Jundishapur Journal of Microbiology
Volume:16 Issue: 10, Oct 2023

 Coronavirus-associated pulmonary aspergillosis (CAPA) is defined as invasive pulmonary aspergillosis (IPA) occurring in patients with COVID-19 infection.

 This study aimed to identify CAPA patients and describe their clinical-epidemiological characteristics in Ahvaz, Iran, from the third to the fifth COVID-19 waves.

 The serum galactomannan (GM) antigen assay was used to detect CAPA in 257 COVID-19 hospitalized patients according to the EORTC/MSGERC (European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium) 2020 criteria. The demographic and clinical data, host risk factors, lung radiographic imaging, laboratory findings, antifungal agents used, and the outcomes of the patients were extracted in cases that were available. All findings were statistically analyzed.

 Of the 257 patients, 114 (44.35%) were positive for GM levels (CAPA cases). The demographic and clinical information of 51 cases showed that diabetes mellitus (25.5%) was the most common underlying condition, followed by oropharyngeal candidiasis (22%) and hypertension (21.6%). In both surviving and deceased patients, the frequency of CAPA in older ages was statistically significant (r = 0.519; P < 0.0001). In surviving individuals, GM had a significant relationship with age (r = 0.520; P = 0.032), blood glucose (BS; r = 0.497; P = 0.043), diagnosis of hyperglycemia during hospitalization (P = 0.039), and diabetes mellitus (P = 0.039). In deceased patients, the frequency of CAPA in older ages was statistically significant (r = 0.503; P = 0.002). Galactomannan had a significant association with the variables of age (r = 0.503; P = 0.002) and suspicion of fungal infection (P = 0.003).

 The prevalence of CAPA was high in critically ill patients with COVID-19. Diabetes mellitus, hyperglycemia, and old age are the main factors that predispose COVID-19 patients to IPA.

 Early immune responses to COVID-19 can help eliminate the virus; therefore, strategies to improve the immune system have become important in disease prevention. Vitamin D plays a crucial role in the immune response to SARS-CoV-2 by increasing the expression of the vitamin D receptor.

 This study investigated the impact of vitamin D deficiency, Fok 1, and Taq 1 Vitamin D Receptor (VDR) gene polymorphisms and comorbidities on the susceptibility to COVID-19.

 Fok1 and Taq1 polymorphisms were analyzed using the RT-PCR method, and vitamin D levels were measured using the chemiluminescence method. A total of 200 patients, 100 with COVID-19 and 100 without, provided blood samples for analysis.

 The COVID-19 positive group had a significantly lower mean vitamin D level of 16.2 ± 11.3 ng/mL compared to the COVID-19 negative control group, 26.7 ± 15.9 ng/mL (P < 0.001). Individuals with a vitamin D level below 18.4 ng/mL had a 2.448 times higher risk of COVID-19 positivity (P < 0.001). There was no significant difference in the Fok1 and Taq1 gene polymorphisms between the two groups. (P = 0.548 and P = 0.098). The COVID-19 positive group had a significantly higher number of comorbid diseases with 40 (40%) compared to the negative group with 10 (10%) participants (P < 0.001).

 Levels of vitamin D above the cut-off value of 18.4 ng/mL were found to protect against COVID-19, while the presence of comorbid diseases was identified as a risk factor. However, no association was observed between the Fok1 and Taq1 polymorphisms and susceptibility to COVID-19.

 In hospitals and communities, Methicillin-resistant Staphylococcus aureus (MRSA) plays a critical role due to its ability to acquire resistance against several antibiotics and play a role in the spread of diseases.

 This research aimed to investigate the pattern of antibiotic resistance in MRSA isolates and perform molecular typing of MRSA isolates using various elements, including SCCmec type, ccr type, prophage type, and gene toxin profiles.

 The research spanned 20 months at Al-Zahra Hospital in Isfahan and involved 148 isolates from various anatomical sites. The isolates were evaluated for their antibiotic susceptibility patterns. They were characterized by screening for SCCmec typing, ccr typing, phage typing, and PCR profiling of pvl, hlb, sak, eta, and tst toxin genes.

 From 148 total S. aureus isolates, 42% (n = 62) were methicillin-resistant. The MRSA isolates demonstrated substantial resistance to penicillin and ciprofloxacin, and 90.3% of MRSA isolates were multiple-drug resistant. Also, SCCmec types III, I, and IV were identified in 45.16%, 35.48%, and 19.35% of MRSA isolates, respectively. Also, seven prophage patterns and 15 toxin patterns were detected among MRSA isolates.

 Multi-drug resistance is common among MRSA isolates. The only effective drug among the investigated antibiotics was chloramphenicol. The MRSA isolates can be controlled by changing the prescribing procedure of antibiotics and applying infection control strategies. The studied MRSA isolates can cause a wide range of diseases due to having several bacteriophages that encode virulence factors. Identification of different types of prophages may be useful in predicting such pathogenic agents.

 To the best of our knowledge, the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRM) in Iranian children has not been investigated.

 The present study aimed to evaluate the prevalence of MRM in Iranian children with community-acquired pneumonia (CAP).

 A total of 222 children with CAP, aged 3 - 15 years, who were hospitalized in 10 different children's hospitals, were enrolled in this study. Mycoplasmas were detected using the polymerase chain reaction (PCR) assay. The severity of CAP was evaluated according to the Infectious Diseases Society of America (IDSA) guidelines. The level of C-reactive protein (CRP) was also measured by the particle-enhanced turbidimetric immunoassay. Additionally, the chest X-rays of children with CAP were recorded and sent to a radiologist for further evaluation.

 Twenty-one children (9.4%) diagnosed with CAP also had M. pneumoniae infection, 17 (77.27%) of whom were positive for A2063G transition and high-level macrolide resistance. The severity of CAP (P ≥ 0.99), CRP level (0.07), and chest X-ray changes (P = 0.08) were not significantly different between children with MRM pneumonia and those with macrolide-susceptible M. pneumoniae.

 The prevalence of high-level MRM pneumonia in children is high in Iran, similar to other Asian countries. However, this type of Mycoplasma infection was not associated with the severity of CAP and did not have significant effects on chest X-ray (CXR) changes or the CRP level in the patients.

 The accurate diagnosis of infections can significantly enhance preventative measures against abortion.

 The rates of Streptococcus agalactiae, Mycoplasma hominis, and Listeria monocytogenes were investigated in the vaginal secretions of women with abortion. Furthermore, this study aimed to detect S. agalactiae capsular types by multiplex Polymerase Chain Reaction (PCR) and sequencing.

 The study collected vaginal samples obtained from a cohort of women with abortions of unknown cause from various healthcare facilities across Iran, as well as their counterparts who did not experience any reproductive issues. Molecular identification was performed by a multiplex PCR protocol for the amplification of specific regions within the bacterial 16S rRNA gene. The capsular polysaccharide of S. agalactiae was identified by multiplex PCR of the caps gene. Then, the sequences of the amplified gene were analyzed by Mega X. Finally, some factors that exerted a noteworthy influence on the likelihood of miscarriage were determined.

 The study found S. agalactiae, M. hominis, and L. monocytogenes in the vaginal secretions of women with abortion, with respective frequencies of 4.54%, 2.7%, and 9.09%, which were more than the frequencies in the pregnant healthy women. The caps III (4%) and caps V (6%) genes were identified in the S. agalactiae isolates. The sequences of caps III or caps V did not show any differences among the isolates containing each gene.

 The findings demonstrated the significance of preemptively managing prevalent infections and investigating risk factors in women prior to pregnancy. No difference in the sequences of the caps genes is promising for the adoption of vaccination and therapeutic strategies.

 Candida parapsilosis complex, as an opportunistic pathogen, can cause various infections, especially in immunocompromised patients.

 This study investigated a novel thymoquinone-liposomal nanoparticle to increase the stability of thymoquinone with antifungal effects against C. parapsilosis isolates.

 The thymoquinone was encapsulated in liposomal nanoparticles using a thin-film hydration technique and then analyzed by transmission electron microscopy (TEM), particle size, zeta potential, and UV-visible spectrophotometer. Also, the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay was used on peripheral blood mononuclear cells (PBMCs) for cell metabolic activity. The antifungal activity of thymoquinone-liposomal nanoparticle against 15 clinical isolates of C. parapsilosis and the reference strain was examined based on the M27-A3 guideline.

 The synthesized thymoquinone-liposomal nanoparticle was approved by the TEM, particle size, zeta potential, and UV-Vis. The thymoquinone-liposomal nanoparticle showed no toxic effect on PBMCs following the MTT assay. The minimum inhibitory concentration (MIC) range of free thymoquinone and liposomal formulations with inhibitory effects on Candida isolates was 50 to 6.25 and 150 to 18.75 µg/mL, respectively. The MIC50 and MIC90 values of free thymoquinone and thymoquinone-liposomal nanoparticle were 25 and 50, and 75 and 150 µg/mL.

 The synthesized thymoquinone-liposomal nanoparticle shows significant antifungal activity against C. parapsilosis isolates compared to free thymoquinone. However, because of its hydrophilicity and hydrophobicity, biocompatibility, particle size, non-toxic effect, and higher cell viability, the thymoquinone-liposomal nanoparticle is a more effective method for treating fungal infections.