Background: Drug addiction is known to compromise the immune system, thereby increasing susceptibility to infectious diseases. However, the status of visceral leishmaniasis (VL) among drug users, a high-risk group, has not been well understood yet. Therefore, this study aimed to explore the seroepidemiology of VL among drug users in Fars Province, southern Iran. Methods: This cross-sectional study analyzed 1,400 serum samples from drug users in Fars Province for anti-Leishmania antibodies using a homemade enzyme-linked immunosorbent assay method. The data collected during sampling were documented in a questionnaire and analyzed with SPSS (version 27). Results: The mean age of the participants was 44.59 (±12.50) years, with 52.7% aged between 40 and 50 years. Anti-Leishmania antibodies were detected in the sera of 27 (1.9%) of the subjects, predominantly in males (92.6%). No significant gender difference was observed in the presence of antibodies. Additionally, seroprevalence did not noticeably differ between injecting and non-injecting drug users. Eventually, the majority of seropositive individuals were under the age of 20 years (18.2%, n=11), highlighting a higher burden among younger participants. Conclusion: The findings revealed a significant prevalence of VL among drug users in Fars Province, indicating the importance of tailored public health initiatives and additional studies to support this at-risk group.
Background: Escherichia coli is a common intestinal commensal that includes pathogenic strains responsible for sepsis, gastrointestinal infections, and urinary tract infections (UTIs). Its diverse pathotypes, virulence factors, and O-serogroups contribute to its clinical significance. The emergence of multidrug-resistant (MDR) strains has complicated treatment strategies, representing a critical global health concern. Methods: A literature search was conducted on PubMed, Scopus, and Google Scholar using the keywords E. coli, pathogenicity, O-serogroups, immune evasion, and antibiotic resistance to identify peer-reviewed English-language studies. Included were studies focusing on E. coli virulence, immune evasion, and MDR, while non-English studies, case reports, and editorials were excluded. Results: Our analysis indicates that O-serogroups O25, O78, O145, and O157 are predominantly associated with MDR profiles, especially against β-lactams and aminoglycosides. This high prevalence of MDR in these serogroups significantly complicates clinical management, often leading to prolonged hospital stays, increased treatment failures, and higher rates of severe complications such as hemolytic uremic syndrome (HUS) in EHEC infections or recurrent UTIs in UPEC cases. For instance, resistance of O25 to β-lactams, observed in 92% of isolates for piperacillin, limits the efficacy of first-line therapies and necessitates the use of last-line antibiotics such as carbapenems, which may increase healthcare costs and the risk of further resistance development. The high resistance rates in these serogroups are attributed to O-antigen variability and the horizontal transfer of resistance determinants. Conclusion: This study underscores the clinical significance of O-serogroup diversity in E. coli infections and its impact on therapeutic challenges. Understanding the distribution of virulence factors and resistance genes among key serogroups provides critical insights for developing effective management strategies for MDR E. coli infections. Future research should prioritize innovative therapeutic approaches targeting serogroup-specific resistance mechanisms.
Background: Antibiotic-resistant enterococci have turned into major pathogens in humans in Iraq. Therefore, this study examined genetic variations and clonal relationships among Enterococcus strains concerning antibiotic resistance in Al-Diwaniya, Iraq, using RAPD-PCR. Methods: Overall, 250 clinical samples were collected under sterilized conditions between December 2020 and May 2021. Using standard methods, enterococci isolates were identified and evaluated for antibacterial susceptibility. Moreover, molecular techniques were utilized to examine genetic variations and clonal relationships of Enterococcus spp. and detect EsβL genes. The random amplified polymorphic deoxyribonucleic acid-polymerase chain reaction (RAPD-PCR) results were analyzed by BioNumerics software. Results: Thirty-four enterococci strains were isolated and identified by amplifying and sequencing the 16S–23S rRNA gene. Of these strains, 82.3%, 8.8%, 5.8%, and 2.9% were identified as E. faecalis, E. faecium, E. casseliflavus, and E. gallinarum, respectively. The highest antibiotic resistance among E. faecium isolates was associated with ampicillin, cefotaxime, ceftriaxone, and gentamicin (100%), while the lowest resistance belonged to chloramphenicol (66.60%). Multidrug-resistant and extensively drug-resistant strains were present in 50% and 5.8% of the enterococci isolates, respectively. The presence of the bla-TEM, bla-SHV, and bla-CTX-M2 genes in several isolates at frequencies of 44.1%, 38.2%, and 11.7%, respectively, indicated the spread of antibiotic resistance mechanisms. RAPD results confirmed a relationship between RAPD patterns, isolate sources, and antibiotic resistance patterns. Conclusion: Our findings demonstrated a distinct genotypic variety of the E. faecalis, E. faecium, E. casseliflavus, and E. gallinarum strains isolated from various clinical cases. RAPD analysis proved to be highly effective in determining the genetic variation among Enterococcus species.
Background: Helicobacter pylori infection is highly prevalent worldwide and can cause serious complications, necessitating effective eradication regimens. Rising antibiotic resistance has reduced the efficacy of the standard triple therapy involving antibiotics, proton pump inhibitors (PPIs), and bismuth. Mastic gum exhibits promising antibacterial properties and may enhance eradication rates when combined with standard treatment, potentially limiting resistance. This study evaluates a modified triple regimen incorporating mastic gum for H. pylori eradication, providing insights into alternative treatment options. Methods: In this randomized controlled trial (Trial Registration: NBEAH-2023-001), 360 H. pylori-positive patients were assigned to two groups: Group A received standard triple therapy (clarithromycin, amoxicillin, and omeprazole), and Group B received the same triple therapy plus mastic gum capsules for 10 days. H. pylori infection was confirmed pre-treatment by urea breath and fecal antigen tests. Eradication rates post-treatment were compared using chi-square tests, with significance set at p≤0.05. Data analysis was performed using SPSS version 20. Results: In Group B (n=180), 14 patients (7.8%) remained H. pylori-positive after treatment, yielding a 92.2% eradication rate. In Group A (n=180), 66 patients (36.7%) remained positive, yielding a 63.3% eradication rate. The difference in eradication rates was statistically significant (P≤0.001). Conclusion: Adding mastic gum to standard triple therapy significantly improves H. pylori eradication rates. This combination may serve as an effective alternative, particularly in antibiotic-resistant infections, and could help reduce antibiotic use and resistance development.
Background: The accurate and timely diagnosis of tuberculosis (TB) is crucial in the effective management and control of this infectious disease. Several molecular tests have been developed and are currently utilized for the diagnosis of Mycobacterium tuberculosis (MTB) in suspected patients. This study aimed to investigate various criteria affecting both the analytical and clinical specificity and sensitivity of primer pairs derived from published literature. The study also compared these established primer pairs with two novel primer pairs using in silico and in vitro methodologies. Methods: All studies related to the detection of MTB using polymerase chain reaction (PCR) and quantitative PCR (qPCR) were included based on established criteria. Eventually, all reported primer pairs were analyzed using in silico online software tools. Results: Among the 386 primarily retrieved articles, 98 met the eligibility criteria and were included for data extraction and analysis. Of these, 85 studies (86.7%) employed endpoint PCR, while 13 studies (13.3%) utilized q-PCR. All reported primers were thoroughly analyzed, resulting in the selection of six primers. Approximately 50% of the analyzed primer pairs targeted IS6110 and demonstrated a clinical sensitivity exceeding 80%. The rpoB gene revealed that nearly 35% of the primer pairs exhibited a clinical sensitivity greater than 80%. Conclusion: The newly designed primers, based on in silico analysis, represented favorable clinical sensitivity and specificity. Consequently, PCR using these primers may prove to be highly beneficial for the diagnosis and management of TB in low-resource settings.
Background: Identifying the genotypes of Mycobacterium tuberculosis (MTB) enables the classification of tuberculosis (TB) isolates at the strain level and facilitates phylogenetic analysis of the bacterium. This study aimed to determine and evaluate the genetic diversity and phylogenetic relationships of both drug-susceptible and drug-resistant Mycobacterium tuberculosis complex (MTBC) isolates with respect to first- and second-line anti-tuberculosis drugs using the 24-locus Mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) genotyping approach. Methods: A total of 81 MTBC isolates, including both drug-susceptible and drug-resistant strains, were collected from patients with pulmonary and extrapulmonary tuberculosis. All collected isolates were then subjected to genotyping using the 24-locus MIRU-VNTR method. Results: Among the 81 MTBC isolates, 72 distinct MIRU-VNTR patterns were identified. Of these, six were clustered together, while 66 isolates exhibited unique patterns. The identified genotypes included Delhi/CAS (35 isolates), NEW-1 (25 isolates), LAM (eight isolates), H37Rv (four isolates), Beijing (three isolates), Mycobacterium bovis (three isolates), URAL (two isolates), and UgandaI (one isolate). Conclusion: The Delhi/CAS genotype was the most common, while the UgandaI genotype was the least common among the studied isolates. Additionally, isoniazid-resistant isolates were more frequently observed within the Delhi/CAS genotype compared to others; however, no specific genotype was linked to drug resistance.
Background: Ocular brucellosis is a rare manifestation, and most references in the literature consist of case reports, resulting in a lack of data on the incidence of this condition. This study presents a case of anterior uveitis due to brucellosis in a liver transplant patient. Ocular involvement in organ transplant patients can arise from various causes; however, given the patient’s history and occupation, Brucella-related ocular involvement was strongly suspected in this case. Case Presentation: This is the first reported case of uveitis attributed to Brucella infection in an organ transplant patient. The patient had undergone a liver transplant 10 years ago due to familial hyperlipidemia and was taking Cellcept and Tacrolimus daily as antirejection medications. Additionally, he had a background as a rancher and farmer and reported a history of consuming small amounts of raw milk, although he had not consumed it so regularly in the past. He was referred for evaluation with a two-month history of fatigue, photophobia, and a mild decrease in visual acuity, presenting in May 2022. The complicated Brucella uveitis was diagnosed by a combination of clinical manifestations, including fever, as well as epidemiological and serological findings and ophthalmological examination. The patient was treated with gentamicin, doxycycline, and cotrimoxazole in the first week and was discharged and completed a twelve-week outpatient treatment course with doxycycline 100 mg twice daily, cotrimoxazole 800/160 mg every 12 hours, and ciprofloxacin 500 mg every 12 hours. The patient’s symptoms, including ocular discomfort and fever, completely resolved within four weeks. In addition, Brucella serology tests demonstrated a decline over three months, with no relapses occurring during the subsequent 24-month follow-up period. Conclusion: Although uveitis caused by various opportunistic infections is not uncommon among organ transplant patients who are undergoing treatment with immunosuppressive medications, it is important to specifically consider Brucella infections in areas where Brucella is endemic. In such areas, healthcare providers should perform appropriate investigations for Brucella in these cases to ensure accurate diagnosis and appropriate treatment.
Background: Cystic echinococcosis (CE) is a neglected zoonosis caused by Echinococcus granulosus. This cross-sectional study aimed to determine the seroepidemiological status and associated risk factors of CE in South Khorasan province, Iran. Methods: Overall, 400 participants were systematically recruited from comprehensive health service centers. Demographic data and risk profiles (dog contact, raw vegetable consumption, and handwashing routines) were collected after obtaining informed consent. Serum samples were tested for anti-Echinococcus immunoglobulin G using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Finally, the associations between seropositivity and various exposures were assessed using chi-square tests and logistic regression. Results: In general, 5 out of 400 subjects tested positive, yielding an overall seroprevalence of 1.25%. Although men exhibited a marginally higher rate (2.3%) than women (0.7%), this difference was not significant. Irregular handwashing and frequent consumption of raw vegetables revealed significant associations with increased seroprevalence. Meanwhile, dog ownership, urban vs. rural residence, and educational status demonstrated no statistically significant relationships. Moreover, farmer occupation had notably higher positivity (8.5%) than other groups. Conclusion: Our findings highlight the role of personal hygiene and dietary practices in transmission. Despite a relatively low prevalence, CE remains an ongoing public health concern in Birjand, particularly for certain high-risk groups. Accordingly, preventive efforts (e.g., promoting regular handwashing, ensuring careful vegetable cleaning, and strengthening livestock management) merit attention from local health authorities.
Human toxocariasis, caused by the larvae of Toxocara canis and Toxocara cati, is a globally prevalent parasitic disease with significant public health implications. Although soil is a primary route of transmission for Toxocara spp., data on soil contamination in Iran remain limited. To address this gap, the present study expands upon a systematic review published in 2018, which analyzed studies conducted between January 2000 and November 2016. This study provides an updated estimate of the prevalence of Toxocara spp. eggs in soil from public areas in Iran, using recent data to guide control strategies. A comprehensive literature search was performed in accordance with PRISMA guidelines, covering studies published between 2000 and April 2025. A random-effects meta-analysis was conducted to pool prevalence rates, and associations with geographic and environmental factors were examined through meta-regression and sensitivity analyses. A total of 28 studies (31 datasets) were included, comprising 6,264 soil samples collected from 25 Iranian provinces. The pooled prevalence of Toxocara spp. eggs was 16% (95% CI: 12–21%), with high heterogeneity (I² = 94.4%, P < 0.001). The high heterogeneity (I² = 94.4%) observed across studies may be attributed to differences in sampling methods, climatic conditions, study quality, and regional variations in stray animal density. Prevalence varied by region and climate, with the highest rates reported in the Central region (23%) and in hot desert climates (20%). No statistically significant effects of sample size, year of publication, or environmental variables were observed. These findings underscore significant environmental contamination by Toxocara spp. eggs throughout Iran. This contamination indicates an ongoing risk of human infection. These results highlight the need for geographically targeted interventions, public education, and integrated One Health strategies to inform health policy and prevent human toxocariasis.
Background: The genus Providencia, a member of the Enterobacteriaceae family, has emerged as a significant pathogen in human infections, particularly in immunocompromised individuals and hospital settings. With increasing global reports of antimicrobial resistance in Providencia species, understanding the resistance patterns and mechanisms in specific geographic regions is critical. This review evaluated the antibiotic resistance status of Providencia spp. in Iran, summarizing findings from existing literature to identify trends, gaps, and implications for public health and clinical practice. Methods: For this purpose, Google, PubMed, and Scopus databases were searched, along with conducting a systematic review of peer-reviewed articles, clinical case reports, and surveillance studies to assess the antibiotic resistance profiles of Providencia in Iran. Studies published from 2000 to 2024 were included in this review, with a focus on Providencia resistance to critical antibiotics such as carbapenems, cephalosporins, fluoroquinolones, and the like, which are multidrug resistant (MDR) or pandrug resistance (PDR) Providencia based on CLSI performance guidelines for antimicrobial susceptibility testing. The data were analyzed to identify prevalent resistance genes, mechanisms, and regional variations. Results: The findings revealed a concerning rise in MDR among Providencia isolates in Iran, with resistance to carbapenems, fluoroquinolones, aminoglycosides, and extended-spectrum beta-lactams frequently reported. Regional studies highlight variability in resistance rates, likely reflecting differences in antimicrobial stewardship and healthcare practices. Emergency PDR Providencia is a serious health threat due to its intrinsic resistance to some antibiotics, such as colistin, and tigecycline, which are used for other MDR Enterobacteriaceae species. Accordingly, understanding regional resistance patterns is helpful in choosing the appropriate treatment option. Conclusion: Given the high rate of carbapenem resistance, this is likely substantiated by other studies conducted in Asia that have identified various carbapenemases, including VIM, IMP, NDM-1 MBL, OXA-48, and KPC, which underscores the urgent need for effective antimicrobial stewardship and surveillance strategies to combat the spread of these resistant pathogens.
Background: Effective surface disinfection techniques are necessary to decrease the risk of dissemination of hospital-acquired infections (HAIs), which pose a serious concern in the healthcare industry. The aim of this study was to evaluate the efficacy of four disinfectants (Lysoformin 3000, Epimax Surclean, Minuten Spray, and Epimax quick) in reducing pathogenic bacteria on surfaces in the intensive care units (ICUs) of Abadan and Khorramshahr hospitals. Methods: A descriptive-analytical approach was used with non-probability convenience sampling in three hospitals. High patient and staff contact areas were taken into consideration when choosing sampling locations. Before and after each agent’s disinfection, 240 samples in total were gathered and then subjected to culture and biochemical testing to determine the presence of pathogens. Paired t-tests were utilized for statistical analysis. Results: Before disinfection, the mean colony counts of pathogenic bacteria were determined for each disinfectant in different ICU locations. After disinfection, significant reductions in pathogen counts were observed for all four disinfectants. Commonly identified Gram-negative bacteria included Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli, while Staphylococcus aureus and Enterococcus were prevalent among Gram-positive bacteria. Conclusion: Effective disinfection is critical in healthcare settings to reduce the risk of infection transmission. The findings highlight the importance of selecting appropriate disinfectants tailored to specific circumstances and pathogens. Continued research and improvement of disinfection protocols are essential to meet the evolving challenges of infection control. This study contributes to the knowledge base for improving the safety of healthcare environments and reducing HAIs.
Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infections among women. This virus, which has a global distribution, is one of the most serious factors related to cervical cancer (CC). Despite the importance of the virus, there is not enough information about its prevalence in Iran. The aim of this study was to investigate the frequency of HPV and its common types in healthy women referred to HPV screening centers by polymerase chain reaction (PCR) and compare it with cytology results. Methods: In our cross-sectional study, 271 vaginal and cervical swab samples collected from December 2016 to November 2017 and examined in terms of cytology were received from the laboratory. The samples were related to married women aged 16–72 years. The cytological examination was performed on each specimen. Then, the presence of HPV was investigated using PCR. Positive samples were typed by specific primers of genotypes 6, 11, 16, and 18. Results: Out of 271 samples, 50 (18.45%) were positive for HPV by PCR. These positive samples demonstrated normal or inflammatory cytology. Among all samples, 1 (0.3%) and 4 (1.47%) cases were positive for HPV-18 and HPV-6, respectively; however, types 11 and 16 were not detected. Conclusion: Although all samples were negative on the Pap smear, DNA HPV was found in at least 18.45% of the samples. Considering the identification of at least one case of high-risk genotype 18, it is recommended that PCR be used alongside Pap-smear screening, as it enables earlier detection of HPV infections compared to cytology alone, potentially enhancing CC prevention strategies.
Cervical cancer (CC) ranks fourth in incidence and is one of the most serious global health problems. Infection with high-risk human papillomaviruses (hrHPV), including types 16 and 18, plays a significant role in the occurrence of this type of cancer. Micro ribonucleic acids (miRNAs) and long non-coding RNAs (lncRNAs) are essential in various cellular processes. The effect of changes in the expression of these oligonucleotides on carcinogenesis has been confirmed in many research studies. Therefore, investigating the differential expression of miRNAs and lncRNAs in cancer biology is a useful method for early detection of precancerous lesions. This research aimed to review the current knowledge on the correlation between HPV infections, dysregulation of miRNAs, and lncRNAs in CC patients. The required data were searched and collected by entering relevant keywords in scientific databases, such as the National Center for Biotechnology Information, ScienceDirect, EMBASE, Scopus, and Google Scholar. Articles related to HPV infections, dysregulation of miRNAs, and lncRNAs in CC were selected for review and study. Based on our findings, various alterations and deregulation of expression profiles in miRNAs and lncRNAs by comparing healthy people and patients were reported regarding CC. Furthermore, it was found that persistent infection with HPV affects miRNA and lncRNA expression patterns. E6 and E7 oncoproteins of HPV are the two main proteins in cervical carcinogenesis. This search highlighted 43 deregulated miRNAs and 37 deregulated lncRNAs. By further analyzing and identifying the exact mechanism of function and the relationship between HPV oncoproteins and the expression changes, it is possible to achieve great goals in the field of early diagnosis and treatment of CC.
Background: Toxoplasmosis is a common zoonotic disease in the world, which is caused by an intracellular protozoan parasite called Toxoplasma gondii. In its congenital form, the pathogen is transferred to the fetus through placenta. The acquired infection is caused by either consuming contaminated meat and vegetables or contact with cats. The present research aimed to investigate the prevalence of anti-T. gondii IgG antibody in women referring to health centers for premarital tests in Sabzevar, Northeast of Iran (2021-2022). Methods: This cross-sectional descriptive-analytical study included 190 women admitted to health centers in Sabzevar for premarital tests. The participants were selected by simple random sampling. A questionnaire was used to collect the clients’ demographic information and data on some risk factors. In order to perform the tests, 2 mL of their blood samples was taken and their serum was separated. The serum samples were kept at -20 °C until the test was performed. To perform the test, after thawing the serum samples, the presence of anti-T. gondii IgG antibody was examined using the ELISA method in the immunology laboratory of the medical school. The data analysis was done using the chi-square test in SPSS. Results: The results showed that out of 190 participants, 171 had no history of infection with this parasite and only 19 of them had a positive anti-T. gondii IgG antibody test result. Additionally, 90% did not have enough immunity. The Chi-square test showed a significant positive relationship between the presence of anti-T. gondii IgG antibody and age, education, consumption of semi-cooked meat and vegetables (P<0.05). Conclusion: The results suggest that the positive rate of IgG test in this Northeast Iranian region is lower than in other parts, and this problem may be attributable to its specific climatic conditions, where it is hot and dry, and the humidity level is relatively low. The destruction of the parasite oocyst due to these factors can result in a low rate of parasite transmission. Therefore, the need for a screening program is not necessary, but educational programs are recommended to educate women before marriage.
Background: Bacterial secondary infections in patients can exacerbate disease symptoms and significantly increase mortality rates. This study aimed to evaluate the prevalence of bacterial agents responsible for secondary infections in hospitalized patients and to identify the presence of erythromycin resistance genes (ermB, ermA, and mefA) in bacterial isolates. Methods: Samples from secondary infections were collected from hospitalized patients to determine the most prevalent bacterial pathogens and assess their resistance profiles using the polymerase chain reaction method. Results: The bacterial species most frequently associated with secondary infections were Escherichia coli (32.2%), Klebsiella pneumoniae (31.2%), Enterococcus faecalis (24.3%), and Acinetobacter baumannii (11.3%). Testing for antibiotic susceptibility indicated that most bacterial isolates were resistant to erythromycin and ciprofloxacin. Notably, the ermB gene was detected in 89.6% of the isolates, while ermA and mefA genes were absent in all bacterial isolates. Conclusion: These findings underscore the significant level of erythromycin resistance among pathogens responsible for secondary infections in hospitalized patients, with a predominant association with the ermB gene. This highlights the pressing need for improved antibiotic stewardship and the development of alternative therapeutic strategies to combat the growing threat of secondary bacterial infections in clinical settings.
Background: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, started with an outbreak of COVID-19 in Wuhan, China, in December 2019, resulting in millions of deaths in the following years. Bacterial coinfections and superinfections are concerns for patients with COVID-19. This study aimed to determine the mortality rate of COVID-19, its associated risk factors, and the bacterial isolates from urine samples of hospitalized patients suspected of having COVID-19 in Salmas, northwest Iran. Methods: The data from 3,733 patients suspected of COVID-19 who were referred to Khatam Al-Anbiya hospital in Salmas, West Azerbaijan, Northwest Iran, from December 2019 to February 2024, were collected and analyzed in a retrospective study. Results: Of the 3,733 patients, 2,172 (58.2%) tested positive for COVID-19, while 1,561 (41.8%) tested negative. Among those who tested positive, 1,210 were females (59.6%), and 962 were males (56.5%). The highest COVID-19 rate was observed in 2021 (72%), whereas the lowest rate was reported in 2024 (13.8%). Of the COVID-19-positive patients, 328 (15.1%) died, and the bacterial isolates from their urine samples included Escherichia coli (68.75%), which was the most prevalent isolate, followed by Klebsiella spp. (12.5%), coagulase-negative staphylococci spp. (10%), Enterobacter spp. (3.75%), nonhemolytic streptococci spp. (2.5%), Pseudomonas aeruginosa (1.25%), and Streptococcus beta-hemolytic spp. (1.25%). Conclusion: Based on the results, the overall mortality rate of COVID-19 over five years was 15.1%. The most important risk factors for COVID-19-related death included older age, chronic kidney and lung diseases, diabetes mellitus, and male gender. Bacterial isolates from the urine samples of COVID-19 patients were E. coli, Klebsiella spp., coagulase-negative staphylococci spp., P. aeruginosa, Enterobacter spp., and non-hemolytic streptococci spp.
Background: Sepsis is a life-threatening condition with high mortality rates. The emergence of antimicrobial resistance (AMR) among pathogens that cause sepsis poses a significant challenge to effective treatment. This study was conducted to determine the AMR patterns of bacterial isolates from septic patients’ blood cultures with emphasis on extended-spectrum beta-lactamases (ESBLs), carbapenemase, and methicillin-resistant Staphylococcus aureus (MRSA) prevalence. Methods: This cross-sectional laboratory study examined blood culture samples of 1248 patients. The blood cultures were subcultured on MacConkey and chocolate agar media. Bacterial identification was based on gram-staining and biochemical tests. Initial and confirmatory antibiotic susceptibility testing was then performed according to CLSI 2022 for MRSA, vancomycin-resistant Enterococcus (VRE), and ESBLs. The statistical analysis of the study findings was conducted using SPSS. The accuracy level of the evaluations was determined with a 95% confidence interval. Results: Among the 174 cases of bloodstream infection (BSI) (13.9% positivity), Enterobacterales (59.8%) and gram-positive cocci (32.7%) were dominant isolates. Interestingly, the prevalence of MRSA was 67.5%, with a significantly higher prevalence in ICUs (81.3%; P=0.037). In gram-negative isolates, resistance to third-generation cephalosporins and carbapenems was 48.7% and 22.2%, respectively. Significant resistance to carbapenems (80%) was observed in Acinetobacter isolates, but all strains remained susceptible to colistin. ESBL producers included Escherichia coli (36.3%) and Klebsiella pneumoniae (16%). Notably, 52.4% of multidrug-resistant Enterobacteriaceae cases were isolated from patients in emergency departments and intensive care units. Conclusion: This study highlights the alarming prevalence of MDR bacteria among sepsis isolates. Precautions should be taken against this growing threat by focusing on three priorities: enhancing infection control, maintaining continuous surveillance, and exploring novel therapeutic approaches.
Background: Rising antimicrobial resistance, especially in Pseudomonas aeruginosa, has renewed interest in Myoviridae phages as therapeutic agents. Their long-term stability under refrigeration remains a key challenge. This study was conducted to examine the stability and therapeutic potential of three Myoviridae bacteriophages (PA45, PA32, and PA6) stored at refrigeration temperatures (approximately 4°C with minor variations) over 18 months. Methods:The refrigerator temperature was checked weekly using a manual thermometer. Regular enrichment was performed on a monthly basis to maintain phage infectivity. Phage titers were measured using the double-layer agar method. Results: Results indicated that jumbo phage PA32 retained over 90% of its infectivity, PA45 retained about 85%, and PA6 retained approximately 70% of its initial level. Conclusion: These findings highlight refrigeration as a viable and practical approach for long-term phage storage, particularly in resource-limited settings.
Background: Carbapenem-resistant gram-negative bacteria are major challenges in antibiotic therapy globally due to their innate ability to cause life-threatening diseases, leading to treatment failure, high morbidity and mortality, and an increase in hospital-acquired infections. Nonetheless, limited studies exist on their molecular characterization in Nigeria. Accordingly, this study aimed to identify the distinct strains of hospital-acquired carbapenem-resistant gram-negative bacteria from a tertiary hospital in Lagos, Nigeria, using molecular characterization. Methods: Bacteria isolates from the cultures of in-patients’ samples were identified phenotypically by selective/differential diagnostic media and biochemical tests based on standard microbiological protocols. Carbapenem resistance was determined using the Kirby-Bauer disc diffusion method. The isolates of carbapenem-resistant bacteria were characterized using 16S rRNA nucleotide sequencing. Their nucleotide sequences were analyzed using the Basic Local Alignment Search Tool, and accession numbers were assigned to them from the NCBI GenBank. Results: A total of 162 gram-negative bacteria were isolated based on the results. Among them, 13 (8%) were carbapenem-resistant, and 10/13 of the carbapenem-resistant bacteria were molecularly characterized. The molecularly characterized carbapenem-resistant bacteria had 99.38%, 99%, and 98.85% gene similarity indices to Escherichia coli (PP808947), Klebsiella pneumoniae (PP808950), and Pseudomonas aeruginosa (PP808949), respectively. They also showed 98.71%, 98.53%, 98.26%, and 97.80% gene similarity indices to Enterobacter hormaechei (PP808946), E. hormaechei (PP808945), Alcaligenes faecalis (PP808944), and Providencia stuartii (PP808942), respectively. E. coli was the most predominant molecularly characterized hospital-acquired carbapenem-resistant gram-negative strain. Conclusion: This study provided knowledge of the phenotypes and genotypes of hospital-acquired carbapenem-resistant gram-negative Enterobacterales in the study population. It is recommended that these molecularly characterized gram-negative bacteria be monitored in hospitals through effective infection control programs to mitigate their disease outbreak.
