Archives of Clinical Infectious Diseases
Volume:16 Issue: 1, Feb 2021

 It seems that the risk of developing complications associated with coronavirus disease 2019 (COVID-19) is higher among individuals with weakened immune systems.

 Therefore, this study was carried out to determine the effectiveness of intravenous immunoglobulin (IVIG) for the treatment of patients not entering the intubation phase compared to those entering the intubation phase.

 This descriptive case-control study was performed on 26 patients with COVID-19 referring to Imam Reza hospital in Mashhad, Iran, in March 2020. For subjects with COVID-19 not responding to the standard three-drug protocol (i.e., ribavirin, hydroxychloroquine, and lopinavir/ritonavir), three doses of IVIG (0.4 g/kg/day) were added to the protocol. The patients were divided into two groups of subjects not entering the intubation phase and those entering the intubation phase and compared in terms of different variables.

 The comparison of laboratory findings showed a significant difference before and after receiving IVIG regarding oxygen saturation (P < 0.005), white blood cell (P = 0.001), hemoglobin level (P = 0.0002), lymphocyte count (P = 0.03), and C-reactive protein (P = 0.001). In general, 53.8% and 46.2% of the patients were discharged and expired, respectively. All the subjects not entering the intubation phase were recovered; nevertheless, only one case entering the intubation phase was recovered, and 92.3% of the patients expired. A significant difference was observed between the patients not entering the intubation phase and those entering the intubation phase in terms of mortality (χ2 = 22.28; P < 0.005).

 In summary, the obtained results of the current study confirmed the therapeutic effects of IVIG on patients with COVID-19. Moreover, better treatment results, shorter hospital stay, and lower mortality rates were observed among COVID-19 patients who did not enter the intubation phase in comparison with those entering the intubation phase.
 

 Transurethral resection of the prostate (TURP) has been widely used for patients suffering from bladder colonization with bacteria, increasing the probability of bacteremia and sepsis despite consuming prophylaxis antibiotics.

 The study aimed to evaluate the effect of pre- TURP bladder irrigation with 0.2% chlorhexidine in reducing postoperative bacteremia.

 This clinical trial study was conducted on 60 benign prostatic hyperplasia (BPH) patients who were candidates for TURP in the urology department of Al-Zahra Hospital. All patients suffered from urinary catheters, and they were allocated into two groups (n = 30). Antibiotic prophylaxis was prescribed for all the patients. In the case group, the bladder was rinsed by chlorhexidine 0.2% before TURP; however, and the bladder in the control group was rinsed by distilled water. Postoperative bacteria were evaluated using procalcitonin (PCT) measurement and BACTEC automated blood culture six hours after surgery.

 Positive BACTEC blood culture was observed in three (10%) and no (0%) patients in the control and case groups, respectively (P = 0.071). Moreover, 6.6 % and 46.6 % of the patients in the control group had low and high PCT levels, respectively. Furthermore, 40 % and 6.66 % of the patients in the case group had low and high PCT levels, respectively. There was a significant difference between the two groups in terms of the PCT level (P < 0.01).

 The frequency of patients with a high PCT level was higher in the control group than in the case group, suggesting that chlorhexidine in the catheterized patients undergoing TURP reduced the number of bacteria in the bladder.

 Coronavirus disease 2019 (COVID-19) as an alarming attack broke out in China and spread rapidly worldwide.

 Based on a theory indicating the correlation between some viral diseases and blood types, we investigated the relationship between blood groups and coronavirus infection risk in Guilan Province, Iran.

 Retrospectively, all the files of the admitted patients with suspected COVID-19, in peak conditions of the disease between March 1 and May 30, 2020, were reviewed using the Census method. The required data, including epidemiological and clinical information and outcomes, were obtained from electronic records.

 A total of 249 cases were analyzed, of whom 109 were collected from governmental centers, and the rest were collected from private hospitals. The most common co-morbidity was diabetes with 71 (37.6%) cases and the main symptom at the admission time was dyspnea with 170 (24.5%) cases. Of the total patients, 155 (62.2%) were discharged, and the rest died. The most common blood group among our patients was O Rh-positive with 91 (36.5%) cases. No meaningful correlation was found between outcomes and blood groups in terms of ABO types (P = 0.89) or Rh factor (P = 0.456). The Rh-positive proportion was significantly higher in the COVID-19 cases than in the general population (P = 0.038).

 We found that the Rh-positive proportion was significantly higher in the COVID-19 cases than in the healthy individuals. However, no correlation was observed between the groups regarding ABO typing.

 Recently, infection has been considered one of the most important causes of cancers because a large number of cases of cancer with infectious origin was reported.

 The present investigation aimed to evaluate the prevalence and risk factors of Blastocystis hominis infection in patients with colorectal cancer in comparison to healthy individuals.

 The present descriptive case-control study was performed on 67 healthy individuals and 67 patients with colorectal cancers attending the general hospitals of Lorestan Province, Western Iran from October 2017 to August 2018. Colorectal cancers were diagnosed by an experienced gastroenterologist. A fresh stool specimen was collected from each subject in a sterile labeled container. The collected specimens were tested microscopically using saline and iodine wet preparations, then stained with trichrome stain according to the manufacturer’s instruction to find the cases of B. hominis forms. The DNA of the samples was extracted and specific primer-polymerase chain reaction (PCR) was performed.

 Among the colorectal cancer patients, B. hominis was found in 16 (23.9%) patients, whereas of 67 healthy participants, 6 (9%) cases were found, indicating a significant difference (P < 0.001) in the prevalence B. hominis among the participants in the case and control groups. By the multifactorial logistic regression models, agriculture activity (0.24; 95% CI: 0.075 - 0.809), as well as consumption of unwashed fruit and vegetables (0.136; 95% CI: 0.040 - 0.459), were significantly related to the prevalence of B. homonis infection. All 22 positive samples (16 patients and 6 (9%) healthy people) were also positive by PCR method, indicating the presence of B. hominis and accuracy of microscopic examination, extraction, and PCR reaction.

 The obtained findings revealed that B. hominis may strongly link with human colorectal cancers given novel information about the important role of B. hominis in the progress of colorectal cancer. Nevertheless, more investigations are required to obtain accurate information about this suggestion.

 Prostate cancer is one of the most frequent cancers in men, with several risk factors, including infection. In this study, we aimed to assess the association of human papillomavirus (HPV) infection with prostate cancer risk and aggressiveness.

 This case-control study was performed on a total of 70 archival formalin-fixed paraffin-embedded (FFPE) prostatic tissue blocks. Among them, 35 histopathologically confirmed prostate cancer tissues and 35 benign prostate hyperplasia (BPH) samples were enrolled as cases and controls, respectively. The specimens were examined by the polymerase chain reaction (PCR) and in situ hybridization for the detection of HPV DNA of both low-risk (6, 11) and high-risk (16, 18) types.

 The primary results of PCR for the L1 region revealed HPV infection in 34.3% and 8.6% of the cases and controls, respectively (P = 0.018). The HPV typing using hybridization revealed a significant difference between the two groups in terms of infection with HPV types 16 and 18 (P = 0.003, P = 0.028, respectively). The findings showed no significant association of HPV infection with age and prostate specific antigen (PSA) level of the patients. In addition, no significant association was found between infection with HPV and Gleason score (GS).

 Our findings indicated that HPV infection, especially with high-risk types 16 and 18, has a significant association with prostatic carcinogenesis. In addition, although patients with GS = 7 showed higher rates of infection with HPV, we did not observe any statistical association between HPV infection and GS.

The virus causing COVID-19 disease is known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease spread rapidly and was transmitted like a contagious disease throughout China, and then it gradually spread in other parts of the world. Accordingly, the rapid and accurate detection of the SARS-CoV-2 virus plays an essential role in selecting timely treatments, saving lives, and preventing the spread of the disease. This study summarizes the methods used to identify coronavirus nucleic acid. The effectiveness of coronavirus nucleic acid detection kits by different samples and the performance of other diagnostic techniques are also addressed in this study. We searched Embase, Google Scholar, MEDLINE, Web of Science, Scopus, and PubMed databases as well as the references of all relevant articles in English published during 2019 - 2020 using keywords related to COVID-19, detection kits, and respiratory failure and proceedings from relevant conferences and congresses. The authors collected the relevant reports, and each of the authors independently reviewed the data published in different studies. The results of previous studies indicated that the diagnosis methods of the COVID-19 disease are the RT-PCR method, ELISA kits, quick tests, white blood cell count, C-reactive protein (CRP) levels, other laboratory factors and antigenic detection methods. Given the sensitivity and specificity of these methods at different periods using different samples, the disease interpretation can be performed accurately. The findings showed that proper laboratory equipment and appropriate laboratory kits are necessary for the rapid and precise identification of COVID-19.

 Vitamin D insufficiency is common in critically ill patients. It is hypothesized that vitamin D deficiency would be associated with sepsis in the critically ill. Thus, the present study aimed to investigate the association between vitamin D and sepsis severity.

 In this cross-sectional study, patients with sepsis referring to a university hospital in Tehran, Iran, from February 2018 to March 2019 were included. Plasma concentrations of vitamin D in critically ill subjects admitted were assessed. Data were analyzed using SPSS version 20.0. P-values less than 0.05 were considered statistically significant.

 Among the investigated patients, the mean serum level of vitamin D3 was 19.03 ± 13.08 ng/mL. The prevalence of vitamin D insufficiency in critically ill subjects with sepsis was 100% (150/150). Only sex (P = 0.01) indicated a significant association with vitamin D. Patients suffering from severe sepsis had lower levels of vitamin D compared to the patients with non-severe sepsis (P = 0.07).

 The present study showed that all critically ill patients studied had vitamin D insufficiency. In line with the biological evidence, the present study suggests that vitamin D deficiency may predispose patients to sepsis. Further studies are needed to establish the causes and mechanisms underlying these interpretations.

This study aimed to compare the effects of inhaled colistin and inhaled amikacin-fosfomycin combination in the treatment of ventilator-associated pneumonia (VAP) caused by extensively drug-resistant (XDR) Acinetobacter. This clinical trial is the first study to evaluate the effect of inhaled fosfomycin on VAP in Iran.

In this clinical trial, 60 patients with Acinetobacter VAP were divided into two groups of 30 patients. The empirical regimen changed to meropenem plus intravenous colistin in both groups. Inhaled colistin in the first group and inhaled amikacin-fosfomycin in the second group were added to the intravenous therapy. Next, the mortality rate, if any, duration of treatment success, and patient withdrawal from VAP were evaluated in the two groups.

Although the mean clinical pulmonary infection score (CPIS) before treatment was not significantly different between the two groups, the mean score of the amikacin-fosfomycin group was significantly lower at 72 hours and seven days after the onset of treatment and at the end of treatment. Based on the intra-group assessments, the CPIS in both groups was significantly reduced (P < 0.001). Also, in the inter-group assessments, the mean CPIS changes were significantly different between the two groups, and in the amikacin-fosfomycin group, a greater reduction in the CPIS was observed (P = 0.007).

The findings of the present study showed that the use of amikacin-fosfomycin nebulization could lead to increased recovery and reduced treatment duration in patients with VAP, caused by drug-resistant Acinetobacter baumannii.

Rotavirus A species is associated with severe gastroenteritis in children. Rotavirus G1P[8] was the most prevalent genotype found in Kuwait in a study conducted between 2005 and 2006. The RotaTeq vaccine was included in the Kuwait national immunization program at the end of 2017.

Since there is no available data on the rotavirus genotypes circulating before the introduction of the vaccine, we conducted a study to investigate the role of rotaviruses in causing severe diarrhea in children hospitalized in a major tertiary referral hospital in Kuwait during the year 2016.

Viral RNA was isolated from the stool samples of 101 children under five years of age, hospitalized for acute gastroenteritis. Rotavirus VP4 and VP7 dsRNA were detected by RT-PCR, and their partial sequences were analyzed by phylogenic analysis.

Rotavirus dsRNA was detected in 24.7% of children with median age of 1 year. The genotype G3P[8] accounted for 47% of cases, followed by G1P[8] (26%), G9P[8] (10.5%), G4P[8] (10.5%), and G9P[4] (5%). Only VP7 nucleotide sequences of rotavirus G3 or G4 type clustered in the same lineage as RotaTeq vaccine, while most VP4 nucleotide sequences of rotavirus P[8] type clustered in a different lineage compared to Rotarix and RotaTeq vaccines.

Our findings highlight the role of rotavirus G3P[8] in causing severe diarrhea and invites future investigations to know whether the recent introduction of RotaTeq vaccine in Kuwait selects certain genotypes and subgenomic lineages.

 Identification of the causes of gallstone would result in better planning for the prevention of this disease. One of the proposed risk factors for this problem is Helicobacter pylori(H. pylori) infection.

 The purpose of this study was to determine the incidence rate of gallstone in patients with H. pylori gastritis.

 This was an observational study performed as a descriptive-comparative cross-sectional survey. We enrolled 169 consecutive patients with H. pylori gastritis admitted to Imam-Hossein Hospital, Tehran, Iran, in 2018, and gallstone frequency in them was determined and compared with other variables.

 Overall, 14 (8.3%) patients had gallstone, and all the patients had H. pylori gastritis. There was no significant association between gallstone and H. pylori gastritis (P = 0.561).

 It may be concluded that gallstone frequency in patients with H. pylori gastritis is low, and there is no significant association between these two conditions.