Archives of Clinical Infectious Diseases
Volume:18 Issue: 4, Aug 2023

 Thalassemia is a genetic disorder that leads to chronic anemia and requires frequent blood transfusions. With the coronavirus disease 2019 (COVID-19) outbreak, thalassemia patients are at increased risk of disease.

 We aimed to study the epidemiology of COVID-19 in thalassemia patients and its mortality to determine the disease severity.

 This cross-section study was conducted in the first year of the pandemic. Provincial information was collected. A questionnaire was developed to collect demographic, clinical, and paraclinical data and outcomes using history, examination, and laboratory tests. The patients' data were analyzed statistically using SPSS (v. 21).

 The number of thalassemia patients was 19 387, of whom 442 were infected by COVID-19 (50.9% female and 49.1% male), with a mean age of 36.98 years (16 - 67). Of them, 419 had a positive PCR test, and 23 had no positive test. Also, 98% of patients complained of fever, and 54% had cough. Of 442 patients, 14 (3.2%) died, four having a ferritin level > 5000. There was a significant relationship between COVID-19 mortality and increased pulmonary artery pressure (PAP) (P value = 0.003). Also, there was a correlation between COVID-19 mortality and ferritin level (P value = 0.005), while there were no significant correlations between COVID-19 mortality and respiratory symptoms (P value = 0.30), PCR test result (P value = 0.74), and diabetes (P value = 0.47).

 Thalassemia patients are more prone to COVID-19. Comparing familial and thalassemia patients statistics, the prevalence and percentage of COVID-19 mortality were higher among the patients.

 Rabies is a usually fatal viral zoonotic and preventable disease. The efficacy and safety of animal rabies vaccination made in permanent BHK-21 cell culture have been proven over a long period of use. By increasing the yield of cells and viruses, the efficacy of the vaccine can be increased.

 The objective of this study was to optimize and maximize the output of a rabies vaccine made on BHK cells in a bioreactor.

 This study examined the impacts of independent parameters, such as pH, temperature, cell density, and dissolved oxygen (DO), on rabies virus strain PV-PARIS yield for a central composite design. To achieve high viral production, this study used the central composite approach to optimize cell development.

 The findings showed that BHK-21 cells were grown under the ideal conditions of pH 7.21, temperature 35.05ºC, 68.75% for DO, and 2.30 × 106 cell/mL of cell density to produce high titers of rabies virus (4.7 × 107 plaque-forming unit [PFU]/mL). High correlation coefficients (0.927) validated that the predicted model was well-fitted with the data, and the statistical analysis of the collected data indicated that the experimental data and predicted model were well-matched. The accuracy of this model’s predictions was correlated with values of adjusted R-squared (R2Adj) and predicted R-squared (R2Pred).

 These upgrades lead to a more reliable and economical procedure that makes industrialization and commercialization easier.

 Bloodstream infection with multi-drug resistant (MDR) bacteria has been introduced as the main risk factor for in-hospital mortality in vulnerable children worldwide. COVID-19 can complicate the treatment process in patients with bacteremia; however, data about this co-infection in children are scant.

 This was a study on the antimicrobial patterns of Gram-negative bacteria (GNB) isolated from blood samples of children with bacteremia and their correlation with COVID-19.

 In this cross-sectional study, blood samples of children with bacteremia were analyzed using BACTEC bottles. The bacterial isolates were characterized based on standard microbiology laboratory methods, and MDR strains were detected based on a standard protocol. Real-time PCR tests for COVID-19 were recorded from the patients’ hospital documents.

 A total of 255 positive blood samples were detected in children with bacteremia. The bacterial isolates included Enterobacteriaceae spp. 43.5% (111/255), Pseudomonas spp. 33.7% (86/255), Acinetobacter spp. 21.6% (55/255), and Stenotrophomonas spp. 1.2% (3/255). Of 255 GNB, 86.66% (221/255) were MDR, and the frequency of MDR strains was as follows: Enterobacteriaceae spp. 91.8% (102/111), Pseudomonas spp. 77.9% (67/86), Acinetobacter spp. 89% (49/55), and Stenotrophomonas spp. 100% (3/3). Of 255 children with GNB-related bacteremia, COVID-19 infection was confirmed in 25.1% (64/255) of them. Nearly 93.7% (60/64) of these patients had both MDR bacteremia and COVID-19. The correlation was significant between MDR bacteremia and COVID-19 (P-value = 0.002). The death rate was 43.33% (26/60) among these children.

 The results of this study showed that MDR-GNB was the main cause of bacteremia in children. Our findings showed a notable risk of concomitant COVID-19 and GNB-related bacteremia in these patients.

 The emergence of antimicrobial-resistant pathogens in intensive care units (ICU) makes treatment of these infections very difficult.

 This study aimed to survey the resistance phenotype, risk factors, and possible treatment options for hospital-acquired infections (HAI) at ICUs in a referral university hospital.

 Samples were prepared from ICU patients with HAIs. Pathogens were isolated, and the resistance phenotype, prescribed antibiotics, mortality rate, associated risk factors, and clonal relationship of the isolates were assessed.

 From 100 patients admitted to ICUs, 76 (76%) showed clinical symptoms of HAIs. The most common sources of infection were lung secretions (51.8%). The isolated bacteria were Gram-negative (77, 90.6%) and Gram-positive (9.4%). The most common isolated microorganism was the Acinetobacter baumannii complex (63.5%). The most effective antimicrobials were colistin (96.1%) and linezolid (100%) for Gram-negative and Gram-positive isolates, respectively. An extensively drug-resistant (XDR) phenotype was documented in all isolates of A. baumannii, Pseudomonas aeruginosa, and Serratia marcescens. The XDR phenotype was a significant risk factor only for mortality. A. baumannii had the highest mortality rate (66.6%) among all the isolates. While A. baumannii strains had limited diversity, the other species were highly divergent.

 The results revealed a high mortality rate for Gram-negative isolates, especially in adenosine triphosphate-binding cassette (ABC). The high genetic similarities of ABC strains might be an indication of neglecting infection control prevention. The use of cotrimoxazole and colistin instead of carbapenems can be promising for mortality reduction in the studied ICUs.

 Various micronutrients have been used to manage patients affected by coronavirus disease 2019 (COVID-19). However, data on the potential benefits of selenium for COVID-19 patients are scarce.

 This study was conducted to monitor the efficacy and safety of selenium supplementation in COVID-19 patients hospitalized at Shahid Mostafa Khomeini Hospital in Ilam, Iran, in 2021.

 In this randomized controlled trial, 100 COVID-19 cases were included and divided into two groups: The selenium group (n = 50) was prescribed the hospital treatment protocol as well as selenium supplementation in a daily dose of 200 µg, and the control group (n = 50) that received only the hospital treatment protocol. Laboratory tests, including platelet, white blood count (WBC), hemoglobin, ferritin, c-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), were performed before the trial and on the 14th day. Two groups were compared based on laboratory findings, duration of hospitalization, and dependency on mechanical ventilation.

 In the selenium group, platelets, WBC, and hemoglobin rose remarkably compared to their pre-treatment concentrations (P < 0.05), while a considerable drop was detected in levels of ESR, CRP, and ferritin (P < 0.05). The mean length of stay in the selenium and control groups was 9.27 ± 13.50 and 11.45 ± 14.33 days, respectively (P = 0.401). The mean mechanical ventilation dependency days in the selenium and control groups were 9.65 ± 11.71 and 7.45 ± 4.93, respectively, implying no statistically significant difference (P = 0.307).

 Selenium supplement may reduce levels of inflammatory markers in COVID-19 patients. Nevertheless, further trials are required to monitor its clinical effectiveness.

 The prevalence of human papillomavirus (HPV) infection in infertile men is significantly higher than that in the general population. Nevertheless, it is unclear whether the presence of HPV in semen samples is related to reduced semen quality.

 The present article aims to elucidate the possible association between HPV infection and semen parameters in Iranian infertile men.

 This cross-sectional study included semen samples from 140 infertile Iranian male partners of couples seeking fertility assessment. Standard semen analysis was performed. Sperm DNA fragmentation index (DFI), sperm chromatin maturation, anti-sperm antibodies, leukocyte count, fructose concentration, and zinc concentration were also assessed. Nested polymerase chain reaction (PCR) and INNO-LiPA were used to identify HPV DNA sequences in semen samples and to determine HPV genotype, respectively. Independent samples t-tests were used to compare sperm parameters between HPV-positive and HPV-negative groups.

 Human papillomavirus DNA was detected in 18 (12.85%) out of 140 semen samples (10% high-risk genotypes, 2.14% low-risk genotypes, and one sample was excluded). Our findings revealed that HPV18 was the most prevalent type (8.57%). According to our results, the presence of HPV DNA in semen samples was associated with higher semen anti-sperm antibodies (P = 0.001), higher white blood cell (WBC) counts (P = 0.02), and increased DFI values (P = 0.03).

 Human papillomavirus -positive patients had higher semen anti-sperm antibodies, semen WBC counts, and sperm DFI values. These results highlight the importance of careful screening for the presence of HPV in semen samples from infertile men. It should also be noted that more studies are required.

 The adhesin gene (FimH) of uropathogenic Escherichia coli (UPEC) plays a critical role in mediating the first contact of UPEC bacterial strains with uroepithelial cells, leading to colonization and invasion of host cells.

 This study aimed to determine the prevalence of FimH in UPEC strains isolated from patients with urinary tract infections (UTIs) in North Lebanon and characterize the resistance profile of UPEC isolates.

 A total of 881 urine samples were collected from UTI-symptomatic patients admitted to different hospitals and laboratories in North Lebanon. Seventy UPEC isolates were identified and transferred to the Biomedical Laboratory of Beirut Arab University (BAU) for further analysis. All UPEC isolates were subjected to antimicrobial susceptibility testing, phenotypic assays for ESBL detection, and PCR to detect the FimH gene.

 The prevalence of UTIs reached 42% (370/881), with UPEC representing 19% (70/370) of the detected uropathogens. The highest and the lowest resistance among UPEC isolates were reported against Ampicillin (80%; 56/70) and carbapenem (0%; 0/70), respectively. A high prevalence of MDR (68%; 48/70) and ESBL (64%; 45/70) was reported. Molecular analysis revealed that most of the tested UPEC (98.6%; 69/70) harbored the FimH gene. A significant correlation was found between FimH and the antimicrobial resistance properties of UPEC (P < 0.05).

 This study highlighted the high prevalence of the FimH adhesin gene among UPEC isolates, revealing its crucial role in enhancing the resistance of these bacteria to antimicrobial agents.