Journal of Medical Microbiology and Infectious Diseases
Volume:9 Issue: 4, Autumn 2021

Burkholderia cepacie complex (Bcc) is an emerging multidrug-resistant gram-negative bacteria frequently isolated from health care facilities worldwide. The present study investigated the prevalence of Bcc in health care settings in Sebha, Libya.

Two hundred swabs were initially collected. Forty-seven nosocomial Bcc isolates were identified from three medical care facilities, i.e., 40 (20%) from Sebha Medical Center, five from the Sebha Infertility Treatment Center, and two from Althanweya Clinic. The isolates were identified using a combination of biochemical tests and USP chapter <60> Microbiological Examination of Non-Sterile Products Tests for Burkholderia Cepacia Complex guidelines. A UPGMA dendrogram was used to examine the biochemical relationship of isolates. Some of the putative virulence factors contributing to the pathogenicity of the isolates were also explored.

  Of the 47 isolates, 29.79% were B. cepcia, 23.40% B. cenocepcia, 12.77% B. thailandensis, 8.51% B. vietnamiensis,  6.38% B. ambifaria, B. pyrrocinia, and B. stabilis each,  4.26% B. anthina, and 2.13% B. arboris. A variation in virulence factors was observed among isolates; all (100%) isolates produced siderophore, 91% had capsules, 91% produced lipase, 89% formed a biofilm, and 49% produced alkaline protease. The UPGMA dendrogram revealed that Bcc species shared substantial phenotypical identity among themselves.

In developing countries with limited resources, diagnostic challenges in identifying Bcc species can be resolved using selective media and USP chapter <60> guidelines.

Introduction. Helicobacter pylori infection is one of the primary etiological factors associated with gastric carcinogenesis. This study investigated the expression of microRNAs, miR-20a, miR-30a, miR-210, and miR-874, in H. pylori-infected patients with and without gastric cancer (GC) compared to healthy subjects. Methods. Total RNA was extracted from the plasma of H. pylori-infected GC patients (n=40), H. pylori-infected patients (n=40), and healthy individuals (n=12). The expression of microRNAs was analyzed using a reverse transcription-quantitative real-time PCR (RT-qPCR) technique. Results. The miR-20a, miR-30a, miR-210, and miR-874 exhibited higher overexpression in H. pylori-infected GC patients than healthy persons (P=0.004, 0.033, 0.023, 0.024). The H. pylori-positive patients without GC also had higher miR-20a, miR-30a, and miR-210 levels than the healthy individuals (P= 0.013, 0.036, 0.032). There were no statistical differences between H. pylori-infected GC patients and H. pylori-infected patients without GC Conclusion. The microRNAs overexpression in H. pylori-infected patients with GC might be linked to H. pylori rather than GC. Therefore, these microRNAs can be helpful in H. pylori infection diagnosis rather than predicting GC. in H. pylori-infected patients.

Salivirus (SalV), a possible causative agent of gastroenteritis, belongs to the genus Salivirus in Picornaviridae Family. The fecal-oral path seems to be the entry route for SalV in susceptible peoples such as children that consume polluted water. We investigated the SalV occurrence in children's stool with acute gastroenteritis using a reverse transcription-quantitative polymerase chain reaction assay (RT-qPCR).

From Sep. 2018 to May 2019, 160 stool samples were collected from children with acute gastroenteritis admitted to Imam Ali General Hospital, Alborz University of Medical Sciences, Iran. After viral RNA extraction, the 5'UTR region of the SalV genome was amplified by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and the viral load was defined.

Of the 160 stool samples, 41 (25.6%) were positive for SalV RNA. The highest SalV detection rate was in Feb. (28.2%), and the highest viral load (6.2×107 copies/g) belonged to a 1-month-old patient.

Salivirus occurs among Iranian children with acute gastroenteritis. Our results suggest that Salivirus might contribute to acute gastroenteritis.

Chronic suppurative otitis media (CSOM) is one of the most common middle ear infections leading to extra and intracranial complications if not diagnosed promptly. Early identification and detection of the etiological agents and antibiotic susceptibility patterns assist in preventing complications.

Two hundred twelve ear swabs were collected using sterile cotton swabs. Direct gram staining was done and then inoculated into blood, MacConkey, and Nutrient agar. Bacterial isolates were identified using conventional methods. According to CLSI guidelines, Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method. Minimum inhibitory concentration (MIC) was performed by the agar dilution method. Extended-spectrum beta-lactamases producing bacteria were detected by the phenotypic confirmatory test and then corroborated by uniplex PCR.

Out of 212 samples, 157 samples (74.06%) were culture-positive for bacteria. The isolated bacteria included Pseudomonas aeruginosa (46.24%), Staphylococcus aureus (26.59%), Klebsiella pneumoniae (14.45%), coagulase-negative Staphylococcus aureus (5.20%), Proteus mirabilis (4.05%), Enterococcus faecalis (2.89%), and Escherichia coli (0.58%). The P. aeruginosa isolates showed 96.25% and 95% susceptibility to amikacin and ofloxacin, respectively. All Gram-negative bacilli isolates were 100% sensitivite to imipenem. Ten (30.30%) isolates were ESBL producers with the CTX-M-14 gene detected in most of them.

Our study found that P. aeruginosa was the most common isolated pathogen bacteria. Knowledge of CSOM causing bacteria and their susceptibility to antibiotics would help choose an appropriate treatment, thereby preventing antibiotic resistance and complications in these cases.

Identification of carbapenem resistance genes in intrinsically colistin-resistant Enterobacteriaceae (ICRE), i.e., Proteus spp., Providencia spp., Serratia spp., and Morganella spp., is necessary for preventing such life-threatening bacteria. Here, we characterized carbapenemase resistance genes and their carriage within class 1 integron structures in clinical intrinsically colistin-resistant Enterobacteriaceae.

Clinical samples were collected from six general hospitals in Tehran and Torbat-e-Heydarieh, Iran, from 2018 to 2020. The isolates were identified by standard microbiological techniques and 16s rRNA sequencing. The resistance to imipenem and colistin was determined by disk diffusion and minimum inhibitory concentration (MIC) assays. PCR-sequencing was performed to detect primary carbapenemase-encoding genes, including blaOXA-48, blaIMP, blaVIM, blaKPC, and blaNDM.

Three Proteus mirabilis, three Providencia stuartii, and two Serratia marcescens isolates were identified. The MICIMP values of all isolates were >16 µg/ml. The blaVIM-1 gene and blaKPC-2 genes were detected in five and four isolates, respectively. Cassette arrays consisting of blaVIM-1-aacA7-dhfrA1-aadA1were detected in five isolates and aadB in one isolate. The blaVIM-1 gene in all blaVIM-1 positive isolates was located on class 1 integrons, while the blaKPC-2 carriage was not related to these genetic elements. The in silico analysis of the large plasmids carrying blaVIM-1-aacA7-dhfrA1-aadA1 array belonging to the IncA/C incompatibility group showed transmissibility among Enterobacteriaceae members.

  Transferable plasmid harboring blaVIM-1 in ICREs can pose a severe threat to public health. More investigations are required to depict the epidemiology of these underestimated carbapenem-resistant Enterobacteriaceae members.

Acinetobacter baumannii (AB) is a Gram-negative bacteria associated with various hospital infections. The present study deals with in silico analysis of the biofilm-associated protein (Bap) in this pathogen.

Sixty-eight multi-drug resistant (MDR) AB were isolated from two hospitals in Kerman, Iran. Biofilm-formation was investigated using the microtiter method and PCR followed by sequencing to detect the bap gene in the strongest biofilm-forming isolate. The physicochemical parameters of Bap protein were determined by the ProtParam tool using the ExPasy program. The 3D models from the primary amino acid sequence were constructed using the I-TASSER modeling platform based on multiple-threading alignments by LOMETS. Nevertheless, to ensure the correct initial structure, the protein was minimized in energy through the 3DRefine software of the deep learning system. For the accuracy of predicted models, calculation of the orientation of dihedral angles, including the phi (φ) and psi (ψ) and backbone conformation using the PROCHECK module of the PDB Sum server was performed. The domains and key amino acids involved in protein structure were studied by the Pfam and Interpro softwares.

Analysis of the amino acid content of the Bap protein revealed the absence of Arg and Cys in the protein structure. Our Bap protein exhibited ~99.6% identity with other Bap sequences in the GenBank database. Stereochemical simulation identified 19 antiparallel β-sheets with two small α-helices. The N-terminal of Bap protein formed oligomers that mediate cellular adhesion.

This study adds considerable information about Bap protein 3D structure, its conformation, domain analysis, and amino acids involved in cellular attachment.

Coronavirus disease (COVID-19) pandemic has affected worldwide health care. Given the possibility for coronavirus to prompt oxidative stress, masked glucose-6-phosphate dehydrogenase deficiency (G6PD) deficiency in the presence of the COVID-19 viral infection may instigate hemolytic crisis and dangerous consequences in affected individuals. G6PD deficiency is an X-linked recessive disorder that affects some 400 million people worldwide, with a higher prevalence in Africa, the Mediterranean Region, and Asia. A dearth of studies and literature on available antivirals for managing COVID-19 patients with G6PD deficiency brings the healthcare workers to a conundrum. Here, we report an interesting symptomatic case of COVID-19 patient with G6PD deficiency, hypertension, and resolved hepatitis B. Antiviral therapy for COVID-19 positive patients with G6PD deficiency should be individualized by considering the risk and benefit of treatment involved, recommending a multidisciplinary team approach.

Hematopoietic stem cell transplantation (HSCT) severely undermines the recipients' immune status and makes them prone to complications following viral infection. Here, we report a 3-year-old boy with mucopolysaccharidosis type VI who acquired SARS-CoV-2 infection after HSCT. The boy was diagnosed with SARS-CoV-2 during the post-transplant period (19 days after HSCT) when dealing with acute graft versus host disease (GVHD). He was successfully treated with remdesivir and tocilizumab and recovered. Well-timed treatment with tocilizumab might reduce the risk of invasive mechanical ventilation and death in patients with severe COVID-19 pneumonia in the early post HSCT period.