Levofloxacin Resistance in Blood and Urine Culture Samples in Khalij Fars Hospital of Bushehr

Background: Due to the broad-spectrum antimicrobial activity of Levofloxacin, it has been used widely around the world. Recently, levofloxacin-resistance reports have been published. In this study, we investigated resistance to levofloxacin in positive urine and blood culture samples in Persian Gulf hospital in Bushehr, Iran, during 2015-16. Materials and Methods: In this cross-sectional study, the selection criteria included all positive urine or blood culture samples in which the amount of the isolated pathogen colony counts were more than 105 . Culture samples were divided into three groups including sensitive, intermediate and resistant; based on bacterial growth around the discs. SPSS version 18.0 was used as the statistical analysis software, and a pvalue of less than 0.05 was considered statistically significant. Results: Culture samples consisted of samples of150 patients including 61 (%40.7) male and 89 (%59.3) female. Mean age of participants was 42.98 ± 29.25. Culture samples consisted of urine (% 50.7) and blood cultures (% 49.3). E.coli was the most common pathogen (% 46) and Klebsiella (% 16.7) was the second common pathogen in all cultures. Regarding the sensitivity to levofloxacin, 119 (% 79.3) samples were sensitive, 22 (% 14.7) cultures had intermediate sensitivity and 9 (%6) samples were resistant to levofloxacin. The only resistant pathogen was E.coli. Conclusion: This study showed that Levofloxacin has a reasonably high efficiency against most of the bacterial pathogens except for the E.coli that showed some resistance. Hence, this antibiotic can still be a considered as a good choice in the treatment of most infections except E.col

The Association of Chlamydia pneumonia and Helicobacter pylori IgG Seropositivity With Omentin-1, Visfatin and Adiponectin Levels in Postmenopausal Women.

Abstract Some adipocytokines are cardioprotective or pro-inflammatory for cardiovascular system. Chronic infection with Chlamydia pneumoniae and Helicobacter pylori has been also considered as novel risk factors for atherosclerosis. The main aim of the current population-based study is to investigate the potential link between circulating adipocytokines and Chlamydia pneumoniae or Helicobacter pylori IgG seropositivities. A total of 250 healthy postmenopausal women who participated in a prospective cohort study were evaluated for IgG antibodies directed against C.pneumoniae and H. pylori. Omentin-1, visfatin, adiponectin, and high sensitivity C-reactive protein were measured by highly specific enzyme-linked immunosorbent assay methods. The prevalence of IgG antibodies against C. pneumoniae and H. pylori among the studied population was 20.4% (51 women) and 57.2% (143 women), respectively. There were no significant differences in adipocytokine levels between H. pylori IgG seropositive and H. pylori seronegative subjects. Similar results for visfatin and omentin-1 were found when C. pneumoniae IgG seropositive were compared with C. pneumoniae IgG seronegative subjects. However, in general linear model adjusted for age, body mass index and hs-CRP levels revealed significant difference between C. pneumoniae seropositive and C. pneumoniae seronegative subjects for circulating adiponectin. In conclusion, Chlamydia pneumoniae IgG seropositivity was associated with higher adiponectin levels in postmenopausal women. The elucidation of interaction mechanism of Chlamydia pneumoniae and a cardioprotective adipocytokine (adiponectin) will be useful in future therapeutic strategies

The COVID‑19‑diabetes mellitus molecular tetrahedron

Accumulating molecular evidence suggests that insulin resistance, rather than SARS-CoV-2- provoked beta-cell impair- ment, plays a major role in the observed rapid metabolic deterioration in diabetes, or new-onset hyperglycemia, during the COVID-19 clinical course. In order to clarify the underlying complexity of COVID-19 and diabetes mellitus interactions, we propose the imaginary diabetes-COVID-19 molecular tetrahedron with four lateral faces consisting of SARS-CoV-2 entry via ACE2 (lateral face 1), the viral hijacking and replication (lateral face 2), acute inflammatory responses (lateral face 3), and the resulting insulin resistance (lateral face 4). The entrance of SARS-CoV-2 using ACE2 receptor triggers an array of multiple molecular signaling beyond that of the angiotensin II/ACE2-Ang-(1–7) axis, such as down-regulation of PGC-1 α/ irisin, increased SREBP-1c activity, upregulation of CD36 and Sirt1 inhibition leading to insulin resistance. In another arm of the molecular cascade, the SARS-CoV-2 hijacking and replication induces a series of molecular events in the host cell metabolic machinery, including upregulation of SREBP-2, decrement in Sirt1 expression, dysregulation in PPAR-ɣ, and LPI resulting in insulin resistance. The COVID-19-diabetes molecular tetrahedron may suggest novel targets for therapeutic interventions to overcome insulin resistance that underlies the pathophysiology of worsening metabolic control in patients with diabetes mellitus or the new-onset of hyperglycemia in COVID-19. Keywords Covid-19 · Diabetes mellitus · Insulin resistance · Inflammation · ACE2 receptor · SARS-CoV-

Omentin-1, visfatin and adiponectin levels in relation to bone mineral density in Iranian postmenopausal women

The potential link between infection with Chlamydia pneumoniae or Helicobacter pylori and osteoporosis has not been investigated in population-based longitudinal studies. A total of 250 healthy postmenopausal women who participated in a prospective cohort study were evaluated for IgG antibodies directed against C. pneumoniae and H. pylori, osteoprotegerin (OPG), the receptor activator of nuclear factor kappa B ligand (RANKL), CrossLaps, and osteocalcin. Bone mineral density (BMD) was measured at the femoral neck and lumbar spine at baseline and at follow- up 5.8 years later. There were no significant differences in age-adjusted bone turnover markers, OPG, RANKL, the RANKL/OPG ratio, and BMD between the C. pneumoniae and H. pylori IgG seropositive and seronegative subjects (P > 0.05). Neither C. pneumoniae nor H. pylori IgG seropositivity was associated with age-and body massindex-adjusted BMD at the femoral neck and lumbar spine or bone loss at the 5.8-year follow-up. In logistic regression analysis, neither C. pneumoniae nor H. pylori IgG seropositivities predicted incident lumbar or spine osteoporosis 5.8 years later. In conclusion, neither C. pneumoniae nor H. pylori IgG seropositivity was associated with bone turnover markers, the RANKL/OPG ratio, BMD, or bone loss in postmenopausal women. In addition, chronic infection with C. pneumoniae or H. pylori did not predict incident osteoporosis among this group of women

Chlamydia pneumoniae and Helicobacter pylori IgG seropositivities are not predictors of osteoporosis‑associated bone loss: a prospective cohort study

The potential link between infection with Chlamydia pneumoniae or Helicobacter pylori and osteoporosis has not been investigated in population-based longitudinal studies. A total of 250 healthy postmenopausal women who participated in a prospective cohort study were evaluated for IgG antibodies directed against C. pneumoniae and H. pylori, osteoprotegerin (OPG), the receptor activator of nuclear factor kappa B ligand (RANKL), CrossLaps, and osteocalcin. Bone mineral density (BMD) was measured at the femoral neck and lumbar spine at baseline and at follow-up 5.8 years later. There were no significant differences in age-adjusted bone turnover markers, OPG, RANKL, the RANKL/OPG ratio, and BMD between the C. pneumoniae and H. pylori IgG seropositive and seronegative subjects (P > 0.05). Neither C. pneumoniae nor H. pylori IgG seropositivity was associated with age-and body mass index-adjusted BMD at the femoral neck and lumbar spine or bone loss at the 5.8-year follow-up. In logistic regression analysis, neither C. pneumoniae nor H. pylori IgG seropositivities predicted incident lumbar or spine osteoporosis 5.8 years later. In conclusion, neither C. pneumoniae nor H. pylori IgG seropositivity was associated with bone turnover markers, the RANKL/OPG ratio, BMD, or bone loss in postmenopausal women. In addition, chronic infection with C. pneumoniae or H. pylori did not predict incident osteoporosis among this group of women. Keywords Chlamydia pneumoniae · Helicobacter pylori · Bone mineral density · Osteoporosi

Association of serum uric acid with high-sensitivity C-reactive protein in postmenopausal women.

OBJECTIVES: To explore the independent correlation between serum uric acid and low-grade inflammation (measured by high-sensitivity C-reactive protein, hs-CRP) in postmenopausal women. METHODS: A total of 378 healthy Iranian postmenopausal women were randomly selected in a population-based study. Circulating hs-CRP levels were measured by highly specific enzyme-linked immunosorbent assay method and an enzymatic calorimetric method was used to measure serum levels of uric acid. Pearson correlation coefficient, multiple linear regression and logistic regression models were used to analyze the association between uric acid and hs-CRP levels. RESULTS: A statistically significant correlation was seen between serum levels of uric acid and log-transformed circulating hs-CRP (r = 0.25, p < 0.001). After adjustment for age and cardiovascular risk factors (according to NCEP ATP III criteria), circulating hs-CRP levels were significantly associated with serum uric acid levels (β = 0.20, p < 0.001). After adjustment for age and cardiovascular risk factors, hs-CRP levels ≥3 mg/l were significantly associated with higher uric acid levels (odds ratio =1.52, 95% confidence interval 1.18-1.96). CONCLUSION: Higher serum uric acid levels were positively and independently associated with circulating hs-CRP in healthy postmenopausal women. KEYWORDS: C-reactive protein; Uric acid; inflammation; postmenopaus

A Pooled Analysis of Diagnostic Value of 99mTc-Ubiquicidin (UBI) Scintigraphy in Detection of an Infectious Process

Purpose: Although the data are promising fromlimited studies with technetium- 99m ubiquicidin (99mTc-UBI) scintigraphy in detection of infection in humans, these studies have had a limited sample size. This study was conducted to provide a systematic review and meta-analysis of the reported diagnostic accuracy of 99mTc-UBI scintigraphy in detection of an infectious process. Materials and Methods: The PubMed/MEDLINE,Web of Science, EMBASE, and Google Scholar literature databases were systematically searched to find the relevant human studies on 99mTc-UBI scintigraphy. For each eligible study, the truepositive, false-positive, true-negative, and false-negative findings at 99mTc-UBI scintigraphy were recorded, and the overall statistical parameters were acquired. Result: Ten studies carried out from 2004 to 2010 were included in the analysis. The pooled data sensitivity was 94.5 % and with a 95% confidence interval of 91.2%Y96.8%. The pooled specificity was still as high as about 92.7%. The range of reported specificity was from 80% to 100%. The overall accuracy was 93.7% (95% CI: 91.2%Y95.7%). Conclusion: The study demonstrated that 99mTc-UBI scintigraphy can be used to identify an infectious process with admirable accuracy in early views; however, further investigations are recommended

Molecular epidemiology of hepatitis C virus genotypes in Bushehr province, Iran

Background and Objectives: Molecular epidemiology of hepatitis C virus (HCV) is very important for the treatment of hepatitis C infection. The aim of this study was to determine the distribution of HCV genotypes in Bushehr province (South West of Iran). Materials and Methods: A total of 100 patients who were detected as positive for HCV antibody (by using ELISA method and RIBA test) referred to Arya Virology Laboratory between 2007-2009 in order to molecular diagnosis and furthermore virus genotyping. After detection of HCV, RNA genotyping of virus was done by using genotype specific primers. Results: Genotype 1a was found in 49% of the patients and genotype 3a was found in 40% of the patients and 1b in 5% of patients, while the genotype of the virus could not be identified in 5% of the patients. Finally, in 1% of patients coinfection due to 1a-3a genotypes was identified. Conclusion: The dominant genotype of HCV in Bushehr province, Iran, was determined as 1a.with acute hepatitis C ultimately develop chronic infection1. Only a minority of cases of acute HCV recover completely, with spontaneous virus eradication. In most cases the acute infection progresses to chronicity. Chronic HCV infection is defined as an infection that persists for more than 6 months, with or without clinical manifestations of hepatic or extrahepatic disease. Chronic type of this infection can cause cirrhosis, liver failure, and liver cancer. HCV infection is a global health problem and it is estimated that 200 million people of the world population are infected5. The global spread of chronic HCV infection coincided with the widespread use of transfused blood and blood products and with the expansion of intravenous drug use but decreased prior to the wide implementation of anti-HCV screening6. There are at least six major genotypes designated by Arabic numerals and more than 50 subtypes of HCV identified by lower case letters. The different genotypes have different geographic distributions1,4. Genotype determination of HCV is one of the most important factors in order to prediction of the viral persistency, pathogenicity and resistancy to antivirals7. The success and the treatment period of interferon and ribavirin seems to be related to the genotype of virus8. Furthermore, HCV genotyping is a useful tool to determine its molecular epidemiology, as they are indicative of transmission route of infection9,10. There is no published data about the distribution of HCV genotypes from Bushehr province (South West of Iran). Prevalence of HCV genotypes in Bushehr is an issue that is not sufficiently investigated and there is a need, therefore, to study this in detail

Association of Pathogen Burden and Hypertension: The Persian Gulf Healthy Heart Study

background Chronic infection with cytomegalovirus (CMV), Chlamydia pneumoniae, herpes simplex virus 1 (HSV-1), and Helicobacter pylori may contribute to essential hypertension. However, the evidence now available does not clarify whether the aggregate number of pathogens (pathogen burden) may be associated with hypertension. methods Sera from 1,754 men and women aged ≥25  years were analyzed for immunoglobulin G antibodies to C.  pneumoniae, HSV-1, H.  pylori, and CMV using enzyme-linked immunosorbent assay. The aggregate number of seropositives to the studied viral and bacterial agents was defined as pathogen burden. Hypertension was defined according to World Health Organization criteria. results A total of 459 (26.3%) of the subjects had hypertension. In the hypertensive group, 4.2% had 0 or 1 pathogens present, 20.6% had 2, 43.2% had 3, and 32.1% had 4; in the normotensive group, 7.9% had 0 or 1, 28.4% had 2, 42.7% had 3, and 21.0% had 4. Of the 4 studied pathogens, H.  pylori seropositivity showed a significant independent association with hypertension (odds ratio (OR) =1.37; 95% confidence interval (CI) =1.05–1.79; P = 0.02). In multiple logistic regression analyses, the pathogen burden did not show a significant independent association with hypertension. Coinfection with H.  pylori and C.  pneumoniae was significantly associated with hypertension compared with double seronegativity after adjustment for age, sex, chronic low-grade inflammation, and cardiovascular risk factors (OR = 1.68; 95% CI = 1.14–2.47; P = 0.008]. conclusions The pathogen burden was not associated with hypertension. However, coinfection with C. pneumoniae and H. pylori showed a significant association with essential hypertension, independent of cardiovascular risk factors and chronic low-grade inflammation. Keywords: blood pressure; Chlamydia pneumoniae; cytomegalovirus; Helicobacter pylori; herpes simplex virus; hypertension; pathogen