Evaluation the intestinal level of LCN2/NGAL in patients with Clostridium difficile infection in the south of Iran

Clostridium difficile is a Gram-positive obligate anaerobic bacterium that recognized an important pathogen of humans. The present study aimed to evaluate the intestinal level of neutrophil gelatinase-associated lipocalin (NGAL) in patients with C. difficile infection (CDI) as a disease activity marker in the south of Iran. This cross-sectional study conducted from October 2017 to June 2018 on patients referred to Nemazee and Amir Hospital in Shiraz, South of Iran. Patients less than two years old were excluded from the study. The study population was consist of 46 cases (Symptomatic patients that confirmed as a CDI), and 21 control individuals (Asymptomatic patients colonized by C. difficile). C. difficile isolates were identified by conventional microbiological producers and amplification of housekeeping gene by PCR method. The level of NGAL was determined by enzyme-linked immunosorbent assay (ELISA) according to the instructions of the kit manufacturer. The results showed that the level of NGAL in symptomatic patients' (case group) was higher than asymptomatic carriers (control group), 5.9 ng/mL vs. 4.1 ng/mL; however the observed difference was not statistically significant. Also, in both groups, the mean level of NGAL was significantly higher in patients with gastrointestinal diseases than others.  In summary, despite all the limitations, the results of the present study indicate that the intestinal level of NGAL is a biological indicator of intestinal inflammation, regardless of CDI. However, further study needs to elucidate the role of NGAL in inflammation caused by bacterial infections

Sustainable planning based on scenarios in the field of sustainable social tourism (Case Study: Meybod City)

Objective: The rapid growth of the tourism industry due to the accelerated growth of revenue in this field in recent decades, and the constant change and uncertainty of high impact events in this sector, on the other hand, the necessity of using new methods of future research and Long and long-term planning has made it more visible. Therefore, the main purpose of this study is to formulate future tourism scenarios and test the viability of sustainable social tourism strategies. Methods: In the present study, a combination of Delphi methods, PEST environmental scanning and interaction effects was used. Key parameters of sustainable social tourism were integrated and identified by key expert uncertainties using Interaction Analysis Questionnaire. Then, using the key uncertainties of the three scenarios, namely golden (optimistic), predictable (appropriate) and recessionary (pessimistic) future. Results: Unique historical background and attractions, specialized management, system planning and foreign policy and international relations of the most influential parameters and the world city of Zilo, competitive services and amenities, quality of land and air network network and promotion Technology in tourism has been identified as one of the most influential parameters, secondary lever exchange rate variations, market control of water and customs, and independent variable rituals. Capacity building for tourism in the age of communication and social cohesion is also considered as regulatory variables in sustainable social tourism. Conclusions: The results obtained from the analysis and evaluation of sustainable social tourism strategies indicate that some strategies are useful and robust in only one or two scenarios and weak in others. Therefore, it is necessary to consider multifaceted strategies that can respond to situations in different situation

Functional and Structural Characterization of SARS-Cov-2 Spike Protein: An In Silico Study

BACKGROUND፡ Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the global outbreak of coronavirus disease 2019 (Covid-19), which has been considered as a pandemic by WHO. SARS-CoV-2 encodes four major structural proteins, among which spike protein has always been a main target for new vaccine studies. This in silico study aimed to investigate some physicochemical, functional, immunological, and structural features of spike protein using several bioinformatics tools.METHOD: We retrieved all SARS-CoV-2 spike protein sequences from different countries registered in NCBI GenBank. CLC Sequence Viewer was employed to translate and align the sequences, and several programs were utilized to predict B-cell epitopes. Modification sites such as phosphorylation, glycosylation, and disulfide bonds were defined. Secondary and tertiary structures of all sequences were further computed.RESULTS: Some mutations were determined, where only one (D614G) had a high prevalence. The mutations did not impact the B-cell and physicochemical properties of the spike protein. Seven disulfide bonds were specified and also predicted in several N-link glycosylation and phosphorylation sites. The results also indicated that spike protein is a non-allergen.CONCLUSION: In summary, our findings provided a deep understanding of spike protein, which can be valuable for future studies on SARS CoV-2 infections and design of new vaccines

Emergence of Multidrug Resistance and Metallo‑beta‑lactamase Producing Acinetobacter baumannii Isolated from Patients in Shiraz, Iran

Background: Metallo‑beta‑lactamase (MβL) enzymes production is one of the most important resistance mechanisms against carbapenems in some bacteria including Acinetobacter baumannii. Aims: This study was aimed to determine the antimicrobial susceptibility and the prevalence of MβL among carbapenem‑resistant isolates of A. baumannii. Materials and Methods: In this cross‑sectional study from October 2012 to April 2013, 98 isolates were identified as A. baumannii using Microgen™ kits and confirmed by molecular method. These isolates were tested for antimicrobial susceptibilities by disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines. Carbapenem‑resistant isolates were further detected phenotypically by MβL minimal inhibitory concentration (MIC)‑test strips, and subsequently positive MβL isolates were confirmed by polymerase chain reaction (PCR). Results: Overall, 98% (96/98) of A. baumannii isolates were detected as carbapenem‑resistant by MIC test. Highest sensitivity to the tested antibiotic with 42.9% (42/98) was observed to colistin. Of 96 carbapenem‑resistant isolates, 43 were phenotypically positive for MβL; out of 43 isolates, 37 were confirmed for the presence of MβL genes by PCR. Conclusion: The frequency of drug resistance among the clinical samples of A. baumannii isolated in our study against most of the antibiotics was very high. Moreover, all MβL producing isolates were multidrug resistance. Therefore, systematic surveillance to detect MβL producing bacteria and rational prescription and use of carbapenems could be helpful to prevent the spread of carbapenem resistance.Keywords: Acinetobacter baumannii, Antibiotic resistance, Carbapenem, Iran, Metallo‑beta‑lactamas

Associations between socio-environmental determinants and the risk of pulmonary tuberculosis in Guilan, Iran

Background: Certain social determinants may influence host susceptibility to tuberculosis (TB) infections, and increase the risk of developing the disease. Objectives: The present study aimed to evaluate the effects of several host and environmental factors on the risk of TB in northern Iranian households. Patients and Methods: This case control study was conducted for one year between 2010 and 2011 in the Guilan province in Iran. Eightyseven confirmed TB positive cases, based on convenience sampling, were included in this study. A patient positive for TB was confirmed by a positive sputum smear, chest X-ray, and clinical manifestations as diagnosed by a physician. The data were collected using observational methods, and were analyzed by SPSS software. Results: The average mean age of the TB cases was 51±22 years old, and 40.2 (35/87) of the TB cases were male and 59.8 (52/87) were female. The majority of TB cases were from rural areas (71.3, 62/87), while 28.7 (25/87) were from urban areas. Significant differences (P < 0.001) were observed between the geographical conditions and distribution of the disease. The room density of the individuals was significantly different (2.9±1.2 vs. 2.2±1.9, P<0.002) among the TB cases and control group, respectively. A statistical difference was observed between the groups in terms of the building materials (P < 0.05), while significantly inadequate UV irradiation was seen in the houses of the TB patients, compared to the control group (82.8 vs. 14.9,P<0.001). The hygiene of the houses seemed to be a significant risk factor (P<0.001) for TB infection.Conclusions: The results suggest that in the studied region several host and environmental factors were associated with higher risks of TB infection. © 2016, Infectious Diseases and Tropical Medicine Research Center

Antibiotic resistance pattern and distribution of psla gene among biofilm producing pseudomonas aeruginosa isolated from waste water of a burn center

Background: Pseudomonas aeruginosa is considered as a major cause of hospital-acquired infections due to its high antibacterial resistance. Biofilm formation is a well-known pathogenic mechanism in P. aeruginosa infections, since sessile bacteria are protected in an extracellular matrix of exopolysaccharide. The expression of polysaccharide synthesis locus (pslA gene) can be important for biofilm formation by P. aeruginosa. Objectives: The purpose of this research was to evaluate the antibiotic resistance pattern and distribution of the pslA gene among biofilm-producing P. aeruginosa isolates obtained from waste water of Burn Centre in Guilan, Iran. Materials and Methods: Fifty isolates of P. aeruginosa were obtained from waste water of a burn center. The P. aeruginosa isolates were identified using standard bacteriological procedures. Drug susceptibility test was performed by disk diffusion method for all the isolates against nine antimicrobial agents. Biofilm formation was measured by microtiter plate assay. Polymerase chain reaction (PCR) was used to identify the presence of the pslA gene among the isolates. Results: Biofilm formation was observed in 70 of the P. aeruginosa isolates. The potential formation of biofilm was significantly associated with resistance to gentamicin, imipenem, tobramycin and piperacillin. In addition, the pslA gene only existed in biofilm-producing isolates with a frequency of 42.9 (n = 15).Conclusions: The findings of the present study well demonstrated that the P. aeruginosa biofilm-producing isolates were more resistant to the tested antibiotics. Furthermore, because of wide distribution, it seems that the pslA gene is associated with biofilm formation. � 2015, Ahvaz Jundishapur University of Medical Sciences

MOLECULAR CHARACTERIZATION OF VANCOMYCIN, MUPIROCIN AND ANTISEPTIC RESISTANT STAPHYLOCOCCUS AUREUS STRAINS.

Background: Staphylococcus aureus is a common cause of nosocomial infections that leads to broad spectrum of diseases. Increasing antibiotic resistance among S. aureus strains, particularly methicillin-resistant S. aureus (MRSA) is a serious concern. In addition, the emergence of antiseptics resistance in MRSA helps organism to easily persist and spread in healthcare environments. The aim of this study was to determine the molecular characteristics of vancomycin, mupirocin and antiseptic resistant S. aureus strains. Materials and Methods: This cross-sectional study was performed on a total of 120 MRSA isolates collected from two major hospitals in Shiraz, Iran. Minimum inhibitory concentrations (MICs) of vancomycin and mupirocin were determined by E-test method according to CLSI and Eucast guidelines. Presence of resistance genes were investigated by PCR method. Results: Antibacterial susceptibility tests for MRSA isolates showed that 7 isolates (5.8%) were vancomycin-resistant S. aureus (VRSA) and 15 isolates (12.5%) were high-level mupirocin resistant (MuH). None of the isolate had vancomycin resistance gene (vanA), but the frequency of mupirocin resistance gene was significant and 55 (45.8%) isolates carried mupA gene. Moreover, norA, smr and qacA/B genes were detected in 110 (91.7%), 55 (45.8%) and 36 (30%) strains, respectively. Conclusion: This study showed the existence of VISA and VRSA strains in our region, and we also found high frequency of mupirocin and biocide resistance genes among strains

Clinical and immunological comparison of COVID-19 disease between critical and non-critical courses: a systematic review and meta-analysis

IntroductionAcute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which appeared in 2019, has been classified as critical and non-critical according to clinical signs and symptoms. Critical patients require mechanical ventilation and intensive care unit (ICU) admission, whereas non-critical patients require neither mechanical ventilation nor ICU admission. Several factors have been recently identified as effective factors, including blood cell count, enzymes, blood markers, and underlying diseases. By comparing blood markers, comorbidities, co-infections, and their relationship with mortality, we sought to determine differences between critical and non-critical groups.MethodWe used Scopus, PubMed, and Web of Science databases for our systematic search. Inclusion criteria include any report describing the clinical course of COVID-19 patients and showing the association of the COVID-19 clinical courses with blood cells, blood markers, and bacterial co-infection changes. Twenty-one publications were eligible for full-text examination between 2019 to 2021.ResultThe standard difference in WBC, lymphocyte, and platelet between the two clinical groups was 0.538, -0.670, and -0.421, respectively. Also, the standard difference between the two clinical groups of CRP, ALT, and AST was 0.482, 0.402, and 0.463, respectively. The odds ratios for hypertension and diabetes were significantly different between the two groups. The prevalence of co-infection also in the critical group is higher.ConclusionIn conclusion, our data suggest that critical patients suffer from a suppressed immune system, and the inflammation level, the risk of organ damage, and co-infections are significantly high in the critical group and suggests the use of bacteriostatic instead of bactericides to treat co-infections

Evaluation of the antibacterial and antibiofilm activity of probiotic bacteria against causative bacterial pathogens of dental caries

The most important factor in tooth decay and periodontal disease is the attachment of oral bacteria, especially streptococci, to different levels of the mouth and teeth. Therefore, by changing the microbial ecology in the mouth using probiotic producing bacteria, we can help prevent tooth decay and periodontal infections. This study aimed to evaluate the antibacterial and antibiofilm activities of probiotic producing Lactobacillus against several streptococci that cause tooth decay. Antimicrobial activity and minimal inhibitory concentration (MIC) of probiotic lactobacilli was determined by disk diffusion method and standard broth microdilution, respectively. Antibiofilm activity was assayed by a microtiter-plate screening method. The five isolates of Lactobacillus strains with probiotic properties include Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus reuteri, Lactobacillus fermentum, and Lactobacillus brevis were tested against Streptococcus mutans and Streptococcus sanguinis. Most of tested Lactobacillus strain at concentrations above 125 µg/mL showed antibacterial properties. Also, examination of the MICs showed that probiotic bacteria had greater effects on S. sanguinis. While, the tested probiotic bacteria did not show a significant antibiofilm effect. Our results suggest that lactobacilli with potential probiotic properties can be effective used for eliminating oral streptococcal colonization

High prevalence of vancomycin and high-level gentamicin resistance in Enterococcus faecalis isolates

Multiple drug-resistant enterococci are major cause of healthcare-associated infections due to their antibiotic resistance traits. Among them, Enterococcus faecalis is an important opportunistic pathogen causing various hospital-acquired infections. A total of 53 E. faecalis isolates were obtained from various infections. They were identified by phenotypic and genotypic methods. Determination of antimicrobial resistance patterns was done according to CLSI guidelines. The isolates that were non-susceptible to at least one agent in ≥3 antimicrobial categories were defined as multidrug-resistant (MDR). Detection of antimicrobial resistance genes was performed using standard procedures. According to MDR definition, all of the isolates were MDR (100%). High-level gentamicin resistance was observed among 50.9% of them (MIC ≥ 500 μg/ml). The distributions of aac(6′)-Ie-aph(2′′)-Ia and aph(3′)-IIIa genes were 47.2% and 69.8%, respectively. The aph(2′′)-Ib, aph(2′′)-Ic, aph(2′′)-Id, and ant(4′)-Ia genes were not detected. Vancomycin resistance was found in 45.3% of strains. The vanA gene was detected in 37.7% of isolates, whereas vanB and vanC1 genes were not observed in any strain. Erythromycin resistance rate was 79.2% and the frequencies of ermB and ermC genes were 88.6% and 69.8%, respectively. The ermA and msrA genes were not present in any of the isolates. Our data indicate a high rate of MDR E. faecalis strains. All of high-level gentamicin-resistant isolates carried at least one of aac(6′)-Ie-aph(2′′)-Ia or aph(3′)-IIIa genes. Distribution of vanA was notable among the isolates. In addition, ermB and ermC were accountable for resistance to erythromycin