Infection, Epidemiology And Medicine
Volume:7 Issue: 3, Summer 2021

Mupirocin is a topical antibiotic inhibiting most Gram-positive cocci. Shortly after taking mupirocin, drug resistance emerges. This study aimed to determine mupirocin resistance in Staphylococcus aureus strains isolated from clinical specimens in Rasht.

In this study, a total of 85 clinical isolates of S. aureus were collected. Biofilm formation ability and antibacterial resistance patterns of isolates were investigated. Disc diffusion method and MIC determination were used to determine the susceptibility of strains to mupirocin antibiotic. Agr types, the presence of mupA, and mutation in ileS-1 were evaluated in mupirocin non-susceptible isolates by PCR and PCR sequencing, respectively.

Out of 85 tested strains, 57 (67%) isolates were recognized as biofilm producers, and all of which showed multidrug resistance phenotype. Agr type 1 was the most commonly detected type. Additionally, 12 mupirocin-resistant strains were identified in the disc diffusion and MIC tests. A total of four strains were mup-A positive and showed high-level resistance. In sequencing and mutation evaluation of the ileS-1 gene in eight low-level mupirocin-resistant strains, 12 types of silent mutation and one type of missense mutation were determined.

The study of mupirocin-resistant strains in this study showed the need to identify factors affecting the occurrence of resistance and to take control and prevention measures before mupirocin losses its efficacy.

This study aimed to analyse hybrid Entroaggregative/Uropathogenic Escherichia coli (EAEC/UPEC) isolates. To do so, the antibiotic resistance pattern and virulence genes were investigated in E. coli strains isolated from clinical specimens of patients hospitalized in Isfahan, Iran.

Disc diffusion method was used to determine the antibiotic susceptibility pattern of EAEC/UPEC isolates. Also, virulence determinants of these isolates were determinated by singleplex and multiplex PCR.

Overall, a total of 148 E. coli isolates were collected, of which 12 (8.1%) isolates were hybrid EAEC/UPEC strains, then antibiotic susceptibility examination was operated on these strains. The higest antibiotic resistance rate was related to ofloxacin (42%), followed by trimethoprim-sulfamethoxazole (41%), ceftriaxone and cefepime (33%), and cefoxitin (17%). All the isolates showed susceptibility to fosfomycin.

According to the current study, since resistance to fluoroquinolones has increased in hybrid strains, monitoring the drug susceptibility of hybrid strains seems critical in Iran. Fosfomycin is considered to be the drug of choise for infections caused by multidrug-resistant (MDR) Gram-positive and Gram-negative bacteria. Fortunately, 100% of the strains were sensitive to fosfomycin.

Hospital sewage is known as an important source of human pathogenic bacteria such as methicillin resistant Staphylococcus aureus (MRSA) strains disseminated from hospital to the environment. This study aimed to investigate the presence of MRSA in the treated outgoing wastewater collected from a referral hospital in Tehran, Iran.

During 2015, sampling was carried out at two stages from a hospital wastewater. All black colonies with halos on HiCrome aureus agar medium supplemented with oxacillin were collected and identified as MRSA using specific primers for nucA and mecA genes. Isolates susceptibility to 18 antibiotics was determined according to the recommendations of the Clinical and Laboratory Standards Institute (CLSI). Bacterial typing was performed for the isolates using a combination of Phene plate (PhP) typing, prophage typing, staphylococcal cassette chromosome mec (SCCmec) and ccr typing methods.

A total of 79 MRSA isolates were confirmed using specific primers and showed susceptibility to quinupristin-dalfopristin, vancomycin, chloramphenicol, and linezolid. High resistance to penicillin, ciprofloxacin, kanamycin, tobramycin, and erythromycin was reported. Sixteen PhP types consisting of eight common types (CTs) and eight single types (STs) were identified among the strains, among which CT1 was the dominant type. Also, two prophage patterns and four prophage types were identified, and all the strains were positive for SCCmec type III and ccr type 3.

The results of this study revealed that sewage-treatment process was able to remove community-acquired MRSA (CA-MRSA) strains; however, hospital-acquired MRSA (HA-MRSA) strains were able to survive during the treatment process in this hospital.

Due to the emergence of multidrug-resistant Candida species, the discovery of new antifungal agents with minimum side effects is essential. The aim of this study was to investigate the antifungal activity of caprylic acid and nano-encapsulated caprylic acid against C. albicans as well as their effect on the expression of EFG1 gene.

In this laboratory trial study, the minimum inhibitory concentration (MIC) of caprylic acid and nano-encapsulated caprylic acid against C. albicans was evaluated at various concentrations (400-625 and 1.3-50 μL/mL, respectively). Real time-PCR was performed to assess the expression level of EFG1 gene. Cytotoxicity effect of caprylic acid and nano-encapsulated caprylic acid was evaluated on SW480 cell line using MTT test.

Antifungal activity findings displayed that MIC90 and MIC50 values of caprylic acid were 500 and 450 μg/mL, respectively, whereas MIC90 and MIC50 values of nano-encapsulated caprylic acid were 6.2 and 3.1 μg/mL, respectively. The expression of EFG1 gene significantly decreased in the groups treated with caprylic acid and nano-encapsulated caprylic acid compared to the control group. According to the cytotoxicity evaluation findings, the viability of cells treated with caprylic acid was significantly higher than that of cells exposed to nano-encapsulated caprylic acid.

According to the obtained results, nano-encapsulated caprylic acid successfully inhibited C. albicans growth at a lower concentration compared to caprylic acid. Overall, it was found that nano-encapsulated caprylic acid is a promising antifungal agent against Candida species; however, further studies are needed to be performed about nano-encapsulation of caprylic acid.

This study aimed to describe the epidemiological and clinical characteristics of inactive HBV chronic carriers at the gastroenterology department of the university teaching hospital Yalgado Ouedraogo.

This descriptive cross-sectional study was conducted from January 1, 2007 to December 31, 2014 by employing a prospective data collection method. It was a census of all cases meeting the eligibility criteria. All patients with chronic viral hepatitis B (VHB) and ≥15 years of age and presenting the following signs were included in this study: positive result on hepatitis B surface antigen test for at least 6 months, normal levels of alanine amino-transferase for at least one year, positive anti-HBe antibodies, negative HBeAg, and viral DNA < 20,000 IU/mL.

The mean age of patients was 35 years, and the mean duration of HBsAg carriage was 6 years. The physical examination was normal in all participants. Ultrasound exam was normal in 150 (92.6%) participants and showed a fatty liver in 12 (7.4%) participants. Overall 4.4% of participants developed severe fibrosis, and no patient developed cirrhosis. The main indications for drug treatment included the existence of a family history of hepatocellular carcinoma (36.7%), the presence of active hepatitis (33.3%), and the progression of the fibrosis (30%).

This study confirms the importance of close follow up of HBV-infected patients to dramatically reduce the risk of developing complications such as cirrhosis or hepatocellular carcinoma.

The present study aimed to determine the quick Sepsis-related Organ Failure Assessment (qSOFA) score in comparison with systemic inflammatory response syndrome (SIRS) criteria to predict adverse consequences of a suspected bacterial infection in patients outside the intensive care unit (ICU).

This retrospective study was conducted on patients during March 2018 to March 2019. All hospitalized patients with this suspected infection were positive for both SIRS and microbial cultures. Demographic and laboratory variables were recorded for all patients to determine the presence and time of various components of both SIRS criteria and the qSOFA score.

Out of 128 patients with suspected sepsis, 87 (68%) patients were confirmed to have septicemia based on SIRS criteria. SIRS criteria classified 68% of patients in the sepsis group (87 of 128), of which 39(44.8%) had a positive qSOFA score. The sensitivity and specificity ratios of qSOFA were 44.83 and 80.49%, respectively. Receiver operating characteristic (ROC) curve analysis results showed that the area under the ROC curve (AUC) of pSOFA scores for predicting sepsis patients was not significantly different. Moreover, regarding the sepsis-related mortality, the area under ROC showed that qSOFA criteria (score ≥ 2) were able to predict mortality in patients with 71% sensitivity and 72% specificity.

This study findings revealed that the qSOFA score was significantly efficient in predicting mortality. However, SIRS criteria were more sensitive than the qSOFA score in predicting the definitive diagnosis of sepsis. Therefore, the qSOFA score seems to be an invaluable tool for predicting outcome in sepsis patients.

Plasmodium species are the causative agents of malaria, which is considered as a mosquito-borne infectious disease transmitted by anopheles mosquitoes. It is endemic in the southern and south-eastern areas of the country. This study aimed to report a case of imported malaria infection in a Pakistani man in Bandare Kong located in the central region of Bandar Lengeh County in Hormozgan province, Iran.

A Pakistani male fisherman aged 21 years referred to a general practitioner in Bandare kong with symptoms such as a long-lasting fever that worsened every 2 days. He underwent a malaria rapid diagnostic test (RDT), and the result of which was positive. Therefore, for further malaria testing, he was dispatched to Shohada hospital in Bandar Lengeh. All the laboratory tests findings were in an acceptable range, except for direct bilirubin titer, which was higher than the normal range (0.3 mg/dL) (< 0.2 mg/dL=normal). Blood smear test results also showed P. falciparum-associated malaria infection. According to the malaria therapy protocols followed in the hospital, 24 coartem pills at a dose of 4 pills per 12 hours were administered to the patient for 3 days, and then primaquine was administered simultaneously after three days, resulting in a rapid reduction in the parasitic load so that it could not be detected after 2 days.

In recent decades, most malaria patients diagnosed in Iran have been infected cases entered Iran from neighboring countries where malaria is endemic. Therefore, early diagnosis and therapy of imported malaria cases in endemic areas of Iran is essential and makes it possible to implement malaria preventive and control measures.

COVID-19 diagnostic testing and research substantially depend on high-quality COVID-19 specimens, for which biobanks are an important repository. This systematic review aimed to highlight the considerations for maintaining safety in biobanks during the COVID-19 pandemic.

A systematic review of literature was conducted using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search was conducted across Google Scholar, PubMed, and Directory of Open Access Journal because of their high indexation on many journals. Pre-defined search terms were used in the literature search. Overall, 7,184 articles were retrieved, and 2,054 duplicates among them were removed. After screening for eligibility using pre-defined criteria, 12 articles were included in the review.

Challenges faced by biobanks amid the COVID-19 pandemic include poor handling of COVID-19 specimens, poor sample collection, and sample contamination due to unclarified standard operating procedures. Strategies such as developing a framework for governing and monitoring the export of biological samples should be employed to overcome dangers eminent in the collection of biological samples. Total adherence to standard operating procedures should be ensured to maintain safety in COVID-19 samples collection, handling, and storage modalities. A deficit in material supply should be promptly addressed.

Compliance with issued guidelines should be ensured by the management and staff of COVID-19 biobanks.

The clinical and socioeconomic effects of COVID-19 are still being felt throughout the world. The disease affects people of all age groups, but it is known to have a milder clinical course in children including neonates. There is paucity of data from Sub-Saharan Africa on neonatal COVID-19 infection, and no such case has been reported in the literature in Ghana.

This study presented a case report of a neonate who was found to be positive for COVID-19 infection after presenting symptoms such as respiratory distress, rhinorrhoea, and cough. This neonate was managed with in-hospital standard protocol for sepsis with a focus on pneumonia.

The national guidelines on COVID-19 management were used for the neonate who was recovered and discharged.