantavirus research outputs indicates the scientific community is dynamic and active.

Acknowledgment

The authors thank all those who helped them writing this paper.

Conflict of Interest

Authors declared no conflict of interests.