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Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, the clinical manifestations of the virus have undergone many changes. Recently, there have been many reports on gastrointestinal symptoms in COVID-19 patients. This study is aimed to perform a detailed phylogenetic study and assessment of different SNVs in the RNA genome of viruses isolated from fecal samples of patients with COVID-19 who have gastrointestinal symptoms, which can help better understand viral pathogenesis. In the present study, 20 fecal samples were collected by written consent from COVID-19 patients. According to the manufacturer's protocol, virus nucleic acid was extracted from stool samples and the SARS-CoV-2 genome presence in stool samples was confirmed by RT-PCR assay. Three viral genes, S, nsp12, and nsp2, were amplified using the reverse transcription polymerase chain reaction (RT-PCR) method and specific primers. Multiple sequencing alignment (MSA) was performed in the CLC word bench, and a phylogenetic tree was generated by MEGA X based on the neighbor-joining method. Of all cases, 11 (55%) were males. The mean age of the patients was 33.6 years. Diabetes (70%) and blood pressure (55%) were the most prevalent comorbidities. All 20 patients were positive for SARS-CoV-2 infection in respiratory samples. Molecular analysis investigation among 20 stool samples revealed that the SARS-CoV-2 genome was found among 10 stool samples; only three samples were used for sequencing. The polymorphism and phylogenetic analysis in SARS-CoV-2 showed great similarity among all of the evaluated genes with the Wuhan reference sequence and all of the current variants of concern (VOCs). The current study represents a great similarity in polymorphism and phylogenetic analysis of the SARS-CoV-2 isolates with the Wuhan reference sequence and all of the current VOC in the particular evaluated partial sequences of S, nsp12, and nsp2.
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COVID-19 , SARS-CoV-2 , Adulto , Feminino , Humanos , Masculino , COVID-19/virologia , Teste para COVID-19 , Irã (Geográfico)/epidemiologia , Filogenia , SARS-CoV-2/genéticaRESUMO
BACKGROUND: This study was aimed to evaluate the antibiotic resistance, biofilm formation, and genetic diversity of carbapenem-resistant Pseudomonas aeruginosa (CRPA) strains isolated from four types of nosocomial infections (NIs) including urinary tract infection (UTI), ventilator-associated pneumonia (VAP), surgical site infection (SSI), and bloodstream infection (BSI). METHODS AND RESULTS: In total, 115 isolates of NIs-causing P. aeruginosa were collected from NIs. Antibiotic susceptibility testing (AST) was performed using disk diffusion method and minimum inhibitory concentrations. Biofilm formation was tested on 96-well polystyrene microtiter plates (MTP). CRPA isolates were genotyped using multiple-locus variable number of tandem repeat analysis (MLVA). The most resistance and susceptibility rates were observed to amikacin (70.6%) and colistin (96.1%), respectively. Colistin and meropenem were the most active antimicrobial agents in VAP, SSI, and BSI. While, colistin and cefepime were the most active in UTIs. In total, 52.2% (n = 60/115) of P. aeruginosa isolates were carbapenem resistant, of which 95.0%, 55.0%, and 5.0% were multidrug-resistant, extensively drug-resistant, and pandrug-resistant, respectively. There was a significant association between resistance to carbapenem and resistance to other antibiotics except for piperacillin/tazobactam. The biofilm production of CRPA isolates was 95.0%, of which 23.3% were strong biofilm producers. Based on MLVA, there were 34 different types of CRPA isolates classified into three main clusters and 5 sub clusters. CONCLUSION: The association of CRPA with other antibiotic resistance, the high rates of biofilm production, and the high genetic diversity of the isolates may be a warning of the need for a careful surveillance program.
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Infecção Hospitalar , Infecções por Pseudomonas , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Biofilmes , Carbapenêmicos/farmacologia , Colistina/farmacologia , Infecção Hospitalar/epidemiologia , Resistência Microbiana a Medicamentos , Variação Genética , Humanos , Irã (Geográfico)/epidemiologia , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/epidemiologia , Pseudomonas aeruginosaRESUMO
INTRODUCTION: Due to the upper and lower respiratory involvement in coronavirus disease 2019 (COVID-19), the voice quality of these patients is expected to be impaired. In this study, we aimed to conduct an auditory-perceptual evaluation of the vocal characteristics of patients with different severities of COVID-19. METHODS: One hundred two patients with mild, moderate, or severe COVID-19 as well as 30 healthy individuals were recruited to compare their respiratory/phonatory parameters. The Persian version of the CAPE-V and GRBAS scales, along with the maximum phonation time and s/z ratio values were used to evaluate the severity of respiratory/phonatory disorders during verbal tasks in the participants. RESULTS: Significant differences were found between the subgroups of patients and their healthy counterparts in all respiratory/phonatory parameters (p ≤ 0.03) except the s/z ratio (p = 0.81). CONCLUSIONS: Based on auditory-perceptual assessments, patients with COVID-19 showed dysphonia. The severity of dysphonia was significantly different among patients with different severities of COVID-19. Smoking can also play a significant role in vocal dysfunction in COVID-19 patients.
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COVID-19 , Disfonia , Voz , Disfonia/diagnóstico , Disfonia/etiologia , Rouquidão , Humanos , Fonação , Índice de Gravidade de Doença , Qualidade da VozRESUMO
The management of multidrug-resistant (MDR) and extensively drug-resistant tuberculosis (XDR-TB) presents a main challenge and the drug options for treating these infections are very limited. Linezolid (LNZ) has recently been approved for the treatment of MDR and XDR-TB. But, there are narrow data on genotypic and phenotypic LNZ resistance in clinical isolates. So, we aimed to determine the prevalence of LNZ resistance and to identify the mutations associated with LNZ resistance among clinical MDR-TB isolates. The minimum inhibitory concentration (MIC) values of LNZ for 22 MDR-TB isolates were determined by broth microdilution method. All MDR-TB isolates were sequenced in the rrl and rplC genes conferring LNZ resistance. LNZ resistance was found in 3 (13.6%) of 22 MDR-TB isolates. The MICs of LNZ were 8 µg/mL for two isolates and 16 µg/mL for one isolate. The 421 (A/G) and 449 (T/A) mutations in rplC gene were detected in one of the LNZ-resistant isolates. There was no mutation in rrl gene. The results reveal that the prevalence of LNZ-resistant isolates is 13.6% among MDR-TB isolates and drug susceptibility testing (DST) against LNZ is useful in the management of complicated and drug-resistant cases. However, further studies could identify other possible genetic mechanism of resistance in TB.
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Background: COVID-19 spread rapidly throughout the world and affected many people. The purpose of this study was to investigate the epidemiological characteristics of patients with COVID-19 in southwest of Iran from February 19 to June 20, 2020. Methods: In this retrospective study, the epidemiological characteristics of 7313 patients with COVID-19 in southwest of Iran were analyzed and reported from February 19, 2020, to the end of Jun,2020. Data were extracted from electronic records in hospitals. Sex ratio and mortality rate of the disease were calculated. A multiple logistic regression analysis was used to evaluate the factors affecting mortality. Results: From all patients studied, 3920 (53.5%) were men and 2066 (28.24%) were in the age 30 to 40 years age group. The case fatality rate of the disease based on the total number of patients (hospitalized and nonhospitalized) was 4.84%. The highest mortality rate was seen in patients with various cancers and in those aged over 80 years. The most common symptoms in patients were fever and cough, diabetes, hypertension, and cardiovascular diseases. Logistic regression results also showed that the chances of death in the 70-60 and 80-70 years age group were 5.94 (OR, 5.94; 95% CI, 2.14-16.43) and 8.63 (OR, 8.63, 95% CI, 3.09-24.14) compared to 10-20 years age group. Conclusion: These results indicate the need to increase primary care, provide the necessary equipment to treat patients, and more importantly, early identification of patients and treatment for them.
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OBJECTIVES: Sofosbuvir and daclatasvir are direct-acting antivirals highly effective against hepatitis C virus. There is some in silico and in vitro evidence that suggests these agents may also be effective against SARS-CoV-2. This trial evaluated the effectiveness of sofosbuvir in combination with daclatasvir in treating patients with COVID-19. METHODS: Patients with a positive nasopharyngeal swab for SARS-CoV-2 on RT-PCR or bilateral multi-lobar ground-glass opacity on their chest CT and signs of severe COVID-19 were included. Subjects were divided into two arms with one arm receiving ribavirin and the other receiving sofosbuvir/daclatasvir. All participants also received the recommended national standard treatment which, at that time, was lopinavir/ritonavir and single-dose hydroxychloroquine. The primary endpoint was time from starting the medication until discharge from hospital with secondary endpoints of duration of ICU stay and mortality. RESULTS: Sixty-two subjects met the inclusion criteria, with 35 enrolled in the sofosbuvir/daclatasvir arm and 27 in the ribavirin arm. The median duration of stay was 5 days for the sofosbuvir/daclatasvir group and 9 days for the ribavirin group. The mortality in the sofosbuvir/daclatasvir group was 2/35 (6%) and 9/27 (33%) for the ribavirin group. The relative risk of death for patients treated with sofosbuvir/daclatasvir was 0.17 (95% CI 0.04-0.73, P = 0.02) and the number needed to treat for benefit was 3.6 (95% CI 2.1-12.1, P < 0.01). CONCLUSIONS: Given these encouraging initial results, and the current lack of treatments proven to decrease mortality in COVID-19, further investigation in larger-scale trials seems warranted.
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Antivirais/administração & dosagem , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Imidazóis/administração & dosagem , Pneumonia Viral/tratamento farmacológico , Ribavirina/administração & dosagem , Sofosbuvir/administração & dosagem , Adulto , Idoso , COVID-19 , Carbamatos , Infecções por Coronavirus/mortalidade , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/mortalidade , Pirrolidinas , SARS-CoV-2 , Resultado do Tratamento , Valina/análogos & derivadosRESUMO
BACKGROUND: To explore the prevalence, transmission routes and genotypes distribution of HCV in HIV-1/HCV co-infected individuals in Ahvaz, Iran. METHODS: The present cross-sectional study was conducted among HIV adult voluntary counseling and testing (VCT) clients, from September to November 2016. Reverse transcription (RT) nested PCR was performed to amplify the HCV core and 5'UTR regions from 90 HIV/HCV co-infected individuals. The PCR products were then sequenced for HCV subtyping. Genetic analysis was done by MEGA6 software. RESULTS: The prevalence of HCV in HIV-1-infected individuals was 58.7%. Injection drug use (IDU) was the most common route (99.1%) of transmission, and most of the patients (97.8%) had a history of imprisonment. The HCV subtypes were identified as 1a (55.2%), 3a (35.8%), 3 h (4.5%), 1b (3%) and 4a (1.5%) respectively, HCV 1a and 3a subtypes were predominant. CONCLUSIONS: The diversity of HCV subtypes in HIV-1/HCV co-infected individuals in Ahvaz city was high, although two subtypes (1a and 3a) are predominant.
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Infecções por HIV/epidemiologia , Hepacivirus/genética , Hepatite C/epidemiologia , Adolescente , Adulto , Coinfecção/epidemiologia , Estudos Transversais , Feminino , Variação Genética , Genótipo , Infecções por HIV/virologia , HIV-1/patogenicidade , Hepacivirus/patogenicidade , Hepatite C/virologia , Humanos , Irã (Geográfico) , Masculino , Reação em Cadeia da Polimerase , Prevalência , Abuso de Substâncias por Via Intravenosa/epidemiologiaRESUMO
BACKGROUND & OBJECTIVES: West Nile virus (WNV) is a neurotropic Flavivirus transmitted to humans through mosquito bites. As there is no specific antiviral treatment or approved vaccine against WNV, control and prevention of the infection is the best strategy to reduce the burden of WNV-related diseases. The circulation of WNV has been indicated in several regions of Iran including the Khuzestan province. Considering the complex ecology of WNV, the latest data are necessary for the implementation of preventive measures. Therefore, the present study was designed to provide updated information on the seroepidemiology of WNV in Khuzestan province. METHODS: A total of 408 sera were taken from volunteers living in Khuzestan. The presence of specific immunoglobulin G (IgG) antibody against WNV was tested by the enzyme-linked immunosorbent assay (ELISA) method. All the data and participants' demographic information were analyzed by SPSS and Esri's ArcMap GIS software programs. RESULTS: Anti-WNV IgG antibody was detected in 97 (23.8%) out of the 408 tested sera. The highest seropositivity rate was observed in cases aged between 20-29 yr and the lowest seropositivity rate was seen in those <19 yr of age (p = 0.001). There was no statistically significant association between WNV infection and gender, occupation, and educational level. The majority of positive cases were from the city of Ahvaz (47 cases, 48.4%) and Andimeshk (32 cases, 33%). INTERPRETATION & CONCLUSION: This study supports the earlier findings suggesting the circulation of WNV in Khuzestan province. Therefore, the implementation of an integrated surveillance system and training of health care workers and general population regarding the infection would be valuable to reduce the burden of possible outbreaks.
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Anticorpos Antivirais/sangue , Febre do Nilo Ocidental/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Estudos Transversais , Surtos de Doenças , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Febre do Nilo Ocidental/imunologia , Vírus do Nilo Ocidental , Adulto JovemRESUMO
Botulism is one of the most important foodborne diseases and is caused by Clostridium botulinum toxin. The main manifestations are flaccid muscle paralysis and cranial nerve palsies. Botulism is an essential health problem because of its high mortality. The diagnosis of botulism, especially in sporadic cases, is a medical challenge and a high clinical suspicion is necessary for early recognition. So, every physician should be familiar with its signs and symptoms for early detection and treatment. We describe a family with dysphasia and acute paralysis after the ingestion of locally made cheese. The clinical presentations of the 1st patient were similar to myasthenic crisis and she, therefore, received plasma exchange. After the appearance of similar symptoms in the other family members, they were treated with polyvalent botulinum antitoxin and diagnosis was confirmed by toxicology and detection of serotype A botulinum toxin in cheese and stool samples. Uncommon clinical presentations and unusual sources of botulinum toxin should be kept in mind because of the importance of early diagnosis and treatment.
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In recent years, through a national programme for schistosomiasis control, this infection has been eliminated from Iran. The aim of this study was to report the process of significant decrease of urogenital schistosomiasis in southwestern Iran. During national programme surveillance for urogenital schistosomiasis control which was implemented by Centres for Disease Control and Prevention (CDC) of Khuzestan province from 1975 to 2013, more than 1·3 million urine samples were taken from inhabitants of high risk foci. All urine samples were gathered between 10:00 a.m and 02:00 p.m and, after centrifuging, specimens were tested under optical microscope in order to detect Schistosoma haematobium eggs. Data analysis was performed using SPSS 18 software. In this retrospective study significant reduction was seen in number of infections between 1975 and 2013. During the years 1975-1980, 1981-1990 and 1991-2000 there were 1582, 761 and 79 cases of S. haematobium, respectively. In 2001 only one case was reported from Ahvaz and indeed this was the last case of urogenital schistosomiasis in Khuzestan and of course, in Iran. Prevalence from 1·064% between 1975 and 1980 slumped to 0% in 2012-2013. During several projects for surveillance of urogenital schistosomiasis, selective population chemotherapy, snail control, population education, environmental improvement, etc were carried out throughout the surveillance period. According to elimination of S. haematobium in Khuzestan province, the only endemic region of Iran, control of disease, especially the campaign with intermediate host snails should be continued. Iran can be a successful model for countries suffering from this disease.
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Erradicação de Doenças , Schistosoma haematobium/isolamento & purificação , Esquistossomose Urinária/epidemiologia , Esquistossomose Urinária/prevenção & controle , Adolescente , Adulto , Animais , Estudos Transversais , Monitoramento Epidemiológico , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Óvulo , Prevalência , Estudos Retrospectivos , Esquistossomose Urinária/tratamento farmacológico , Esquistossomose Urinária/parasitologia , Caramujos/parasitologia , Adulto JovemRESUMO
Ahvaz, the capital city of Khuzestan Province, which produces Iran's most oil, is on the rolls of fame in view of air pollution. It has also suffered from dust storm during the recent two decades. So, emissions from transportation systems, steel, oil, black carbon, and other industries as anthropogenic sources and dust storm as a new phenomenon are two major concerns of air pollution in Ahvaz. Without any doubt, they can cause many serious problems for the environment and humans in this megacity. The main objective of the present study was to estimate the impact of ground-level ozone (GLO) as a secondary pollutant on human heath. Data of GLO in four monitoring stations were collected at the first step and they were processed and at the final step they were inserted to a health effect model. Findings showed that cumulative cases of cardiovascular and respiratory deaths which attributed to GLO were 43 and 173 persons, respectively. Corresponding RR for these two events were 1.008 (95% CI) and 1.004 (95% CI), respectively. Although we did not provide a distinction between winter and summer in case of mentioned mortalities attributed to GLO, ozone concentrations in winter due to more fuel consumption and sub adiabatic condition in tropospheric atmospherewere higher than those GLO in summer.
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Poluentes Atmosféricos/análise , Doenças Cardiovasculares/mortalidade , Monitoramento Ambiental/métodos , Ozônio/análise , Doenças Respiratórias/mortalidade , Monitoramento Ambiental/estatística & dados numéricos , Humanos , Irã (Geográfico) , Modelos Teóricos , Estações do AnoRESUMO
OBJECTIVES: The voice quality of patients with Coronavirus Disease 2019 (COVID-19) seems to be affected due to lower and upper respiratory involvement. Patient-based voice assessment scales are important clinical measures to diagnose voice disorders and monitor treatment outcomes in COVID-19 patients. This study compared vocal fatigue between COVID-19 patients and those with normal voices. Furthermore, the relationship between vocal fatigue and acoustic voice parameters of COVID-19 patients was evaluated. METHODS: This cross-sectional study enrolled 30 laboratory-confirmed patients with COVID-19 (18 males and 12 females) and 30 healthy individuals with normal voices (14 males and 16 females) to compare their respiratory or phonatory parameters. The Persian versions of the Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) and the vocal fatigue index (VFI) were conducted before and after reading the text. The Jitter, shimmer, maximum phonation time, and harmonic-to-noise ratio (HNR) were analyzed by Praat software based on the recorded voices of CAPE-V tasks. The acoustic assessment and VFI questionnaire results were compared between COVID-19 patients and the control group. RESULTS: There were significant differences between COVID-19 patients and their healthy counterparts in all VFI subscales (P < 0.001). Moreover, after reading the text, we found significant differences between the two groups regarding Jitter, shimmer, and HNR of /a/ and /i/ vowels (P < 0.05). Our findings also indicated a significant correlation between symptom improvement with rest and acoustic parameters in all tasks, except the Jitter of /a/ before reading the text. CONCLUSION: Patients with COVID-19 showed significantly more vocal fatigue than people with normal voices after reading the text. Moreover, there was a significant relationship between Jitter, shimmer, and HNR and the tiredness of voice and physical discomfort subscales of VFI.
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Background and aims: The main goal of the present study is to investigate the incidence of Rotavirus co-infection in COVID-19 patients. Methods and Results: Fecal samples of COVID-19 patients with gastrointestinal symptoms which had positive PCR- were collected from Abadan's hospital, Iran during the period December 2020 to January 2021. Samples were analyzed by RT-PCR to determine the presence of Rotavirus. Finally, the total samples size of 37 were included in this study. The mean age of patients was 48.22 years. Abdominal pain alone was detected in 48.65% of the patients. At least one gastrointestinal symptom was detected in all of the patients. Diarrhea and fever were seen in 13.51% and 59.46% of patients, respectively. Nausea and vomiting were seen in 5.41% of the patients. RT-PCR showed no infection of Rotavirus among the patients. Conclusion: Gastrointestinal symptoms related to COVID-19 are common. More studies is need among these patients groups for investigate co-infection with other fecal viral shedding carries, due to a worse prognosis and its association with disease severity.
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COVID-19 , Coinfecção , Gastroenteropatias , Infecções por Rotavirus , Rotavirus , Humanos , Pessoa de Meia-Idade , COVID-19/diagnóstico , COVID-19/epidemiologia , Rotavirus/genética , Coinfecção/epidemiologia , SARS-CoV-2 , Gastroenteropatias/epidemiologia , Infecções por Rotavirus/complicações , Infecções por Rotavirus/diagnóstico , Infecções por Rotavirus/epidemiologiaRESUMO
The world is faces a significant global health challenge in the form of viral infections, particularly the emergence of viral strains that are resistant to effective antiviral therapies. This underscores the urgent need for the development of effective and safe antiviral agents. Nanoscale materials are now being used as novel antiviral agents. Cerium nanoparticles have unique chemical and physical properties that make them particularly promising for viral infections. These particles reduce inflammation and the autoimmune response. Cerium nanoparticles, in addition to their antiviral properties, have many other advantages that are highly sought after for various aspects of biomedical applications. This review focuses on the various properties of cerium nanoparticles as a novel agent against viral infections.
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Cério , Nanopartículas , Viroses , Humanos , Cério/farmacologia , Cério/uso terapêutico , Nanopartículas/química , Antioxidantes/química , Viroses/tratamento farmacológico , Antivirais/farmacologia , Antivirais/uso terapêuticoRESUMO
BACKGROUND: Tranilast is a potential NLRP3 inflammasome inhibitor that may relieve progressive inflammation due to COVID-19. AIM OF THE STUDY: To evaluate the therapeutic effects of Tranilast in combination with antiviral drugs in non-ICU-admitted hospitalized patients with COVID-19. METHODS: This study was an open-label clinical trial that included 72 hospitals admitted patients with severe COVID-19 at Razi Hospital, Ahvaz, Iran, from July 2020-August 2020. These patients were randomly assigned in a 1:1 ratio to control (30) and intervention groups (30). Patients in the control group received antiviral therapy, while patients in the intervention group received Tranilast (300 mg daily) in addition to the antiviral drugs for Seven days. The collected data, including the expression of inflammatory cytokine, laboratory tests, and clinical findings, was used for intragroup comparisons. RESULTS: The intervention group showed significantly lower levels of NLR (p = 0.001), q-CRP (p = 0.002), IL-1 (p = 0.001), TNF (p = 0.001), and LDH (p = 0.046) in comparison with the control group. The effect of intervention was significant in increasing the o2 saturation (F = 7.72, p = 0.007). Long hospitalization (four days or above) was 36.6% in the Tranilast and 66.6% in the control group (RR = 0.58; 95% CI: 0.38-1.06, p = 0.045). In the Tranilst and control groups, one and four deaths or hospitalization in ICU were observed respectively (RR = 0.31; 95% CI: 0.03-2.88, p = 0.20). CONCLUSIONS: Tranilast might be used as an effective and safe adjuvant therapy and enhance the antiviral therapy's efficacy for managing patients with COVID-19.
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Tratamento Farmacológico da COVID-19 , Antivirais/uso terapêutico , Humanos , SARS-CoV-2 , Resultado do Tratamento , ortoaminobenzoatosRESUMO
BACKGROUND: Different resistance mechanisms for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) have been reported. Although mutations in target genes are the main cause of drug resistance, efflux pumps (Eps) also play an important role in this process. Here, we investigated the overexpression of five putative EP genes plus gene mutations in MDR-TB clinical isolates. METHODS: A total of 27 M. tuberculosis (Mtb) clinical isolates including, 22 MDR and 5 sensitive isolates were analyzed. Minimum inhibitory concentrations (MIC) were determined in the absence and presence of efflux inhibitor. The expression level of 5 EP genes (Rv3065, Rv2942, Rv1258c, Rv1410c, Rv2459) was investigated by quantitative real time PCR (RT-qPCR). DNA sequencing of rpoB, katG, and inhA promoter was done. RESULTS: Among the 22 MDR-TB isolates, 13 (59.1%) showed significant overexpression (>4-fold) for at least one EP gene. The expression levels of 5 genes were significantly higher (P < 0.05) in MDR-TB isolates than sensitive isolates. The Rv3065 (22.7%), and Rv1410c (18.2%) were found to be the most commonly overexpressed EPs. The observed MICs were as follows: RIF (2 to >128 µg/ml) and INH (2-32 µg/ml). After efflux pump inhibitor exposure, 10/22 (45.45%) isolates showed a decrease in MIC of INH, and 17/22 (77.27%) isolates showed a decrease in MIC of RIF. Of the isolates that overexpressed, 4 isolates lacked mutation in inhA, rpoB, and katG genes and 10 ones lacked mutation in inhA and katG. CONCLUSION: The results showed that overexpression of EP genes in Mtb isolates, besides target gene mutations can contribute to the development of MDR phenotype.
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INTRODUCTION: Despite the great efforts to control tuberculosis (TB), the disease is still one of the major health challenges throughout the world. The basic treatment for TB is drug therapy. Currently, the main anti-tuberculosis drugs with major use in the treatment and control of the disease are isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin. One of the serious crises in controlling TB epidemic is diagnosis and treatment of patients with Multidrug Resistant Tuberculosis (MDR-TB MDR). The purpose of the study was to examine and evaluate the resistance of mycobacterium TB strains isolated from specimens of newly diagnosed smear positive pulmonary TB to isoniazid and rifampin using molecular methods and their risk factors. METHODS: Sputum samples of newly diagnosed smear positive pulmonary TB patients were prepared, collected, and sent to Reference Laboratory in Ahvaz. DNA of mycobacterium tuberculosis was prepared from the samples using Qiagen kit according to the instructions of the manufacturing company. Isoniazid resistance was evaluated using specific primers for inhA and KatG genes. Rifampin resistance was evaluated using MAS-PCR method with three specific alleles of rpobB codons and codons 516, 526 and 531. RESULTS: Mycobacterium tuberculosis resistance to Isoniazid was 7.3%, to Rifampin 5.5% and to both drugs 1.8%. In our study, there were no association between drug resistance and gender, age, prison history, smoking, drug use, underlying disease, occupation, and HIV. CONCLUSION: According our findings that include prevalence of 7.3% Isoniazide resistance, 5.5% Rifampin resistance and 1.8% to both drugs, evaluating all newly diagnosed patients for resistance to standard anti-tuberculosis treatment seems rational.
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With sand flies as the main vectors, Leishmania species cause ancient zoonotic diseases called leishmaniasis. Iran is an endemic country regarding cutaneous leishmaniasis. A number of 100 smear slides were collected from cutaneous lesions referred to Ahvaz health centers. The DNA was extracted and ITS1-PCR using LITSR and L5.8S primer pair was performed to detect the genus Leishmania. Then, enzymatic digestion of PCR products was done by HaeIII (species detection), TaqI (strain detection), DpnI and HpaII (mutation assessment). Furthermore, 50 samples were sent for sequencing. Microscopic examination showed amastigote form in all 100 slides. Also, molecular identification confirmed the infection of all cases to Leishmania genus, representing a 350 bp band. HaeIII digestion yielded 150 and 200 bp bands, indicating Leishmania major, while 130 and 200 bp fragments following TaqI digestion suggested A1 strain of the parasite. Moreover, no likely mutations was detected in ITS1 fragment of obtained parasites using DpnI (140 and 200 bp digestion) and HpaII (without digestion). The sequencing result also was consistent with our findings, having 100% homology to A1 strain sequence (AY550178). Leishmania major A1 strain was the predominant species in clinical samples of Ahvaz. Nevertheless, future researches should address the parasite strains in other foci and hosts of epidemiological significance.
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BACKGROUND: The current study was aimed to assess the prevalence of intestinal parasitic infections (IPIs) in persons who were referred to selected hospitals of Abadan and Khorramshahr cities, in the southwest of Iran. MATERIALS AND METHODS: In this descriptive cross-sectional study, 43200 and 28821 stool specimens were gathered from Abadan and Khorramshahr cities, respectively, during four consecutive years (2014-2017). RESULTS: A decreasing trend was seen in the prevalence rate of IPIs in Abadan and Khorramshahr cities. The overall prevalence of IPIs was estimated to be 5.82% and 6.11% in Abadan and Khorramshahr cities, respectively. In Abadan city, the proportion of IPIs in male persons with 56% was higher than females 44%, while in Khorramshahr city, more prevalence was observed in females (54% vs. 46%). Moreover, according to the season, the highest prevalence was recorded in Spring (30.4%) and Summer (31.1%) in Abadan and Khorramshahr cities, respectively. We found Giardia lamblia, as the most frequent parasite in studied individuals of both cities (Abadan: 2.92%; 1261/43200 and Khorramshahr: 3.15%; 908/28821). Other parasites were as follows: Entamoeba histolytica/dispar, E. coli, E. hartmanni, Blastocystis hominis, Hymenolepis nana, Enterobius vermicularis, Strongyloides stercoralis, and Taenia spp. CONCLUSION: This was the first study on the prevalence of IPIs in Abadan and Khorramshahr cities, southwest of Iran. Intestinal parasites are still the main public health concern in these regions. Health education, improving sanitary conditions, screening and treatment of infected people, particularly in rural and semi-urban areas can be helpful.
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Enteropatias Parasitárias , Estudos Transversais , Escherichia coli , Fezes , Feminino , Humanos , Enteropatias Parasitárias/epidemiologia , Irã (Geográfico) , Masculino , Prevalência , Estudos RetrospectivosRESUMO
Myiasis is caused by invasion of larvae stage of dipterans fly in living tissue of vertebrate host including human and animals. The most important family is Calliphoridae and included Calliphora, Lucilia, Chrysomyia and Cochliomyia genus. A 35-yr-old man with gastric cancer history referred to Golestan Hospital in Ahvaz Southwest of Iran in 2015. He was infected by nasal myiasis from Lucilia spp. in ICU. The genus of third larvae stage was identified by microscopic examination and culture of pupa. The population of flies inducing myiasis should be controlled in hospitals.