Infection, Epidemiology And Medicine
Volume:9 Issue: 2, Spring 2023

Multidrug-resistant Pseudomonas aeruginosa is known as a major opportunistic pathogen in burn patients with hospital-acquired infections. The aim of this study was to investigate antibiotic resistance and the capability of (GTG) 5-PCR (polymerase chain reaction) assay for molecular typing of P. aeruginosa strains isolated from clinical samples of hospitalized burn patients in southern Iran.
Materials &

This cross-sectional research was carried out on 70 P. aeruginosa isolates collected from hospitalized burn patients in southern Iran from June 2020 to January 2021. Antimicrobial susceptibility patterns of the isolates were determined using disk diffusion method. Additionally, repetitive extragenic palindromic-PCR (rep-PCR) method was used to examine the genetic similarities among the strains.

Antimicrobial susceptibility patterns revealed that the highest antibiotic resistance was against gentamicin (95.8%), followed by imipenem (94.3%) and piperacillin–tazobactam (92.8%), while colistin was the most effective antimicrobial agent. Rep-PCR typing revealed that 60 P. aeruginosa strains were classified into 49 GTG5 types (G1-G49), which were then grouped into 12 clusters (A-L) and 10 isolates with unique banding patterns according to the 80% cut off point.

The present study data indicated a substantial resistance to the studied antimicrobial agents, especially the last-resort antimicrobial agents. In addition, rep-PCR analysis revealed that most of the evaluated strains had partial genetic diversity; therefore, infection control activities should be carried out to decrease the colonization of MDR P. aeruginosa isolates in the hospital setting.

Acinetobacter baumannii could develop resistance through different mechanisms, leading to the emergence of strains resistant to all commercially accessible antibiotics. This research aimed to evaluate the antimicrobial resistance pattern and the prevalence of genes encoding quinolone resistance in quinolone-resistant isolates.

In this study, 114 A. baumannii strains were isolated from patients admitted to a teaching hospital in Kashan, during 2013-2014. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk-diffusion breakpoint assay. Polymerase chain reaction (PCR) was employed to identify quinolone resistance encoding genes (gyrA and parC).

All A. baumannii strains showed resistance to piperacillin, ceftriaxone, ceftazidime, and cefotaxime, and all of them were susceptible to colistin and polymyxin B. In addition, 100% of A. baumannii strains were MDR (Multi-drug resistance), and 68.4% (78 isolates) of them were XDR (Extensively-drug resistant), while none of them were PDR (Pan-drug resistant). All A. baumannii strains isolated in this study were positive for the presence of parC and gyrA genes.

MDR A. baumannii strains were highly prevalent among hospitalized patients in this study. Based on these comes about, novel prevention and treatment procedures against A. baumannii infections are justified. Moreover, these information may help in reexamining treatment rules and territorial arrangements in care units to moderate the rise of antimicrobial resistance.

Bacterial urinary tract infections are observed in all age groups due to the development of antibiotic-resistant species. This study aimed to investigate resistance genes gyrase subunit A (gyrA), topoisomerase IV (parC) subunit gene, beta lactamase (blaZ), erythromycin ribosome methylase (ermC), ermB, and ermA in Staphylococcus saporophyticus isolated from patients with urinary tract infections (UTIs) in Mazandaran Province, Iran.
Materials &

In this cross-sectional descriptive study, 3280 clinical samples were collected from patients with UTIs in Mazandaran Province from April to December 2022. Isolates were identified by biochemical tests. Microbial sensitivity tests were performed by disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Polymerase chain reaction (PCR) was used to check the presence of resistance genes.

Out of a total of 3280 clinical samples collected, 2088 samples were detected by biochemical tests at the genus level. Escherichia coli (55.22%) and staphylococci (21.59%) were the most frequent bacterial isolates. S. saprophyticus was identified in 52 (2.49%) samples. The frequency of gyrA and parC genes in S. saprophyticus isolates was 23 and 1.92%, respectively. The blaZ gene was observed in none of the samples. The prevalence of ermA, ermB, and ermC genes was 21, 1.92, and 26%, respectively.
 The antibiogram test showed that the highest frequency of resistance to erythromycin, azithromycin, and clarithromycin was 70, 36, and 20%, respectively.

According to the present study findings, rapid detection of these strains in hospitals leads to more effective control of the spread of these strains.

Chlamydial infections could lead to ectopic pregnancy and infertility. Considering the high prevalence of infertility in Iran and little information about the role of urogenital bacterial infections in this disease, this study aimed to evaluate the prevalence and sequence types of Chlamydia trachomatis in the urogenital tract of infertile couples in North Khorasan.
Materials &

Cervical or urethral swabs collected from infertile patients referring to two private clinics and the infertility center of Bent Al-Hoda hospital in Bojnurd during 2017-2021 were tested for C. trachomatis. These specimens were evaluated using PCR for C. trachomatis orf8 gene. Multi-locus sequence typing (MLST) was performed on positive samples using PCR amplification of seven housekeeping genes (GlyA, leuS, lysS, mdhC, pdhA, pykF, and yhbG) following a previously described protocol.
Findings. Out of 268 samples tested, 44 (16.4%) samples were positive for C. trachomatis. Among which, 35 cases were obtained from women, and nine samples were from men. Of the 44 positive samples, 10 cases were not typable. Only two sequence types were detected among 34 typeable isolates: 25 (73.5%) isolates belonged to ST80, and nine (26.5%) samples belonged to ST4.
Conclusion. The high prevalence of ST4 and ST80 in most symptomatic infertile patients may be attributed to the higher pathogenicity of these types in the urogenital tract. However, our sample size was insufficient to draw such a conclusion.,  Further research on the prevention and treatment of Chlamydial infections could potentially help to reduce infertility in Iran.

This study aims to investigate the in-vitro antibacterial activity, mineral and vitamin compositions, proximate composition, and organoleptic properties of a syrup derived from Vitex doniana fruits.

V. doniana fruits were mashed, mixed with water, strained, and boiled to thicken the filtrate.  The syrup’s antibacterial activity was tested on 7 clinical and 6 American Type Culture Collection (ATCC) isolates using well-in-agar diffusion method on Mueller Hinton agar. The fruit juice underwent mineral analysis using atomic spectroscopy and mass spectrometry. Proximate composition, vitamin, and organoleptic properties of a syrup were evaluated.

Clinical Escherichia coli 0157:H7 and Staphylococcus aureus isolates were susceptible to the syrup, with inhibition zone of 25 mm each while S. aureus ATCC 25923had the highest susceptibility with a 33 mm inhibition zone. The syrup showed varying minimum inhibitory concentrations (12.5-50 mg/ml) and minimum bactericidal concentrations (25-150 mg/ml) against tested bacteria. The syrup contained 18.4±0.36 mg calcium, 36.92±0.14 mg magnesium, 3.21±0.30 mg iron, 4.80±0.24 mg sodium, and 43.56±1.05 mg potassium as mineral composition per 100 g. Although the prepared syrup had higher calcium, magnesium and iron values prepared to the commercial sample, there was no significant difference between the two. Proximate composition analysis revealed moisture content was measured at 20.83±1.08% moisture content, pH=4.76, 0.20±0.01% crude fiber, 2.40±0.35% crude protein, 3.18±1.12% ash, 0.62±0.24% crude fat, and 76.70±0.16% carbohydrate levels in the syrup. Significant difference was only found in ash and carbohydrate values, with the prepared sample showing higher levels. The syrup exhibited higher vitamin content, including vitamin C, B1, B2, B6 and A, compared to the commercial sample. In terms of organoleptic properties, the prepared syrup scored slightly better in taste, flavor, and overall acceptability (0.18%) compared to the commercial product.

Based on these finding, the syrup derived from V doniana shows potential as a nutrient food product with antimicrobial properties. It could be used in healthcare, industrial applications (such as preservatives or sweeteners), and as a base for pharmaceutical formulations. Furthermore, the syrup may find applications in the confectionery, bakery industries, and traditional medicine.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and influenza virus are quite distant viruses, but they share significant similarities such as mode of transmission and clinical manifestations. No specific clinical signs reliably distinguish early influenza sickness from the disease caused by SARS-CoV-2 (COVID-19); therefore, it will be critical in clinical practice to determine the viral etiology. The present study aimed to screen for influenza virus A and B among COVID-19 patients by quantitative reverse transcription polymerase chain reaction (RT-qPCR).
Materials &

A total of 100 nasal swabs from COVID-19 patients were collected in viral transport medium (VTM) during June to July 2022. RNA extraction was done using QIagen RNA extraction kit, and then RT-qPCR was performed using HELINI swine flu (H1N1) kit.

The average age of the study participants was 31 years, and 13 patients were hospitalized due to the COVID infection. Hypertension, diabetes, and chronic lung, heart and kidney diseases were identified as comorbidities. It was found that none of the tested samples were positive for influenza A and B.

Although none of the patients were positive for influenza, the importance of co-infection could not be ignored. Screening of a large number of samples is needed during the seasonal period.

Several studies have elucidated vitamin D as an important immunomodulatory factor regulating immune responses to different viral infections and vaccines. This study aimed to evaluate the impact of 25(OH) D serum levels on immune responses to hepatitis B virus (HBV) vaccine.
Materials &

This study was conducted on 134 healthy individuals aged 18-35 years, referring to health centers for HBV vaccination in Mane and Samalghan city in North Khorasan, Iran from June to September 2021. Demographic data were collected through a questionnaire. Serum 25(OH) D levels were analyzed using commercial sandwich ELISA kits. Anti-hepatitis B surface antibody (anti-HBsAb) levels were determined in blood samples 4-6 weeks post-vaccination.

The prevalence of vitamin D deficiency and insufficiency among the participants was 46.3 was 34.3%, respectively. The level of 25(OH) D was insignificantly higher in women than in men. There was no significant association between serum 25(OH) D levels and participants' ethnicities and BMI ranges. Anti-HBsAb titer was significantly higher in participants with sufficient vitamin D levels compared to those with insufficient and deficient levels (1835 ± 252.55 vs. 1129 ± 120.7 and 1363 ± 0.125 ng/ml). Serum anti-HBsAb levels post HBV vaccination were significantly higher in women and younger individuals than in men and older individuals, respectively.  

This study findings suggest that participants with different serum vitamin D levels produce seroprotective antibody titers post HBV vaccination, while those with sufficient vitamin D levels may produce higher titers against HBV vaccine.

The primary goal of this study was to identify the potential association between COVID-19 prognosis and demographic and clinical features, underlying diseases, and drug and supplement use in patients admitted to Amir al-Momenin hospital in Zabol.

Materials &

This retrospective study surveyed the electronic health records of 848 COVID-19 patients hospitalized in a tertiary referral hospital in southeastern Iran from the beginning of the COVID-19 outbreak until the end of February 2021. Univariate and multiple analytical tests including unconditional and penalized logistic regressions were used for statistical analysis.

Out of a total of 848 patients, 371 (43.75%) patients were female, and 477 (56.25%) patients were male. Age, underlying pulmonary and cardiovascular diseases, and loss of consciousness predicted a higher mortality rate. On the contrary, a negative chest X-ray was associated with a lower risk of death.

Identifying predisposing factors of mortality in COVID-19 patients will help physicians provide more intensive care to those at higher risk of death by classifying patients based on risk factors and underlying diseases.

In developing countries like Nigeria, screening of Zika virus (ZIKV) infection in pregnant women remains limited due to a lack of diagnostic facilities and non-specific symptoms, leading to potential misdiagnosis of the disease as other febrile illnesses such as malaria or typhoid.
Materials &

To address this issue, this study aimed to investigate the prevalence of anti-ZIKV IgM antibodies in pregnant women using enzyme-linked immunoassay. Additionally, the quantitative reverse transcription polymerase chain reaction (RT-qPCR) assay targeted a specific region of the membrane protein (prM) gene to detect Zika virus presence in the collected serum samples. For a period of four months from December 2021 to March 2022, a total of 360 serum samples were collected from pregnant women attending antenatal care units in two tertiary hospitals located in different regions of Nigeria.

The results of this study revealed a prevalence of 17.2% (62 samples) for anti-ZIKV IgM antibodies among pregnant women. Further analysis using the RT-qPCR method detected Zika virus (prM gene) in 1.9% (7/62) of the serum samples. In addition to these virological results, the statistical analysis of sociodemographic data, clinical characteristics, and risk factors for ZIKV infection demonstrated a significant correlation between seropositivity and various factors including ethnicity, residence, occupation, and history of arboviral diseases (p< .005).

Given the potential consequences of ZIKV infection in pregnant women, early diagnosis and intervention could improve maternal outcomes and prevent fetal abnormalities.

Delay in the diagnosis of tuberculosis (TB) leads to poor response to treatment and the disease transmission to susceptible individuals. The Xpert MTB/RIF assay efficiently detects Mycobacterium tuberculosis (MTB). The present study aimed to compare acid-fast bacilli (AFB) microscopy, culture, and Xpert MTB/RIF assay in the diagnosis of pulmonary and extrapulmonary tuberculosis cases.
Materials &

This retrospective study was conducted in the Department of Microbiology, Government Medical College, Srinagar, India over 18 months from February 2019 to July 2020. Samples were processed and evaluated using AFB microscopy, culture, and Xpert MTB/RIF assay.

Among the 1862 samples evaluated, 224 samples were found to be positive using AFB microscopy, culture, and Xpert MTB/RIF assay. The overall sensitivity and specificity of the Xpert MTB/RIF assay in diagnosing pulmonary TB cases was 98.23 and 97.69%, respectively. Among the smear-negative extrapulmonary samples, 52 (5.75%) and 86 (9.6%) samples were positive in culture and the Xpert MTB/RIF assay, respectively. The maximum recovery of MTB by Xpert MTB/RIF assay was from tissue biopsy specimens. Rifampicin resistance was observed in six samples.

Both culture and Xpert MTB/RIF methods were sensitive in detecting smear-positive samples. Although both techniques missed some smear-negative pulmonary and extrapulmonary TB cases, the Xpert MTB/RIF assay enhanced the detection rate of MTB compared to culture. The Xpert MTB/RIF assay enabled the accurate diagnosis of tuberculosis cases with a rapid turnaround time; therefore, it could assist clinicians to start timely therapeutic interventions for these patients.