Archives of Clinical Infectious Diseases
Volume:16 Issue: 2, Apr 2021

 Bacteremia is the status, which is detected via a positive blood culture test with no contamination. Centers for Disease Control and Prevention (CDC) indicates that direct medical procedures and total costs are significantly high. Antibiotic resistance can play a major role in the costs, which are related to the long duration of treatment.

 The aim of this study was to investigate the rate and profiles of antimicrobial susceptibility of blood culture isolates from Tehran, Iran.

 In the current cross-sectional study, a total of 5,000 blood culture samples were collected from patients hospitalized in the Loghman General Hospital, Tehran, Iran, with positive blood culture results from 2012 to 2013. Susceptibility to antimicrobial agents was analyzed using National Committee for Clinical Laboratory Standards guidelines.

Coagulase-negative staphylococci (38.8%), Staphylococcus aureus (20.5%), Acinetobacter (11.9%), and Escherichia coli (11.7%) were the most frequent bacteria isolated from the blood cultures, collectively accounting for > 80% of the isolates. Of isolated microorganisms, 63.75% and 36.24% belonged to Gram-positive and Gram-negative bacteria, respectively. Moreover, 88% of the isolates were MRSA (oxacillin-/methicillin-resistant), and 7% were VRE (vancomycin-resistant).

 The most frequent isolated organisms were Gram-positive bacteria, and the rate of MDR (multi-drug resistance) was high. The results of the current study obviously indicate the misuse of antibiotic in society. National surveillance studies in Iran will be useful for clinicians to choose the right empirical treatment and will help control and prevent infections caused by resistant organisms.

 Brucellosis is the most common zoonotic disease in Iran, imposing a significant financial burden on the healthcare system. The diversity of non-specific clinical manifestations of this disease can lead to misdiagnosis or delayed diagnosis. Therefore, it is important to pay attention to other aspects of this disease.

 This study aimed to determine the epidemiology, clinical and laboratory manifestations, and outcomes of brucellosis.

 In this cross-sectional study, brucellosis patients, admitted to three hospitals, affiliated to Shahid Beheshti University of Medical Sciences (Tehran, Iran) from April 2015 to September 2020, were examined. The patients' medical records were reviewed for epidemiological, clinical, and laboratory findings. The outcomes of the disease were evaluated by phone calls.

 Of the 104 patients included in this study, 53.8% were male, and 46.2% were female. The mean age of the patients was 43.07 ± 18.521 years. Unpasteurized dairy consumption and contact with livestock were reported in 60.6 and 27.9% of the patients, respectively. Also, 23.1% of the patients had high-risk occupations. The most common symptoms included fever (80.8%), chills (58.7%), backache (55.8%), and sweating (51%). The most common complication was osteoarticular involvement (21.2%), followed by neurobrucellosis (6.7%). Elevated alkaline phosphatase (89.7%), anemia (67.3%), increased C-reactive protein (57.7%), and increased erythrocyte sedimentation rate (48.1%) were common laboratory findings. The rates of improvement, treatment failure, and relapse were 86.9, 9.1, and 4%, respectively. There was no significant relationship between the rate of improvement and the antibiotic regimen. However, the most common cause of treatment failure was the patient’s poor compliance with treatment.

 The diversity of non-specific clinical manifestations of brucellosis is a diagnostic challenge. Therefore, physicians must request laboratory tests to evaluate brucellosis after taking a precise epidemiological and clinical history of suspected cases.

 Toxoplasma gondii, an obligate intracellular parasite, can be involved in the infection of the male reproductive system.

 Since more than a third of the human population and an increasing number of couples with idiopathic infertility are affected by toxoplasmosis, there is a necessity to evaluate the effects of T. gondii on the reproductive system.

 In this experimental study, detailed description of sperm parameters, hormone levels (testosterone, follicular stimulating factor [FSH], and luteinizing hormone [LH]), and histomorphometric analysis were gathered every 10 days on T. gondii infected Wistar male rats until day 80. Data on testis and body weight were also collected.

 Sperm parameters (motility, viability, count, and normal sperms) as well as LH level were significantly lower in infected rats. No significant decrease was observed in FSH and testosterone levels. The number of Leydig cells significantly decreased on day 20. Significant reduction of Sertoli cells was also detected on day 60. Bodyweight reduced significantly on days 20 and 60, but the testis weight was elevated.

 T. gondii infection can lead to diminished fertility parameters, but not sterility in rats. The parasite could temporarily interfere with the male reproductive system.
 

 Vulvovaginal candidiasis (VVC) is the most frequent fungal disorder in healthy and normal women.

 The aim of this study was to evaluate the in vitro antifungal susceptibility of clinical isolates Candida albicans and Candida glabrata, the two most common candida species in Iranian patients with VVC.

 One hundred and eight clinical isolates of candida, including; C. albicans (n = 77) and C. glabrata: (n = 31) were isolated from the 108 patients with VVC. The in vitro activity of caspofungin (CAS), amphotericin B (AMB), voriconazole (VRC), itraconazole (ITC), fluconazole (FLC), and nystatin (NYS) were determined according to the CLSI M27-A3 and CLSI M27-S4.

 Our results were shown 8 (25.8 %) and 6 (7.8 %) C. glabrata and C. albicans isolates resistance to FLU, respectively. Furthermore, resistance to VRC and ITC were observed in 8.4%, and 3.7% of all isolates, and six isolates (5.6%) had intermediate MIC to CAS.

 We reported 8 (25.8 %) and 6 (7.8 %) C. glabrata and C. albicans isolates resistance to FLU, respectively. Furthermore, resistance to VRC and ITC were observed in 8.4% and 3.7% of all isolates, respectively.

 Chlamydia trachomatis is one of the most common sexually transmitted infections in the world. However, there is no detailed information on its incidence, especially in developing countries where routine laboratory diagnosis is unavailable.

 This study aimed to investigate the prevalence of endocervical C. trachomatis infection and related risk factors among women attending the University Gynecology Clinic of Birjand, East of Iran.

 This cross-sectional study was conducted on 195 women attending the University Gynecology Clinic in South Khorasan, Birjand. Endocervical sampling was performed in a lithotomy position using a sterile brush. Identification of C. trachomatis was performed by real-time PCR method using GeneProof C. trachomatis PCR kit. Data on socio-demography and potential risk factors for genital infection were analyzed using SPSS software (version 21).

 In the study, the prevalence rate of C. trachomatis among women was reported 4.1% (8/195 subjects). Statistical analysis showed that the rate of C. trachomatis infection in women was only statistically related to the history of vaginal infection (P = 0.001). Although there was no statistically significant association between chlamydial infection and age, the highest infection rate was in women less than 30 years old.

 Given the relatively significant incidence of C. trachomatis infection among women, our findings highlight the importance of routine screening and early diagnosis of C. trachomatis to control the infection.

 Pyrazinamide is one of the most important first-line medications for the treatment of tuberculosis and an alternative intake for MDR-TB and XDR-TB patients.

 The purpose of this study was to evaluate resistance to pyrazinamide in the isolates resistant to the Mycobacterium tuberculosis drug in patients in the city of Isfahan.

 In this study, the drug susceptibility test was performed with pyrazinamide using the proportion method and PZA assay on 47 isolates resistant to Mycobacterium tuberculosis. Then, the mutations of the pncA and rpsA genes of the isolates resistant to pyrazinamide were evaluated by the sequencing method.

 According to the proportion method, 19 cases were resistant to pyrazinamide, 16 of which had mutations in their pncA and rpsA genes. Besides, five new mutations were recorded, and three isolates lacked mutations in the mentioned genes.

 Pyrazinamide resistance is high in MDR-TB and INH mono-resistant isolates. Therefore, evaluating the susceptibility to pyrazinamide in patients with MDR-TB before the initiation of treatment with pyrazinamide is considered essential.

 People with diabetes mellitus (DM) have a higher risk for drug-resistant tuberculosis (DR-TB). DR-TB patients with comorbidity of DM were also vulnerable to experience adverse effects of DR-TB treatment. Management of DR-TB with comorbidity of DM is complicated. Also, DM may affect TB response treatment and cause more adverse effects.

 This study was conducted on DR pulmonary TB (DR-PTB) patients to evaluate the effect of DM on adverse effects, especially renal function impairment and audiology impairment, as well as treatment outcomes due to treatment regimens containing kanamycin.

 A retrospective study was conducted from 2016 to 2017 at Dr. Soetomo Hospital. Patients who received DR-TB regimens containing kanamycin were included in this study. HbA1c >7 was used to define DM. The adverse effects in this study were impaired renal function (increased serum creatinine) and audiology impairment.

 Patients who experienced increased serum creatinine were 28/82 (34.1%) with DM and 20/120 (16.7%) without DM, audiology impairment were 22/82 (26.8%) with DM and 19/120 (15.8%) without DM, and unfavorable outcome were 37/82 (45%) with DM and 46/120 (38%) without DM. Moreover, DM is associated with adverse effects and treatment outcomes. Patients with DM have a risk ratio (RR) for increased serum creatinine, audiology impairment, and unfavorable outcome with RR 2.049 (95% CI: 1.242 – 3.379), RR 1.694 (95% CI: 0.982 – 2.925), and RR 1.177 (95% CI: 0.847 – 1.636), respectively.

 Diabetes mellitus increases the risk of adverse effects, increased serum creatinine, and audiology impairment. Also, it increases the risk of unfavorable treatment outcomes in patients with DR-PTB who receive DR-TB regimens containing kanamycin.

 vaginal infections are common among women referring to gynecological clinics worldwide, but treatment modalities cannot provide complete remission of the disease. Laboratory diagnosis of vaginal infections using more sensitive and specific methods is essential for the best treatment options.

 In this study, diagnosis of bacterial vaginosis (BV) using the polymerase chain reaction (PCR) method was investigated.

 vaginal samples were collected from 635 symptomatic women referring to gynecology clinics in Chaharmahal and Bakhtiari, Iran, in 2017. All samples were then diagnosed using microscopy, culture, and PCR methods.

 Of 635 symptomatic women, 200 cases (31.4%) were diagnosed with BV according to the culture method using the PCR method. However, 3.9% of samples who were negative based on the culture method, were diagnosed to have BV based on PCR results.

 PCR is more sensitive than culture and microscopy methods for the diagnosis of BV.

 This study aimed to assess the outcome and mortality predictors of SARS-CoV-2 infection requiring hospitalization among elderly population.

 In this retrospective study, hospitalized elderly people with virologically confirmed SARS-CoV-2 infection were evaluated. Participants were divided into three groups of mild, moderate, and severe based on oxygenation. The primary outcome was death or discharge to home.

 A total of 169 patients were studied (mean age: 68 years). Apart from respiratory symptoms, other reported symptoms included gastrointestinal complaints in 11% (n = 19), acute stroke in 1.1% (n = 2), delirium in 1.7% (n = 3), and anosmia or ageusia in 8.88% (n = 15). Also, 65 (38.5%) patients required oxygen support, 25 (14.7%) were admitted to the intensive care unit (ICU), 7 (4.1%) required non-invasive ventilation (Fio2 0.6 to 1.0), 14 (8.28%) were mechanically ventilated. 72 (42%) received steroid, and 100 (59%) received prophylactic heparin. Overall mortality was 12.4% (n = 21). Gender had no effect on mortality (P = 0.83). Presence of ≥ 3 risk factors, elevated neutrophil lymphocyte ratio, D-dimer, and lactate dehydrogenase, were associated with mortality (P = 0.001, P = 0.0005, P = 0.05, and P = 0.0005, respectively). Sepsis and cardiovascular events were higher among those who died.

 We observed a low mortality among the elderly treated with steroids compared to studies done in the pre-steroid period. Elevated NLR, LDH, and D-dimer were associated with mortality.