Increased Levels of serum Pentraxin 3 in Critical Coronavirus Disease-2019 Patients.

Pentraxin 3 (PTX3) and ficolin are the plasma phase of pattern recognition receptors (PRRs) and can activate complement through classical and lectin pathways, respectively, which may contribute to disease severity. This study aimed to investigate the association between PTX3 and ficolin with disease severity in patients with coronavirus disease-2019 (COVID-19). Seventy-three COVID-19 patients and 25 healthy controls were enrolled in this study. The participants were divided into three groups as follows: 14 patients as the intensive care unit (ICU) group, 59 patients as the non-ICU group, and 25 subjects as the healthy control group. The serum levels of PTX3 and ficolin were measured by enzyme-linked immunosorbent assay (ELISA) kits. Patients in ICU and non-ICU groups had significantly higher levels of PTX3 compared to the healthy control group (p = 0.0002 and p = 0.0072, respectively). Patients in the ICU group also had an increased amount of PTX3 (1957 ± 1769 pg/ml) compared to non-ICU patients (1220 ± 1784 pg/ml). However, this difference was not significant. On the other hand, serum levels of ficolin were not different among the three groups. PTX3, as an acute phase protein, may contribute to disease severity. Its probable inflammatory role could result from the high activation of the complement system. On the other hand, it could be suggested that ficolin has no crucial role in the disease severity of COVID-19 patients.

Toxoplasma gondii infection and spontaneous abortion: A systematic review and meta-analysis.

Toxoplasmosis is one of the most common parasitic infections in humans, which is caused by Toxoplasma gondii. It is usually asymptomatic but primary infection in a pregnant woman can cause severe consequences in the fetus such as miscarriage. This study aimed to estimate the global prevalence of T. gondii infection in women with spontaneous abortion. It also evaluates the possible relationship between recent Toxoplasma infection and miscarriage. Five electronic databases were reviewed. We used the random effects model and 95% confidence intervals(CI) to determine the overall prevalence and odds ratio (OR). Heterogeneity was calculated using Cochran's Q test and I2 statistic. The included studies were divided into three sub-groups based on antibody class against T. gondii and the existence of parasite DNA. Based on PCR, the pooled random-effects estimates that the prevalence of T. gondii infection in women with abortion was 10% (95% CI 7-14%). The pooled random effect favored a statistically significant increased risk of latent Toxoplasma infection [OR = 1.84; 95% CI: 1.41-2.40, P < 0.001] and recent infection [OR = 3.72; 95% CI: 2.21-6.26, P < 0.001] in women with spontaneous abortions. In recent infections, significant pooled ORs of positive association were observed in women with miscarriage [OR = 4.2; 95% CI: 2.04-8.85; χ2 = 17.2; I2 = 42.0%, P = 0.07]. This study demonstrates that recent T. gondii infection is associated with an elevated risk of spontaneous abortion. Further studies concerning all risk factors related to toxoplasmosis, and undertaking confirmatory tests at the time of abortion should be performed to investigate the impact of T. gondii infection and spontaneous abortion.

Linkage of Lambda Interferons in Protection Against Severe COVID-19.

The most recently discovered interferon (IFN) family, type III IFNs or lambda IFNs (IFN-λs) are caused by viral infection and act in mucosal barriers, such as the respiratory tract. In this study, we assessed the serum levels of IFN-λs in new coronavirus disease-2019 (COVID-19) patients. Sixty-four COVID-19 patients were enrolled in this study. All cases were divided into the intensive care unit (ICU) and non-ICU groups according to their symptoms. Fourteen samples of healthy controls were also included. The serum levels of IFN-λ1 and IFN-λ2 were analyzed by specific enzyme-linked immunosorbent assay (ELISA) kits. The concentrations of IFN-λ1 and IFN-λ2 induced in the serum of non-ICU patients (836.7 ± 284.6 and 798.8 ± 301.5 pg/mL, respectively) were higher than found in ICU patients (81.57 ± 34.25 and 48.32 ± 28.13 pg/mL, respectively) (P = 0.004 and P = 0.006, respectively) and healthy controls (85.57 ± 33.63 and 65.82 ± 21.26 pg/mL, respectively) (P = 0.03 and P = 0.04, respectively). Meanwhile, no significant differences were found in the concentration of both cytokines between the ICU patients and healthy controls. We conclude that higher levels of IFN-λs are associated with decreased clinical manifestations in COVID-19 patients. These cytokines could be a promising therapeutic agent to avoid the overwhelming consequences of COVID-19.

Reduced frequency of T helper 17 and T helper 1 cells and their association with critical coronavirus disease 2019.

There is very little knowledge about the immune responses, particularly cellular immunity to coronavirus disease 2019 (COVID-19). The main objective of this study was to evaluate the frequency of T helper (Th) cell subtypes, including Th1, Th17, and Treg cells, in moderate-to-severe and critical COVID-19 patients compared to healthy controls. Twenty-nine moderate-to-severe and 13 critical patients confirmed for COVID-19, and 15 healthy subjects were included in this study. Interferon-γ (IFN-γ)-producing Th1 and interleukin-17A-producing Th17 and Treg cells in peripheral blood were measured with flow cytometry. The frequency of Th1 and Th17 was significantly decreased in critical patients compared to healthy subjects (aMD: -2.76 and - 2.34) and moderate-to-severe patients (aMD: -1.89 and - 1.89), respectively (p < 0.05). Differences were not significant between moderate-to-severe patients and healthy subjects for both Th1 (p = 0.358) and Th17 (p = 0.535), respectively. In contrast, significant difference was not observed between study subjects regarding the frequency of Treg cells. Patients with critical COVID-19 had a markedly lower Th1/Treg and Th17/Treg ratios compared with the controls and moderate-to-severe cases. Our study showed a dysregulated balance of Th1 and Th17 cells and its relation to the severity of COVID-19.

Pronounce expression of Tim-3 and CD39 but not PD1 defines CD8 T cells in critical Covid-19 patients.

BACKGROUND: During viral infection, inhibitory receptors play a key role in regulating CD8 T-cell activity. The objective of this research was to investigate programmed cell death protein 1 (PD-1), T-cell immunoglobulin and mucin domain-containing protein-3 (TIM-3), and CD39 exhaustion markers in CD8 T cells of new coronavirus disease-2019 (COVID-19) patients. METHODS: A total of 44 patients with COVID-19 (17 subjects in a critical group and 27 patients in a non-critical group) and 14 healthy controls, who were admitted to Hospitals in Babol, were recruited to the study. In subjects' peripheral blood mononuclear cells (PBMCs), we compared the phenotype of CD8 T lymphocytes, expressing PD-1, TIM-3, or CD39, both alone and in various combinations. RESULTS: The findings showed that the percentage of CD8+ cells was significantly lower in patients. Critical and non-critical patients were more likely than healthy controls to have an escalated frequency of CD8+ TIM-3+, CD8+ CD39+, and CD8+ TIM-3+ CD39+ cells. No significant differences were observed between all groups in the CD8+ PD-1+ cell counts. There was also no difference between three groups regarding the counts of CD8+ TIM-3+ PD-1+, CD8+ PD-1+ CD39+, and CD8+ TIM-3+ PD-1+ CD39+ cells. The counts of non-exhausted cells were significantly lower in critical and non-critical individuals compared to the healthy individuals' value. CONCLUSION: Patients, infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), altered exhausted CD8 T lymphocytes with CD39 and TIM-3 exhaustion markers, which may account the dysregulated immune response found in COVID-19.

Phenotypic and genotypic detection of metallo-beta-lactamases in Carbapenem resistant Acinetobacter baumannii.

BACKGROUND: Carbapenem resistance in Acinetobacter baumannii has become a major concern for treating physicians. The aim of this study was to investigate the prevalence of metallo ß-lactamase (MBL) genes (bla VIM , and bla IMP) among isolated multidrug-resistant A. baumannii . METHODS: Fifty non-repetitive carbapenem-resistant A. baumannii isolates were collected. Antibiotic susceptibility was performed by disk diffusion method. MICs were determined by E test method. The resistant strains were tested for the production of carbapenemases by the Modified Hodge Test (MHT) followed by EDTA-disk synergy test was performed for metallo-ß-lactamases (MBL) phenotypic detection. Detection of bla VIM , and bla IMP was performed by PCR followed by sequencing. RESULTS: All isolates had a multidrug resistant profile, and were all resistant to all antibiotics including the carbapenems but remained susceptible to colistin. Among these isolates, Carbapenemase production was confirmed by the Modified Hodge test for 42 (84%) isolates. Phenotypic method showed the production of MBL in 15 (30%) isolates. PCR techniques revealed that out of 50 isolates, 13 (26%) were positive for bla VIM and all were negative for bla IMP . CONCLUSION: Our study concludes that the high prevalence of carbapenem resistant Acinetobacter species with MBL production is one of the main concerns in our country and this situation needs strict infection control measures.

Molecular detection of class 1, 2 and 3 integrons and some antimicrobial resistance genes in Salmonella Infantis isolates.

BACKGROUND AND OBJECTIVES: Multidrug resistant Salmonella strains have been observed around the world in recent years. Many mechanisms contribute to the spread of antimicrobial resistance genes. This study aimed at determining the distribution and transmission of class 1, 2 and 3 integrons among MDR Salmonella isolates collected from a selection of chicken broilers in the north of Iran. MATERIALS AND METHODS: PCR assays were used to detect genes for tetracyclines (tetA, tetB and tetG), chloramphenicol (cat1 and floR), and streptomycin (strA). Also, the presence of class 1, 2 and 3 integrons in all MDR isolates was evaluated using specific primers for the integrase genes of integrons intI1, intI2 and intI3. RESULTS: Class 1, 2 and 3 integrons were present in 36%, 42% and 4% of the MDR isolates, respectively. Out of the tetracyclines resistant isolates, 47 (100%) and 5 (10.6%) carried tetA, tetB genes, respectively, while no isolate was positive for the tetG gene. All 36 chloramphenicol-resistant strains carried floR and cat1 genes. Nine (18%) Salmonella Infantis isolates harbored the strA gene, conferring resistance to sterptomycin. CONCLUSION: This study found a high frequency of antimicrobial resistance genes among Salmonella isolates; therefore, management strategies are needed to prevent food-borne diseases caused by MDR Salmonella from food supplies.

Polythiacalix[4]amides as a Novel Category of Macromolecules; Synthesis, Antibacterial Evaluation and Investigation on their Spectral and Thermophysical Characteristics.

Polythiacalix[4]amides as a novel category of polyamides, with high sorption capability towards some environmentally hazardous metal cations, especially Hg2+, have been synthesized via direct polycondensation protocol using a thiacalix[4] arene dicarboxylic acid and commercial diamines. The polyamides were obtained in high yields and possess inherent viscosities in the range of 0.55-0.75 dl/g. The photophysical characteristic was studied by looking for the maximum absorption wavelength of each polymer using UV absorption spectroscopy. Thermogravimetric analysis displayed high thermal stability for these polyamides in range of 337 to 346 °C at the point of 10% weight loss, and their char yields were about 32.9-58.5% at 600 °C. Also, glass transition temperatures were between 157 and 178 °C. To survey on possible sorption capability of these polythiacalixamides, solid-liquid extraction of some toxic transition metal cations, such as Cu2+, Co2+, Cd2+, Pb2+ and Hg2+ from wastewater was performed. Antibacterial evaluation was conducted using Gram positive and Gram negative bacteria strains and some reliable results have been obtained. The results showed some promising features of their ability for being employed as possible ingredients of industrial antibacterial membranes.

Skeletal complications of brucellosis: A study of 464 cases in Babol, Iran.

BACKGROUND: Skeletal complication of brucellosis is common in endemic region of brucellosis, but its frequency has not been clearly determined. The aim of this study was to determine the frequency of skeletal complication in brucellosis patients in Babol, north of Iran. METHODS: From 2005-2015, 1252 cases of brucellosis were diagnosed at the Department of Infectious Diseases, Ayatollah Rouhani Teaching Hospital, in Babol, North of Iran. The diagnosis of brucellosis was established using serum agglutination test (SAT≥1/160), and 2-mercaptoethanol (2ME≥ 1/80) with clinical and epidemiological findings compatible with brucellosis. Among them, 464 (37.1%) cases demonstrated skeletal complication. The diagnosis of skeletal involvement was established with appropriate diagnostic facilities. The data were collected and analyzed. RESULTS: The mean age of these patients (299 males, 165 females) was 33.2±17.6 years. Three hundred-thirty four (72%) cases were from rural areas. In 350 (75.4%) patients with peripheral arthritis, 242 (52.1%) cases were monoarthritis. Furthermore the knee arthritis was seen in 148 (31.9%) patients and hip in 54 (11.6) cases. Sacroiliitis was seen in 59 (12.7%) patients and spondylitis in 55 (11.9%) cases. There were no significant differences regarding the occurrence of these focal lesions in both sexes. CONCLUSION: The results show that about one-third of brucellosis in human is associated with skeletal complication. Peripheral arthritis, sacroiliitis and spondylitis are the frequent skeletal complications of human brucellosis.

Polymerase Chain Reaction-Based Assays for the Diagnosis of Active and Relapsed Cases of Human Brucellosis.

This study aimed to compare polymerase chain reaction (PCR) with serum agglutination test (SAT) in the diagnosis of patients before and 6 months after treatment. Peripheral blood specimens from 50 patients with brucellosis (case group) and 30 subjects without brucellosis (control group) were selected and entered into the study. The diagnosis of brucellosis was established using SAT ≥ 1:160 and 2-mercaptoethanol (2-ME) ≥ 1:80 with clinical signs and symptoms compatible with brucellosis. For each case, both before treatment and 6 months after completion of therapy, SAT, 2-ME, and PCR were performed. Subjects in the control group were assessed by the same tests at the initial visit. In the case group, 50 patients (36 males, 14 females) with the mean age of 43.6 ± 14.5 years were evaluated. The mean age of the control group was 40.6 ± 14 years. Among the 50 patients whose nested PCR assays were initially positive, 43 (86%) were negative 6 months after completing treatment. Relapse occurred in five (10%) patients within 6 months after treatment and all were PCR positive. None of the patients in the control group was PCR positive. Results show that PCR seems to be highly sensitive and specific, and therefore is a useful method for both the initial diagnosis and detection of relapse or chronic brucellosis.

Different Clinical Presentations of Brucellosis.

BACKGROUND: Brucellosis is one of the important multi-organ zoonotic infectious diseases. The forms of the clinical course of brucellosis in humans are acute, sub-acute and chronic. OBJECTIVES: The present study aimed to retrospectively analyze the clinical characteristics and complications in the clinical forms of human brucellosis in Iran. PATIENTS AND METHODS: The population included 957 patients admitted in the infectious diseases clinic affiliated to Babol University of Medical Sciences, Babol, Iran, within the past two decades. Data for the patients were obtained and documented in questionnaires. Patients were divided into three groups according to their history, symptoms and clinical presentation time: acute (0 - 2 months), sub-acute (3 - 12 months), and chronic (> 1 year). RESULTS: Most of the patients (73.8%) were in the acute stages of brucellosis, 22.6% had sub-acute brucellosis and 3.7% had chronic brucellosis. The most frequently observed symptoms were arthralgia (71%), sweating (66.7%), fever (57.2%) and backache (39.3%). The most common complication was arthritis (13.2%) in this study. CONCLUSIONS: This infection was observed with a diversity of clinical manifestations. Therefore, diagnostic difficulty because of the various clinical presentations and the way to find undiagnosed complications should be investigated in the differential diagnosis of other diseases.

Evaluation of Different Primers for Detection of Brucella by Using PCR Method.

INTRODUCTION: Brucellosis is a worldwide zoonosis and a significant cause of loss of health in humans and animals. Traditionally, classic diagnosis is carried out by isolation of Brucella, which is time-consuming, technically challenging and potentially dangerous. The aim of this study was to expand a molecular test that would be used for the develop detection of Brucella in a single reaction with high sensitivity and specificity, by targeting IS711element. METHODS: This study was carried out from 2015 to 2016 at the Ayatolla Rohani hospital in Babol, Iran. The present study was designed to develop PCR assay, based on IS711 gene for rapid diagnosis of Brucella spp. and immediate detection of Brucella, with high sensitivity and specificity. Four pairs of oligo-nucleotide primers with sizes of 547, 403, 291 and 127bp respectively, were planned to exclusively amplify the targeted genes of Brucella species. RESULTS: Our results show that, five PCR primers set up, would be helpful in amplifying the DNAs from the genus Brucella with high specificity and sensitivity so it can be 12 fg, for Brucella species to provide a valuable tool for diagnosis. CONCLUSION: This method can be more useful than serological and biochemical tests and in addition, this reduces the number of required tests more rapidly and economically.

Nosocomial emerging of (VIM1) carbapenemase-producing isolates of Klebsiella pneumoniae in North of Iran.

BACKGROUND AND OBJECTIVES: The rapid emergence and dissemination of carbapenemase-producing Klebsiella pneumoniae strains and other members of the Enterobacteriaceae poses a considerable threat to the care of hospitalized patients and to public health. The aim of this study was to determine the frequency of metallo-ß-lactamases (MBL) and VIM-1 gene in multidrug-resistant strains of K. pneumoniae. METHODS: 50 isolates of non - duplicated K. pneumoniae cultured from patients at intensive care units were tested for their susceptibilities to 13 different antibiotics using microbroth dilution assay. Isolates showing resistance to at least one of the carbapenems were checked for production of metallo-ß-lactamase (MBLs) using imipenem-EDTA synergy tests. PCR was used to detect the gene encoding VIM-1 metallo-ß-lactamase (MBL). RESULTS: Of 50 clinical isolates, 26 (52%) were resistant to imipenem in disk diffusion method. Using imipenem-EDTA synergy tests, production of MBL was detected in 15 (30%) isolates. PCR assay showed that 15 isolates were positive for VIM and these included 10 and 5 isolates showing positive and negative results in phenotypic method of MBL detection test respectively. Amikacin was found as the most effective antibiotic against the MBL producers in this study. CONCLUSION: The emergence of bla(VIM-1) producing K. pneumoniae in North of Iran is concerning. Microorganisms producing bla(VIM-1) constitute the prevalent multidrug-resistant population of K. pneumoniae in that region.

Risk Factors for Relapse of Human Brucellosis.

BACKGROUND & PROPOSE: Brucellosis is serious disease around the world, especially in underdeveloped countries. Relapse is major problem in therapy of brucellosis. This study aimed to evaluate risk factors of relapse after treatment in patients. METHODS: It is a descriptive-analytic study from 1990 to 2014, in Ayatolla Rohani hospital in Babol, Iran. We studied 980 patients with brucellosis. The studied community included patients infected with brucellosis and the required information was gathered based on their hospital files. The base for recognizing Malta fever were clinical symptoms and Para-clinical sign congruent with infection like as, titer SAT>1:320 and 2-ME>1:160. Patients with relapse and patients without relapse were placed separately in two groups. The data were statistically compared with Spss 16, by Chi-square and Cox -regression tests. RESULTS: Based on this study, treatment regimen is a preventive factor (P=0.000). Moreover, Based on some statistical methods, regimens no. 3 and 4 were introduce preventive factors (P=0.001) and (P=0.004). It should also be noted that findings the same statistical model, factors like gender, age, residence, professional contacts, complications and delay in treatment were also analyzed but none of them are considered as preventive factors. CONCLUSION: Based our finding, we suggest aminoglycosides (gentamicin or streptomycin with doxycycline) are associated with lower rate of relapse in brucellosis.

The use of antibacterial activity of ZnO nanoparticles in the treatment of municipal wastewater.

Nanotechnology holds great potential in advanced water and wastewater treatment to improve treatment efficiency. Zinc oxide nanoparticles (ZnO NPs) have received considerable attention due to their unique antibacterial activities toward various microorganisms that are commonly found in the environment. In the present study, ZnO NPs were synthesized through both mechano-chemical and sol-gel methods. The synthesized ZnO NPs were characterized through X-ray diffraction and transmission electron microscopy techniques. Then, their antibacterial activities against separated wastewater bacteria were evaluated by determining the zone inhibitor, the minimum inhibitory concentration, and the minimum bactericidal concentration. The results were compared with those obtained from wastewater after chlorine disinfection and ultraviolet (UV) disinfection. These studies demonstrated that the antibacterial activity of ZnO NPs depends on the type and the strain of bacteria. They have also demonstrated that the activity increases as the concentration of ZnO NPs increases. Overall, the experimental results suggest that ZnO NPs can potentially be an antibacterial reagent to treat wastewater. They can particularly be applied as a complementary method with UV disinfection. Thus, they can be developed as antibacterial agents to improve wastewater quality.

Comparison of Genital Chlamydia trachomatis Infection Incidence Between Women With Infertility and Healthy Women in Iran Using PCR and Immunofluorescence Methods.

BACKGROUND: For a long time, infertility has been one of the most sequels in medical sciences with microbial agents as one group of its causes. The possible etiological role of Chlamydia trachomatis in infertility was suggested years ago, but it has not yet been proved completely. To decrease the severe involvements of C. trachomatis infections, screening by efficient diagnostic methods are necessary. OBJECTIVES: In this study we attempted to determine the incidence of C. trachomatis in infertile women and compared this with healthy women. MATERIALS AND METHODS: This case-control study was performed on 150 infertile women with unknown causes and without physiological deficiency for infertility. The control group consisted of 200 fertile safe and impregnated women. Presence of C. trachomatis in the two groups was examined by direct and indirect immunofluorescence tests and PCR. RESULTS: C. trachomatis was detected by direct immunofluorescence method in 23 (15.3%) infertile women compared and 7 (3.5%) healthy controls. Using indirect immunofluorescence tests, a positive test titer of 1:16 as well as the above results were detected in 34 (22.6%) of the infertile cases and 9 (4.5%) of the controls. C. trachomatis was detected by PCR method in 48 (32%) infertile women and 13 (8.7%) among the controls. CONCLUSIONS: The results of our study suggest that there is a significant association between C. trachomatis infection and female infertility.

Investigation of Class I Integron in Salmonella infantis and Its Association With Drug Resistance.

BACKGROUND: Infection with non-typhoid Salmonella (NTS) is one of the most important health problems all over the world. Antimicrobial drug resistance is increasing among Salmonella infantis species. OBJECTIVES: The aim of this study was to investigate the frequency of presence of class 1 integrons in S. infantis species as well as its association with drug resistance. MATERIALS AND METHODS: This cross-sectional study was performed on 50 S. infantis isolated strains, collected from chicken samples between 2009-2011. These strains were identified by standard biochemical tests and serology. Antibiotic susceptibility profiles and minimum inhibitory concentration determination for 14 antibacterial agents were performed using micro dilution and disk diffusion methods. The detection of class 1 integron was performed by the PCR method. The demographic and microbiological data for the integron positive and negative isolates were compared by SPSS software. RESULTS: Eighteen out of 50 (36%) of isolated S. infantis species had intl gene. The isolated bacteria were sensitive to cefotaxime and ciprofloxacin (100%). Also isolates were resistant to nalidixic acid, tetracycline and streptomycin. All isolate with class 1 integron were multidrug resistant. CONCLUSIONS: The result of this study showed that due to increased level of drug resistance in S. infantis and the presence of class 1 integron in these strains, resistance can be transferred to other food borne pathogens.