Bacterial infections are associated with cardiovascular disease in Iran: a meta-analysis.

INTRODUCTION: The present study aimed to assess the prevalence and association of various bacterial infections with cardiovascular disease (CVD) in Iran. MATERIAL AND METHODS: An electronic search was performed using related keywords in the national and international databases up to June 30, 2017. Out of the 1807 articles found on the associations between bacterial infections and CVD, 20 relevant studies were selected for the meta-analysis. RESULTS: The prevalence of bacterial infections was higher in case groups compared with the control groups. Odds ratios for assessing the association between Chlamydia pneumonia infection and CVD based on PCR, IgG and IgA tests were 7.420 (95% CI: 3.088-17.827), 3.710 (95% CI: 1.361-10.115) and 2.492 (95% CI: 1.305-4.756), respectively. Moreover, the calculated odds ratio for Mycoplasma pneumonia infection was 1.815 (95% CI: 0.973-3.386). For Helicobacter pylori infection, odds ratios based on IgG and IgA tests were 3.160 (95% CI: 1.957-5.102) and 0.643 (95% CI: 0.414-0.999), respectively. CONCLUSIONS: The present meta-analysis suggested that there was a significant association between H. pylori, C. pneumonia and M. pneumonia infections and CVD in Iran. These findings confirm the potential role of bacterial infections as predisposing factors for CVD.

Direct detection of Pseudomonas aeruginosa from patients with healthcare associated pneumonia by real time PCR.

Using oprL sequences, a TaqMan real time PCR was developed and used for quantitative detection of Pseudomonas aeruginosa from 99 broncoalveolar lavage and 11 sputum specimens collected from patients with health care associated pneumonia. All specimens were cultured on appropriate media to isolate bacteria. Twenty five specimens were positive by both methods. Polymicrobial infections were found in 13 specimens. Amplification of oprL in serial dilutions ranged from 10(9)CFU/ml to 10(2)CFU/ml. Standard curve of duplicated every dilution had slope 3.25±0.1 and R(2)>0.99 with SD 0.1. Our real time PCR assay showed high sensitivity (100%) and specificity (98.85%). This technique could detect and enumerate 100 bacteria directly from clinical specimens and showed that the threshold is 10(3)CFU/ml in cases with clinical symptoms. Our method can be used for quantitative detection of P. aeruginosa from BAL and sputum specimens in 1h and 10min.

Distribution of bla(TEM), bla(SHV), bla(CTX-M) genes among clinical isolates of Klebsiella pneumoniae at Labbafinejad Hospital, Tehran, Iran.

Extended-spectrum beta-lactamase (ESBL)-producing isolates of Klebsiella pneumoniae have been increasingly recognized in the hospital settings in Iran as well as throughout the world. The aim of this study was to detect and determine the genes encoding the ESBLs including bla(TEM), bla(SHV), and bla(CTX-M) groups among the K. pneumoniae isolates at Labbafinejad Hospital by polymerase chain reaction (PCR) and characterize them by direct sequencing of PCR products. Eighty-nine isolates were isolated from patients at different wards during March 2008-March 2009. They were identified as K. pneumoniae using biochemical tests. Susceptibility of isolates to 17 different antimicrobial agents was determined using agar disk diffusion method. The phenotypic confirmatory test was used to screen the isolates for production of ESBLs. To amplify the bla(SHV) the template DNA was extracted by boiling method. Plasmid DNA was extracted using minipreparation kit and used as template in PCR for detection of bla(TEM) and bla(CTX-M). The selected PCR products were sequenced and analyzed. All 89 strains were susceptible to imipenem. The rates of resistance to different antibiotics were in the following order: aztronam (79.7%), cefexime (67.4%), cefpodoxime (66.2%), cefotaxime (65.1%), ceftazidime (61.7%). The phenotypic confirmatory test detected 62 isolates (69.7%) as ESBL-producing K. pneumoniae. The prevalence of genes encoding ESBLs were as follows: bla(TEM) 54% (n = 48), bla(SHV) 67.4% (n = 60), bla(CTX-M-I) 46.51% (n = 40), and bla(CTX-M-III) 29% (n = 25). The bla(CTX-M-II) and bla(CTX-M-IV) were not detected. All bla(TEM) types were characterized as bla(TEM-1) and all bla(CTX-M-I) were identified as bla(CTX-M-15). The SHV types were characterized as SHV-5, SHV-11, and SHV-12. The rate of ESBL at Labbafinejad Hospital was 25% increase in a 4-year study that ended in March 2009. It appears that bla(TEM-1), bla(SHV-5), bla(SHV-11), bla(SHV-12), and bla(CTX-M-15) are the dominant ESBLs among the resistant strains of K. pneumoniae in Iran.