Infection, Epidemiology And Medicine
Volume:8 Issue: 1, Winter 2022

A common problem among diabetic patients is foot ulcers and infections, impacting up to 15% of diabetic patients over their lifetime. The aim of this study was to investigate the frequency of bacterial agents and their antimicrobial resistance pattern in patients with diabetic foot infection in Namazi and Shahid Faghihi hospitals in Shiraz.

This cross-sectional study was conducted in Namazi and Shahid Faghihi hospitals in Shiraz. The collected samples were transferred to the laboratory for culture and biochemical tests. After accurate identification of bacterial agents, antibiotic susceptibility of all isolated bacteria was evaluated by disk diffusion method based on CLSI guidelines. Data were analyzed using SPSS software (Version 19).

In this study, 166 patients with diabetic foot ulcers were evaluated. The mean age of patients was 55.8± 13.2 years, and 109 (66.4%) cases were male. Also, 62% of patients had an underlying disease, while most of them had hypertension (27%). The most prevalent isolated bacterium was Staphylococcus epidermidis. The most effective antibiotics against isolated Gram-positive and Gram-negative bacteria were vancomycin and amikacin, respectively.

  In this study, it was concluded that the frequency of Gram-negative bacteria in diabetic foot ulcer infections was higher than that of Gram-positive bacteria.

Infectious diseases are one of the main leading causes of morbidity and mortality worldwide. Therefore, diagnosis and treatment of infectious diseases are very important. Infection affects some blood indices that could be used as diagnostic markers. Therefore, this study aimed to compare blood parameters in four important and prevalent infectious diseases.

In this study, 202 out of 892 patients with a final diagnosis of UTI (urinary tract infection), septicemia, pneumonia, or diabetic foot infection were evaluated; they were hospitalized in Rasoul Akram hospital in Iran from August 2017 to February 2018. Patients' demographic and laboratory data, such as RDW (red cell distribution width), PDW (platelet distribution width), RBC (red blood cell), CRP (C-reactive protein), ESR (erythrocyte sedimentation rate), and, WBC (white blood cells), were evaluated.

This study results showed that mortality rate in sepsis cases was higher than in other cases (42.1%). Changes in blood parameters such as RDW, PDW, and EDR levels as well as monocyte, basophil, and eosinophil counts were significant among patients with different infectious diseases, while there was no significant difference in terms of changes in some blood parameters, such as WBC, neutrophil, and lymphocyte counts and CRP level between patients with different infectious diseases. For statistical analysis, one-way ANOVA and LSD post hoc tests were used.

According to this study results, it was found that the range of blood parameters varies in different types of infectious diseases. Therefore, the physician could employ routine blood parameters along with other diagnostic factors to more accurately diagnose the type of infection and prescribe more appropriate antibiotics.

Aspergillus fumigatus is a pathogen responsible for invasive aspergillosis and the main leading cause of death in immunosuppressed individuals. The present study aimed to evaluate the impact of eugenol-loaded chitosan nanoparticles on the expression of CYP51a and CYP51b, two well-known genes responsible for triazole drug resistance in A. fumigatus.

The minimum inhibitory concentration (MIC) of eugenol-loaded chitosan nanoparticles, chitosan, eugenol, and itraconazole was determined based on the Clinical and Laboratory Standards Institute M38-E3 method at concentrations of 4.6-2400, 11.7-12000, 2-2048, and 1-256 μg/mL, respectively. The expression of CYP51a and CYP51b was evaluated in A. fumigatus exposed to 0.5, 1, and 2× of MIC concentration of NPs and itraconazole using the real-time polymerase chain reaction.

The obtained results showed that eugenol-loaded chitosan nanoparticles sucessfully reduced A. fumigatus fungal growth at 300 μg/mL concentration. MIC of chitosan, eugenol, and itraconazole was measured to be 6000, 256, and 4 μg/mL, respectively. The results of real-time PCR also revealed that eugenol-loaded chitosan nanoparticles increased the expression of both CYP51a and CYP51b in a dose-dependent manner. The expression of fungal CYP51a and CYP51b at mRNA level was significantly increased 1.26, 1.93, and 3.1-fold as well as 1.2, 2.1, and 2.4-fold at concentrations of 150, 300, and 600 μg/mL, respectively (p<.05). However, it seems that the prepared nanoparticles had a lower impact on the expression of these genes compared to itraconazole.

Overall, these findings suggest that the treatment of A. fumigatus with eugenol-chitosan nanoparticles could increase the expression of the CYP51 gene, suggesting the anti-fungal property of these nanoparticles.

Trichomoniasis is one of the most common sexually transmitted infections in the world. The main aim of the present descriptive study was to determine the prevalence rate and clinical symptoms of trichomoniasis among women referring to the hospital in Mahshahr city in Khuzestan province, southwest of Iran.

Urine samples were collected from 2200 women referring to Imam Musa Kazim hospital in Mahshahr city. In addition, 500 Pap smear samples were used for early detection of Trichomonas vaginalis. At first, parasitological tests were performed to detect T. vaginalis in urine and dissolved Pap smear samples using microscopic examination. Finally, DNA extraction was performed on 34 parasites isolated from positive urine and Pap smear samples. Then the 18s rRNA gene of the parasite was amplified by PCR method. The PCR products of the 18s rRNA gene were finally sequenced.

The prevalence rate of this parasite was determined to be 1.54%. The highest prevalence rate of infection and clinical symptoms were observed in women aged 31-40 years. Totally, clinical symptoms were observed in 64.70% of infected women, including vaginal itching and irritation (64.70%) and abnormal discharge (26.47%).

The prevalence rate of Trichomonas infection was relatively low in women living in Mahshahr. In addition, about 35.29% of infected women were found to be clinically asymptomatic.

Many factors are involved in the development of SARS-CoV-2 infection in individuals in each region, such as physiological conditions, underlying diseases, and observance of personal protection and hygiene; therefore, this study aimed to investigate factors affecting the incidence of COVID-19 in Bandar Lengeh, Hormozgan province, southern Iran.

Blood samples and demographic information were collected from suspected COVID-19 patients referring to Shahid Rajaei governmental health centers in Bandar Lengeh city. Hematological, biochemical, and serological tests were performed on the samples. PCR experiment was conducted to confirm SARS-CoV-2 infection. The thorax computed tomography (CT) was performed for all patients.  

According to the PCR test results, the prevalence rate of SARS-CoV-2 infection was 26.92% among 130 individuals enrolled in this study. SARS-CoV-2 infection was more prevalent among clerks than in other occupational groups (p=0.017). Increased ESR (erythrocyte sedimentation rate) and decreased WBC (white blood cell), lymphocyte, and platelet counts were evident in COVID-19 patients. Also, the prevalence of COVID-19 infection was higher in patients with blood group A (33.3%) than in patients with other blood groups. The CRP (C-reactive protein) test was positive for 31 patients whose PCR test was positive for SARS-CoV-2. In addition, LDH (lactate dehydrogenase) level was higher in infected individuals compared to other participants (p=0.018).   

In addition to the PCR test result, the most effective factors for diagnosing COVID-19 patients best on blood tests were as follows: increased CRP, ESR, and LDH levels and decreased WBC, lymphocyte, and platelet counts.

Malnutrition is a major cause of morbidity and mortality in children under five years. This study aimed to evaluate malaria and urinary tract infections among children under five years of age with malnutrition.

This cross-sectional study was carried out on 189 children under five years with malnutrition. Their weight and height were measured using standard scales. Weight to height/length (wasting), weight to age (underweight), and height/length to age (stunting) ratios were computed using WHO growth charts. Clinical features were assessed. Blood smear, rapid diagnostic test for malaria, as well as urine dipstick test were done to detect those with malaria and urinary tract infections.

About 80.95% of participants had marasmus, and 11.64% had marasmic kwashiorkor, while 7.41% had kwashiorkor. Also, 23.70 and 62.42% of participants had moderate and severe malnutrition, respectively; in addition, 21.69 and 2.12% were moderately and severely stunted, respectively. Regarding underweight (weight to age), 50.26 and 4.76% were moderately and severely underweight, respectively. Also, 15.87% of participants had a positive blood smear for malaria, and 19.58% had a positive rapid diagnostic test for malaria, while 20.11 and 20.63% had positive results for nitrite and leukocyte esterase activity in urine dipstick test, respectively.

Malaria and urinary tract infections are common among children with malnutrition and could be diagnosed using simple laboratory tests such as rapid diagnostic tests and urine dipstick tests in health facilities without laboratory support in resource-limited countries.

This study aimed to investigate the prevalence of cryptococcaemia in HIV infected patients with CD4 counts of ≤100 cells/mm3 in a tertiary care hospital. 

The present cross sectional study was conducted at the Sri Guru Ram Das Institute of Health Sciences and Research, India, as a tertiary care hospital. All HIV infected patients with CD4 counts of ≤100 cells/mm3, referring to the hospital during May 2020 to May 2021 were enrolled in this study. Blood samples taken from patients were processed for wet mounting, negative staining with India ink, gram staining, fungal culture, and cryptococcal antigen (CrAg) lateral flow assay (LFA). Statistical analysis was done using SPSS software Version 20.0 (SPSS Inc. Chicago, IL, USA) by employing Chi-square and Fisher's exact tests to compare categorical variables. 

Out of 100 patients enrolled, 28 (28%) cases had CD4 counts below 50, while 72 (84.7%) patients had CD4 counts in the range of 51-100. Also, 55 patients (55%) received antiretroviral therapy (ART), and 45 (45%) cases were ART naïve. About 56% of patients had no opportunistic infections, and 37% had pulmonary tuberculosis. Three samples were positive in LFA, showing a prevalence of 3%, while only one of the culture samples was positive for Cryptococcus species. However, low CD4 count was found to be strongly correlated with positive serum cryptococcal antigenemia. 

The present study reveals that cryptococcal antigenemia is a health problem, and that cryptococcal antigen screening and treatment policy recommended by WHO should be performed routinely for HIV patients registered in ART centres in the current setting, especially for those who are ART naïve and have CD4 counts of ≤100 cells/mm3.

This study aimed to describe the aetiological profile of fever without focus (FWF) in children aged one to thirty-six months and to identify clinical and laboratory predictors of specific aetiologies, especially serious bacterial infection (SBI).

Children in the age range of one to thirty-six months, who were hospitalised due to FWF were included in this study. This prospective study was done over a period of 20 months in a medical college hospital in southern India. CBC (complete blood count) and CRP (c-reactive protein) tests, urine microscopic examination, blood and urine culture, Dengue antigen testing, and chest X-ray test were done for all feverish children. For those with fever beyond 5 days, additional tests including serological tests for Dengue, scrub typhus, and leptospirosis as well as Widal test were done. The final diagnosis was recorded, and clinical and laboratory parameters were analysed.

Among 141 children with FWF, 41 (29%) had SBI, and 21(14.9%) had Dengue fever (DF). Leucocytosis, neutrophilia, and raised CRP levels were good predictors of SBI. Thrombocytopenia was an excellent predictor of DF. High fever was significantly associated with SBI and Dengue (p=.004), and fever beyond 3 days at presentation was significantly associated with SBI (p=<.001). Pyuria had a high specificity (94.5%) for identifying urinary tract infection (UTI). About 50% of UTIs were caused by extended spectrum beta lactamase (ESBL) producing organisms.

SBI and DF were the most common causes of FWF. High fever, fever beyond 3 days at presentation, leucocytosis, neutrophilia, and a positive CRP test were predictors of SBI. Pyuria suggests UTI. Empirical antibiotic therapy should cover ESBL producing organisms. High fever and thrombocytopenia suggest Dengue fever.

It is evident that the success of common cancer treatments is reduced due to limited drug access to tumor tissue, the drug toxicity intolerance in healthy cells, as well as the exposure of the immune system to the drug. Cancer stem cells are also a small population of tumor cells, which have different potentials for regeneration, proliferation, and differentiation and serve as a carcinogenic driving force. They are believed to play a key role in the onset, progression, drug resistance, recurrence of cancer, or metastasis. Although mesenchymal stem cells (MSC) have a slight ability to migrate toward the tumor, they could be considered as a cellular carrier for tumor targeting due to lack of recognition by the host immune system. Stem cells with their own ligands could effectively target cancer cells. One of the CD markers that exist on the surface of stem cells is CD44v6, which is considered as a homing receptor. Given that the expression level of stem cell markers is reduced during consecutive cultures in vitro environment; therefore, in the present study, stem cells were engineered using CD44 lentiviral vectors to more effectively improve the implantation and targeting of the colon cancer cell model.

In this study, the structure of the CD44 gene was designed in lentiviral vectors and transfected to the HEK293T cell line along with auxiliary plasmids PSPAX2 and PMDG2. The growth medium of virus-containing cells was collected at optimized intervals, and transduction into mice mesenchymal stem cells, injection into mice, and homing processes were traced.

Successful production of lentiviral vectors and proper expression of the corresponding factor after transduction were effective in improving the MSC homing in cancer cell.

According to these findings, it could be suggested that high expression of CD44v6 factor could be effective in improving the implantation process in cancer cells and targeting treatment.

Enterococci are Gram-positive bacteria that colonize the intestine of warm-blooded animals and humans as normal flora. Enterococci cause a variety of community-acquired and nosocomial infections. The emergence of vancomycin and gentamicin resistant enterococci has made a major challenge in the treatment of enterococcal infections worldwide. Therefore, the present study was conducted to evaluate the prevalence of vancomycin and gentamycin resistance among Enterococcus spp in Iran during 2007-2019.

In this study, 26 studies were reviewed to collect data on the frequency of vancomycin and gentamicin resistant enterococci in Iran. To find studies published during January 2007 to January 2019, a search strategy was performed by searching different Iranian and international databases, including SID, Google Scholar, Scopus, Medline, Pub Med, and Web of Science.

The prevalence of vancomycin- and gentamicin-resistant enterococci was very high in Iran (41 and 44%, respectively). Accordingly, Enterococcus faecalis was more prevalent in clinical samples compared to E. faecium (75.49% vs. 24.05%). However, resistance to vancomycin was higher in E. faecium strains compared to E. faecalis.

Due to the increasing vancomycin and gentamicin resistance among Enterococcus species in Iran, it is necessary to design strategies that lead to the rational prescription of antibiotics and limit the spread of resistant enterococci.