فهرست مطالب

Jundishapur Journal of Microbiology - Volume:7 Issue: 3, Mar 2014

Jundishapur Journal of Microbiology
Volume:7 Issue: 3, Mar 2014

  • تاریخ انتشار: 1393/01/26
  • تعداد عناوین: 14
|
  • Edgar Cordoba Aguilar, Marisol Herrera Rivero, Alberto Rubi, Omar Arroyo, Helguera, Rocio Coutino Rodriguez * Page 6855
    Background
    During epidemic periods, the strain Vibrio cholera El Tor has been isolated from the aquatic macrophyte roots of Eichhornia crassipens and Lemna minor, suggesting that aquatic plants could be environmental reservoirs through either a non-specific association or a commensalism relationship. Therefore, it is important to understand V. cholera reservoirs in order to establish prevention strategies against this pathogen..
    Objectives
    Our interest was to determine whether V. cholera could be isolated and typified from L. minor and E. crassipens roots..
    Materials And Methods
    From 2004 to 2005, plants were collected from various ecological niches and the roots were used to isolate V. cholera. Standard bacteriological, biochemical and serological tests were used for its typification..
    Results
    In five out of the nine ecological niches explored, we collected either L. minor or E. crassipens, as these specimens cohabited only in two niches. V. cholera was isolated from both L. minor and E. crassipens roots. The isolated V. cholera showed the same biochemical characteristics as the pure V. cholera strain which was used as a control. The isolated V. cholera corresponded to V. cholera O1 El Tor Inaba, which is the same serotype related to the last outbreak in Mexico..
    Conclusions
    For first time V. cholera El Tor Inaba has been isolated several years after the last emergence of cholera in Mexico. A viable and cultivable V. cholera strain, sourced from freshwater niches in E. crassipens and L. minor roots, suggests the importance of these plants as a permanent aquatic reservoir for these organisms. The monitoring of E. crassipens and L. minor is the responsibility of health institutions in order to evaluate the ongoing risks..
    Keywords: Vibrio cholera, Lemnan, Eichhornia crassipens, Vibrionaceae
  • Hamed Alizadeh, Mojtaba Salouti *, Reza Shapouri Page 9039
    Background
    Brucellosis is an infectious disease that is caused by Brucella spp. As Brucella spp. are intramacrophage pathogens, the treatment of this infection is very difficult. On the other hand, due to the side effects of the brucellosis treatment regime, it is necessary to find new antimicrobial agents against it..
    Objectives
    The aim of this study was to investigate the antimicrobial effect of silver nanoparticles against Brucella abortus 544 in the intramacrophage condition..
    Materials And Methods
    The antimicrobial effect of silver nanoparticles was determined by an agar well diffusion method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of silver nanoparticles against B. abortus 544 were determined by a broth macrodilution method. The effect of time on the antimicrobial activity of silver nanoparticles was analyzed. The effect of silver nanoparticles on the intramacrophage survival of B. abortus 544 was studied on mice peritoneal macrophages..
    Results
    The well diffusion agar study showed that silver nanoparticles have an antimicrobial effect on B. abortus 544. The MIC and MBC of silver nanoparticles against B. abortus 544 were; 6 ppm and 8 ppm, respectively. The silver nanoparticles showed antibacterial effects within 40 minutes. The results of the macrophage culture indicated that silver nanoparticles have antibacterial activity against intramacrophage B. abortus 544, and the highest efficiency was observed at a concentration of 8-10 ppm of silver nanoparticles..
    Conclusions
    The results showed that silver nanoparticles have an antimicrobial effect against intramacrophage B. abortus 544..
    Keywords: Brucella abortus, Nanoparticles, Macrophage, Antimicrobial
  • Seyed Mohammad Alavi, Mehrdad Sharifi *, Mehdi Eghtesad Page 9082
    Background
    Management of bacterial sepsis as a common cause of hospitalization and a life threatening clinical syndrome is a challenge. In previous studies, incorrect diagnosis of sepsis and unnecessary treatment have been frequently reported..
    Objectives
    The aim of this study was to evaluate the diagnosis and treatment of cases with a primary diagnosis of sepsis..Patients and
    Methods
    Of 410 medical files of patients with primary diagnosis of bacterial sepsis, 187 fulfilled our criteria and were enrolled in the study. The study was conducted in Razi Hospital of Ahvaz, southwest Iran, from 2009 to 2011. Data included demographic characteristics, underlying disease, clinical symptoms, laboratory and imaging findings, administrated antibacterial drugs, and nurses and doctors-analyzed notes. For evaluation of the diagnosis, patients were divided to two groups, sepsis group and pseudosepsis group, and for evaluation of the treatment, patients were categorized in appropriate and inappropriate treatment groups and compared using SSPS software version 16 by chi-square and fisher exact tests. P-values less than 0.05 were considered significant..
    Results
    Out of 187 cases, 61 were in the intensive care unit (ICU), 98 in the infectious disease ward, and 28 in the internal medicine ward. Correct diagnosis of sepsis in the ICU, internal and infectious diseases wards were made in 16 (26.2%), 4 (14.3%) and 71 (72.4%) cases, respectively. Appropriate treatments for sepsis in the ICU, internal and infectious wards were applied in 12 (19.7%), 3 (10.7%) and 61 (78.2%) cases, respectively. Ninety-one patients (48.6%) were diagnosed correctly (true sepsis) and 76 (40.6%) were treated with proper regimes..
    Conclusions
    Inappropriate and unnecessary use of antibiotics by patients with preliminary diagnosis of sepsis in our hospital, similar to other parts of the world, was high..
    Keywords: Bacterial Sepsis, Diagnosis, Therapeutics
  • Jila Yavarian, Nazanin Zahra Shafiei Jandaghi, Maryam Naseri, Talat Mokhtari Azad * Page 9089
    Background
    In the influenza A viruses, neuraminidase (NA), hemagglutinin (HA), PB2, NS1 and M are responsible for the disease pathogenicity. The mechanism of pathogenicity differs among these viruses. Binding of host proteases by the viral NA, sequence of HA in the cleavage and receptor-binding sites, number of oligosaccharide side chains of HA, shortening of NA, and substitutions in PB2, NS1 and M genes, all have been suggested as molecular correlates of pathogenicity of influenza viruses..
    Objectives
    The goal of this study was to find the alterations in genes, which might be responsible in the virus pathogenesis..
    Materials And Methods
    Reverse transcription-polymerase chain reaction (RT-PCR) and sequencing of HA, NA, PB2, NS and M genes were performed..
    Results
    In the receptor binding site HA, Ile-226, Pro-227, Ser-228, and Asp-190 were found. Arg was in the cleavage site of all viruses and 11-12 N-linked glycosylation sites were found. In NS1, Asp-92 and Ala-149 were detected and Lys-627 was found in PB2 of all viruses in this study. Val-15, Thr-139 and Ala-218 of M1 and Val-28, Leu-54 and His-57 were found in M2 gene. At residue 146 of NA, there was N-linked glycosylation, and Ile-222 was found in the enzyme active site..
    Conclusions
    The changes found in these five genes, compared to other studies, suggest that viruses studied in this research had the ability to bind to Neu Acα2,6 Gal linkage and had low pathogenicity. It is important to mention that these changes were at the amino acid level and studies need to be performed on animals to investigate the significance of these findings..
    Keywords: Influenza A Virus_Pathogenicity_H3N2 Subtype
  • Peyman Derikvand, Zahra Etemadifar * Page 9123
    Background
    Sulfur oxides released from the burning of oil causes severe environmental pollution. The sulfur can be removed via the 4S pathway in biodesulfurization (BDS). Immobilization approaches have been developed to prevent cell contamination of oil during the BDS process..
    Objectives
    The encapsulation of Rhodococcus erythropolis R1 in calcium alginate beads was studied in order to enhance conversion of dibenzothiophene (DBT) to 2-hydroxy biphenyl (2-HBP) as the final product. Also the effect of different factors on the BDS process was investigated..
    Materials And Methods
    Calcium alginate capsules were prepared using peristaltic pumps with different needle sizes to control the beads sizes. Scanning electron microscopy and flow cytometry methods were used to study the distribution and viability of encapsulated cells, respectively. Two non-ionic surfactants and also nano Ƴ-Al2O3were used with the ratio of 0.5% (v/v) and 1:5 (v/v) respectively to investigate their BDS efficiency. In addition, the effect of different bead sizes and different concentrations of sodium alginate in BDS activity was studied..
    Results
    The 2% (w/v) sodium alginate beads with 1.5mm size were found to be the optimum for beads stability and efficient 2-HBP production. The viability of encapsulated cells decreased by 12% after 20 h of desulfurization, compared to free cells. Adding the non-ionic surfactants markedly enhanced the rate of BDS, because of increasing mass transfer of DBT to the gel matrix. In addition, Span 80 was more effective than Tween 80. The nanoƳ-Al2O3 particles could increase BDS rate by up to two-folds greater than that of the control beads..
    Conclusions
    The nano Ƴ-Al2O3 can improve the immobilized biocatalyst for excellent efficiency of DBT desulfurization. Also the BDS activity can be enhanced by setting the other explained factors at optimum levels..
    Keywords: Immobilization, Nano particles, Alginate, Flow Cytometry, Optimization
  • Maryam Varposhti, Ahya Abdi Ali *, Parisa Mohammadi Page 9142
    Background
    Pseudomonas aeruginosa is an opportunistic pathogen that takes advantages of some weaknesses in the immune system to initiate an infection. Biofilms of P. aeruginosa can cause chronic opportunistic infections in immunocompromised and elderly patients. This bacterium is considered as a model organism to study antibiotic resistance as well as biofilm formation. In the biofilm structures, bacteria are protected from many harmful environmental factors such as fluctuations in the level of oxygen and nutrients, and the alterations of pH as well as sensitivity to antibiotics. Decreased permeability of biofilms is one of the important reasons of antimicrobial resistance in bacteria..
    Objectives
    In this study the anti-biofilm activity of bismuth thiols in combination with ciprofloxacin, imipenem and ceftazidime against the P. aeruginosa biofilm was investigated..
    Materials And Methods
    Checkerboard method was used to test the susceptibility of biofilms against various antimicrobial combinations. The biofilm formation was measured by 2,3-bis (2-methoxy-4-nitro-5-sulfo-phenyl)-2H-tetrazolium-5-carboxanilide (XTT) colorimetric assay. The fractional bio-film inhibitory concentration was reported for each agent..
    Results
    The combination of bismuth ethanedithiol with ciprofloxacin showed synergistic inhibitory effect on the P. aeruginosa biofilm formation. The combination of bismuth ethanedithiol ciprofloxacin, ceftazidime and imipenem showed synergistic inhibitory effects on the biofilm formation. Furthermore, the combination of bismuth ethanedithiol, imipenem and ceftazidime did not show any synergistic inhibitory effect on biofilm formation..
    Conclusions
    Our studies show that using appropriate concentrations of bismuth thiols in combination with various antibiotics can act synergistically against P. aeruginosa biofilm formation..
    Keywords: Biofilms, Pseudomonas aeruginosa, Antibacterial Agents
  • Morteza Izadi, Mohammad Mahdi Zamani, Nastaran Sabetkish, Hassan Abolhassani, Seyed Hassan Saadat, Saeed Taheri, Hossein Dabiri * Page 9253
    Background
    Coronary artery disease (CAD) is the most common cause of death worldwide and many studies have been performed on reduction of its prevalence..
    Objectives
    This case control study was designed to investigate the presence of Cytomegaloviruses, Chlamydia pneumoniae and Helicobacter pylori in atherosclerotic plaques of cadaveric coronary endothelium of patients with and without acute myocardial infarction..Patients and
    Methods
    Sixty cadavers in two equal groups were analyzed. Acute myocardial infarction group included cadavers with acute myocardial infarction and atherosclerotic plaque. The non- acute myocardial infarction group included those with innocent atherosclerotic plaques in autopsy, expired due to other causes. Specimens from coronary vessels’ atherosclerotic plaque were taken and studied by polymerase chain reaction for Cytomegaloviruses, C. pneumoniae and H. pylori..
    Results
    Cadavers of 26 males and 34 females underwent autopsy procedures. Their mean age at the time of death was 48.17 ± 18.74 years. Unknown causes (20%), hanging (20%), head trauma (16.7%) and multiple traumas (13.3%) were the most common causes of death in the non- acute myocardial infarction group. PCR test results were negative for C. pneumoniae and H. pylori in all cadavers of both groups. Nine cadavers from the acute myocardial infarction group and one from the non- acute myocardial infarction group showed positive PCR results for Cytomegaloviruses (30% and 3.33%, respectively). There was a significant difference between the two groups regarding Cytomegaloviruses positivity in coronary artery plaques (P < 0.01, odd ratio: 12.42, 95% CI: 10.46 to 15.73)..
    Conclusions
    A significant proportion of coronary atherosclerotic plaques in cadavers with confirmed acute myocardial infarction were detected to be infected with Cytomegaloviruses while no infections of C. pneumoniae and H. pylori were detected..
    Keywords: Atherosclerosis, Cadaver, Chlamydia pneumonia, Coronary Artery Disease, Cytomegalovirus, Helicobacter pylori
  • Ali Akbar Heydari *, Masood Reza Movahhede Danesh, Kiarash Ghazvini Page 9311
    Background
    Culture and specific staining (including Zeil-Nelson and fluorescent methods) are standard measures for the diagnosis of tuberculosis (TB). These methods are time-consuming and sometimes have a low level of accuracy. In addition, in some cases obtaining samples for smear and culture involves invasive procedures; while in other cases there is no suitable sample for evaluation. Therefore, there is a need for faster and more accurate diagnostic methods..
    Objectives
    The current study investigated the diagnostic value of tuberculosis-polymerase chain reaction (TB-PCR) of urine in the diagnosis of pulmonary tuberculosis (PTB)..Patients and
    Methods
    This case-control study included; 77 proven pulmonary tuberculosis cases (according to the national TB protocol), and 30 subjects who were completely healthy. The urine samples (50mL) were mixed with 0.5mLEthylene diamine tetraacetic acid. DNA extraction and PCR testing were performed on all blood samples using SI 6110 primers. Mycobacterium tuberculosis was also cultivated in the sputum and urine samples of the patients..
    Results
    Results of the current study indicated that 48 (62.3%) patients out of 77 had a positive sputum culture. Urine cultures and acid-fast smears were negative. Urine PCR-TB was positive in 48.0% (37/77) of the patients. The specific TBPCR complex was positive in 56.2% (27/48) of the positive cultures and 34.4% (10/29) of the negative culture PTB patients. The control group had negative urine PCR (sensitivity 56.2% and specificity 100%)..
    Conclusions
    With regard to the ease of urine sample preparation and the 100% specificity the PCR method, performing urine PCR could be used as a diagnostic aid in PTB cases obtaining sputum samples is problematic..
    Keywords: Tuberculosis, Mycobacterium tuberculosis, Urine, Polymerase Chain Reaction, Sensitivity, Specificity
  • Mehdi Zarei *, Mohammad Hadi Eskandari, Somayeh Keshtkaran Page 9313
    Background
    Vibrio parahaemolyticus is an important human pathogen which can cause gastroenteritis when consumed in raw or partially-cooked seafood. The pathogenesis of V. parahaemolyticus is based on the presence of virulence factors: the thermostable direct hemolysin (TDH) and TDH-related hemolysin (TRH), encoded by the tdh and trh genes, respectively..
    Objectives
    The present study aimed to evaluate the survival of normal and chlorine-stressed cells of pathogenic and non-pathogenic V. parahaemolyticus under adverse conditions..
    Materials And Methods
    Normal and chlorine-stressed cells of pathogenic and non-pathogenic V. parahaemolyticus were subjected to environmental stresses such as low storage temperature (4 and -18°C), high incubation temperature (50°C) and high NaCl content (20%). Viable counts were then made at various time intervals by surface plating on TSA-2.0% NaCl, and the survival rates of the cells were determined and compared..
    Results
    Findings of the current study revealed that the normal cells of pathogenic and non-pathogenic V. parahaemolyticus, as well as the chlorine-stressed cells of both strains behave similarly under adverse conditions. In addition, chlorine stress increased the susceptibility of pathogenic and non-pathogenic V. parahaemolyticus to incubation at 4°C, and the presence of high NaCl content in the medium. However, chlorine stress did not significantly affect the thermal tolerance of pathogenic and non-pathogenic V. parahaemolyticus, and the susceptibility to incubation at -18°C..
    Conclusions
    Chlorine-stressed cells of V. parahaemolyticus were more susceptible to adverse conditions than the non-stressed ones. Pathogenic and non-pathogenic strains showed the same survival characteristics under the adverse conditions. These results should be considered in the development of food preservation measures..
    Keywords: Vibrio parahaemolyticus, Chlorine, Survival, Stress
  • Hsiu, Lin Huang, Ho, Ting Su, Chung, Hsiun Herbert Wu, Jyy, Jih Tsai, Wu * Page 9367
    Background
    Mycobacterium tuberculosis is a vicious microbe co-existing with the infected host. This pathogen exploited opportunities to spread during periods of urbanization and social upheaval, and got retreated with improved hygiene..
    Objectives
    This investigation was designed to clone and characterize M. tuberculosis mutT gene, a homologue of a DNA repair protein in Escherichia coli. The aim was to depict the possible role of this homologue in the virulent microbe..
    Materials And Methods
    A DNA fragment of the mutT gene was amplified with PCR from the genomic DNA of strain H37Rv M. tuberculosis. The expression vector was transformed into E. coli strains BL21 (DE3) and MK602 (DE3) (mutT-). The protein activity assay was performed by biochemical methods..
    Results
    M. tuberculosis MutT shares 23% identity with the E. coli MutT protein. The mutT gene DNA fragment was subcloned into the expression vector pET28a(+) and the recombinant plasmid was overexpressed in E. coli. Purified and refolded M. tuberculosis MutT possesses a dGTPase activity, which is one of the most well-known preference nucleotidase activities of MutT in E. coli. This study also showed that the dGTPase activity of M. tuberculosis MutT was enhanced by magnesium and inhibited by Ni2+ or EDTA. Endogenous MutT protein in M. tuberculosis lysate displayed a smear pattern in the Western blot, suggesting instability of this protein in the bacteria similar to the important proteins, such as P53 protein, tightly regulated by protein degradation..
    Conclusions
    The cloned M. tuberculosis mutT gene and MutT protein were characterized. M. tuberculosis MutT has a dGTPase activity, which is one of the most well-known preference nucleotidase activities of MutT in E. coli. These findings provide further understanding about the vicious bacterium..
    Keywords: Mycobacterium tuberculosis, Protein Array Analysis, Escherichia coli
  • Azizollah Ebrahimi *, Jalal Sheykh Kanluye Milan, Mohammad Reza Mahzoonieh, Khadijeh Khaksar Page 9394
    Background
    Brucellosis remains a major worldwide zoonosis. Caprine brucellosis is a significant problem for both public health and animal production. Brucella melitensis causes disease in goats, sheep, humans, and occasionally cattle. Transmission is by ingestion or contact with infected materials, vaginal discharge, or milk..
    Objectives
    The current study aimed to determine the rate of B. melitensis seropositives and its probable shedding in lactating goats from flocks in Shahrekord district, Iran..
    Materials And Methods
    In the current study, 1080 samples of milk, blood and vaginal swabs of 360 lactating goats (three samples from each animal) were randomly collected from 12 flocks in Shahrekord district. Serums from blood samples were examined by Rose Bengal plate (RBT) test and the titre of positives determined by tube agglutination test (TAT). Vaginal swab and milk (cream and sediment) samples were cultured on Brucella agar. Brucella spp. suspected pure cultures were incubated in the same conditions and then examined by Modified Zeil-Nelson (MZN) staining, oxidase and catalase tests. Positive isolates were examined by PCR..
    Results
    Out of 360 serum samples, 50 (13.9%) were positive by RBT, and six (1/66%) were positive by TAT. Culturing of milk and vaginal samples lead to isolation of 12 (3.33%) and 10 (2.77%) Brucella spp. suspected colonies, respectively. The PCR examinations of these isolates showed that ten (2.77%) milk and 6 vaginal swab samples (1.66%) belonged to B. melitensis species. Eight goats (2.22%) had positive results in RBT, culture and PCR examinations, simultaneously..
    Conclusions
    The regional distribution of caprine brucellosis and shedding of B. melitensis through vaginal secretions and milk secretions of lactating goats indicated that 50% and 83.33% of the goat flocks contained vaginal and milk shedders, respectively..
    Keywords: Goats, Brucellosis, Brucella melitensis, Milk, Vagina, Serology
  • Tahereh Shokohi *, Seyed Mahmood Nouraei, Mohammad Hosein Afsarian, Narges Najafi, Shirin Mehdipour Page 9428
    Introduction

    Fungal prosthetic valve endocarditis (PVE) is rare but serious complication of valve replacement surgery. Candida species, particularly Candida albicans is the most common isolated pathogen in fungal PVE (1–6%of cases)..

    Case Presentation

    We describe a 35-year-old woman who underwent mechanical mitral valve replacement about 3 years ago. She was admitted with neurological symptoms and later with dyspnea and hypotension. Transesophageal echocardiography showed large and mobile prosthetic valve vegetation. She underwent mitral valve surgery. The explanted valve and vegetation revealed lots of budding yeasts and the isolated yeast was identified as C. parapsilosis. Amphotericin B and broad spectrum antibiotic were started immediately. Unfortunately, the patient died two days after surgery, due to sepsis probably related to the candidemia..

    Conclusions

    Fungal endocarditis is uncommon infection, but it is a serious problem in patients with prosthetic valve. Fungal PVE can occur years after the surgery, thus long-term follow-up is essential..

    Keywords: Candida, Fungi, Endocarditis, Prosthetic valve
  • Yan Qing Tong *, Bing Xin, Li Zhu Page 15056
    Background
    Plasmid transfer among bacteria provides a means for dissemination of resistance. Plasmid Analysis has made it possible to track plasmids that induce resistance in bacterial population..
    Objectives
    To screen the presence of herb-resistance plasmid in Escherichia coli strains and determine the transferability of this resistance plasmid directly from E. coli to the Gram-positive, Staphylococcus aureus..
    Materials And Methods
    The donor strain E. coli CP9 and recipient strain S. aureus RN450RF were isolated from UTI patients. E. coli CP9 was highly resistant to herbal concoction. Isolates of S. aureus RN450RF were fully susceptible. Total plasmid DNA was prepared and transferred into E. coli DH5α. Transconjugants were selected on agar plates containing serial dilutions of herbal concoction. Resistance plasmid was transferred to susceptible S. aureus RN450RFin triple replicas. The mating experiments were repeated twice..
    Results
    The identified 45 kb herb-resistance plasmid could be transferred from E. coli CP9 isolates to E. coli DH5α. As a consequence E. coli DH5α transconjugant MIC increased from 0.0125 g/mL to 0.25 g/mL. The plasmid was easily transferred from E. coli CP9 strain to S. aureus RN450RF with a mean transfer rate of 1×10-2 transconjugants/recipient. The E. coli donor and the S. aureus RN450RF transconjugant contained a plasmid of the same size, which was absent in the recipient before mating. Susceptibility testing showed that the S. aureus RN450RF transconjugant was resistant to herbal concoction..
    Conclusions
    E. coli herb-resistance plasmid can replicate and be expressed in S. aureus..
    Keywords: Escherichia coli, Resistance, Plasmid
  • Nader Saki, Ali Reza Samarbaf Zadeh, Reza Sheikhpour Jonaky, Seyed Mahdi Noori, Gholam Abbas Kayedani, Soheila Nikakhlagh * Page 15694
    Background
    Otitis media with effusion (OME) is a common disease in children. Viral or bacterial infections, allergy, adenoids, functional abnormalities of the Eustachian tube, and gastroesophageal reflux might have a possible role in the pathogenesis of OME. However, the exact pathogenesis of OME is still unsettled..
    Objectives
    The purpose of this study was to compare Helicobacter pylori prevalence rates in the nasopharynx of pediatric patients with and without OME..Patients and
    Methods
    Eighty-four patients (50 males and 34 females) who were subjected to adenoidectomy and myringotomy were included in the study group. Ninety-one patients (48 males and 43 females) who had only adenoidectomy were selected as the control group. Detection of H. pylori was done by polymerase chain reaction (PCR)..
    Results
    Adenoid samples were positive for H. pylori in 21 (25%) patients in study group and 18 (19.8%) patients in control group. In the study group, 36 (42.8%) effusion samples (otitis media) of the patients were positive for H. pylori. In an analysis that compared H. pylori–negative and –positive children, the odds ratio (OR) for the occurrence of H. pylori was 1.35 (95% CI, 0.66 - 2.71). The association of age with H. pylori positivity decreased for 1-5 years age group, (1.09; 95% CI, 0.39 – 3.05) but increased for the 6-10 years group (OR, 1.48; 95% CI, 0.61–3.58). Furthermore, the association of sex with H. pylori positivity decreased for the male group (OR, 1.21; 95% CI, 0.50 – 2.91), but increased in the female group (OR, 1.44; 95% CI, 0.51–0.4.05)..
    Conclusions
    Heavy colonization of H. pylori in adenoid tissue and middle ear might have a role in pathogenesis of this infection. For OME cases resistant to medical treatment, it might be meaningful to evaluate the patient for H. pylori..
    Keywords: Otitis Media with Effusion, Adenoids, Helicobacter pylori