Evaluation of the Patients’ Conditions with Respiratory Tract Infections and Interventions to Prevent Taking Antibiotics in these Patients

Introduction: Overuse and inappropriate antibiotic prescription for acute respiratory infections (ARIs) are among the major contributors to the current antibiotic resistance problem. ARIs are among the most common infections, and due to their high prevalence, they are of great importance and can play a vital role in mortality among children and adults. Therefore, this study aimed to train physicians in terms of communication skills with patients to reduce the use of antibiotic, which results in minimizing antibiotic resistance, proper use of antibiotics when it is necessary to use, and minimize self-medication, which ultimately leads to reducing costs. Material & Methods: This cross-sectional study was conducted to control antibiotic consumption in patients with respiratory infections referring to physicians. (Ethic Code: IR.Medilam.Rec.1395.112) Findings: The results of this study showed that cefixime and co-amoxiclav antibiotics were the least and the most prescribed by gastroenterologists and hepatologists, as well as pediatricians, respectively. In addition, according to the results, cefixime antibiotic showed statistically significant results (P<0.05). Discussion & Conclusion: The results revealed a reduction in the prescriptions of cefixime and amoxicillin by general physicians, amoxicillin, cefixime, and azithromycin by pediatricians, and co-amoxiclav by infectious disease specialists. However, there was an increase in antibiotic prescriptions by gastroenterologists and hepatologists which could lead to resistance increase, and consequently, the treatment failure. Accordingly, it is of necessary importance to take measures and implement instructions for logical prescription of antibiotics leading to infection control, reducing antibiotic resistance, reducing the length of patients’ hospital stay, as well as mortality due to infection, and reducing treatment costs for patients and hospitals

Serum-based microRNA biomarkers for major depression: MiR-16, miR-135a, and miR-1202

Background: Depression is a common medical condition with a high prevalence leading to emotional abnormality. Despite some drawbacks, depression currently diagnosed using a combination of patient interviews and self-report questionnaires. Recently, there is emerging emphasis to establish biomarkers to diagnosis and clinical management of depression. This case–control study was designed to develop microRNA (miRNA)-based serum biomarker for depression. Materials and Methods: In this study, 39 patients with depression and 36 healthy controls were enrolled. Serum miRNAs gene expression was measured using real-time polymerase chain reaction (PCR) analysis; finally, the data represent as the 2–ΔCt followed by further statistical analysis. Results: The serum level of miR-16 was significantly (P < 0.001) down-regulated (mean: 0.9123 and standard deviation [SD]: 0.06) in compared to normal individuals (mean: 1.6848 and SD: 0.09). The concentration of miR-135a was also catastrophically decreased (P < 0.001) in the patients (mean: 1.160 and SD: 0.07) in compared to control (mean: 1.819 and SD: 0.09). The relative miR-1202 expression levels were significantly lower (P < 0.001) in the patients (mean: 0.1755 and SD: 0.01) than in the healthy individuals (mean: 0.2939 and SD: 0.01). The receiver operating characteristic curve analysis indicated the obvious separation between patient and healthy control, with an AUC of 0.75 (95% confidence interval [CI] = 0.642–0.858, P < 0.001), 0.72 (95% CI = 0.607–0.834, P < 0.001), and 0.74 (95% CI = 0.630–0.861, P < 0.001) for miR-16, miR-135a, and miR-1202, respectively. The data suggest that these miRNAs have a potential to be used as a biomarker of depression with sensitivity 77.8% and specificity of 61.5% for miR-16, 94.4% and 41.0% for miR-135a as well as 86.1% and 61.5% for miR-1202, respectively (P < 0.001). Conclusion: Our findings showed that these miRNA can be used as a biomarker of depression diagnosis. MiR-135a and miR-1202 exhibited better sensitivity and specificity, respectively

Molecular typing and antibiotic resistance patterns among clinical isolates of Acinetobacter baumannii recovered from burn patients in Tehran, Iran

Acinetobacter baumannii (A. baumannii) is now considered a highly resistant pathogen to various types of antibiotics. Therefore, tracking the source of its prevalence and continuous control is crucial. This study aimed to determine antibiotic resistance and perform various molecular typing methods on clinical isolates of A. baumannii isolated from hospitalized burn patients in Shahid Motahari Burn Hospital, Tehran, Iran. Hospital isolates were confirmed by phenotypic and molecular methods. Then the sensitivity to different antibiotics was determined using the minimum inhibitory concentration (MIC) method. In order to perform molecular typing, three-locus dual assay multiplex polymerase chain reaction (PCR), multiple-locus variable-number tandem repeat analysis (MLVA), and multilocus sequence typing (MLST) methods were used. Among the 60 isolates collected, the frequencies of multidrug-resistant (MDR) and extensively drug-resistant (XDR) isolates were 90 and 10%, respectively. The most effective antibiotics were colistin with 100% and tigecycline with 83.33% sensitivity. Isolates were 100% resistant to piperacillin/tazobactam and cephalosporins, and 68.3% were resistant to carbapenem. The results of multiplex PCR showed five groups that international clone I (IC I) and IC II were the most common. The MLVA method identified 34 MLVA types (MTs), 5 clusters, and 25 singletons. Multilocus sequence typing results for tigecycline-resistant isolates showed seven different sequence types (STs). Increasing antibiotic resistance in A. baumannii isolates requires careful management to control and prevent the occurrence of the pre-antibiotic era. The results of this study confirm that the population structure of A. baumannii isolates has a high diversity. More extensive studies are needed in Iran to better understand the epidemiology of A. baumannii