فهرست مطالب

Infection, Epidemiology And Medicine - Volume:9 Issue: 4, Autumn 2023

Infection, Epidemiology And Medicine
Volume:9 Issue: 4, Autumn 2023

  • تاریخ انتشار: 1402/10/19
  • تعداد عناوین: 8
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  • Shabnam Sadoogh Abbasian, Ali Sadoogh Abbasian, Ehsanollah Ghaznavi-Rad, Ehsan Zarei-Mehrvarz, Samira Sadelaji, Hamid Abtahi* Pages 277-286
    Aims

    Antimicrobial peptides (AMPs) are beneficial compounds that could be used as a new and effective method to suppress microbes. Both Ib-AMP4 and LL37 are antimicrobial peptides with a wide range of antimicrobial activities. This research aimed to evaluate the antibacterial potential of LL37-rIb-AMP4 hybrid protein as an antimicrobial agent against pathogenic bacteria. Therefore, its antibacterial effects against Acinetobacter baumannii, Pseudomonas aeruginosa, vancomycin-resistant Enterococcus (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) were investigated in vivo and in vitro.

    Materials & Methods

    In this study, antimicrobial peptides rIb-AMP4, LL37, and LL37-rIb-AMP4 were expressed, purified, and refolded, and their synergistic and antibacterial effects in combination with each other (LL37+rIb-AMP4) and as fusion proteins (LL37-rIb-AMP4) were tested against A. baumannii, P. aeruginosa, VRE, and MRSA cells in vitro (MIC, time kill, and SEM) and against P. aeruginosa and VRE cells in vivo.

    Findings

    LL37-rIb-AMP4 Protein with molecular weight= 28 KD was correctly produced and purified. Despite the lack of synergistic effects between LL37 and rIb-AMP4 peptides in vitro, the stability test results showed higher stability for LL37-rIb-AMP4 hybrid protein.
    The findings of in vivo tests confirmed that all infected mice were improved with LL37-rIb-AMP4 and no signs of bacteria were observed in their blood and spleen samples. Also, these results confirmed the stability and higher activity of LL37-rIb-AMP4 than the single form of these proteins.

    Conclusion

    Considering the antimicrobial potential of the produced proteins, it seems that the recombinant LL37-rIb-AMP4 protein could be considered and used as a stable and active antimicrobial drug in future studies.

    Keywords: Antimicrobial peptides, Hybrid protein, LL37 peptide, rIb-AMP4 peptide
  • Ahmed Hamed Hassan Hammoud, Zahra Shafiei*, Nazila Arbab Soleimani Pages 287-295
    Aims

    Pseudomonas aeruginosa is considered as an important opportunistic bacterial pathogen associated with nosocomial infections. Therefore, it is important to identify this bacterium in clinical samples and report the results to health authorities. The aim of this study was the molecular identification of some virulence factors and fosfomycin resistance genes in P. aeruginosa strains.

    Materials & Methods

    A total of 100 P. aeruginosa strains were isolated from clinical samples of patients with eye infections in three distinct laboratories in Tehran hospitals (Pars, Milad, and Motahari). The antibiogram of all isolates against eight antibiotics was determined by standard Kirby-Bauer disk diffusion method. Then DNA was extracted from the isolates, and the frequency of exoY, exoT, exoU, exoS, fosC, fosB, and fosA genes was evaluated by multiplex PCR (polymerase chain reaction).

    Findings

    The highest resistance was observed to cotrimoxazole (85%), ceftazidime (83%), cefotaxime (79%), and cefepime (72%), and the highest sensitivity was observed to ciprofloxacin (55%), gentamicin (52%), and piperacillin (41%), respectively. Out of 60 investigated isolates, 58 isolates were positive for exoY, exoT, and exoU, while only four isolates were exoS positive. In addition, one strain (1.66%) had the fosC gene, two strains (3.33%) had the fosB gene, and 12 strains (20.02%) had the fosA gene.

    Conclusion

    The results showed that the frequency of fosfomycin resistance genes, whose protein product modifies the epoxide group of fosfomycin and reduces the effectiveness of this antibiotic, was significantly low in the investigated strains.

    Keywords: Pseudomonas aeruginosa, Antibiotic resistance, Fosfomycin, Exotoxin
  • Shanjitha Jakir Hussain, Bhargavi Kumar*, Sindhumalini Boopathy, Saravanan Thangavel Pages 297-309
    Aims

    Scrub typhus (ST) is an important cause of acute undifferentiated febrile illness. ST is caused by Orientia tsutsugamushi transmitted by the bite of a trombiculid mite. It is endemic in East Asia, the South Pacific, and the Indian subcontinent. In India, ST accounts for about 23% of all febrile illnesses. This study aimed to assess the clinical profile of ST and associated risk factors.

    Materials & Methods

    This cross-sectional study was conducted on 47 participants in the general medicine department of a tertiary medical college hospital in Coimbatore, south India from January 2020 to June 2021. All the participants suffered from fever and diagnosed with ST based on seropositivity of IgM enzyme linked immunosorbent assay (ELISA). Complete blood count, renal and liver function tests, and chest X-ray were performed. All the participants were admitted to the hospital and followed up.

    Findings

    The participants' age ranged from 18-80 years with a mean age of 48.40 years.  Most ST cases occurred during January (48.9%). Fever was the common symptom (95.7%), while eschar was reported in only 19.1% of the individuals. Thrombocytopenia was detected in 12.8% of ST patients. Hypoalbuminemia was reported in 80% of those with hepatic dysfunction, and anemia was present in 28% of those with acute kidney injury.

    Conclusion

    This disease could present as a severe illness even in non-ICU (intensive care units) settings, and a high degree of suspicion is necessary for diagnosing and treating ST patients in endemic areas.

    Keywords: Orientia tsutsugamushi, Rickettsia, Scrub typhus, Tsutsugamushi disease, Vector borne diseases
  • Fazel Tarkhan, Asghar Aaliehpour, Asghar Sepahvand* Pages 311-321
    Aims

    Hidden fungal infections may lead to errors in blood cell counts and inappropriate treatment selection with serious consequences in many patients. This study aimed to evaluate the results of two automated blood cell counters Sysmex-X 500 and KX-21 in samples containing Candida albicans and Candida glabrata.

    Materials & Methods

    In this study, 144 blood samples of O- blood type were examined in the presence and absence of C. glabrata and C. albicans fungi at different concentrations by two automated blood cell counters Sysmex-X 500 and KX-21 in Lorestan University of Medical Sciences in 2017. Fungal samples were prepared at a concentration of 0.5 McFarland, equally added to the blood samples, and read by Sysmex-X 500 and KX-21.

    Findings

    The average number of erythrocytes, leukocytes, and platelets read by Sysmex-X 500 and KX-21 devices increased in the presence of both fungal samples compared to the primary samples. In addition, the number of lymphocytes, neutrophils, and monocytes read by Sysmex-X 500 and KX-21 devices in the presence of fungal samples was significantly higher compared to the primary samples (p< .05). The increase in mean blood cell counts in the presence of both fungal samples was significantly higher in X 500 than in KX-21 (p< .05).

    Conclusion

    This study results showed that among these two devices, the Sysmex-X Series 500 device showed less variation compared to the actual values of blood cells. The use of this device seems to reduce measurement error in blood cell counting.

    Keywords: Candida glabrata, Candida albicans, Leukocytes, Erythrocytes, Platelets
  • Marzieh Eslami Kojidi, Somayeh Shatizadeh Malekshahi*, Mohammad Reza Jabbari Pages 323-330
    Aims

    The purpose of this study is to evaluate the viral load of active human cytomegalovirus (HCMV) infection in the plasma samples of people suspected of kidney transplant rejection and to investigate the host and risk factors related to the activation of HCMV in these patients.

    Materials & Methods

    This cross-sectional study was conducted between December 2022 and June 2023. In this study, 98 blood samples related to patients suspected of kidney transplant rejection referring to Labbafinezhad hospital in Tehran were collected. The samples were tested by the GeneProof Cytomegalovirus (CMV) PCR Kit to determine HCMV viral load. ROC curve analysis was used to determine the viral load cutoff point.

    Findings

    HCMV viremia was detected in 18 (18.36%) of 98 transplant recipients. The median viral load in the HCMV viremia group was 24914.0 IU/ml (5147.0-155106.5). The optimal cut-off value for HCMV was determined 778 IU/ml using ROC analysis. Duration of time after transplantation in the viremia and no viremia groups was 120.5 and 46 months, respectively with a statistically significant difference (P=0.014).

    Conclusion

    This study provides valuable insights into the prevalence of HCMV viremia and its associated risk factors in kidney transplant recipients suspected of rejection. The study also highlights the importance of post-transplant monitoring and preventive measures to address viral infections. Quick and timely diagnosis of viral activation in kidney transplant patients is effective and mandatory for patient management and the use of appropriate preventive and therapeutic strategies that lead to the reduction of nephropathy, transplant rejection and other diseases. Long-term studies with larger sample sizes are needed to evaluate the role of factors influencing the occurrence of viremia after transplantation.

    Keywords: Human cytomegalovirus, Kidney transplantation, Viral load
  • Hamed Pahlevani, Mohammad Farahnakian, Fatemeh Sadat Asgarian, Maedeh Najafizadeh* Pages 331-338
    Aims

    Reports show that vaccination against influenza could elicit nonspecific immune reactions against coronavirus disease-19 (COVID-19). The present research aimed to evaluate the prevalence of COVID-19 disease among the staff of Shahid Beheshti hospital in Kashan despite vaccination against influenza.

    Materials & Methods

    This study was performed on 1400 employees of Shahid Beheshti hospital in Kashan from February to August 2020. Personnel whose disease was confirmed by PCR test or CT scan were considered to have COVID-19. In the present research, the relationship between influenza vaccination and the incidence of COVID-19 infection was evaluated. The collected data were analyzed by SPSS software Version 26.

    Findings

    Out of a total of 1400 hospital personnel participating in this study, 272 people were diagnosed as COVID-19. Among 272 patients, 23 (8.45%) cases were vaccinated. The average age of vaccinated patients was 33.48 ± 12.72 years, of whom 14 (60.87%) patients were female. Vaccination was significantly associated with prevention of COVID-19 infection (p< .05). The study of odds ratio (OR) to evaluate the effect of vaccination showed that the OR was 0.61 (95% CI: 0.39- 0.97). There was a significant difference in SpO2, type of treatment, and lung involvement based on CT between the two groups of vaccinated and unvaccinated COVID-19 patients (p< .05).

    Conclusion

    In vaccinated group, COVID-19 was lower than of the no influenza vaccinated group. According to the results, the use of influenza vaccine as an effective vaccine against the new coronavirus strains could be helpful in controlling the disease.

    Keywords: Influenza vaccine, COVID-19, Vaccine efficacy, COVID-19 disease severity
  • Parmida Shahbazi, Mahshid Talebi-Taher*, Behrooz Banivaheb, Zeynab Yassin, Ashkan Yahyavi, Nima Hemmati Pages 339-347
    Aims

     This study aimed to investigate persistent symptoms of coronavirus disease 2019 (COVID-19) patients admitted to a general tertiary teaching hospital during a 9-month follow-up period.

    Materials & Methods

    In this study, 400 hospitalized COVID-19 patients in Iran were studied, among them 78 RT-qPCR positive cases were identified from February 19 to March 18, 2020. After excluding readmitted and deceased patients, 75 cases underwent in-hospital follow-up. Out-of-hospital follow-up was done for 57 living patients, of whom four cases were unreachable, and five cases died after discharge. The remaining 48 participants were followed up for nine months, and their symptoms and complaints were checked by regular visits to the infectious disease clinic and telephone calls via a checklist designed by the authors.

    Findings

    The mean age of RT-qPCR positive hospitalized patients was 54.64 ± 17.42 years, and 38.7% of them were female. Overall, five (10.4%) patients complained of dyspnea, three (6.2%) patients of olfactory nerve complications, three (6.2%) patients of persistent fatigue, and two (4.2%) patients of prolonged cough up to the end of the follow-up period. New-onset symptoms were reported in five (10.4%) patients; in most of them (4 out of 5), these symptoms were neurological (urinary retention, tremor with ataxia, distraction, and insomnia).

    Conclusion

    A large proportion of patients who recover from COVID-19 infection experience prolonged symptoms. Further investigations should be done to provid more data on the underlying causes and risk factors of developing these post-COVID conditions.

    Keywords: COVID-19, Persistent symptoms, Follow-up
  • Ilyes Zatla*, Lamia Boublenza, Amina Boublenza, Amira Sebiane, Ikram Salah Pages 349-357
    Aims

    SARS-CoV-2, the virus responsible for the COVID-19 pandemic, has caused a worldwide health crisis, impacting millions of individuals across the globe. The focus of In this study, is to conduct an epidemiological investigation was carried out on the progression of COVID-19 in the North African region, encompassing Morocco, Algeria, Tunisia, Libya, and Egypt, from January 2020 to May 2023. The aim of this study was to conduct an epidemiological investigation into the progression of COVID-19 in the North African region, encompassing Morocco, Algeria, Tunisia, Libya, and Egypt, from January 2020 to May 2023, with a primary focus on analyzing and understanding the COVID-19 data in these five North African countries.

    Materials & Methods

    This research aimed toinvolved the observeation and analyzesis of an international database from our World in Data,  using SPSS and Excel,. A comparative analysis was carried out, considering the number of COVID-19 cases, fatalities, and vaccination rates in the five specified North African countries.

    Findings

    Over the course of three years, a total of 3,722,56017,862 new COVID-19 cases and 83,860757 deaths were documented in North African countries, and the year 2021 emerged as the most devastating period, with the highest number of COVID-19 cases (1,767,410) and fatalities (50,341) across the region. Among the countries studied, Morocco (1,274,180 cases, 34.23% ) and Tunisia (1,153,261 cases, 31%) of cases, reportedwere the mosthighest infection ratesaffected, with Morocco reporting 1,272,490 cases (34%) and Tunisia 150,962 cases (31%). Similarly, the highest death tolls were recorded in Tunisia , accounting for (29,415331 deaths, (35%), and Egypt, with (24,83012 deaths, (30%). Additionally, Morocco led the region in vaccination efforts in the region, administering 47% of the total of 384,851,069 vaccine doses.

    Conclusion

    The COVID-19 pandemic has posed a significant global health challenge, affecting each North African country differently, depending on various factors such as their population, control measures, and vaccination campaigns. This study emphasizes the importance of continued efforts and tailored strategies for each country in the region to combat the pandemic in the region and underscores the significance of tailored strategies for each country to effectively address the ongoing crisis.

    Keywords: SARS-COV-2, COVID-19, North Africa, Cases, Deaths, Vaccination