Infectious disorders drug targets最新文献

Introduction: Urinary tract infections (UTIs) are among the most common bacterial infections in children and are increasingly complicated by rising rates of antimicrobial re-sistance. Recent multicenter studies have reported Escherichia coli as the predominant uropath-ogen in pediatric UTIs, with resistance rates to commonly used antibiotics such as ampicillin, cefixime, and ceftriaxone ranging from 50% to 70%. This study investigates the frequency and antibiotic resistance of bacterial strains isolated from pediatric patients with UTIs.

Method: This cross-sectional descriptive analytical study was conducted on 113 children under 14 years of age with UTIs at Imam Khomeini Hospital (RA) in Jiroft city from 2022 to 2023. The data were collected by referring to the medical records of the hospital and using a checklist from the medical records of the studied patients. The data were analyzed using SPSS (version 22) with both descriptive and inferential statistical methods, applying a significance level of <0.05.

Results: Escherichia coli was the most frequently isolated pathogen, responsible for 63.7% of cases, followed by Enterobacter at 19.4%.

Discussion: Notably, alarming levels of antibiotic resistance were observed, with some strains exhibiting complete (100%) resistance to commonly used antibiotics such as ampicillin and cefixime. These findings underscore the necessity for continuous surveillance of uropathogens and their antimicrobial resistance patterns to guide evidence-based therapeutic decision-making.

Conclusion: A comprehensive understanding of regional epidemiological trends is imperative for clinicians to optimize antibiotic stewardship programs and mitigate the escalating public health challenge of multidrug-resistant pathogens in pediatric urinary tract infections.

Introduction: The mechanisms of Coronavirus Disease 2019 (COVID-19) remain not fully elucidated. The present study aimed to trace the presence of autoantibodies among COVID-19 patients and to determine the association between COVID-19 and these antibodies.

Methods: This study is a cross-sectional, hospital-based study involving 90 participants, who were arranged into three groups: the COVID-19 group, the rheumatoid arthritis group, and the control group. The study population was tested for serum concentration of rheumatoid factor and anti-CCP antibodies.

Results: The results showed significant elevations in serum levels of rheumatoid factor (P < 0.000) and anti-CCP (P < 0.000) among the rheumatoid arthritis group. Similar findings of a significant increase in rheumatoid factor (P < 0.000) were observed among the COVID-19 group compared to the control group, while an insignificant increase (P = 0.605) was reported between the Anti-CCP and COVID-19 groups.

Discussion: The present study revealed a significant increase in rheumatoid factors among the COVID-19 group compared to the healthy control group. These results suggested that COVID-19 contributes to the development of autoantibodies, which might play a critical role in the pathogenesis of COVID-19.

Conclusion: These findings suggest that the rheumatoid factor plays a crucial role in the pathogenesis of COVID-19 infection.

Introduction: Targeted infection imaging is crucial for accurate diagnosis in postpartum women. This project uses 99mTc-labeled cefixime to develop a radiopharmaceutical for detecting, distinguishing, and treating infections and abscesses in women.

Method: Technetium (TcO4-) chelated with cefixime, reduced by stannous chloride, confirmed via thin-layer chromatography. Mice injected with the labeled compound showed pyrogenicity and stability tests at one, two, and three hours. Bio distribution and SPECT (CT) imaging revealed in vivo aspects post-injection.

Results: Radiolabeling achieved over 95% technetium binding to cefixime, as shown by ITLC with acetone, demonstrating high labeling efficiency. The labeled molecule remained stable for three hours, providing an adequate imaging window. SEM analysis confirmed drug presence on the complex, IR spectroscopy verified cefixime-tracer bond formation, and HPLC quantified radiolabeling yield.

Discussion: Bio distribution studies revealed that radiolabeled cefixime accumulated mainly in the kidney and bladder (31.38%) and liver (30.1%), indicating renal and hepatic clearance pathways. Moderate uptake appeared in the small and large intestines (24.6%), whereas lower distribution was observed in the lungs (4.3%), heart (4.1%), stomach, and spleen (5.4%). SPECT/CT imaging demonstrated drug accumulation in infected thigh tissues, distinguishing them from inflamed sites, underscoring its diagnostic potential for differentiating infectious from inflammatory conditions. The approach shows promise for clinical translation in postpartum infection management and beyond.

Conclusion: Cefixime, labeled with 99mTc, accurately detects rodent infections via scanning. Its potential extends to distinguishing healthy and malignant cells in human plasma, indicating promise in medical diagnostics, including identifying unknown-etiologic pyrexia in post-partum women.

Introduction: Typhoid fever, caused by Salmonella Typhi and Paratyphi, remains a sig-nificant public health concern, particularly in developing countries. The emergence of antimicrobial resistance, including resistance to first-line drugs, fluoroquinolones, and the development of re-sistance to ceftriaxone, poses a significant threat to effective treatment.

Methods: This study investigated extended-spectrum β-lactamase (ESBL)-producing Salmonella Typhi isolates from blood samples of patients with suspected typhoid fever at a tertiary care hospital in Western Rajasthan, India, between April 2022 and May 2024. Antimicrobial susceptibility testing followed by PCR for ESBL-producing genes (blaTEM, blaSHV, blaCTX-M) and blaCTX-M sub-types (blaCTX-M1, blaCTX-M2, blaCTX-M8, blaCTX-M9, blaCTX-M10, blaCTX-M14, and blaCTX-M15) was performed.

Results: Among 79 Salmonella Typhi isolates, 18 (22.8%) exhibited resistance to ceftriaxone. PCR analysis revealed blaCTX-M as the predominant ESBL gene, detected in 77.8% of resistant isolates. Notably, blaCTX-M1, blaCTX-M15, and blaCTX-M10 types were identified among the blaCTX-M-positive isolates.

Discussion: In our study, 48% of Salmonella Typhi strains were resistant to fluoroquinolones, while chloramphenicol and co-trimoxazole showed re-emerging susceptibility (87%), likely due to their restricted use. Emerging ceftriaxone resistance, mediated by ESBL genes, predominantly blaCTX-M (especially blaCTX-M-15 and blaCTX-M-1) and blaSHV, poses challenges in clinical management. Notably, our study detected blaCTX-M10, which has not been previously reported in S. Typhi. Re-sistance gene spread is attributed to plasmids prevalent in E. coli and Klebsiella, which facilitate horizontal transfer. Study limitations include a small sample size, the absence of whole-genome sequencing, and a lack of clinical outcome data.

Conclusion: This study highlights the emergence of ceftriaxone-resistant Salmonella Typhi in Western Rajasthan, India. The high prevalence of blaCTX-M-producing isolates underscores the importance of ongoing surveillance and the implementation of infection control measures to prevent the further spread of antimicrobial resistance. Additionally, this study also highlights the re-emergence of sensitivity to chloramphenicol and co-trimoxazole.

Introduction: The rise of Multidrug-resistant (MDR) Enterobacter species is a significant global health concern, particularly in hospital settings where they contribute to nosocomial infections. This study aimed to determine the prevalence of MDR Enterobacter spp. in clinical specimens from Khartoum State, Sudan, to detect key resistance genes (CTX-M, AmpC, OXA-48, NDM-1, VIM, IMP, MCR-1, SHV, and TEM), and to analyze the correlation between genotypic and phenotypic resistance patterns.

Methods: A cross-sectional, laboratory-based study was conducted from February to October 2021. A total of 384 clinical specimens, including urine, wound swabs, sputum, and blood, were collected from hospitals in Khartoum. Enterobacter spp. isolates were identified using conventional methods such as colony morphology, Gram staining, and biochemical tests. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Multiplex Polymerase Chain Reaction (PCR) was employed to detect ESBL genes (CTX-M, SHV, TEM, AmpC) and carbapenemase genes (OXA-48, NDM-1, VIM, IMP, MCR-1).

Results: Among the 384 clinical specimens, 14 (3.6%) were confirmed as Enterobacter spp. by PCR. All isolates exhibited multidrug resistance. CTX-M was detected in 100% of isolates, while SHV and TEM genes were absent. Other detected resistance genes included AmpC in 5 isolates (35.7%), IMP in 2 (14.3%), NDM-1 in 3 (21.4%), VIM in 5 (35.7%), OXA-48 in 7 (50.0%), and MCR-1 in 13 (92.9%). The predominance of CTX-M, car-bapenemase genes, and the absence of SHV and TEM suggest a distinct resistance profile in these isolates.

Discussion: The findings highlight a concerning emergence of MDR Enterobacter spp. in Sudan, primarily driven by the widespread presence of CTX-M and carbapenemase genes. The lack of SHV and TEM genes indicates potential regional differences in genetic resistance patterns. This underscores the critical need for molecular monitoring and effective infection control policies.

Conclusion: The high prevalence of MDR Enterobacter spp., particularly due to CTX-M and carbapenemase gene expression, poses a serious threat to public health in Khartoum. Regional variation in resistance mechanisms, such as the absence of SHV and TEM, necessitates targeted antimicrobial stewardship and the development of localized treatment guidelines to limit the spread of resistance in Sudanese healthcare facilities.

Introduction: Preseptal cellulitis, the most common periorbital cellulitis manifestation, is more common in children. The aim of this cross-sectional study was to analyze the diagnosis and treatment of preseptal cellulitis infections in patients admitted to Children's Medical Center, an Ira-nian referral hospital, between 2015 and 2019.

Methods: The demographic characteristics of patients, symptoms at admission, affected eye (unilat-eral/bilateral and right/left), the duration of symptoms and treatment, imaging findings, and the mi-crobial culture were recorded from patient history and medical files.

Results: During 5 years, 136 children with preseptal cellulitis, of whom 71 (52.2%) were boys and 65 (47.8%) were girls. The age range of the patients was between 9 days and 15 years, with a mean age of 41.9±39.3 months. All of the children had eyelid swelling and edema upon their initial visit. The most common accompanying symptoms in patients after edema and swelling of the eyelids were fever (41.2%), followed by eye discharge in 30.1%, and tenderness in 19.9% of patients. Ocular in-volvement was 51.5% in the right eye, 44.9% in the left eye, and 3.7% in both eyes. A CT scan was performed in 58 cases (42.6%), showing preseptal cellulitis in 29 patients (21.3%), followed by eth-moid sinusitis in 14 cases (10.3%). The most commonly used antibiotics, either alone or in combina-tion, were clindamycin (72.8%, n=99), ceftriaxone (54.4%, n=74), vancomycin (27.2%, n=37), met-ronidazole (23.5%, n=32), and cefotaxime (17.6%, n=24).

Discussion: Preseptal cellulitis in children presents with a spectrum of symptoms and is frequently associated with risk factors such as sinusitis, odontogenic infections, insect bites, or periocular trauma. Imaging, particularly CT, is essential for evaluating disease severity and identifying compli-cations. One limitation of this study is the occurrence of negative culture results, which could be due to factors such as sample collection, transportation, or possible issues with the culture techniques.

Conclusion: According to this study, children with preseptal cellulitis might exhibit a variety of symptoms. The most common risk factors for preseptal cellulitis infection are sinusitis, odontogenic infections, animal or insect bites, and periocular trauma. Patients usually received clindamycin, ceftri-axone, and combination antibiotics.

Introduction: The present study examined the effect of different concentrations of platelet- rich plasma (PRP) on cell growth and proliferation, and the expression levels of MUC-1 and MUC-4 genes in repeated implantation failure (RIF) patients.

Methods: Twenty-eight women were included in the study. The control group and the group of patients with RIF were treated with different concentrations of PRP 3%, 5% and 10%. Using the MTT test, cell growth and proliferation were checked at 12, 24, and 48 hours. In order to evaluate the effect of different concentrations of PRP on the expression of MUC-1 and MUC-4 genes, a real-time PCR test was conducted.

Results: Cell growth and proliferation of the endometrial cells were significantly increased after treatment with different concentrations of PRP. Based on different doses of PRP, the expression levels of MUC-1 and MUC-4 genes were significantly increased in both the control group and the RIF patient group. The significant increase in expression levels was observed in all groups treated with 10% PRP doses (P<0.05).

Discussion: The treatment of endometrial tissue cells with PRP is associated with the increased expression levels of MUC-1 and MUC-4 genes. This reinforces the hypothesis that PRP, through its contents, the growth factors and inflammatory factors, can increase the activity and expression levels of MUC-1 and MUC-4 genes by activating signaling cascades related to growth factors and inflammatory factors.

Conclusion: PRP in different doses can cause the growth and proliferation of uterine endometrial cells and also increase the expression of MUC-1 and MUC-4 genes.

Background: Tuberculosis (TB) primarily affects the lungs, but extrapulmonary manifestations, such as musculoskeletal TB, account for 15-20% of cases. Isolated intramuscular TB abscesses are exceedingly rare cases of extrapulmonary TB. Predisposing factors, such as diabetes mellitus, immunosuppression, and advanced age, increase the risk of such atypical presentations. This report presents a rare case of a primary tuberculous intramuscular abscess in an elderly diabetic male, emphasizing diagnostic challenges and the importance of a multidisciplinary approach.

Case presentation: A 63-year-old male with uncontrolled type 2 diabetes presented with a 2-month history of right thigh pain and progressive swelling. Examination revealed an 8×9 cm, nontender, firm lump in the right thigh with normal overlying skin. Imaging with 3T MRI showed a multilobulated fluid collection in the thigh's upper third region, predominantly in the adductor and anterior compartments, with surrounding muscle edema and multiple enlarged inguinal lymph nodes. Histo-pathological examination of drained material revealed caseating granulomas with Langhans giant cells, consistent with tuberculosis. CBNAAT confirmed rifampicin-sensitive Mycobacterium tuberculosis. The patient was diagnosed with a primary tuberculous abscess and initiated on a 6-month antituberculosis therapy. He showed significant clinical improvement at the 1-month follow-up and successfully completed his 6-month ATT without any intolerance.

Conclusion: This case underscores the importance of considering TB in atypical presentations, particularly in endemic regions and high-risk populations. Prompt diagnosis through advanced imaging, histopathology, molecular testing, and appropriate surgical and pharmacological interventions is crit-ical for optimal outcomes in such rare presentations.

Introduction: Monkeypox (Mpox) is a disease primarily transmitted through direct contact with infected animals and humans. Recently, it has generated worldwide interest due to its expansion from endemic to non-endemic areas, raising concerns about its clinical consequences.

Method: A comprehensive literature review was conducted using PubMed, Scopus, and Web of Science, focusing on clinical data, immune evasion mechanisms, and public health reports related to monkeypox.

Result: The review revealed that monkeypox presents with fever, rash, and lymphadenopathy. Key findings include the emergence of immune evasion strategies and an increase in human-to-human transmission, highlighting significant challenges for global surveillance, vaccination coverage, and outbreak preparedness.

Discussion: The findings underscore the varied clinical manifestations of Mpox, especially its severe impact on vulnerable populations such as HIV co-infected individuals and those with ocular involvement. The detailed analysis of immune evasion strategies reveals critical challenges in developing effective treatments and preventive measures. These insights align with existing research, emphasizing the need for targeted interventions and improved diagnostic approaches. However, limitations include a reliance on available clinical reports and the evolving nature of monkeypox outbreaks, which may affect the generalizability of the conclusions.

Conclusion: Understanding the clinical characteristics of Mpox is crucial for guiding effective treatment and prevention strategies, particularly in vulnerable populations. These insights can support public health efforts, improve patient outcomes, and inform future research on emerging infectious diseases.