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.
{"title":"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","authors":"S. Şahin, O. Karaşahin, P. Tasar","doi":"10.5812/jjm-132890","DOIUrl":"https://doi.org/10.5812/jjm-132890","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45873033","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 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.
{"title":"Analysis and Characterization of the Facial Skin Microbiota in Rosacea","authors":"Junying Li, Peng Cao, Quanzhong Liu, Weifeng Yao, Zhenhua Nie, Litao Zhang","doi":"10.5812/jjm-132246","DOIUrl":"https://doi.org/10.5812/jjm-132246","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43993806","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}
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.
{"title":"Effect of Peganum harmala Extract on Biofilm and Involved Gene Expression in Biofilm Production of Candida albicans","authors":"Maryam Erfaninejad, E. Aboualigalehdari, M. Fatahinia","doi":"10.5812/jjm-132692","DOIUrl":"https://doi.org/10.5812/jjm-132692","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48634881","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. 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.
{"title":"Comparison of the Polymerase Chain Reaction Method with Serological Tests in the Diagnosis of Human Brucellosis","authors":"R. Sharififar, K. Heidari, Mahdi Mazandarani, Narges Lashkarbolouk","doi":"10.5812/jjm-128698","DOIUrl":"https://doi.org/10.5812/jjm-128698","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42169585","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, 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.
{"title":"HSV-1 Infection Among COVID-19 Cases with Ocular and Neurological Manifestations","authors":"S. Soltani, Mehrdokht Sadrkhanloo, G. Siri, A. Zakeri, Mohammad Saeid Emadi, A. Tabibzadeh, M. Didehdar, A. Farahani","doi":"10.5812/jjm-135251","DOIUrl":"https://doi.org/10.5812/jjm-135251","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41253427","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}
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.
{"title":"TaqMan Multiplex Real-time PCR Assay for Crimean-Congo Hemorrhagic Fever Virus Diagnosis Using Armored RNA Technology","authors":"Saleh Jamehdor, N. Hosseinirouzbahani, Seyed javad Hoseinishokoh, K. Ghorban, A. Teimoori, M. Gholami, Parisa Agahi, Ghazale Azizi, M. Mohammadimehr","doi":"10.5812/jjm-134188","DOIUrl":"https://doi.org/10.5812/jjm-134188","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46760891","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: 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}
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.
{"title":"Serogroup and Pathogenicity Island Marker Distributions Among Uropathogenic Escherichia coli Isolates in Rasht, Iran","authors":"Ali Moradpoor Shamami, M. Anvari, H. Pourmoshtagh, T. Shafighi, Hadi Seddigh Ebrahim-Saraie","doi":"10.5812/jjm-132754","DOIUrl":"https://doi.org/10.5812/jjm-132754","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49620089","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}
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.
{"title":"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","authors":"C. Shen, Tao Lv, Ge Huang, Xiaoxiang Zhang, Lisi Zheng, Yunbo Chen","doi":"10.5812/jjm-133210","DOIUrl":"https://doi.org/10.5812/jjm-133210","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46663263","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}
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.
{"title":"Immunologic Profile of Severe COVID-19 Patients in Alborz Province, Iran","authors":"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","doi":"10.5812/jjm-134264","DOIUrl":"https://doi.org/10.5812/jjm-134264","url":null,"abstract":"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.","PeriodicalId":17803,"journal":{"name":"Jundishapur Journal of Microbiology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45266009","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}