Microbiological qualification of air, water and dialysate in a haemodialysis centre; a new focus on Legionella spp.

Background and Objectives: The microbiological monitoring of the water used for haemodialysis is important especially for Legionella and non-fermentative bacteria since patients with end stage renal disease (ESRD) are suffering from deteriorated function of immune system. Materials and Methods: A total 50 water and dialysate samples were weekly collected over a period of 10 weeks from 5 sites. Total and faecal coliforms were determined by utilizing the most probable number (MPN) method. For isolation of Legionella, water samples were inoculated on a BCYE medium. DNA extraction was performed and was used to amplify 16S rRNA gene of Legionella species. Airborne bacteria were sampled using a single stage Andersen air sampler. Results: Out of total 50 water samples, 24 samples had bacterial contamination. The highest rate of Legionella contamination was observed in the storage tank (67 cfu/ml). Legionella was not isolated from the dialysate effluent samples. The highest rate of total bacterial count was related to the dialysate effluent and the maximum total count of coliforms was related to the reverse osmosis. The isolated bacteria were Gram-negative bacilli (mostly Pseudomonas isolates), Gram-positive cocci (mostly Micrococcus spp.) and Gram-positive bacilli (mostly Bacillus spp.). Six samples were contaminated with coliforms. No faecal coliform was isolated from the samples. Conclusion: These results indicated that dialysis machine is an important source of contaminations such as Staphylococcus, Pseudomonas and Legionella. Therefore an efficient prevention program is needed to eliminate bacterial contamination of dialysis water system. Moreover, in haemodialysis centres, periodic surveillance programs for microbiological qualification can lead to a better planning for disinfection of haemodialysis water systems. © 2016, Tehran University of Medical Science. All rights reserved

Global prevalence and distribution of vancomycin resistant, vancomycin intermediate and heterogeneously vancomycin intermediate Staphylococcus aureus clinical isolates: a systematic review and meta-analysis

Vancomycin-resistant Staphylococcus aureus (VRSA), Vancomycin-intermediate S. aureus (VISA) and heterogeneous VISA (hVISA) are subject to vancomycin treatment failure. The aim of the present study was to determine their precise prevalence and investigate prevalence variability depending on different years and locations. Several international databases including Medline (PubMed), Embase and Web of Sciences were searched (data from 1997 to 2019) to identify studies that addressed the prevalence of VRSA, VISA and hVISA among human clinical isolates around the world. Subgroup analyses and meta-regression were conducted to indicate potential source of variation. Publication bias was assessed using Egger�s test. Statistical analyses were conducted using STATA software (version 14.0). Data analysis showed that VRSA, VISA and hVISA isolates were reported in 23, 50 and 82 studies, with an overall prevalence of 1.5 among 5855 S. aureus isolates, 1.7 among 22,277 strains and 4.6 among 47,721 strains, respectively. The overall prevalence of VRSA, VISA, and hVISA before 2010 was 1.2, 1.2, and 4, respectively, while their prevalence after this year has reached 2.4, 4.3, and 5.3. The results of this study showed that the frequency of VRSA, VISA and hVISA after 2010 represent a 2.0, 3.6 and 1.3-fold increase over prior years. In a subgroup analysis of different strain origins, the highest frequency of VRSA (3.6) and hVISA (5.2) was encountered in the USA while VISA (2.1) was more prevalent in Asia. Meta-regression analysis showed significant increasing of VISA prevalence in recent years (p value � 0.05). Based on the results of case reports (which were not included in the calculations mentioned above), the numbers of VRSA, VISA and hVISA isolates were 12, 24 and 14, respectively, among different continents. Since the prevalence of VRSA, VISA and hVISA has been increasing in recent years (especially in the Asian and American continents), rigorous monitoring of vancomycin treatment, it�s the therapeutic response and the definition of appropriate control guidelines depending on geographical regions is highly recommended and essential to prevent the further spread of vancomycin-resistant S. aureus. © 2020, The Author(s)

Global genotype distribution of human clinical isolates of New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae; A systematic review

Background and Aim: The global rise of antimicrobial resistance among bacterial strains is a rapidly growing challenge and is becoming a major public health concern. This study documents the worldwide spread and genotype distribution of human clinical isolates of New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae (NPKP). Methods: Several international databases, including Web of Science, Embase and Medline were searched (2010 - 2019) to identify studies addressing the frequency of NPKP regionally or worldwide. Results: Of 4779 articles identified, 202 studies fulfilled the eligibility criteria and were included in our analysis. The frequency of NPKP in Asia, Europe, America, Africa and Oceania was 64.6, 20.1, 9.0, 5.6 and 0.4, respectively. The most prevalent sequence types (STs) among NPKP were ST11, ST290, ST147, ST340, ST15, ST278 and ST14 based on published studies. Conclusion: The dissemination of blaNDM variants in different STs among NPKP in the various region of world is a serious concern to public health. The prevalence of NPKP should be controlled by comprehensive infection control measures and optimization of antibiotic therapy. © 202

Micro-RNA-incorporated electrospun nanofibers improve osteogenic differentiation of human-induced pluripotent stem cells

Smart scaffolds have a great role in the damaged tissue reconstruction. The aim of this study was developing a scaffold that in addition to its fiber's topography has also content of micro-RNAs (miRNAs), which play a regulatory role during osteogenesis. In this study, we inserted two important miRNAs, including miR-22 and miR-126 in the electrospun polycaprolactone (PCL) nanofibers and after scaffold characterization, osteoinductivity of the fabricated nanofibers was investigated by evaluating of the osteogenic differentiation potential of induced pluripotent stem cells (iPSCs) when grown on miRNAs-incorporated PCL nanofibers (PCL-miR) and empty PCL. MiRNAs incorporation had no effect on the fibers size and morphology, cell attachment, and protein adsorption, although viability and proliferation rate of the human iPSCs were increased after a week in PCL-miR compared to the empty PCL. The results obtained from alkaline phosphatase activity, calcium content, bone-related genes, and proteins expression assays demonstrated that the highest osteogenic markers were observed in iPSCs grown on the PCL-miR compared to the cells cultured on PCL and culture plate. According to the results, miR-incorporated PCL nanofibers could be considered as a promising potential tissue-engineered construct for the treatment of patients with bone lesions and defects. © 2019 Wiley Periodicals, Inc