Archives of Clinical Infectious Diseases
Year:2018 | Volume:13 | Issue:3|Papers Count:13

Background: Testing for antifungal susceptibility to newly introduced drugs is standardized through the clinical laboratory standard institute (CLSI) broth micro-dilution method for testing of molds (M38-A2), yet is difficult to use routinely. Objectives: To compare two agar-based diffusion methods on two types of media for fungal drug sensitivity testing. Materials and Methods: The E-test method and the disc diffusion method were used on non-supplemented Muller Hinton agar (MHA) and RPMI for evaluating the in-vitro susceptibility of 48 clinical isolates of filamentous fungi to amphotericin B, itraconazole, voriconazole, and caspofungin. Results: Categorical agreement between E-test and disc diffusion method for itraconazole and voriconazole was 100%, yet for amphotericin B on MHA agar was 66. 67%, and on RPMI, it was 47. 92%. The correlation coefficient (R) between the inhibition zone diameters when using MHA and RPMI for itraconazole, voriconazole, amphotericin B and caspofungin was +0. 745, +0. 901 +0. 649, and +0. 409, respectively. Conclusions: Routine antifungal susceptibility testing using disk diffusion can be implemented in routine microbiology work up in limited resources.

Background: Cystic Echinococcosis (CE) is one of the major zoonotic parasitic diseases caused by the larval stages of parasite Echinococcus granulosus. This is an endemic disease in a number of regions in Iran, such as Lorestan province, and is considered as a health problem. Objectives: Due to the close contact of nomadic people with sheep dog, this research aimed at studying the seroepidemiology of CE among in-migration and out-migration nomads of Lorestan province, Iran. Methods: In this cross-sectional study, among 5920 residents of nomadic areas, 315 people were randomly selected and serum samples were obtained from these individuals. IgG antibodies against CE were evaluated using the Enzyme Linked Immunosorbent Assay (ELISA). Demographic data of all subjects were collected by a questionnaire, and the results were statistically analyzed using SPSS V. 20 and STATA12. Results: According to the results, the seroepidemiology of CE amongthe nomads was 18 (5. 7%); 13 (72. 22%) were male and five (27. 77%) were female yet the difference was not statistically significant. The highest prevalence (7. 79%) was in the age group of 20 to 30 years old, yet no significant difference was observed between various age groups. In terms of education, more seropositive cases were found amongst subjects with low education, yet no significant difference was observed between educational level and seropositivity of CE. It should also be noted that all the participants were not aware of proper washing of vegetables and fruits. Conclusions: This study was conducted for the first time in Lorestan province, Iran, and showed that the seroprevalence among the nomadic population of Aligoudarz and Sepiddasht was considerable. In order to prevent zoonotic disease, increased awareness of nomads in understanding the transmission ways of disease is suggested through health education programs according to the educational level of the target population, the majority of whom are illiterate. Active surveillance is also recommended in these areas.

Primary spinal hydatid cyst is considered as a very rare form of hydatid disease, which accounts for less than 0. 5% to 1% of hydatid disease cases. Intramedullary hydatid cyst is extremely rare. Herein, the researchers reported on a 23-year-old male patient, who presented neck pain for 1. 5 month and numbness of the right upper and lower extremities as well as ipsilateral disturbance in temperature sensation (Brown-Sequard syndrome) since two weeks prior to this hospital admission. Magnetic resonance imaging of cervical vertebrae revealed a 21 14mmcystic intramedullary mass lesion with faint rim enhancement at C3 to C4 level with adjacent edema (Figure 1). Surgical resection was done and pathologic evaluation of the specimen was in favor of hydatid cyst disease, and the patient was treated with postoperative anthelmintic chemotherapy.

Background: Bacterial burn infections are one of the serious infections and since their treatment with antibiotics is very difficult, infection control in such wounds is very important. Therefore, methods should be sought to enhance the effects of antibiotics and also reduce the resistance to them. It seems that probiotics have antimicrobial features and are effective in wound healing. Objectives: The current study aimed at evaluating and comparing the antimicrobial effects of antibiotics and probiotics, as well as their combination on bacterial burn infections. Methods: Thirty clinically resistant Pseudomonas aeruginosa species isolated from hospitalized patients with burn wounds were collected. Antibacterial activity of five antibiotics and 11 probiotic strains, and also their combination were evaluated by disk diffusion method. One-way ANOVA and Tukey post hoc test were used for data analysis. Results: It was found that the effect of inhibitory zone in combination use of tetracycline + a probiotic strain was more than using the antibiotic and probiotic alone. Also, the current study found that among the probiotics, Lactobacillus plantarum 299v had the highest effect, although not significant, on resistant P. aeruginosa. The current study explained that the inhibitory effect of L. plantarum 299v was significantly higher than that of ciprofloxacin (P = 0. 009). In addition, antibacterial activity of gentamicin + L. salivarius (ES1) was significantly higher compared with that of gentamicin + L. routeri (P = 0. 01). Conclusions: The current study explained that probiotics had a useful potential inhibitory effect on the growth of the pathogens. The study showed that in most cases, inhibitory zones of probiotics were greater than those of antibiotics as well as combination of antibiotic + probiotic. But, there was an exception in tetracycline, which had synergistic effect with probiotics. Conversely, in the cases of imipenem and chloramphenicol, addition of probiotics had antagonistic effects. Further studies are needed to describe different results. Therefore, itseemsthat the type of antibioticsandprobiotics are important to create the synergistic or antagonistic effects.

Zika virus (ZIKV) is a vector transmitted, arthropod-borne viral disease. People around the globe, especially pregnant females are more prone to it. Various neurological and ophthalmological congenital abnormalities make it an epidemic in Central and South Americas as well as Pacific regions. Therefore, the present review, by considering available literature, aims to evaluate the link between ZIKV infection and maternofetal damage. We used a number of electronic databases (PubMed, Google Scholar, Scopus, and Science Direct) to identify the relevant published studies. Of 200 articles found initially, 144 were selected for additional review. Subsequently, 69 articles were finally selected. ZIKV is a life threatening fetal infection. It can easily encounter developing fetus through maternal circulation. Large numbers of fetal mortalities and adult morbidities have been reported till date. WHOhas reported cases of ZIKV associated fetus neural damage from 29 countries in its recent report of 2017. Though the exact mechanism of maternofetal ZIKV transmission is still inconspicuous, it is evident that in the 1st trimester the risk of developing microcephaly is at its peak, thus, maximizing the risk of various congenital anomalies. The lack of proper therapeutic and preventive measurements makes it more deleterious.

Background: Human T-Cell Leukemia Virus (HTLV) infection is endemic in Neyshabour, and even higher than other cities. Objectives: The aim of this investigation was to determine the prevalence of HTLV antibodies among young females attending a large medical diagnostic laboratory in Neyshabour, during 2011 to 2015. Methods: The researchers established this study by data, which were collected from the surveillance system. Based on HTLV-1 and HTLV-2 ELISA kit instruction, 5724 females were evaluated. Variables were age, year, and season. Data were analyzed by the SPSS software. Results: According to the Enzyme Linked Immunosorbent Assay (ELISA) results, 117 (2. 04 %) young females indicated evidence of antibodies to HTLV-1 and HTL-2. Most infected young females were aged 38 to 39 years (4. 16%) and according to annual prevalence, the highest rates were found in 2012. Also, most infected young females had referred in October (3. 16%). Conclusions: The data obtained suggests that Neyshabour is a high endemic city of HTLV infected young females. Making them aware seems to be vital in avoiding transfer of HTLV infection, especially to the next generation. However, further investigations like population-based studies are required to confirm these results.

The incidence of oropharyngeal cancer, which incorporates cancers arising from the tonsils, oropharynx, pharynx, is increasing globally, especially in younger age groups, driven mostly by sexually transmitted human papillomavirus (HPV) infection (1). ...

Dear Editor, Taenia genus is the group of parasites that can cause infection in humans. The invasive form of the infection is possible and can cause the internal parasitic cystic lesion namely cysticercosis. The cysticercosis lesion can be observed at any organ and the most fatal lesion is at the brain, which is clinically known as cerebral neurocysticercosis. At least three common species can cause neurocysticercosis including Taenia solium, T. asiatica, and T. martis (1). ...

Background: Prostate cancer (PCa) is the most common cancer and the second cause of death among men worldwide. Recent documents have disclosed that chronic inflammation can be a major risk factor for PCa. Based on recent studies, the presence of Propionibacterium acnes (P. acnes) asananaerobic gram-positive bacterium in prostate tissue can be a predisposing factor for PCa. The aim of this study was to evaluate the P. acnes presence in patients with PCa compared to patients with benign prostatic hyperplasia (BPH). Methods: In a descriptive study that was conducted from January 2015 to December 2016, 95 paraffin-embedded prostate tissue samples (57 PCa and 38 BPH) were evaluated. All samples were collected from the pathology unit of a hospital. DNA was extracted with an extraction kit (GeneAll, Korea) and then PCR was carried out using specific primers for P. acnes. Sequencing was performed onthePCRproducts toconfirmthe presence of P. acnes. Demographicdata were analyzed using statistical package for social sciences (SPSS) software (version 21). Results: Out of 95 patients, 57 (60%) were patients with PCa and 38 (40%) were patients with BPH. 39 (41%) and 22 (23%) samples were P. acnes positive in cancer and BPH groups, respectively. Conclusions: The results suggest that the spread of P. acnes in males with PCa may be common. This finding reflects the possible role of P. acnes in the carcinogenesis of PCa. P. acnes infection may play a relative role in the pathogenesis of PCa or it could facilitate the PCa progression.

Background: Nontuberculous mycobacteria (NTM) are opportunist pathogens, which can cause pulmonary and non-pulmonary diseases. Objectives: This study aimed at investigating the frequency of NTM at a teaching hospital of Tehran, Iran. Methods: Clinical samples from patients with signs and symptoms of TB were collected from March 2016 to July 2017. Specimens were investigated using conventional methods and the GeneXpert MTB/RIF system. Phenotypic, polymerase chain reaction (PCR)-restriction enzyme analysis (PRA) and sequencing methods were used to identify the mycobacterial species. Results: Of 230 culture positive samples, 12 (5. 2%) were NTM, according to conventional and molecular approaches. Mycobacterium simiae (6, 50. 0%), M. fortuitum (4, 33. 3%), M. intracellulare (1, 8. 3%) and M. kansasii (1, 8. 3%) were the isolated NTM species. Conclusions: The current study strongly highlights the need to design strategies for surveillance, monitoring, and management of NTM cases.

Background: Adhesion to host cells is an important and critical feature of Acinetobacter baumannii pathogenesis. OmpA, ABAYE1319-CsuA/b, and ABAYE2132 are highly prevalent and conserved fimbrial proteins; ABAYE1859 and ABAYE0304 fimbrial antigens are the factors described as novel vaccine candidates against multidrug-resistant (MDR) A. baumannii. Methods: The current study aimed at investigating the significance of A. baumannii fimbrialandoutermembraneproteinsA(OmpA) in adherence to human epithelial cells. Antibiotic resistance was determined by the broth microdilution method. Phenotypic identification of isolates producing ESBL (extended-spectrum beta-lactamase) was conducted using double-disc synergy test (DDST). The virulence factors were detected by the polymerase chain reaction (PCR) in 100 non duplicate clinical isolates of A. baumannii; 18 clinical isolates were selected for adhesion assay based on antibiotic resistance and PCR results. Results: The current study results showed that ABAYE2132, ABAYE0304, and ABAYE1319-CsuA/B had significant correlation with cell adhesion (P 0. 05). There was no significant correlation between cell adhesion and ABAYE1859 (P 0. 05). ABAYE2132 was the most effective factor in cell adhesion. It was also observed that cell adhesion rate reduced with the increase of fimbrial proteins. Conclusions: The current study findings suggested that different products and structures of A. baumannii, most still unknown, play a pivotal role in pathogen-biotic reactions. Better exposure of some non-pili adhesins or other biofilm forming factors could be a reason for this phenomenon.

Context: Attention and taking care for communicable diseases are very important in mass gatherings. The aim of this study was to illustrate an overview about infectious diseases distribution among pilgrims in Hajj. Evidence Acquisition: This was a review article, in which the authors used all papers, which were indexed in PubMed and Irandoc from 2000 to 2015. The following key words were searched in the databases: hajj, infectious diseases, emerging and re-emerging diseases, vaccination, and chemoprevention. Three hundred and fifty-four papers were found and their contents were subsequently reviewed after abstract screening. Results: The results showed that the most frequent diseases in Hajj were respiratory infections. The most frequent causes of respiratory infections were upper respiratory viral infections and bacterial respiratory infections, respectively. In the recent years, emerging and reemerging diseases, such as Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome due to coronaviruses (MERS-CoV), and Ebola have imposed many stresses on the pilgrims and health policy managers. Conclusions: In this study, the researchers offered some effective recommendations for vaccinations, chemoprophylaxis, and other preventive measures for pilgrims.

Background: With regard to the increasing number of antifungal-resistant dermatophytes, the requirement for precise identification of causative agents of infections and antifungal susceptibility test is vital. Antifungal susceptibility testing of dermatophytes plays a pivotal role in managing dermatophytosis. The current study aimed at determining antifungal susceptibility profile of 161 important dermatophyte species isolated from Iranian patients. Methods: The current descriptive, cross sectional study was conducted on 508 clinically suspected samples of dermatophytosis collected and identified by conventional methods. All dermatophyte isolates were identified using polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP) method. The susceptibility of dermatophyte strains to two routine antidermatophyte agents (terbinafine and griseofulvin) was evaluated using micro-dilution method according to CLSI (the clinical and laboratory standards institute) M38-A2 guidelines. Trichophyton rubrum PTCC 5143 and Candida krusei ATCC 6258 were used as quality controls. Results: Among 161 dermatophyte isolates, T. interdigitale was reported as the most frequent species isolated from patients using PCR-RFLP and Microsporum ferruginum was the least isolated species. The minimum inhibitory concentration (MIC) values of griseofulvin and terbinafine were ranged 0. 0312-8 and 0. 008-4  g/mL, respectively. The most susceptible and resistant species to griseofulvin were T. interdigitale (MIC = 0. 0312  g/mL) and T. interdigitale/T. rubrum (MIC = 8  g/mL), respectively. The results indicated that T. verrucosum (MIC = 0. 008  g/mL) was the most susceptible species to terbinafine, whereas T. interdigitale and T. rubrum were the most resistant species to it (MIC = 4  g/mL). Conclusions: The obtained results assist clinicians to monitor the trendandbe able to choose effective medications to treat patients with dermatophytosis, especially in countries such as Iran, where dermatophytosis is still a public health problem.