Gonorrhea and syphilis co-infection and related risk factors in HIV patients from Shiraz, South of Iran

Background: Neisseria gonorrhea and Treponema pallidum as an obligate human pathogen are two common causes of sexually transmitted diseases (STDs). The present study aimed to determine the prevalence of N. gonorrhoeae and T. pallidum among human immunodeficiency virus (HIV) patients in the southwest Iran. Methods: This retrospective study was performed from 2004 to 2013, on HIV patients who were tested for detection of gonorrhea and syphilis infection at Shiraz HIV/AIDS Research Center. ELISA technique was used for preliminary detection of HIV and confirmed by a Western Blotting test. Gonorrhea was routinely diagnosed using direct Gram-staining and culturing on selective agar. Syphilis was routinely diagnosed by RPR test. Results: Of the 806 HIV patients, 39 (2.6%) cases had co-infection with gonorrhea. Compared with mono-HIV infected patients, gonorrhea was significantly more likely among the males (69.4% vs. 92.3%, P=0.002). History of addiction and prison seems to be a significant risk factor for gonorrhea infection (P<0.05). Also, the mean of CD4+lymphocyte was higher among gonorrhea infected patients (368 +/- 238 vs. 415 +/- 328). Logistic regression analysis showed that sexual contact increased risk of gonococcal infection about 4 fold (OR: 4, CI: 1.7-9.39, P=0.001). None of the HIV patients had syphilis co-infection. Conclusions: As a preliminary survey, our findings provided unique information on the prevalence of gonorrhea and syphilis co-infections among HIV patients. Moreover, we introduced the main risk factors associated with gonorrhea co-infection in HIV patients in our region including gender, history of addiction and prison, CD4+lymphocyte count, and transmission routes for effective management of STDs

Gonor¬rhea and syphilis co-infection and related risk factors in HIV patients from Shiraz, South of Iran

Background: Neisseria gonorrhea and Treponema pallidum as an obligate human pathogen are two common causes of sexually transmitted diseases (STDs). The present study aimed to determine the prevalence of N. gonorrhoeae and T. pallidum among human immunodeficiency virus (HIV) patients in the southwest Iran. Methods: This retrospective study was performed from 2004 to 2013, on HIV patients who were tested for detection of gonorrhea and syphilis infection at Shiraz HIV/AIDS Research Center. ELISA technique was used for preliminary detection of HIV and confirmed by a Western Blotting test. Gonorrhea was routinely diagnosed using direct Gram-staining and culturing on selective agar. Syphilis was routinely diagnosed by RPR test. Results: Of the 806 HIV patients, 39 (2.6%) cases had co-infection with gonor¬rhea. Compared with mono-HIV infected patients, gonor¬rhea was significantly more likely among the males (69.4% vs. 92.3%, P=0.002). History of addiction and prison seems to be a significant risk factor for gonor¬rhea infection (P<0.05). Also, the mean of CD4+lymphocyte was higher among gonor¬rhea infected patients (368±238 vs. 415±328). Logistic regression analysis showed that sexual contact increased risk of gonococcal infection about 4 fold (OR: 4, CI: 1.7-9.39, P=0.001). None of the HIV patients had syphilis co-infection. Conclusions: As a preliminary survey, our findings provided unique information on the prevalence of gonorrhea and syphilis co-infections among HIV patients. Moreover, we introduced the main risk factors associated with gonorrhea co-infection in HIV patients in our region including gender, history of addiction and prison, CD4+lymphocyte count, and transmission routes for effective management of STDs

Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients

Abstract Background Urinary tract infections (UTIs) are one of the most frequent diseases encountered by humans worldwide. The presence of multidrug-resistant (MDR) uropathogenic Escherichia coli (UPEC) harboring several virulence factors, is a major risk factor for inpatients. We sought to investigate the rate of antibiotic resistance and virulence-associated genes among the UPECs isolated from an Iranian symptomatic population. Methods A total of 126 isolates from inpatients with UTI from different wards were identified as UPEC using the conventional microbiological tests. After identification of UPECs, all the isolates were subjected to antimicrobial susceptibility test and polymerase chain reaction (PCR) to identify the presence of 9 putative virulence genes and their association with the clinical outcomes or antimicrobial resistance. Results The data showed that the highest and the lowest resistance rates were observed against ampicillin (88.9%), and imipenem (0.8%), respectively. However, the frequency of resistance to ciprofloxacin was found to be 55.6%. High prevalence of MDR (77.8%) and extended-spectrum β-lactamase (ESBL) (54.8%) were substantial. PCR results revealed the frequency of virulence genes ranged from 0 to 99.2%. Among 9 evaluated genes, the frequency of 4 genes (fimH, sfa, iutA, and PAI marker) was > 50% among all the screened isolates. The iutA, pap GII, and hlyA genes were more detected in the urosepsis isolates with significantly different frequencies. The different combinations of virulence genes were characterized as urovirulence patterns. The isolates recovered from pyelonephritis, cystitis, and urosepsis cases revealed 27, 22, and 6 virulence patterns, respectively. A significant difference was determined between ESBL production with pap GII, iutA, and PAI marker genes. Conclusions Our study highlighted the MDR UPEC with high heterogeneity of urovirulence genes. Considering the high rate of ciprofloxacin resistance, alternative drugs and monitoring of the susceptibility profile for UPECs are recommended

Antimicrobial Resistance Pattern and Frequency of Multiple-Drug Resistant Enterobacter Spp. at A Tertiary Care Hospital in Southwest of Iran

Background: Strains belonging to Enterobacter genus are important opportunistic nosocomial pathogens. Resistance to broad-spectrum antibiotics often complicates the treatment of Enterobacter infections. Aim and Objectives: The present study was aimed to determine the frequency and antibiotic resistance patterns of Enterobacter spp. obtained from a specialized Women's and Children's hospital. Material and Methods: This retrospective study was conducted during September 2015 to July 2016 in Shiraz, Iran. Enterobacter isolates were obtained from various clinical specimens and were identified using standard microbiological procedure. Antimicrobial susceptibility patterns were determined in accordance with CLSI recommendation. Results: Out of 61 Enterobacter spp., majority of isolates were obtained from blood 11 (18%) and followed by urine and eye specimens (11.5%). Antibiotic susceptibility revealed that all isolates were resistance to amikacin, and mostly resistance to cefotaxim and gentamycin with 90.2% and 75.4%, respectively. The highest sensitivity was toward polymyxin B 96.7%, co-trimoxazole 65.6% and imipenem 57.4%. Overall, the rate of Multiple Drug Resistant (MDR) isolates were 91.8% (n=56). Of MDR isolates, 39.2% of isolates were resistance to at least 3 antibiotics. Conclusion: Despite the significant role of MDR isolates in occurrence of infections, several locally available antibiotics still can have promising effects on outcome of Enterobacter infections in pregnant women and neonates

Antimicrobial Resistance Pattern in Escherichia coli Isolates Obtained from a Specialized Women and Children Hospital in Shiraz, Iran: A Prevalence Study

Abstract Background: Escherichia coli, known as a clinically significant bacteria, can cause a wide range of infections, including urinary tract infections (UTIs), blood stream infections (BSIs), and can frequently be isolated from various clinical specimens. Evaluation of antimicrobial resistant pattern is a necessary action, especially about such bacteria which are frequent and life threatening. The aim of this study was to determine the frequency and antimicrobial resistance pattern of E. coli isolates obtained from various clinical specimens. Methods: This retrospective study was performed within a seven month period from January 2015 to August 2015 at a specialized women and children hospital in Shiraz, Iran. E. coli isolates were obtained from various clinical specimens and identified using standard microbiological procedure. Antimicrobial susceptibility patterns were determined using disk diffusion method in accordance with CLSI recommendation. Results: Of the total 130 positive cultures, the majority of E. coli isolates were obtained from urine (96=73.8%) and blood (11=8.5%) specimens. Overall, gentamicin (70.8%) was the effective antibiotic for the tested E. coli isolates. E. coli isolates obtained from urine specimens showed the highest resistance rates against ampicillin (84.4%) and nalidixic acid (61.5%); while they showed the most sensitivity to gentamicin (79.2%), nitrofurantoin (70.8%) and ciprofloxacin (66.7%). Moreover, the highest antibiotic resistance rates belonged to the isolates recovered from endotracheal tube (ETT). Conclusion: The results showed that gentamicin was the most effective antibiotic against E. coli infections. However, in addition to the gentamicin, we can recommend nitrofurantoin and ciprofloxacin as the other effective agents for UTI

Distribution of Class 1-3 Integrons in Carbapenem-Resistant Pseudomonas aeruginosa Isolated from Inpatients in Shiraz, South of Iran

BACKGROUND: Health-care-associated infection (HAI) is effect on patients for the time of staying in the hospital. Opportunistic pathogens including Pseudomonas aeruginosa are the most dangerous biological agents in nosocomial infections. This study aimed to assess the prevalence of 3 classes of integrons carrying to carbapenem resistance in P. aeruginosa strains collected from Nemazee hospital.METHODS: This cross-sectional study was conducted on clinical P. aeruginosa isolates were collected from Nemazee hospital. The identification of the isolates was performed by routine biochemical tests. Antimicrobial sensitivity testing was determined using the disk diffusion method against imipenem and meropenem. The int1, int2 and int3 genes were detected using the polymerase chain reaction (PCR).RESULTS: Seventy-five clinical isolates of P. aeruginosa were recovered from various clinical infections. A carbapenemresistant phenotype was detected in 42.7% (imipenem) and 29.3%(meropenem) of isolates. As the PCR results, 48 (64%) and 15 (20%) isolates were identified as being positive for class 1 and class 2 integrons, respectively. Class 3 integrons were not found among the studied isolates.CONCLUSIONS: Our data demonstrate the importance of class 1 and 2 integrons in carbapenem resistant P. aeruginosa strains. Therefore, integrons play an important role in acquisition and dissemination of carbapenem resistance genes among these pathogens, so, management of infection control policies and the appropriate use of antibiotics is essential for control the spreading of antibiotics resistance genes

Non-coding RNAs in gynecologic cancer

The term “gynecologic cancer” pertains to neoplasms impacting the reproductive tissues and organs of women encompassing the endometrium, vagina, cervix, uterus, vulva, and ovaries. The progression of gynecologic cancer is linked to various molecular mechanisms. Historically, cancer research primarily focused on protein-coding genes. However, recent years have unveiled the involvement of non-coding RNAs (ncRNAs), including microRNAs, long non-coding RNAs (LncRNAs), and circular RNAs, in modulating cellular functions within gynecological cancer. Substantial evidence suggests that ncRNAs may wield a dual role in gynecological cancer, acting as either oncogenic or tumor-suppressive agents. Numerous clinical trials are presently investigating the roles of ncRNAs as biomarkers and therapeutic agents. These endeavors may introduce a fresh perspective on the diagnosis and treatment of gynecological cancer. In this overview, we highlight some of the ncRNAs associated with gynecological cancer