Phobia and Fear of COVID-19: origins, complications and management, a narrative review.

Introduction: The outbreak of Coronavirus Disease 2019 (COVID-19) have changed into a global crisis. Psychologically, this process of alteration can lead to feelings of fear, insecurity, and anxiety. This fear and anxiety can be caused by a variety of factors. However, due to the lack of extensive studies at this time, there are little data on these conditions related to COVID-19. Therefore, in this narrative review, we have tried to identify the most important possible causes of anxiety and fear due to this disease, based on logical shreds of evidence. Then we tried to discuss the consequences and ways to manage and prevent them. Methods: The current focus was on three major axes of corona-phobia, fear and anxiety. PubMed, Science Direct, Scopus, Google Scholar and authoritative news and information sources were considered as the data sources. Results: Findings from the analysis of the results revealed that, in addition to the real and the logical reasons which belong to the intrinsic properties of SARS-CoV-2, some misleadings and misconceptions induced by media, governmental policies, public awareness level, and non-scientific speculations and contradictory data expressed by experts, researchers and scientific societies, could provide the way for the development of corona-phobia, and fear. Conclusions: Each of these causal components, in its place, leads to some degrees of psychological disorders and subsequent consequences and complications. Finally, here we reviewed, summarized the previous research findings on how to prevent and manage this type of psychological disorder, and made comparisons.

Biofilm-producing ability of Staphylococcus spp isolated from different foodstuff products.

BACKGROUND: In recent times, microbial-biofilm contamination has attracted considerable attention to the food industry. Pathogenic microorganisms can attach to food surfaces, grow on them, and form biofilm that cause an increase in the food safety risk. The mechanisms of biofilm formation have become an important issue in the food-processing industry, therefore, the aim of this study is to determine the biofilm formation and profiles of genes involved in biofilm production of staphylococci isolated from various foodstuff products. MATERIAL AND METHODS: This cross-sectional study was conducted at some grocery stores and confectionaries from September 2015 to October 2016 in different areas of Isfahan, Iran. Staphylococcus spp were isolated from different foodstuff samples including sweet pastries, cakes and similar baked goods, dairy products such as cheese and yogurt, meat products such as sausages, and hamburgers. Standard microbiological methods were used for identification of Staphylococcus spp isolates. Antibiotic susceptibility pattern was determined by the disc diffusion method and icaA/icaD genes have been investigated as PCR target because of their role in the expression of intercellular adhesions involved in biofilm formation by S. aureus. RESULTS: From a total of 194 different foodstuffs samples, 84 Staphylococcus spp were isolated. Out of the 84 Staphylococcus isolates, 95.2% (80/84) were positive to the ability of biofilm formation. Overall, 35.7% (30/84) and 26.2% (22/84) of Staphylococcus spp isolates were positive for icaA and icaD genes, respectively. CONCLUSION: The results of the present study indicate that the remarkable rate of biofilm formation with the emergence of antibiotic resistance still remains a significant risk for the food safety, especially in foodstuff samples.

Epidemiology of toxic shock syndrome toxin-1 harboring Staphylococcus aureus obtained from clinical samples in Iran: A Systematic Review and Meta-analysis.

BACKGROUND: S. aureus strains, with the capability of producing toxic shock syndrome toxin-1 (TSST-1), are more likely to cause complicated infections. However, due to lack of comprehensive local data on the prevalence of TSST-1, we aimed to determine the prevalence of TSST-1 harboring S. aureus isolates in Iran. METHODS: A systematic search was performed by using PubMed and Scopus databases from papers published by Iranian authors from January 2000 to the end of March 2017. Then, 10 publications which were matched with inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. RESULTS: The overall prevalence of TSST-1 carrying S. aureus in Iran was 21.3% (95% CI: 7.9%-46.1%), ranging from 0% to 68%. Moreover, from the included studies, the pooled prevalence of TSST-1 producing MRSA isolates was estimated to be 25.2% (95% CI: 13.3%-42.5%), ranging from 0% to 69.8%. From those studies which showed the distribution of toxin-harboring S. aureus it was found that the skin and soft tissue, respiratory and bloodstream infections were the common sites of TSST-1 harboring S. aureus. CONCLUSIONS: In summary, it seems that emergence of MRSA strains leads to higher prevalence of TSST-1 carrying strains in the north of Iran. However, further research is required to elucidate the interplay between the outcome of diseases and TSST-1 producing strains, especially in our country.

Prevalence of metallo­beta­lactamase producing Acinetobacter baumannii isolated from intensive care unit in tertiary care hospitals.

INTRODUCTION: The emergence of Metallo-beta-lactamase (MBL)-producing Acinetobacter baumannii has become a global concern in nosocomial infections. The aim of this study is to determine the prevalence of MBL producing genes among clinical isolates of A. baumannii from hospitalized patients. METHODS: This study was performed from October 2015 to October 2016 at three teaching hospitals located in Isfahan, Iran. Totally, 100 A-baumannii isolates were collected from clinical specimens and identified as A-baumannii using standard microbiological methods. Antimicrobial susceptibility test was determined by disc diffusion method according to the CLSI. Furthermore, the determination of bla IMP-1, bla IMP-2, bla VIM-1, bla VIM-2and bla SIM-1 was detected by PCR. RESULTS: Totally, Sixty-eight percent (68%) of isolates of A. baumannii were recovered from tracheal aspirate. According to the antibiotic susceptibility pattern, the highest level of resistance was against ciprofloxacin (99%), while among tested antibiotics amikacin (10%) was found to be the most effective. 21%, 4%, 7% and 6% isolates carried bla IMP-1, bla IMP-2, bla VIM-1 and bla VIM-2 genes, respectively. Also, bla SIM-1 was not detected in any of the isolates. CONCLUSION: The results of this study showed high rate of the MBL producing A-baumannii isolates in our region and displayed that MBLs producing A-baumannii strains are emerging threats to ICUs.

Molecular characteristics of methicillin-resistant Staphylococcus aureus nasal carriage from hospitalized patients and medical staff in Isfahan, Iran.

OBJECTIVES: Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been accounted as one of the main risk factors for the development of complicated nosocomial infections. The present study aimed to determine nasal carriage rate, antimicrobial susceptibility pattern and molecular characteristics of MRSA isolates. METHODS: This cross-sectional study was performed within 6 months period from July 2015 at 3 hospitals of Isfahan, Iran. Totally, 326 nasal samples were collected by cotton sterile swab from the nasal cavity of participants. Standard microbiological methods were used for identification S. aurues and MRSA isolates. Antibiotic susceptibility pattern was determined by the disc diffusion method according to the CLSI recommendation. Determination of SCCmec typing, agr groups, and virulence genes were performed by PCR method. RESULTS: Overall, 23.6% of cases were S. aureus carriers including, 23.4% (25/107) of HCWs and 23.7% (52/219) of patients. The rate of MRSA nasal carriages among patients was found to be 51.9% and 16% in HCWs. The highest levels of resistance among MRSA isolates were against ampicillin (93.5%) and tetracycline (83.4%); while, the most effective antibiotics were vancomycin and co-trimoxazole with 100% and 71%, susceptibility. The presence of hla and pvl genes was detected in 80.6% and 3.2% of MRSA isolates, respectively. SCCmec types I, III, IV and V were found in 16.1%, 25.8%, 25.8%, and 16.1% of isolates, respectively. Moreover, agr group I was the predominant type with 43.3. CONCLUSION: Our results showed a high rate of MRSA colonization in hospitalized patients which remains a significant healthcare problem in our region.

Bacterial etiology and antibiotic resistance pattern of septicemia in HIV and non-HIV patients admitted to tertiary care hospitals, Shiraz, South of Iran.

The present study aimed to determine the bacteriological etiology and antibiotic susceptibility pattern of sepsis in HIV infected and HIV uninfected patients, and related risk factors to introduce an appropriate therapy. This cross-sectional study was conducted from January 2014 to January of 2015 enrolling patients with sepsis associated with or without HIV infection admitted to Shiraz teaching hospitals, South of Iran. Blood and urine cultures were performed and standard microbiological methods were followed for isolation and identification of the bacteria. HIV antibody testing and CD4+ lymphocyte count were done for HIV-infected patients. Antimicrobial susceptibility tests were performed using the disk diffusion method in accordance with CLSI recommendations. Totally, 140 patients with sepsis including 30 HIV-positive, and 110 HIV-negative were enrolled. Our finding showed 26.7% and 20% blood and urine culture positivity in HIV-positive and 20.9% and 14.5% positivity in HIV-negative patients. Staphylococcus aureus, Salmonella spp. and coagulase-negative staphylococci (CoNS) each with frequency of 25% were detected as the most prevalent isolates in samples of HIV patients. In contrast, the main etiology for sepsis in HIV-negative patients was CoNS (47.8%), followed by Escherichia coli (17.4%). The median of CD4+ lymphocyte count and viral load in HIV patients were estimated 10.15 cells/mm3 and 68019.48 copies/mL, respectively. The results of the present study revealed that the main cause of sepsis in the studied hospitals was nosocomial pathogens. These findings highlighted the importance of infection control policies for preventing the emergence and spread of nosocomial infections.

Atypical bacterial etiology of acute respiratory infections and clinical characterizations among Iranian children.

Acute respiratory infections (ARIs) in children younger than 5 years of age are one of the leading causes of morbidity and mortality, particularly in developing countries. Mycoplasma pneumoniae and Chlamydophila pneumoniae are prevalent causative agents of ARIs, worldwide. We sought M. pneumoniae and C. pneumoniae in respiratory samples from Iranian children with ARIs.  From November 2014 to April 2015, respiratory samples of 150 children aged 1 month to 15 years old were screened for presence of M. pneumoniae and C. pneumoniae. Polymerase chain reaction (PCR) and culture methods were used to detect these bacteria in respiratory samples in the form of throat swabs and nasopharyngeal aspirates. A questionnaire containing demographic and clinical information has been filled up for all participants in this study. Our obtained data showed that out of 150 tested samples, 7 (4.7%) were PCR positive for M. pneumoniae and only one (0.7%) positive sample for C. pneumoniae was detected. However, none of the tested samples was detected M. pneumoniae using the bacterial culture method. All patients with ARIs due to M. pneumoniae showed up with sore throat and flu like symptoms. According to our data, PCR method is more sensitive than culture for detection of M. pneumoniae. With regards to our results, it appears that M. pneumoniae and especially C. pneumoniae were infrequent causative agents in our studied population.