Rifampicin resistance in Mycobacterium tuberculosis in Iran: a two-centre study.

Multidrug-resistant tuberculosis remains a challenge. In this study, we investigated the incidence of rifampicin (RIF) resistance in Mycobacterium tuberculosis in a large number of pulmonary specimens. A two-center study in Tehran, the capital of Iran, was performed with 6624 pulmonary samples of patients with tuberculosis (TB) who were subjected to detection of RIF-resistant TB by GeneXpert MTB/RIF assay between May 2014 and July 2018. Conventional drug susceptibility testing was performed to confirm the results. Xpert MTB/RIF identified a total of 96 positives for M. tuberculosis, of which 5 (5.3%) samples were found to be RIF-resistant TB. All RIF-resistant and sensitive isolates detected by GeneXpert were phenotypically confirmed by drug susceptibility testing. These results indicated that the Xpert MTB/RIF test can be used as a rapid diagnostic method and can potentially decrease the morbidity associated with diagnostic delay and mistreatment.

Performance of Wayne assay for detection of pyrazinamide resistance in Mycobacterium tuberculosis: a meta-analysis study.

Conventional culture-based drug susceptibility testing (DST) of Mycobacterium tuberculosis to pyrazinamide (PZA) is time-consuming and difficult to perform. The current systematic review and meta-analysis was aimed to evaluate the diagnostic accuracy of Wayne assay against culture-based DSTs as the reference standard. We searched the MEDLINE/Pubmed, Embase, and Web of Science databases for the relevant records. The QUADAS-2 tool was used to assess the quality of the studies. Diagnostic accuracy measures (i.e., sensitivity and specificity) were pooled with a random-effects model. Statistical analyses were performed with STATA (version 14, Stata Corporation, College Station, TX, USA), RevMan (version 5.3; The Nordic Cochrane Centre, the Cochrane Collaboration, Copenhagen, Denmark), and Meta-DiSc (version 1.4, Cochrane Colloquium, Barcelona, Spain). A total of 31 articles comprising data for 2457 isolates of M. tuberculosis were included in the final analysis. The pooled sensitivity and specificity of the Wayne assay against all reference tests (the combination of BACTEC MGIT 960, BACTEC 460, and proportion method) were 86.6% (95% CI: 84.3-88.7) and 96.0% (95% CI: 94.8-97). The positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC) estimates were found to be 17.6 (95% CI: 10.5-29.3), 0.11 (95% CI: 0.06-0.20), 164 (95% CI: 83-320) and 97%, respectively. Deek's test result indicated no evidence for publication bias (P > 0.05). Although the current study shows that the Wayne test is sensitive and specific for detecting PZA resistance, it may be used in combination with conventional DSTs to diagnose PZA resistance accurately.

Lovastatin attenuates glyoxal-induced toxicity on rat liver mitochondria.

Alpha-dicarbonyls such as glyoxal (GO) trigger mitochondrial dysfunction resulting in the development of different diabetic complications. The present study investigated the effects of lovastatin against GO-induced toxicity on rat liver mitochondria. The rat liver mitochondria (0.5 mg protein/mL) were treated with various concentrations of lovastatin (1, 5, 10 µM) at 37°C for 30 min and then exposed to GO (3 mM) at 37°C for 30 min. Oxidative stress markers including MDA, reactive oxygen species (ROS), glutathione (GSH) and protein carbonylation (PC) level were measured. Mitochondrial complex II activity and mitochondrial membrane potential (MMP) were assessed for evaluating mitochondrial function. Glyoxal significantly increased the level of ROS, PC and MDA. This effect was associated with the reduction of MMP, complex II activity and GSH content. Pre-treatment with lovastatin potentially reversed GO-induced mitochondrial toxicity. These results suggest that lovastatin have a protective effect against GO-induced toxicity in isolated rat liver mitochondria.

First report of methicillin-resistant Staphylococcus aureus carrying the mecC gene in human samples from Iran: prevalence and molecular characteristics.

There is a lack of information concerning mecC clinical methicillin-resistant Staphylococcus aureus (MRSA) strains throughout the world. In the present survey, 345 MRSA strains were characterized by antimicrobial susceptibility testing and staphylococcal cassette chromosome mec element (SCCmec) typing. mecC-positive MRSA isolates were characterized by study of biofilm formability, adhesion and virulence analysis, multilocus sequence typing, accessory gene regulator (agr) typing, S. aureus protein A locus (spa) typing and staphylocoagulase typing. The present study found ten SCCmec types, with the majority being SCCmec type III (38.3%). The presence of mecC was confirmed in three isolates from skin wounds (two isolates) and burn wounds (one isolate). All the mecC-positive isolates carried SCCmec XI and belonged to coa type III. Molecular typing showed that these isolates belonged to clonal complex/ST130-spa type t843-agr type III (two isolates) and clonal complex/ST599-spa type 5930-agr type I. The presence of SCCmec type IV confirms the hypothesis of extensive infiltration from the community to the hospital. Detection of MRSA isolates harbouring the mecC gene highlights the need to perform routine detection methods and molecular investigations in order to identify these emerging strains and limit their transfer in hospitals and communities.

Characteristics of methicillin-resistant Staphylococcus aureus carrying the toxic shock syndrome toxin gene: high prevalence of clonal complex 22 strains and the emergence of new spa types t223 and t605 in Iran.

Methicillin-resistant Staphylococcus aureus (MRSA) strains that carry the tst gene are disseminated worldwide with varying regional incidences and different genetic backgrounds. The data on molecular characteristics of these strains is insufficient in Iran. The present study aimed to assess the characteristics and distribution of spa types of tst-positive MRSA strains. We investigated 89 MRSA isolates carrying the tst gene with spa typing, resistance gene detection and in vitro antimicrobial susceptibility. Of the 89 tested isolates, 61 (68.5%) were confirmed as multidrug resistant (MDR). The isolates were distributed across seven clonal complexes (CCs) including CC22 (42.7%), CC8 (28.1%), CC5 (11.2%), CC59 (5.6%), CC30 (4.5%), CC80 (4.5%) and CC15 (3.4%). spa typing identified 11 distinct types, with t223 (16.9%) and t790 (15.7%) being the most prevalent. All high-level mupirocin-resistant strains belonged to t002 (n = 8) and low-level mupirocin-resistant strains belonged to t790 (n = 6) spa types. Fusidic-acid-resistant isolates belonged to t437 (n = 3). iMLSB phenotype was observed in t005 (6.7%), t002 (5.6%), t790 (3.4%), and t030, t044 and t084 (each 2.2%). It was found that in the tst-carrying MRSA strains, there were genetic diversities with a majority of the t223 spa type. Indeed, there is a necessity for more constructive surveillance/infection control strategies to address the prevalence and prevention of the emerging spa types.

Antibacterial characteristics of thermal plasma spray system.

The objective of this study is to investigate antibacterial characteristics of a thermal plasma spray system. For this purpose, copper powder was coated on a handmade atmospheric plasma spraying system made by the stainless steel 316 substrate, which is preheated at different temperatures before spraying. A number of deposition characteristics such as antibacterial characteristics, adhesion strength and hardness of coating, was investigated. All of the spray parameters are fixed except the substrate temperature. The chemical composition was analyzed by X-ray diffraction (XRD). A scanning electron microscopy (SEM) and back scattering electron microscopy (BSE) were used to show the coating microstructure, its thickness and also the powder micrograph. The energy dispersive X-ray spectroscopy (EDX) was used to analyze the coating particles. Hardness of the deposition was examined by Vickers tester (HV0.1). Its adhesion strength was declared by cross cut tester (TQC). In addition, the percentage of bactericidal coating was evidenced with Staphylococcus aurous and Escherichia coli bacteria. Study results show that as the substrates temperature increases, the number of splats in the shape of pancake increases, the greatness and percentage of the deposition porosity both decrease. The increment of the substrate temperature leads to more oxidation and makes thicker dendrites on the splat. The enhancement of the substrate temperature also enlarges thickness and efficiency of coating. The interesting results are that antibacterial properties of coatings against the Escherichia coli are more than Staphylococcus aurous bacteria. However the bactericidal percentage of the coatings against Staphylococcus aurous and Escherichia coli bacteria roughly does not change with increasing the substrate temperature. Furthermore, by increment of the substrate temperature, coatings with both high adhesion and hardness are obtained. Accordingly, the temperature of substrate can be an important parameter for progressing mechanical properties of the antiseptic deposition.

Glyoxal toxicity in isolated rat liver mitochondria.

Glyoxal is a physiological metabolite formed by lipid peroxidation, ascorbate autoxidation, oxidative degradation of glucose, and degradation of glycated proteins. Glyoxal has been linked to oxidative stress and can cause a number of cellular damages, including covalent modification of amino and thiol groups of proteins to form advanced glycation end products. However, the mechanism of glyoxal toxicity has not been fully understood. In this study, we have focused on glyoxal toxicity in isolated rat liver mitochondria. Isolated mitochondria (0.5 mg protein per milliliter) were prepared from the Wistar rat liver using differential centrifugation and incubated with various concentrations of glyoxal (1, 2.5, 5, 7.5, and 10 mM) for 30 min. The activity of mitochondrial complex II was determined by measurement of MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) conversion. The mitochondrial membrane potential (MMP), lipid peroxidation (MDA), reactive oxygen species (ROS) formation, glutathione (GSH) content, and protein carbonylation were also assessed. After an incubation of isolated liver mitochondria with glyoxal, disrupted electron transport chain, increased mitochondrial ROS formation, lipid peroxidation, mitochondrial membrane damage, GSH oxidation, and protein carbonylation ensued as compared to the control group ( p < 0.05). Glyoxal toxicity in isolated rat liver mitochondria was dose-dependent. In conclusion, glyoxal impaired the electron transport chain, which is the cause of increased ROS and MDA production, depletion of GSH, and disruption of MMP. Mitotoxicity of glyoxal might be related to the pathomechanisms involved in diabetes and its complications.

Medical equipment antiseptic processes using the atmospheric plasma sprayed copper coatings.

Antibacterial surfaces such as copper coatings are able to reduce the growth of bacteria. In this study, copper coatings was deposited on the 316 stainless steel substrates by a handmade device operating as an atmospheric plasma spraying system. The chemical composition microstructure and morphology surface of the coatings are examined by x-ray diffraction (XRD) and scanning electron microscope (SEM) and back scattering electron microscope (BSE). Micro hardness as one of the key properties of the coating is characterized based on cross-section. We also evaluate the thickness and the adhesion strength of the coating. Dissection material of coating is performed by energy dispersive x-ray spectroscopy (EDX). Further, the antibacterial activity of our coatings is assessed by both gram negative Escherichia coli ATCC 10536 and gram positive Staphylococcus aureus PTCC 1112 bacteria. As the last step, the antibacterial performance of the coated stainless steel surface with copper are compared to uncoated one. Results confirm that the copper coatings improve the antibacterial property of substrates and owning fine antibacterial behavior compared to stainless steel.

Carriage of Class 1 and Class 2 Integron in Multidrug Resistant Pseudomonas aeruginosa Isolated from Burn Patients in Tehran Hospitals, Iran.

OBJECTIVE: To investigate the antimicrobial susceptibility patterns of Pseudomonas aeruginosa clinical isolates and their associations with the existence of integrons. METHODS: During a 12-month study, 140 clinically significant Pseudomonas aeruginosa isolates were collected from patients hospitalized in the burn ward of different hospitals in Tehran. Pseudomonas aeruginosa isolates were identified using standard laboratory procedures. Antimicrobial susceptibility testing was performed for 13 antimicrobial agents according to the standard Kirby-Bauer disk diffusion method and Clinical and Laboratory Standards Institute (CLSI) guidelines. The frequency of Class 1, 2 and 3 integrons was detected using a polymerase chain reaction (PCR) method. RESULTS: The resistance rates of Pseudomonas aeruginosa isolates to 13 antimicrobial agents were between 34.7% and 90.8%. Ceftriaxone and imipenem had good activity against the isolates. Of 140 tested isolates, 91 (65%) were multidrug resistant. The most predominant resistance profile among the isolates included resistance to 10 (12.14%), 9 (12.14%) and 8 (12.14%) antibiotics. Class 1 and 2 integrons were detected in 57.2% (56/98) and 30.6% (30/98) of tested Pseudomonas aeruginosa isolates, respectively. Of 98 (70%) integron positive isolates, only 12 (12.2%) isolates were positive for both classes of integrons. Resistance of the isolates to cefotaxime, aztreonam, imipenem, tobramycin, ticarcillin, ciprofloxacin and cloxacillin was observed to be significantly associated with the existence of integrons. CONCLUSION: These data confirmed high prevalence of Class 1 integrons among Pseudomonas aeruginosa isolates from burn patients in this study. Based on these results, integrons may play an important role in the possible transmission of resistance genes to the clinical Pseudomonas aeruginosa isolates.

Determination of mercury, cadmium and lead in human milk in Iran.

Breast milk contains both essential and nonessential trace elements. Mercury, cadmium and lead are nonessential, potentially toxic heavy metals with hematotoxic, neurotoxic and nephrotoxic properties even at very low concentrations. The objectives of this study were to determine the concentrations of mercury, cadmium and lead in the breast milk of healthy lactating women who were living in Isfahan, Iran. Concentrations of mercury, cadmium and lead were determined by graphite furnace atomic absorption spectrometry in 37 milk samples from healthy lactating women collected on first to sixth postpartum week. Accuracy of the analysis was checked by various methods including the use of reference material. The mean ± SD of the concentrations of mercury, cadmium and lead in human milk were 0.92 ± 0.54 µg/L (range 0.0-2.07 µg/L), 1.92 ± 1.04 µg/L (range 0.45-5.87 µg/L) and 7.11 ± 3.96 µg/L (range 3.06-19.47 µg/L), respectively. The results of this study showed that the concentrations of mercury, lead and cadmium in the milk samples from lactating women in Isfahan were high, which makes a major public health hazard for the inhabitants, especially neonatal and children, of the industrial locations. The results of the present study indicate a need for establishing safe intake values of heavy metals in human milk.

Cadmium concentrations in shrimp (Penaeus semisulcatus and Penaeus monodon) caught from the coastal areas in Southern Iran.

This study was undertaken to determine the concentration of cadmium in two shrimp species, namely, Penaeus semisulcatus and Penaeus monodon caught from the coastal areas in southern Iran. Cadmium concentration was determined by graphite furnace atomic absorption spectrophotometry in 91 shrimp samples after nitric acid/perchloric acid digestion. Accuracy of the analysis was checked by various methods including the use of reference material. The mean ± SD of cadmium concentrations in shrimp samples were 0.128 ± 0.144 (µg/g). The cadmium concentrations ranged from 0.010 to 0.96 µg/g of the muscle tissues of shrimp. Higher cadmium concentration in shrimp samples was found in summer (significant p < 0.05). The results show that the mean concentration of cadmium in shrimp is lower than the maximum allowed levels according to International standards, although the concentration of cadmium in only one sample was more than the amount recommended by Food and Agriculture Organization. Therefore, no risk to the consumer arises from the cadmium contents of the shrimp caught in these areas.

Is it worthwhile to fully evaluate the stomach in every ultrasound examination of the abdominal cavity?

BACKGROUND/OBJECTIVE: To evaluate the usefulness of abdominal sonography in the fasting state with no hypotonic agents in the detection and exclusion of gastric lesions. PATIENTS AND METHODS: One-hundred patients with normal upper gastrointestinal endoscopy, 94 patients with a major gastric abnormality (including 59 intraluminal tumors, three submucosal masses, 29 ulcers, two polyps and one hypertrophied gastric mucosa) and 75 patients with minor gastric abnormalities (mainly gastritis) were enrolled into the study. RESULTS: Of the 100 normal patients, ultrasound showed four false positive results with 96% specificity of the examination. Within the major gastric lesion group, ultrasound was true positive in 55 of 59 tumors, 15 of 29 ulcers, three of three submucosal masses and the case of giant gastric mucosa. It was negative in the detection of gastric polyps. It could detect only 8% of minor gastric abnormalities. CONCLUSION: Abdominal sonography in the fasting state, if carefully performed, is sufficiently accurate in detection and exclusion of major gastric lesions. Therefore, although it cannot replace endoscopic and barium studies of the stomach, careful evaluation of the stomach is recommended in every sonographic evaluation of the abdominal cavity.

A quantitative thin layer chromatography method for determination of theophylline in plasma.

A simple assay method for theophylline in plasma using thin layer chromatography (TLC) was developed. The method involves extraction of the drug and internal standard (acetaminophen) by chloroform-isopropanol (75:25) followed by separation on TLC silica plates using a mixture of acetic acid, isopropanol, toluene (1: 12: 6), as the eluting solvent. Both peak height ratios and peak are ratios showed high correlation coefficient (r>0.98, p<0.001). However we used peak heights for the determinations. Within-day and between-day coefficients of variation were less than 4.4% and 7.8% respectively. The assay proved inexpensive, accurate and reproducible with a limit of detection of 100 ng/ml that makes it suitable for bioavailability studies.