International Journal of Infection
Volume:6 Issue: 1, Jan 2019

The increase in the resistance of group A β-hemolytic streptococci (GABHS) to antibiotics is considered as a serious threat to human health. The current study aimed at determining the antimicrobial effect of zinc oxide nanoparticles (ZnONPs) on the growth of erythromycin-resistant GABHS harboring mef gene isolated from university student carriers. The study was conducted on 100 healthy students from Islamic Azad University, Gorgan Branch. Specimens were collected from the nasopharyngeal region using sterile swab. After biochemical tests to identify GABHS, resistance to various antibiotics was determined using agar disk diffusion test (the Kirby-Bauer method). The minimum inhibitory concentration (MIC) of erythromycin was also determined by broth micro-dilution test. The macrolide resistance gene (mefA) was identified by polymerase chain reaction (PCR) using specific primers, and the antibacterial properties of ZnONPs were evaluated by agar-well diffusion method. The data were analyzed by chi-square and ANOVA tests (P < 0.001). In the current study, the frequency of GABHS carriers was reported 11%. The highest amount of bacterial resistance was correlated with erythromycin with the frequency of 45.4%. Also, 91% of the isolated streptococci were susceptible to cefazolin, followed by cefalexin (82%), penicillin (73%), and amoxicillin (46%). Besides, 43% of the erythromycin-resistant isolates had the MIC of ≥ 1 µg/mL. From the five isolates resistant to erythromycin, 60% harbored the mefA gene. The results of agar-well diffusion test showed that 40% of the strains, which were resistant to erythromycin and harbored mefA gene, were inactivated in the concentration of 50 mg/mL of ZnONPs, and the rest were also inactivated in the concentration of 100 mg/mL. The ZnONPs used in the current study had a high antimicrobial activity against all GABHS isolates that were resistant to erythromycin. It was revealed that the bactericidal property increased upon increasing the concentration of the nanoparticles.

Human T-lymphotropic virus type 1 (HTLV-1) infection has known to be endemic in various regions of the world, including northeastern Iran. This study aimed to determine the prevalence of HTLV-1 infection and its related factors among hemodialysis (HD) patients in Neyshabur, northeast of Iran. Serum samples of 138 HD patients were screened for HTLV-1 antibodies using enzyme-linked immunosorbent assay, and seroreactive samples were confirmed by a line immunoassay. The participants included 76 (55.1%) males and 62 (44.9%) females aged 12 - 84 years. HTLV-1 seropositivity was detected in 20 (14.5%) cases, all of which were confirmed by the line immunoassay. No significant difference was observed between males and females (10.5% vs. 19.3%; P = 0.143). However, there was a significant association between HTLV-1 seropositivity and patients’ age (P = 0.028). The prevalence of HTLV-1 infection among HD patients in northeastern Iran was considerably higher than that reported from other endemic areas. It seems that more specific preventive measures are required to be applied by local health authorities to control the infection.

Infection with toxoplasma, cytomegalovirus (CMV) or rubella is associated with negative pregnancy outcomes. The aim of this study was to determine the prevalence of anti-toxoplasma, CMV and rubella IgM antibodies in women with abortion. This was a cross sectional study conducted in Kurdistan region of Iraq. Samples were collected between January 2015 and October 2018. Women with a recent history of abortion were included in the study and electrical chemiluminescence immunoassay (ECLIA) was used to determine the IgM positivity. Overall, 1275 women were recruited. Amongst these cases, 36 out of 1275 (2.82%) were positive for anti-toxoplasma IgM antibodies. Additionally, 29 out of 1275 (2.27%) of the samples were positive for anti-CMV IgM antibodies, and 22 out of 1275 (1.73%) were positive for anti-Rubella IgM antibodies. The prevalence of toxoplasmosis, CMV, and rubella IgM positivity was low in women with abortion. It seems that infections with these microorganisms are not major causes of abortion in the studied region.

The diagnosis of endobronchial tuberculosis (EBTB) remains a diagnostic challenge due to its protean clinical presentation and absence of radiographic findings in 20% of the cases. In this report, we described a case of EBTB in a man who was presented to the emergency department with chest pain and hemoptysis. A 21-year-old man who was presented to the emergency department with a 3-day hemoptysis and central chest pain. His past medical history was not remarkable. Chest computed tomography and bronchoscopy were performed and the lesion was biopsied; EBTB was confirmed based on histologic and microbiological evidences. A daily regimen of four-drug antitubercular therapy (ATT) was initiated and the patient was discharged home to follow tuberculosis clinic monthly. During the last follow-up visit, the patient did not show any symptoms and the repetition of the physical examination was not remarkable. Investigations showed a negative smear sputum, normal chest X-ray, and Normal Respiratory Function test. EBTB is a variant form of tuberculosis infection with a nonspecific clinical presentation and often, undetectable AFB in sputum smears. The lesion can be detected early by chest computed tomography and bronchoscopy, and the prognosis is good if the disease is confirmed and treated early.

The purpose of this study was to isolate CTX-M1 and CTX-M3 genes producing extended-spectrum beta-lactamase (ESBL) from clinical samples of Salmonella typhimurium isolated from poultry in Zabol, Iran. All the strains were cultured and identified in a clinical microbiology laboratory and were recovered from blood and urine cultures. The in vitro presence of ESBL was confirmed with Clinical and Laboratory Standard Institute double disc and PCR methods for CTX-M1 and CTX-M3. The results of this study showed that Salmonella typhimurium samples were resistant to ampicillin (41.66%), gentamycin (0%), cefazolin (0%), amoxi-clav (10%), and azithromycin (5%) antibiotics. The widespread use of ESBL antibiotics has increased the spread of ESBL enzymes in Iran and throughout the world and the use of these antibiotics is becoming more and more limited. Therefore, the complete identification of ESBL by experiments, the restriction of the use of beta-lactam antibiotics and the use of beta-lactamase inhibitors can maintain the efficacy of beta-lactam antibiotics as much as possible.

Extrahepatic presentation in hepatitis is a relatively uncommon clinical condition. In particular, pancytopenia related to hepatitis is a rare phenomenon encountered in these patients. Pancytopenia can be associated with a variety of hepatitis viruses; however, its association with hepatitis A virus (HAV) is unusual. In current case series, we reported 11 children who presented with three suppressed blood lineages, including white blood cells, platelets, reticulocytes, and hemoglobin with mean values of 2.4 × 103/µL, 54.5 × 103/µL, 1%, and 9.4 g/dL. Of these 11 children, 5 were boys. The mean age was 6.5 years old. The patients presented with abdominal pain, hepatitis, and pallor. Biochemical analysis showed liver function enzymes were increased in all patients. Serologic studies for antibodies against viral components, including hepatitis B (HBV), hepatitis C (HCV), and HAV, as well as cytomegalovirus (CMV) showed positive results for anti-HAV IgM. Coombs tests were negative in all the patients. Clinicians should consider extrahepatic presentations of hepatitis infections, especially HAV infection that may present with non-specific clinical features. This can help health care providers to timely and correct diagnosis and treatment of this infection.

Typhoid splenic abscess is a rare clinical entity that can be fatal if left untreated. Herein, we reported a case of typhoid splenic abscess who responded to ultrasound-guided aspiration and antibiotic therapy. A 25-year-old Nepalese man with no significant medical history presented to the emergency department with fever and the left upper abdominal pain lasting for seven days. One month before his presentation to our hospital, he returned from an eight-week holiday in Nepal. Splenic abscess was diagnosed by abdomen ultrasound and enhanced-computerized tomography. The patient refused surgical intervention and ultrasound-guided abscess aspiration was performed while piperacillin-tazobactam was initiated. Blood and aspirated pus microscopy revealed Gram-negative bacilli and the culture grew Salmonella typhi, which was sensitive to piperacillin-tazobactam, ampicillin, ciprofloxacin, and ceftriaxone. Piperacillin-tazobactam was continued for 4 weeks with successful recovery. This case highlights the importance of considering typhoid splenic abscess in the differential of fever and abdominal pain in returning travelers.

Visceral leishmaniasis (VL) is an endemic disease in East and South Africa and the Mediterranean area. Fever, splenomegaly, and weakness are the most common symptoms of VL, but pulmonary involvement is very rare. The present study reports a patient with VL and pulmonary complication. An 18-year-old immunocompetent patient was referred to a local hospital with submandibular lymphadenopathy, nonproductive cough, and occasional fever. In spiral chest CT scan, bilateral massive bronchopulmonary consolidation with a diffused nodular pattern was seen. After a few days, because of absent response to antibiotic therapy and prednisolone, fine needle aspiration from pulmonary nodules was done that showed multiplex Leishman bodies. The patient showed a good response to amphotericin B and glucantime.