Farzad Mohammadi Ebli, Z. Heshmatipour, K. Daneshjou, S. Siadat
Background: Nosocomial infections have increased among patients admitted to the intensive care unit (ICU). Objectives: This study investigated the microbiota pattern of the respiratory system in hospitalized patients with treatment-resistant respiratory infections compared to those without treatment-resistant respiratory infections. Methods: This case-control study utilized sputum samples from hospital-acquired infection (HAI) and non-HAI (NHAI) patients over 52 years old hospitalized in the ICU. Identification and determination of the drug sensitivity of the bacteria responsible for treatment-resistant respiratory infections were made by culture method in selective and differential media and VITEK 2 device. Finally, quantitative polymerase chain reaction (qPCR) was used to analyze the microbiota of the respiratory system. Results: Excessive prescription of antibiotics, long hospitalization, and history of surgery were important risk factors for nosocomial infections. The study of antibiotic resistance of pathogens causing hospital infections indicated their high resistance to most common antibiotics. Also, nosocomial infections led to a change in lung microbiota in HAI patients. The frequencies of Streptococcus pyogenes, S. pneumoniae, and Haemophilus influenzae were higher in patients with treatment-resistant respiratory infection (P < 0.05), but the frequency of Neisseria spp. was higher in patients without treatment-resistant respiratory infection (P < 0.05). Conclusions: The pathogens responsible for nosocomial infections had acquired resistance to a wide range of antibiotics, leading to changes in their respiratory microbiota.
{"title":"Comparison of Respiratory Microbiota in Patients with and Without Hospital-Acquired Infection","authors":"Farzad Mohammadi Ebli, Z. Heshmatipour, K. Daneshjou, S. Siadat","doi":"10.5812/jjm-133257","DOIUrl":"https://doi.org/10.5812/jjm-133257","url":null,"abstract":"Background: Nosocomial infections have increased among patients admitted to the intensive care unit (ICU). Objectives: This study investigated the microbiota pattern of the respiratory system in hospitalized patients with treatment-resistant respiratory infections compared to those without treatment-resistant respiratory infections. Methods: This case-control study utilized sputum samples from hospital-acquired infection (HAI) and non-HAI (NHAI) patients over 52 years old hospitalized in the ICU. Identification and determination of the drug sensitivity of the bacteria responsible for treatment-resistant respiratory infections were made by culture method in selective and differential media and VITEK 2 device. Finally, quantitative polymerase chain reaction (qPCR) was used to analyze the microbiota of the respiratory system. Results: Excessive prescription of antibiotics, long hospitalization, and history of surgery were important risk factors for nosocomial infections. The study of antibiotic resistance of pathogens causing hospital infections indicated their high resistance to most common antibiotics. Also, nosocomial infections led to a change in lung microbiota in HAI patients. The frequencies of Streptococcus pyogenes, S. pneumoniae, and Haemophilus influenzae were higher in patients with treatment-resistant respiratory infection (P < 0.05), but the frequency of Neisseria spp. was higher in patients without treatment-resistant respiratory infection (P < 0.05). Conclusions: The pathogens responsible for nosocomial infections had acquired resistance to a wide range of antibiotics, leading to changes in their respiratory microbiota.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45297229","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}
M. Nakhaie, E. Taheri, J. Charostad, Nasir Arefinia, D. Kalantar-Neyestanaki, Mohammad Rezaei Zadeh Rukerd, F. Ahmadpour, Mohamad Hossein Pourebrahimi, Sara Ahmadinejad Farsangi, Sara Shafieipour
Background: Hepatitis C virus (HCV) is one of the most common infections in hemodialysis patients, which has been associated with increased incidence of morbidity and mortality, particularly in low- and middle-income countries. Objectives: The current study aimed to evaluate the HCV antibody, occult HCV infection (OCI), and related risk factors among hemodialysis patients. Methods: In this cross-sectional study, 100 hemodialysis patients referred to a dialysis center in Kerman between December 2021 and March 2022 were assessed for HCV, OCI, and their related risk factors. The information related to risk factors was collected by questionnaire, while HCV and OCI were detected through serology and real-time polymerase chain reaction (PCR) methods, respectively. Results: Among the patients participating in the study, 61 were men, and 39 were women. The average age was 58.1 ± 14.9 years in men and 63.6 ± 11.4 years in women. Diabetes and hypertension history, old age, low education, self-employment, and urban living were more common in chronic kidney disease patients. The enzyme-linked immunosorbent assay (ELISA) revealed 3% positive seroprevalence HCV infection, but only 1% was positive for OCI. Although no statistically significant relationship was found between the presence of HCV (antibody and OCI) and other parameters, all positive HCV cases were identified in patients with low education and freelance employment. Conclusions: Hemodialysis patients had a low prevalence of HCV antibody and OCI. Improving various factors and conditions such as lifestyle, occupation, educational level, and dialysis ward and machine disinfection could be beneficial in managing and controlling hemodialysis complications such as HCV and OCI.
{"title":"Prevalence of Hepatitis C Virus and Its Occult Infection in Hemodialysis Patients","authors":"M. Nakhaie, E. Taheri, J. Charostad, Nasir Arefinia, D. Kalantar-Neyestanaki, Mohammad Rezaei Zadeh Rukerd, F. Ahmadpour, Mohamad Hossein Pourebrahimi, Sara Ahmadinejad Farsangi, Sara Shafieipour","doi":"10.5812/jjm-136504","DOIUrl":"https://doi.org/10.5812/jjm-136504","url":null,"abstract":"Background: Hepatitis C virus (HCV) is one of the most common infections in hemodialysis patients, which has been associated with increased incidence of morbidity and mortality, particularly in low- and middle-income countries. Objectives: The current study aimed to evaluate the HCV antibody, occult HCV infection (OCI), and related risk factors among hemodialysis patients. Methods: In this cross-sectional study, 100 hemodialysis patients referred to a dialysis center in Kerman between December 2021 and March 2022 were assessed for HCV, OCI, and their related risk factors. The information related to risk factors was collected by questionnaire, while HCV and OCI were detected through serology and real-time polymerase chain reaction (PCR) methods, respectively. Results: Among the patients participating in the study, 61 were men, and 39 were women. The average age was 58.1 ± 14.9 years in men and 63.6 ± 11.4 years in women. Diabetes and hypertension history, old age, low education, self-employment, and urban living were more common in chronic kidney disease patients. The enzyme-linked immunosorbent assay (ELISA) revealed 3% positive seroprevalence HCV infection, but only 1% was positive for OCI. Although no statistically significant relationship was found between the presence of HCV (antibody and OCI) and other parameters, all positive HCV cases were identified in patients with low education and freelance employment. Conclusions: Hemodialysis patients had a low prevalence of HCV antibody and OCI. Improving various factors and conditions such as lifestyle, occupation, educational level, and dialysis ward and machine disinfection could be beneficial in managing and controlling hemodialysis complications such as HCV and OCI.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47790979","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}
Samaneh Salarvand, A. Abdollahi, Masoumeh Doraghi, Seyed Amir Miratashi Yazdi, Z. Panahi, S. Mortazavi, E. Nazar
Background: Patients undergoing orthopedic surgery are at risk of nosocomial infections, and antibiotic resistance is known to increase the risk of such infections. Objectives: We aimed to determine the rate of antibiotic resistance in patients admitted to orthopedic wards in one of the largest referral hospitals in Iran. We also ascertained responsible antibiotic-resistant microorganisms in patients with bone and joint infections. Methods: The present cross-sectional investigation was concluded over a period of five years, from March 2018 to March 2022, at a great referral hospital in Tehran. Laboratory data, including the organisms isolated and their antibiotic resistance patterns, were collected by reviewing the hospital information system. Results: In total, 2650 specimens obtained from patients with suspected bacterial infections were transferred to the hospital’s laboratory, 880 (33.2%) of which were positive for bacterial infections. The maximum antibiotic resistance rate against an antibiotic was observed to be 58% for Staphylococcus aureus (erythromycin), 75% for Klebsiella pneumonia (ampicillin/sulbactam), 64.5% for Escherichia coli (imipenem), 76.2% for coagulase-negative Staphylococcus (vancomycin), 100% for Acinetobacter baumannii (imipenem), 52% for S. epidermidis (erythromycin), 85.9% for Enterobacter species (gentamycin), and 65.6% for Pseudomonas aeruginosa (ampicillin/sulbactam). The overall rate of multi-drug resistance was obtained as 27.6%. Conclusions: A high rate of resistance of various bacterial strains to common antibiotics, especially erythromycin, ampicillin, imipenem, vancomycin, and gentamycin, was denoted in orthopedic wards. Also, a high rate of multi-antibiotic resistance was encountered in these wards, where more than a quarter of the bacterial strains showed such resistance.
{"title":"Microbiological Profile and Drug Resistance in Bone and Joint Infections: A Survey in Orthopedic Wards of a Great Referral Hospital in Tehran, Iran","authors":"Samaneh Salarvand, A. Abdollahi, Masoumeh Doraghi, Seyed Amir Miratashi Yazdi, Z. Panahi, S. Mortazavi, E. Nazar","doi":"10.5812/jjm-137125","DOIUrl":"https://doi.org/10.5812/jjm-137125","url":null,"abstract":"Background: Patients undergoing orthopedic surgery are at risk of nosocomial infections, and antibiotic resistance is known to increase the risk of such infections. Objectives: We aimed to determine the rate of antibiotic resistance in patients admitted to orthopedic wards in one of the largest referral hospitals in Iran. We also ascertained responsible antibiotic-resistant microorganisms in patients with bone and joint infections. Methods: The present cross-sectional investigation was concluded over a period of five years, from March 2018 to March 2022, at a great referral hospital in Tehran. Laboratory data, including the organisms isolated and their antibiotic resistance patterns, were collected by reviewing the hospital information system. Results: In total, 2650 specimens obtained from patients with suspected bacterial infections were transferred to the hospital’s laboratory, 880 (33.2%) of which were positive for bacterial infections. The maximum antibiotic resistance rate against an antibiotic was observed to be 58% for Staphylococcus aureus (erythromycin), 75% for Klebsiella pneumonia (ampicillin/sulbactam), 64.5% for Escherichia coli (imipenem), 76.2% for coagulase-negative Staphylococcus (vancomycin), 100% for Acinetobacter baumannii (imipenem), 52% for S. epidermidis (erythromycin), 85.9% for Enterobacter species (gentamycin), and 65.6% for Pseudomonas aeruginosa (ampicillin/sulbactam). The overall rate of multi-drug resistance was obtained as 27.6%. Conclusions: A high rate of resistance of various bacterial strains to common antibiotics, especially erythromycin, ampicillin, imipenem, vancomycin, and gentamycin, was denoted in orthopedic wards. Also, a high rate of multi-antibiotic resistance was encountered in these wards, where more than a quarter of the bacterial strains showed such resistance.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45885285","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: The composition of lung tissue microorganisms in patients with different tissue types of lung cancer has not yet been determined. Previous studies have shown changes in the composition of pulmonary microbial flora in patients with lung cancer. Objectives: This study aimed to investigate the differences and correlations in the microbial flora of pulmonary tissue among different histological types of lung cancer. Methods: Samples of tumor and normal lung tissue from 29 patients with early-stage lung cancer were collected. The samples were sequenced using Illumina HiSeq high throughput sequencing technology for 16S rDNA in the V4 region of the bacteria. Also, their microbiological characteristics were detected, and bioinformatics analysis was performed. Results: The results of microbial abundance analysis in the lung tissue of patients with lung cancer showed that the bacterial colony composition of the two tissues was similar, with Proteobacteria, Thickwalled Bacteria, Anomalococcus, Bacteroides, and Actinobacteria predominating. Analysis of microbial diversity found no difference in α diversity and β diversity between normal lung tissue and tumor tissue. When analyzing patients with adenocarcinoma, the abundance of Micrococcales and Blastomonas was significantly higher in tumor tissue than in normal lung tissue. Conclusions: The composition of microbial flora in different parts of lung tissue of early-stage lung cancer patients is consistent, but the dominant flora varies among different histological types of lung cancer.
{"title":"Microbial Diversity and Abundance in Pulmonary Tissue of Patients with Early-Stage Lung Cancer","authors":"Zhao Shouhua, L. Meilan","doi":"10.5812/jjm-137478","DOIUrl":"https://doi.org/10.5812/jjm-137478","url":null,"abstract":"Background: The composition of lung tissue microorganisms in patients with different tissue types of lung cancer has not yet been determined. Previous studies have shown changes in the composition of pulmonary microbial flora in patients with lung cancer. Objectives: This study aimed to investigate the differences and correlations in the microbial flora of pulmonary tissue among different histological types of lung cancer. Methods: Samples of tumor and normal lung tissue from 29 patients with early-stage lung cancer were collected. The samples were sequenced using Illumina HiSeq high throughput sequencing technology for 16S rDNA in the V4 region of the bacteria. Also, their microbiological characteristics were detected, and bioinformatics analysis was performed. Results: The results of microbial abundance analysis in the lung tissue of patients with lung cancer showed that the bacterial colony composition of the two tissues was similar, with Proteobacteria, Thickwalled Bacteria, Anomalococcus, Bacteroides, and Actinobacteria predominating. Analysis of microbial diversity found no difference in α diversity and β diversity between normal lung tissue and tumor tissue. When analyzing patients with adenocarcinoma, the abundance of Micrococcales and Blastomonas was significantly higher in tumor tissue than in normal lung tissue. Conclusions: The composition of microbial flora in different parts of lung tissue of early-stage lung cancer patients is consistent, but the dominant flora varies among different histological types of lung cancer.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41420017","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: NAP1/027 Clostridium difficile infection (CDI) has rarely been reported in China. Objectives: The objective of this study was to strengthen the understanding of the risk factors and outcomes of NAP1/027 CDI. Methods: A single-center, retrospective, case-control (1: 3) study was performed to identify risk factors and outcomes specific to NAP1/027 CDI using a group of patients with NAP1/027 CDI (n = 20) and a group of age-matched control patients with non-NAP1/027 CDI (n = 60) within June 2018 and August 2021. The patient charts were thoroughly reviewed to assess the markers of severity, risk factors, and outcomes. Results: Out of the 272 stool specimens, 41 cases (15.07%) tested positive for the NAP1 strain of C. difficile using the polymerase chain reaction. Among these specimens, 20 cases fulfilled the inclusion criteria. No significant difference was observed between the NAP1/027 and non-NAP1/027 groups in disease severity, length of hospital stay, or mortality. Logistic regression analysis revealed that risk factors for acquiring NAP1/027 infection included hospitalization in the 90 days before CDI diagnosis and high C-reactive protein level within ± 3 days of C. difficile detection. Conclusions: In a large non-epidemic tertiary hospital in China, NAP1/027 strains were more prevalent in patients with previous hospitalization and high CRP level than non-NAP1/027 strains.
{"title":"Clostridium difficile Infection Risk Factors and Outcomes Among Inpatients Infected with NAP1/BI/027 Strain Compared to Non-NAP1 Strain in a Major Chinese Hospital","authors":"Guangyue Yao, Wenjia Wang, Chunhong Shao, Jing Shao, Hui Fan, Yuanyuan Bai","doi":"10.5812/jjm-136904","DOIUrl":"https://doi.org/10.5812/jjm-136904","url":null,"abstract":"Background: NAP1/027 Clostridium difficile infection (CDI) has rarely been reported in China. Objectives: The objective of this study was to strengthen the understanding of the risk factors and outcomes of NAP1/027 CDI. Methods: A single-center, retrospective, case-control (1: 3) study was performed to identify risk factors and outcomes specific to NAP1/027 CDI using a group of patients with NAP1/027 CDI (n = 20) and a group of age-matched control patients with non-NAP1/027 CDI (n = 60) within June 2018 and August 2021. The patient charts were thoroughly reviewed to assess the markers of severity, risk factors, and outcomes. Results: Out of the 272 stool specimens, 41 cases (15.07%) tested positive for the NAP1 strain of C. difficile using the polymerase chain reaction. Among these specimens, 20 cases fulfilled the inclusion criteria. No significant difference was observed between the NAP1/027 and non-NAP1/027 groups in disease severity, length of hospital stay, or mortality. Logistic regression analysis revealed that risk factors for acquiring NAP1/027 infection included hospitalization in the 90 days before CDI diagnosis and high C-reactive protein level within ± 3 days of C. difficile detection. Conclusions: In a large non-epidemic tertiary hospital in China, NAP1/027 strains were more prevalent in patients with previous hospitalization and high CRP level than non-NAP1/027 strains.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42625789","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}
Xiuhong Zhang, Sihui Cai, C. Chang, Qiuhui Wang, Weizhen Qiao
Introduction: Fulminant myocarditis is a life-threatening disease among young patients. Pseudomonas aeruginosa is distributed in nature and is often spread as an opportunistic pathogen to cause hospital-acquired infections in patients with underlying diseases and low immunity. Case Presentation: This report presented a case of a 28-year-old woman with fulminant myocarditis followed by P. aeruginosa infection. After hospitalization, she received veno-arterial extracorporeal membrane oxygenation (ECMO) and continuous renal replacement treatment (CRRT). Initially, piperacillin sodium tazobactam combined with amikacin was used for anti-infection therapy, which had a poor clinical effect. Subsequently, it was recommended to use ceftazidime-avibactam and amikacin for treatment. Finally, the infection index of the patient returned to normal. Conclusions: It is necessary to select correct and effective drugs according to etiology, considering the influence of ECMO and CRRT on the patient’s antimicrobial pharmacokinetics/pharmacodynamics (PK/PD). This case could provide a reference for safe and rational drug use in clinical practice.
{"title":"Combination Therapy with Ceftazidime-Avibactam and Amikacin for Multidrug-Resistant Pseudomonas aeruginosa Infection with Fulminant Myocarditis in a Younger Patient: A Case Report and Literature Review","authors":"Xiuhong Zhang, Sihui Cai, C. Chang, Qiuhui Wang, Weizhen Qiao","doi":"10.5812/jjm-136894","DOIUrl":"https://doi.org/10.5812/jjm-136894","url":null,"abstract":"Introduction: Fulminant myocarditis is a life-threatening disease among young patients. Pseudomonas aeruginosa is distributed in nature and is often spread as an opportunistic pathogen to cause hospital-acquired infections in patients with underlying diseases and low immunity. Case Presentation: This report presented a case of a 28-year-old woman with fulminant myocarditis followed by P. aeruginosa infection. After hospitalization, she received veno-arterial extracorporeal membrane oxygenation (ECMO) and continuous renal replacement treatment (CRRT). Initially, piperacillin sodium tazobactam combined with amikacin was used for anti-infection therapy, which had a poor clinical effect. Subsequently, it was recommended to use ceftazidime-avibactam and amikacin for treatment. Finally, the infection index of the patient returned to normal. Conclusions: It is necessary to select correct and effective drugs according to etiology, considering the influence of ECMO and CRRT on the patient’s antimicrobial pharmacokinetics/pharmacodynamics (PK/PD). This case could provide a reference for safe and rational drug use in clinical practice.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45967007","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 Mohammad Hassan Aletayeb, M. Dehdashtian, A. Malakian, M. Aramesh, L. Kouti, Fateme Aletayeb
Background: One of the leading causes of neonatal mortality in low- and middle-income countries (LMICs) is neonatal sepsis caused by carbapenem-resistant gram-negative bacteria. Objectives: This study aimed to determine the frequency, bacterial profile, and outcome of carbapenem-resistant Gram-negative neonatal sepsis in southwest Iran. Methods: This 15-month retrospective cross-sectional descriptive study was conducted at a level 3 referral training hospital. The study included all neonates hospitalized from birth who had positive blood cultures for Gram-negative bacteria. Patients were divided into carbapenem-resistant and carbapenem-sensitive groups. Results: During the study, Gram-negative bacteria were isolated from the blood cultures of 113 neonates. Positive Gram-negative bacteria blood cultures and carbapenem-resistant cases were 2.38% and 1.52%, respectively. In these cases, 66 (58.4%) of the infants were males, 100 (88.4%) were preterm, and 74 (65.4%) required mechanical ventilation within the first three days of life. The study found 45 (39.8%) infants with early-onset sepsis. Acinetobacter was the most common isolated organism, while Enterobacter had the lowest isolation rate. Carbapenem resistance was discovered in 72 (63.7%) positive blood cultures. Acinetobacter had the highest prevalence of carbapenem resistance, while Pseudomonas had the lowest. Mortality rates in infants infected with carbapenem resistance bacteria (CRB) were 89.3% compared to 10.7% in those infected with carbapenem-sensitive bacteria (CSB). Conclusions: The frequency of carbapenem-resistant Gram-negative sepsis in our ward was 1.52 percent of all admissions, and Acinetobacter bacteria was the most common cause of this type of neonatal sepsis. Infants infected with CRB had a higher mortality rate than those infected with CSB, 89.3% versus 10.7%.
{"title":"Frequency, Bacteriological Profile, and Outcome of Neonatal Sepsis with Carbapenem-Resistant Gram-Negative Bacteria at the Tertiary Neonatal Intensive Care Unit, Ahvaz, Iran","authors":"Seyyed Mohammad Hassan Aletayeb, M. Dehdashtian, A. Malakian, M. Aramesh, L. Kouti, Fateme Aletayeb","doi":"10.5812/jjm-134278","DOIUrl":"https://doi.org/10.5812/jjm-134278","url":null,"abstract":"Background: One of the leading causes of neonatal mortality in low- and middle-income countries (LMICs) is neonatal sepsis caused by carbapenem-resistant gram-negative bacteria. Objectives: This study aimed to determine the frequency, bacterial profile, and outcome of carbapenem-resistant Gram-negative neonatal sepsis in southwest Iran. Methods: This 15-month retrospective cross-sectional descriptive study was conducted at a level 3 referral training hospital. The study included all neonates hospitalized from birth who had positive blood cultures for Gram-negative bacteria. Patients were divided into carbapenem-resistant and carbapenem-sensitive groups. Results: During the study, Gram-negative bacteria were isolated from the blood cultures of 113 neonates. Positive Gram-negative bacteria blood cultures and carbapenem-resistant cases were 2.38% and 1.52%, respectively. In these cases, 66 (58.4%) of the infants were males, 100 (88.4%) were preterm, and 74 (65.4%) required mechanical ventilation within the first three days of life. The study found 45 (39.8%) infants with early-onset sepsis. Acinetobacter was the most common isolated organism, while Enterobacter had the lowest isolation rate. Carbapenem resistance was discovered in 72 (63.7%) positive blood cultures. Acinetobacter had the highest prevalence of carbapenem resistance, while Pseudomonas had the lowest. Mortality rates in infants infected with carbapenem resistance bacteria (CRB) were 89.3% compared to 10.7% in those infected with carbapenem-sensitive bacteria (CSB). Conclusions: The frequency of carbapenem-resistant Gram-negative sepsis in our ward was 1.52 percent of all admissions, and Acinetobacter bacteria was the most common cause of this type of neonatal sepsis. Infants infected with CRB had a higher mortality rate than those infected with CSB, 89.3% versus 10.7%.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46809742","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}
R. Besharati, Hatef Ajoudanifar, H. Ghasemzadeh-moghaddam, A. Azimian
Background: In the COVID-19 era, co-infections can lead to an increase in morbidity and mortality. Normal flora bacteria can transfer to the pulmonary tract and create bacterial co-infections. The nasal cavity is one of the main areas housing normal flora in the human body. Objectives: In this study, we evaluated the prevalence and antibiotic resistance of gram-positive cocci in the pre– and post–COVID-19 eras among health care workers. Methods: We assessed 376 nasal swabs from the pre–COVID-19 era and 376 from the post–COVID-19 era. Conventional and molecular methods were used to identify bacterial types and evaluate antimicrobial resistance. Results: The most common gram-positive cocci in the pre–COVID-19 samples were Staphylococcus aureus, S. epidermidis, S. capitis, S. hominis, S. haemolyticus, Streptococcus pneumoniae, and Enterococcus faecalis. In the post–COVID-19 samples, the most common gram-positive cocci were S. aureus, S. epidermidis, S. warneri, S. hominis, and E. faecalis. We observed higher resistance rates in post–COVID-19 samples, as well as resistance to linezolid and vancomycin in S. aureus, S. epidermidis, and S. hominis. Additionally, our isolates showed a high resistance rate to antiseptics. Conclusions: It seems that after the beginning of the COVID-19 pandemic, due to the change in the protective procedures in hospitals, the prevalence and variety of bacteria have decreased, but instead, they have been replaced by more pathogenic bacteria with higher antibiotic resistance.
{"title":"Increasing Antimicrobial Resistance of Gram-Positive Cocci in the Nostrils of Health Care Workers in the Post–COVID-19 Era Compared to Pre–COVID-19 Era in North Khorasan, Iran","authors":"R. Besharati, Hatef Ajoudanifar, H. Ghasemzadeh-moghaddam, A. Azimian","doi":"10.5812/jjm-135551","DOIUrl":"https://doi.org/10.5812/jjm-135551","url":null,"abstract":"Background: In the COVID-19 era, co-infections can lead to an increase in morbidity and mortality. Normal flora bacteria can transfer to the pulmonary tract and create bacterial co-infections. The nasal cavity is one of the main areas housing normal flora in the human body. Objectives: In this study, we evaluated the prevalence and antibiotic resistance of gram-positive cocci in the pre– and post–COVID-19 eras among health care workers. Methods: We assessed 376 nasal swabs from the pre–COVID-19 era and 376 from the post–COVID-19 era. Conventional and molecular methods were used to identify bacterial types and evaluate antimicrobial resistance. Results: The most common gram-positive cocci in the pre–COVID-19 samples were Staphylococcus aureus, S. epidermidis, S. capitis, S. hominis, S. haemolyticus, Streptococcus pneumoniae, and Enterococcus faecalis. In the post–COVID-19 samples, the most common gram-positive cocci were S. aureus, S. epidermidis, S. warneri, S. hominis, and E. faecalis. We observed higher resistance rates in post–COVID-19 samples, as well as resistance to linezolid and vancomycin in S. aureus, S. epidermidis, and S. hominis. Additionally, our isolates showed a high resistance rate to antiseptics. Conclusions: It seems that after the beginning of the COVID-19 pandemic, due to the change in the protective procedures in hospitals, the prevalence and variety of bacteria have decreased, but instead, they have been replaced by more pathogenic bacteria with higher antibiotic resistance.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42209310","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: Klebsiella pneumoniae is an important pathogen among nosocomial infections, which can cause urinary and respiratory system infections, surgical site infections, and sepsis. Recently, carbapenem-resistant K. pneumoniae showed an upward trend with the wide use of clinical carbapenem antibiotics. However, there are few studies on the relationship between drug resistance, virulence, and phylogeny of K. pneumoniae in patients with different infections. Objectives: We investigated the drug resistance, virulence, and phylogeny of K. pneumoniae in patients with different infections. Methods: Seventy infected patients were selected as subjects. The extended-spectrum β-lactamases (ESBLs) color screening plane and blood plate medium were used for culture. Identification and drug resistance analysis was carried out by VITEK-2 compact automatic bacterial analyzer. Multilocus sequence typing (MLST) and capsule genotyping analysis were also performed. The Xpert CarbaR cartridge detected the carbapenem resistance genes. Comprehensive Antibiotic Research Database (CARD) and Virulence Factor Database (VFDB) predicted the drug-resistant genes and virulence factor genes, respectively. The phylogenetic tree was constructed, and the correlation was analyzed. Results: A total of 43 K. pneumoniae strains were cultured. We found that all K. pneumoniae strains exhibited different multiple drug resistance. MLST analysis indicated that ST11 was the main ST (60.61%). Analysis of the carbapenem-resistance genes showed that all isolates harbored the blaKPC-2 gene and some others blaOXA. The prediction result of capsular blood genotyping and virulence factor genes indicated that K47, K64, and K25 were the main types of capsular blood, and the top three detection rates of virulence genes were fimH (97.67%), mrkD (94.19%), and entB (84.88%). All isolates were clustered into one branch based on the virulence factor genes in the phylogenetic tree, and the strains of the same ST type or capsular blood type showed a closer relationship. Correlation analysis manifested that the drug resistance of K. pneumoniae in infected patients was positively correlated with virulence and phylogeny (r = 0.682, P = 0.000). Conclusions: There were complicated differences in the multidrug resistance to K. pneumoniae, resulting in high independent gene-positive rates of strains and a strong correlation with phylogeny, which can provide a reference for the selection of clinical antimicrobial drugs.
{"title":"Analysis of Drug Resistance, Virulence, and Phylogeny of Klebsiella pneumoniae in Patients with Different Infections","authors":"Jianhua Liu, Rui Li, Shukun Qian, J. Xi","doi":"10.5812/jjm-133082","DOIUrl":"https://doi.org/10.5812/jjm-133082","url":null,"abstract":"Background: Klebsiella pneumoniae is an important pathogen among nosocomial infections, which can cause urinary and respiratory system infections, surgical site infections, and sepsis. Recently, carbapenem-resistant K. pneumoniae showed an upward trend with the wide use of clinical carbapenem antibiotics. However, there are few studies on the relationship between drug resistance, virulence, and phylogeny of K. pneumoniae in patients with different infections. Objectives: We investigated the drug resistance, virulence, and phylogeny of K. pneumoniae in patients with different infections. Methods: Seventy infected patients were selected as subjects. The extended-spectrum β-lactamases (ESBLs) color screening plane and blood plate medium were used for culture. Identification and drug resistance analysis was carried out by VITEK-2 compact automatic bacterial analyzer. Multilocus sequence typing (MLST) and capsule genotyping analysis were also performed. The Xpert CarbaR cartridge detected the carbapenem resistance genes. Comprehensive Antibiotic Research Database (CARD) and Virulence Factor Database (VFDB) predicted the drug-resistant genes and virulence factor genes, respectively. The phylogenetic tree was constructed, and the correlation was analyzed. Results: A total of 43 K. pneumoniae strains were cultured. We found that all K. pneumoniae strains exhibited different multiple drug resistance. MLST analysis indicated that ST11 was the main ST (60.61%). Analysis of the carbapenem-resistance genes showed that all isolates harbored the blaKPC-2 gene and some others blaOXA. The prediction result of capsular blood genotyping and virulence factor genes indicated that K47, K64, and K25 were the main types of capsular blood, and the top three detection rates of virulence genes were fimH (97.67%), mrkD (94.19%), and entB (84.88%). All isolates were clustered into one branch based on the virulence factor genes in the phylogenetic tree, and the strains of the same ST type or capsular blood type showed a closer relationship. Correlation analysis manifested that the drug resistance of K. pneumoniae in infected patients was positively correlated with virulence and phylogeny (r = 0.682, P = 0.000). Conclusions: There were complicated differences in the multidrug resistance to K. pneumoniae, resulting in high independent gene-positive rates of strains and a strong correlation with phylogeny, which can provide a reference for the selection of clinical antimicrobial drugs.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43725061","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. Shamsizadeh, N. Neisi, Seyede Shabnam Seyedsalehi, M. Fathi, Mohsen Alisamir, Seyed Mohammadreza Mirkarimi
Background: Viral infections are the most common cause of fever and neutropenia in children without underlying disease, and data are still limited in this regard. Objective: This study aimed to identify the most common viral causes of fever and neutropenia in pediatrics. Methods: This descriptive-analytical study was conducted on pediatric patients younger than 18 years old referred to the pediatric emergency ward with fever as the chief complaint and no underlying diseases; patients with neutropenia and no evidence of bacterial infections in terms of different cultures were included in the study. After obtaining parental consent, nasopharyngeal swab specimens were taken from patients during the coronavirus disease 2019 (COVID-19) pandemic, and blood samples were analyzed to detect viruses in each patient. Results: Fifty patients (54.3%) had mild neutropenia (absolute neutrophil count (ANC): 1000 - 1500/μL), 40 patients (43.5%) had moderate neutropenia (ANC: 1000 - 500/μL), and 2 cases (2.2%) had severe neutropenia (ANC < 500/μL). Among all the cases, 19 cases were positive in terms of virus examination, including adenovirus (6.5%), enterovirus (5.4%), cytomegalovirus (CMV) (3.3%), Epstein-Barr virus (EBV) (3.3%), and Herpes virus 6 (2.2%). A significant correlation was found between enterovirus and neutropenia (P = 0.005). Conclusions: The most common viruses found in neutropenic children hospitalized due to fever without any underlying disease were adenovirus and enterovirus, respectively. Considering the good general condition and relatively quick recovery, consideration of viral causes is recommended in this category of patients, and it is better to avoid prescribing broad-spectrum antibiotics, and careful follow-up should be carried out.
{"title":"Evaluation of the Most Common Viral Causes of Fever and Neutropenia in Children Hospitalized in Abuzar Children’s Medical Center in Ahvaz, Iran","authors":"A. Shamsizadeh, N. Neisi, Seyede Shabnam Seyedsalehi, M. Fathi, Mohsen Alisamir, Seyed Mohammadreza Mirkarimi","doi":"10.5812/jjm-135198","DOIUrl":"https://doi.org/10.5812/jjm-135198","url":null,"abstract":"Background: Viral infections are the most common cause of fever and neutropenia in children without underlying disease, and data are still limited in this regard. Objective: This study aimed to identify the most common viral causes of fever and neutropenia in pediatrics. Methods: This descriptive-analytical study was conducted on pediatric patients younger than 18 years old referred to the pediatric emergency ward with fever as the chief complaint and no underlying diseases; patients with neutropenia and no evidence of bacterial infections in terms of different cultures were included in the study. After obtaining parental consent, nasopharyngeal swab specimens were taken from patients during the coronavirus disease 2019 (COVID-19) pandemic, and blood samples were analyzed to detect viruses in each patient. Results: Fifty patients (54.3%) had mild neutropenia (absolute neutrophil count (ANC): 1000 - 1500/μL), 40 patients (43.5%) had moderate neutropenia (ANC: 1000 - 500/μL), and 2 cases (2.2%) had severe neutropenia (ANC < 500/μL). Among all the cases, 19 cases were positive in terms of virus examination, including adenovirus (6.5%), enterovirus (5.4%), cytomegalovirus (CMV) (3.3%), Epstein-Barr virus (EBV) (3.3%), and Herpes virus 6 (2.2%). A significant correlation was found between enterovirus and neutropenia (P = 0.005). Conclusions: The most common viruses found in neutropenic children hospitalized due to fever without any underlying disease were adenovirus and enterovirus, respectively. Considering the good general condition and relatively quick recovery, consideration of viral causes is recommended in this category of patients, and it is better to avoid prescribing broad-spectrum antibiotics, and careful follow-up should be carried out.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43577173","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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