Nasser Samadi, Mehdi Kalani, T. Azimi, H. Hosainzadegan, Nahal Hadi
Background: Carbapenem-resistant Klebsiella pneumoniae (Cr-KPN) poses a significant global public health challenge. Objectives: This study aimed to investigate the prevalence and expression levels of carbapenemase-encoding genes in Cr-KPN isolated from patients admitted to teaching hospitals in Shiraz, Iran. Methods: A total of 671 distinct clinical samples were collected from two teaching hospitals in Shiraz. Initial identification and final confirmation of K. pneumoniae isolates were carried out using conventional biochemical tests and PCR assays, respectively. The detection of carbapenemase-producing K. pneumoniae, both phenotypically and genotypically, was performed through modified carbapenem inactivation methods (mCIM) and multiplex PCR assays. Real-time PCR was utilized to assess the expression levels of carbapenemase-encoding genes. Results: The overall frequency of K. pneumoniae strains was 14.9% (n = 100/671). mCIM indicated that 26% of K. pneumoniae isolates exhibited carbapenemase production. Furthermore, 24% and 17% of K. pneumoniae isolates demonstrated resistance to imipenem and meropenem, respectively. The blaIMI/IMP gene was detected in 91% of the isolates. Among imipenem-resistant isolates, 62.5% tested positive for the blaOXA-48 gene. Additionally, 29.4%, 76.5%, and 11.8% of meropenem-resistant isolates were positive for the blaKPC, blaOXA-48, and blaNDM genes, respectively. Real-time PCR analysis revealed increased expression levels of blaKPC (1.66-fold), blaOXA-48 (7.30-fold), blaNDM (4.22-fold), and blaIMI/NMC (2.39-fold) genes in resistant isolates when exposed to imipenem. Conclusions: These findings underscore the significance of establishing active surveillance networks to monitor and track the dissemination of carbapenemase-producing K. pneumoniae, which presents a global public health threat.
{"title":"Phenotypic and Molecular Detection of Carbapenemase-Producing Klebsiella pneumoniae Isolated from Patients Admitted to Teaching Hospitals in Shiraz, Iran","authors":"Nasser Samadi, Mehdi Kalani, T. Azimi, H. Hosainzadegan, Nahal Hadi","doi":"10.5812/jjm-142449","DOIUrl":"https://doi.org/10.5812/jjm-142449","url":null,"abstract":"Background: Carbapenem-resistant Klebsiella pneumoniae (Cr-KPN) poses a significant global public health challenge. Objectives: This study aimed to investigate the prevalence and expression levels of carbapenemase-encoding genes in Cr-KPN isolated from patients admitted to teaching hospitals in Shiraz, Iran. Methods: A total of 671 distinct clinical samples were collected from two teaching hospitals in Shiraz. Initial identification and final confirmation of K. pneumoniae isolates were carried out using conventional biochemical tests and PCR assays, respectively. The detection of carbapenemase-producing K. pneumoniae, both phenotypically and genotypically, was performed through modified carbapenem inactivation methods (mCIM) and multiplex PCR assays. Real-time PCR was utilized to assess the expression levels of carbapenemase-encoding genes. Results: The overall frequency of K. pneumoniae strains was 14.9% (n = 100/671). mCIM indicated that 26% of K. pneumoniae isolates exhibited carbapenemase production. Furthermore, 24% and 17% of K. pneumoniae isolates demonstrated resistance to imipenem and meropenem, respectively. The blaIMI/IMP gene was detected in 91% of the isolates. Among imipenem-resistant isolates, 62.5% tested positive for the blaOXA-48 gene. Additionally, 29.4%, 76.5%, and 11.8% of meropenem-resistant isolates were positive for the blaKPC, blaOXA-48, and blaNDM genes, respectively. Real-time PCR analysis revealed increased expression levels of blaKPC (1.66-fold), blaOXA-48 (7.30-fold), blaNDM (4.22-fold), and blaIMI/NMC (2.39-fold) genes in resistant isolates when exposed to imipenem. Conclusions: These findings underscore the significance of establishing active surveillance networks to monitor and track the dissemination of carbapenemase-producing K. pneumoniae, which presents a global public health threat.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139859940","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}
A. Alamdary, Alireaza Gholami, Maryam Shahali, D. Doroud, Rasul Moukhah, Mohammad Javad Hossein Tehrani, R. Mardani, Nayebali Ahmadi
Background: Despite global control measures aimed at ending the COVID-19 pandemic, the disease continues to pose a threat to public health. In this study, we examined the serum levels of vitamins C, D, and E, as well as IgG and IgM antibodies in individuals who had previously been vaccinated against COVID-19 and subsequently experienced a relapse of the disease. Objectives: The objective of this study was to investigate the correlation between sufficient levels of vitamins E, D, and C, the severity of the disease, and the immunological response in vaccinated patients who have experienced a recurrence of COVID-19. Methods: Given the potential role of vitamins C, D, and E in the management of COVID-19, we conducted a study to examine the serum levels of these vitamins in individuals who had previously been vaccinated against COVID-19 and experienced a disease relapse, characterized by symptoms, such as body pain, shortness of breath, cough, and fever. We compared two groups of hospitalized individuals with varying disease severity to healthy individuals. Additionally, we investigated IgG and IgM antibodies in these patients due to the significance of antibody levels in determining disease severity. Results: Our results revealed significant differences in the levels of vitamins C, D, and E between hospitalized individuals and healthy individuals. Furthermore, a notable disparity in serum IgM and IgG levels was observed based on the severity of the disease. However, no significant difference was detected in the average levels of anti-SARS-CoV-2 immunoglobulins among the different groups, whether they had received the AstraZeneca or Sinopharm vaccines. Conclusions: Vitamins C, D, and E play supportive roles in the immune system, aiding the host's immune response. These findings suggest that maintaining adequate levels of these vitamins may be beneficial in preventing SARS-CoV-2 reinfection and reducing disease severity, particularly in cases where vaccine efficacy is uncertain.
背景:尽管全球采取了旨在结束 COVID-19 大流行的控制措施,但该疾病仍对公共健康构成威胁。在这项研究中,我们检测了曾接种过 COVID-19 疫苗但后来疾病复发的人的血清中维生素 C、D 和 E 以及 IgG 和 IgM 抗体的水平。研究目的本研究旨在调查接种过 COVID-19 疫苗后复发的患者体内维生素 E、D 和 C 的充足水平、疾病严重程度以及免疫反应之间的相关性。研究方法鉴于维生素 C、D 和 E 在治疗 COVID-19 中的潜在作用,我们进行了一项研究,以检测曾接种过 COVID-19 疫苗并以身体疼痛、呼吸急促、咳嗽和发烧等症状为特征的疾病复发患者的血清中这些维生素的水平。我们将疾病严重程度不同的两组住院病人与健康人进行了比较。此外,我们还调查了这些患者的 IgG 和 IgM 抗体,因为抗体水平在确定疾病严重程度方面具有重要意义。结果我们的研究结果表明,住院病人与健康人的维生素 C、D 和 E 含量存在明显差异。此外,根据疾病的严重程度,血清 IgM 和 IgG 水平也存在明显差异。不过,无论接种的是阿斯利康疫苗还是国药集团疫苗,不同群体的抗 SARS-CoV-2 免疫球蛋白平均水平均无明显差异。结论维生素 C、D 和 E 在免疫系统中发挥辅助作用,有助于宿主的免疫反应。这些研究结果表明,保持足够的维生素水平可能有利于预防 SARS-CoV-2 的再次感染并减轻疾病的严重程度,尤其是在疫苗疗效不确定的情况下。
{"title":"The Protective Effect of Serum Levels of Vitamins C, D, and E and IgG and IgM Antibodies in Individuals Vaccinated Against COVID-19 and Experienced Disease Relapse","authors":"A. Alamdary, Alireaza Gholami, Maryam Shahali, D. Doroud, Rasul Moukhah, Mohammad Javad Hossein Tehrani, R. Mardani, Nayebali Ahmadi","doi":"10.5812/jjm-142026","DOIUrl":"https://doi.org/10.5812/jjm-142026","url":null,"abstract":"Background: Despite global control measures aimed at ending the COVID-19 pandemic, the disease continues to pose a threat to public health. In this study, we examined the serum levels of vitamins C, D, and E, as well as IgG and IgM antibodies in individuals who had previously been vaccinated against COVID-19 and subsequently experienced a relapse of the disease. Objectives: The objective of this study was to investigate the correlation between sufficient levels of vitamins E, D, and C, the severity of the disease, and the immunological response in vaccinated patients who have experienced a recurrence of COVID-19. Methods: Given the potential role of vitamins C, D, and E in the management of COVID-19, we conducted a study to examine the serum levels of these vitamins in individuals who had previously been vaccinated against COVID-19 and experienced a disease relapse, characterized by symptoms, such as body pain, shortness of breath, cough, and fever. We compared two groups of hospitalized individuals with varying disease severity to healthy individuals. Additionally, we investigated IgG and IgM antibodies in these patients due to the significance of antibody levels in determining disease severity. Results: Our results revealed significant differences in the levels of vitamins C, D, and E between hospitalized individuals and healthy individuals. Furthermore, a notable disparity in serum IgM and IgG levels was observed based on the severity of the disease. However, no significant difference was detected in the average levels of anti-SARS-CoV-2 immunoglobulins among the different groups, whether they had received the AstraZeneca or Sinopharm vaccines. Conclusions: Vitamins C, D, and E play supportive roles in the immune system, aiding the host's immune response. These findings suggest that maintaining adequate levels of these vitamins may be beneficial in preventing SARS-CoV-2 reinfection and reducing disease severity, particularly in cases where vaccine efficacy is uncertain.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140504889","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}
Mahsa Najafi, E. Lotfali, Reyhaneh Shoorgashti, H. Ebrahimi, Simin Lesan
Background: Antifungal resistance is increasing, posing a challenge for treating candidiasis. Cold atmospheric plasma (CAP) is a potential alternative, but its association with traditional antifungals is poorly understood. Objectives: This study aims to evaluate the effects of dielectric barrier discharge (DBD) plasma on Candida albicans. Methods: In this in vitro study, C. albicans strains were irradiated with DBD plasma for 5, 10, and 15 minutes, both with and without nystatin. The number of colonies was counted, and the MTT method assessed Candida's survival. Data were analyzed with SPSS26. Results: This study showed that in both experimental groups, with and without nystatin, the lowest C. albicans cell viability was observed following a 10 minute DBD exposure within the groups subjected to plasma treatment (P < 0.001). The positive control group (nystatin without plasma exposure) exhibited a diminished count of viable cells in comparison to the group with 10 minute plasma irradiation without nystatin (P < 0.001). The 10 and 15 minute DBD plasma exposures, along with their positive control counterparts, demonstrated a statistically significant reduction in colony count compared to the 5 minute DBD exposure and the negative control groups (P < 0.001). Conclusions: Nystatin was more effective than DBD plasma irradiation in reducing C. albicans cell viability. When used in combination, 10 minute DBD plasma irradiation with nystatin was more effective than 5 or 15 minute irradiation times in reducing the survival rate of C. albicans.
{"title":"Evaluation of the Effects of Dielectric Barrier Discharge Plasma on Candida albicans Strains: An in vitro Study","authors":"Mahsa Najafi, E. Lotfali, Reyhaneh Shoorgashti, H. Ebrahimi, Simin Lesan","doi":"10.5812/jjm-142236","DOIUrl":"https://doi.org/10.5812/jjm-142236","url":null,"abstract":"Background: Antifungal resistance is increasing, posing a challenge for treating candidiasis. Cold atmospheric plasma (CAP) is a potential alternative, but its association with traditional antifungals is poorly understood. Objectives: This study aims to evaluate the effects of dielectric barrier discharge (DBD) plasma on Candida albicans. Methods: In this in vitro study, C. albicans strains were irradiated with DBD plasma for 5, 10, and 15 minutes, both with and without nystatin. The number of colonies was counted, and the MTT method assessed Candida's survival. Data were analyzed with SPSS26. Results: This study showed that in both experimental groups, with and without nystatin, the lowest C. albicans cell viability was observed following a 10 minute DBD exposure within the groups subjected to plasma treatment (P < 0.001). The positive control group (nystatin without plasma exposure) exhibited a diminished count of viable cells in comparison to the group with 10 minute plasma irradiation without nystatin (P < 0.001). The 10 and 15 minute DBD plasma exposures, along with their positive control counterparts, demonstrated a statistically significant reduction in colony count compared to the 5 minute DBD exposure and the negative control groups (P < 0.001). Conclusions: Nystatin was more effective than DBD plasma irradiation in reducing C. albicans cell viability. When used in combination, 10 minute DBD plasma irradiation with nystatin was more effective than 5 or 15 minute irradiation times in reducing the survival rate of C. albicans.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507881","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}
Arzu Irvem, Selen Zeliha Mart Komurcu, Sule Celik, Derya Erdogan Cakir, Cengiz Aydin, C. Kazezoğlu
Background: It is known that the change in coagulation parameters has an effect on mortality and prognosis in COVID-19 patients. The SARS-CoV-2 virus has changed with mutations in the genome of the virus since the beginning of the pandemic, and the resulting variants have been recorded by the World Health Organization. With these variations, the clinical severity of the disease and laboratory parameters have also changed. Objectives: In this study, we examined the changes in D-dimer levels, fibrinogen levels, platelet count (PLT), and mean platelet volume (MPV) between SARS-CoV-2 Alpha (B.1.1.7), Beta (B.1.351) Delta (B.1.617.2), and Omicron (B.1.1.529) variants. Methods: The study was conducted retrospectively on 28 195 adult patients with SARS-CoV-2 infection. At the time of application, data on age, gender, SARS-CoV-2 variant status, D-dimer levels (n = 7090), fibrinogen (n = 5709), PLT (n = 7066), and MPV (n = 8330) were collected. Patients were divided according to alpha, beta, delta, and omicron variants. The changes in variants were examined statistically. Results: The incidence of the delta variant in women was higher than the other variants, followed by alpha and omicron (P = 0.001). The Beta variant was detected at a higher rate in males. The ages of the cases with the Omicron variant were higher than the cases with Alpha, Beta, and Delta variants (P = 0.001, P = 0.001, P = 0.001, and P < 0.01, respectively). In laboratory parameters, D-dimer and fibrinogen levels were detected to be significantly higher in Delta and Omicron variants. PLT and MPV were determined to be lower in delta and omicron than in alpha and beta variants. Conclusions: Examination of the changes in laboratory coagulation parameters according to variants shows that the tendency to clot increases from alpha to omicron.
{"title":"Examining the Changes in Coagulation Parameters in Patients Infected with SARS-CoV-2 Variants (Alpha, Beta, Delta, and Omicron)","authors":"Arzu Irvem, Selen Zeliha Mart Komurcu, Sule Celik, Derya Erdogan Cakir, Cengiz Aydin, C. Kazezoğlu","doi":"10.5812/jjm-142213","DOIUrl":"https://doi.org/10.5812/jjm-142213","url":null,"abstract":"Background: It is known that the change in coagulation parameters has an effect on mortality and prognosis in COVID-19 patients. The SARS-CoV-2 virus has changed with mutations in the genome of the virus since the beginning of the pandemic, and the resulting variants have been recorded by the World Health Organization. With these variations, the clinical severity of the disease and laboratory parameters have also changed. Objectives: In this study, we examined the changes in D-dimer levels, fibrinogen levels, platelet count (PLT), and mean platelet volume (MPV) between SARS-CoV-2 Alpha (B.1.1.7), Beta (B.1.351) Delta (B.1.617.2), and Omicron (B.1.1.529) variants. Methods: The study was conducted retrospectively on 28 195 adult patients with SARS-CoV-2 infection. At the time of application, data on age, gender, SARS-CoV-2 variant status, D-dimer levels (n = 7090), fibrinogen (n = 5709), PLT (n = 7066), and MPV (n = 8330) were collected. Patients were divided according to alpha, beta, delta, and omicron variants. The changes in variants were examined statistically. Results: The incidence of the delta variant in women was higher than the other variants, followed by alpha and omicron (P = 0.001). The Beta variant was detected at a higher rate in males. The ages of the cases with the Omicron variant were higher than the cases with Alpha, Beta, and Delta variants (P = 0.001, P = 0.001, P = 0.001, and P < 0.01, respectively). In laboratory parameters, D-dimer and fibrinogen levels were detected to be significantly higher in Delta and Omicron variants. PLT and MPV were determined to be lower in delta and omicron than in alpha and beta variants. Conclusions: Examination of the changes in laboratory coagulation parameters according to variants shows that the tendency to clot increases from alpha to omicron.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140509898","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}
Sepideh Saeb, G. Talei, A. Ghaziasadi, Arash Letafati, S. Khanizadeh, M. Jamalidoust
Background: The coronavirus disease 2019 (COVID-19) poses a threat to the global economy and public health. Mutations in the spike protein of the virus can impact the functional characteristics and effectiveness of vaccines. Objectives: This study aimed to analyze mutations in three key regions of the spike protein, investigate clinical presentations, and assess protective immune levels in healthcare workers (HCWs) who had received full vaccine doses but were re-infected. Methods: In this cross-sectional study, 49 breakthrough-infected HCWs were included from November 2021 to May 2022. After confirming COVID-19 reinfection, the SARS-CoV-2 genome was extracted using the ROJE extraction kit, and genetic variation analysis was performed through Sanger sequencing. Blood samples were collected with prior consent, and ELISA tests were performed to determine antibody levels. Clinical presentations were recorded, and independent t-tests revealed no significant gender-based differences in the C-terminal point mutation. Results: In this study, 75.5% (37/49) of the included HCWs were female (P-value < 0.05), and 25 were qualified for PCR and gene sequencing. Mutations were observed in 25, 10, and 1 sequence(s) of the C-terminal domain, N-terminal domain, and RBD regions of the S1 gene, respectively. The mutations had no significant correlation with the patient's gender, age, or occupation, but they were significantly more prevalent in those with underlying diseases. 63.3% (31/49) of patients had high or very high IgG levels, and none had undetectable antibody levels at the time of reinfection. Loss of the sense of smell (69.4% - 34/49), sore throat (65.3% - 32/49), headache (59.2% - 29/49), and cough (57.1% - 28/49) were the most prevalent clinical manifestations (P > 0.05) in breakthrough-infected HCWs, aligning with the pattern of symptoms seen in the Omicron wave. However, the loss of the sense of taste showed significant results concerning clinical manifestation (P < 0.05). The examination of mutations revealed the presence of the Omicron variant in the majority of individuals. Point mutations in the C-terminal region did not significantly vary based on age, gender, or vaccine type. No significant difference was observed between vaccine types and clinical symptoms. Conclusions: In conclusion, this study identified spike protein mutations in reinfections among vaccinated healthcare workers. While mutations were prevalent, no significant correlations were found with demographics or vaccine types. Symptoms resembled the Omicron variant, notably with the loss of the sense of taste as a significant marker. Detectable antibody levels post-reinfection suggest that vaccine-induced immunity remains robust. Continuous monitoring of virus variants is crucial for optimizing vaccination strategies in the face of evolving strains.
{"title":"Molecular, Immunological, and Clinical Characterization of SARS-CoV-2 Infection in Breakthrough-Infected Healthcare Workers During the Last Wave of The Pandemic in Shiraz, Iran","authors":"Sepideh Saeb, G. Talei, A. Ghaziasadi, Arash Letafati, S. Khanizadeh, M. Jamalidoust","doi":"10.5812/jjm-142644","DOIUrl":"https://doi.org/10.5812/jjm-142644","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) poses a threat to the global economy and public health. Mutations in the spike protein of the virus can impact the functional characteristics and effectiveness of vaccines. Objectives: This study aimed to analyze mutations in three key regions of the spike protein, investigate clinical presentations, and assess protective immune levels in healthcare workers (HCWs) who had received full vaccine doses but were re-infected. Methods: In this cross-sectional study, 49 breakthrough-infected HCWs were included from November 2021 to May 2022. After confirming COVID-19 reinfection, the SARS-CoV-2 genome was extracted using the ROJE extraction kit, and genetic variation analysis was performed through Sanger sequencing. Blood samples were collected with prior consent, and ELISA tests were performed to determine antibody levels. Clinical presentations were recorded, and independent t-tests revealed no significant gender-based differences in the C-terminal point mutation. Results: In this study, 75.5% (37/49) of the included HCWs were female (P-value < 0.05), and 25 were qualified for PCR and gene sequencing. Mutations were observed in 25, 10, and 1 sequence(s) of the C-terminal domain, N-terminal domain, and RBD regions of the S1 gene, respectively. The mutations had no significant correlation with the patient's gender, age, or occupation, but they were significantly more prevalent in those with underlying diseases. 63.3% (31/49) of patients had high or very high IgG levels, and none had undetectable antibody levels at the time of reinfection. Loss of the sense of smell (69.4% - 34/49), sore throat (65.3% - 32/49), headache (59.2% - 29/49), and cough (57.1% - 28/49) were the most prevalent clinical manifestations (P > 0.05) in breakthrough-infected HCWs, aligning with the pattern of symptoms seen in the Omicron wave. However, the loss of the sense of taste showed significant results concerning clinical manifestation (P < 0.05). The examination of mutations revealed the presence of the Omicron variant in the majority of individuals. Point mutations in the C-terminal region did not significantly vary based on age, gender, or vaccine type. No significant difference was observed between vaccine types and clinical symptoms. Conclusions: In conclusion, this study identified spike protein mutations in reinfections among vaccinated healthcare workers. While mutations were prevalent, no significant correlations were found with demographics or vaccine types. Symptoms resembled the Omicron variant, notably with the loss of the sense of taste as a significant marker. Detectable antibody levels post-reinfection suggest that vaccine-induced immunity remains robust. Continuous monitoring of virus variants is crucial for optimizing vaccination strategies in the face of evolving strains.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140510683","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}
Elaheh Asghari Gharakhyli, Seyedeh Elham Norollahi, H. Sedigh Ebrahim-Saraie, Kosar Babaei, M. Hasannejad-Bibalan, A. Samadani
Background: Pseudomonas aeruginosa is one of the most important opportunistic pathogens causing hospital infections. Objectives: This study aimed to investigate the abundance of integrons and the pattern of resistance to carbapenems (metallo-β-lactamases including Spm, Imp, and Vim) and its relationship with the presence of integrons classes I and II in P. aeruginosa isolates. Methods: This study was conducted on 73 samples of P. aeruginosa isolated from burn wounds of patients admitted to the burn center of Velayat Hospital, Rasht, Iran. To confirm the phenotype of P. aeruginosa, Gram staining and diagnostic biochemical tests, including oxidation-fermentation (OF), pigment production, citrate utilization, catalase activity, oxidase test, and growth at 42°C, were used. After identification and confirmation, molecular diagnosis was conducted to identify strains producing genes classes I and II using the polymerase chain reaction (PCR) method. Results: In this research, the frequency of carbapenem resistance genes in clinical isolates of P. aeruginosa was found to be zero, 13.7%, and 21.9% for blaSpm, blaImp, and blaVim genes, respectively. Integrons of classes I and II were present in 53.4% of isolates of class I and 17.8% of isolates of class II. Also, 4.1% of the total integrin-positive isolates had both integron classes. Conclusions: There was a statistically significant relationship between class I integron and the blaImp gene. Importantly, the mechanisms of other integrons play a role in the development of resistance and the presence of these genes involved in this project.
背景:铜绿假单胞菌是导致医院感染的最重要的机会性病原体之一。研究目的本研究旨在调查铜绿假单胞菌分离株中整合子的丰度、对碳青霉烯类(金属-β-内酰胺酶,包括 Spm、Imp 和 Vim)的耐药性模式及其与整合子 I 类和 II 类存在的关系。方法:本研究对从伊朗拉什特 Velayat 医院烧伤中心收治的烧伤患者伤口中分离出的 73 个铜绿假单胞菌样本进行了研究。为确认铜绿假单胞菌的表型,采用了革兰氏染色法和诊断性生化测试,包括氧化发酵(OF)、色素生成、柠檬酸利用、过氧化氢酶活性、氧化酶测试和 42°C 生长。经鉴定和确认后,采用聚合酶链式反应(PCR)方法进行分子诊断,以确定产生 I 类和 II 类基因的菌株。研究结果本研究发现,铜绿假单胞菌临床分离株的碳青霉烯耐药基因频率分别为 0、13.7% 和 21.9%,其中 blaSpm、blaImp 和 blaVim 基因的频率分别为 0、13.7% 和 21.9%。53.4% 的 I 类分离物和 17.8% 的 II 类分离物含有 I 类和 II 类整合子。此外,4.1%的整合素阳性分离物同时具有两种整合素。结论I 类整合素与 blaImp 基因之间存在统计学意义上的显著关系。重要的是,其他整合素的机制在抗药性的产生中起着一定的作用,这些基因的存在也与该项目有关。
{"title":"Examining the Frequency of Carbapenem Resistance Genes and Its Relationship with Different Classes of Integrons Including Classes I and II in Pseudomonas aeruginosa Isolates of Burn Patients","authors":"Elaheh Asghari Gharakhyli, Seyedeh Elham Norollahi, H. Sedigh Ebrahim-Saraie, Kosar Babaei, M. Hasannejad-Bibalan, A. Samadani","doi":"10.5812/jjm-140912","DOIUrl":"https://doi.org/10.5812/jjm-140912","url":null,"abstract":"Background: Pseudomonas aeruginosa is one of the most important opportunistic pathogens causing hospital infections. Objectives: This study aimed to investigate the abundance of integrons and the pattern of resistance to carbapenems (metallo-β-lactamases including Spm, Imp, and Vim) and its relationship with the presence of integrons classes I and II in P. aeruginosa isolates. Methods: This study was conducted on 73 samples of P. aeruginosa isolated from burn wounds of patients admitted to the burn center of Velayat Hospital, Rasht, Iran. To confirm the phenotype of P. aeruginosa, Gram staining and diagnostic biochemical tests, including oxidation-fermentation (OF), pigment production, citrate utilization, catalase activity, oxidase test, and growth at 42°C, were used. After identification and confirmation, molecular diagnosis was conducted to identify strains producing genes classes I and II using the polymerase chain reaction (PCR) method. Results: In this research, the frequency of carbapenem resistance genes in clinical isolates of P. aeruginosa was found to be zero, 13.7%, and 21.9% for blaSpm, blaImp, and blaVim genes, respectively. Integrons of classes I and II were present in 53.4% of isolates of class I and 17.8% of isolates of class II. Also, 4.1% of the total integrin-positive isolates had both integron classes. Conclusions: There was a statistically significant relationship between class I integron and the blaImp gene. Importantly, the mechanisms of other integrons play a role in the development of resistance and the presence of these genes involved in this project.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139453250","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}
Nur Efe Iris, Ozlem Akman, Demet Akin, Palmet Gun Atak, Ahmed Cihad Genc, Funda Simsek, T. Yıldırmak, G. Demircan
Background: Early immune responses to COVID-19 can help eliminate the virus; therefore, strategies to improve the immune system have become important in disease prevention. Vitamin D plays a crucial role in the immune response to SARS-CoV-2 by increasing the expression of the vitamin D receptor. Objectives: This study investigated the impact of vitamin D deficiency, Fok 1, and Taq 1 Vitamin D Receptor (VDR) gene polymorphisms and comorbidities on the susceptibility to COVID-19. Methods: Fok1 and Taq1 polymorphisms were analyzed using the RT-PCR method, and vitamin D levels were measured using the chemiluminescence method. A total of 200 patients, 100 with COVID-19 and 100 without, provided blood samples for analysis. Results: The COVID-19 positive group had a significantly lower mean vitamin D level of 16.2 ± 11.3 ng/mL compared to the COVID-19 negative control group, 26.7 ± 15.9 ng/mL (P < 0.001). Individuals with a vitamin D level below 18.4 ng/mL had a 2.448 times higher risk of COVID-19 positivity (P < 0.001). There was no significant difference in the Fok1 and Taq1 gene polymorphisms between the two groups. (P = 0.548 and P = 0.098). The COVID-19 positive group had a significantly higher number of comorbid diseases with 40 (40%) compared to the negative group with 10 (10%) participants (P < 0.001). Conclusions: Levels of vitamin D above the cut-off value of 18.4 ng/mL were found to protect against COVID-19, while the presence of comorbid diseases was identified as a risk factor. However, no association was observed between the Fok1 and Taq1 polymorphisms and susceptibility to COVID-19.
背景:对 COVID-19 的早期免疫反应有助于消灭病毒;因此,改善免疫系统的策略在疾病预防中变得非常重要。维生素 D 通过增加维生素 D 受体的表达,在对 SARS-CoV-2 的免疫反应中起着至关重要的作用。研究目的本研究调查了维生素 D 缺乏、Fok 1 和 Taq 1 维生素 D 受体(VDR)基因多态性及合并症对 COVID-19 易感性的影响。方法:采用 RT-PCR 法分析 Fok1 和 Taq1 多态性,采用化学发光法测定维生素 D 水平。共有 200 名患者提供了血样用于分析,其中 100 人患有 COVID-19,100 人未患有 COVID-19。结果显示COVID-19 阳性组的平均维生素 D 水平为 16.2 ± 11.3 ng/mL,明显低于 COVID-19 阴性对照组的 26.7 ± 15.9 ng/mL(P < 0.001)。维生素 D 水平低于 18.4 纳克/毫升的个体 COVID-19 阳性风险高出 2.448 倍(P < 0.001)。两组人的 Fok1 和 Taq1 基因多态性无明显差异。(P = 0.548 和 P = 0.098)。COVID-19 阳性组有 40 人(40%)患有合并症,明显高于阴性组的 10 人(10%)(P < 0.001)。结论研究发现,维生素 D 水平高于 18.4 纳克/毫升的临界值可预防 COVID-19,而合并疾病的存在被认为是一个风险因素。然而,在 Fok1 和 Taq1 多态性与 COVID-19 易感性之间未发现任何关联。
{"title":"Vitamin D Deficiency and Receptor Polymorphisms as Risk Factors for COVID-19","authors":"Nur Efe Iris, Ozlem Akman, Demet Akin, Palmet Gun Atak, Ahmed Cihad Genc, Funda Simsek, T. Yıldırmak, G. Demircan","doi":"10.5812/jjm-140726","DOIUrl":"https://doi.org/10.5812/jjm-140726","url":null,"abstract":"Background: Early immune responses to COVID-19 can help eliminate the virus; therefore, strategies to improve the immune system have become important in disease prevention. Vitamin D plays a crucial role in the immune response to SARS-CoV-2 by increasing the expression of the vitamin D receptor. Objectives: This study investigated the impact of vitamin D deficiency, Fok 1, and Taq 1 Vitamin D Receptor (VDR) gene polymorphisms and comorbidities on the susceptibility to COVID-19. Methods: Fok1 and Taq1 polymorphisms were analyzed using the RT-PCR method, and vitamin D levels were measured using the chemiluminescence method. A total of 200 patients, 100 with COVID-19 and 100 without, provided blood samples for analysis. Results: The COVID-19 positive group had a significantly lower mean vitamin D level of 16.2 ± 11.3 ng/mL compared to the COVID-19 negative control group, 26.7 ± 15.9 ng/mL (P < 0.001). Individuals with a vitamin D level below 18.4 ng/mL had a 2.448 times higher risk of COVID-19 positivity (P < 0.001). There was no significant difference in the Fok1 and Taq1 gene polymorphisms between the two groups. (P = 0.548 and P = 0.098). The COVID-19 positive group had a significantly higher number of comorbid diseases with 40 (40%) compared to the negative group with 10 (10%) participants (P < 0.001). Conclusions: Levels of vitamin D above the cut-off value of 18.4 ng/mL were found to protect against COVID-19, while the presence of comorbid diseases was identified as a risk factor. However, no association was observed between the Fok1 and Taq1 polymorphisms and susceptibility to COVID-19.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139092","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}
Seyyed Alireza Fahimzad, A. Karimi, S. Nadji, Najmeh Tavousi, M. Abedini, Roghayeh Amini, A. Hosseininasab, Fatemeh Hosseininasab, K. Ghadiri, Roya Chegene Lorestani Sha Masoomshahi, M. Aelami, B. Abdinia, H. Hashemian, M. S. Rezai, Anahita Sanaei Dashti, Z. Pourmoghaddas
Background: To the best of our knowledge, the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRM) in Iranian children has not been investigated. Objectives: The present study aimed to evaluate the prevalence of MRM in Iranian children with community-acquired pneumonia (CAP). Methods: A total of 222 children with CAP, aged 3 - 15 years, who were hospitalized in 10 different children's hospitals, were enrolled in this study. Mycoplasmas were detected using the polymerase chain reaction (PCR) assay. The severity of CAP was evaluated according to the Infectious Diseases Society of America (IDSA) guidelines. The level of C-reactive protein (CRP) was also measured by the particle-enhanced turbidimetric immunoassay. Additionally, the chest X-rays of children with CAP were recorded and sent to a radiologist for further evaluation. Results: Twenty-one children (9.4%) diagnosed with CAP also had M. pneumoniae infection, 17 (77.27%) of whom were positive for A2063G transition and high-level macrolide resistance. The severity of CAP (P ≥ 0.99), CRP level (0.07), and chest X-ray changes (P = 0.08) were not significantly different between children with MRM pneumonia and those with macrolide-susceptible M. pneumoniae. Conclusions: The prevalence of high-level MRM pneumonia in children is high in Iran, similar to other Asian countries. However, this type of Mycoplasma infection was not associated with the severity of CAP and did not have significant effects on chest X-ray (CXR) changes or the CRP level in the patients.
{"title":"Macrolide-resistant Mycoplasma pneumoniae in an Iranian Pediatric Sample with Community-Acquired Pneumonia","authors":"Seyyed Alireza Fahimzad, A. Karimi, S. Nadji, Najmeh Tavousi, M. Abedini, Roghayeh Amini, A. Hosseininasab, Fatemeh Hosseininasab, K. Ghadiri, Roya Chegene Lorestani Sha Masoomshahi, M. Aelami, B. Abdinia, H. Hashemian, M. S. Rezai, Anahita Sanaei Dashti, Z. Pourmoghaddas","doi":"10.5812/jjm-137413","DOIUrl":"https://doi.org/10.5812/jjm-137413","url":null,"abstract":"Background: To the best of our knowledge, the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRM) in Iranian children has not been investigated. Objectives: The present study aimed to evaluate the prevalence of MRM in Iranian children with community-acquired pneumonia (CAP). Methods: A total of 222 children with CAP, aged 3 - 15 years, who were hospitalized in 10 different children's hospitals, were enrolled in this study. Mycoplasmas were detected using the polymerase chain reaction (PCR) assay. The severity of CAP was evaluated according to the Infectious Diseases Society of America (IDSA) guidelines. The level of C-reactive protein (CRP) was also measured by the particle-enhanced turbidimetric immunoassay. Additionally, the chest X-rays of children with CAP were recorded and sent to a radiologist for further evaluation. Results: Twenty-one children (9.4%) diagnosed with CAP also had M. pneumoniae infection, 17 (77.27%) of whom were positive for A2063G transition and high-level macrolide resistance. The severity of CAP (P ≥ 0.99), CRP level (0.07), and chest X-ray changes (P = 0.08) were not significantly different between children with MRM pneumonia and those with macrolide-susceptible M. pneumoniae. Conclusions: The prevalence of high-level MRM pneumonia in children is high in Iran, similar to other Asian countries. However, this type of Mycoplasma infection was not associated with the severity of CAP and did not have significant effects on chest X-ray (CXR) changes or the CRP level in the patients.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138611625","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}
Fatemeh Sadat Zarkesh Esfahani, F. Ghandehari, Bahram Nasr Esfahani, K. Beheshti-Maal
Background: In hospitals and communities, Methicillin-resistant Staphylococcus aureus (MRSA) plays a critical role due to its ability to acquire resistance against several antibiotics and play a role in the spread of diseases. Objectives: This research aimed to investigate the pattern of antibiotic resistance in MRSA isolates and perform molecular typing of MRSA isolates using various elements, including SCCmec type, ccr type, prophage type, and gene toxin profiles. Methods: The research spanned 20 months at Al-Zahra Hospital in Isfahan and involved 148 isolates from various anatomical sites. The isolates were evaluated for their antibiotic susceptibility patterns. They were characterized by screening for SCCmec typing, ccr typing, phage typing, and PCR profiling of pvl, hlb, sak, eta, and tst toxin genes. Results: From 148 total S. aureus isolates, 42% (n = 62) were methicillin-resistant. The MRSA isolates demonstrated substantial resistance to penicillin and ciprofloxacin, and 90.3% of MRSA isolates were multiple-drug resistant. Also, SCCmec types III, I, and IV were identified in 45.16%, 35.48%, and 19.35% of MRSA isolates, respectively. Also, seven prophage patterns and 15 toxin patterns were detected among MRSA isolates. Conclusions: Multi-drug resistance is common among MRSA isolates. The only effective drug among the investigated antibiotics was chloramphenicol. The MRSA isolates can be controlled by changing the prescribing procedure of antibiotics and applying infection control strategies. The studied MRSA isolates can cause a wide range of diseases due to having several bacteriophages that encode virulence factors. Identification of different types of prophages may be useful in predicting such pathogenic agents.
{"title":"Molecular Characterization and Phage Typing of Methicillin-resistant Staphylococcus aureus Isolated from Clinical Samples in Isfahan, Iran","authors":"Fatemeh Sadat Zarkesh Esfahani, F. Ghandehari, Bahram Nasr Esfahani, K. Beheshti-Maal","doi":"10.5812/jjm-139277","DOIUrl":"https://doi.org/10.5812/jjm-139277","url":null,"abstract":"Background: In hospitals and communities, Methicillin-resistant Staphylococcus aureus (MRSA) plays a critical role due to its ability to acquire resistance against several antibiotics and play a role in the spread of diseases. Objectives: This research aimed to investigate the pattern of antibiotic resistance in MRSA isolates and perform molecular typing of MRSA isolates using various elements, including SCCmec type, ccr type, prophage type, and gene toxin profiles. Methods: The research spanned 20 months at Al-Zahra Hospital in Isfahan and involved 148 isolates from various anatomical sites. The isolates were evaluated for their antibiotic susceptibility patterns. They were characterized by screening for SCCmec typing, ccr typing, phage typing, and PCR profiling of pvl, hlb, sak, eta, and tst toxin genes. Results: From 148 total S. aureus isolates, 42% (n = 62) were methicillin-resistant. The MRSA isolates demonstrated substantial resistance to penicillin and ciprofloxacin, and 90.3% of MRSA isolates were multiple-drug resistant. Also, SCCmec types III, I, and IV were identified in 45.16%, 35.48%, and 19.35% of MRSA isolates, respectively. Also, seven prophage patterns and 15 toxin patterns were detected among MRSA isolates. Conclusions: Multi-drug resistance is common among MRSA isolates. The only effective drug among the investigated antibiotics was chloramphenicol. The MRSA isolates can be controlled by changing the prescribing procedure of antibiotics and applying infection control strategies. The studied MRSA isolates can cause a wide range of diseases due to having several bacteriophages that encode virulence factors. Identification of different types of prophages may be useful in predicting such pathogenic agents.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139201220","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}
WangQiang Hu, Han Chen, Dan Zhang, Fangyou Yu, Mingpeng Hu, Zhou Zheng
Background: The emergence of resistance to azithromycin complicates the treatment of Neisseria gonorrhoeae, the causative agent of gonorrhea. Objectives: The main objective of this study was to investigate the impact of mutations in different sites of the rplD gene on azithromycin resistance (AZM-R) and the molecular characteristics of N. gonorrhoeae. This study aimed to provide evidence for drug resistance and transmission. Methods: A total of 37 isolates of N. gonorrhoeae were collected within January 2018 to December 2020. These isolates were obtained from urine, semen, or vaginal secretions of different patients. Azithromycin resistance was assessed, and genes associated with AZM-R, namely rplD, and rplV, were analyzed using polymerase chain reaction (PCR) and deoxyribonucleic acid (DNA) sequencing. All clinical isolates were characterized through multi-locus sequence typing (MLST). Results: The study comprised 21 azithromycin-resistant N. gonorrhoeae isolates, with two of them demonstrating high resistance, indicated by a minimum inhibitory concentration (MIC) greater than 256 µg/mL. Additionally, 16 sensitive isolates were included in the study. Ten isolates were observed to have rplD point mutations, including mutations such as G70D, G70S, G68D, and A43T. No mutations were detected in rplV. The rate of point mutations in rplD was significantly different between the azithromycin-sensitive (AZM-S) group and the AZM-R group (P < 0.05). Among the 37 isolates studied, 12 distinct MLST types were identified and further grouped into four different MLST goeBURST groups. The two isolates with high-level AZM-R were ST1901 and ST1588, respectively. Conclusions: The clinical isolates of N. gonorrhoeae from Wenzhou, Eastern China, exhibit significant genetic diversity and a relatively high prevalence of AZM-R. Mutations in the rplD gene were identified, which reduced susceptibility to macrolides and were significantly associated with increased AZM-R.
{"title":"Molecular Characteristics and the Effect of Mutations in Different Sites of the rplD Gene Among Clinical Isolates of Azithromycin Resistance Neisseria gonorrhoeae in Eastern China","authors":"WangQiang Hu, Han Chen, Dan Zhang, Fangyou Yu, Mingpeng Hu, Zhou Zheng","doi":"10.5812/jjm-140659","DOIUrl":"https://doi.org/10.5812/jjm-140659","url":null,"abstract":"Background: The emergence of resistance to azithromycin complicates the treatment of Neisseria gonorrhoeae, the causative agent of gonorrhea. Objectives: The main objective of this study was to investigate the impact of mutations in different sites of the rplD gene on azithromycin resistance (AZM-R) and the molecular characteristics of N. gonorrhoeae. This study aimed to provide evidence for drug resistance and transmission. Methods: A total of 37 isolates of N. gonorrhoeae were collected within January 2018 to December 2020. These isolates were obtained from urine, semen, or vaginal secretions of different patients. Azithromycin resistance was assessed, and genes associated with AZM-R, namely rplD, and rplV, were analyzed using polymerase chain reaction (PCR) and deoxyribonucleic acid (DNA) sequencing. All clinical isolates were characterized through multi-locus sequence typing (MLST). Results: The study comprised 21 azithromycin-resistant N. gonorrhoeae isolates, with two of them demonstrating high resistance, indicated by a minimum inhibitory concentration (MIC) greater than 256 µg/mL. Additionally, 16 sensitive isolates were included in the study. Ten isolates were observed to have rplD point mutations, including mutations such as G70D, G70S, G68D, and A43T. No mutations were detected in rplV. The rate of point mutations in rplD was significantly different between the azithromycin-sensitive (AZM-S) group and the AZM-R group (P < 0.05). Among the 37 isolates studied, 12 distinct MLST types were identified and further grouped into four different MLST goeBURST groups. The two isolates with high-level AZM-R were ST1901 and ST1588, respectively. Conclusions: The clinical isolates of N. gonorrhoeae from Wenzhou, Eastern China, exhibit significant genetic diversity and a relatively high prevalence of AZM-R. Mutations in the rplD gene were identified, which reduced susceptibility to macrolides and were significantly associated with increased AZM-R.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139210457","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}