Detection of Exotoxins and Antimicrobial Susceptibility Pattern in Clinical Pseudomonas Aeruginosa Isolates

Background: Pseudomonas aeruginosa is a common opportunistic pathogen that causes nosocomial infection in immunocompromised patients. Among different virulence factors, the type III secretion system (TTSS) is an important agent in virulence and development of antimicrobial resistance in P. aeruginosa. Objectives: Previous studies have shown that production of type III secretion system proteins was correlated with increasing virulence and resistance to several antibiotics. In this study we determined the exotoxins genes (exoU and exoS) and pattern of antimicrobial susceptibility in clinical P. aeruginosa isolates. Methods: A total of 175 P. aeruginosa isolates were collected from patients hospitalized in educational hospitals of Shahrekord and Chamran hospital of Isfahan, Iran from April to December 2015. Antimicrobial susceptibility test was performed by disk diffusion test. The presence of exotoxins genes was detected using multiplex PCR of exoU and exoS genes. Results: The antibiotic resistance rate was higher than 70% to many antibiotics. The highest rate of resistance was related to Levofloxacin and Meropenem (155 (88.6%), 148 (84.6%)) respectively. The exoU gene was found in 75 (42.9%) isolates and 136 (77.7%) of the isolates carried the exoS. In addition, 36(20.6%) of the isolates carried the both of gens. A statistical significance was detected between the presence of exoU gene and resistance to pipracillin (P = 0.01). Conclusions: The result of this study was indicated a high resistance rate to the most antibiotic classes and a specific relationship between the virulence genotype and antimicrobial resistance especially more virulent genotype of exoU+ . In order to prevent the spread of more virulent strains in health care facilities, molecular methods alongside antimicrobial susceptibility tests is suggested

Molecular and microscopy detection of Pneumocystis jirovecii in hospitalized patients during the COVID-19 pandemic

IntroductionEarly detection of Pneumocystis jirovecii as an opportunistic pathogen that may endanger predisposed persons, including COVID-19 patients, may help to choose the optimal management.MethodsIn this study, 585, including 530 COVID-19 patients, with clinical and radiological evidence of respiratory diseases, were investigated for P. jirovecii screening. Clinical specimens were examined by direct microscopy and PCR, and randomly selected positive PCR products were confirmed through DNA sequence analysis.ResultsThirty-one (5.3%) samples were positive in P. jirovecii-specific nested-PCR, while by direct microscopic tests, Pneumocystis was observed in 22 (3.76%) samples. Males (61.7%) and patients over 50 years old (75.6%) were more commonly affected than others, and malaise and fatigue (84%), and wheezing (75%) were the most common symptoms, followed by fever (40.48%) and dyspnea (39.51%). Among the Pneumocystis-positive patients, three cases had coinfection with Aspergillus fumigatus, A. flavus, and A. niger (each n = 1), as documented by direct microscopy, culture, and species identification by PCR-sequencing.ConclusionPneumocystis pneumonia is still a diagnostic challenge; therefore, additional large-scale studies are needed to clarify the epidemiology of the disease in immunocompromised or COVID-19 patients

Epidemiology of bloodstream infections and antimicrobial susceptibility pattern in ICU and non-ICU wards: A four-year retrospective study in Isfahan, Iran

Background: Bloodstream infections (BSIs) are one of the causes of morbidity and mortality in hospitalised patients. This study evaluated BSI's incidence, trend, antimicrobial susceptibility patterns and mortality in AL Zahra Hospital in Isfahan, Iran. Materials and Methods: This retrospective study was conducted in AL Zahra Hospital from March 2017 to March 2021. The Iranian nosocomial infection surveillance system was used for data gathering. The data included demographic and hospital data, type of bacteria, and antibiotic susceptibility findings and were analysed in SPSS-18 software. Results: The incidence of BSIs was 1.67% and 0.47%, and the mortality was 30% and 15.2% in the intensive care unit (ICU) and non-ICU wards, respectively. In the ICU, the mortality was correlated with the use of the catheter, type of organism and year of study, but in non-ICU, correlated with age, gender, use of the catheter, ward, year of study and duration between the incidence of BSIs and discharging/death. Staphylococcus epidermidis, Acinetobacter spp. and Klebsiella spp. were the most frequent germs isolated in all wards. Vancomycin (63.6%) and Gentamycin (37.7%) for ICU and Vancomycin (55.6%) and Meropenem (53.3) for other wards were the most sensitive antibiotics. Conclusion: Despite the few rate of BSI in the last four years in AL Zahra Hospital, our data showed that its incidence and mortality in the ICU ward are significantly more than in other hospital wards. We recommend prospective multicentre studies to know the total incidence of BSI, local risk factors and patterns of pathogens causing BSI

Herbal medicines as potential inhibitors of SARS-CoV-2 infection

Coronavirus disease 2019 (COVID-19) is the result of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Understanding molecular pathogenesis is an essential factor for the allocation of effective preventive measures and the development of targeted therapeutics against COVID-19. The genome of SARS-CoV-2 encodes structural and nonstructural proteins, which can be targets for compounds with potential therapeutic ability. On the other hand, the virus life cycle has stages susceptible to targeting by drug compounds. Many natural antiviral compounds have been studied and evaluated at the cellular and molecular levels with antiviral potential. Meanwhile, many studies over the past few months have shown that plant polysaccharides have good ability to target proteins and stages of the virus life cycle. In this regard, in this review study, the virus specifications and infectious process and structural and functional components of SARS-CoV-2 will be reviewed, and then the latest studies on the effect of plant compounds with more focus on polysaccharides on viral targets and their inhibitory potential on the infectious process of COVID-19 will be discussed. Keywords: Alkaloids; COVID-19; Herbal medicines; Polyphenols; Polysaccharides; SARS-CoV-2; Terpene

Concordance of the tuberculin skin test and T-SPOT® .TB test results in kidney transplant candidates

Background: Detection of latent tuberculosis infection (LTBI) in transplant candidates is very important. The tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are standard immunologic tools for LTBI detection. The aim of this study was to compare the TST results and T-SPOT® .TB test (a type of IGRAs) in kidney transplant candidates for the screening of LTBI and follow the patients with positive test for an activation of tuberculosis (TB) after transplantation and using anti-TB prophylaxis. Materials and Methods: This study was a prospective study and carried out in 44 renal transplant candidates from March 2010 to February 2011 in the teaching hospitals of Isfahan University of Medical Sciences, Iran. TST and T-SPOT® .TB test were performed and their results evaluated. Patients with a positive skin test and/or T-SPOT® .TB test were started on anti-TB prophylaxis and followed after transplantation for an activation of their LTBI for 1 year. Results: Overall, 8 (18.2%) patients were positive for TST and 6 (13.6%) patients for T-SPOT® .TB test. The agreement between TST and T-SPOT®.TB test was moderate (κ = 0.49, 95% confidence interval 0.145-0.839). The overall agreement between TST and T-SPOT® .TB test was 86%. No relation was found between the underlying diseases and TST or T-SPOT® .TB test positivity. Although isoniazid prophylaxis was used for patients with positive TST and/or T-SPOT® .TB test, one patient had reactivation of TB. Conclusion: In kidney transplant candidates both TST and T-SPOT® .TB test were comparable for the diagnosis of LTBI with reasonable agreement between the tests. However, further studies are needed to determine the ability of T-SPOT® .TB test to detect LTBI and to evaluate the need for prophylaxis in these patients

Establishment and Development of the First Biobank of Inflammatory Bowel Disease, Suspected to Primary Immunodeficiency Diseases in Iran

Background: Inflammatory bowel disease (IBD) might be an immunodeficiency rather than an excessive inflammatory reaction. IBD, suspected to primary immunodeficiency diseases biobank (IBDSPIDB) as a resource for researches can help improve the prevention, diagnosis, and illness treatment and the health promotion throughout the society. Therefore, we launched the biobank of IBDSPID for the first time in Iran. Materials and Methods: This study was designed to provide the IBDSPIDB to have a high-quality DNA, RNA, and cDNA. Among of 365 patients, 39 have inclusion criteria that were as below: (1) IBD diagnosis before 5 years of age. (2) Resistance to conventional therapy of IBD. (3) Severe IBD. (4) Signs of SPID (including ear infections or pneumonia or recurrent sinus within the 1-year period; failure to thrive; poor response to the prolonged use of antibiotics; persistent thrush or skin abscesses; or a family history of PID). Results: Out of 39 patients, 51.3% were males. The mean age was 32.92 ± 15.90 years old. Ulcerative colitis (79.5%) was more than Crohn's disease. The majority of patients (50.0%) had severe IBDSPID. Resistance to drugs and consanguinity was 12.9% and 47.4%, respectively. Age at onset in 65.8% of patients was after 17 years old. Patients with autoimmune, allergy, and immunodeficiency disease history were 33.3%, 33.3%, and 10.36%, respectively. RNA and cDNA yields large quantities of high-quality DNA obtained and stored. Conclusion: Our biobank would be valuable for future genetic and molecular study to be more about the relation between IBD and PID