دو ماهنامه میکروب شناسی پزشکی ایران
سال پانزدهم شماره 2 (فروردین و اردیبهشت 1400)

In general, examining and prioritizing the factors influencing the increase of the new COVID-19 virus is essential for the survival of the world. The purpose of this study is to rank the effective factors (12 identified factors) on the increase of Coronavirus from the perspective of the people of Alborz province, in the second half of 2020, in this province.

This study was conducted using the Friedman test. In this applied research, A questionnaire was used, which was randomly distributed among 402 people (sample size using was derived using the Cochranchr('39')s formula).

 In the forthcoming research, three fundamental questions were answered:1) what are the factors influencing the increase in the number of patients with COVID-19 desease in Alborz province? This was done studying the literature and announcements of the Central Headquarters for Corona and library studies and "12" factors were identified, (other factors may also be involved), 2) considering the above factors, which factor is the first priority? 3) what are the basic solutions to reduce the number of patients? 

Based on the results, the increase in the number of people infected with the Corona virus is affected by 12 factors from the perspective of the people of Alborz province. Regarding the importance of each of these "12" factors, the most effective factor, was identified as insufficiency of personal hygiene. The results of this research can help with monitoring, reducing the number of people who are infected, and creating and maintaining better conditions in this province and other parts of the country, and even other countries.

 Malaria is one of the most life-threatening infectious diseases worldwide. Transmission of the parasite from human to vector mosquitoes is carried out by the gametocyte of the Plasmodium parasite, while these cells are not involved in the symptoms of the disease. The control of the human to mosquito  transmission stage of the parasite life cycle by antigametocyte drugs is currently under increasing scrutiny in an effort to eradicate the disease globally. In this study the gametocytocidal activity of eosin B on asexual blood stages and gametocytes of Plasmodium falciparum has been probed.

The parasite Plasmodium falciparum 3D7 was first cultured and then  gametocytogenesis was induced to obtain gametocyte cells. After microscopically studying the developmental stages of the parasite during the culture of the parasite, eosin B was tested on blood and sexual parasites and the viability was assessed by lactate dehydrogenase assay and the results were compared for the two groups.

Mature gametocytes were produced during 12 days. The blood parasites in culture were increased until day 4 and then gradually diminished. The results of lactate dehydrogenase assay showed a stronger effect of eosin B on gametocytes (IC50 = 23 nM) than asexual blood stages (IC50 = 133 nM).

Due to the rarity of anti-gametocyte drugs and importance of these intervention on malaria elimination, eosin B appears to be a suitable candidate for combination therapy against Plasmodium falciparum gametocytes.

Salmonella typhi infection occurs in most endemic areas. Patients suspected of typhoid fever located in the Badda and Shantinagar localities of Dhaka were the studied population. A total of 107 blood specimens were collected.
This study attempted to determine the antibiotic susceptibility pattern of Salmonella typhi among different age and gender groups having clinical symptoms of typhoid fever.

 The microorganisms obtained from blood specimens were identified by phenotypical and biochemical tests following standard protocols. Antibiotic susceptibility test was done by the Agar-disc-diffusion method to understand antibiotic susceptibility of the isolates. All the Salmonella typhi isolates were serologically confirmed using a commercial antisera kit.

Out of 107, 74 Salmonella typhi isolates showed multidrug-resistant properties. Nalidixic acid, ampicillin, azithromycin, and ciprofloxacin showed high antibiotic resistance percentage. On the other hand meropenem, amikacin, gentamycin showed low antibiotic resistance. Age and sex groups also revealed significant attributes to the multidrug-resistant isolates. Multidrug-resistant pattern of the clinical isolates of Salmonella typhi of the current study has presented a matter of great public health concern in Dhaka city, Bangladesh. The first line of antibiotics can be prescribed, taking into consideration of age and gender. The sources of Salmonella typhi infection and mode of transmission must be identified.

 Uropathogenic Escherichia coli (UPEC) are the most common cause of urinary tract infections. The binding of these bacteria to epithelial cells and the formation of biofilms cause these bacteria to be further colonized and difficult to remove in the urinary tract. This study aimed to determine the antibiotic resistance and to evaluate the biofilm formation power in Escherichia coli isolated from pregnant women in the city of Karaj, Iran.

This descriptive-analytical study was performed on 64 isolates of UPEC. Identification of these bacteria was determined using biochemical tests and antibiotic resistance by Kirby – Bauer method and according to the recommendation of the Clinical and Laboratory Standards Institute (CLSI 2017) guideline. The ability to form biofilms, using the microtiter plate method and the presence of papC and sfa genes was examined by Duplex PCR.

Based on the results; the highest levels of resistance were related to cotrimoxazole (40.6%), and ampicillin (31.3%). The examination of biofilm formation by the phenotypic method also showed that of the isolates, 48.4% (strongly), 15.6% (moderately) and 21.8% (weakly) have biofilm formation power. Based on the obtained Duplex PCR results, 15 isolates had papC gene, 10 isolates had sfa gene and 9 isolates had both genes simultaneously. 100% of the isolates with both papC and sfa genes were able to produce biofilms.

The results showed that most UPEC causing urinary tract infections can form biofilms. Also, the abundance of papC and sfa genes encoding pili in these strains can act as one of the binding factors of this bacterium.

 Canine distemper (CD) is a highly transmissible serious disease of carnivores. Distemper virus has immunosuppression effects, which, in turn, could lead to opportunistic infections. The present study was performed to detect CDV by the genomic and immunological methods and investigate its co- infection with canine parainfluenza virus type 2 (CPiV-2).

In this study, which was conducted from Spring 2018 to Winter 2019, samples of blood, eye, respiratory, and digestive system were collected from 50 dogs suspected to CDV (group 1: symptomatic dogs) as well as 50 seemingly healthy dogs (group 2: asymptomatic dogs). Rapid distemper immunochromatography kit was applied for the primary detection of CDV. RT_PCR test was also performed using special primers for molecular investigation.

Results of immunochromatography showed twenty nine and one positive cases among dogs suspected to CDV and seemingly healthy dogs, respectively. After RT_PCR assay, in the first group, 37 samples were reported as CDV positive and 11, CpiV-2 positive. Furthermore, three CDV- and one CpiV-2-positive cases were found in the second group. Besides, the frequency of CDV and CpiV-2 co-infection was 4%.

In the present study, using statistical tests, we observed no association between distemper and CpiV-2.

Asymptomatic bacteriuria is bacteria in the properly collected urine of a patient, leading to a urinary tract infection with no symptoms. Asymptomatic bacteriuria is a common complication in clinical practice with an increasing prevalence due to increase of age. The present study investigated the prevalence of asymptomatic bacteriuria among pregnant women receiving antenatal care in Ovia North East Local Government Area, Edo State, Nigeria.

A total of 201 urine samples were collected randomly from pregnant women at Igbinedion University Teaching Hospital, Okha Maternity and Usen General Hospital in in Ovia North East Local Government Area. The bacteria isolation was carried out using the pour plate technique. The bacteria identification was conducted by gram staining and biochemical tests and the antibiotic susceptibility pattern of the bacterial isolates was determined by Kirby-Bauer disc diffusion technique.

Eighty-one of the subjects had significant bacteriuria, with a prevalence of 40.3 %. The bacteria isolated in the samples were Streptococcus, Proteus, Klebsiella and Micrococcus species as well as Staphylococcus epidermidis, Escherichia coli and Staphylococcus aureus. Streptococcus spp. occurred more frequently (42.0 %) while S. aureus had the lowest frequency of occurrence (2.5 %) in the samples. The infection was most prevalent among women aged between 28 and 37 years (74.5 %). Pregnant women in their third trimester in this study had the highest prevalence of asymptomatic bacteriuria (55.2 %). Ciprofloxacin was found to be the most effective antibiotic against the urinary isolates. 

Pregnancy promotes the progression from symptomatic to asymptomatic bacteriuria with its consequences such as pyelonephritis and increased fetal mortality. Therefore, routine culture test should be carried out for all antenatal women to detect asymptomatic bacteriuria and all positive cases should be treated with appropriate antibiotic therapy to prevent any obstetric complications which are associated with pregnancy.

Salmonellosis is one of the most important zoonotic diseases; most of the infections caused by the consumption of contaminated food is caused by this bacterium. During the last decades, the resistance of Salmonella isolates to conventional antibiotics has increased, which is a global health problem. The objective of this study was to investigate Salmonella serotypes in chicken meat and their antibiotic resistance regarding ten commonly used antibiotics in Iran.

A totsl of 100 chicken meat samples were collected randomly from meat supply and distribution centers of Ardabil City. After cultivation and isolation of Salmonella, its colonies were examined by serological and PCR methods. Finally, PCR confirmatory test was also used for confirmation of Salmonella Typhimurium. Antibiotic resistance of the isolates was determined by Kirby Bauer method.

Of the 100 samples, 6 isolates of Salmonella (6%) were obtained of which, 3 isolates (50%) belonged to Salmonella infantis, 1 isolate (16.6%) to Salmonella enteritidis, 1 isolate (16.6%) to Salmonella Typhimurium and 1 isolate (16.6%) to Salmonella thompson. More than 60% of the isolates were resistant to seven antibiotics. The highest drug resistance rates were against ampicillin (83.3%), sulfadiazine+trimethoprim (83.3%), chloramphenicol (83.3%), co-trimoxazole (66.7%), amikacin (66.7%), tetracycline (66.7%), doxycycline (66.7%) and florphenicol (16.7%). No resistance was observed against enrofloxacin and ciprofloxacin.

The results of this study indicated the dominant serotype of Salmonella which is Salmonella infantis. The results showed that Salmonella isolates are resistant to the majority of the ten antimicrobial agents commonly used in the livestock and poultry industry, which is important for public health.

A 49-year-old woman with a history of diabetes mellitus (DM), and hypothyroidism referred to the emergency ward complaining of shortness of breath which had lasted for three weeks. Due to inspiratory and expiratory stridor in the clinical examination, a tracheal lesion was proposed for her. In computed tomography (CT) scan (without contrast) of the neck and chest, a lesion resembling a malignant tracheal tumor was observed spreading around the cervical trachea. Subsequently, the patientchr('39')s respiratory distress worsened and she underwent tracheostomy under general anesthesia. During tracheostomy, a white to creamy lesion that resembled necrosis with extensive granulation was seen in cervical trachea, and a biopsy was taken. Histopathological reports showed evidence of acute and chronic inflammation, in necrotic background, along with aseptate fungi which confirmed mucormycosis. Initially, intravenous liposomal amphotericin-B was selected as an antifungal drug which was discontinued due to drug-induced acute renal failure. Posaconazole suspension was replaced as an antifungal drug. After about six weeks, the patient was discharged from the hospital in good general condition. Contrary to few previous studies on mucormycosis of the trachea and lower airways, tracheal disease was limited in our patient; therefore, we avoided debridement of the conflict site and tried to control the disease by controlling the underlying disease (DM), and antifungal therapy. Finally, the desired result was achieved. It should be noted that all patients who have been reviewed in the previous published studies have had a wider conflict sites compared to our patient. Therefore, due to the lack of standard treatment for this disease, our therapeutic approach in this study can be considered as an option in limited and localized cases.

COVID-19 pandemic due to the respiratory infection of SARS-CoV-2 has now become a global threat. The thrombotic complications are common in COVID-19 patients which have been extensively addressed in various studies. The hemorrhagic complications, however, have received less attention. In this article, 4 cases of COVID-19 patients with hemorrhagic complications are presented. All 4 patients were hospitalized in ICU and received routine COVID-19 treatments such as heparin prophylaxis. During hospitalization, all four patients had rectus sheath hematoma and retroperitoneal hemorrhage. They underwent embolization to control hemorrhage. Embolization of the inferior epigastric artery and the anterior trunk of internal iliac artery was carried out under fluoroscopy-guided angiography. The active hemorrhage of the patients was controlled. Three patients recovered after the treatment and were discharged while one patient, unfortunately, died due to the severity of the pulmonary involvement, old age, and hemorrhage. First, the hemorrhage of these patients was assigned to the hemorrhagic complications due to the use of heparin. But the hemorrhage volume was not justifiable with the symptoms and complications of prophylaxis dosage of heparin. The attention was gradually drawn to the coagulopathy of the COVID-19 patients. further investigations are required to clarify the role of effective factors and complications of coagulopathy in patients with COVID-19 and their appropriate treatment.