Prevalence of Pseudomonas aeruginosa and its antibiotic resistance in patients who have received Hematopoietic Stem-Cell Transplantation; A globally Systematic Review.

Gram-negative bacteria are infectious and life-threatening agents after hematopoietic stem cell transplantation (HSCT). So, this study aimed to investigate the prevalence of Pseudomonas aeruginosa and its antibiotic resistance in patients who have received Hematopoietic Stem-Cell Transplantation through a systematic review. The systematic search was done with key words; Pseudomonas aeruginosa, hematopoietic stem cell transplantation from 2000 to the end of July 2023 in Google Scholar and PubMed/Medline, Scopus, and Web of Science. Twelve studies were able to include our study. Quality assessment of studies was done by Appraisal tool for Cross-Sectional Studies. The most of the included studies were conducted as allo-HSCT. Infections such as respiratory infection, urinary infection and bacteremia have occurred. The rate of prevalence with P. aeruginosa has varied between 3 and 100%. The average age of the participants was between 1 and 74 years. The rate of prevalence of P. aeruginosa resistant to several drugs has been reported to be variable, ranging from 20 to 100%. The highest antibiotic resistance was reported against cefotetan (100%), and the lowest was related to tobramycin (1.8%) followed by amikacin, levofloxacin and ciprofloxacin with the prevalence of 16.6%. Our findings showed a high prevalence and antibiotic resistance rate of P. aeruginosa in Hematopoietic stem cell transplantation. Therefore, more serious health measures should be taken in patients after transplantation.

Effect of curcumin nanoparticles and alcoholic extract of Falcaria vulgaris on the growth rate, biofilm, and gene expression in Pseudomonas aeruginosa isolated from burn wound infection.

PURPOSE: This study aimed to investigate the effect of Curcumin nanoparticles and alcoholic extract of Falcaria vulgaris on the growth rate, biofilm, and gene expression in Pseudomonas aeruginosa isolated from burn wound infection. METHODS: The alcoholic extract of Falcaria vulgaris was purchased from Pasargad Company. Curcumin nanoparticles were synthesized. Antibacterial activity of Curcumin nanoparticles and alcoholic extract of Falcaria vulgaris was investigated by microdilution method alone and in combination. Biofilm inhibitory was investigated by microtitrplate method. Effect of Curcumin nanoparticles and alcoholic extract of Falcaria vulgaris were evaluated on algD gene expression via Real-Time PCR. Cytotoxicity was evaluated by MTT assay on HDF cell line. Then, the data were analyzed using SPSS software. RESULTS: Synthesized Curcumin nanoparticles were approved by Fourier Transform Infrared (FTIR), and Scanning Electron Microscope. The alcoholic extract of Falcaria Vulgaris showed significant antibacterial activity against multidrug resistance (MDR) P. aeruginosa isolates at a concentration of 156.25 µg/mL. Moreover, MIC of the curcumin nanoparticle for isolates was 625 µg/mL. Based on fraction inhibition concentration, synergy, and the additive effect were shown against %7.7, and %93.3 of MDRs, respectively. The sub-MIC concentration of the binary compound reduced biofilms and algD gene expression in P. aeruginosa isolates. The Biological function of HDF cell lines was desirable after the effect of the binary compound. CONCLUSIONS: Regarding our results, this combination can be suggested as a promising agent in terms of biofilm inhibitory and antimicrobial properties.

Candida coinfection among patients with pulmonary tuberculosis in Asia and Africa; A systematic review and meta-analysis of cross-sectional studies.

Diagnosis of fungal co-infections in patients suffering from pulmonary tuberculosis has critical importance. Therefore, we aimed to determine the prevalence of candida coinfection in patients with pulmonary tuberculosis. The present systematic review of cross-sectional studies was conducted based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) Protocol. Studies published online in English from January 2001 to March 2019 were assessed. Literature search was done in Web of Science, MEDLINE/PubMed, and Scopus databases and search engines using keywords combinations of "pulmonary fungi", "pulmonary coinfection", OR "pulmonary mycosis", "pulmonary fungal infections/agents", OR "polymicrobial infection", OR "secondary infection", OR "mixed infections", "pulmonary candidiasis", "fungi coinfection", "fungal co-colonization", AND "pulmonary tuberculosis", OR "pulmonary TB", AND "Asia", AND "Africa". Data was analyzed using Comprehensive Meta-Analysis software (CMA). Heterogeneity between studies was evaluated by Cochran's Q and I2 tests. The pooled prevalence of candida coinfection among patients with pulmonary tuberculosis was 25.7% (95% CI: 23.7-27.9). C. albicans was the most prevalent Candida spp. with a pooled prevalence of 65.8% (95% CI: 54.3-75.7). Risk factors of candida coinfection were smoking, diabetes, advanced age, and low body mass index. The present review showed a high rate of candida coinfection among patients suffering from pulmonary tuberculosis. So, appropriate measures are necessary to early diagnose and treat these infections.

Aspergillus coinfection among patients with pulmonary tuberculosis in Asia and Africa countries; A systematic review and meta-analysis of cross-sectional studies.

Progress of the disease and prolonged treatment with antibiotics or immunosuppressive agents makes tuberculosis patients susceptible to fungal infections. This study aimed to determine the prevalence of pulmonary Aspergillus coinfection among patients with pulmonary tuberculosis in Asia and Africa. The present review of cross-sectional studies was conducted on the prevalence of pulmonary Aspergillus coinfection among patients with pulmonary tuberculosis according to the PRISMA Protocol. Literatures published online in English from January 2001 to March 2019 via key databases such as Web of Science, MEDLINE, PubMed, Scopus, and Cochrane Library were searched. The used MeSH and non-MeSH keywords were; "pulmonary fungal", "pulmonary coinfection", OR "Pulmonary mycosis", "pulmonary fungal infections/agents", OR "Polymicrobial infection", OR "Secondary infection", OR "Mixed infections", "pulmonary aspergillosis", "fungi coinfection", "Fungal co-colonization", AND "pulmonary tuberculosis", OR "pulmonary TB", AND "Asia" AND "Africa". Finally, data analyzed using Comprehensive Meta-Analysis software (CMA). The combined Aspergillus coinfection among patients with pulmonary tuberculosis was 15.4% (95% CI: 11.4-20.5), Q = 105.8 and Z = 9.57 in Asia and Africa. The most frequency of Aspergillus spp. was related to A. fumigatus with a combined prevalence of 57.6%. Most of the studies included in the present review showed a higher Aspergillus coinfection in the age group of 40 years and higher. Also, the existence of a correlation between increasing age and Aspergillus coinfection was reported (p < 0.05). The present review showed a high combined Aspergillus coinfection among patients with pulmonary tuberculosis in Asia and Africa. Also, amongst the Aspergillus spp., the most frequent was related to A. fumigatus.

Inhibitory effects of Cinnamaldehyde, Carvacrol, and honey on the expression of exoS and ampC genes in multidrug-resistant Pseudomonas aeruginosa isolated from burn wound infections.

This study aimed to evaluate the effects of Cinnamaldehyde, Carvacrol, and honey either alone or in combinations on the expression of exoS and ampC genes in multidrug-resistant (MDR) P. aeruginosa isolates. Thirty-five P. aeruginosa isolates were recovered from burn wound infections of patients admitted to the burn ward of Besat hospital of Hamadan, Iran, during 2018. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method to identify MDR isolates. The antibacterial effects of Cinnamaldehyde, Carvacrol, and honey either alone or in combinations with each other were compared to Imipenem (as the control group) using the broth dilution method. The expressions of exoS and ampC genes were determined in bacteria treated with sub-minimum inhibitory concentration (MIC) of the ternary combination of Cinnamaldehyde, Carvacrol, and honey by Real-Time-PCR. The data were analyzed using SPSS software applying student t-test, Kruskal-Wallis, and Mann-Whitney U tests. The P-value less than 0.05 was considered as statistically significant. The average MICs of Cinnamaldehyde, Carvacrol, and honey were 0.82-0.01, 0.01-0.6, and 62.5-250 µg/mL, respectively. The average MIC of the mentioned compounds was 430 times lower than that of Imipenem. A synergistic effect was detected between these drugs against 70% of the isolates. At sub-MIC concentration, the triple combination of Cinnamaldehyde, Carvacrol, and honey reduced the expressions of exoS and ampC genes by 6.12 and 2.85 folds, respectively. The combination of Cinnamaldehyde, Carvacrol, and honey showed a higher antibacterial effect than Imipenem. However, it needs confirmation with more isolates.

Comparison of RT-LAMP and RT-qPCR assays for detecting SARS-CoV-2 in the extracted RNA and direct swab samples.

Rapid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in infected patients is critical for infection control. Loop-mediated isothermal amplification (LAMP) has been demonstrated to be a rapid, simple, reliable, cost-effective and sensitive method to detect SARS-CoV-2 in a variety of samples in considerably less time than Real-Time PCR. In this study, we developed and optimized a rapid detection method for SARS-CoV-2 based on RT-LAMP method utilizing a specific primer set targeting the ORF1a gene and then examined its sensitivity and efficiency using a serially diluted viral RNA sample with a known concentration. Furthermore, the sensitivity of the RT-LAMP to detect SARS-CoV-2 in direct swab samples with varying Ct values were compared to a commercial molecular RT-qPCR based detection kit. According to our findings the optimal incubation time for RT-LAMP assay was 45 min. There was a complete agreement between RT-LAMP and RT-qPCR in diagnosing the viral genome in the diluted extracted RNA sample. However, it had a lower sensitivity (71%) to detect the viral genome in direct swab samples compared to RT-qPCR. In conclusion, due to its simplicity, rapidness, sensitivity, and specificity, RT-LAMP has tremendous potential as a point-of-care tool; nevertheless, more research is needed to utilize it for detecting SARS-CoV-2, particularly in direct swab samples.

Epidemiology of Pseudomonas aeruginosa in diabetic foot infections: a global systematic review and meta-analysis.

Pseudomonas aeruginosa is one of the most common causes of diabetic foot infection globally. This study aimed to determine the global distribution of P. aeruginosa isolated from diabetic foot ulcer infection. PRISMA procedure was used to perform the current systematic review and meta-analysis. The Web of Science, MEDLINE/PubMed, Scopus, and other databases were searched for studies published in English from 2000 to 2022. Data was analyzed using the Comprehensive Meta-Analysis software (CMA). Keywords and MESH phrases included Pseudomonas aeruginosa, diabetic foot ulcer, P. aeruginosa, and diabetic foot infection. As a result of this review, 16.6% of diabetic foot wound infections were caused by P. aeruginosa. About 37.9% of strains were multidrug resistant (MDR). P. aeruginosa infection rates in diabetic foot ulcers ranged from 0.5 to 100% globally. In total, the prevalence rates of P. aeruginosa in diabetic foot ulcer infection from Asia, Africa, and Western countries were reported at 18.5%, 16.3%, and 11.1%, respectively. Data have shown that the prevalence of P. aeruginosa, particularly MDR strains, isolated from diabetic foot ulcer infection was relatively high; inherent resistance to antibiotics is also high; the wound either does not heal or if it does, it will be delayed. Therefore, timely treatment is essential.

Evaluate the Effect of Zinc Oxide and Silver Nanoparticles on Biofilm and icaA Gene Expression in Methicillin-Resistant Staphylococcus aureus Isolated From Burn Wound Infection.

Methicillin-resistant Staphylococcus aureus is the cause of nosocomial and community-acquired infections. This study aimed to evaluate the effect of zinc oxide and silver nanoparticles (ZnO-Ag NPs) on biofilms formation and icaA gene expression in methicillin-resistant S. aureus (MRSA). In this study, three standard strains (ATCC 43300, 25923, and 29913) and a clinical isolate are included. The minimum inhibitory concentration (MIC) of nanoparticles was determined by microdilution broth method. The antibacterial effects of ZnO-Ag NPs either alone or in combination with each other were compared with vancomycin (as the control group). The effect of MIC and sub-MIC concentrations of ZnO-Ag NPs on biofilm formation was determined by the microtiter plate method. The expression level of the icaA gene was assessed by real-time PCR LightCycler® 96 software (Version 1.1.0.1320, Roche, Germany). technique. All experiments were repeated three times. Data were analyzed using SPSS software through ANOVA and t-test. The P-value of less than .05 was considered as statistically significant. The average MICs of ZnO, Ag, and ZnO-Ag NPs compounds were 393.2, 179.8, and 60.8 µg/ml, respectively. The compound of ZnO-Ag NPs had a synergistic effect against all isolates. ZnO-Ag NPs decreased the biofilm formation rate at MIC and sub-MIC concentrations (P < .001). Sub-MIC ZnO-Ag NPs concentration significantly reduced the icaA gene expression in S. aureus strains (P < .03). The sub-MIC concentration of ZnO-Ag NPs reduced biofilm formation rate and icaA gene expression in Staphylococcus aureus strains compared with vancomycin. It can be used to cover medical devices after examining more clinical isolates to prevent bacterial colonization.

Prevalence and Antimicrobial Resistance of Bacterial Uropathogens Isolated from Iranian Kidney Transplant Recipients: A Systematic Review and Meta-Analysis.

BACKGROUND: Urinary tract infection (UTI) is a major complication in patients who receive the kidney transplant. We aimed to evaluate the prevalence and antimicrobial resistance of bacterial uropathogens isolated from Iranian kidney transplant recipients. METHODS: We searched according to Prisma protocol for UTI infection, prevalence, occurrence and distribution of bacteria and their pattern of antibiotic resistance among Iranian patients who receive kidney transplant through online electronic databases with MeSh terms and text words in published references in both Persian and English languages during 1990-2017. Data analysis was performed using Comprehensive meta-analysis software (CMA) by Cochrane Q and I2 Random Effects Model. RESULTS: Eleven studies met the eligible inclusion criteria. The prevalence of UTI among kidney transplant patients varied from 11.7% to 67.5%. The combined prevalence of UTI was 32.6%. Among Gram-negative pathogens causing UTI, E. coli was the most dominant followed by Klebsiella pneumonia with prevalence 41.3% and 11.9%, respectively. Also, amongst Gram-positive bacteria, the highest prevalence belonged to Enterococcus spp. (9.8%) and coagulase-negative Staphylococci (9.4%). Also in Gram-negative pathogens, the most resistance was to ampicillin (91.2%), followed by ceftazidime (89.5%). The minimum resistance was against imipenem with prevalence 14.3%. CONCLUSION: The combined prevalence of UTI was 32.6%. Gram-negative pathogens especially E. coli were the most agents of UTI in Iranian patients who receive kidney transplant. Also, in gram-negative pathogens, the most resistance was to ampicillin that it needs a new strategy for prophylaxis and treatment of UTI after the kidney transplant.

Zinc oxide nanoparticle reduced biofilm formation and antigen 43 expressions in uropathogenic Escherichiacoli.

OBJECTIVES: This study aimed to investigate the effect of zinc oxide nanoparticles (ZnO-np) on biofilm formation and expression of the flu gene in uropathogenic Escherichia coli (UPEC) strains. MATERIALS AND METHODS: Minimum inhibitory concentration (MIC) of ZnO-np was determined by agar dilution method. The effect of MIC and sub-MIC concentrations of ZnO-np on biofilm formation were determined by microtiter plate assay. The expression level of the flu gene was assessed by Real-Time PCR assay. RESULTS: MIC and sub-MIC ZnO-np concentrations reduced biofilm formation by 50% and 33.4%, respectively. Sub-MIC ZnO-np concentration significantly reduced the flu gene expression in the UPEC isolates (P<0.0001). CONCLUSION: The sub-MIC concentration of ZnO-np reduces biofilm formation and flu gene expression in UPEC isolates. It is suggested to use nanoparticles for coating medical devices to prevent bacterial colonization.