A systematic literature review and meta-analysis on the global prevalence of Naegleria spp. in water sources.

Naegleria species (spp.) is a free-living amoeba whose pathogenic species such as N. fowleri pose a significant health risk to young people, and the most important source of infection is water source. This study aims to perform a systematic review and meta-analysis of the data on the prevalence of Naegleria spp. in water sources in the available literature. Included articles on the prevalence of Naegleria spp. in water sources in PubMed, Google Scholar, ProQuest, ScienceDirect, EMBASE, Scopus and Web of Science were systematically searched between January 1977 and September 2019. Regarding meta-analysis, the random-effect model was employed by forest plot with 95% of confidence interval (CI). The meta-analysis considered 103 articles surveying the prevalence of Naegleria spp. in various water sources. The pooled worldwide prevalence of Naegleria spp. across 35 countries was 26.42% (95% CI = 21.52-31.63). The subgroup analysis reported that the pooled worldwide prevalence of N. fowleri is 23.27%, N. australiensis 9.12%, N. lovaniensis 7.68%, N. pagei 5.95, N. polaris 5.17%, N. gruberi 3.95%, N. clarki 3.54%, N. americana 3.19%, N. philippinensis 1.99% and N. dobsoni 1.73%. This is the first systematic review on the prevalence of Naegleria spp. in water sources. Our findings suggest a wide distribution of Naegleria spp., including potential pathogenic species such as N. fowleri, in water sources all over the world. Therefore, it is of paramount importance to provide comprehensive data and systematic analysis regarding the prevalence of Naegleria spp. in water sources. Accordingly, further studies are highly recommended to investigate the presence of pathogenic N. fowleri in other countries.

Is there association between Trichomonas vaginalis infection and prostate cancer risk?: A systematic review and meta-analysis.

We performed a systematic review and meta-analysis to reveal the association between Trichomonas vaginalis (TV) infection and the risk of prostate cancer (PCa) development. Systematic searching (PubMed/Medline, Scopus, Embase, Web of Science, Cinhal, Wiley, Cochrane, Psychoinfo, ProQuest and Google Scholar) was done, up to March 2018 for case-control studies. Random effects model was applied to define odds ratios and their 95% confidence intervals. In total, 6 enteries were included in our meta-analysis, comprising 5590 individuals (2677 PCa cases and 2913 control individuals) examined for trichomoniasis, with a total positivity of 469 (17.51%) and 482 (16.54%) individuals, respectively. Totally, such association was documented in three countries, including USA (4 studies), Kuwait (one study) and Taiwan (one study). Based on pooled estimations, however a 1.17-time increase of PCa was observed among individuals with a previous exposure of TV, it was not statistically significant [OR = 1.17 (95% CI: 1.01 to 1.36)]. Egger's regression test demonstrated no publication bias among studies. Also, year of publication for included records was not significantly correlated to the relationship between trichomoniasis and PCa. Any further inferences should be based on future investigations for better understanding this relationship and shedding light on the cryptic pathogenesis of TV in PCa patients.

Molecular identification of Entamoeba histolytica from stool samples of Ilam, Iran.

INTRODUCTION: Amoebiasis is a multifactorial, life-threatening public health issue and the third parasitic disease cause of mortality in worldwide, particularly in low- and mid-income countries. The aim of this study was to attempt to explore genetic encoding differences of CP8 (conserved gene) of Entamoeba histolytica/Entamoeba dispar in its various infectious properties isolated from Ilam located at a southwest part of Iran. MATERIALS AND METHODS: A total of 2023 stool samples were collected between 2016 and 2018 from the hospital in Ilam, of which only 30 isolates were identified as E. histolytica/E. dispar. These isolates were collected from the intensive care unit, infectious disease, and surgery settings. The isolates were identified and the polymerase chain reaction (PCR) was performed to detect the CP8 gene. In all stages, Entamoeba histolytica HM1: IMSS was used as a positive control. RESULTS: In genotype confirmation, only two isolates had the CP8 gene found in the PCR technique. The sequencing results confirmed the mentioned gene with 99%-100% specificity. CONCLUSION: It is concluded that PCR is highly sensitive to detect E. histolytica and indicating this important role as screening tools in direct DNA extraction from stool samples and valuable technique in early detection of symptomatic and asymptomatic E. histolytica patients.

Detection of Acanthamoeba spp. from dust phenomenon in Ilam Province, West Iran.

In recent years, increasing dust phenomenon in the west of Iran has led to social, economic, and health concerns. This study aimed to represent the existence and genotyping of Acanthamoeba spp. in dust phenomenon in Ilam Province, Iran. In this study, 55 dust samples were collected and by targeting the diagnostic fragment 3 region of the 18S rRNA gene, the genotypes were determined. Utilizing the tolerance ability test, the pathogenic potential of all positive isolates was also recognized. Eighteen samples of Acanthamoeba (32.7%) were detected in the sampling areas. According to sequencing analysis, the isolates related to T4 (77.7%) and T2 (22.3%) genotypes were reported. It was revealed by thermo- and osmotolerance tests in which six strains are extremely pathogenic. To our knowledge, the pathogenic Acanthamoeba was potentially isolated initially from dust phenomenon in Ilam Province. Thus, these strains are probably highly virulent, and dusts are possible sources of Acanthamoeba infection in humans.

NeutroPhase(®) in chronic non-healing wounds.

Chronic non-healing wounds, such as venous stasis ulcers, diabetic ulcers, and pressure ulcers are serious unmet medical needs that affect a patient's morbidity and mortality. Common pathogens observed in chronic non-healing wounds are Staphylococcus including MRSA, Pseudomonas, Enterobacter, Stenotrophomonas, and Serratia spp. Topical and systemically administered antibiotics do not adequately decrease the level of bacteria or the associated biofilm in chronic granulating wounds and the use of sub-lethal concentrations of antibiotics can lead to resistant phenotypes. Furthermore, topical antiseptics may not be fully effective and can actually impede wound healing. We show 5 representative examples from our more than 30 clinical case studies using NeutroPhase(®) as an irrigation solution with chronic non-healing wounds with and without the technique of negative pressure wound therapy (NPWT). NeutroPhase(®) is pure 0.01% hypochlorous acid (i.e. >97% relative molar distribution of active chlorine species as HOCl) in a 0.9% saline solution at pH 4-5 and is stored in glass containers. NovaBay has three FDA cleared 510(k)s. Patients showed a profound improvement and marked accelerated rates of wound healing using NeutroPhase(®) with and without NPWT. NeutroPhase(®) was non-toxic to living tissues.

NVC-422 topical gel for the treatment of impetigo.

Impetigo is a highly contagious bacterial skin infection affecting children worldwide that is caused by the Gram-positive bacteria Staphylococcus aureus, Streptococcus pyogenes, or both. Staphylococcus species can quickly develop drug resistance rendering mupirocin, fusidic acid, and erythromycin ineffective. Preclinical and clinical studies demonstrated that NVC-422 (N, N-dichloro-2, 2-dimethyltaurine) rapidly kills pathogens without the development of drug resistance. 129 patients with clinically diagnosed impetigo were randomized to three dose groups (0.1, 0.5, or 1.5% NVC-422 topical gel) in a study conducted at 2 centers; 125 patients (97%) had microbiologically confirmed infection. Treatment was administered three times a day (TID) for 7 days to all randomized subjects. Response was measured at the completion of treatment (Day 8) and 1 week post treatment (Day 15) by the Skin Infection Rating Scale (SIRS) and by microbiological response. A total of 120 subjects (96%) completed all 7 days of treatment and were assessed at end of treatment (EOT). Clinical response rate at EOT in the PPC population was excellent in each of the dose groups (84.6%, 87.2%, and 92.3% in the 0.1%, 0.5% and 1.5% dose groups respectively). The majority of the infections were caused by S. aureus, alone (106/125, 85%) of which approximately 10% were MRSA. There were no clinical recurrences in any treatment groups. Treatment-emergent adverse events were seen in 5.4% of the subjects (7/129) and were mild to moderate and resolved. NVC-422 topical gel administered TID was well tolerated, with high rates of clinical and microbiological responses for treating impetigo.