Tuberculosis Status and Coinfection of Pulmonary Fungal Infections in Patients Referred to Reference Laboratory of Health Centers Ghaemshahr City during 2007-2017

BACKGROUND: Pulmonary tuberculosis is one of the most important health concerns. Pulmonary fungal infections have clinical and radiological characteristics similar to tuberculosis which may be easily misdiagnosed as tuberculosis. This study aimed to evaluate tuberculosis (TB) status and coinfection of TB with pulmonary fungal infections in patients referred to reference laboratory of health centers Ghaemshahr city during 2007-2017.METHODS: This cross-sectional study was conducted during eleven years, between 2007 2017, on 3577 patients with suspected TB referred to health centers of Ghaemshahr City. For isolation, sputum smear preparation and Ziehl-Neelson staining in companying with microscopy direct observation and KOH 10% + white Calcofluor staining was used. The culture of fungi was performed on Sabouraud Dextrose agar, Czapek and chrome agar media. Then, data were analyzed using SPSS software (version 16) through Student's t-test, Fisher test, and Odds Ratio. P values <0.05 were considered statistically significant.RESULTS: Of 3577 patients, 10731 smears were prepared, 3.6% (n=130) of patients were identified as smear-positive pulmonary tuberculosis, 86.4% (n=3090) were smear negative and 10% (n=357) drug-resistant TB. The mean age of patients was 48±1.8 years. With increasing age, the prevalence of TB has increased which was statistically significant (P value <0.05). Prevalence of tuberculosis in the age group over than 57 years in males and females had an ascending trend. Amongst the positive tuberculosis patients, 16/130 cases (12.3%) had the coinfection of TB with fungi microorganisms.CONCLUSION: Our findings showed the coinfection of fungi agents in patients with tuberculosis that should be considered.

Pulmonary fungal co-infection prevalence among Iranian patients with pulmonary tuberculosis: a systematic review and meta-analysis

Tuberculosis (TB) is further aggravated if it is accompanied with fungal co-infection. This study aimed to evaluate the prevalence of pulmonary fungal co-infection among Iranian patients with pulmonary TB using a systematic review and meta-analysis. The present study was a review of cross-sectional studies on the prevalence of pulmonary fungal co-colonization among Iranian patients with pulmonary TB with regard to the PRISMA Protocol. To this end, the articles published online in English and Persian were searched on the main databases and gateways such as Google Scholar, Science Direct, Web of Science, MEDLINE, PubMed, SCOPUS, Cochrane Library, Magiran, Irandoc, and Scientific Information Databases. The reviews of the literatures published online from 2000 to the end of 2018 were included in the study. The keywords used for searching through the databases were pulmonary fungal co-infection with pulmonary TB, pulmonary mycosis co-infection with pulmonary TB, pulmonary fungal colonization/agents with pulmonary TB, AND Iran. Finally, the collected data were analyzed by Comprehensive Meta-Analysis software. The analyses showed that the prevalence of fungal co-infection among patients with pulmonary TB varied from 12.3-68.8%, and that the combined prevalence of fungal co-infection among patients with pulmonary TB was 17.4%. Amongst the fungi involved in co-infection with TB, Candida spp. was the most predominant with the prevalence of 6.9%, followed by Aspergillus spp. (3.2%). Moreover, the highest prevalence of Aspergillus spp. was observed for Aspergillus fumigatus (1.6%). The most frequent Candida spp. was Candida albicans with a frequency of 6%. The findings showed that the combined prevalence of fungal co-infection among Iranian patients with pulmonary TB was high. In this regard, among the fungi involved in co-infection with TB, Candida spp. was the most frequent

Prevalence of Catheter-associated bacteriuria in patients who received short-term catheterization in the northeast of Iran

Background: Catheter-associated (CA) bacteriuria is a result of the extensive usage of urinary catheterization. Once a catheter is placed, many patients achieve bacteriuria, even with the use of greatest consideration and care of the catheter. In this study, we decided to evaluate the prevalence of Catheter-associated bacteriuria in patients who received short-term catheterization in the northeast of Iran.Materials and Methods: In this cross-sectional study during one year (among 2014-2015) 275 patients who have admitted recently and have no history of catheterization and drug consumption were included. Three samples were taken from patients before, one day after catheterization and after removal of the catheter. The urine samples were analyzed and cultured on the suitable media. Antibiotics susceptibility testing was performed by disk diffusion method. Then, data analyzed using SPSS software by Student t-test. In addition, the p values less than 0.05 were considered as significant.Results: In general, the rate of catheter-associated bacteriuria in these hospitals was 68% (187 cases of 275). The mean age of the participants and patients with bacteriuria were 41±1.2 and 24.8±6.2 years old, respectively. The most common isolated bacteria were Escherichia coli (50.6%) followed by Staphylococcus aureus and Klebsiella pneumonia (21.6%). The highest sensitivity was reported against kanamycin (68.9%) and highest resistance was observed against ampicillin with a rate of 96.3%.Conclusion: For prevention of healthcare-associated UTI, correct catheterization and use of the closed catheter system is recommended. In addition, before prescribing any antibiotics it should be paying attention to the antibiotics susceptibility testing results

Prevalence of Pulmonary Tuberculosis, Failure of Treatment, and its Related Factors in Kashan During 2004-2017

Background: Mycobacterium tuberculosis affects the lungs in 85% of all cases and the remaining 15% through extra pulmonary affecting other parts of the body such as lymph nodes, pleura, and the genitourinary system. This study aimed to investigate extra-pulmonary tuberculosis (TB) associated factors, failure of treatment, and trends between 2004-2017 in Kashan, Iran.Materials and Methods: This study was conducted during 2004-2017 on newly registered extrapulmonary tuberculosis patients referred to TB Referral Center in Isfahan province, Kashan city, Iran. Information (demographic characteristics, related factors of the disease, and treatment status) of 197 extrapulmonary tuberculosis (EPTB) patients was extracted from Medical case records.Results: In total, 527 cases of Tuberculosis were reported, of which, 159 (30.17%) were confirmedextrapulmonary TB. Eighty-five (53.5%) and 74 (46.5%) were male and female, respectively. Also, 74(46.5%), and 84 (53.5%) of EPTB were from Iran, and Afghanistan immigrants, respectively. The average age of patients was 41.9±2.18. Among underlying diseases in extrapulmonary TB positive, diabetes mellitus (DM) was predominant with a prevalence of 31 (19.5%), while, 128 (80.5%) cases did not show any underlying disease. Most of the patients were in the age group (21-40 years) with a frequency of 60 (37.7%), and the lowest of patients belonged to the age group (>80 years) with a frequency of 9 (5.7%). No correlation was found between related factors and infection with EPTB (p> 0.05).Conclusion: Our findings showed that the prevalence of EPTB in Kashan was relatively high, but, a relative decrease was shown during 2004-2017, which with preventative measures can be reduced the prevalence

Study of drug resistance of Staphylococcus aurous and Pseudomonas aeruginosa strains isolated from environmental samples of Hamadan educational hospitals in 2017 using disk diffusion and minimum inhibitory concentration

Background: Staphylococcus aureus and Pseudomonas aeruginosa are the most important bacteria causing the nosocomial infections, which are resistant to most of the antibiotics. The aim of this study was to evaluate the drug resistance of S. aureus and P. aeruginosa strains isolated from environmental samples of Hamedan educational hospitals using disk diffusion and minimum inhibitory concentration (MIC) methods. Materials and Methods: In this descriptive cross-sectional study, 400 samples were collected from Hamedan educational hospitals. To assess the antibiotic susceptibility of 10 common antibiotics, the agar dilution (Kirby-Bauer) method was used. Also, to determine the MIC of S. aureus and P. aeruginosa, vancomycin and ciprofloxacin antibiotics were used. Results: From a total of 400 samples, 39 (9.7) isolates were P. aeruginosa and 28 (7) were S. aureus. Staphylococcus aureus showed the highest resistance to ofloxacin (82.1) and the highest drug resistance to P. aeruginosa was related to meropenem (82). Also, the highest MIC and maximum bactericidal concentration (MBC) for S. aureus to vancomycin were 128 and 256, respectively. In P. aeruginosa, the highest MIC and MBC to ciprofloxacin were 128 and 256, respectively. Conclusion: Staphylococcus aureus and P. aeruginosa showed the highest resistance to ofloxacin and meropenem, respectively. Considering the rapid increase of antibiotic resistance, accurate evaluation of the antibiotic resistance pattern of the bacteria is required

Seroprevalence and Trend of HBV, HCV, and HIV Infections among Blood Donors of Fars Province, Iran (2006-2018)

BACKGROUND: Blood transfusion is a life-saving procedure; millions of lives are saved each year. However, blood transfusions are associated with certain risks that can lead to adverse consequences. This study aimed to survey the prevalence and trend of hepatitis B virus (HBV), hepatitis C virus (HCV), and Human immunodeficiency virus (HIV) among blood donors of Fars province, Iran (2006-2018).METHODS: This retrospective cross-sectional study was conducted by reviewing the records of the blood transfusion organization of Fars province. A total of 1952478 blood units were screened for transfusion-transmitted infections (TTIs). Then, data were entered into SPSS software (Negare. version 25). Chi-square test was used to compare the sof TTIs among blood donors. Chisquare test for trend was used to analyze the variations in trends of TTIs during this period. Finally, p-values less than 0.05 were considered statistically significant. GraphPad Prism software was used for the depiction of the graphs.RESULTS: Among the 1952478 blood donations within the 13-years, 4479(0.229 %) of donors were HBsAg, HCV Ab, and HIV Ag-Ab positive. The seroprevalence of HBV, HCV, and HIV was 2684(0.137%), 1703(0.087 %), and 92(0.0047%), respectively.CONCLUSION: The current study showed that the overall prevalence of TTIs among blood donors was low and had a descending trend over the years of study

Prevalence of Nontuberculous Mycobacteria (NTM) in Iranian Clinical Specimens: Systematic Review and Meta-Analysis

Background: Although, nontuberculous mycobacteria can cause disease in different organisms, theyusually are not reported in most countries because scientists in general consider them as non-pathogens.But, increasing nontuberculous mycobacteria diseases occurrence has changed this belief. Nevertheless,there is no meta-analysis review about prevalence of nontuberculous mycobacteria in Iran.Methods: Any data about prevalence of nontuberculous mycobacteria in clinical specimens in Iranwere retrieved by searching data bases such as Pub Med, MEDLINE, and Iranian data bases. Then themeta-analysis was performed by comprehensive meta-analysis software (CMA).Results: The meta-analysis showed that the prevalence of nontuberculous mycobacteria in the clinicalspecimens in Iran was 1.3%. In the studies that had sample size less than 300, and in studies conductedafter 2004, the prevalence was higher. Also, the prevalence of nontuberculous mycobacteria was higherin the West of Iran. In this study, the most prevalent rapid-growing mycobacterium was Mycobacterium.fortuitum and most prevalent slow-growing mycobacterium was M. simiae with the prevalence 44.2%and 14.3%, respectively.Conclusion: M. simiae is the most prevalent nontuberculous mycobacteria in the clinical specimensin Iran. As this species of nontuberculous mycobacteria has similar clinical and radiologicalmanifestations with tuberculosis, it is often treated as tuberculosis. Unfortunately, M. simiae is resistantagainst first-line anti-TB drugs resulting in treatment failure after using routine anti-TB medication.Therefore, there is an urgent need for application of new diagnostic strategy for identification ofnontuberculous mycobacteria species.</span

Prevalence and antibiotic resistance patterns of bacterial agents isolated from urinary tract infections in outpatients referred to Kashan Reference Laboratory in Iran during 2021-2022

Background and Aim: The prevalence and patterns of antibiotic resistance among bacterial agents causing urinary tract infections (UTIs) can vary over time and across different geographical regions. This study aimed to evaluate the prevalence and antibiotic resistance patterns of bacterial agents isolated from urine cultures of outpatients referred to the Reference Laboratory in Kashan, Iran, during 2021-2022. Methods: This cross-sectional study analyzed 7365 urine culture samples collected from patients referred to the Reference Laboratory in Kashan, Iran, between April 2021 and March 2022. Urine samples were obtained using the mid-stream method under sterile conditions and cultured on MacConkey agar, blood agar, and specific bacterial media. The identified organisms were tested for antibiotic resistance using the disc diffusion method on Mueller Hinton agar medium following the guidelines of the National Committee for Clinical Laboratory Standards (CLSI 2020). Results: Among the 7365 patients with urine cultures, 401 individuals (5.4%) had positive culture results, with a predominance of women (88.8%). Escherichia coli (62.5%) and Klebsiella (24.6%) were the most frequently isolated organisms. Escherichia coli exhibited the highest resistance rates to cefazolin (54.7%), cotrimoxazole (51%), and ciprofloxacin (41%), while showing the lowest resistance to imipenem and nitrofurantoin (4.4%). Klebsiella showed the highest resistance to cefazolin (58.3%) and cotrimoxazole (41.4%), with the lowest resistance to imipenem (7.1%). Gram-positive bacteria demonstrated the highest resistance to clindamycin (71.4%) and cotrimoxazole (57.9%), while displaying the lowest resistance to gentamicin (14.7%) and nitrofurantoin (17.5%). Conclusion: Escherichia coli and Klebsiella were the predominant causative agents of UTIs, exhibiting similar antibiotic resistance patterns. Empirical antibiotic treatment based on these results may be considered before obtaining culture results

Phylogenetic relationships among Staphylococcus aureus isolated from clinical samples in Mashhad, Iran

SummaryThe spa gene occurs in all strains of Staphylococcus aureus (S. aureus), can function as a genetic marker and might be used distinguish strains at the species level. Hence, due to these advantages, we used spa typing and the Based Upon Repeat Pattern (BURP) to assign the clonal and phylogenetic relationships of S. aureus strains. The sensitivity of S. aureus strains to methicillin was determined using agar disk diffusion. The extracted DNA from 56 isolates of S. aureus was subjected to PCR to detect the spa gene with specific primers. The spa typing method was performed for each of the isolates, and then, BURP was used to cluster spa types (spa-CCs). Finally, using relevant software, the phylogenic tree was drawn. The results of this study showed that 25 out of 56 (44.6%) isolates were resistant to methicillin. The typing of S. aureus isolates revealed 24 different spa types among 56 isolates, and BURP analysis clustered the 24 spa types into 5 spa clonal complexes (CCs) and 12 singletons. The process of spa typing, in combination with BURP analysis, provides an efficient method for investigating phylogenetic and clonal relationships among clinical isolates and can be useful for monitoring bacterial spread between hospitals and communities as well as between and within hospitals