Avicenna Journal of Clinical Microbiology and Infection
Volume:3 Issue: 4, Nov 2016

Diagnosis of the occult hepatitis B virus (HBV) infection in patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is important due to the fact that the HBV infection may have a clinical impact on liver disease in coinfected HIV/HCV patients. Isolated hepatitis B core antibody (HBcAb) positive HBV infection has been reported in HIV patients. The aim of this study was to determine the occult hepatitis B in patients co-infected with HCV-HIV.
In a cross-sectional study, hepatitis B surface antigen (HBsAg) and HBcAb tests were performed for all HIV-HCV co-infected patients, referred to the HIV Clinic of Hamadan. HBsAb was requested for HBsAg negative-HBcAb positive individuals and in the case of negative HBsAb, HBV-DNA PCR was performed. Finally the collected data was analyzed with SPSS.
Of 103 HIV-HCV coinfected patients, both HBsAg and HBcAb were positive in 7 patients (6.8%), negative in 44 (42.7%) patients and 52 (50.5%) of all patients were HBsAg negative and HBcAb positive, which positivity of HBsAg had statistical correlation with positivity of HBcAb. In the last group HBsAb and HBV-DNA PCR were done, which resulted in the titer of antibody to be positive in 4 patients (7.7%) and the PCR to be negative in all (100%) patients.
The significant number of coinfected HIV-HCV patients only had HBcAb positive test without detectable HBV-DNA. Further studies for detection of HBV-DNA in both serum and liver biopsy specimens may help clarify the impact of HBV infection in coinfected HIV/HCV patients.

The aim of this study was to determine the prevalence of bacterial urinary tract infections (UTIs) and their antibiotic resistance patterns among patients referred to a clinical laboratory in Isfahan, Iran, during 2014 - 2015.

In this retrospective study, the data of urine culture tests which were performed from May 2014 to March 2015 at the Dr. Sharifi Clinical Laboratory were recorded and analyzed. A total of 4,506 patients with urine culture testing were included. Antimicrobial susceptibility testing was performed by the disk diffusion method according to the CLSI criteria. The gathered data were then analyzed with SPSS software using descriptive tests.

Among the 4,506 studied patients with urine cultures, 300 (6.65%) and 4,206 (93.35%) urine samples showed positive and negative bacterial growth, respectively. The rates of urine cultures with bacterial growth for women and men were 90.66% and 9.44%, respectively. With regard to the bacterial growth, 90.33% were Gram-negative and 9.67% were Gram-positive. The most common isolated agent was Escherichia coli, followed by Klebsiella spp. The highest rate of resistance was seen for penicillin and ampicillin in all isolates, and the lowest resistance rate was observed for ciprofloxacin and gentamycin.

The results of the present study showed that antimicrobial resistance among the causative agents of UTIs is high in Isfahan, and treatment of UTIs based on antibiotic-susceptibility test results can be suggested.

The genus Bifidobactrium enjoys considerable significance among the probiotic bacteria for having appropriately adapted to the human gastrointestinal tract. As the properties of Bifidobacteria are strain-oriented and niche-dependent, there is growing interest in studying the different sources of these probiotics. Kashk-e Zard, a traditional fermented food produced from wheat and yogurt through a two-week, two-step fermentation process, is rich in probiotics and is worthy of study in this regard. The present study aimed to identify Bifidobacterium spp. in Kashk-e Zard.
Twenty-three samples of Kashk-e Zard were collected and subjected to Bifidobacterium identification experiments. Polymerase chain reaction (PCR) and sequencing methods were applied for bacterial identification.
Twelve of the isolates obtained were G , rod-shaped, and catalase-, whereas only three of them identified positive for fructose 6-phosphate phosphoketolase (F6PPK a Bifidobacterium specific test) and mupirocin resistance. These three isolates were then considered for further identification using the 16SrDNA sequencing technique.
Although carbohydrate fermentation patterns specified these three isolates as B. infantis, B. bifidum, and B. longum, the molecular results did not confirm B. longum, which is still also controversial in the literature. Overall, our results demonstrated that Kashk-e Zard is a rich potential source of probiotic bacteria and further investigations should be undertaken.

Staphylococcus aureus is a lethal opportunistic pathogen capable of causing a wide range of infections, especially in debilitated hosts such as the elderly. Nasal carriers of this organism have an increased risk of becoming infected with the pathogen. The purpose of this study was to assess the prevalence of S. aureus nasal carriage, to determine the probable risk factors, and to examine the frequency of methicillin-resistant S. aureus (MRSA) among elderly people in hospital and nursing home settings in Lagos, Nigeria.
Two hundred thirty nasal samples were collected from the anterior nares of individuals aged 65 years and older. Possible risk factors were assessed using well-structured questionnaires, and the samples were subjected to standard bacteriological procedures. Antibiotic susceptibility of the isolates was determined with the disk diffusion method. Detection of methicillin resistance was done with the disk diffusion test using cefoxitin 30 μg, and confirmed with OXOID MRSA CHROMagar.
Fifty (21.7%) S. aureus strains were identified among the samples, and antibiotic susceptibility testing showed that multidrug resistance was common. Approximately 20% were resistant to gentamicin, ofloxacin, and mupirocin. Cloxacillin, amoxicillin/clavulanate, and ceftazidime showed the least anti-staphylococcal activity, and almost half of the isolates were resistant to ceftriaxone and cefuroxime. The MRSA nasal carriage rate was 10% and colonization was favored by previous antibiotic use, hypertension, and tuberculosis.
The occurrence of multidrug-resistant S. aureus in the elderly cohort indicates their capacity to serve as reservoirs for these strains, which could facilitate the dissemination of MRSA into the community. Therefore, decolonization and the implementation of measures to prevent the spread of this organism are necessary.

Acinetobacter baumannii is an opportunistic nosocomial pathogen and a cause of severe infections in hospitalized patients, owing to its ability to acquire drug resistance by the efflux pump mechanism. The current study investigated the detection and prevalence of efflux pump genes (AdeABC) in multidrug resistant A. baumannii isolates and the role of these genes in multidrug and carbapenems resistance.
This study was conducted on 84 multidrug resistant and 13 carbapenem-susceptible A. baumannii isolates obtained from burn and wound infections in Baghdad hospitals, Iraq. The AdeABC genes were detected by polymerase chain reaction (PCR) assay. Phe-arg-beta-naphthylamide (PAβN)-based method was used for determination of efflux pump activity.
This study showed high prevalence of efflux pump genes in our local isolates. The AdeB gene was present in all multidrug resistant isolates (100%) while AdeRS gene was found in 95.2%, AdeC gene in 83.3% and AdeA gene in 77.4%. By comparing the prevalence of these gene in carbapenem-susceptible isolates, it was demonstrated that the gene AdeB was absent in all susceptible isolates, also the regulatory gene AdeRS was not found in most of these isolates, while the other genes (AdeA and AdeC) were detected in most carbapenem- susceptible isolates. Susceptibility of isolates to Amikacin, Gentamicin, Ciprofloxacin, Levofloxacin, Tetracycline and Tigecycline was highly increased in the presence of efflux pump inhibitor, so that, PAβN reduced the minimum inhibitory concentrations (MICs) by 4 to 32 folds. Also, MICs of carbapenems were reduced in the presence of the inhibitor by two to eight folds, while the MICs of colistin were not affected.
AdeABC efflux system plays a vital role in multidrug resistance in clinical A. baumannii isolates. It was noted that the most important gene responsible for multidrug resistance within this system was the AdeB gene especially in carbapenems resistance.

The main goal of the treatment of the hepatitis C virus (HCV) infection is reduction and elimination of viruses as well as achieving high sustained viral response (SVR). The present study aimed to assess response to treatment of HCV infection by focusing on virological and biochemical aspects.
This study was performed in Hamadan, Iran on HCV infected patients who were referred between 2009 and 2013. All participants were under the treatment with Pegylated Interferon (PEG-IFN) and Ribavirin (RBV). The duration of treatment varied based on the HCV genotype as 24 weeks for genotypes 2 and 3, and 48 weeks for other genotypes.
Of the 186 patients with HCV infection, 52.8% had a genotype of 3a and 35.6% had a genotype of 1a/b. Three months after treatment, 75 patients were willing to do quantitative PCR and early virologic response was observed in 58 cases (78.4%). Also, 112 patients were assessed after completing the treatment (75 patients in 24 weeks and 37 patients in 48 weeks treatment protocol) and the end-of-treatment response (ETR) was 94.7% and 86.5% respectively. Amongst the 103 patients with ETR, 76 were followed up six months after treatment and the PCR was negative in 71 cases (SVR = 93.4). With the progress and completion of the treatment, improvement is observed in liver function tests.
Even with the introduction of new drugs and interferon free protocols in treatment of hepatitis C infection it seems that the IFN-based treatment is still used in low/middle income countries for treatment-naive patients with HCV genotype 3.