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1.
Artigo em Inglês | MEDLINE | ID: mdl-34478034

RESUMO

PURPOSE: Tumor necrosis factor alpha (TNF-α) is an inflammatory cytokine which may play a role in the development of gastric cancer (GC). This study aimed to investigate the association of five TNF-α polymorphisms including TNF-α-857, TNF-α-1031, TNF-α-863, TNF-α-308, and TNF-α-238 polymorphisms with GC risk. METHODS: All eligible case-control studies were collected by searching PubMed, Scopus, and Web of Science. The association of the risk of GC with TNF-α polymorphisms was estimated using odds ratio (OR) and 95% confidence interval (CI). Heterogeneity was assessed via Cochrane's Q and I2 analyses. RESULTS: A total of 46 publications involving 16, 715 cases with GC and 27, 998 controls were recruited. The study revealed a significant association for TNF-α 308 (recessive model: OR = 0.646, P = 0.035), TNF-α-1031 (homozygote model: OR = 1.584, P = 0.027), and TNF-α-857 (homozygote model: OR = 1.760, P = 0.001) polymorphisms with the GC risk. The results of subgroup analysis based ethnicity found a significant association between GC risk and TNF-α-857 polymorphism in Caucasian subgroup (P = 0.005) and TNF-α-1031 polymorphism and GC risk in Asians (P = 0.018). CONCLUSIONS: This study suggested that TNF-α-857 and TNF-α-1031 polymorphisms may be associated with the increased gastric cancer risk.

2.
Burns ; 47(3): 538-544, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32532479

RESUMO

PURPOSE: The pathogenesis of Pseudomonas aeruginosa is multifactorial and attributed to the production of several cell-associated and extracellular virulence factors including those implicated in adherence, iron uptake, exoenzymes (Exo) and exotoxins. The present study aimed to determine the prevalence of type III secretion systems (T3SS) effectors in Iranian burn patients with P. aeruginosa wound infection. METHODS: A systematic search was conducted to identify papers published by Iranian authors in the Web of Science, PubMed, Scopus, Embase, and Google Scholar electronic databases during the period of January, 2000 to December, 2018. Publications which met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The inclusion criteria were articles that include burn patients with a wound infection caused by P. aeruginosa, and reported the prevalence of aimed exoenzymes. RESULTS: Ten publications were selected out of 15 full-text reviewed articles with the inclusion criteria. Of ten studies, the pooled prevalence of ExoS producing isolates was estimated at 57.1% (95% CI: 40.3-72.5%). Five studies reported the prevalence of ExoU and ExoT, from which, the pooled prevalence of ExoU and ExoT producing isolates was estimated at 51.4% (95% CI: 31.4-70.9%) and 86.4% (95% CI: 48.1-97.8%), respectively. Four studies reported the prevalence of ExoY, from which, the pooled prevalence of ExoY producing isolates was estimated at 79.0% (95% CI: 48.6-93.8%). CONCLUSION: Our results showed a remarkable prevalence of T3SS-positive genotype in patients with burn injuries. These findings provided attractive targets for new therapeutic strategies for burn patients who were infected with cytotoxin-producing P. aeruginosa.


Assuntos
Queimaduras/complicações , Sistemas de Secreção Tipo III/efeitos dos fármacos , Infecção dos Ferimentos/etiologia , Antibacterianos/metabolismo , Antibacterianos/farmacocinética , Queimaduras/fisiopatologia , Humanos , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/patogenicidade , Infecção dos Ferimentos/microbiologia
3.
Infez Med ; 28(3): 314-321, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32920566

RESUMO

The present study aims to investigate the prevalence of Pseudomonas aeruginosa in Iranian Cystic Fibrosis (CF) patients. We conducted a systematic search on this topic in Web of Science, PubMed, Embase, Scopus, and Google Scholar electronic databases to the end of July 2019. Then, 14 articles with eligible criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The pooled prevalence of P. aeruginosa was 40.6% (95% CI: 32.4%-49.4%) ranging from 32.4% to 49.4%. There was a significant heterogeneity among the studies (χ2 =21.02; p <0.001; I2 = 86.07%). The funnel plot for publication bias showed no evidence of asymmetry. Based on the results of Begg's and Egger's test no significant publication bias was observed. The study demonstrated a relative prevalence of P. aeruginosa among CF patients in Iran. Due to the rapid spread and infection severity of P. aeruginosa and other opportunistic pathogens, efforts are required to identify risk factors, reservoirs, transmission routes and source of infection.


Assuntos
Fibrose Cística/complicações , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/epidemiologia , Pseudomonas aeruginosa , Humanos , Irã (Geográfico)/epidemiologia , Prevalência
4.
BMC Res Notes ; 13(1): 383, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795378

RESUMO

OBJECTIVE: The present study aimed to investigate the frequency and antibiotic susceptibility pattern of Gram-negative bacteria (GNB) isolated from surgical site infections (SSIs) in the North of Iran. RESULTS: This cross-sectional study conducted over a two-year period during 2018-2020 on all cases of SSIs who had a positive culture for a GNB. Standard microbiological tests were followed for the bacterial isolation and identification. Antimicrobial susceptibility profiles were determined using disk diffusion method. During the study period, a total of 78 nonduplicated GNB isolated from SSIs. The most prevalent surgical procedures were fracture fixation (37.2%), and tissue debridement (23.1%). Klebsiella isolates showed the highest isolation rate (29.5%) followed by Enterobacter (28.2%), and Acinetobacter (16.7%). Antibiotic susceptibility results showed that Acinetobacter isolates were almost resistant to all of the tested antibiotics, except gentamicin, co-trimoxazole, and meropenem. Enterobacteriaceae isolates showed the lowest resistance against amikacin, co-trimoxazole, and imipenem. Overall, 49 (62.8%) of isolates were multiple drug-resistant (MDR). In summary, a remarkable rate of MDR isolates which showed an increasing trend during recent years is a serious alarm for the management of SSIs caused by GNB. Moreover, the results of regional assessments, provide good epidemiological background for comparing our situation with other regions.


Assuntos
Infecções por Bactérias Gram-Negativas , Infecção da Ferida Cirúrgica , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Estudos Transversais , Farmacorresistência Bacteriana , Bactérias Gram-Negativas , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Testes de Sensibilidade Microbiana , Prevalência , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/epidemiologia
5.
Microb Drug Resist ; 26(11): 1357-1364, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32380906

RESUMO

Escherichia coli sequence type (ST) 131 is considered a high-risk pandemic clone and frequently extended-spectrum ß-lactamase (ESBL)-producing clone that is strongly associated with the global dissemination of CTX-M-15 type. The emergence of ST131 has become a public health threat because this clonal group typically exhibits multiple virulence factors and antimicrobial resistance. Therefore, this study aimed to analyze the literature published on the estimation of the prevalence of clone ST131 among E. coli strains isolated from patients with urinary tract infections in western Asia. A systematic search was carried out to identify eligible articles in the Web of Science, PubMed, Scopus, Embase, and Google Scholar electronic databases from January 2010 to December 2018. Next, 13 articles meeting the inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The included studies were conducted in Iran, Jordan, Kuwait, Pakistan, Saudi Arabia, Turkey, and Yemen. In all studies, the pooled prevalence of ST131 was 24.6% (95% CI: 13.5%-40.4%) in wild type isolates, 42.7% (95% CI: 32.5%-53.5%) among ESBLs-producing isolates, and 64.8% (95% CI: 36%-85.5%) among multiple-drug resistant (MDR) isolates. Moreover, the prevalence of ST131 isolates carrying CTX-M-15 type was 68% (95% CI: 48.4%-82.8%). Our study indicated the high prevalence of broadly disseminated ST131 clone among MDR and ESBLs isolates in western Asia. Moreover, O25b was the predominant ST131 clone type, which was mostly associated with CTX-M-15 type.


Assuntos
Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/patogenicidade , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Animais , Antibacterianos/farmacologia , Ásia Ocidental/epidemiologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Escherichia coli/metabolismo , Infecções por Escherichia coli/tratamento farmacológico , Humanos , Infecções Urinárias/tratamento farmacológico , beta-Lactamases/metabolismo
6.
Microb Drug Resist ; 26(10): 1208-1218, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32282274

RESUMO

Objectives: The present systematic review and meta-analysis study aimed to investigate the prevalence of class 1 integrons and their associated antibiotic resistance in uropathogenic Escherichia coli. Materials and Methods: A systematic search was conducted to identify studies meeting our inclusion criteria in the Web of Science, PubMed, Embase, Scopus, and Google Scholar electronic databases to the end of July 2019. Finally, 35 articles were selected for data extraction, and meta-analysis was performed using the metaprop program in the STATA, version 11.0, software. Results: The pooled prevalence of class 1 integrons was 47% (95% confidence interval [CI]: 40-54), ranging from 6% to 90%. There was significant heterogeneity among the 35 studies (χ2 = 840.37; p < 0.001; I2 = 95.95%). The results of the subgroup analysis based on characterization of patients indicated that pooled prevalence of class 1 integrons was 52% (95% CI: 41-63; n = 14 studies) and 43% (95% CI: 34-54; n = 19 studies) in hospitalized and community patients, respectively. The lowest and highest prevalence of antibiotic resistance was observed for imipenem and ampicillin, respectively. According to the results of Begg's and Egger's tests, we did not find significant publication bias both in the included studies and in the subgroup analysis. Conclusions: The results show the high prevalence of class 1 integrons and high level of antibiotic resistance in association with those among uropathogenic E. coli. Moreover, the prevalence of class 1 integrons in Asian countries, as well as hospital-acquired urinary tract infection (UTI), was higher than in other countries and community-acquired UTI.


Assuntos
Antibacterianos/farmacologia , Infecções por Escherichia coli/epidemiologia , Escherichia coli Uropatogênica/isolamento & purificação , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Humanos , Integrons/genética , Prevalência , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Escherichia coli Uropatogênica/efeitos dos fármacos , Escherichia coli Uropatogênica/genética
7.
Acta Microbiol Immunol Hung ; 67(3): 182-186, 2020 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-32160785

RESUMO

This study was aimed to evaluate occurrence of antibiotic resistance and the presence of resistance determinants among clinical isolates of Acinetobacter baumannii. This cross-sectional study from January to September 2018 was performed on 59 A. baumannii strains isolated from clinical samples in the north of Iran. Isolates were identified by standard microbiologic tests and molecular method. Antimicrobial susceptibility testing was carried out by disk diffusion and broth microdilution methods. The presence of carbapenem resistance genes was detected by PCR method. All isolates were resistant to cefepime, meropenem, imipenem and ceftazidime. The lowest resistance rate was observed against doxycycline with 33.9%. Minimum inhibitory concentration (MIC) results showed that all carbapenem-resistant A. baumannii (CRAB) isolates were susceptible to colistin with MIC50 and MIC90 values of 1/2 µg/mL. Among 59 CRAB, blaOXA-23-like was the most prevalent gene (86.4%) followed by blaOXA-24-like (69.5%). Meanwhile, none of the clinical isolates harbored blaOXA-58-like gene. We found a high prevalence of CRAB strains harboring OXA-type carbapenemases in the north of Iran. Our results suggests that the presence of OXA-type genes was not directly correlated with the increase of imipenem MIC level, but can be clinically important as they contribute to the selection of CRAB strains.


Assuntos
Infecções por Acinetobacter/epidemiologia , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/genética , Antibacterianos/farmacologia , Colistina/farmacologia , Acinetobacter baumannii/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas de Bactérias/genética , Técnicas Bacteriológicas , Carbapenêmicos/farmacologia , Estudos Transversais , DNA Bacteriano , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prevalência , Adulto Jovem , beta-Lactamases/genética
9.
Infect Drug Resist ; 12: 1683-1689, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354317

RESUMO

Background: Quinolones are a family of synthetic antimicrobial agents with a broad antibacterial activity commonly used as a suitable therapy in patients with urinary tract infection (UTI). In the present study, we aimed to evaluate the prevalence of quinolones resistance and the presence of plasmid-mediated quinolone resistance (PMQR) genes among Escherichia coli isolates. Methods: This study was performed on a collection of 121 E. coli isolates derived from patients with UTI. Antimicrobial susceptibility to nalidixic acid, ciprofloxacin, levofloxacin, norfloxacin, and ofloxacin was specified by the disk diffusion method. The presence of PMQR genes was determined by PCR method. Results: Antibiotic susceptibility results showed that the highest and lowest resistance rates were against nalidixic acid (71.9%) and norfloxacin (44.6%), respectively. The molecular results showed that 40 (33.1%) and 15 (12.4%) of the isolates were positive for qnrS and qnrB genes, respectively. Meanwhile, 5 (4.1%) of the isolates were found positive for both genes, while none were found to be positive for qnrA gene. There was no significant association between the presence of qnr genes and higher antibiotic resistance. Conclusion: We found high levels of quinolones resistance (more than 40%) among E. coli strains isolated from patients with UTIs in the south of Iran. We further report the prevalence of PMQR genes among uropathogenic E. coli; however, it seems that these genes are not the main components of quinolone resistance in our region.

10.
Microb Drug Resist ; 25(9): 1330-1337, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31290721

RESUMO

Antibiotic resistance is an increasing phenomenon and has become a serious public health concern. Nowadays, limited therapeutic options exist for the treatment of invasive infections caused by drug-resistant strains, particularly methicillin-resistant Staphylococcus aureus (MRSA). The present study was conducted to analyze the published literature on the in vitro activity of tedizolid toward MRSA strains. A systematic literature search was conducted on the Web of Science, PubMed, Scopus, and Google Scholar electronic databases from January 2000 to December 2017 to cover all published articles relevant to our study. Then, 18 publications that met our inclusion criteria were selected for data extraction and analysis by the Comprehensive Meta-analysis software. The overall antibacterial activity of tedizolid on 10,119 MRSA isolates was estimated 0.25 and 0.5 µg/mL for MIC50 and MIC90 (minimum inhibitory concentration at which 50% and 90% of isolates were inhibited, respectively), respectively. The pooled prevalence of tedizolid susceptibility was estimated at 99.6% (95% confidence interval: 99.5-99.8%). Only 4 of 18 included publications have reported the antibacterial activity of tedizolid against linezolid-resistant isolates, of which the MIC range of tedizolid was 0.25-16 µg/mL. Of the four studies, all of the linezolid-resistant isolates were susceptible to tedizolid in one study, and in the other studies, the susceptibility rates were <50%. Based on the results of the systematic reviews, tedizolid had a promising antibacterial activity against MRSA isolates from different clinical sources. However, future studies are needed to provide clinical evidence to support these observations.


Assuntos
Antibacterianos/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Oxazolidinonas/farmacologia , Tetrazóis/farmacologia , Antibacterianos/administração & dosagem , Farmacorresistência Bacteriana Múltipla , Humanos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Oxazolidinonas/administração & dosagem , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Tetrazóis/administração & dosagem
11.
BMC Res Notes ; 12(1): 301, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138309

RESUMO

OBJECTIVE: The present study aimed to determine in vitro activity of colistin and other agents against drug-resistant isolates of Pseudomonas aeruginosa and Acinetobacter baumannii. RESULTS: This in vitro study performed on a collection of non-fermenting Gram-negative bacilli (NFB) consist of 18 A. baumannii and 21 P. aeruginosa isolates. Non-duplicated isolates (one per patient) were isolated from blood, endotracheal tube and sputum samples of hospitalized patients in the south of Iran. The minimum inhibitory concentrations (MICs) of each isolate was determined using Epsilometer (E)-test strips containing colistin, imipenem, and ceftazidime. In overall, all A. baumannii isolates were non-susceptible to imipenem and ceftazidime. In contrast, all isolates were susceptible to colistin with MIC50 and MIC90 of 0.75/1.5 µg/mL, respectively. Antibiotic susceptibility results showed that 81% and 23.8% of P. aeruginosa isolates were susceptible to ceftazidime and imipenem, respectively. While, all of the P. aeruginosa isolates were susceptible to colistin with MIC50 and MIC90 of 0.5/1 µg/mL, respectively. In summary, colistin showed the promising in vitro activity against drug-resistant strains of two clinically important NFB in our region. However, investigation on a larger collection of drug-resistant strains demands to support these observations in the near future.


Assuntos
Acinetobacter baumannii/isolamento & purificação , Ceftazidima/farmacologia , Colistina/farmacologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Imipenem/farmacologia , Pseudomonas aeruginosa/isolamento & purificação , Acinetobacter baumannii/efeitos dos fármacos , Irã (Geográfico) , Testes de Sensibilidade Microbiana , Pseudomonas aeruginosa/efeitos dos fármacos
12.
Iran J Basic Med Sci ; 22(7): 813-819, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32373304

RESUMO

Objectives: Clostridioides (Clostridium) difficile infection as a healthcare-associated infection can cause life-threatening infectious diarrhea in hospitalized patients. The aim of this study was to investigate the toxin profiles and antimicrobial resistance patterns of C. difficile isolates obtained from hospitalized patients in Shiraz, Iran. Materials and Methods: This study was performed on 45 toxigenic C. difficile isolates. Determination of toxin profiles was done using polymerase chain reaction method. Antimicrobial susceptibility to vancomycin, metronidazole, clindamycin, tetracycline, moxifloxacin, and chloramphenicol was determined by the agar dilution method. The genes encoding antibiotic resistance were detected by the standard procedures. Results: The most frequent toxin profile was tcdA+, tcdB+, cdtA-, cdtB- (82.2%), and only one isolate harboured all toxin associated genes (tcdA+, tcdB+, cdtA+, cdtB+) (2.2%). The genes encoding CDT (binary toxin) were also found in six (13.3%) isolates. Resistance to tetracycline, clindamycin and moxifloxacin was observed in 66.7%, 60% and 42.2% of the isolates, respectively. None of the strains showed resistance to other antibiotics. The distribution of the ermB gene (the gene encoding resistance to clindamycin) was 57.8% and the tetM and tetW genes (the genes encoding resistance to tetracycline) were found in 62.2% and 13.3% of the isolates, respectively. The substitutions Thr82 to Ile in GyrA and Asp426 to Asn in GyrB were seen in moxifloxacin resistant isolates. Conclusion: Our data contributes to the present understanding of virulence and resistance traits amongst the isolates. Infection control strategies should be implemented carefully in order to curb the dissemination of C. difficile strains in hospital.

13.
Infez Med ; 26(4): 308-315, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30555133

RESUMO

Clostridium difficile (recently Clostridioides difficile) is a leading cause of hospital- and antimicrobial-associated diarrhea (AAD). The present study was carried out to investigate the prevalence of toxigenic C. difficile, antibiotic resistance and its associated risk factors in Iranian hospitalized patients. This cross-sectional study was conducted from October 2017 to June 2018 in three teaching hospitals in southwestern Iran. During this period, a total of 215 non duplicated nosocomial AAD samples were collected from the hospitalized patients older than two years of age. Presumptive C. difficile isolates were identified by standard microbiologic methods and confirmed by specific PCR primers. The minimum inhibitory concentrations (MICs) were determined by the agar dilution method. PCR was carried out to determine the presence of toxin genes (tcdA, and tcdB). In all, from the 215 diarrheal samples, the frequency of C. difficile culture-positive samples was 21.4% (n = 46). Of the 46 C. difficile isolates, 43 carried both toxins, two isolates only had the tcdB gene, and one was negative for both toxins. Overall, all isolates of C. difficile were susceptible to metronidazole and vancomycin. The MIC50/MIC90 of metronidazole and vancomycin were 0.75/2 µg/mL, 0.25/0.75 µg/mL, respectively. The findings of this study show the prevalence of CDI in hospitalized patients in southwestern Iran, highlighting the importance of active surveillance of CDI in hospitals. Meanwhile, all of the tested isolates were susceptible to metronidazole and vancomycin, which encourages the use of these antibiotics as the drug of choice for initial treatment of CDI in our region.


Assuntos
Antibacterianos/uso terapêutico , Clostridioides difficile , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Enterocolite Pseudomembranosa/tratamento farmacológico , Enterocolite Pseudomembranosa/epidemiologia , Metronidazol/uso terapêutico , Vancomicina/uso terapêutico , Adolescente , Adulto , Idoso , Antibacterianos/farmacologia , Anti-Infecciosos , Criança , Pré-Escolar , Clostridioides difficile/efeitos dos fármacos , Estudos Transversais , Farmacorresistência Bacteriana , Feminino , Hospitais de Ensino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Metronidazol/farmacologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Fatores de Risco , Vancomicina/farmacologia , Adulto Jovem
14.
Caspian J Intern Med ; 9(4): 397-402, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30510656

RESUMO

Background: Neisseria gonorrhea and Treponema pallidum as an obligate human pathogen are two common causes of sexually transmitted diseases (STDs). The present study aimed to determine the prevalence of N. gonorrhoeae and T. pallidum among human immunodeficiency virus (HIV) patients in the southwest Iran. Methods: This retrospective study was performed from 2004 to 2013, on HIV patients who were tested for detection of gonorrhea and syphilis infection at Shiraz HIV/AIDS Research Center. ELISA technique was used for preliminary detection of HIV and confirmed by a Western Blotting test. Gonorrhea was routinely diagnosed using direct Gram-staining and culturing on selective agar. Syphilis was routinely diagnosed by RPR test. Results: Of the 806 HIV patients, 39 (2.6%) cases had co-infection with gonorrhea. Compared with mono-HIV infected patients, gonorrhea was significantly more likely among the males (69.4% vs. 92.3%, P=0.002). History of addiction and prison seems to be a significant risk factor for gonorrhea infection (P<0.05). Also, the mean of CD4+lymphocyte was higher among gonorrhea infected patients (368±238 vs. 415±328). Logistic regression analysis showed that sexual contact increased risk of gonococcal infection about 4 fold (OR: 4, CI: 1.7-9.39, P=0.001). None of the HIV patients had syphilis co-infection. Conclusions: As a preliminary survey, our findings provided unique information on the prevalence of gonorrhea and syphilis co-infections among HIV patients. Moreover, we introduced the main risk factors associated with gonorrhea co-infection in HIV patients in our region including gender, history of addiction and prison, CD4+lymphocyte count, and transmission routes for effective management of STDs.

15.
BMC Infect Dis ; 18(1): 572, 2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-30442101

RESUMO

BACKGROUND: Urinary tract infections (UTIs) are one of the most frequent diseases encountered by humans worldwide. The presence of multidrug-resistant (MDR) uropathogenic Escherichia coli (UPEC) harboring several virulence factors, is a major risk factor for inpatients. We sought to investigate the rate of antibiotic resistance and virulence-associated genes among the UPECs isolated from an Iranian symptomatic population. METHODS: A total of 126 isolates from inpatients with UTI from different wards were identified as UPEC using the conventional microbiological tests. After identification of UPECs, all the isolates were subjected to antimicrobial susceptibility test and polymerase chain reaction (PCR) to identify the presence of 9 putative virulence genes and their association with the clinical outcomes or antimicrobial resistance. RESULTS: The data showed that the highest and the lowest resistance rates were observed against ampicillin (88.9%), and imipenem (0.8%), respectively. However, the frequency of resistance to ciprofloxacin was found to be 55.6%. High prevalence of MDR (77.8%) and extended-spectrum ß-lactamase (ESBL) (54.8%) were substantial. PCR results revealed the frequency of virulence genes ranged from 0 to 99.2%. Among 9 evaluated genes, the frequency of 4 genes (fimH, sfa, iutA, and PAI marker) was > 50% among all the screened isolates. The iutA, pap GII, and hlyA genes were more detected in the urosepsis isolates with significantly different frequencies. The different combinations of virulence genes were characterized as urovirulence patterns. The isolates recovered from pyelonephritis, cystitis, and urosepsis cases revealed 27, 22, and 6 virulence patterns, respectively. A significant difference was determined between ESBL production with pap GII, iutA, and PAI marker genes. CONCLUSIONS: Our study highlighted the MDR UPEC with high heterogeneity of urovirulence genes. Considering the high rate of ciprofloxacin resistance, alternative drugs and monitoring of the susceptibility profile for UPECs are recommended.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana/genética , Infecções por Escherichia coli/microbiologia , Escherichia coli Uropatogênica/genética , Escherichia coli Uropatogênica/patogenicidade , Fatores de Virulência/genética , Virulência/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Cistite/tratamento farmacológico , Cistite/epidemiologia , Cistite/microbiologia , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Lactente , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pielonefrite/tratamento farmacológico , Pielonefrite/epidemiologia , Pielonefrite/microbiologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Adulto Jovem
16.
BMC Res Notes ; 11(1): 711, 2018 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-30305181

RESUMO

OBJECTIVE: The present study aimed to determine the phenotypic and genotypic profile of macrolide, lincosamide and streptogramin B (MLSB) resistance in clinical isolates of staphylococci. RESULTS: This cross-sectional study was conducted on 164 non-duplicated staphylococci isolates collected during August 2015 to February 2016 from two tertiary care hospitals in Shiraz, southwest of Iran. Of the 164 isolates, 86 erythromycin-resistant isolates consist of 35 Staphylococcus aureus and 51 coagulase negative staphylococci (CoNS) were included in the study. Of the 35 S. aureus, the prevalence of cMLS (constitutive), iMLS (inducible), and MS phenotypes were found 82.9%, 8.6% and 8.6%, respectively. Among 51 CoNS, the frequencies of cMLS, iMLS, and MS phenotypes were detected 66.7%, 11.8% and 21.6%, respectively. Among S. aureus isolates, the predominant genes were ermC in 82.9% isolates, followed by ermA in 57.1% and msrA in 28.6% of isolates. Among CoNS isolates, the most frequent genes were diagnosed ermC in 70.6% isolates followed by msrA in 68.6% and ermA in 11.8% of isolates. In conclusion, regarding the presence of MLSB resistance in our region, diagnosis of this resistance type on a routine basis in staphylococcal clinical isolates is of particular importance.


Assuntos
Antibacterianos/farmacologia , Genes Bacterianos , Lincosamidas/farmacologia , Macrolídeos/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus/efeitos dos fármacos , Estreptogramina B/farmacologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Farmacorresistência Bacteriana Múltipla/genética , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Irã (Geográfico)/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Fenótipo , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus/classificação , Staphylococcus/genética , Staphylococcus/isolamento & purificação , Staphylococcus aureus/classificação , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Centros de Atenção Terciária
17.
Cell Mol Biol (Noisy-le-grand) ; 64(7): 75-79, 2018 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-29974849

RESUMO

The emergence of extended-spectrum beta-lactamases (ESBL) producing strains become a great concern, because few antimicrobial agents remain active against them. Due to the lack of data on the genotyping characteristics and antibiotics resistance of clinical isolates of Klebsiella pneumoniae in the north of Iran, this study aimed to determine the occurrence of ESBL-producing isolates and their molecular characteristics in order to analyses their epidemiological relationships. This cross-sectional study performed on 60 K. pneumoniae isolates which were recovered from different clinical specimens within May and November 2016. Isolates were identified by standard microbiologic tests and confirmed by API 20E strip. Antimicrobial susceptibility testing was carried out by disk diffusion method. The genetic relatedness among the isolates was assessed by RAPD-PCR. Totally, the lowest level of susceptibility was toward amoxicillin/clavulanat, and nalidixic acid. On the other hand, the highest level of susceptibility was toward imipenem (86.7%). The rate of ESBL-producing isolates was 45% (27/60). There was a significant association between production of ESBLs and higher antibiotic resistance in tested isolates. The RAPD-PCR dendrogram revealed 5 major clusters with a similarity of 80% which indicates the high relatedness of the studied isolates. Twenty-one isolates out of the 27 ESBL-producing isolates were clustered in cluster A. In summary, results showed the high prevalence of multiple-drug resistant and ESBL-producing K. pneumoniae isolates in our ICUs. Also, results revealed a significant similarity between ESBL-producing isolates that necessitate restricted infection control policies and rational prescription and use of antibiotics.


Assuntos
Farmacorresistência Bacteriana Múltipla/genética , Unidades de Terapia Intensiva , Infecções por Klebsiella/enzimologia , Klebsiella pneumoniae/genética , beta-Lactamases/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Ácido Clavulânico/uso terapêutico , Estudos Transversais , Feminino , Humanos , Imipenem/uso terapêutico , Irã (Geográfico)/epidemiologia , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/isolamento & purificação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Epidemiologia Molecular , Ácido Nalidíxico/uso terapêutico , Centros de Atenção Terciária , Inibidores de beta-Lactamases/uso terapêutico
18.
Cell Mol Biol (Noisy-le-grand) ; 64(3): 53-55, 2018 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-29506640

RESUMO

Infections due to Elizabethkingia meningoseptica, a Gram-negative oxidative bacterium are frequently founded in neonatal and immunocompromised individuals. The notable characteristic of this organism is its multi-drug resistance to common antibiotics used for infections caused by Gram-negative bacteria. We report a rare case of complicated pericardial effusion due to E. meningoseptica in a 2-year-old boy, who was admitted with chief complaints of fever and tachypnea (mentioned by his parents) and suffered from a rare lung malignancy (lymphangioleiomyomatosis). He was successfully treated with vancomycin.  E. meningoseptica infection is a rare situation in immunocompetent hosts, and we concluded that this infection was probably originated from device medicine or even hands of healthcare workers.


Assuntos
Antibacterianos/uso terapêutico , Chryseobacterium/efeitos dos fármacos , Infecções por Flavobacteriaceae/complicações , Infecções por Flavobacteriaceae/tratamento farmacológico , Derrame Pericárdico/complicações , Vancomicina/uso terapêutico , Pré-Escolar , Chryseobacterium/isolamento & purificação , Humanos , Linfangioleiomiomatose/complicações , Masculino
19.
J Chin Med Assoc ; 81(6): 536-540, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29030025

RESUMO

BACKGROUND: One of the most important emerging carbapenem-resistant bacteria is Klebsiella pneumoniae (K. pneumoniae). The present study aimed to investigate the antibiotic susceptibility pattern of K. pneumoniae isolates and detection of carbapenemase producing K. pneumoniae obtained from Iranian hospitalized patients. METHODS: This cross-sectional study was performed on 211 K. pneumoniae isolates which were recovered from different clinical specimens from 2014 to 2015. Modified Hodge test (MHT) and double disk synergy test (DDST) were done for detection of carbapenemase and metallo-beta-lactamase (MBL) producing K. pneumoniae. The presence of antibiotic resistance determinants was investigated by polymerase chain reaction (PCR) method. RESULTS: The results of antibiotic susceptibility showed that all isolates were resistant to ampicillin, and then mostly resistant to piperacillin and ceftazidime with 76.3% and 66.8%, respectively. On the other hand, the highest sensitivity was toward polymyxin B, followed by carbapenems. Of 29 carbapenem-resistant isolates, all were high-level imipenem-resistant isolates (Minimum inhibitory concentration ≥4), except 4 isolates. The results of MHT and DDST showed that 93.1% (27/29) of carbapenem-resistant isolates were carbapenemase and MBL producing isolates, respectively. The presence of blaNDM-1 and blaOXA-48-like genes was detected in 27 (10.9%) and 2 (0.9%) isolates, respectively. CONCLUSION: This is the first identification of blaNDM-1 and blaOXA-48-like in K. pneumoniae in Southwestern Iran and the highest reported prevalence of blaNDM in this bacterium from Iran. Since carbapenem-resistant isolates containing New Delhi metallo-beta-lactamase 1 (NDM-1) were almost resistant to all the tested antibiotics, the resistance due to this gene may be increased in the near future as a potential health threat.


Assuntos
Carbapenêmicos/farmacologia , Klebsiella pneumoniae/isolamento & purificação , beta-Lactamases/genética , Estudos Transversais , Farmacorresistência Bacteriana , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia
20.
Infez Med ; 25(3): 217-223, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28956538

RESUMO

Panton-Valentine Leukocidin (PVL) producing Staphylococcus aureus has been associated with severity of skin infections and pathology that suggest a major role in pathogenicity. The present study aimed to determine the overall prevalence of PVL harbouring S. aureus isolates from cutaneous infections in Iran. A systematic search was performed by using Medline electronic databases (PubMed) from the papers published by Iranian authors to the end of March 2017. Ten publications which met our inclusion criteria were then selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The pooled prevalence of PVL in cutaneous infections was estimated at 27.9% (95% CI: 17.9-40.6). The range of PVL positivity among S. aureus isolates obtained from cutaneous infections was from 7.4% to 55.6%. In summary, despite the emergence of multiple-drug resistant strains, it seems that the overall prevalence of PVL carrying S. aureus in Iran remains steady regardless of methicillin resistance. However, further research is required to elucidate the interplay between the risk of invasive disease and PVL, especially in Iran.


Assuntos
Toxinas Bacterianas/análise , Exotoxinas/análise , Leucocidinas/análise , Infecções Cutâneas Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Queimaduras/complicações , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Staphylococcus aureus Resistente à Meticilina/química , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Cutâneas Estafilocócicas/epidemiologia , Staphylococcus aureus/química , Infecção dos Ferimentos/epidemiologia , Infecção dos Ferimentos/microbiologia
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