Background: Klebsiella pneumoniae is one of the main pathogens of lower respiratory tract infections. Carbapenems are considered the last line of defense for the treatment of Gram-negative bacteria with multidrug resistance. In recent years, with the increase of bacteria producing carbapenemase, the resistance rate of carbapenems has increased gradually. Objectives: The main objective of this study was to detect the blaKPC and blaVIM genes in K. pneumoniae isolates from blood culture specimens. Methods: Within September 2020 to August 2022, 1033 bacterial strains were isolated from blood cultures in Yijishan Hospital of Wannan Medical College, Wuhu, Anhui province, China, including 141 strains of K. pneumoniae. All K. pneumoniae strains were processed for antimicrobial susceptibility testing (AST) using the minimum inhibitory concentration method. Meanwhile, the isolates were phenotypically identified for carbapenemase production by the colloidal gold method. Finally, the confirmed carbapenem enzyme phenotype was further verified for the production of blaKPC and blaVIM by polymerase chain reaction (PCR). Results: Regarding the rate of isolated strains in blood culture, positivity was 11.16% (1033/9255), and the proportion of K. pneumoniae was 13.65% (141/1033). Overall, according to AST results, 7.80% (11/141) of the isolates demonstrated resistance to carbapenems, such as ertapenem, imipenem, and meropenem; nevertheless, they showed sensitivity to colistin and ceftazidime/avibactam. Colloidal gold phenotypically confirmed 81.82% (9/11) of the isolates as carbapenemase producers. Subsequently, nine isolates’ strains were verified to be positive for blaKPC and blaVIM by PCR; the proportions of the blaKPC and blaVIM genes were 88.89% (8/9) and 11.11% (1/9), respectively. Conclusions: The identification of carbapenemase phenotype and genotype is helpful for the accurate understanding of drug resistance and management of the disease.
{"title":"Detection of KPC and VIM Genes in Carbapenem-resistant Klebsiella pneumoniae Isolates from Blood Culture in Southern Anhui, China","authors":"Peng Zhang, Jie Li, Yangyan Wang, Fang Yang, Jianjun Qi, Chenlei Huang","doi":"10.5812/jjm-133705","DOIUrl":"https://doi.org/10.5812/jjm-133705","url":null,"abstract":"Background: Klebsiella pneumoniae is one of the main pathogens of lower respiratory tract infections. Carbapenems are considered the last line of defense for the treatment of Gram-negative bacteria with multidrug resistance. In recent years, with the increase of bacteria producing carbapenemase, the resistance rate of carbapenems has increased gradually. Objectives: The main objective of this study was to detect the blaKPC and blaVIM genes in K. pneumoniae isolates from blood culture specimens. Methods: Within September 2020 to August 2022, 1033 bacterial strains were isolated from blood cultures in Yijishan Hospital of Wannan Medical College, Wuhu, Anhui province, China, including 141 strains of K. pneumoniae. All K. pneumoniae strains were processed for antimicrobial susceptibility testing (AST) using the minimum inhibitory concentration method. Meanwhile, the isolates were phenotypically identified for carbapenemase production by the colloidal gold method. Finally, the confirmed carbapenem enzyme phenotype was further verified for the production of blaKPC and blaVIM by polymerase chain reaction (PCR). Results: Regarding the rate of isolated strains in blood culture, positivity was 11.16% (1033/9255), and the proportion of K. pneumoniae was 13.65% (141/1033). Overall, according to AST results, 7.80% (11/141) of the isolates demonstrated resistance to carbapenems, such as ertapenem, imipenem, and meropenem; nevertheless, they showed sensitivity to colistin and ceftazidime/avibactam. Colloidal gold phenotypically confirmed 81.82% (9/11) of the isolates as carbapenemase producers. Subsequently, nine isolates’ strains were verified to be positive for blaKPC and blaVIM by PCR; the proportions of the blaKPC and blaVIM genes were 88.89% (8/9) and 11.11% (1/9), respectively. Conclusions: The identification of carbapenemase phenotype and genotype is helpful for the accurate understanding of drug resistance and management of the disease.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48634707","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}
Arezou Araghi, M. Taghizadeh, Seyed Reza Hosseini Doust, A. Paradise, S. M. Azimi Dezfouli
Background: Foot and mouth disease (FMD) and enterotoxaemia are serious livestock diseases. The livestock industry has suffered heavy economic losses, especially in developing countries. Objectives: These two diseases can be effectively controlled and prevented via vaccination. To prepare multivalent vaccines, Clostridium perfringens (B, C, and D) toxoids were mixed with foot and mouth disease virus (FMDV; type O) along with adjuvants aluminum hydroxide and Montanide ISA206. Methods: According to the guidelines of the World Organization for Animal Health (OIE) and pharmacopeia, sheep were the target animals. Following the injection of vaccines, ELISA and virus neutralization test (VNT) antibody titers determined the effectiveness of the test vaccines. Results: The combination vaccine with ISA206 adjuvant resulted in anti-enterotoxaemia and anti-FMD antibody titers higher than OIE values and pharmacopeia standards. A statistically significant difference was found between the combination vaccine groups with and without Montanide ISA206 adjuvant for anti-enterotoxaemia antibody titers after the second vaccination (P < 0.05). In contrast, the mean VNT antibody titer of the combined vaccine against serotype O with ISA206 adjuvant was significantly higher than that of other FMD vaccine groups (P < 0.05). Moreover, all vaccinated groups (A, B, C, D, E, Fand G) displayed significantly higher than the negative control group (P < 0.05). Conclusions: This study showed that enterotoxaemia-FMD combined vaccines could replace traditional livestock vaccines on an industrial scale.
{"title":"Field Evaluation of Novel Combination Vaccines Against Foot and Mouth Disease Virus and Clostridium perfringens Toxoid Using Different Immunization Protocols","authors":"Arezou Araghi, M. Taghizadeh, Seyed Reza Hosseini Doust, A. Paradise, S. M. Azimi Dezfouli","doi":"10.5812/jjm-132415","DOIUrl":"https://doi.org/10.5812/jjm-132415","url":null,"abstract":"Background: Foot and mouth disease (FMD) and enterotoxaemia are serious livestock diseases. The livestock industry has suffered heavy economic losses, especially in developing countries. Objectives: These two diseases can be effectively controlled and prevented via vaccination. To prepare multivalent vaccines, Clostridium perfringens (B, C, and D) toxoids were mixed with foot and mouth disease virus (FMDV; type O) along with adjuvants aluminum hydroxide and Montanide ISA206. Methods: According to the guidelines of the World Organization for Animal Health (OIE) and pharmacopeia, sheep were the target animals. Following the injection of vaccines, ELISA and virus neutralization test (VNT) antibody titers determined the effectiveness of the test vaccines. Results: The combination vaccine with ISA206 adjuvant resulted in anti-enterotoxaemia and anti-FMD antibody titers higher than OIE values and pharmacopeia standards. A statistically significant difference was found between the combination vaccine groups with and without Montanide ISA206 adjuvant for anti-enterotoxaemia antibody titers after the second vaccination (P < 0.05). In contrast, the mean VNT antibody titer of the combined vaccine against serotype O with ISA206 adjuvant was significantly higher than that of other FMD vaccine groups (P < 0.05). Moreover, all vaccinated groups (A, B, C, D, E, Fand G) displayed significantly higher than the negative control group (P < 0.05). Conclusions: This study showed that enterotoxaemia-FMD combined vaccines could replace traditional livestock vaccines on an industrial scale.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48232317","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}
Shu Li Wang, Jun Lin Wang, Shu Hong Sun, Hua Tao, Li Wang, Xing Wu, Mingjuan Han, Yong Yan
Background: Staphylococcus aureus can cause fatal pneumonia. The evolution of bacteria and the overuse of antibiotics have enhanced the drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA). Objectives: This study aimed to recapitulate the microbiological profile and clinical characteristics of paediatric patients with MRSA. Methods: This retrospective study was conducted to investigate 1372 paediatric patients with S. aureus pneumonia from January 2017 to December 2021. Sputum specimens were collected and processed for performing bacterial culture and drug sensitivity tests. Medical records of patients were reviewed for clinical characteristics and laboratory examination results. Results: The MRSA and MSSA pneumonia mainly occurred in infants; however, comparisons of sex, age, and sampling time between patients with MRSA and MSSA pneumonia showed no significant differences (P > 0.05). The results of drug sensitivity in sputum culture revealed that all MRSA and MSSA isolates were susceptible to vancomycin, tigecycline, linezolid, teicoplanin, and ceftaroline. Methicillin-sensitive Staphylococcus aureus was completely sensitive to rifampicin and oxacillin. Methicillin-resistant Staphylococcus aureus was completely resistant to penicillin and oxacillin, while MSSA was less sensitive to penicillin. Methicillin-resistant Staphylococcus aureus and MSSA both maintained high sensitivity rates to gentamicin, sulfamethoxazole-trimethoprim, levofloxacin, and moxifloxacin, with the exception of clindamycin and erythromycin. According to our results, moreover, the sensitivity of MRSA to gentamicin and sulfamethoxazole-trimethoprim was significantly higher than that of MSSA (P < 0.05). The common symptoms of patients with S. aureus pneumonia were fever, cough, and wheezing. patients with MRSA pneumonia had significantly higher counts of white blood cells (WBCs), C-reactive protein (CRP), and procalcitonin (PCT) than patients with MSSA pneumonia (P < 0.05). Conclusions: The results of antimicrobial sensitivity test in sputum culture of MRSA and MSSA isolates can reflect the sensitivity of antibiotics and guide the use of clinical antibiotics. Infectious biomarkers can reflect the severity of infection and guide prognosis.
{"title":"Clinical Characteristics and Microbial Profiles of Paediatric Patients with Methicillin-Resistant Staphylococcus aureus Pneumonia in China","authors":"Shu Li Wang, Jun Lin Wang, Shu Hong Sun, Hua Tao, Li Wang, Xing Wu, Mingjuan Han, Yong Yan","doi":"10.5812/jjm-132894","DOIUrl":"https://doi.org/10.5812/jjm-132894","url":null,"abstract":"Background: Staphylococcus aureus can cause fatal pneumonia. The evolution of bacteria and the overuse of antibiotics have enhanced the drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA). Objectives: This study aimed to recapitulate the microbiological profile and clinical characteristics of paediatric patients with MRSA. Methods: This retrospective study was conducted to investigate 1372 paediatric patients with S. aureus pneumonia from January 2017 to December 2021. Sputum specimens were collected and processed for performing bacterial culture and drug sensitivity tests. Medical records of patients were reviewed for clinical characteristics and laboratory examination results. Results: The MRSA and MSSA pneumonia mainly occurred in infants; however, comparisons of sex, age, and sampling time between patients with MRSA and MSSA pneumonia showed no significant differences (P > 0.05). The results of drug sensitivity in sputum culture revealed that all MRSA and MSSA isolates were susceptible to vancomycin, tigecycline, linezolid, teicoplanin, and ceftaroline. Methicillin-sensitive Staphylococcus aureus was completely sensitive to rifampicin and oxacillin. Methicillin-resistant Staphylococcus aureus was completely resistant to penicillin and oxacillin, while MSSA was less sensitive to penicillin. Methicillin-resistant Staphylococcus aureus and MSSA both maintained high sensitivity rates to gentamicin, sulfamethoxazole-trimethoprim, levofloxacin, and moxifloxacin, with the exception of clindamycin and erythromycin. According to our results, moreover, the sensitivity of MRSA to gentamicin and sulfamethoxazole-trimethoprim was significantly higher than that of MSSA (P < 0.05). The common symptoms of patients with S. aureus pneumonia were fever, cough, and wheezing. patients with MRSA pneumonia had significantly higher counts of white blood cells (WBCs), C-reactive protein (CRP), and procalcitonin (PCT) than patients with MSSA pneumonia (P < 0.05). Conclusions: The results of antimicrobial sensitivity test in sputum culture of MRSA and MSSA isolates can reflect the sensitivity of antibiotics and guide the use of clinical antibiotics. Infectious biomarkers can reflect the severity of infection and guide prognosis.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45880946","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}
Mozhdeh Safari, Robab Rafiei Tabatabaei, H. Abtahi, S. Fahimirad, A. Alimoradian
Background: Multidrug-resistant (MDR) Acinetobacter baumannii is one of the most common nosocomial pathogens. Antimicrobial peptides (AMPs) have been introduced as a viable alternative to antibiotics in the treatment of MDR pathogens. Objectives: This study was designed to assess the in vitro pharmacokinetics of the combination of two potent AMPs, LL-37 and oncorhyncin II, against A. baumannii (ATCC19606). Methods: The synthesized genes of oncorhyncin II and LL-37 were introduced into Escherichia coli BL21 as the expression host. The minimum inhibitory concentration (MIC), time-kills, and growth kinetics of these peptides were used to evaluate their antimicrobial efficiencies against A. baumannii (ATCC19606). Results: LL-37 and oncorhyncin II recombinant peptides showed MIC of 30.6 and 95.87 µg/mL against A. baumannii, respectively. Additive action was confirmed by combining the generated AMPs at the checkerboard approach. The combination of LL-37 and oncorhyncin II at 2 × MIC resulted in a rapid drop in log10 CFU/mL of A. baumannii in the time-kill and growth kinetic findings studies. Conclusions: The combination of the produced LL-37 and oncorhyncin II synergizes the bioactivity of the individual peptides. Therefore, these peptides or their combinations might function as novel antibiotics and be used to develop and produce new antimicrobial drugs for the treatment of infections caused by A. baumannii.
{"title":"In Vitro Pharmacokinetics of LL-37 and Oncorhyncin II Combination Against Acinetobacter baumannii","authors":"Mozhdeh Safari, Robab Rafiei Tabatabaei, H. Abtahi, S. Fahimirad, A. Alimoradian","doi":"10.5812/jjm-131299","DOIUrl":"https://doi.org/10.5812/jjm-131299","url":null,"abstract":"Background: Multidrug-resistant (MDR) Acinetobacter baumannii is one of the most common nosocomial pathogens. Antimicrobial peptides (AMPs) have been introduced as a viable alternative to antibiotics in the treatment of MDR pathogens. Objectives: This study was designed to assess the in vitro pharmacokinetics of the combination of two potent AMPs, LL-37 and oncorhyncin II, against A. baumannii (ATCC19606). Methods: The synthesized genes of oncorhyncin II and LL-37 were introduced into Escherichia coli BL21 as the expression host. The minimum inhibitory concentration (MIC), time-kills, and growth kinetics of these peptides were used to evaluate their antimicrobial efficiencies against A. baumannii (ATCC19606). Results: LL-37 and oncorhyncin II recombinant peptides showed MIC of 30.6 and 95.87 µg/mL against A. baumannii, respectively. Additive action was confirmed by combining the generated AMPs at the checkerboard approach. The combination of LL-37 and oncorhyncin II at 2 × MIC resulted in a rapid drop in log10 CFU/mL of A. baumannii in the time-kill and growth kinetic findings studies. Conclusions: The combination of the produced LL-37 and oncorhyncin II synergizes the bioactivity of the individual peptides. Therefore, these peptides or their combinations might function as novel antibiotics and be used to develop and produce new antimicrobial drugs for the treatment of infections caused by A. baumannii.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48493807","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}
Çiğdem Arabacı, Serkan Aydemir, Kenan E. Ak, T. Dal
Background: Candida infections are a significant cause of morbidity and mortality in hospitalized patients. Acquired resistance to antifungal agents and strains with intrinsic resistance makes it hard to manage the infection. Objectives: We aimed to examine the risk factors of candidemia associated with patient mortality, the species causing candidemia, and their antifungal susceptibility. Methods: Patient data were collected from medical records retrospectively. MALDI-TOF MS was used to identify Candida species. Antifungal susceptibility testing was conducted by the colorimetric broth microdilution method. Results: A total of 155 patients were included in the study. The incidences of candidemia were 0.92, 0.72, 0.99, 0.97, and 2.28 per 1,000 cases in 2016, 2017, 2018, 2019, and 2020, respectively. Candida albicans accounted for 45% of all cases, followed by C. parapsilosis complex (28%), C. tropicalis (10%), and C. glabrata (8%). The 30-day crude mortality was 45%. There was no significant difference in mortality between C. albicans and non-albicans yeast species. The susceptibility rates for anidulafungin, micafungin, caspofungin, voriconazole, and fluconazole were as follows: 97%, 97%, 97%, 97%, and 90% in C. albicans, 95%, 95%, 98%, 72%, and 67% in C. parapsilosis complex, and 100%, 100%, 100%, 38%, and 63% in C. tropicalis. The susceptibility rates for anidulafungin, micafungin, and caspofungin in C. glabrata were 100%, 100%, and 92%, respectively. All 12 C. glabrata strains were susceptible-dose-dependent against fluconazole and uninterpretable for voriconazole. Conclusions: Incidences of candidemia and susceptibility patterns of strains may vary over time and amongst the regions. Candida albicans was the predominant strain, and echinocandins demonstrated the highest susceptibility rates against the most common species isolated in this study. Antifungal susceptibility tests are crucial in guiding patient treatment.
{"title":"Epidemiology, Antifungal Susceptibility, and Risk Factors of Invasive Candidiasis in a Tertiary Hospital During a Four-Year Period","authors":"Çiğdem Arabacı, Serkan Aydemir, Kenan E. Ak, T. Dal","doi":"10.5812/jjm-132098","DOIUrl":"https://doi.org/10.5812/jjm-132098","url":null,"abstract":"Background: Candida infections are a significant cause of morbidity and mortality in hospitalized patients. Acquired resistance to antifungal agents and strains with intrinsic resistance makes it hard to manage the infection. Objectives: We aimed to examine the risk factors of candidemia associated with patient mortality, the species causing candidemia, and their antifungal susceptibility. Methods: Patient data were collected from medical records retrospectively. MALDI-TOF MS was used to identify Candida species. Antifungal susceptibility testing was conducted by the colorimetric broth microdilution method. Results: A total of 155 patients were included in the study. The incidences of candidemia were 0.92, 0.72, 0.99, 0.97, and 2.28 per 1,000 cases in 2016, 2017, 2018, 2019, and 2020, respectively. Candida albicans accounted for 45% of all cases, followed by C. parapsilosis complex (28%), C. tropicalis (10%), and C. glabrata (8%). The 30-day crude mortality was 45%. There was no significant difference in mortality between C. albicans and non-albicans yeast species. The susceptibility rates for anidulafungin, micafungin, caspofungin, voriconazole, and fluconazole were as follows: 97%, 97%, 97%, 97%, and 90% in C. albicans, 95%, 95%, 98%, 72%, and 67% in C. parapsilosis complex, and 100%, 100%, 100%, 38%, and 63% in C. tropicalis. The susceptibility rates for anidulafungin, micafungin, and caspofungin in C. glabrata were 100%, 100%, and 92%, respectively. All 12 C. glabrata strains were susceptible-dose-dependent against fluconazole and uninterpretable for voriconazole. Conclusions: Incidences of candidemia and susceptibility patterns of strains may vary over time and amongst the regions. Candida albicans was the predominant strain, and echinocandins demonstrated the highest susceptibility rates against the most common species isolated in this study. Antifungal susceptibility tests are crucial in guiding patient treatment.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47631715","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}
Alireza Nilav, A. Karimi Rouzbahani, Golnaz Mahmoudvand, Tabassom Zavari
Background: The outbreak of a new coronavirus in China in 2019 (COVID-19) caused a global health crisis. Objectives: This study was performed to investigate the effect of different underlying diseases on mortality in patients with COVID-19. Methods: This retrospective cohort study was performed on COVID-19 patients admitted to the Shahid Rahimi and Sohada-ye Ashayer teaching hospitals in Khorramabad, Iran, from 2019 to 2021. Data on disease severity, clinical manifestations, mortality, and underlying disorders were collected and analyzed using the SPSS software version 22 at a 95% confidence interval and 0.05 significance level. Results: The study included 9653 men (48%) and 10332 women (52%). Patients with chronic kidney diseases, cancer, chronic obstructive pulmonary disease, hypertension, cardiovascular disease, and diabetes were at higher mortality risk than those without these underlying diseases, respectively. However, there was no significant relationship between asthma and mortality. Also, age > 50 years, male gender, oxygen saturation < 93 on admission, and symptoms lasting ≤ 5 days were associated with increased mortality. Conclusions: Since patients with underlying diseases are at higher mortality risk, they should precisely follow the advice provided by health authorities and receive a complete COVID-19 vaccination series.
{"title":"Evaluation of the Effect of Underlying Diseases on Mortality of COVID-19 Patients: A Study of 19,985 Cases","authors":"Alireza Nilav, A. Karimi Rouzbahani, Golnaz Mahmoudvand, Tabassom Zavari","doi":"10.5812/jjm-133603","DOIUrl":"https://doi.org/10.5812/jjm-133603","url":null,"abstract":"Background: The outbreak of a new coronavirus in China in 2019 (COVID-19) caused a global health crisis. Objectives: This study was performed to investigate the effect of different underlying diseases on mortality in patients with COVID-19. Methods: This retrospective cohort study was performed on COVID-19 patients admitted to the Shahid Rahimi and Sohada-ye Ashayer teaching hospitals in Khorramabad, Iran, from 2019 to 2021. Data on disease severity, clinical manifestations, mortality, and underlying disorders were collected and analyzed using the SPSS software version 22 at a 95% confidence interval and 0.05 significance level. Results: The study included 9653 men (48%) and 10332 women (52%). Patients with chronic kidney diseases, cancer, chronic obstructive pulmonary disease, hypertension, cardiovascular disease, and diabetes were at higher mortality risk than those without these underlying diseases, respectively. However, there was no significant relationship between asthma and mortality. Also, age > 50 years, male gender, oxygen saturation < 93 on admission, and symptoms lasting ≤ 5 days were associated with increased mortality. Conclusions: Since patients with underlying diseases are at higher mortality risk, they should precisely follow the advice provided by health authorities and receive a complete COVID-19 vaccination series.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43569934","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}
Introduction: Polymyositis is an idiopathic inflammatory myopathy that mainly manifests itself in muscle weakness. Patients with polymyositis have a higher risk of developing infections and malignancies. We report concurrent pulmonary and cerebral lesions in a polymyositis patient with many diagnostic challenges. Case Presentation: A 56-year-old woman complained of a productive cough and dyspnea two weeks ago. Her symptoms gradually progressed until a sudden loss of consciousness occurred. She was a known case of polymyositis and was treated with oral prednisolone. Imaging revealed concurrent pulmonary and cerebral lesions. Initially, the patient underwent empirical therapy. However, the patient underwent a bronchoscopy because she did not respond to treatment. Specimens obtained from respiratory secretions revealed branched septate hyphae, and the culture was positive for Aspergillus fumigatus. She was diagnosed with invasive aspergillosis, so we replaced the therapy with voriconazole. After three months, the lung lesions improved, but the number and extent of cerebral lesions increased. Finally, after a stereotactic biopsy, the patient was diagnosed with astrocytoma and became a candidate for radiotherapy. Conclusions: Patients with polymyositis are prone to contracting opportunistic infections and malignancies. Both of them can mimic each other and present diagnostic challenges to physicians. Thus, they should think about them for early diagnosis and timely treatment.
{"title":"A Case-report of Concurrent Pulmonary and Cerebral Lesions in a Patient with Polymyositis: Invasive Aspergillosis or Astrocytoma?","authors":"S. Tehrani, D. Yadegarynia, Amirreza Keyvanfar","doi":"10.5812/jjm-132821","DOIUrl":"https://doi.org/10.5812/jjm-132821","url":null,"abstract":"Introduction: Polymyositis is an idiopathic inflammatory myopathy that mainly manifests itself in muscle weakness. Patients with polymyositis have a higher risk of developing infections and malignancies. We report concurrent pulmonary and cerebral lesions in a polymyositis patient with many diagnostic challenges. Case Presentation: A 56-year-old woman complained of a productive cough and dyspnea two weeks ago. Her symptoms gradually progressed until a sudden loss of consciousness occurred. She was a known case of polymyositis and was treated with oral prednisolone. Imaging revealed concurrent pulmonary and cerebral lesions. Initially, the patient underwent empirical therapy. However, the patient underwent a bronchoscopy because she did not respond to treatment. Specimens obtained from respiratory secretions revealed branched septate hyphae, and the culture was positive for Aspergillus fumigatus. She was diagnosed with invasive aspergillosis, so we replaced the therapy with voriconazole. After three months, the lung lesions improved, but the number and extent of cerebral lesions increased. Finally, after a stereotactic biopsy, the patient was diagnosed with astrocytoma and became a candidate for radiotherapy. Conclusions: Patients with polymyositis are prone to contracting opportunistic infections and malignancies. Both of them can mimic each other and present diagnostic challenges to physicians. Thus, they should think about them for early diagnosis and timely treatment.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45457703","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}
E. F. Karaşahin, E. Sebin, İrem Akın Şen, O. Karaşahin
Background: SARS-CoV-2 infections (COVID-19) first occurred in Wuhan, China, in December 2019 and spread worldwide, causing significant mortality and morbidity. IL-17A may mediate numerous immunopathological effects secondary to cytokine release syndrome during SARS-CoV-2 infection. However, there has not been enough research on its effect on prognosis. Objectives: This study evaluated the predictive power of serum interleukin (IL)-17A level as a prognostic marker in COVID-19. Methods: The study included 152 patients diagnosed with COVID-19 by real-time polymerase chain reaction analysis of nasopharyngeal swab samples in the infectious diseases department and intensive care unit of our hospital between October 1 and December 31, 2020. The control group consisted of 40 asymptomatic healthcare workers who had negative RT-PCR results during routine COVID-19 screening in our hospital. Samples were collected in anticoagulant-free tubes and left at room temperature for 30 minutes. Afterward, it was centrifuged at 1000 × g for 15 minutes at 4°C per the instructions provided with the enzyme-linked immunoassay (ELISA) kit. Serum IL-17A levels were measured using the Human Interleukin 17A ELISA Kit. Results: Serum IL-17A levels were significantly higher in COVID-19 patients than in controls (P < 0.001). IL-17A levels increased significantly in association with disease severity in patients with the moderate, severe, and critical disease, with a less pronounced difference between severe and critical patients (moderate vs. severe, P < 0.001; severe vs. critical, P = 0.048). IL-17A levels at hospital admission and day 7 were significantly higher in non-surviving patients (P < 0.001). At a cut-off value of 210.25 ng/L, IL-17A at admission had a predictive power of 0.792 (P < 0.001). Compared to baseline, IL-17A values on day seven were significantly increased in non-survivors (P = 0.004) and decreased in survivors (P = 0.014). An increase of 26.17 ng/L or more on day 7 had a predictive mortality power of 0.634 (P = 0.005). Conclusions: The results of this study suggest that IL-17A, an important part of the immune system previously shown to be useful in the treatment and follow-up of COVID-19, may also help predict mortality in COVID-19 patients.
{"title":"The Value of Interleukin-17A as a Prognostic Indicator in COVID-19 Patients","authors":"E. F. Karaşahin, E. Sebin, İrem Akın Şen, O. Karaşahin","doi":"10.5812/jjm-130316","DOIUrl":"https://doi.org/10.5812/jjm-130316","url":null,"abstract":"Background: SARS-CoV-2 infections (COVID-19) first occurred in Wuhan, China, in December 2019 and spread worldwide, causing significant mortality and morbidity. IL-17A may mediate numerous immunopathological effects secondary to cytokine release syndrome during SARS-CoV-2 infection. However, there has not been enough research on its effect on prognosis. Objectives: This study evaluated the predictive power of serum interleukin (IL)-17A level as a prognostic marker in COVID-19. Methods: The study included 152 patients diagnosed with COVID-19 by real-time polymerase chain reaction analysis of nasopharyngeal swab samples in the infectious diseases department and intensive care unit of our hospital between October 1 and December 31, 2020. The control group consisted of 40 asymptomatic healthcare workers who had negative RT-PCR results during routine COVID-19 screening in our hospital. Samples were collected in anticoagulant-free tubes and left at room temperature for 30 minutes. Afterward, it was centrifuged at 1000 × g for 15 minutes at 4°C per the instructions provided with the enzyme-linked immunoassay (ELISA) kit. Serum IL-17A levels were measured using the Human Interleukin 17A ELISA Kit. Results: Serum IL-17A levels were significantly higher in COVID-19 patients than in controls (P < 0.001). IL-17A levels increased significantly in association with disease severity in patients with the moderate, severe, and critical disease, with a less pronounced difference between severe and critical patients (moderate vs. severe, P < 0.001; severe vs. critical, P = 0.048). IL-17A levels at hospital admission and day 7 were significantly higher in non-surviving patients (P < 0.001). At a cut-off value of 210.25 ng/L, IL-17A at admission had a predictive power of 0.792 (P < 0.001). Compared to baseline, IL-17A values on day seven were significantly increased in non-survivors (P = 0.004) and decreased in survivors (P = 0.014). An increase of 26.17 ng/L or more on day 7 had a predictive mortality power of 0.634 (P = 0.005). Conclusions: The results of this study suggest that IL-17A, an important part of the immune system previously shown to be useful in the treatment and follow-up of COVID-19, may also help predict mortality in COVID-19 patients.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49450593","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. Mokhtari, A. Mojtahedi, N. Mahdieh, A. Jafari, M. Arya
Background: Due to the increasing antibiotic resistance, treating infections caused by Klebsiella pneumoniae has become more challenging. Objectives: The present study aimed to investigate the prevalence of blaOXA-48 and blaNDM producing carbapenem-resistant K. pneumoniae isolated from clinical samples in Shahid Rajaei hospital in Tehran, Iran. Methods: Various clinical samples were collected from 1,186 patients admitted with open heart surgery in two wards (ICU and surgery) in Shahid Rajaei Heart Hospital in Tehran, Iran. Klebsiella pneumoniae isolates were identified by standard microbiologic tests. Antimicrobial susceptibility of isolates were determined by disk diffusion and E-test methods. A modified carbapenem inactivation method (mCIM) was performed to detect the presence of carbapenemase. Antibiotic resistance genes were detected using conventional polymerase chain reaction (PCR) by primers targeting blaOXA-48, blaSPM, blaIMP, blaVIM, and blaNDM genes. Results: A total of 131 clinical isolates of K. pneumoniae were isolated and 45.8% (60/131) of them were resistant to carbapenem. Klebsiella pneumoniae isolates showed the highest resistance rate (100%) to ceftriaxone, ceftazidime, cefazolin, and cefepime and the maximum sensitivity to tigecycline (96.7%). The carbapenemase-encoding blaOXA-48 and blaNDM-1 genes were detected in 96.7% and 66.7% of isolates, respectively. Eight different clusters of the isolates, considering a ≥ 80% homology cut-off, were shown with the same rep-PCR pattern. Clusters A, B, C, D, E, F, G, and H included 20, 11, 7, 6, 6, 3, 2, and 2 members, respectively. Conclusions: The RAPD-PCR method reveals the clonal relationship between isolates and may help improve infection control procedures.
{"title":"High Prevalence of blaOXA-48 and blaNDM-Producing Carbapenem-Resistant Klebsiella pneumoniae Isolated from Clinical Samples in Shahid Rajaei Hospital in Tehran, Iran","authors":"M. Mokhtari, A. Mojtahedi, N. Mahdieh, A. Jafari, M. Arya","doi":"10.5812/jjm-130804","DOIUrl":"https://doi.org/10.5812/jjm-130804","url":null,"abstract":"Background: Due to the increasing antibiotic resistance, treating infections caused by Klebsiella pneumoniae has become more challenging. Objectives: The present study aimed to investigate the prevalence of blaOXA-48 and blaNDM producing carbapenem-resistant K. pneumoniae isolated from clinical samples in Shahid Rajaei hospital in Tehran, Iran. Methods: Various clinical samples were collected from 1,186 patients admitted with open heart surgery in two wards (ICU and surgery) in Shahid Rajaei Heart Hospital in Tehran, Iran. Klebsiella pneumoniae isolates were identified by standard microbiologic tests. Antimicrobial susceptibility of isolates were determined by disk diffusion and E-test methods. A modified carbapenem inactivation method (mCIM) was performed to detect the presence of carbapenemase. Antibiotic resistance genes were detected using conventional polymerase chain reaction (PCR) by primers targeting blaOXA-48, blaSPM, blaIMP, blaVIM, and blaNDM genes. Results: A total of 131 clinical isolates of K. pneumoniae were isolated and 45.8% (60/131) of them were resistant to carbapenem. Klebsiella pneumoniae isolates showed the highest resistance rate (100%) to ceftriaxone, ceftazidime, cefazolin, and cefepime and the maximum sensitivity to tigecycline (96.7%). The carbapenemase-encoding blaOXA-48 and blaNDM-1 genes were detected in 96.7% and 66.7% of isolates, respectively. Eight different clusters of the isolates, considering a ≥ 80% homology cut-off, were shown with the same rep-PCR pattern. Clusters A, B, C, D, E, F, G, and H included 20, 11, 7, 6, 6, 3, 2, and 2 members, respectively. Conclusions: The RAPD-PCR method reveals the clonal relationship between isolates and may help improve infection control procedures.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46182836","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}
S. Soltani, Sayed-Hamidreza Mozhgani, G. Siri, Mohammad Saeid Emadi, A. Rahimi Foroushani, S. Jazayeri, Atefeh Bahavar, M. Norouzi
Background: Human T-cell lymphotropic virus type 1 (HTLV-1) is the etiological agent of adult T-cell leukemia/lymphoma (ATLL) without any specific antiviral. Objectives: This study aimed to evaluate the expression level of inflammatory chemokines and pro-inflammatory cytokines in ATLL patients, asymptomatic carriers (ACs), and healthy individuals to assess the role of these inflammatory markers in ATLL pathogenicity. Methods: This study was conducted from May 2021 to August 2022. The ATLL blood samples were collected from the oncology wards of Imam Khomeini, Shariati, and Imam Hossein hospitals, in Tehran, Iran. The blood samples of ACs and normal control subjects were collected from blood donors referred to blood transfusion centers of Tehran and Alborz provinces, Iran. RNA extraction, complementary DNA (cDNA) synthesis, and real-time polymerase chain reaction (PCR) were done in targeted sample groups to investigate the correlation and expression rate of C-C motif chemokine ligand 3 (CCL3), C-C motif chemokine ligand 4 (CCL4), C-X-C motif chemokine ligand 8 (CXCL8), interleukin 23 subunit alpha (IL-23A), and interleukin 17 A (IL-17A). Results: A total of 30 samples were collected from 3 groups. The CCL3, CCL4, CXCL8, and IL-17A messenger RNA (mRNA) expression levels were significantly upregulated in the ATLL groups. There was a significant difference between CCL3 expression between the ACs and ATLL groups. In addition, CCL4 and CXCL8 expression levels were more significant in the ATLL group than in the normal control group. The IL-17A expression level significantly increased between groups. The IL-23A expression levels had no significant differences between the ATLL, ACs, and normal control groups. Conclusions: This study showed significant upregulation of pro-inflammatory cytokines and chemokines mRNAs in HTLV-1–associated ATLL compared to the ACs and normal control groups. Conducting more experiments to investigate the therapeutic effect of chemokines/cytokines in ATLL is essential.
{"title":"High Expression of Inflammatory Cytokines and Chemokines in Human T-lymphotropic Virus 1-Associated Adult T-cell Leukemia/Lymphoma","authors":"S. Soltani, Sayed-Hamidreza Mozhgani, G. Siri, Mohammad Saeid Emadi, A. Rahimi Foroushani, S. Jazayeri, Atefeh Bahavar, M. Norouzi","doi":"10.5812/jjm-132348","DOIUrl":"https://doi.org/10.5812/jjm-132348","url":null,"abstract":"Background: Human T-cell lymphotropic virus type 1 (HTLV-1) is the etiological agent of adult T-cell leukemia/lymphoma (ATLL) without any specific antiviral. Objectives: This study aimed to evaluate the expression level of inflammatory chemokines and pro-inflammatory cytokines in ATLL patients, asymptomatic carriers (ACs), and healthy individuals to assess the role of these inflammatory markers in ATLL pathogenicity. Methods: This study was conducted from May 2021 to August 2022. The ATLL blood samples were collected from the oncology wards of Imam Khomeini, Shariati, and Imam Hossein hospitals, in Tehran, Iran. The blood samples of ACs and normal control subjects were collected from blood donors referred to blood transfusion centers of Tehran and Alborz provinces, Iran. RNA extraction, complementary DNA (cDNA) synthesis, and real-time polymerase chain reaction (PCR) were done in targeted sample groups to investigate the correlation and expression rate of C-C motif chemokine ligand 3 (CCL3), C-C motif chemokine ligand 4 (CCL4), C-X-C motif chemokine ligand 8 (CXCL8), interleukin 23 subunit alpha (IL-23A), and interleukin 17 A (IL-17A). Results: A total of 30 samples were collected from 3 groups. The CCL3, CCL4, CXCL8, and IL-17A messenger RNA (mRNA) expression levels were significantly upregulated in the ATLL groups. There was a significant difference between CCL3 expression between the ACs and ATLL groups. In addition, CCL4 and CXCL8 expression levels were more significant in the ATLL group than in the normal control group. The IL-17A expression level significantly increased between groups. The IL-23A expression levels had no significant differences between the ATLL, ACs, and normal control groups. Conclusions: This study showed significant upregulation of pro-inflammatory cytokines and chemokines mRNAs in HTLV-1–associated ATLL compared to the ACs and normal control groups. Conducting more experiments to investigate the therapeutic effect of chemokines/cytokines in ATLL is essential.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41493882","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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