Sedigheh Barzegar, Ali Amanati, Fatemeh Ghasemi, H. Jafarian, P. Badiee
Background: The incidence of invasive aspergillosis and the administration of voriconazole have risen among immunocompromised patients. Objectives: This study aimed to evaluate serum voriconazole concentration and its corresponding influential factors in pediatric patients with hematologic disorders. Methods: A total of 132 blood samples were collected from 44 pediatric patients with hematologic disorders infected with invasive aspergillosis and treated with voriconazole. Among these patients, 20.5% were classified as having proven invasive aspergillosis, 77.2% as probable, and 2.3% as possible. Voriconazole serum levels were evaluated using HPLC on the 3rd, 5th, and 7th days of treatment. Genotyping of the CYP2C19 alleles (*2, *3, and *17) was performed, and demographic and clinical data were gathered from records between 2018 to 2020. Results: The voriconazole concentration in 70.5% of patients and 77.3% of treatment cases (complete or partial) ranged from 1 to 5.5 µg/mL. Adverse events were observed in 4.5% of the patients. Genotyping of CYP2C19 genes revealed CYP2C1911 (5.4%), CYP2C19117 (16.2%), CYP2C1912 (51.4%), and CYP2C19217 (27%). Multivariate analysis using linear regression demonstrated that serum voriconazole concentration increased by 0.037 µg/mL per year of age and by 0.06 µg/mL for each unit increase in C-reactive protein (on the 3rd day of voriconazole therapy). Additionally, an increase in alanine aminotransferase level by 1 unit decreased the mean voriconazole concentration by 0.03 µg/mL. Of these patients, 65.9% were completely treated, 11.4% were partially treated, and 22.7% died. Conclusions: Serum voriconazole concentrations varied among pediatric hematologic patients receiving standard doses, with age, C-reactive protein, and alanine aminotransferase levels affecting the concentration of voriconazole in the sera of pediatric patients.
{"title":"A Perspective Study on Therapeutic Drug Monitoring of Voriconazole in Pediatric Patients with Hematologic Disorders","authors":"Sedigheh Barzegar, Ali Amanati, Fatemeh Ghasemi, H. Jafarian, P. Badiee","doi":"10.5812/jjm-146488","DOIUrl":"https://doi.org/10.5812/jjm-146488","url":null,"abstract":"Background: The incidence of invasive aspergillosis and the administration of voriconazole have risen among immunocompromised patients. Objectives: This study aimed to evaluate serum voriconazole concentration and its corresponding influential factors in pediatric patients with hematologic disorders. Methods: A total of 132 blood samples were collected from 44 pediatric patients with hematologic disorders infected with invasive aspergillosis and treated with voriconazole. Among these patients, 20.5% were classified as having proven invasive aspergillosis, 77.2% as probable, and 2.3% as possible. Voriconazole serum levels were evaluated using HPLC on the 3rd, 5th, and 7th days of treatment. Genotyping of the CYP2C19 alleles (*2, *3, and *17) was performed, and demographic and clinical data were gathered from records between 2018 to 2020. Results: The voriconazole concentration in 70.5% of patients and 77.3% of treatment cases (complete or partial) ranged from 1 to 5.5 µg/mL. Adverse events were observed in 4.5% of the patients. Genotyping of CYP2C19 genes revealed CYP2C1911 (5.4%), CYP2C19117 (16.2%), CYP2C1912 (51.4%), and CYP2C19217 (27%). Multivariate analysis using linear regression demonstrated that serum voriconazole concentration increased by 0.037 µg/mL per year of age and by 0.06 µg/mL for each unit increase in C-reactive protein (on the 3rd day of voriconazole therapy). Additionally, an increase in alanine aminotransferase level by 1 unit decreased the mean voriconazole concentration by 0.03 µg/mL. Of these patients, 65.9% were completely treated, 11.4% were partially treated, and 22.7% died. Conclusions: Serum voriconazole concentrations varied among pediatric hematologic patients receiving standard doses, with age, C-reactive protein, and alanine aminotransferase levels affecting the concentration of voriconazole in the sera of pediatric patients.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tianjiao Li, Yi Gao, Yu Zhang, Xiaojie Peng, Haimei Ye, Wenfang Long
Background: The rapid spread of multidrug-resistant gram-negative bacteria, particularly the increase in carbapenem-resistant strains, has led to a critical level of resistance in clinical settings. Colistin is considered to be the last line of defense against these gram-negative bacteria. Objectives: This study aims to investigate the genetic characteristics and antimicrobial resistance (AMR) patterns of four mcr-1 (mobile colistin resistance) Escherichia coli isolates from various sources in Hainan Province, tropical China, and to determine their genetic relationships with both domestic and global strains. Methods: Samples were collected from swimming pools, marine beaches, and beach personnel in Haikou and Sanya, Hainan Province, China. E. coli isolates were obtained, multilocus sequence typing was performed, and the mcr family resistance genes were amplified by polymerase chain reaction. The mobile sequences, AMR genes, phenotypes, and virulence genotypes of the mcr-1 strains were analyzed. Phylogenetic analyses were conducted to investigate the relationships between the mcr-1E. coli strains and those in the NCBI database. Results: In the current study, the mcr-1 resistance gene was detected in 4 strains, accounting for 2.94% (4/136) of the total. The 4 strains of E. coli were isolated from a freshwater swimming pool, a pool wall, seawater, and a human body. Among the four strains, the minimum inhibitory concentration of polymyxin was 8 mg/L, except for one strain, which showed low-level resistance at 4 mg/L. All four strains showed complete resistance to ampicillin, three were resistant to compound sulfamethoxazole and chloramphenicol, and all strains were sensitive to other common antibiotics. The virulence genes cfaA, cfaB, cfaC, and cfaD/cfaE were detected in all E. coli strains. The insertable sequence IS3 was the most widely distributed type. Three isolates were identified as ST987, whereas the isolate from marine sources was identified as ST24. Comparison of the core genes of the strains indicated that the four strains were closely related to the Chrysomya sp. from Northern Thailand. Conclusions: The four mcr-1 genes can mediate low to medium levels of colistin resistance, facilitating their dissemination within the population and the environment. It is crucial to trace the source of multidrug-resistant bacteria in recreational water, which is in direct contact with humans, and to reduce the risks to human health through effective supervision.
{"title":"Genomic Characterization and Antimicrobial Resistance of Four Mcr-1 Escherichia coli Strains Isolated from Human and Environment Sources, Hainan Province, Tropical China","authors":"Tianjiao Li, Yi Gao, Yu Zhang, Xiaojie Peng, Haimei Ye, Wenfang Long","doi":"10.5812/jjm-144735","DOIUrl":"https://doi.org/10.5812/jjm-144735","url":null,"abstract":"Background: The rapid spread of multidrug-resistant gram-negative bacteria, particularly the increase in carbapenem-resistant strains, has led to a critical level of resistance in clinical settings. Colistin is considered to be the last line of defense against these gram-negative bacteria. Objectives: This study aims to investigate the genetic characteristics and antimicrobial resistance (AMR) patterns of four mcr-1 (mobile colistin resistance) Escherichia coli isolates from various sources in Hainan Province, tropical China, and to determine their genetic relationships with both domestic and global strains. Methods: Samples were collected from swimming pools, marine beaches, and beach personnel in Haikou and Sanya, Hainan Province, China. E. coli isolates were obtained, multilocus sequence typing was performed, and the mcr family resistance genes were amplified by polymerase chain reaction. The mobile sequences, AMR genes, phenotypes, and virulence genotypes of the mcr-1 strains were analyzed. Phylogenetic analyses were conducted to investigate the relationships between the mcr-1E. coli strains and those in the NCBI database. Results: In the current study, the mcr-1 resistance gene was detected in 4 strains, accounting for 2.94% (4/136) of the total. The 4 strains of E. coli were isolated from a freshwater swimming pool, a pool wall, seawater, and a human body. Among the four strains, the minimum inhibitory concentration of polymyxin was 8 mg/L, except for one strain, which showed low-level resistance at 4 mg/L. All four strains showed complete resistance to ampicillin, three were resistant to compound sulfamethoxazole and chloramphenicol, and all strains were sensitive to other common antibiotics. The virulence genes cfaA, cfaB, cfaC, and cfaD/cfaE were detected in all E. coli strains. The insertable sequence IS3 was the most widely distributed type. Three isolates were identified as ST987, whereas the isolate from marine sources was identified as ST24. Comparison of the core genes of the strains indicated that the four strains were closely related to the Chrysomya sp. from Northern Thailand. Conclusions: The four mcr-1 genes can mediate low to medium levels of colistin resistance, facilitating their dissemination within the population and the environment. It is crucial to trace the source of multidrug-resistant bacteria in recreational water, which is in direct contact with humans, and to reduce the risks to human health through effective supervision.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141660940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sanaz Paikar, N. Bahrami, Robab Rafiei Tabatabai, A. Mohamadnia
Background: The factors responsible for the progression of COVID-19 from a mild illness to a severe and often lethal condition, characterized by respiratory failure and multiple organ involvement, remain unclear. The identification of biomarkers capable of predicting disease progression is of the highest importance. Objectives: This study sought to assess laboratory measurements of interferon-gamma inducible protein-10 (IP-10), macrophage inflammatory protein 1-alpha (MIP1α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1β) to achieve this objective. Methods: We measured IP-10 and MIP1α by qRT-PCR and IL-6 and IL-1β using an enzyme-linked immunosorbent assay in 120 serum samples. We analyzed differences between patients with moderate, severe, and recovered COVID-19. Results: The number of positive cases for biomarkers IP-10, MIP1α, IL-6, and IL-1β were significantly different between groups. The expression levels of IP-10 and MIP1α were significantly higher in patients with severe COVID-19 compared to those who had recovered. A strong positive association was observed between IP-10 and MIP1α in severe infection cases. Additionally, these biomarkers were relatively independent predictors of disease severity. Conclusions: The results suggest that IP-10, MIP1α, IL-6, and IL-1β are promising research candidates for understanding the severity of COVID-19 and for investigating possible pathophysiological mechanisms of the disease.
{"title":"IP-10, MIP1α, IL-6, and IL-1β as Biomarkers Associated with Disease Severity of COVID-19","authors":"Sanaz Paikar, N. Bahrami, Robab Rafiei Tabatabai, A. Mohamadnia","doi":"10.5812/jjm-144812","DOIUrl":"https://doi.org/10.5812/jjm-144812","url":null,"abstract":"Background: The factors responsible for the progression of COVID-19 from a mild illness to a severe and often lethal condition, characterized by respiratory failure and multiple organ involvement, remain unclear. The identification of biomarkers capable of predicting disease progression is of the highest importance. Objectives: This study sought to assess laboratory measurements of interferon-gamma inducible protein-10 (IP-10), macrophage inflammatory protein 1-alpha (MIP1α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1β) to achieve this objective. Methods: We measured IP-10 and MIP1α by qRT-PCR and IL-6 and IL-1β using an enzyme-linked immunosorbent assay in 120 serum samples. We analyzed differences between patients with moderate, severe, and recovered COVID-19. Results: The number of positive cases for biomarkers IP-10, MIP1α, IL-6, and IL-1β were significantly different between groups. The expression levels of IP-10 and MIP1α were significantly higher in patients with severe COVID-19 compared to those who had recovered. A strong positive association was observed between IP-10 and MIP1α in severe infection cases. Additionally, these biomarkers were relatively independent predictors of disease severity. Conclusions: The results suggest that IP-10, MIP1α, IL-6, and IL-1β are promising research candidates for understanding the severity of COVID-19 and for investigating possible pathophysiological mechanisms of the disease.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141367291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Pseudomonas aeruginosa (P. aeruginosa) significantly contributes to hospital-acquired infections. Objectives: This study aimed to investigate the genetic diversity of P. aeruginosa strains using multiple-locus variable-number tandem repeat analysis (MLVA) and to explore the relationship between biofilm production and antibiotic resistance. Methods: In this cross-sectional study, 79 P. aeruginosa isolates were collected. Antibiotic sensitivity was tested using the Kirby-Bauer method, and biofilm production capability was assessed through the microtiter plate method. Genetic diversity was evaluated by MLVA, analyzing eight variable-number tandem repeat (VNTR) loci: MS-213, MS-214, MS-207, MS-217, MS-222, MS-209, MS-77, and MS-172. Phylogenetic relationships were delineated using PHYLOViZ 2.0 software. Results: The patient cohort comprised 51.9% males, with the majority of samples (35.4%) obtained from urine. Ceftazidime (CAZ 30µg) showed the highest resistance rate at 77.2%. Notably, 92.4% of isolates were capable of forming biofilms, categorized as 22.7% weak, 28.7% moderate, and 46.5% strong. Phylogenetic analysis demonstrated variability across one or more VNTR loci. Simpson’s index (0.906) and Shannon-Weiner diversity indices (H: 3.466, J: 0.910, Hmax: 3.807, Hmin: 1.242) identified MS77 as the most informative marker for genetic diversity among the isolates. Conclusions: The study highlights an alarming trend in antibiotic resistance, underscoring the necessity of regular monitoring. The findings confirm that MLVA is a straightforward, rapid genotyping method suitable for assessing the genetic diversity of P. aeruginosa.
{"title":"Multiple-Locus Variable-Number Tandem Repeat Analysis Genotyping of Biofilm-Producing Pseudomonas aeruginosa Clinical Isolates","authors":"Raziyeh Ramazani, Rabeeh Izadi Amoli, Mojtaba Taghizadeh Armaki, Abazar Pournajaf, H. Kaboosi","doi":"10.5812/jjm-143820","DOIUrl":"https://doi.org/10.5812/jjm-143820","url":null,"abstract":"Background: Pseudomonas aeruginosa (P. aeruginosa) significantly contributes to hospital-acquired infections. Objectives: This study aimed to investigate the genetic diversity of P. aeruginosa strains using multiple-locus variable-number tandem repeat analysis (MLVA) and to explore the relationship between biofilm production and antibiotic resistance. Methods: In this cross-sectional study, 79 P. aeruginosa isolates were collected. Antibiotic sensitivity was tested using the Kirby-Bauer method, and biofilm production capability was assessed through the microtiter plate method. Genetic diversity was evaluated by MLVA, analyzing eight variable-number tandem repeat (VNTR) loci: MS-213, MS-214, MS-207, MS-217, MS-222, MS-209, MS-77, and MS-172. Phylogenetic relationships were delineated using PHYLOViZ 2.0 software. Results: The patient cohort comprised 51.9% males, with the majority of samples (35.4%) obtained from urine. Ceftazidime (CAZ 30µg) showed the highest resistance rate at 77.2%. Notably, 92.4% of isolates were capable of forming biofilms, categorized as 22.7% weak, 28.7% moderate, and 46.5% strong. Phylogenetic analysis demonstrated variability across one or more VNTR loci. Simpson’s index (0.906) and Shannon-Weiner diversity indices (H: 3.466, J: 0.910, Hmax: 3.807, Hmin: 1.242) identified MS77 as the most informative marker for genetic diversity among the isolates. Conclusions: The study highlights an alarming trend in antibiotic resistance, underscoring the necessity of regular monitoring. The findings confirm that MLVA is a straightforward, rapid genotyping method suitable for assessing the genetic diversity of P. aeruginosa.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141116859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chiman Hamarahim Fattah, Khattab Ahmed Mustafa Shekhany, Shwan Rachid
Background: Candida albicans (C. albicans) is notably pathogenic due to its ability to form biofilms that are resistant to conventional antifungal treatments. Objectives: This study aims to explore the effectiveness of Streptomyces cellulosae (S. cellulosae) extract in disrupting biofilm formation by targeting specific genes within C. albicans. Methods: The study began by isolating S. cellulosae from soil and C. albicans from clinical specimens. S. cellulosae was then cultured and fermented to produce bioactive compounds. The ability of these extracts to inhibit C. albicans biofilm formation was tested using a crystal violet assay. Additionally, the effects of the S. cellulosae extracts on the expression of biofilm-related genes in C. albicans were evaluated using quantitative real-time PCR (qRT-PCR). The growth rates of C. albicans were also measured to determine the impact of the extracts. Results: The crude extract of S. cellulosae significantly (P < 0.05) inhibited the formation of C. albicans biofilms at concentrations exceeding 0.5 µg/mL, with the inhibition becoming more pronounced at concentrations above 2.0 µg/mL. The qRT-PCR results showed significant changes in the expression of biofilm-related genes ALS1, ALS3, and EFG1 at different extract concentrations (P < 0.05). The extract also significantly affected the expression of the HWPa and BRG1 genes. Conclusions: The crude extract of Streptomyces cellulosae shows potential as a novel antibiofilm agent against C. albicans. This finding opens new avenues for research and potential therapeutic applications in combating biofilm-associated infections.
{"title":"Efficacy of Crude Extract from Streptomyces cellulosae Against Biofilm-Related Genes of Candida albicans","authors":"Chiman Hamarahim Fattah, Khattab Ahmed Mustafa Shekhany, Shwan Rachid","doi":"10.5812/jjm-145959","DOIUrl":"https://doi.org/10.5812/jjm-145959","url":null,"abstract":"Background: Candida albicans (C. albicans) is notably pathogenic due to its ability to form biofilms that are resistant to conventional antifungal treatments. Objectives: This study aims to explore the effectiveness of Streptomyces cellulosae (S. cellulosae) extract in disrupting biofilm formation by targeting specific genes within C. albicans. Methods: The study began by isolating S. cellulosae from soil and C. albicans from clinical specimens. S. cellulosae was then cultured and fermented to produce bioactive compounds. The ability of these extracts to inhibit C. albicans biofilm formation was tested using a crystal violet assay. Additionally, the effects of the S. cellulosae extracts on the expression of biofilm-related genes in C. albicans were evaluated using quantitative real-time PCR (qRT-PCR). The growth rates of C. albicans were also measured to determine the impact of the extracts. Results: The crude extract of S. cellulosae significantly (P < 0.05) inhibited the formation of C. albicans biofilms at concentrations exceeding 0.5 µg/mL, with the inhibition becoming more pronounced at concentrations above 2.0 µg/mL. The qRT-PCR results showed significant changes in the expression of biofilm-related genes ALS1, ALS3, and EFG1 at different extract concentrations (P < 0.05). The extract also significantly affected the expression of the HWPa and BRG1 genes. Conclusions: The crude extract of Streptomyces cellulosae shows potential as a novel antibiofilm agent against C. albicans. This finding opens new avenues for research and potential therapeutic applications in combating biofilm-associated infections.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141113625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Mucormycosis, a fatal fungal infection, has increased during the COVID-19 pandemic and posed significant challenges for clinicians. Objectives: Our research focused on identifying the clinical traits of patients with COVID-19-associated mucormycosis (CAM), comparing them with a control group, and identifying risk factors for the development of CAM. Methods: Our study was conducted on 39 CAM patients and 78 control patients from September 2020 to October 2022 at a tertiary education center and regional hospital. The control group was selected blindly in a 1:2 ratio among patients who did not develop mucormycosis, were hospitalized due to COVID-19, and were either discharged or deceased. The control group was matched to the case group regarding age and hospitalization date. To test potential risk factors for CAM, we performed a binary logistic regression analysis. The variables included in the multivariate binary logistic regression model were gender, diabetes, cumulative steroid dose (dexamethasone equivalent), duration of steroid treatment, and tocilizumab/anakinra treatment. Results: In our study, 39 patients were diagnosed with CAM. The average age of the patients was 66 ± 11.5 years. Of the patients, 54.7% (n = 64) were male, with a statistically significantly higher proportion of men in the CAM group (74.4% vs. 44.9%, P = 0.003). The diabetes rate was 51.3% (n = 60) among all patients, and it was higher in the CAM group (69.2% vs. 42.3%, P = 0.006). Regarding in-hospital mortality, the rate was higher in the CAM group (56.4% vs. 14.1%, P < 0.001). The median length of stay in the hospital was 37 days for the CAM group and 10 days for the control group (P < 0.001). The cumulative steroid dose was elevated in the CAM group compared to the control group (191 ± 61.4 mg vs. 117 ± 69.8 mg, P < 0.001). The duration of steroid treatment was 16.5 ± 6.2 days in the CAM group, compared to 9.8 ± 4.7 days in the control group (P < 0.001). Among CAM cases, paranasal involvement was the most common (56.4%), followed by rhino-orbital involvement (33.3%). In binary logistic regression analysis, male gender (OR, 3.9; 95% CI, 1.4 – 11.3), diabetes mellitus (OR, 4.4; 95% CI, 1.5 – 12.4), more than ten days of steroid use (OR, 5.5; 95% CI, 1.3 – 22.4), and tocilizumab/anakinra use (OR, 0.23; 95% CI, 0.06 – 0.8) were identified as risk factors for the development of CAM (p values 0.011, 0.005, 0.019, and 0.020, respectively). Conclusions: Male gender, diabetes mellitus, and steroid use for more than ten days were identified as positive risk factors, while tocilizumab/anakinra use was identified as a negative risk factor for the development of CAM.
{"title":"COVID-19 Associated Mucormycosis and Risk Factors: A Case-Control Study from Turkey","authors":"Ayşin Kılınç Toker, Ayse Turunc Ozdemir, Azade Kanat, Esma Eryılmaz Eren, Hafize Sav, Ibrahim Ozcan, İlhami Çelik","doi":"10.5812/jjm-146817","DOIUrl":"https://doi.org/10.5812/jjm-146817","url":null,"abstract":"Background: Mucormycosis, a fatal fungal infection, has increased during the COVID-19 pandemic and posed significant challenges for clinicians. Objectives: Our research focused on identifying the clinical traits of patients with COVID-19-associated mucormycosis (CAM), comparing them with a control group, and identifying risk factors for the development of CAM. Methods: Our study was conducted on 39 CAM patients and 78 control patients from September 2020 to October 2022 at a tertiary education center and regional hospital. The control group was selected blindly in a 1:2 ratio among patients who did not develop mucormycosis, were hospitalized due to COVID-19, and were either discharged or deceased. The control group was matched to the case group regarding age and hospitalization date. To test potential risk factors for CAM, we performed a binary logistic regression analysis. The variables included in the multivariate binary logistic regression model were gender, diabetes, cumulative steroid dose (dexamethasone equivalent), duration of steroid treatment, and tocilizumab/anakinra treatment. Results: In our study, 39 patients were diagnosed with CAM. The average age of the patients was 66 ± 11.5 years. Of the patients, 54.7% (n = 64) were male, with a statistically significantly higher proportion of men in the CAM group (74.4% vs. 44.9%, P = 0.003). The diabetes rate was 51.3% (n = 60) among all patients, and it was higher in the CAM group (69.2% vs. 42.3%, P = 0.006). Regarding in-hospital mortality, the rate was higher in the CAM group (56.4% vs. 14.1%, P < 0.001). The median length of stay in the hospital was 37 days for the CAM group and 10 days for the control group (P < 0.001). The cumulative steroid dose was elevated in the CAM group compared to the control group (191 ± 61.4 mg vs. 117 ± 69.8 mg, P < 0.001). The duration of steroid treatment was 16.5 ± 6.2 days in the CAM group, compared to 9.8 ± 4.7 days in the control group (P < 0.001). Among CAM cases, paranasal involvement was the most common (56.4%), followed by rhino-orbital involvement (33.3%). In binary logistic regression analysis, male gender (OR, 3.9; 95% CI, 1.4 – 11.3), diabetes mellitus (OR, 4.4; 95% CI, 1.5 – 12.4), more than ten days of steroid use (OR, 5.5; 95% CI, 1.3 – 22.4), and tocilizumab/anakinra use (OR, 0.23; 95% CI, 0.06 – 0.8) were identified as risk factors for the development of CAM (p values 0.011, 0.005, 0.019, and 0.020, respectively). Conclusions: Male gender, diabetes mellitus, and steroid use for more than ten days were identified as positive risk factors, while tocilizumab/anakinra use was identified as a negative risk factor for the development of CAM.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: This study focuses on drug-resistant mutations in protease inhibitors (PIs) and the distribution of Human immunodeficiency virus type 1 (HIV-1) subtypes in Lorestan province, Iran. A total of 59 patients were categorized into two groups: Recipients of antiretroviral therapy (ART) and drug-naive individuals. Genotypic resistance testing was performed using nested PCR, followed by sequencing and analysis of the PCR product to identify drug-resistance mutations and determine the viral subtype. Among the ART recipients, 11 (78%) exhibited major mutations, while 3 (22%) had minor mutations specifically in PIs. The most commonly observed major protease inhibitor (PI) mutations were D30N (27.2%) and V32I (27.2%), followed by G48A (18.1%), L90M (18.1%), and L76V (9%). The most frequent minor PI mutations recorded were K20R (40%), L10I (20%), F53I (20%), and V11I (20%). No drug resistance was detected in drug-naive patients. Lopinavir (LPV) and nelfinavir (NFV) exhibited the highest levels of resistance, while saquinavir (SQV) and fosamprenavir (FPV) showed the highest levels of susceptibility. All participants were found to be infected with CRF35_AD, the dominant HIV-1 subtype in Iran. This study represents the first attempt in the region to analyze drug-resistant mutations in PIs among ART-experienced patients in Lorestan province. The findings contribute to ongoing efforts aimed at controlling the spread of drug-resistant HIV-1 strains.
{"title":"Exploring Drug-Resistant Mutations in Protease Inhibitors and Subtype Distribution Among HIV-1 Positive Patients in Lorestan Province, Iran","authors":"Gholam Reza Talei, Zahra Heydarifard, Sayyad Khanizadeh","doi":"10.5812/jjm-145562","DOIUrl":"https://doi.org/10.5812/jjm-145562","url":null,"abstract":": This study focuses on drug-resistant mutations in protease inhibitors (PIs) and the distribution of Human immunodeficiency virus type 1 (HIV-1) subtypes in Lorestan province, Iran. A total of 59 patients were categorized into two groups: Recipients of antiretroviral therapy (ART) and drug-naive individuals. Genotypic resistance testing was performed using nested PCR, followed by sequencing and analysis of the PCR product to identify drug-resistance mutations and determine the viral subtype. Among the ART recipients, 11 (78%) exhibited major mutations, while 3 (22%) had minor mutations specifically in PIs. The most commonly observed major protease inhibitor (PI) mutations were D30N (27.2%) and V32I (27.2%), followed by G48A (18.1%), L90M (18.1%), and L76V (9%). The most frequent minor PI mutations recorded were K20R (40%), L10I (20%), F53I (20%), and V11I (20%). No drug resistance was detected in drug-naive patients. Lopinavir (LPV) and nelfinavir (NFV) exhibited the highest levels of resistance, while saquinavir (SQV) and fosamprenavir (FPV) showed the highest levels of susceptibility. All participants were found to be infected with CRF35_AD, the dominant HIV-1 subtype in Iran. This study represents the first attempt in the region to analyze drug-resistant mutations in PIs among ART-experienced patients in Lorestan province. The findings contribute to ongoing efforts aimed at controlling the spread of drug-resistant HIV-1 strains.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140972162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peiyan He, Yong Yan, Guoying Zhu, Ze Zhu, Zhongwen Chen
Background: Salmonellosis, a disease caused by Salmonella, is a significant public health concern and economic burden worldwide. The ability of various Salmonella serovars to cause disease is closely linked to the virulence genes they possess. Objectives: The aim of this study was to develop a multiplex fluorescence PCR for detecting ten major virulence genes (ssaR, spvC, pefA, sipA, fimA, sifA, sopE2, sopB, prgH, and stn) in Salmonella. Methods: Primer pairs specific to ten target virulence genes were designed using Primer Premier 5.0 and distributed across two reaction tubes. The multiplex fluorescence PCR was optimized by adjusting one factor at a time. Results: A total of sixty Salmonella strains were analyzed using the newly developed multiplex fluorescence PCR. All strains contained seven or more of the tested virulence genes. The positive rates of virulence genes ssaR, sipA, sopE2, sopB, prgH, and stn were high, each at 100%. The positive rate of sifA was also relatively high at 81.67%. However, the positive rates of spvC at 5% and pefA at 3.33% were relatively low. Conclusions: The newly developed multiplex fluorescence PCR provides a straightforward, cost-effective, and high-throughput solution for detecting virulence genes in Salmonella. It has the potential to become a routine method for analyzing Salmonella virulence genes.
{"title":"Development and Evaluation of a Multiplex Fluorescence PCR for Salmonella Virulence Genes Analysis","authors":"Peiyan He, Yong Yan, Guoying Zhu, Ze Zhu, Zhongwen Chen","doi":"10.5812/jjm-144579","DOIUrl":"https://doi.org/10.5812/jjm-144579","url":null,"abstract":"Background: Salmonellosis, a disease caused by Salmonella, is a significant public health concern and economic burden worldwide. The ability of various Salmonella serovars to cause disease is closely linked to the virulence genes they possess. Objectives: The aim of this study was to develop a multiplex fluorescence PCR for detecting ten major virulence genes (ssaR, spvC, pefA, sipA, fimA, sifA, sopE2, sopB, prgH, and stn) in Salmonella. Methods: Primer pairs specific to ten target virulence genes were designed using Primer Premier 5.0 and distributed across two reaction tubes. The multiplex fluorescence PCR was optimized by adjusting one factor at a time. Results: A total of sixty Salmonella strains were analyzed using the newly developed multiplex fluorescence PCR. All strains contained seven or more of the tested virulence genes. The positive rates of virulence genes ssaR, sipA, sopE2, sopB, prgH, and stn were high, each at 100%. The positive rate of sifA was also relatively high at 81.67%. However, the positive rates of spvC at 5% and pefA at 3.33% were relatively low. Conclusions: The newly developed multiplex fluorescence PCR provides a straightforward, cost-effective, and high-throughput solution for detecting virulence genes in Salmonella. It has the potential to become a routine method for analyzing Salmonella virulence genes.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Min Ding, Juan Yang, XueLi Zeng, Pei Liu, ShunLing Zhang, Sheng Zheng
Background: Hepatocellular carcinoma (HCC) is one of the most prevalent malignant tumors in clinical practice, with hepatitis B virus (HBV) being the most common risk factor for HCC. MicroRNAs (miRNAs) have emerged as a new marker for disease diagnosis and molecularly targeted therapies; however, the mechanism of miR-642a-5p in HBV-associated HCC remains unclear. Objectives: The aim of this study was to investigate the expression of miR-642a-5p, which targets DNA damage-inducible transcript 4 (DDIT4), in HBV-associated HCC, and its effect on the proliferation, migration, and invasion of HBV-positive HCC cells. Methods: miR-642a-5p in the serum of patients with HBV-associated liver cancer (LC), as well as miR-642a-5p and DDIT4 mRNA in LC tissues and cells, and HBV DNA in HBV-positive cells were detected. The targeting of DDIT4 by miR-642a-5p and the progression of cells were also examined. All cell experiments were repeated five times. Results: The results indicated that levels of miR-642a-5p were decreased, while levels of DDIT4 were increased in the serum, tissues, and cells of HBV-positive HCC patients. Overexpression of miR-642a-5p inhibited the progression of HBV-positive HCC cells, suppressed HBV DNA replication, cell proliferation, and invasion, and promoted apoptosis in HepG2.2.15 cells. Conclusions: In addition, miR-642a-5p directly targeted DDIT4, and knockdown of DDIT4 reversed the effects of miR-642a-5p upregulation, promoting the progression of HBV-positive HCC cells. In conclusion, miR-642a-5p is expressed at low levels in HBV-associated HCC and inhibits HBV DNA replication and tumor progression in HBV-positive HCC by targeting DDIT4. This study provides a foundation for molecular targeted therapy in HBV-positive HCC.
{"title":"MicroRNA-642a-5p Targets DNA Damage-Inducible Transcript 4 to Suppress Hepatitis B Virus Hepatoma Carcinoma Cell","authors":"Min Ding, Juan Yang, XueLi Zeng, Pei Liu, ShunLing Zhang, Sheng Zheng","doi":"10.5812/jjm-145798","DOIUrl":"https://doi.org/10.5812/jjm-145798","url":null,"abstract":"Background: Hepatocellular carcinoma (HCC) is one of the most prevalent malignant tumors in clinical practice, with hepatitis B virus (HBV) being the most common risk factor for HCC. MicroRNAs (miRNAs) have emerged as a new marker for disease diagnosis and molecularly targeted therapies; however, the mechanism of miR-642a-5p in HBV-associated HCC remains unclear. Objectives: The aim of this study was to investigate the expression of miR-642a-5p, which targets DNA damage-inducible transcript 4 (DDIT4), in HBV-associated HCC, and its effect on the proliferation, migration, and invasion of HBV-positive HCC cells. Methods: miR-642a-5p in the serum of patients with HBV-associated liver cancer (LC), as well as miR-642a-5p and DDIT4 mRNA in LC tissues and cells, and HBV DNA in HBV-positive cells were detected. The targeting of DDIT4 by miR-642a-5p and the progression of cells were also examined. All cell experiments were repeated five times. Results: The results indicated that levels of miR-642a-5p were decreased, while levels of DDIT4 were increased in the serum, tissues, and cells of HBV-positive HCC patients. Overexpression of miR-642a-5p inhibited the progression of HBV-positive HCC cells, suppressed HBV DNA replication, cell proliferation, and invasion, and promoted apoptosis in HepG2.2.15 cells. Conclusions: In addition, miR-642a-5p directly targeted DDIT4, and knockdown of DDIT4 reversed the effects of miR-642a-5p upregulation, promoting the progression of HBV-positive HCC cells. In conclusion, miR-642a-5p is expressed at low levels in HBV-associated HCC and inhibits HBV DNA replication and tumor progression in HBV-positive HCC by targeting DDIT4. This study provides a foundation for molecular targeted therapy in HBV-positive HCC.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Davod Sheikh-Hoseini, Saeed Soleiman-Meigooni, Hassan Jalaeikhoo, J. Rajabi, M. H. Kazemi-Galougahi, T. Azimi, Ali Asgari
Background: Invasive fungal infection (IFI) is a life-threatening condition, particularly in individuals with compromised immune systems. Objectives: Our study aims to evaluate IFI in hospitalized patients with hematological malignancies. Methods: In this retrospective cross-sectional study, we evaluated patients with hematological malignancies admitted to two university hospitals in Tehran, Iran, from 2020 to 2021 for IFI. We selected only those patients who had been hospitalized for at least four days for antimicrobial treatment. Data analysis was conducted using SPSS-26 software, employing Mann-Whitney U, chi-square, and Fisher exact tests. Results: During the study period, 60 out of 213 patients with hematological malignancies were admitted for antimicrobial treatment. The average age of the patients was 57.1 years, with fever being the most common symptom, reported in 63.3% of cases. We identified 24 cases of IFI, including three proven cases (Candida spp.) and 21 probable cases. Statistical analysis showed a lower mean neutrophil count in the IFI group compared to the non-IFI group (3862 versus 12881, P = 0.001) and a higher mortality rate (58.3% versus 27.8%, P = 0.031). Conclusions: Our study revealed that severe neutropenia is a significant risk factor for IFI, and the mortality rate associated with IFI remains high despite advances in the treatment of hematological malignancies.
{"title":"Invasive Fungal Infections Among Patients with Hematological Malignancies: A Two-Year Multicentric Study from Tehran, Iran","authors":"Davod Sheikh-Hoseini, Saeed Soleiman-Meigooni, Hassan Jalaeikhoo, J. Rajabi, M. H. Kazemi-Galougahi, T. Azimi, Ali Asgari","doi":"10.5812/jjm-144500","DOIUrl":"https://doi.org/10.5812/jjm-144500","url":null,"abstract":"Background: Invasive fungal infection (IFI) is a life-threatening condition, particularly in individuals with compromised immune systems. Objectives: Our study aims to evaluate IFI in hospitalized patients with hematological malignancies. Methods: In this retrospective cross-sectional study, we evaluated patients with hematological malignancies admitted to two university hospitals in Tehran, Iran, from 2020 to 2021 for IFI. We selected only those patients who had been hospitalized for at least four days for antimicrobial treatment. Data analysis was conducted using SPSS-26 software, employing Mann-Whitney U, chi-square, and Fisher exact tests. Results: During the study period, 60 out of 213 patients with hematological malignancies were admitted for antimicrobial treatment. The average age of the patients was 57.1 years, with fever being the most common symptom, reported in 63.3% of cases. We identified 24 cases of IFI, including three proven cases (Candida spp.) and 21 probable cases. Statistical analysis showed a lower mean neutrophil count in the IFI group compared to the non-IFI group (3862 versus 12881, P = 0.001) and a higher mortality rate (58.3% versus 27.8%, P = 0.031). Conclusions: Our study revealed that severe neutropenia is a significant risk factor for IFI, and the mortality rate associated with IFI remains high despite advances in the treatment of hematological malignancies.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140987745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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