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Antimicrobial Resistance Rates and Risk Factors for Extended-spectrum beta-Lactamase-producing Escherichia coli-associated Urinary Tract Infections in Older Outpatients in East Anatolia from 2011 - 2019 2011 - 2019年东安纳托利亚老年门诊患者广谱β -内酰胺酶产生大肠杆菌相关尿路感染的抗菌素耐药率和危险因素
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-05-15 DOI: 10.5812/jjm-132890
S. Şahin, O. Karaşahin, P. Tasar
Background: Community-acquired urinary tract infection is among the most common infections in older adults. Regardless of age, the most frequently detected causative microorganism is Escherichia coli. In parallel with the increase in antibiotic use, the frequency of community-acquired extended-spectrum beta-lactamase-producing E. coli (ESBL-E. coli) has reached critical levels. The use of empirical antibiotic therapy is determined by assessing patient-based risk factors. Therefore, knowing the risk factors and the frequency of antimicrobial resistance can guide the treatment to shape the treatment. Objectives: This study aimed to determine the risks and resistance frequencies to guide the empirical treatment selection for ESBL-E. coli-associated urinary tract infection (UTI) in elderly patients. Methods: This study is a retrospective cohort study. It was carried out between 2011 - 2019. Escherichia coli growth of ≥ 105 colony-forming units (cfu)/mL in urine culture was included in 815 patients aged 65 and over who applied to outpatient clinics. Results: Two hundred and sixty (31.9%) of the patients had ESBL-E. coli. In ESBL-E. coli, antimicrobial resistance rates were highest (100%) for penicillins + β-lactamase inhibitors. The lowest resistance rates were determined for carbapenems, aminoglycosides, phosphonic acid, and nitrofurantoins. Risk factors for ESBL-producing bacteria were determined. These were the presence of benign prostatic hypertrophy, antibiotic use in the last three months, history of UTI in the last year, urinary catheter uses in the last year, male gender, and hospitalization in the last year (P < 0.05). The only independent risk factor was a history of UTI in the last year, which increased the risk of ESBL by 2.8 times. Conclusions: Carbapenems can be chosen as parenteral options, and phosphonic acids and nitrofurantoin as oral options for empirical antibiotic treatment, especially in patients with a history of UTI in the past year.
背景:社区获得性尿路感染是老年人最常见的感染之一。无论年龄大小,最常检测到的致病微生物是大肠杆菌。随着抗生素使用的增加,社区获得性广谱β -内酰胺酶产生大肠杆菌(ESBL-E)的频率也在增加。大肠杆菌)已达到临界水平。经验性抗生素治疗的使用是通过评估基于患者的危险因素来确定的。因此,了解抗菌素耐药的危险因素和频率可以指导治疗,制定治疗方案。目的:本研究旨在确定ESBL-E的风险和耐药频率,以指导经验治疗方案的选择。老年患者结肠炎相关尿路感染(UTI)。方法:本研究为回顾性队列研究。该研究于2011年至2019年进行。815例65岁及以上门诊患者尿液培养物中大肠杆菌生长≥105菌落形成单位(cfu)/mL。结果:260例(31.9%)患者有ESBL-E。杆菌。在ESBL-E。大肠杆菌对青霉素+ β-内酰胺酶抑制剂的耐药率最高(100%)。碳青霉烯类、氨基糖苷类、膦酸和呋喃妥英类的耐药率最低。测定产esbl细菌的危险因素。其中良性前列腺肥大、近3个月使用抗生素、近1年尿路感染史、近1年导尿管使用情况、男性、近1年住院情况(P < 0.05)。唯一的独立危险因素是去年有尿路感染史,使ESBL的风险增加了2.8倍。结论:在经验性抗生素治疗中,尤其在过去一年有尿路感染史的患者中,碳青霉烯类药物可作为外注射选择,磷酸和呋喃妥因可作为口服选择。
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引用次数: 0
Analysis and Characterization of the Facial Skin Microbiota in Rosacea 酒渣鼻面部皮肤微生物群的分析与特征
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-05-10 DOI: 10.5812/jjm-132246
Junying Li, Peng Cao, Quanzhong Liu, Weifeng Yao, Zhenhua Nie, Litao Zhang
Background: The evidence has shown the relationship between the microbiota of the face and several skin conditions. However, for rosacea patients, the changes in the facial skin microbiota still remain unknown. Objectives: This study was performed to explore the correlation between the facial skin microbiota and rosacea and analyze and characterize the facial skin microbiota of rosacea patients in comparison to healthy controls using 16S rDNA amplicon sequencing. Methods: A total of 27 rosacea patients and 25 healthy controls were matched. The DNA was extracted from participants’ skin swabs taken from the nose, chin, forehead, and bilateral cheeks. The V3V4 region of the 16S rRNA gene was sequenced using Illumina MiSeq technology. The diversity of the face skin microbiota was examined using alpha and beta diversity. Utilizing linear discriminant analysis effect size (LEfSe), the quantitative study of biomarkers in the two groups was carried out. Clusters of orthologous groups and Kyoto encyclopedia of genes and genomes function predictions were made at the genus level utilizing phylogenetic investigation of communities by reconstruction of unobserved states. Results: The alpha diversity of the facial skin microbiota increased significantly in rosacea patients, and beta diversity showed substantial differences between the rosacea and healthy control groups. The facial skin microbiota community structure changed in rosacea patients; however, the dominant strains were the same as in healthy controls, both being Propionibacterium acnes and Staphylococcus epidermidis. The LEfSe demonstrated that Xanthomonas, Acinetobacter, and Pseudomonas were enriched in the rosacea patients; nevertheless, Corynebacterium, Finegoldia, and Peptoniphilus were enriched in the healthy controls. The rosacea patients showed significantly decreased expression in the pathways of membrane transport, carbohydrate metabolism, metabolic diseases, amino acid transport and metabolism, carbohydrate transport and metabolism, transcription, and inorganic ion transport and metabolism. Conclusions: The facial skin microbiota diversity and community structure changed, and the expression of several metabolic pathways was downregulated in the rosacea patients in comparison to the healthy controls, which might outline new strategic methods for the surveillance, diagnosis, and treatment of rosacea.
背景:有证据表明面部微生物群与几种皮肤状况之间存在关系。然而,对于酒渣鼻患者,面部皮肤微生物群的变化仍然未知。目的:本研究利用16S rDNA扩增子测序技术,探讨面部皮肤微生物群与酒渣鼻的相关性,并对酒渣鼻患者面部皮肤微生物群与健康对照进行分析和表征。方法:将27例酒渣鼻患者与25例健康对照进行配对。DNA是从参与者的鼻子、下巴、前额和双颊的皮肤拭子中提取的。采用Illumina MiSeq技术对16S rRNA基因V3V4区进行测序。使用α和β多样性检测面部皮肤微生物群的多样性。利用线性判别分析效应量(linear discriminant analysis effect size, LEfSe)对两组生物标志物进行定量研究。利用群落的系统发育调查,通过重建未观察到的状态,在属水平上进行了同源类群和京都基因百科全书的功能预测。结果:红斑痤疮患者面部皮肤微生物群的α多样性显著增加,β多样性在红斑痤疮患者与健康对照组之间存在显著差异。酒渣鼻患者面部皮肤微生物群落结构发生改变;然而,优势菌株与健康对照组相同,均为痤疮丙酸杆菌和表皮葡萄球菌。LEfSe结果显示酒渣鼻患者中含有丰富的黄单胞菌、不动杆菌和假单胞菌;然而,棒状杆菌、细细杆菌和嗜胃杆菌在健康对照中富集。酒渣鼻患者在膜转运、碳水化合物代谢、代谢性疾病、氨基酸转运与代谢、碳水化合物转运与代谢、转录、无机离子转运与代谢等途径的表达均显著降低。结论:与健康对照组相比,酒渣鼻患者面部皮肤微生物群多样性和群落结构发生变化,多种代谢途径表达下调,可能为酒渣鼻的监测、诊断和治疗提供新的策略方法。
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引用次数: 0
Effect of Peganum harmala Extract on Biofilm and Involved Gene Expression in Biofilm Production of Candida albicans 骆驼蓬提取物对白色念珠菌生物膜及相关基因表达的影响
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-05-08 DOI: 10.5812/jjm-132692
Maryam Erfaninejad, E. Aboualigalehdari, M. Fatahinia
Background: Since common drug therapies cannot eradicate Candida biofilm, extensive studies are required to develop more effective antifungal compounds and identify their mechanism of action against Candida biofilm. Peganum harmala L. is a traditional medicinal plant, the seeds of which have been used to treat various diseases. Objectives: This study aimed to investigate the anti-biofilm mechanisms of P. harmala extract (PHE) and the expression of CAT1, EFG1, and BCR1 genes involved in oxidative stress response and biofilm formation in Candida albicans. Methods: Anti-biofilm activity of PHE was evaluated by crystal violet assay to determine biofilm formation on 33 C. albicans isolates. Finally, a real-time polymerase chain reaction was performed to analyze the effect of PHE on the expression of CAT1, EFG1, and BCR1 genes in C. albicans. Results: This study determined the minimum biofilm eradication concentration (MBEC) of 15 isolates in concentrations between 0.49 - 3.9 μg/mL of P. harmala extract. Statistical analysis showed that the exposure of C. albicans biofilm to PHE significantly reduced the expression of CAT1 mRNA in C. albicans isolates (P = 0.0068). However, no significant difference was observed in the expression of EFG1 and BCR1 genes. Conclusions: The results demonstrated that PHE significantly decreased CAT1 expression in C. albicans cells treated with the herbal extract. PHE is likely to accumulate hydrogen peroxide (H2O2) by reducing CAT1 expression and disrupting the pro-oxidant/antioxidant balance that leads to the overproduction of reactive oxygen species (ROS) and can cause damage to cellular components and eventually destroy C. albicans biofilm.
背景:由于常见的药物治疗不能根除念珠菌生物膜,因此需要进行广泛的研究来开发更有效的抗真菌化合物,并确定其对念珠菌生物膜的作用机制。骆驼蓬是一种传统药用植物,其种子已被用于治疗各种疾病。目的:本研究旨在探讨骆驼蓬提取物(PHE)的抗生物膜机制以及CAT1、EFG1和BCR1基因在白色念珠菌氧化应激反应和生物膜形成中的表达。方法:采用结晶紫法测定PHE对33株白色念珠菌的生物膜形成情况。最后,进行实时聚合酶链反应来分析PHE对白色念珠菌中CAT1、EFG1和BCR1基因表达的影响。结果:本研究确定了15个分离株的最小生物膜根除浓度(MBEC),其浓度在0.49-3.9μg/mL骆驼蓬提取物之间。统计分析表明,PHE暴露于白色念珠菌生物膜可显著降低白色念珠菌分离株中CAT1mRNA的表达(P=0.0068),但EFG1和BCR1基因的表达没有显著差异。结论:PHE能显著降低中药提取物处理的白色念珠菌细胞中CAT1的表达。PHE可能通过减少CAT1表达和破坏促氧化剂/抗氧化剂平衡来积累过氧化氢(H2O2),从而导致活性氧(ROS)的过量产生,并可能对细胞成分造成损伤,最终破坏白色念珠菌生物膜。
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引用次数: 0
Comparison of the Polymerase Chain Reaction Method with Serological Tests in the Diagnosis of Human Brucellosis 聚合酶链反应法与血清学试验诊断人布鲁氏菌病的比较
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-05-01 DOI: 10.5812/jjm-128698
R. Sharififar, K. Heidari, Mahdi Mazandarani, Narges Lashkarbolouk
Background: Brucellosis is a zoonotic disease with different clinical symptoms. Its early diagnosis is essential to prevent severe complications. Due to the limitations of serological diagnostic methods, the polymerase chain reaction (PCR) method has become important in the diagnosis of the disease. Objectives: Our study aimed to evaluate the PCR method in patients with suspected brucellosis and compare it with serological tests. Methods: This cross-sectional study was performed on 90 febrile patients with clinical features of brucellosis who were examined by an infectious disease specialist. A total of 90 serum samples were collected from the suspected brucellosis patients admitted to the hospital and were analyzed by serological (Rose Bengal) and PCR tests. Then, each method's results were recorded and compared with each other. Results: According to serological test results, 45 samples were negative, and 45 were positive. Then, among the serology-positive patients, all had positive PCR results. However, 40 out of 45 patients had a positive PCR test in serology-negative patients. According to this study, the sensitivity of PCR in diagnosing human brucellosis with the serology-positive test is 100%, and with the negative serology test is 88.9%. Therefore, the sensitivity of PCR is higher than that of serology tests in patients, which was 50% in this study. Conclusions: The PCR test can be a valuable diagnostic method for patients with negative serologic test results.
背景:布鲁氏菌病是一种具有不同临床症状的人畜共患疾病。早期诊断对预防严重并发症至关重要。由于血清学诊断方法的局限性,聚合酶链式反应(PCR)方法在疾病诊断中变得重要。目的:本研究旨在评估PCR方法在疑似布鲁氏菌病患者中的应用,并将其与血清学检测进行比较。方法:对90例具有布鲁氏菌病临床特征的发热患者进行横断面研究。共从入院的疑似布鲁氏菌病患者中采集了90份血清样本,并通过血清学(玫瑰孟加拉)和PCR检测进行了分析。然后,记录每种方法的结果并相互比较。结果:血清学检测结果为阴性45例,阳性45例。然后,在血清学阳性患者中,所有患者的PCR结果均为阳性。然而,在血清学阴性的患者中,45名患者中有40人的PCR检测呈阳性。根据本研究,血清学阳性检测的PCR诊断人类布鲁氏菌病的敏感性为100%,血清学阴性检测的敏感性为88.9%。因此,PCR的敏感性高于本研究中50%的血清学检测。结论:对于血清学检测结果为阴性的患者,PCR检测是一种有价值的诊断方法。
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引用次数: 2
HSV-1 Infection Among COVID-19 Cases with Ocular and Neurological Manifestations 伴有眼部和神经系统症状的COVID-19病例的HSV-1感染
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-04-30 DOI: 10.5812/jjm-135251
S. Soltani, Mehrdokht Sadrkhanloo, G. Siri, A. Zakeri, Mohammad Saeid Emadi, A. Tabibzadeh, M. Didehdar, A. Farahani
Introduction: SARS-CoV-2 progression depends on multiple factors, including the compromised immune system and underlying diseases. HSV-1 reactivation in SARS-CoV-2 infection, more likely in patients with pneumonia and immunodeficiency, may be potentially life-threatening and implicate the prognosis. Case Presentation: We report two COVID-19 cases presenting ocular and neurological manifestations suspicious for HSV-1 encephalitis. Conclusions: Our study showed HSV-1 ocular manifestation among two COVID-19 cases. So, the recurrence of HSV-1 infection probably is related to immune responses during COVID-19 pathophysiology.
引言:严重急性呼吸系统综合征冠状病毒2型的进展取决于多种因素,包括免疫系统受损和潜在疾病。严重急性呼吸系统综合征冠状病毒2型感染中的HSV-1再激活,更可能发生在肺炎和免疫缺陷患者中,可能危及生命并影响预后。病例介绍:我们报告了两例新冠肺炎病例,其眼部和神经系统表现怀疑为HSV-1脑炎。结论:我们的研究在两例新冠肺炎病例中显示了HSV-1的眼部表现。因此,HSV-1感染的复发可能与新冠肺炎病理生理过程中的免疫反应有关。
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引用次数: 0
TaqMan Multiplex Real-time PCR Assay for Crimean-Congo Hemorrhagic Fever Virus Diagnosis Using Armored RNA Technology TaqMan多重实时PCR技术在克里米亚-刚果出血热病毒诊断中的应用
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-04-29 DOI: 10.5812/jjm-134188
Saleh Jamehdor, N. Hosseinirouzbahani, Seyed javad Hoseinishokoh, K. Ghorban, A. Teimoori, M. Gholami, Parisa Agahi, Ghazale Azizi, M. Mohammadimehr
Background: Crimean-Congo hemorrhagic fever virus (CCHFV) is a highly lethal virus that causes hemorrhagic fever in humans and is endemic in many countries, including Iran. Therefore, fast, accurate, and reliable diagnosis is crucial for patient management and outbreak control. Objectives: This study aims to optimize a TaqMan multiplex real-time RT-PCR for the rapid and specific diagnosis of CCHFV. Methods: In this study, the L (NC_005301.3) and S (NC_005302.1) fragments were used as reference sequences for blast analysis. The L and S sequence segments of CCHFV with more than 90% identity from different areas were downloaded from the Genbank database. Primers and probes were designed based on the best-conserved regions of CCHFV L and S sequence segments. To construct the plasmid, a 1751 bp fragment from the MS2 phage that was previously amplified using cloning primers was inserted into the pET-32a plasmid. The S and L segments of the CCHFV, which were 110 bp and 135 bp, respectively, were inserted downstream of the MS2 phage sequence from HindIII to NotI. The Viral-like particles (VLPs) were produced in Escherichia coli, strain BL-21(DE3), in the presence of 1 mM Isopropyl β-D-1-thiogalactopyranoside (IPTG). The stability of VLP particles was confirmed in the presence of the ribonuclease enzyme. The fabrication of VLPs was approved by transmission electron microscopy (TEM) with negative staining (1% phosphotungstic acid). To validate the specificity of the primers and probes sequences, we compared them to the NCBI database and tested them experimentally using extracted DNA and RNA samples from healthy subjects and an infectious panel. Results: The VLPs showed complete resistance in the presence of the ribonuclease enzyme, and the TEM results confirmed that the VLPs were correctly produced. The TaqMan multiplex real-time RT-PCR confirmed that the primers and probes were designed correctly and were completely specific to the CCHFV. The limit of detection (LOD) of the multiplex assay for the L and S genes was one copy of the VLPs per µL. Conclusions: This TaqMan assay is reliable for amplifying CCHFV due to its design on conserved regions of the CCHFV sequences, which have minimal variability and high specificity.
背景:克里米亚-刚果出血热病毒(CCHFV)是一种导致人类出血热的高致死性病毒,在包括伊朗在内的许多国家流行。因此,快速、准确和可靠的诊断对患者管理和疫情控制至关重要。目的:本研究旨在优化TaqMan多重实时RT-PCR用于CCHFV的快速和特异性诊断。方法:在本研究中,使用L(NC_005301.3)和S(NC_00530 2.1)片段作为参考序列进行爆破分析。从Genbank数据库中下载了来自不同地区的具有90%以上同一性的CCHFV的L和S序列片段。引物和探针是基于CCHFV L和S序列片段的最佳保守区设计的。为了构建质粒,将先前使用克隆引物扩增的来自MS2噬菌体的1751bp片段插入pET-32a质粒中。CCHFV的S和L片段分别为110bp和135bp,插入从HindIII到NotI的MS2噬菌体序列的下游。在1mM异丙基β-D-1硫代吡喃半乳糖苷(IPTG)存在下,在大肠杆菌BL-21(DE3)菌株中产生病毒样颗粒(VLP)。VLP颗粒的稳定性在核糖核酸酶的存在下得到证实。VLP的制备通过透射电子显微镜(TEM)和阴性染色(1%磷钨酸)获得批准。为了验证引物和探针序列的特异性,我们将它们与NCBI数据库进行了比较,并使用从健康受试者和感染小组提取的DNA和RNA样本对它们进行了实验测试。结果:在核糖核酸酶存在下,VLP表现出完全的抗性,TEM结果证实VLP是正确产生的。TaqMan多重实时RT-PCR证实引物和探针设计正确,对CCHFV完全特异。L和S基因多重检测的检测限(LOD)为每µL一个VLP拷贝。结论:该TaqMan分析法是扩增CCHFV的可靠方法,因为它设计在CCHFV序列的保守区,具有最小的变异性和高特异性。
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引用次数: 0
Parainfluenza Virus Type 3 Co-infection with Other Respiratory Pathogens Among Hospitalized Children with Acute Respiratory Infections in Wuhan, China 武汉市急性呼吸道感染住院儿童中3型副流感病毒与其他呼吸道病原体的联合感染
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-04-26 DOI: 10.5812/jjm-135823
Dan Z. Lu, Ying Cheng, Hongbo Hu
Background: Bacterial and viral co-infections are increasingly recognized as the cause of Acute Respiratory Infection (ARI). The role of co-infection in ARI patients with Parainfluenza Virus type 3 (PIV3) infection is unclear. Objectives: This study aimed to determine the prevalence of PIV3 co-infections in hospitalized children and assess the co-infections' role in ARI patients with PIV3 infections. Methods: Between January 2018 and December 2021, children were confirmed to have a PIV3 infection via throat swabs or nasopharyngeal aspirates. Some digital clinical data were analyzed, including demographic, epidemiological, diagnostic, and laboratory data. Results: During the study period from 2018 to 2021, 2,539 patients were hospitalized with ARI caused by PIV3. Of them, 34.0% had co-infection with other pathogens, and 2.4% had co-infection with more than two pathogens. Mycoplasma pneumoniae was the most common co-infecting pathogen (71.3%), followed by other bacteria (13.3%) and viruses (8.2%). A significantly higher proportion of patients with M. pneumoniae co-infection was found in girls (χ2 = 19.233, P < 0.001). Co-infections with M. pneumoniae were observed principally in patients aged 1 – 2 years (χ2 = 202.130, P < 0.001). In contrast, viral (56.3%) and bacterial (66.1%) co-infections occurred mainly in children younger than one year. The diagnosis of PIV3 as a single infection included pneumonia (41.2%), bronchitis (39.9%), upper respiratory tract infections (15.0%), and laryngitis (3.9%), which were distinguished from those with bacterial co-infections (χ2 = 16.424, P = 0.001) and co-infections with more than two pathogens (χ2 = 11.687, P = 0.010). Co-infections of PIV3 with any pathogen were not associated with admissions to intensive care units or ventilator support. However, the mean hospitalization was significantly higher in M. pneumoniae co-infections (t = 2.367, P = 0.018), bacterial co-infections (t = 2.402, P = 0.016), and co-infections with more than two pathogens (t = 2.827, P = 0.006) than in single PIV3 infection. Conclusions: Parainfluenza virus type 3 frequently occurs with other pathogens. The epidemiological and clinical characteristics of co-infections with different pathogens differed. Mycoplasma pneumoniae co-infections, bacterial co-infections, and co-infections with more than two pathogens lengthened the hospitalization. Bacterial co-infections and co-infections with more than two pathogens increased the severity of ARI and worsened the symptoms.
背景:细菌和病毒合并感染越来越被认为是急性呼吸道感染(ARI)的原因。ARI患者合并副流感病毒3型(PIV3)感染的合并感染的作用尚不清楚。目的:本研究旨在确定住院儿童PIV3合并感染的患病率,并评估合并感染在伴有PIV3感染的ARI患者中的作用。方法:2018年1月至2021年12月期间,通过咽拭子或鼻咽吸痰确认儿童感染PIV3。分析了一些数字临床数据,包括人口统计、流行病学、诊断和实验室数据。结果:2018年至2021年研究期间,2539例因PIV3引起的ARI住院。其中34.0%的患者合并感染其他病原菌,2.4%的患者合并感染2种以上病原菌。肺炎支原体是最常见的共感染病原体(71.3%),其次是其他细菌(13.3%)和病毒(8.2%)。女孩合并肺炎支原体感染的比例明显高于女孩(χ2 = 19.233, P < 0.001)。肺炎支原体合并感染主要发生在1 ~ 2岁的患者中(χ2 = 202.130, P < 0.001)。相比之下,病毒(56.3%)和细菌(66.1%)合并感染主要发生在一岁以下的儿童中。PIV3为单一感染的诊断包括肺炎(41.2%)、支气管炎(39.9%)、上呼吸道感染(15.0%)和喉炎(3.9%),与合并细菌感染(χ2 = 16.424, P = 0.001)和合并两种以上病原体感染(χ2 = 11.687, P = 0.010)有明显区别。PIV3与任何病原体的合并感染与入住重症监护病房或呼吸机支持无关。然而,肺炎支原体合并感染(t = 2.367, P = 0.018)、细菌合并感染(t = 2.402, P = 0.016)和两种以上病原体合并感染(t = 2.827, P = 0.006)的平均住院率显著高于单一PIV3感染。结论:3型副流感病毒常与其他病原体一起发生。不同病原菌合并感染的流行病学和临床特征存在差异。肺炎支原体合并感染、细菌合并感染和两种以上病原体合并感染延长了住院时间。细菌共感染和两种以上病原体的共感染增加了ARI的严重程度并使症状恶化。
{"title":"Parainfluenza Virus Type 3 Co-infection with Other Respiratory Pathogens Among Hospitalized Children with Acute Respiratory Infections in Wuhan, China","authors":"Dan Z. Lu, Ying Cheng, Hongbo Hu","doi":"10.5812/jjm-135823","DOIUrl":"https://doi.org/10.5812/jjm-135823","url":null,"abstract":"Background: Bacterial and viral co-infections are increasingly recognized as the cause of Acute Respiratory Infection (ARI). The role of co-infection in ARI patients with Parainfluenza Virus type 3 (PIV3) infection is unclear. Objectives: This study aimed to determine the prevalence of PIV3 co-infections in hospitalized children and assess the co-infections' role in ARI patients with PIV3 infections. Methods: Between January 2018 and December 2021, children were confirmed to have a PIV3 infection via throat swabs or nasopharyngeal aspirates. Some digital clinical data were analyzed, including demographic, epidemiological, diagnostic, and laboratory data. Results: During the study period from 2018 to 2021, 2,539 patients were hospitalized with ARI caused by PIV3. Of them, 34.0% had co-infection with other pathogens, and 2.4% had co-infection with more than two pathogens. Mycoplasma pneumoniae was the most common co-infecting pathogen (71.3%), followed by other bacteria (13.3%) and viruses (8.2%). A significantly higher proportion of patients with M. pneumoniae co-infection was found in girls (χ2 = 19.233, P < 0.001). Co-infections with M. pneumoniae were observed principally in patients aged 1 – 2 years (χ2 = 202.130, P < 0.001). In contrast, viral (56.3%) and bacterial (66.1%) co-infections occurred mainly in children younger than one year. The diagnosis of PIV3 as a single infection included pneumonia (41.2%), bronchitis (39.9%), upper respiratory tract infections (15.0%), and laryngitis (3.9%), which were distinguished from those with bacterial co-infections (χ2 = 16.424, P = 0.001) and co-infections with more than two pathogens (χ2 = 11.687, P = 0.010). Co-infections of PIV3 with any pathogen were not associated with admissions to intensive care units or ventilator support. However, the mean hospitalization was significantly higher in M. pneumoniae co-infections (t = 2.367, P = 0.018), bacterial co-infections (t = 2.402, P = 0.016), and co-infections with more than two pathogens (t = 2.827, P = 0.006) than in single PIV3 infection. Conclusions: Parainfluenza virus type 3 frequently occurs with other pathogens. The epidemiological and clinical characteristics of co-infections with different pathogens differed. Mycoplasma pneumoniae co-infections, bacterial co-infections, and co-infections with more than two pathogens lengthened the hospitalization. Bacterial co-infections and co-infections with more than two pathogens increased the severity of ARI and worsened the symptoms.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48651042","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: 1
Serogroup and Pathogenicity Island Marker Distributions Among Uropathogenic Escherichia coli Isolates in Rasht, Iran 伊朗拉什特市尿路致病性大肠杆菌分离株的血清群和致病性岛标记分布
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-04-10 DOI: 10.5812/jjm-132754
Ali Moradpoor Shamami, M. Anvari, H. Pourmoshtagh, T. Shafighi, Hadi Seddigh Ebrahim-Saraie
Background: Urinary tract infections (UTIs) are among the most prevalent infections in hospitals and communities worldwide. Objectives: Due to the medical importance of UTIs caused by uropathogenic Escherichia coli (UPEC), this study aimed to investigate pathogenicity island (PAI) markers, O-antigen serogroups, and resistance to antibiotic agents associated with UPEC isolates obtained from hospitalized patients in Rasht city hospitals. Methods: A total of 110 urine samples were taken from patients with UTI referred to selected hospitals in Rasht, Iran. The double-disk synergy test (DDST) was used to detect the isolate’s ability to produce extended-spectrum β-lactamase (ESBL). Using particular primers, eight PAIs were detected (ie, PAI I536, PAI II536, PAI III536, PAI IV536, PAI ICFT073, PAI IICFT073, PAI IJ96, and PAI IIJ96). Results: According to the antibiotic susceptibility pattern, a high level of antibiotic resistance was observed against nalidixic acid (81.8%) and co-trimoxazole (78.2%), while the most effective agent was amikacin (85.5%). Double-disk synergy test revealed that the incidence of ESBL-positive strains was 62.7% (69/110). Of the 110 UPEC isolates, 106 (96.4%) carried at least one of the investigated PAI markers. UPEC isolates with PAI IV536 (81.8%) had the highest prevalence, and PAI J196 (6.4%) had the lowest PAI marker. The most predominant serogroup O was O25 (36.4%), followed by O16 (17.3%), while the O4 and O7 serogroups (0.9%) were the lowest serogroups among UPEC isolates. Conclusions: The characterization of our strain revealed the co-occurrence of PAI and serogroups, confirming the importance of antibiotic resistance among the distinct serogroups and PAI markers. Our results have potential application for epidemiological studies and designing UTI treatment strategies against UTIs caused by UPEC.
背景:尿路感染是世界各地医院和社区最常见的感染之一。目的:鉴于尿路致病性大肠杆菌(UPEC)引起的尿路感染在医学上的重要性,本研究旨在调查致病性岛(PAI)标志物、O-抗原血清群以及与Rasht市医院住院患者的UPEC分离株相关的抗生素耐药性。方法:从伊朗拉什特选定医院转诊的尿路感染患者身上共采集110份尿液样本。采用双纸片协同试验(DDST)检测分离株产超广谱β-内酰胺酶(ESBL)的能力。使用特定的引物,检测到8种PAI(即,PAI I536、PAI II536、PAI III536、PAI IV536、PAI ICFT073、PAI IICFT073,PAI IJ96和PAI IIJ96)。结果:从药敏模式来看,萘啶酸和复方三恶唑的耐药率较高(81.8%),阿米卡星的耐药率最高(85.5%),双纸片协同试验显示ESBL阳性菌株的发生率为62.7%(69/110)。在110个UPEC分离株中,106个(96.4%)携带至少一种所研究的PAI标记。具有PAI IV536的UPEC分离株(81.8%)的患病率最高,PAI J196(6.4%)的PAI标记物最低。最主要的O血清群是O25(36.4%),其次是O16(17.3%),而O4和O7血清群(0.9%)是UPEC分离株中最低的血清群。结论:我们菌株的特征揭示了PAI和血清群的共存,证实了不同血清群和PAI标记物之间抗生素耐药性的重要性。我们的研究结果有可能应用于流行病学研究和设计针对UPEC引起的尿路感染的UTI治疗策略。
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引用次数: 0
Genomic Insights Into Molecular Characteristics and Phylogenetic Linkage Between the Cases of Carbapenem-Resistant Klebsiella pneumoniae From a Non-tertiary Hospital in China: A Cohort Study 中国一家非三级医院耐碳青霉烯肺炎克雷伯菌病例的分子特征和系统发育联系的基因组学研究:一项队列研究
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-03-29 DOI: 10.5812/jjm-133210
C. Shen, Tao Lv, Ge Huang, Xiaoxiang Zhang, Lisi Zheng, Yunbo Chen
Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) strains have been listed as one of the major clinical concerns. Objectives: We investigated CPKP isolates from non-tertiary hospitals to find disseminated clones and analyze extensive phenotypic and genetic diversity in this study. Methods: In this cohort study, a total of 49 CRKP isolates from 3 hospitals in the same region were collected in 2021. The prevalence and antimicrobial susceptibility patterns were analyzed. Clinical data were retrieved from electronic medical record systems. The molecular types, antimicrobial resistance (AMR) profiles, plasmid replicons, and virulence factors were analyzed. The maximum-likelihood phylogenetic tree and transmission networks were constructed using single-nucleotide polymorphisms (SNPs). Results: The median age of patients (N = 49) was 66.0 years, and 85.7% were male. The most common CRKP infection was nosocomial pneumonia (75.5%), followed by bacteremia (10.2%). More than 53% of isolates were resistant to ceftazidime-avibactam (CAZ/AVI). Forty-five isolates were successfully sequenced; the predominant carbapenem-resistant gene was blaKPC-2 (93.3%). The 30-day mortality in our cohort was 24.5%. The most dominant sequence type (ST) was ST11 (60.0%), followed by ST15 (13.3%). Whole genome sequencing (WGS) analysis exhibited dissemination of ST11 strain clones, ST420, and ST15 clones, both within and outside the given hospital. Conclusions: In this surveillance study, several dissemination chains of CRKP were discovered in the hospital and the region, as ST11 was the main epidemic clone. Our findings suggest that effective infection control practices and antimicrobial stewardship are needed in non-tertiary hospitals in China.
背景:耐碳青霉烯类肺炎克雷伯菌(CRKP)菌株已被列为临床关注的主要菌株之一。目的:在本研究中,我们调查了来自非三级医院的CPKP分离株,以寻找传播性克隆并分析广泛的表型和遗传多样性。方法:在本队列研究中,2021年共收集了来自同一地区3家医院的49株CRKP分离株。分析了流行率和耐药性模式。临床数据是从电子病历系统中检索的。分析了分子类型、抗微生物耐药性(AMR)谱、质粒复制子和毒力因子。利用单核苷酸多态性(SNPs)构建了最大似然系统发育树和传播网络。结果:患者的中位年龄(N=49)为66.0岁,其中85.7%为男性。最常见的CRKP感染是医院内肺炎(75.5%),其次是菌血症(10.2%)。超过53%的分离株对头孢他啶-阿维巴坦(CAZ/AVI)具有耐药性。45个分离株成功测序;主要的碳青霉烯抗性基因是blaKPC-2(93.3%)。我们队列中的30天死亡率为24.5%。最主要的序列类型(ST)是ST11(60.0%),其次是ST15(13.3%)。全基因组测序(WGS)分析显示,ST11菌株克隆、ST420和ST15克隆在医院内外传播。结论:在本监测研究中,由于ST11是主要的流行克隆,在医院和该地区发现了CRKP的几个传播链。我们的研究结果表明,中国非三级医院需要有效的感染控制措施和抗菌药物管理。
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引用次数: 0
Immunologic Profile of Severe COVID-19 Patients in Alborz Province, Iran 伊朗阿尔布尔茨省新冠肺炎重症患者免疫概况
IF 0.6 4区 医学 Q4 Medicine Pub Date : 2023-03-27 DOI: 10.5812/jjm-134264
Arman Shafiee, S. Rezaian, Mansur Aliyu, Ali Shayeghpour, Z. Mokhames, Hamed Mohammadi, Somayeh Yaslianifard, A. Soleimani, Fatemeh Soleimanifar, Taranom Tojari, M. Qorbani, Sayed-Hamidreza Mozhgani
Background: The coronavirus disease 2019 (COVID-19) pandemic has prompted researchers to look for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenicity in depth. Immune system dysregulation was one of the major mechanisms in its pathogenesis. The evidence regarding the levels of interferons (IFNs) and pro- and anti-inflammatory cytokines in COVID-19 patients is not well-established. Objectives: Therefore, this study evaluated the expression level of type-I, II, III IFNs, along with interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-10 (IL-10), and FOXP3 genes in patients with severe COVID-19 to provide additional insights regarding the regulation of these cytokines during COVID-19 infection. Methods: Peripheral blood mononuclear cells were isolated from two groups, including severe COVID-19 patients and healthy controls. Ribonucleic acid was extracted to evaluate the expression level of IFN-a, IFN-b, IFN-g, IFN-la, IL-1, IL-6, IL-10, and FOXP3 genes using real-time polymerase chain reaction. The correlations between the expression levels of these genes were also assessed. Results: A total of 40 samples were divided into two groups, with each group consisting of 20 samples. When comparing the severe COVID-19 group to the controls, the expression levels of IFN-g, tumor necrosis factor-alpha (TNF-α), IL-6, and IL-10 genes were significantly higher in the severe COVID-19 group. The two groups had no significant differences in IFN-a, IFN-b, IFN-la, IL-1, and FOXP3 expression. The correlation analysis revealed a negative correlation between type I and type III IFNs (i.e., IFN-a and IFN-la) and pro-inflammatory cytokines (i.e., IL-1 and IL-10). Conclusions: This study suggests the possible upregulation of IFN-g, IL-6, IL-10, and TNF-α during SARS-CoV-2 pathogenicity. The preliminary findings of this study and those reported previously show that the levels of IFNs and pro- and anti-inflammatory cytokines are not uniformly expressed among all COVID-19 patients and might differ as the disease progresses to the severe stage.
背景:2019冠状病毒病(新冠肺炎)大流行促使研究人员深入寻找严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的致病性。免疫系统失调是其发病机制之一。关于新冠肺炎患者中干扰素(IFN)、促炎和抗炎细胞因子水平的证据尚不明确。目的:因此,本研究评估了重症新冠肺炎患者中I型、II型、III型IFN以及白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、白介素-10(IL-10)和FOXP3基因的表达水平,以提供有关这些细胞因子在新冠肺炎感染期间的调节的更多见解。方法:从新冠肺炎重症患者和健康对照组中分离外周血单核细胞。提取核糖核酸,使用实时聚合酶链反应评估IFN-a、IFN-b、IFN-g、IFN-la、IL-1、IL-6、IL-10和FOXP3基因的表达水平。还评估了这些基因的表达水平之间的相关性。结果:将40份样本分为两组,每组20份。当将重症新冠肺炎组与对照组进行比较时,重症新冠肺炎组IFN-g、肿瘤坏死因子α(TNF-α)、IL-6和IL-10基因的表达水平显著升高。两组在IFN-a、IFN-b、IFN-la、IL-1和FOXP3表达方面没有显著差异。相关性分析显示,I型和III型IFN(即IFN-a和IFN-la)与促炎细胞因子(即IL-1和IL-10)之间呈负相关。结论:本研究提示IFN-g、IL-6、IL-10和TNF-α在严重急性呼吸系统综合征冠状病毒2型致病过程中可能上调。这项研究的初步结果和之前报道的结果表明,在所有新冠肺炎患者中,IFN以及促炎和抗炎细胞因子的水平并不一致,并且可能随着疾病发展到严重阶段而有所不同。
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引用次数: 0
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Jundishapur Journal of Microbiology
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