Jundishapur Journal of Microbiology
Volume:16 Issue: 5, May 2023

Hepatitis C virus (HCV) is one of the most common infections in hemodialysis patients, which has been associated with increased incidence of morbidity and mortality, particularly in low- and middle-income countries.

The current study aimed to evaluate the HCV antibody, occult HCV infection (OCI), and related risk factors among hemodialysis patients.

In this cross-sectional study, 100 hemodialysis patients referred to a dialysis center in Kerman between December 2021 and March 2022 were assessed for HCV, OCI, and their related risk factors. The information related to risk factors was collected by questionnaire, while HCV and OCI were detected through serology and real-time polymerase chain reaction (PCR) methods, respectively.

Among the patients participating in the study, 61 were men, and 39 were women. The average age was 58.1 ± 14.9 years in men and 63.6 ± 11.4 years in women. Diabetes and hypertension history, old age, low education, self-employment, and urban living were more common in chronic kidney disease patients. The enzyme-linked immunosorbent assay (ELISA) revealed 3% positive seroprevalence HCV infection, but only 1% was positive for OCI. Although no statistically significant relationship was found between the presence of HCV (antibody and OCI) and other parameters, all positive HCV cases were identified in patients with low education and freelance employment.

Hemodialysis patients had a low prevalence of HCV antibody and OCI. Improving various factors and conditions such as lifestyle, occupation, educational level, and dialysis ward and machine disinfection could be beneficial in managing and controlling hemodialysis complications such as HCV and OCI.

Nosocomial infections have increased among patients admitted to the intensive care unit (ICU).

This study investigated the microbiota pattern of the respiratory system in hospitalized patients with treatment-resistant respiratory infections compared to those without treatment-resistant respiratory infections.

This case-control study utilized sputum samples from hospital-acquired infection (HAI) and non-HAI (NHAI) patients over 52 years old hospitalized in the ICU. Identification and determination of the drug sensitivity of the bacteria responsible for treatment-resistant respiratory infections were made by culture method in selective and differential media and VITEK 2 device. Finally, quantitative polymerase chain reaction (qPCR) was used to analyze the microbiota of the respiratory system.

Excessive prescription of antibiotics, long hospitalization, and history of surgery were important risk factors for nosocomial infections. The study of antibiotic resistance of pathogens causing hospital infections indicated their high resistance to most common antibiotics. Also, nosocomial infections led to a change in lung microbiota in HAI patients. The frequencies of Streptococcus pyogenes, S. pneumoniae, and Haemophilus influenzae were higher in patients with treatment-resistant respiratory infection (P < 0.05), but the frequency of Neisseria spp. was higher in patients without treatment-resistant respiratory infection (P < 0.05).

The pathogens responsible for nosocomial infections had acquired resistance to a wide range of antibiotics, leading to changes in their respiratory microbiota. 

 NAP1/027 Clostridium difficile infection (CDI) has rarely been reported in China.

 The objective of this study was to strengthen the understanding of the risk factors and outcomes of NAP1/027 CDI.

 A single-center, retrospective, case-control (1: 3) study was performed to identify risk factors and outcomes specific to NAP1/027 CDI using a group of patients with NAP1/027 CDI (n = 20) and a group of age-matched control patients with non-NAP1/027 CDI (n = 60) within June 2018 and August 2021. The patient charts were thoroughly reviewed to assess the markers of severity, risk factors, and outcomes.

 Out of the 272 stool specimens, 41 cases (15.07%) tested positive for the NAP1 strain of C. difficile using the polymerase chain reaction. Among these specimens, 20 cases fulfilled the inclusion criteria. No significant difference was observed between the NAP1/027 and non-NAP1/027 groups in disease severity, length of hospital stay, or mortality. Logistic regression analysis revealed that risk factors for acquiring NAP1/027 infection included hospitalization in the 90 days before CDI diagnosis and high C-reactive protein level within ± 3 days of C. difficile detection.

 In a large non-epidemic tertiary hospital in China, NAP1/027 strains were more prevalent in patients with previous hospitalization and high CRP level than non-NAP1/027 strains.

 The composition of lung tissue microorganisms in patients with different tissue types of lung cancer has not yet been determined. Previous studies have shown changes in the composition of pulmonary microbial flora in patients with lung cancer.

 This study aimed to investigate the differences and correlations in the microbial flora of pulmonary tissue among different histological types of lung cancer.

 Samples of tumor and normal lung tissue from 29 patients with early-stage lung cancer were collected. The samples were sequenced using Illumina HiSeq high throughput sequencing technology for 16S rDNA in the V4 region of the bacteria. Also, their microbiological characteristics were detected, and bioinformatics analysis was performed.

 The results of microbial abundance analysis in the lung tissue of patients with lung cancer showed that the bacterial colony composition of the two tissues was similar, with Proteobacteria, Thickwalled Bacteria, Anomalococcus, Bacteroides, and Actinobacteria predominating. Analysis of microbial diversity found no difference in α diversity and β diversity between normal lung tissue and tumor tissue. When analyzing patients with adenocarcinoma, the abundance of Micrococcales and Blastomonas was significantly higher in tumor tissue than in normal lung tissue.

 The composition of microbial flora in different parts of lung tissue of early-stage lung cancer patients is consistent, but the dominant flora varies among different histological types of lung cancer.

 Klebsiella pneumoniae is an important pathogen among nosocomial infections, which can cause urinary and respiratory system infections, surgical site infections, and sepsis. Recently, carbapenem-resistant K. pneumoniae showed an upward trend with the wide use of clinical carbapenem antibiotics. However, there are few studies on the relationship between drug resistance, virulence, and phylogeny of K. pneumoniae in patients with different infections.

 We investigated the drug resistance, virulence, and phylogeny of K. pneumoniae in patients with different infections.

 Seventy infected patients were selected as subjects. The extended-spectrum β-lactamases (ESBLs) color screening plane and blood plate medium were used for culture. Identification and drug resistance analysis was carried out by VITEK-2 compact automatic bacterial analyzer. Multilocus sequence typing (MLST) and capsule genotyping analysis were also performed. The Xpert CarbaR cartridge detected the carbapenem resistance genes. Comprehensive Antibiotic Research Database (CARD) and Virulence Factor Database (VFDB) predicted the drug-resistant genes and virulence factor genes, respectively. The phylogenetic tree was constructed, and the correlation was analyzed.

 A total of 43 K. pneumoniae strains were cultured. We found that all K. pneumoniae strains exhibited different multiple drug resistance. MLST analysis indicated that ST11 was the main ST (60.61%). Analysis of the carbapenem-resistance genes showed that all isolates harbored the blaKPC-2 gene and some others blaOXA. The prediction result of capsular blood genotyping and virulence factor genes indicated that K47, K64, and K25 were the main types of capsular blood, and the top three detection rates of virulence genes were fimH (97.67%), mrkD (94.19%), and entB (84.88%). All isolates were clustered into one branch based on the virulence factor genes in the phylogenetic tree, and the strains of the same ST type or capsular blood type showed a closer relationship. Correlation analysis manifested that the drug resistance of K. pneumoniae in infected patients was positively correlated with virulence and phylogeny (r = 0.682, P = 0.000).

 There were complicated differences in the multidrug resistance to K. pneumoniae, resulting in high independent gene-positive rates of strains and a strong correlation with phylogeny, which can provide a reference for the selection of clinical antimicrobial drugs.

 Fulminant myocarditis is a life-threatening disease among young patients. Pseudomonas aeruginosa is distributed in nature and is often spread as an opportunistic pathogen to cause hospital-acquired infections in patients with underlying diseases and low immunity.

 This report presented a case of a 28-year-old woman with fulminant myocarditis followed by P. aeruginosa infection. After hospitalization, she received veno-arterial extracorporeal membrane oxygenation (ECMO) and continuous renal replacement treatment (CRRT). Initially, piperacillin sodium tazobactam combined with amikacin was used for anti-infection therapy, which had a poor clinical effect. Subsequently, it was recommended to use ceftazidime-avibactam and amikacin for treatment. Finally, the infection index of the patient returned to normal.

 It is necessary to select correct and effective drugs according to etiology, considering the influence of ECMO and CRRT on the patient’s antimicrobial pharmacokinetics/pharmacodynamics (PK/PD). This case could provide a reference for safe and rational drug use in clinical practice.