Infection Epidemiology and Microbiology
Year:2023 | Volume:9 | Issue:3|Papers Count:8

Background: Treatment of infections caused by metallo-beta-lactamase (MBL)-producing Pseudomonas aeruginosa (P. aeruginosa) is a major healthcare-associated concern. Therefore, the purpose of this study was to ascertain antibiotic resistance patterns and prevalence of MBL genes in clinical isolates of P. aeruginosa. Materials & Methods:   In total, 90 non-repetitive clinical isolates of P. aeruginosa were collected from clinical specimens of patients who referred to Amir Al-Momenin hospital in Zabol, southeast of Iran, from January 2019 to November 2022. Antibiotic susceptibility patterns were determined according to CLSI guidelines. Combined disk test (CDT) was used to detect MBL-producing P. aeruginosa isolates. MBL genes (blaIMP, blaVIM, blaNDM, and blaSPM) were detected by PCR (polymerase chain reaction) method. Findings: The isolates were mostly resistant to ceftriaxone (51.1%, 46 of 90) and gentamicin (43.3%, 39 of 90). Based on CDT results, 89.4% (17 of 19) of carbapenem-resistant isolates were MBL positive. In addition, MBL genes including blaVIM, blaIMP, and blaNDM were detected in 20% (18 of 90), 8.9% (8 of 90), and 5.6% (5 of 90) of the isolates, respectively. Conclusions: Based on this study findings, the use of ceftriaxone and gentamicin should be restricted. In addition, MBL genes (blaVIM and blaIMP) seem to play a crucial role in the spread of carbapenem-resistant infections and the emergence of multidrug-resistant isolates, leading to antibiotic treatment failure.

Background: Pathogenic Escherichia coli (E. coli) is usually known as the principal agent of hospital-acquired infections, particularly those related to urinary tract infections (UTIs). The purpose of tThis study aimedwas to determine ESBL (extended-spectrum B-lactamase) production and quinolone resistance (qnr) genes in cytotoxic necrotizing factor 1 (CNF-1)- producing E. coli isolatesd from UTIs in Iraq. Materials & Methods: A total of 996 E. coli isolates were obtained from UTIs infections in two general hospitals in Hillah, Babylon, Iraq (during 2014-2022), and 100 uropathogenic E. coli (UPEC) were cnf-1 gene carriers. ESBL production was evaluated using the double-disk synergy -test. The qnr genes were detected using polymerase chain reaction (PCR). Findings: Nalidixic acid and chloramphenicol resistance wasincluded 70% and 30%, respectively. ESBL production was observed among 46% of cnf-1 -carriers isolates. The qnrA, qnrB, and qnrS genes were detected in 18%, 21%, and 11% of the isolates, respectively. ESBL-producing isolates mainly carried the qnrB gene and showedhad the highest resistance levels to quinolones. Major risk factors of pathogenic E. coli isolation included older age (68%, p= 0.031), previous hospitalization (76%, p= 0.021), and urinary catheter (83%, p= 0.018). Conclusion: Although the prevalenceexistence of the cnf-1 gene was not high among UPEC isolates, its prevalencerate was high among quinolone-resistant and ESBL-producing isolates. The cContinuous investigation of virulence and resistance genes is essential tfor monitoring and controlling the infections and facilitate their control. ItMore investigation is necessary to determine the virulence  traits factors and resistance genes among UPEC in Iraq and to take in timely measures action to hinder the spread of resistance genes from spreading to other nosocomial isolates.

Background: This study aimed to compare the diagnostic efficacy of standard culture method with multiplex quantitative real-time polymerase chain reaction (qPCR) in examining cerebrospinal fluid (CSF) samples collected from patients with suspected meningitis. Materials & Methods: A retrospective evaluation was conducted on 166 patients with suspected meningitis, who were treated in Vali-Asr hospital in Birjand, Iran between 2011 and 2020. Diagnosis of bacterial meningitis was based on CSF culture and multiplex qPCR results. Findings: Among 166 patients, conventional methods identified causative pathogens in only 10.3% of cases, while multiplex qPCR detected pathogens in eight out of 25 culture-negative cases as well. The most common pathogens identified were enterovirus, Epstein-Barr virus, herpes simplex, Haemophilus influenzae, and Streptococcus pneumoniae. Conclusion: Multiplex qPCR appears to be a more effective method than conventional culture in identifying bacterial and viral pathogens that most commonly cause meningitis. The incorporation of qPCR as a routine diagnostic method for meningitis in clinical practice could significantly enhance clinical decision-making and patient care.

Background: Otomycosis is a common fungal ear infection affecting people worldwide. Cases may be exacerbated by mixed fungal-bacterial infections, especially those involving antibiotic-resistant bacteria. Understanding the microbiological features and antibiotic susceptibility patterns of the pathogens involved is critical for treatment. This study aimed to investigate the prevalence of mixed fungal-bacterial infections in otomycosis cases in Indonesia, to identify the bacterial species involved, and to determine their antibiotic susceptibility patterns. Materials & Methods: In this study, 47 ear swab specimens were collected from 41 clinically-diagnosed otomycosis cases from April to August 2022. The collected samples were processed by culture and microscopy to identify fungal and bacterial isolates. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Findings: Fungal isolates alone were detected in 80.9% of the specimens, while 19.1% showed mixed fungal-bacterial growth. The most common fungi were Aspergillus (57.1%) and Candida (42.9%) species. Among bacterial isolates, Staphylococcus aureus was the most frequent (observed in 66.7% of mixed cases), followed by Pseudomonas aeruginosa (22.2%). Also, two of the six S. aureus isolates were methicillin-resistant (MRSA). Both P. aeruginosa isolates were extended-spectrum beta-lactamase (ESBL) producers. Conclusion: Many otomycosis cases in this study demonstrated polymicrobial etiology. The emergence of antibiotic-resistant bacteria poses diagnostic and therapeutic challenges to healthcare systems.

Background: The use of plant extracts or their compounds as antimicrobial agents for oral infections worldwide represents that herbal medicines could be used as an effective alternative method in oral health care. This study aimed to evaluate the antifungal and antibacterial effects of five traditional medicinal plant extracts on standard and clinical strains of bacteria and fungi causing dental caries. Materials & Methods: Aqueous and methanolic extracts of Zataria multiflora, Lawsonia alba, Zizyphus spina-christi, Myrtus communis, and Citrus aurantium were prepared using maceration method. The minimum inhibitory concentration (MIC) and minimum microbicidal concentration (MMC) of the prepared extracts were evaluated against bacterial (Streptococcus sanguinis and S. mutans) and fungal (Candida albicans, C. krusei, and C. tropicalis) isolates using broth microdilution method.   Findings: Aqueous extracts of the studied plants showed no antimicrobial effects on the studied microorganisms, except M. communis and C. aurantium. The results indicated the antimicrobial potency of the methanolic extract of M. communis (MIC range =2 to 64 µg/mL) against all the studied microorganisms, followed by Z. multiflora (MIC range = 512-2048 µg/mL), L. alba (MIC range = 1024-2048 µg/mL), C. aurantium (MIC range = 1024-4096 µg/mL), and Z. spina-christi (MIC range=2048- ˃4096 μg/mL).  Also, the lowest MMCs against the studied strains were related to the methanolic extract of M. communis (MMC range = 16-512 µg/mL). Conclusion: The results showed remarkable antimicrobial effects of M. communis extract, which could be a suitable alternative to chemical mouthwashes to prevent and control oral infections.

Background: The ongoing global health crisis caused by the infectious coronavirus disease, known as COVID-19, is attributed to the SARS-CoV-2 virus. The pandemic has significantly impacted people of all ages and nationalities and has spread across all continents, with an initial focus on Asia and subsequently reaching Europe. The objective of this study was to analyze the progression of COVID-19 in Europe in contrast to other continents around the world by examining the pandemic's trajectory across different geographic areas, allowing us to gain insights into the effectiveness of containment measures, and identifying potential patterns of virus spread. Materials & Methods: The data source was a curated dataset provided by Our World in Data (OWD), regularly updated during the COVID-19 pandemic. The dataset consisted of 207,316 records with 67 attributes, covering 244 locations, including countries from six continents. These attributes encompassed a wide range of COVID-19-related metrics, such as cases, deaths, testing, vaccinations, and demographic indicators. This comprehensive comparative study specifically focused on the European continent data from January 01, 2020, to August 08, 2022. Findings: The analysis revealed distinct groups of European countries with different experiences with the virus. First, some countries were found to be severely affected by the virus, grappling with higher case numbers and mortality rates. On the other hand, some countries were able to successfully manage the virus spread. Additionally, there was a group with significant case numbers but relatively lower mortality rates. Finally, certain countries effectively limited the virus transmission while maintaining low mortality rates. Conclusion: As the pandemic continues, it is essential to emphasize the significance of international data to develop comprehensive strategies against severe health crises. Evaluating different outcomes across continents and within specific regions could provide crucial insights to guide future control measures. However, the fight against COVID-19 is far from over, necessitating ongoing research and cooperation on a global scale.

Background: Infectious agents are considered as one of the possible etiological factors of systemic lupus erythematosus (SLE). It has been suggested that torque teno virus (TTV) may trigger autoimmune disorders, but few studies have been conducted on the relationship between this virus and autoimmune diseases, especially SLE. The present study aimed to evaluate the association between TTV frequency and SLE. Materials & Methods: Serum samples were collected from a total of 116 participants, including 58 healthy people and 58 SLE patients who referred to the rheumatology clinic of Shahid-Beheshti hospital in Kashan, Iran from January 2020 to January 2021. After the extraction of viral DNA from the samples, a nested PCR test was performed using specific primers to detect TTV. Findings: TTV was detected in 43 SLE patients (74.1%, 95% CI: 63.4-86.2) and 33 healthy individuals (56.9%, 95% CI: 44.1-69.0). A significant correlation was found between SLE and the presence of TTV (r= .32, p= .03). There was no correlation between the presence of TTV and musculoskeletal involvements, skin lesions, renal manifestations, and hematological manifestations (r< .05, p> .05). TTV was detected more frequently in patients with active lupus than in patients with quiescent disease, and this difference was significant (p= .048). Conclusion: A significant association between TTV and SLE was observed in the present study; however, further studies are needed to investigate the role of TTV in the pathogenesis and clinical course of SLE.

Background: The present study aimed to compare the clinical outcome as well as laboratory and clinical profiles of Coronavirus disease 2019 (COVID-19) patients with and without diabetes. Materials & Methods: The present study is a retrospective study that included 266 non-diabetic and 259 diabetic patients who were admitted to a tertiary healthcare center in South India between March 2021 to April 2021.The objective of the study was to compare the clinical outcome and laboratory profiles of COVID-19 patients with and without diabetes. Patients aged 18 years or above, diagnosed with COVID-19 by either RT-PCR and/or HRCT chest as well as diagnosed to be diabetic or non-diabetic were included in the study. After observing inclusion and exclusion criteria, the study included patients whose medical records were scrutinized, and data was analyzed using SPSS v 28.0 and the continuous variables were expressed in mean, standard deviation, minimum and maximum value. The categorical variables are expressed in frequency and percentage. Comparison was done using binomial test and Mann-Whitney U test while association was tested using Fischer exact test. Findings: Primary outcomes show that higher number of patients with diabetes (84.94%) presented with abnormal Interleukin-6 (IL-6) levels and this difference was found to a statistically significant (p<0.001). Hypertension was the most common comorbidity among both diabetic (46.72%) and non-diabetic (33.52%) patients and it was shown to be associated with clinical outcome and oxygen requirement (p<0.001). A significant difference was observed in the mean score of age, total count, IL-6 and number of days admitted between COVID-19 subjects of both groups with the mean being higher in the group of patients with diabetes (p<0.001). Conclusion: The results of the present study reinforce available evidence that IL-6 levels can be used to ascertain progression, morbidity, and mortality to ensure proper management of COVID-19 patients and that diabetes state results in higher total count, IL-6 and number of days admitted.