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Phenotypic and Molecular Detection of Carbapenemase-Producing Klebsiella pneumoniae Isolated from Patients Admitted to Teaching Hospitals in Shiraz, Iran 从伊朗设拉子教学医院收治的患者中分离出的产碳青霉烯酶肺炎克雷伯菌的表型和分子检测
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2024-02-06 DOI: 10.5812/jjm-142449
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.
背景:耐碳青霉烯类肺炎克雷伯氏菌(Cr-KPN)对全球公共卫生构成重大挑战。研究目的本研究旨在调查从伊朗设拉子教学医院收治的患者中分离出的耐碳青霉烯类肺炎克雷伯菌(Cr-KPN)中碳青霉烯类酶编码基因的流行率和表达水平。研究方法从设拉子的两家教学医院共收集了 671 份不同的临床样本。肺炎克氏菌分离物的初步鉴定和最终确认分别采用传统的生化检验和 PCR 检测方法进行。通过改良碳青霉烯类灭活方法(mCIM)和多重 PCR 检测法从表型和基因型上检测产碳青霉烯酶的肺炎双球菌。利用实时 PCR 评估碳青霉烯酶编码基因的表达水平。结果mCIM显示,26%的肺炎克雷伯菌分离株有碳青霉烯酶产生。此外,分别有 24% 和 17% 的肺炎克雷伯菌株表现出对亚胺培南和美罗培南的耐药性。91% 的分离菌株检测到 blaIMI/IMP 基因。在亚胺培南耐药分离物中,62.5%的分离物检测出 blaOXA-48 基因阳性。此外,分别有 29.4%、76.5% 和 11.8% 的美罗培南耐药分离物的 blaKPC、blaOXA-48 和 blaNDM 基因呈阳性。实时 PCR 分析显示,耐药分离物在接触亚胺培南后,其 blaKPC(1.66 倍)、blaOXA-48(7.30 倍)、blaNDM(4.22 倍)和 blaIMI/NMC (2.39 倍)基因的表达水平均有所提高。结论这些发现强调了建立积极的监测网络以监测和追踪产碳青霉烯酶肺炎克氏菌传播的重要性,因为肺炎克氏菌已对全球公共卫生构成威胁。
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引用次数: 0
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 维生素 C、D 和 E 血清水平以及 IgG 和 IgM 抗体对接种 COVID-19 疫苗且疾病复发者的保护作用
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2024-01-17 DOI: 10.5812/jjm-142026
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。
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引用次数: 0
Evaluation of the Effects of Dielectric Barrier Discharge Plasma on Candida albicans Strains: An in vitro Study 评估介质阻挡放电等离子体对白色念珠菌菌株的影响:体外研究
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2024-01-15 DOI: 10.5812/jjm-142236
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.
背景:抗真菌耐药性正在增加,给治疗念珠菌病带来了挑战。冷大气等离子体(CAP)是一种潜在的替代疗法,但人们对它与传统抗真菌药物之间的关系知之甚少。研究目的本研究旨在评估介质阻挡放电(DBD)等离子体对白色念珠菌的影响。方法:在这项体外研究中,用 DBD 等离子体照射白色念珠菌菌株 5、10 和 15 分钟,同时使用或不使用奈司他丁。计数菌落数量,并用 MTT 法评估白色念珠菌的存活率。数据用 SPSS26 进行分析。结果研究结果表明,在两个实验组中,无论是使用还是不使用硝司他丁,在暴露于 DBD 10 分钟后,观察到血浆处理组的白色念珠菌细胞存活率最低(P < 0.001)。阳性对照组(未暴露于等离子体的硝司他丁)与经过 10 分钟等离子体照射但未暴露于硝司他丁的组相比,存活细胞数量减少(P < 0.001)。与 5 分钟 DBD 照射组和阴性对照组相比,10 分钟和 15 分钟 DBD 血浆照射组及其阳性对照组的菌落数量在统计学上显著减少(P < 0.001)。结论:在降低白僵菌细胞活力方面,硝司他丁比 DBD 等离子照射更有效。在降低白僵菌存活率方面,10 分钟 DBD 等离子辐照与硝司他丁联合使用比 5 分钟或 15 分钟辐照更有效。
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引用次数: 0
Examining the Changes in Coagulation Parameters in Patients Infected with SARS-CoV-2 Variants (Alpha, Beta, Delta, and Omicron) 研究 SARS-CoV-2 变体(Alpha、Beta、Delta 和 Omicron)感染者凝血参数的变化
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2024-01-11 DOI: 10.5812/jjm-142213
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.
背景:众所周知,凝血参数的变化对 COVID-19 患者的死亡率和预后有影响。自大流行开始以来,SARS-CoV-2 病毒的基因组发生了变异,由此产生的变种已被世界卫生组织记录在案。随着这些变异,疾病的临床严重程度和实验室参数也发生了变化。研究目的在本研究中,我们研究了 SARS-CoV-2 Alpha(B.1.1.7)、Beta(B.1.351)Delta(B.1.617.2)和 Omicron(B.1.1.529)变种之间 D-二聚体水平、纤维蛋白原水平、血小板计数(PLT)和平均血小板体积(MPV)的变化。研究方法本研究对 28 195 名感染 SARS-CoV-2 的成年患者进行了回顾性研究。申请时,收集了年龄、性别、SARS-CoV-2 变异状态、D-二聚体水平(n = 7090)、纤维蛋白原(n = 5709)、PLT(n = 7066)和 MPV(n = 8330)的数据。根据α、β、δ和Ω变体对患者进行分类。对变异体的变化进行统计分析。结果显示女性中 delta 变体的发生率高于其他变体,其次是 alpha 和 omicron(P = 0.001)。男性的贝塔变体检出率较高。奥米克龙变体病例的年龄高于阿尔法、贝塔和德尔塔变体病例(P = 0.001、P = 0.001、P = 0.001 和 P <0.01)。在实验室参数方面,Delta 和 Omicron 变体的 D-二聚体和纤维蛋白原水平明显较高。与阿尔法和贝塔变异型相比,德尔塔和奥米克龙变异型的 PLT 和 MPV 更低。结论根据变异型对实验室凝血参数变化的研究表明,从α到Ω变异型,凝血倾向会增加。
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引用次数: 0
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 伊朗设拉子大流行最后一波期间突破性感染的医护人员 SARS-CoV-2 感染的分子、免疫学和临床特征分析
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2024-01-10 DOI: 10.5812/jjm-142644
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.
背景:2019 年冠状病毒病(COVID-19)对全球经济和公众健康构成威胁。病毒尖峰蛋白的突变会影响疫苗的功能特性和有效性。研究目的本研究旨在分析尖峰蛋白三个关键区域的突变,调查临床表现,并评估已接种足量疫苗但再次感染的医护人员(HCWs)的保护性免疫水平。研究方法在这项横断面研究中,从 2021 年 11 月到 2022 年 5 月,共纳入了 49 名突破性感染的医护人员。在确认 COVID-19 再次感染后,使用 ROJE 提取试剂盒提取了 SARS-CoV-2 基因组,并通过 Sanger 测序进行了基因变异分析。在事先征得同意的情况下采集血液样本,并进行 ELISA 检测以确定抗体水平。记录临床表现,独立 t 检验显示 C 端点突变无明显性别差异。研究结果在本研究中,75.5%(37/49)被纳入的高危产妇为女性(P 值<0.05),25 人符合 PCR 和基因测序条件。在 S1 基因的 C 端结构域、N 端结构域和 RBD 区域,分别有 25 个、10 个和 1 个序列发生了突变。这些基因突变与患者的性别、年龄或职业没有明显的相关性,但在有潜在疾病的患者中,突变的发生率明显更高。63.3%的患者(31/49)IgG水平较高或很高,没有人在再次感染时检测不到抗体水平。嗅觉丧失(69.4% - 34/49)、咽喉痛(65.3% - 32/49)、头痛(59.2% - 29/49)和咳嗽(57.1% - 28/49)是突破性感染的高危工人最常见的临床表现(P > 0.05),这与 Omicron 波中的症状模式一致。然而,味觉丧失在临床表现方面有显著结果(P < 0.05)。突变检查显示,大多数个体存在奥米克龙变异。C端区域的点突变在年龄、性别或疫苗类型上没有明显差异。疫苗类型与临床症状之间无明显差异。结论:总之,本研究在接种过疫苗的医护人员的再感染中发现了尖峰蛋白突变。虽然突变很普遍,但与人口统计学或疫苗类型没有发现明显的相关性。症状与 Omicron 变异相似,尤其是味觉丧失是一个重要标志。再感染后可检测到的抗体水平表明,疫苗诱导的免疫力仍然很强。面对不断演变的病毒株,持续监测病毒变种对于优化疫苗接种策略至关重要。
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引用次数: 0
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 研究烧伤患者铜绿假单胞菌分离物中碳青霉烯耐药基因的频率及其与包括 I 类和 II 类在内的不同类型整合子的关系
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2024-01-02 DOI: 10.5812/jjm-140912
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。
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引用次数: 0
Vitamin D Deficiency and Receptor Polymorphisms as Risk Factors for COVID-19 维生素 D 缺乏和受体多态性是 COVID-19 的风险因素
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-12-30 DOI: 10.5812/jjm-140726
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}
引用次数: 0
Macrolide-resistant Mycoplasma pneumoniae in an Iranian Pediatric Sample with Community-Acquired Pneumonia 伊朗社区获得性肺炎儿科样本中的耐大环内酯肺炎支原体
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-12-01 DOI: 10.5812/jjm-137413
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.
背景:据我们所知,伊朗儿童的大环内酯耐药肺炎支原体(MRM)患病率尚未调查。目的:本研究旨在评估伊朗社区获得性肺炎(CAP)儿童MRM的患病率。方法:选取10所儿童医院收治的222例3 ~ 15岁CAP患儿为研究对象。采用聚合酶链反应(PCR)法检测支原体。根据美国传染病学会(IDSA)指南评估CAP的严重程度。c反应蛋白(CRP)水平也通过颗粒增强浊度免疫分析法测定。此外,还记录了CAP患儿的胸部x光片,并将其发送给放射科医生进行进一步评估。结果:21例确诊为CAP的患儿(9.4%)同时存在肺炎支原体感染,其中17例(77.27%)A2063G转化阳性,且大环内酯类药物耐药水平较高。MRM肺炎患儿的CAP严重程度(P≥0.99)、CRP水平(0.07)、胸片变化(P = 0.08)与大环内酯敏感肺炎支原体患儿无显著差异。结论:伊朗儿童高水平MRM肺炎患病率高,与其他亚洲国家相似。然而,这种类型的支原体感染与CAP的严重程度无关,对患者的胸部x光片(CXR)变化或CRP水平没有显著影响。
{"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}
引用次数: 0
Molecular Characterization and Phage Typing of Methicillin-resistant Staphylococcus aureus Isolated from Clinical Samples in Isfahan, Iran 从伊朗伊斯法罕临床样本中分离出的耐甲氧西林金黄色葡萄球菌的分子特征和噬菌体分型
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-11-30 DOI: 10.5812/jjm-139277
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.
背景:在医院和社区中,耐甲氧西林金黄色葡萄球菌(MRSA)由于能够获得对多种抗生素的耐药性,在疾病传播中扮演着重要角色。研究目的本研究旨在调查 MRSA 分离物的抗生素耐药性模式,并利用各种要素(包括 SCCmec 类型、ccr 类型、噬菌体类型和基因毒素图谱)对 MRSA 分离物进行分子分型。研究方法研究在伊斯法罕的扎赫拉医院进行,历时 20 个月,涉及来自不同解剖部位的 148 个分离株。对分离物的抗生素敏感性模式进行了评估。通过筛查 SCCmec 分型、ccr 分型、噬菌体分型以及 pvl、hlb、sak、eta 和 tst 毒素基因的 PCR 分析,对这些分离物进行鉴定。结果在总共 148 个金黄色葡萄球菌分离物中,42%(n = 62)具有耐甲氧西林性。MRSA分离株对青霉素和环丙沙星有很强的耐药性,90.3%的MRSA分离株具有多重耐药性。此外,在 45.16%、35.48% 和 19.35% 的 MRSA 分离物中分别发现了 SCCmec III、I 和 IV 型。此外,在 MRSA 分离物中还检测到 7 种噬菌体模式和 15 种毒素模式。结论:MRSA分离株普遍具有多重耐药性。在所调查的抗生素中,唯一有效的药物是氯霉素。可通过改变抗生素处方程序和应用感染控制策略来控制 MRSA 分离物。所研究的 MRSA 分离物由于含有多种编码毒力因子的噬菌体,可导致多种疾病。鉴定不同类型的噬菌体可能有助于预测此类致病因子。
{"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}
引用次数: 0
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 华东地区耐阿奇霉素淋病奈瑟菌临床分离株rplD基因不同位点突变的分子特征及其影响
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-11-29 DOI: 10.5812/jjm-140659
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.
背景:阿奇霉素耐药性的出现使淋病病原体淋病奈瑟菌的治疗变得复杂。研究目的本研究的主要目的是调查 rplD 基因不同位点的突变对阿奇霉素耐药性(AZM-R)和淋病奈瑟菌分子特征的影响。本研究旨在为耐药性和传播提供证据。研究方法在2018年1月至2020年12月期间共收集了37株淋球菌分离株。这些分离物来自不同患者的尿液、精液或阴道分泌物。通过聚合酶链式反应(PCR)和脱氧核糖核酸(DNA)测序,对阿奇霉素耐药性进行了评估,并分析了与AZM-R相关的基因,即rplD和rplV。通过多焦点序列分型(MLST)对所有临床分离株进行了鉴定。研究结果该研究包括 21 个耐阿奇霉素的淋球菌分离株,其中两个表现出高度耐药性,最低抑菌浓度 (MIC) 超过 256 µg/mL。此外,研究还包括 16 个敏感分离株。观察到 10 个分离株有 rplD 点突变,包括 G70D、G70S、G68D 和 A43T 等突变。在 rplV 中未检测到突变。阿奇霉素敏感(AZM-S)组与 AZM-R 组之间的 rplD 点突变率存在显著差异(P < 0.05)。在研究的 37 个分离株中,发现了 12 种不同的 MLST 类型,并进一步分为 4 个不同的 MLST goeBURST 组。两个具有高水平 AZM-R 的分离物分别是 ST1901 和 ST1588。结论来自中国东部温州的淋球菌临床分离株表现出显著的遗传多样性和较高的 AZM-R 感染率。研究发现,rplD基因突变会降低对大环内酯类药物的敏感性,并与AZM-R的增加显著相关。
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引用次数: 0
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Jundishapur Journal of Microbiology
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