International Journal of Infection
Volume:4 Issue: 4, Oct 2017

Oral candidiasis is the most common opportunistic infection of the oral cavity in patients undergoing chemotherapy. Identification of Candida species and the corresponding susceptibility to antifungal agents can be helpful in the management of cancer patients.
The purpose of this study was to determine the susceptibility patterns of Candida species against 3 antifungal agents and define clinical practice guidelines for the prevention and treatment of oral candidiasis in cancer patients.
A total of 12 positive samples of oral lesions caused by Candida species were isolated from patients undergoing chemotherapy through direct examination and culture on CHROMagar Candida medium. Stock cultures were grown on sabouraud dextrose agar and DNA extracts. Then, polymerase chain reaction (PCR) was performed and the products were sequenced. The microdilution method was applied at different concentrations of fluconazole, amphotericin B, and nystatin. The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of each species were compared.
The species distribution of Candida isolates was as follows: C. albicans, 6 (50%); C. krusei, 3 (25%); and C. tropicalis, 3 (25%). The male-to-female ratio was 8:4, and the mean age of cancer patients was 51.25 years (range, 25-81 years). Overall, 100% and 83% of C. albicans were resistant to nystatin and fluconazole, respectively. All Candida species showed the lowest and highest resistance to amphotericin B (8.3%) and nystatin (66.7%), respectively.
DNA sequencing showed that C. albicans is the most commonly identified species in the oral cavity of cancer patients. Amphotericin B, compared to fluconazole and nystatin, is a more suitable antifungal drug for oral candidiasis. Oral hygiene involves dental cleaning, and management of poor denture hygiene and xerostomia can be helpful in eliminating Candida species in patients undergoing chemotherapy.

Hepatitis E, a viral infectious disease transmitted through contaminated food and water, can vary from a simple asymptomatic infection to a lethal disease. Patients with frequent blood transfusion have more positive serology test than the others; also patients undergoing dialysis that continuously receive blood have higher serological infection rate. The current study aimed at determining the prevalence of hepatitis E virus (HEV) in patients with thalassemia major in Mashhad, Iran, compared with a healthy control group.
The study was performed on 150 patients with thalassemia and 150 blood donors attending Mashhad Blood Transfusion Organization laboratory. A 5-mL peripheral blood sample was taken from each person. After the separation of plasma/serum, the samples were stored at -20°C until testing. IgM and IgG antibodies of the samples were analyzed by enzyme-linked immunosorbent assay (ELISA) technique. Then, the collected data were analyzed by SPSS version 21 and Minitab software.
In the group of patients, 89 males (59.3%) and 61 females (7/40%), and in the control group 138 male (92%) and 12 females (8%) were enrolled. According to the results of the tests, 13 (8.6%) subjects in the control group and 4 (2.6%) in the patients group had HEV infection. There was no significant difference between the groups in terms of age. For a comparison between the 2 groups of patients and controls, abnormal hematological parameters including red blood cell (RBC), hematocrit (HCT), and hemoglobin (HB) distribution were considered using the Mann-Whitney test. Distribution of blood groups in the study groups was significant, but that of hematological parameters was insignificant.
Based on the results of the current study, HEV was detected in a few cases of patients with thalassemia major.

Hepatitis B virus (HBV) is a public health problem in Iraq. Healthcare providers have set a plan to eradicate the virus by 2030.
The current study aimed at evaluating the public knowledge in Duhok city, Iraq, about HBV.
A total of 168 subjects were recruited and the data were collected via a self-reporting questionnaire. The subjects were asked about the modes of transmission, symptomatology of HBV, and vaccination.
Totally, 168 persons were recruited in the current study and they were asked 11 questions. In total, 58.6% of the questions were answered correctly; 75% of the participants knew that HBV is transmitted more easily than HIV; 35.2% of the females thought that HIV is transmitted more easily than HBV, which was significantly higher than that of males (20.2%) (P = 0.03). The same trend was found among villagers who thought that HIV is more easily transmitted than HBV (29.5% versus 22.4% for urban residents; P = 0.02). It was also found that only 33.9% of the subjects knew that HBV can be transmitted by toothbrush. In addition, the majority of illiterate participants (75.9%) thought that HBV can be transmitted by food (P = 0.05).
The current study results showed the average levels of knowledge about HBV among participants. More studies are needed to evaluate the level of knowledge after implementing educational programs.

Medicinal plants have been playing important roles in the treatment of different diseases. Peganum harmala is a famous medicinal plant used in the Iranian traditional medicine, due to the antimicrobial compounds found in its seeds and roots.
The main objective of the present study was to investigate the antibacterial activities of alcoholic extracts of P. harmala seeds on MRSA strains and cytotoxicity assessment of ethanolic extract of P. harmala seeds on HEK-293 cell line using MTT assay.
During an 11-month descriptive cross-sectional study, 90 MRSA strains isolated from hospitalized patients in ICU wards were investigated. Micro-broth dilution method was employed to evaluate the antimicrobial effects of the extract on MRSA strains. HEK-293 cells were exposed to different concentrations of ethanolic extract of P. harmala and cytotoxicity was evaluated using MTT assay.
The minimum inhibitory concentration of P. harmala extract was observed in the range from 3.125 mg/ml to 25 mg/mL. The most antibacterial activity of the extract was found to be at 12.5 mg/ml concentration. MRSA strains were inhibited by P. harmala extract at MIC50 and MIC90 of 12.5 mg/mL and 25 mg/ml, respectively. MTT assay showed that the extract concentrations more than 0.5 mg/mL were toxic and caused more than 50% HEK-293 cell death.
The results revealed that the P. harmala extract was very effective against MRSA strains isolated from ICU patients and may be useful to treat some of the infections although further investigation is recommended to assess their toxicity prior to in vivo use.

Nowadays, intestinal parasitic infections (IPIs) are one of the most common and serious public health problems, which affected 3.5 billion people worldwide, especially in developing countries. During the time of distribution, the pattern of disease may alter as a result of changing the life style of residents.
The current study was aimed to determine the prevalence of IPIs in the town of Haftkel, southwest Iran.
In this descriptive cross-sectional study, 13698 stool specimens were collected during 2010 - 2013. For all samples, both direct smear and formalin ether concentration methods were done. Finally data analysis was performed using SPSS version 11.0.1 (SPSS Inc., Chicago, IL, USA).
658 (4.8%) out of 13698 specimens were positive for IPIs and Giardia lamblia was detected in 433 (3.16%) samples as the commonest parasite. Other parasites were included: Entamoeba histolytica/dispar (0.7%), E. coli (0.56%), E. hartmanni (0.21%), Blastocystis hominis (0.1%), Hymenolepis nana (0.04%), Taenia spp (0.014%), and Enterobius vermicularis (0.007%). A decreasing trend was observed in the prevalence of intestinal parasites in which the frequency was 281 (6.42%) cases in 2010 and declined to 114 (3.83) in 2013. The maximum and minimum infection was seen in the summer season (34.35%) and winter (15.35%), respectively. Furthermore, the number of infected men was significantly higher than women (64.5% against 35.5%). Interestingly, no hookworm, Ascaris lumbricoides, and Trichuris trichiura eggs were seen in the current study.
Based on the current findings, IPIs particularly helminthic cases have been declined during the past decades. Therefore, health education and improving facilities environmental especially in rural and semi-urban areas can be helpful.

Anthrax, as a zoonotic disease, is considered a major bioterror threat. Development of effective prophylactic approaches is needed to combat this disease. The protective antigen domain 4 (PAD4) has been extensively studied as a vaccine candidate against anthrax. Previously, we showed that PAD4 can be successfully encapsulated in poly (lactide-co-glycolide) (PLGA)-based particulate systems.
We aimed to determine if there is an intricate relationship between the parameters of PLGA particulate process and the associated immunogenicity.
In this study, PLGA (50:50) and PLGA (85:15) with a similar molecular weight were used as the polymer variants. Polymer variants were evaluated using 3 adaptations of w/o/w solvent evaporation method. Six variants of PLGA-PAD4 particulate systems were developed and studied for size, antigen content, and immunogenicity.
NaCl in the external aqueous phase was required to achieve nonporous and spherical microparticles. Particle size was found to be dependent on the applied methods, and there was no significant difference in size by varying the PLGA compositions. PLGA variants showed a differential behavior with antigen encapsulation in the evaluated methods. The hydrophobic particulate vaccine with the mean diameter of ~ 3 µm elicited the highest IgG titer, compared to particles with mean diameters of ~ 0.2 and ~ 7 µm.
This study could help determine the composition of novel PAD4-encapsulated PLGA-based vaccine formulations.

Acute encephalitis syndrome (AES) is a public health problem in India. One of the causes is the Japanese encephalitis (JE), but in many patients this infection can be ruled out. The current hospital-based surveillance was conducted on patients with AES and JE. No comparative study on the long-term outcomes of JE vs. non-JE AES was available from India and there was no study on socioeconomic impact of the illness.
The current study aimed at comparing the long-term outcomes of JE vs. non-JE AES and studying the socioeconomic impact of AES on the population of Uttar Pradesh, India.
Patients with AES discharged from hospital were followed-up by hospital or home visits, or telephone interviews. Functional outcomes and sequelae were compared between the patients with JE and non-JE AES by the Glasgow outcome scale (GOS), Liverpool outcome scale (LOS), and child & adolescent scale of participation (CASP). Socioeconomic impact and coping mechanisms were studied by the semi-structured qualitative methods.
A total of 91 patients (29 with JE, 62 with non-JE AES) were followed-up based on the mean (SD) duration of 21.9 (5.6) months after discharge from hospital. Functional outcomes were significantly worse in the cases with JE, but there was no significant difference in CASP scores between the groups. Only 4 patients with JE got financial help from the government. In the rest, almost all the expenses for travel, hospitalization, drugs, and investigation were borne by the families themselves. Most of the families borrowed money from relatives, while some mortgaged or sold their land and/or jewelry. Rehabilitation services were seldom available as it needed travelling to cities. The joint family system has a cushioning effect, however, providing physical and mental support.
AES is a serious illness with severe long-term sequelae in survivors. Functional outcomes got worse in the patients with JE compared with the ones with non-JE AES. The illness had a severe socioeconomic impact and all expenses should be borne by poor families. Rehabilitation remained an unmet need. Some supports were provided through the joint family system.

Many diseases are often caused by bacteria, including those caused by Staphylococcus aureus and Listeria monocytogenes. Staphylococcus aureus has a hospital infection source and can cause simple skin diseases such as rashes, as well as more severe diseases, such as pneumonia and meningitis. Listeria monocytogenes has an environmental source, such as water, soil and food, and attacks the central nervous system and causes neurological symptoms, even leading to death.
This study aimed at evaluating antimicrobial effects of ethanol extract and essential oil Eshvark against clinical isolates of S. aureus and L. monocytogenes, which are resistant to antibiotics.
Different strains of S. aureus bacteria were isolated from Bu-Ali hospital of Zahedan, and standard strains of L. monocytogenes (PTCC 1630) were provided as a lyophilized vial in Iranian collection center of fungus and bacteria (Iranian research organization for Science and industry). In this study, the essential oil of Razya stritca was obtained by Clevenger. Then the minimum inhibitory concentrations were investigated to characterize the antibacterial activities of this essential oil.
These tests showed that the approximate minimum inhibitory concentration was at concentrations of 5 and 10 mg per milliliter, and the amount of inhibitory concentration for S. aureus was 25/83 and 6/17 while this amount for L. monocytogenes was 5/53 and 1/7, and the minimum bactericidal concentration (MBC) was also at concentrations of 5 and 10 mg per milliliter.
This study confirmed the antimicrobial potential of investigated plants and their usefulness in treatment of resistant isolates of S. aureus and L. monocytogenes.

Invasive fungal infections have become highly relevant due to the exponential increase in the population, whose immune non mycotic foci by gamma scintigraphy would allow the appropriate treatment of the patient and avoid the appearance of irreversible tissue damage.
The present study aimed at development and evaluation of amphotericin B and 99mTc complexes as potential radiopharmaceuticals for the diagnosis of fungal infections by gamma scintigraphy.
Amphotericin was radiolabeled with 99mTc-tricarbonyl and 99mTc-nitride precursors. The complexes were assessed for in vitro stability, lipophilicity, plasma protein binding, plasma stability, and yeast union. Biological evaluation was conducted in 4 groups of CD1 female mice. G0 healthy animals and G1 were induced sterile inflammation with turpentine oil. G2 and G3 were infected with Candida albicans and Aspergillus niger.
99mTc-amphotericin complexes were obtained with radiochemical purity (RCP) higher than 90%, and both were stable in labelling milieu for at least 20 hours and in plasma for 4 hours. Biodistributions of 99mTc(CO)3-amphotericin revealed that the complex was well tolerated by mice and showed mainly urinary excretion. Lesion uptake was 3 times higher in infected tissues with Candida albicans than in sterile inflammation.
The 99mTc(CO)3-amphotericin complex is outlined as a potential diagnostic agent for fungal infections by gamma scintigraphy.

Contaminated multipledose vaccine vials (MDVVs) have been implicated in the outbreaks of pyogenic abscesses and other bacterial infections. In this study, we aimed to investigate the prevalence of bacterial contamination of MDVVs.
Over 3 months, a total of 3640 in-use MDVVs were collected from 39 urban health centres and health posts in Zahedan, southeast of Iran and inoculated on appropriate bacterial growth media. The bacteria were identified using the methods described by the American type culture collection (ATCC).
Bacterial contamination was identified in 6 out of 3640 (0.2%) MDVVs. The isolated microorganisms included Staphylococcus epidermidis (3 vials), Staphylococcus saprophyticus (2 vials), and Escherichia coli (1 vial).
The present results revealed some breaches in safe injection practices and noncompliance with aseptic techniques in vaccination services provided by urban health centres and health posts. This article highlights the importance of basic infection control training and the need for increased awareness of safe injection practices among healthcare workers.

Rhizopuse Sp. are common infectious agents of invasive rhinosinusitis. Though Alternaria is known to cause allergic rhinosinusitis, invasive sinusitis because of Alternaria Sp. is rare. Coinfections with bacteria and fungus causing rhinosinusitis have been reported as have the Rhizopus infection with other fungus such as Aspergillus, Candida, and Exserohillum. However Rhizopus coinfection with Alternaria has not been reported to the best of our knowledge.
A sixty-year- old woman was admitted with periorbital pain, swelling and complete restriction of movement of her right eye. She had diabetes mellitus for fifteen years. Diagnosis of invasive sinusitis was confirmed by hyperintensities in her right maxillary and bilateral ethmoid sinuses on the MRI on her brain and demonstration of hyphal forms from sinus mucosa. Culture confirmed the presence of Alternariaalternata and Rhizopus arrhizus. Patient responded to treatment with Amphotercin B and had complete resolution.
Co-infection with bacteria and mixed fungal infection should be looked for as treatment strategies may differ with different organisms. Presumptive treatment should include agents, which can cover the broadest possible range of organism known to cause invasive sinusitis.

Hepatitis C virus (HCV) is considered a major public health problem and in the organ transplant subjects, particularly. The classical interferon/ribavirin regimen is unadvisable for renal transplant patients due to intolerability and adverse effects.
Here, the first case of successful treatment of acute HCV in renal transplant patient is described. A 24-week course of sofosbuvir plus ribavirin was given to a 41- year-old male patient with renal transplant who was diagnosed with acute HCV. The patient was treated successfully without major side effects and without undesirable interaction with immunosuppressive medications.
This is the first case report regarding the treatment of acute HCV in renal transplant subject using sofosbuvir-containing regimen. More studies are needed to investigate the treatment of acute HCV with the use of new medications especially in the organ transplant subjects.