Jundishapur Journal of Microbiology
Volume:14 Issue: 8, Aug 2021

Opportunistic infections, such as mucormycosis, in coronavirus disease 2019 (COVID-19) patients has become a new health challenge. Since opportunistic infections can exacerbate COVID-19 patients' status, it is vital to identify the risk factors to prevent, diagnose, and treat them as soon as possible. Viral, fungal, environmental, and host factors may be responsible for this situation. Long hospital stays, impaired host immune system function due to viral infection, and excessive consumption of glucocorticoids in managing COVID-19 patients are the main risk factors for the increased risk of mucormycosis in COVID-19 patients. Educating health care workers and considering the association between mucormycosis of the paranasal sinuses and different strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the cause of COVID-19 can help prevent invasive fungal sinusitis in COVID-19 patients.

O antigen is one of the Uropathogenic Escherichia coli (UPEC) virulence factors used as a biomarker to classify E. coli strains.

In this study, the relationship between antibiotic resistance patterns and O-serogroups was investigated in UPEC strains isolated from patients with Urinary Tract Infections (UTIs) in Southern Iraq.

A total of 100 UPEC isolates from urine specimens of patients with UTI at the age range of 4 months to 78 years in various Southern Iraqi hospitals were collected (May 2017 to January 2018) and confirmed using biochemical tests (API 20E). Antibiotic susceptibility tests were performed using disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines. The Multiple Polymerase Chain Reaction technique was applied to investigate the prevalence of O- serogroups.

The most frequent serogroups in the E. coli isolates were O8 (27.7%) and O25 (24.4%), but serogroup O83 was not found in the samples. Serogroups O75, O6, O16, and O18, had the lowest frequency (1.1%) among the examined isolates. Ten percent of the isolates did not belong to any of the examined serogroups. The phenotypic tests showed that the highest and the lowest resistance belong to Piperacillin (92%) and Imipenem (5%), respectively. Serogroups O4 and O21 showed the highest drug resistance, while serogroups O75, O18, and O1 showed the lowest drug resistance. Ninety-four percent of the isolates were resistant to three or more classes of antibiotics.

According to the results, UPECs isolates showed high resistance to common antibiotics, but were sensitive to imipenem and amikacin. Serogroups of O8 and O25 were the most common among UPECs isolates and O4 and O21 showed the highest drug resistance. There was a direct relationship between antimicrobial resistance and O-serogroups in UPEC isolates.

Background：

It is easy for salmonella to infect children through fecal-oral route and cause diarrhea. The analysis of pathogen distribution and epidemic characteristics of such infectious diseases has become a major topic for national research, providing direction and guidance for national prevention policy.

To study epidemiologyof enterical salmonella in children with diarrhea.

Pediatricians screened suspected cases of Salmonella, and stool specimens were cultured, identified, and serotyped.

A total of 649 salmonella strains were isolated from 6656 children with suspected salmonella infection. The NTS isolation rate was 8.92%, and the S.typhi isolation rate was 0.83%.A total of 19 serotypes were isolated, and the first five serotypes were Salmonella typhimurium, paratyphoid, Dublin, typhoid and London. The positive rates of the five serotypes were 90.29%, and the positive rates of Salmonella typhimurium and Enteritis were 74.88% and 1.08%, respectively. The infection of Salmonella increased with time. The positive rates of typhoid, paratyphoid A, paratyphoid B and paratyphoid C were 4.16%, 0.3%, 3.0% and 0.9%, respectively. Boys: girls = 1.30:1,There was no significant difference in gender of salmonella infection.The infection rate was lowest between 1 day and 6 months (P< 0.05), salmonella mainly infected children under 3 years old, and the positive rate was 88.29%.In the warm and humid summer and autumn season (June to September), the infection rate of Salmonella was the highest, with a positive rate of 72.73%.

The infection rate of salmonella in children under 3 years old was the highest, and the incidence of salmonella in children with diarrhea was increasing in Chengdu. Typhoid and paratyphoid vaccines should be considered together, and vaccines should focus on children under 3 years of age.

The World Health Organization reported Indonesia as one of the countries with the most prevalent cases of diphtheria worldwide. The microbiological aspects of diphtheria-inducing bacteria are of great significance in tracing disease transmission and case management; however, clinical aspects are critical for updating clinical features and case management in the field, which may sometimes differ from theoretical foundations.

This study aimed to identify the microbiological and clinical aspects, including molecular typing and case-fatality rates, in diphtheria confirmed cases from Capital City of Indonesia, Jakarta and surrounding areas, in 2017.

The microbiological aspect of 40 diphtheria confirmed cases were obtained by re-identify diphtheria-inducing bacteria isolated from the samples, while the clinical aspects of the cases were obtained from the medical record and epidemiological data. Chi-squared test was used to examine the correlation between fatal cases and myocarditis and diphtheria antitoxin (DAT) administration delay. In this study, p < 0.05 was set as the significance level.

All 40 diphtheria confirmed cases were induced by toxigenic Corynebacterium diphtheriae with two biotypes, namely intermidius (60.0%) and mitis (40.0%). There are six sequence types of bacteria with two main sequence types, ST534 (46.4%) and ST377 (35.7%). The proportion of cases that had a fever and sore throat were 72.5% and 77.5%; however, the prevalence rates of the cases with pseudomembrane and bull neck were 100% and 47%, respectively. Most cases were administered a combination of penicillin or erythromycin with other antibiotics (40%), and 22.5% of the cases only received penicillin. Myocarditis was noticed in three fatal cases and their relationship was statistically significant (p=0.000). All five fatal cases (12.5% cases) were received DAT lately or have not received it yet.

The toxigenic C. diphtheriae with two biotypes (namely mitis and intermedius) and two main sequence types (i.e., ST534 and ST377) was the causative agent of diphtheria confirmed cases from Jakarta and surrounding area in 2017. It was also concluded that those fatal cases were correlated with myocarditis complications.

Drug resistance and virulence genes are two key factors for the colonization of Pseudomonas aeruginosa in settings with high antibiotic pressure, such as hospitals, and the development of hospital-acquired infections.

The objective of this study was to investigate the prevalence of drug resistance and virulence gene profiles in clinical isolates of P. aeruginosa in Ardabil, Iran.

A total of 84 P. aeruginosa isolates were collected from clinical specimens of Ardabil hospitals and confirmed using laboratory standard tests. The disk diffusion method was used for antibiotic susceptibility testing and polymerase chain reaction (PCR) for the identification of P. aeruginosa virulence genes.

The highest and the lowest antibiotic resistance rates of P. aeruginosa strains were against ticarcillin-clavulanate (94%) and doripenem (33.3%), respectively. In addition, the frequency of multidrug-resistant (MDR) P. aeruginosa was 55.9%. The prevalence of virulence factor genes was as follows: algD 84.5%, lasB 86.9%, plcH 86.9%, plcN 86.9%, exoU 56%, exoS 51.2%, toxA 81%, nan1 13.1%, and pilB 33.3%. A significant association was observed between resistance to some antibiotics and the prevalence of virulence genes in P. aeruginosa.

Our results revealed a high prevalence of antibiotic resistance, especially MDR, and virulence-associated genes in clinical isolates of P. aeruginosa in Ardabil hospitals. Owing to the low resistance rates against doripenem, gentamicin, and tobramycin, these antibiotics are recommended for the treatment of infections caused by highly resistant and virulent P. aeruginosa strains.

The increasing use of antimicrobial agents and resistance is becoming a serious problem in pediatric patients. Hence, antimicrobial stewardship program (ASP) is implemented to lessen the consequences.

This report aimed to demonstrate the impact of ASP on antimicrobials utilization in a referral and tertiary pediatric hospital in Isfahan, Iran.

We launched an ASP for inpatients in March 2018 at the Imam Hussain Hospital, which is a 186-bed pediatrics hospital. Data was collected by ASP multidisciplinary team and using hospital records during February 2017-January 2018 (pre-intervention) and February 2019-January 2020 (post-intervention) periods. Consumption data were expressed as defined daily doses (DDDs) per 100 patient-days (PD). Independent sample t-test and paired t-test were used to assess the significance of differences. The rates of antimicrobials resistance for the most common hospital pathogens were also tracked.

Utilization of total antimicrobials decreased meaningfully by 12.41% (from 62.11 DDDs/100 PD in February 2017-January 2018 to 54.40 DDDs/100 PD in February 2019-January 2020; P = 0.024). The results showed that the reduction in non-restricted antimicrobials was less (5.43%) than restricted antimicrobials (27.6%).

According to our results, the use of antimicrobials, especially the broad-spectrum ones, and the health burden costs significantly decreased after implementing ASP. Thus, continuous monitoring and educational programs are recommended to reduce the negative effects of using antimicrobials.