1
|
Dohál M, Dvořáková V, Šperková M, Pinková M, Ghodousi A, Omrani M, Porvazník I, Rasmussen EM, Škereňová M, Krivošová M, Wallenfels J, Konstantynovska O, Walker TM, Nikolayevskyy V, Cirillo DM, Solovič I, Mokrý J. Tuberculosis in Ukrainian War Refugees and Migrants in the Czech Republic and Slovakia: A Molecular Epidemiological Study. J Epidemiol Glob Health 2024; 14:35-44. [PMID: 38048026 PMCID: PMC11043285 DOI: 10.1007/s44197-023-00166-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND The war in Ukraine has led to significant migration to neighboring countries, raising public health concerns. Notable tuberculosis (TB) incidence rates in Ukraine emphasize the immediate requirement to prioritize approaches that interrupt the spread and prevent new infections. METHODS We conducted a prospective genomic surveillance study to assess migration's impact on TB epidemiology in the Czech Republic and Slovakia. Mycobacterium tuberculosis isolates from Ukrainian war refugees and migrants, collected from September 2021 to December 2022 were analyzed alongside 1574 isolates obtained from Ukraine, the Czech Republic, and Slovakia. RESULTS Our study revealed alarming results, with historically the highest number of Ukrainian tuberculosis patients detected in the host countries. The increasing number of cases of multidrug-resistant TB, significantly linked with Beijing lineage 2.2.1 (p < 0.0001), also presents substantial obstacles to control endeavors. The genomic analysis identified the three highly related genomic clusters, indicating the recent TB transmission among migrant populations. The largest clusters comprised war refugees diagnosed in the Czech Republic, TB patients from various regions of Ukraine, and incarcerated individuals diagnosed with pulmonary TB specialized facility in the Kharkiv region, Ukraine, pointing to a national transmission sequence that has persisted for over 14 years. CONCLUSIONS The data showed that most infections were likely the result of reactivation of latent disease or exposure to TB before migration rather than recent transmission occurring within the host country. However, close monitoring, appropriate treatment, careful surveillance, and social support are crucial in mitigating future risks, though there is currently no evidence of local transmission in EU countries.
Collapse
Affiliation(s)
- Matúš Dohál
- Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic.
| | - Věra Dvořáková
- National Institute of Public Health, Prague, Czech Republic
| | | | | | - Arash Ghodousi
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- San Raffaele University, Milan, Italy
- University of Milan, Milan, Italy
| | - Maryam Omrani
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Igor Porvazník
- National Institute of Tuberculosis, Lung Diseases and Thoracic Surgery, Vyšné Hágy, Slovak Republic
- Catholic University, Ružomberok, Slovak Republic
| | | | - Mária Škereňová
- Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic
| | - Michaela Krivošová
- Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic
| | | | | | - Timothy M Walker
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- University of Oxford, Oxford, UK
| | | | | | - Ivan Solovič
- National Institute of Tuberculosis, Lung Diseases and Thoracic Surgery, Vyšné Hágy, Slovak Republic
- Catholic University, Ružomberok, Slovak Republic
| | - Juraj Mokrý
- Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic
| |
Collapse
|
2
|
Dohál M, Dvořáková V, Šperková M, Ghodousi A, Omrani M, Porvazník I, Rasmussen EM, Škereňová M, Krivošová M, Konstantynovska O, Walker TM, Nikolayevskyy V, Cirillo DM, Solovič I, Mokrý J. Correction: Tuberculosis in Ukrainian War Refugees and Migrants in the Czech Republic and Slovakia: A Molecular Epidemiological Study. J Epidemiol Glob Health 2024:10.1007/s44197-024-00212-w. [PMID: 38407721 DOI: 10.1007/s44197-024-00212-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Affiliation(s)
- Matúš Dohál
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic.
| | - Věra Dvořáková
- National Reference Laboratory for Mycobacteria, National Institute of Public Health, Prague, Czech Republic
| | - Miluše Šperková
- National Reference Laboratory for Mycobacteria, National Institute of Public Health, Prague, Czech Republic
| | - Arash Ghodousi
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Center for Multidisciplinary Research in Health Science-MACH, University of Milan, Milan, Italy
| | - Maryam Omrani
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Igor Porvazník
- National Institute of Tuberculosis, Lung Diseases and Thoracic Surgery, Vyšné Hágy, Slovakia
- Faculty of Health, Catholic University, Ružomberok, Slovakia
| | - Erik M Rasmussen
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | - Mária Škereňová
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic
- Department of Clinical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Martin, Slovakia
| | - Michaela Krivošová
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, Malá Hora 4A, 036 01, Martin, Slovak Republic
| | - Olha Konstantynovska
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
- V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
| | - Timothy M Walker
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - Daniela M Cirillo
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ivan Solovič
- National Institute of Tuberculosis, Lung Diseases and Thoracic Surgery, Vyšné Hágy, Slovakia
- Faculty of Health, Catholic University, Ružomberok, Slovakia
| | - Juraj Mokrý
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, Martin, Slovak Republic
| |
Collapse
|
3
|
Barilar I, Battaglia S, Borroni E, Brandao AP, Brankin A, Cabibbe AM, Carter J, Chetty D, Cirillo DM, Claxton P, Clifton DA, Cohen T, Coronel J, Crook DW, Dreyer V, Earle SG, Escuyer V, Ferrazoli L, Fowler PW, Gao GF, Gardy J, Gharbia S, Ghisi KT, Ghodousi A, Gibertoni Cruz AL, Grandjean L, Grazian C, Groenheit R, Guthrie JL, He W, Hoffmann H, Hoosdally SJ, Hunt M, Iqbal Z, Ismail NA, Jarrett L, Joseph L, Jou R, Kambli P, Khot R, Knaggs J, Koch A, Kohlerschmidt D, Kouchaki S, Lachapelle AS, Lalvani A, Lapierre SG, Laurenson IF, Letcher B, Lin WH, Liu C, Liu D, Malone KM, Mandal A, Mansjö M, Calisto Matias DVL, Meintjes G, de Freitas Mendes F, Merker M, Mihalic M, Millard J, Miotto P, Mistry N, Moore D, Musser KA, Ngcamu D, Nhung HN, Niemann S, Nilgiriwala KS, Nimmo C, O’Donnell M, Okozi N, Oliveira RS, Omar SV, Paton N, Peto TEA, Pinhata JMW, Plesnik S, Puyen ZM, Rabodoarivelo MS, Rakotosamimanana N, Rancoita PMV, Rathod P, Robinson ER, Rodger G, Rodrigues C, Rodwell TC, Roohi A, Santos-Lazaro D, Shah S, Smith G, Kohl TA, Solano W, Spitaleri A, Steyn AJC, Supply P, Surve U, Tahseen S, Thuong NTT, Thwaites G, Todt K, Trovato A, Utpatel C, Van Rie A, Vijay S, Walker AS, Walker TM, Warren R, Werngren J, Wijkander M, Wilkinson RJ, Wilson DJ, Wintringer P, Xiao YX, Yang Y, Yanlin Z, Yao SY, Zhu B. Quantitative measurement of antibiotic resistance in Mycobacterium tuberculosis reveals genetic determinants of resistance and susceptibility in a target gene approach. Nat Commun 2024; 15:488. [PMID: 38216576 PMCID: PMC10786857 DOI: 10.1038/s41467-023-44325-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 12/08/2023] [Indexed: 01/14/2024] Open
Abstract
The World Health Organization has a goal of universal drug susceptibility testing for patients with tuberculosis. However, molecular diagnostics to date have focused largely on first-line drugs and predicting susceptibilities in a binary manner (classifying strains as either susceptible or resistant). Here, we used a multivariable linear mixed model alongside whole genome sequencing and a quantitative microtiter plate assay to relate genomic mutations to minimum inhibitory concentration (MIC) in 15,211 Mycobacterium tuberculosis clinical isolates from 23 countries across five continents. We identified 492 unique MIC-elevating variants across 13 drugs, as well as 91 mutations likely linked to hypersensitivity. Our results advance genetics-based diagnostics for tuberculosis and serve as a curated training/testing dataset for development of drug resistance prediction algorithms.
Collapse
|
4
|
Tagliani E, Kohl TA, Ghodousi A, Groenheit R, Holicka Y, Niemann S, Maurer FP, Cirillo DM, Cambau E. Appeal from the European tuberculosis reference laboratory network (ERLTB-Net) for improving the diagnosis of infections due to nontuberculous mycobacteria. Clin Microbiol Infect 2024; 30:4-6. [PMID: 37321396 DOI: 10.1016/j.cmi.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/28/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Elisa Tagliani
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Thomas A Kohl
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany; National and WHO Supranational Reference Laboratory for Mycobacteria, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Arash Ghodousi
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ramona Groenheit
- National and WHO Supranational Reference Laboratory for Tuberculosis, Public Health Agency of Sweden, Solna, Sweden
| | - Yen Holicka
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany; National and WHO Supranational Reference Laboratory for Mycobacteria, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Florian P Maurer
- National and WHO Supranational Reference Laboratory for Mycobacteria, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emmanuelle Cambau
- Université Paris Cité, IAME Inserm UMR 1137, Service de Mycobactériologie Spécialisée et de Référence, Laboratoire Associé Du CNR des Mycobactéries et de La Résistance des Mycobactéries Aux Antituberculeux (CNR-MyRMA) APHP GHU Paris Nord, Hôpital Bichat, Paris, France.
| |
Collapse
|
5
|
Yenew B, Ghodousi A, Diriba G, Tesfaye E, Cabibbe AM, Amare M, Moga S, Alemu A, Dagne B, Sinshaw W, Mollalign H, Meaza A, Tadesse M, Gamtesa DF, Abebaw Y, Seid G, Zerihun B, Getu M, Chiacchiaretta M, Gaudin C, Marceau M, Didelot X, Tolera G, Abdella S, Kebede A, Getahun M, Mehammed Z, Supply P, Cirillo DM. A smooth tubercle bacillus from Ethiopia phylogenetically close to the Mycobacterium tuberculosis complex. Nat Commun 2023; 14:7519. [PMID: 37980337 PMCID: PMC10657438 DOI: 10.1038/s41467-023-42755-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 10/18/2023] [Indexed: 11/20/2023] Open
Abstract
The Mycobacterium tuberculosis complex (MTBC) includes several human- and animal-adapted pathogens. It is thought to have originated in East Africa from a recombinogenic Mycobacterium canettii-like ancestral pool. Here, we describe the discovery of a clinical tuberculosis strain isolated in Ethiopia that shares archetypal phenotypic and genomic features of M. canettii strains, but represents a phylogenetic branch much closer to the MTBC clade than to the M. canettii strains. Analysis of genomic traces of horizontal gene transfer in this isolate and previously identified M. canettii strains indicates a persistent albeit decreased recombinogenic lifestyle near the emergence of the MTBC. Our findings support that the MTBC emergence from its putative free-living M. canettii-like progenitor is evolutionarily very recent, and suggest the existence of a continuum of further extant derivatives from ancestral stages, close to the root of the MTBC, along the Great Rift Valley.
Collapse
Affiliation(s)
- Bazezew Yenew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Arash Ghodousi
- Vita-Salute San Raffaele University, Milan, Italy.
- IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ephrem Tesfaye
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Misikir Amare
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Shewki Moga
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Binyam Dagne
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Abyot Meaza
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Getachew Seid
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Melak Getu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Cyril Gaudin
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France
| | - Michael Marceau
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France
| | - Xavier Didelot
- School of Life Sciences and Department of Statistics, University of Warwick, CV4 7AL, Coventry, UK
| | | | - Saro Abdella
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abebaw Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Philip Supply
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France.
| | - Daniela Maria Cirillo
- Vita-Salute San Raffaele University, Milan, Italy.
- IRCCS San Raffaele Scientific Institute, Milan, Italy.
| |
Collapse
|
6
|
Ghodousi A, Darban-Sarokhalil D, Shahraki AH, Shanmugam S. Editorial: Genomics-based strategies for advanced drug resistance and epidemiological surveillance of Mycobacterium tuberculosis and other non-tuberculous mycobacteria. Front Microbiol 2023; 14:1264285. [PMID: 37680533 PMCID: PMC10482242 DOI: 10.3389/fmicb.2023.1264285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- Arash Ghodousi
- Division of Immunology, Transplantation and Infectious Diseases, Vita-Salute San Raffaele University, Milan, Italy
| | - Davood Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | |
Collapse
|
7
|
Villar-Hernández R, Ghodousi A, Konstantynovska O, Duarte R, Lange C, Raviglione M. Tuberculosis: current challenges and beyond. Breathe (Sheff) 2023; 19:220166. [PMID: 37334103 PMCID: PMC10270564 DOI: 10.1183/20734735.0166-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/26/2023] [Indexed: 06/20/2023] Open
Abstract
Despite being a preventable and curable disease, tuberculosis (TB) is still a major global health threat and the second leading cause of death due to an infectious agent worldwide. All the efforts invested to end TB have resulted overall in rather slow decreases in TB incidence and mortality rates, which have been further negatively affected by the ongoing coronavirus disease 2019 (COVID-19) pandemic. While the majority of targets of the End TB Strategy remain off track, and we have not yet overcome the disruptions caused by the COVID-19 pandemic, recent conflicts such as the ongoing war in Ukraine are threatening the decrease of the burden of TB even further. To get back on track and get closer to ending TB, we need urgent, global, well-structured and committed multi-sectoral actions that go beyond national and global TB programmes with the support of deep investments in research and facilitation of equitable and rapid implementation of innovation worldwide.
Collapse
Affiliation(s)
- Raquel Villar-Hernández
- Institut d'Investigació Germans Trias i Pujol, Barcelona, Spain
- Genome Identification Diagnostics GmbH (GenID), Straßberg, Germany
- Contributed equally as first authors
| | - Arash Ghodousi
- Vita-Salute San Raffaele University, Milan, Italy
- Contributed equally as first authors
| | - Olha Konstantynovska
- V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
- Contributed equally as first authors
| | - Raquel Duarte
- EPI Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Unidade de Investigação Clínica da Administração Regional de Saúde do Norte, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
- Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Christoph Lange
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- German Center for Infection Research (DZIF) Partner Site Borstel-Hamburg-Lübeck-Riems, Borstel, Germany
- Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany
- Cluster of Excellence Precision Medicine in Chronic Inflammation, Kiel, Germany
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Mario Raviglione
- Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, Italy
| |
Collapse
|
8
|
Haeili M, Barmudeh S, Omrani M, Zeinalzadeh N, Kafil HS, Batignani V, Ghodousi A, Cirillo DM. Whole-genome sequence analysis of clinically isolated carbapenem resistant Escherichia coli from Iran. BMC Microbiol 2023; 23:49. [PMID: 36850019 PMCID: PMC9969672 DOI: 10.1186/s12866-023-02796-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/16/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND The emergence of carbapenem-resistant Enterobacterales (CRE) continues to threaten public health due to limited therapeutic options. In the current study the incidence of carbapenem resistance among the 104 clinical isolates of Escherichia coli and the genomic features of carbapenem resistant isolates were investigated. METHODS The susceptibility to imipenem, tigecycline and colistin was tested by broth dilution method. Susceptibility to other classes of antimicrobials was examined by disk diffusion test. The presence of blaOXA-48, blaKPC, blaNDM, and blaVIM carbapenemase genes was examined by PCR. Molecular characteristics of carbapenem resistant isolates were further investigated by whole-genome sequencing (WGS) using Illumina and Nanopore platforms. RESULTS Four isolates (3.8%) revealed imipenem MIC of ≥32 mg/L and positive results for modified carbapenem inactivation method and categorized as carbapenem resistant E. coli (CREC). Colistin, nitrofurantoin, fosfomycin, and tigecycline were the most active agents against all isolates (total susceptibility rate of 99, 99, 96 and 95.2% respectively) with the last three compounds being found as the most active antimicrobials for carbapenem resistant isolates (susceptibility rate of 100%). According to Multilocus Sequence Type (MLST) analysis the 4 CREC isolates belonged to ST167 (n = 2), ST361 (n = 1) and ST648 (n = 1). NDM was detected in all CREC isolates (NDM-1 (n = 1) and NMD-5 (n = 3)) among which one isolate co-harbored NDM-5 and OXA-181 carbapenemases. WGS further detected blaCTX-M-15, blaCMY-145, blaCMY-42 and blaTEM-1 (with different frequencies) among CREC isolates. Co-occurrence of NDM-type carbapenemase and 16S rRNA methyltransferase RmtB and RmtC was found in two isolates belonging to ST167 and ST648. A colistin-carbapenem resistant isolate which was mcr-negative, revealed various amino acid substitutions in PmrB, PmrD and PhoPQ proteins. CONCLUSION About 1.9% of E. coli isolates studied here were resistant to imipenem, colistin and/or amikacin which raises the concern about the outbreaks of difficult-to-treat infection by these emerging superbugs in the future.
Collapse
Affiliation(s)
- Mehri Haeili
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran.
| | - Samaneh Barmudeh
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Maryam Omrani
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Narges Zeinalzadeh
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Virginia Batignani
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Arash Ghodousi
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
9
|
Dreyer V, Mandal A, Dev P, Merker M, Barilar I, Utpatel C, Nilgiriwala K, Rodrigues C, Crook DW, Crook DW, Peto TEA, Walker AS, Hoosdally SJ, Gibertoni Cruz AL, Carter J, Earle S, Kouchaki S, Yang Y, Walker TM, Fowler PW, Wilson D, Clifton DA, Iqbal Z, Hunt M, Knaggs J, Cirillo DM, Borroni E, Battaglia S, Ghodousi A, Spitaleri A, Cabibbe A, Tahseen S, Nilgiriwala K, Shah S, Rodrigues C, Kambli P, Surve U, Khot R, Niemann S, Kohl T, Merker M, Hoffmann H, Todt K, Plesnik S, Ismail N, Omar SV, Ngcamu LJD, Okozi N, Yao SY, Thwaites G, Thuong TNT, Ngoc NH, Srinivasan V, Moore D, Coronel J, Solano W, Gao GF, He G, Zhao Y, Ma A, Liu C, Zhu B, Laurenson I, Claxton P, Wilkinson RJ, Koch A, Lalvani A, Posey J, Gardy J, Werngren J, Paton N, Jou R, Wu MH, Xiao YX, Ferrazoli L, de Oliveira RS, Millard J, Warren R, Van Rie A, Lapierre SG, Rabodoarivelo MS, Rakotosamimanana N, Nimmo C, Musser K, Escuyer V, Cohen T, Rasigade JP, Wirth T, Mistry N, Niemann S. High fluoroquinolone resistance proportions among multidrug-resistant tuberculosis driven by dominant L2 Mycobacterium tuberculosis clones in the Mumbai Metropolitan Region. Genome Med 2022; 14:95. [PMID: 35989319 PMCID: PMC9394022 DOI: 10.1186/s13073-022-01076-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Multidrug-resistant (MDR) Mycobacterium tuberculosis complex (MTBC) strains are a serious health problem in India, also contributing to one-fourth of the global MDR tuberculosis (TB) burden. About 36% of the MDR MTBC strains are reported fluoroquinolone (FQ) resistant leading to high pre-extensively drug-resistant (pre-XDR) and XDR-TB (further resistance against bedaquiline and/or linezolid) rates. Still, factors driving the MDR/pre-XDR epidemic in India are not well defined.
Methods
In a retrospective study, we analyzed 1852 consecutive MTBC strains obtained from patients from a tertiary care hospital laboratory in Mumbai by whole genome sequencing (WGS). Univariate and multivariate statistics was used to investigate factors associated with pre-XDR. Core genome multi locus sequence typing, time scaled haplotypic density (THD) method and homoplasy analysis were used to analyze epidemiological success, and positive selection in different strain groups, respectively.
Results
In total, 1016 MTBC strains were MDR, out of which 703 (69.2%) were pre-XDR and 45 (4.4%) were XDR. Cluster rates were high among MDR (57.8%) and pre-XDR/XDR (79%) strains with three dominant L2 (Beijing) strain clusters (Cl 1–3) representing half of the pre-XDR and 40% of the XDR-TB cases. L2 strains were associated with pre-XDR/XDR-TB (P < 0.001) and, particularly Cl 1–3 strains, had high first-line and FQ resistance rates (81.6–90.6%). Epidemic success analysis using THD showed that L2 strains outperformed L1, L3, and L4 strains in short- and long-term time scales. More importantly, L2 MDR and MDR + strains had higher THD success indices than their not-MDR counterparts. Overall, compensatory mutation rates were highest in L2 strains and positive selection was detected in genes of L2 strains associated with drug tolerance (prpB and ppsA) and virulence (Rv2828c). Compensatory mutations in L2 strains were associated with a threefold increase of THD indices, suggesting improved transmissibility.
Conclusions
Our data indicate a drastic increase of FQ resistance, as well as emerging bedaquiline resistance which endangers the success of newly endorsed MDR-TB treatment regimens. Rapid changes in treatment and control strategies are required to contain transmission of highly successful pre-XDR L2 strains in the Mumbai Metropolitan region but presumably also India-wide.
Collapse
|
10
|
Khoshbayan A, Shariati A, Razavi S, Baseri Z, Ghodousi A, Darban-Sarokhalil D. Mutation in mgrB is the major colistin resistance mechanism in Klebsiella pneumoniae clinical isolates in Tehran, Iran. Acta Microbiol Immunol Hung 2022; 69:61-67. [PMID: 35113039 DOI: 10.1556/030.2022.01679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/03/2022] [Indexed: 12/22/2022]
Abstract
Colistin is considered as one of a last resort antimicrobial agent against multidrug-resistant Gram-negative bacteria including Escherichia coli and Klebsiella pneumoniae. However, the recent emergence of colistin resistance (ColR) worldwide that severely restricts therapeutic options is a serious threat to global public health. In this study we have investigated the molecular determinants in ColR K. pneumoniae isolates collected from clinical specimens. A total of 98 E. coli and 195 K. pneumoniae clinical isolates were collected from two hospitals from August 2018 to December 2019 in Tehran, Iran. Colistin susceptibility and minimum inhibitory concentrations (MIC) were determined according to the Clinical and Laboratory Standards Institute by disk diffusion method, and microdilution method, respectively. For isolates with colistin MIC ≥4 μg mL-1, PCR was performed for the detection of mcr-1 to mcr-4 genes. Moreover, nucleotide sequences of mgrB, phoP, phoQ, pmrA, and pmrB genes were determined by sequencing. Finally, the transcriptional level of pmrK and pmrC genes was evaluated by quantitative reverse transcription PCR (RT-qPCR). None of the E. coli isolates were resistant to colistin while 21 out 195 K. pneumoniae isolates were identified as resistant, 19 of which carried mutation in the mgrB gene. Three different mutations were observed in the pmrB gene in 3 K. pneumoniae isolates. None of the ColR isolates showed alternations in pmrA, phoP, and phoQ genes. Furthermore, none of the plasmid-encoding genes were detected. Transcriptional level of the pmrK gene increased in all ColR isolates meanwhile, pmrC overexpression was detected in 16 out 21 (76.19%) isolates. Eventually, all ColR isolates were susceptible to tigecycline. Our results demonstrated that the alternation of mgrB gene is the main mechanism related to colistin resistance among ColR K. pneumoniae isolates in this study.
Collapse
Affiliation(s)
- Amin Khoshbayan
- 1 Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Aref Shariati
- 2 Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Shabnam Razavi
- 1 Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zohre Baseri
- 3 Department of Pathology and Laboratory Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Ghodousi
- 4 Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, Vita-Salute San Raffaele University, Milan, Italy
| | - Davood Darban-Sarokhalil
- 1 Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Bateson A, Ortiz Canseco J, McHugh TD, Witney AA, Feuerriegel S, Merker M, Kohl TA, Utpatel C, Niemann S, Andres S, Kranzer K, Maurer FP, Ghodousi A, Borroni E, Cirillo DM, Wijkander M, Toro JC, Groenheit R, Werngren J, Machado D, Viveiros M, Warren RM, Sirgel F, Dippenaar A, Köser CU, Sun E, Timm J. OUP accepted manuscript. J Antimicrob Chemother 2022; 77:1685-1693. [PMID: 35260883 PMCID: PMC9155602 DOI: 10.1093/jac/dkac070] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To develop a robust phenotypic antimicrobial susceptibility testing (AST) method with a correctly set breakpoint for pretomanid (Pa), the most recently approved anti-tuberculosis drug. Methods The Becton Dickinson Mycobacterial Growth Indicator Tube™ (MGIT) system was used at six laboratories to determine the MICs of a phylogenetically diverse collection of 356 Mycobacterium tuberculosis complex (MTBC) strains to establish the epidemiological cut-off value for pretomanid. MICs were correlated with WGS data to study the genetic basis of differences in the susceptibility to pretomanid. Results We observed ancient differences in the susceptibility to pretomanid among various members of MTBC. Most notably, lineage 1 of M. tuberculosis, which is estimated to account for 28% of tuberculosis cases globally, was less susceptible than lineages 2, 3, 4 and 7 of M. tuberculosis, resulting in a 99th percentile of 2 mg/L for lineage 1 compared with 0.5 mg/L for the remaining M. tuberculosis lineages. Moreover, we observed that higher MICs (≥8 mg/L), which probably confer resistance, had recently evolved independently in six different M. tuberculosis strains. Unlike the aforementioned ancient differences in susceptibility, these recent differences were likely caused by mutations in the known pretomanid resistance genes. Conclusions In light of these findings, the provisional critical concentration of 1 mg/L for MGIT set by EMA must be re-evaluated. More broadly, these findings underline the importance of considering the global diversity of MTBC during clinical development of drugs and when defining breakpoints for AST.
Collapse
Affiliation(s)
- Anna Bateson
- Centre for Clinical Microbiology, University College London, Royal Free Campus, London, UK
| | - Julio Ortiz Canseco
- Centre for Clinical Microbiology, University College London, Royal Free Campus, London, UK
| | - Timothy D. McHugh
- Centre for Clinical Microbiology, University College London, Royal Free Campus, London, UK
| | - Adam A. Witney
- Institute of Infection and Immunity, St George’s, University of London, London, UK
| | - Silke Feuerriegel
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
| | - Matthias Merker
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- Evolution of the Resistome, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany
| | - Thomas A. Kohl
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany
| | - Christian Utpatel
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany
| | - Sönke Andres
- National and WHO Supranational Reference Laboratory for Tuberculosis, Research Center Borstel, Borstel, Germany
| | - Katharina Kranzer
- Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious & Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany
| | - Florian P Maurer
- German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany
- National and WHO Supranational Reference Laboratory for Tuberculosis, Research Center Borstel, Borstel, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Arash Ghodousi
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | | | - Daniela Maria Cirillo
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Wijkander
- Supranational Reference Laboratory for Tuberculosis, Public Health Agency of Sweden, Solna, Sweden
| | - Juan C. Toro
- Supranational Reference Laboratory for Tuberculosis, Public Health Agency of Sweden, Solna, Sweden
| | - Ramona Groenheit
- Supranational Reference Laboratory for Tuberculosis, Public Health Agency of Sweden, Solna, Sweden
| | - Jim Werngren
- Supranational Reference Laboratory for Tuberculosis, Public Health Agency of Sweden, Solna, Sweden
| | - Diana Machado
- Unidade de Microbiologia Médica, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Miguel Viveiros
- Unidade de Microbiologia Médica, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Robin M. Warren
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research/South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Frederick Sirgel
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research/South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anzaan Dippenaar
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research/South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Tuberculosis Omics Research Consortium, Family Medicine and Population Health, Institute of Global Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Unit of Mycobacteriology, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Juliano Timm
- TB Alliance, New York City, NY, USA
- Corresponding author. E-mail:
| |
Collapse
|
12
|
Ghodousi A, Rizvi AH, Khanzada FM, Akhtar N, Ghafoor A, Trovato A, Cirillo DM, Tahseen S. In vivo Microevolution of Mycobacterium tuberculosis and transient emergence of atpE_Ala63Pro mutation during treatment in a pre-XDR TB patient. Eur Respir J 2021; 59:13993003.02102-2021. [PMID: 34795042 PMCID: PMC8943273 DOI: 10.1183/13993003.02102-2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/04/2021] [Indexed: 11/27/2022]
Abstract
Bedaquiline is a novel anti-tuberculosis drug for the treatment of multidrug-resistant tuberculosis (MDR-TB) recommended by the World Health Organization (WHO) [1] and recently upgraded to the group A classification of TB drugs as one of the three key drugs, along with linezolid and fluoroquinolones, to be included in all MDR-TB treatment regimens. Based on this grouping of second-line drugs, extensively drug-resistant tuberculosis (XDR-TB) is redefined as MDR- or rifampicin-resistant-TB that is resistant to a fluoroquinolone and to either bedaquiline or linezolid or both. Moreover, bedaquiline, in combination with pretomanid and linezolid, is a part of BPaL regimen recommended for treating adult pulmonary TB patients having pre-XDR-TB or MDR-TB which is either non-responsive or intolerant to recommended standard treatment [2]. However, globally emerging resistance to bedaquiline threatens the effectiveness of novel treatment regimens for drug-resistant TB. This letter describes microevolution of a pre-XDR MTB strain isolated from a pulmonary TB patient over an 18-month exposure to BDQ. MDR-TB therapies with BDQ require a functional background regimen to prevent emergence of additional resistance.https://bit.ly/3D05qT9
Collapse
Affiliation(s)
- Arash Ghodousi
- Vita-Salute San Raffaele University, Milan, Italy.,IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Nasim Akhtar
- National Tuberculosis Control Program, Islamabad, Pakistan.,Pakistan Institute of Medical sciences, Islamabad, Pakistan
| | - Abdul Ghafoor
- National Tuberculosis Control Program, Islamabad, Pakistan
| | | | - Daniela Maria Cirillo
- Vita-Salute San Raffaele University, Milan, Italy.,IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sabira Tahseen
- National TB Reference Laboratory, National Tuberculosis Control Program, Pakistan
| |
Collapse
|
13
|
Villa S, Tagliani E, Borroni E, Castellotti PF, Ferrarese M, Ghodousi A, Lamberti A, Senatore S, Faccini M, Cirillo DM, Codecasa LR. Outbreak of pre- and extensively drug-resistant tuberculosis in northern italy: urgency of cross-border, multidimensional, surveillance systems. Eur Respir J 2021; 58:13993003.00839-2021. [PMID: 34049944 DOI: 10.1183/13993003.00839-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/11/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Simone Villa
- Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, Italy.,co-first (equally contributed)
| | - Elisa Tagliani
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.,co-first (equally contributed)
| | - Emanuele Borroni
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Maurizio Ferrarese
- Regional TB Reference Centre, Villa Marelli Institute and Laboratory/ASST Niguarda, Milan, Italy
| | - Arash Ghodousi
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Anna Lamberti
- Health Protection Agency, Metropolitan Area of Milan, Milan, Italy
| | - Sabrina Senatore
- Health Protection Agency, Metropolitan Area of Milan, Milan, Italy
| | - Marino Faccini
- Health Protection Agency, Metropolitan Area of Milan, Milan, Italy.,co-last (equally contributed)
| | | | - Luigi Ruffo Codecasa
- Regional TB Reference Centre, Villa Marelli Institute, ASST Niguarda, Milan, Italy.,co-last (equally contributed)
| |
Collapse
|
14
|
Ghodousi A, Rizvi A, Baloch A, Ghafoor A, Khanzada F, Qadir M, Borroni E, Trovato A, Tahseen S, Cirillo D. Acquisition of Cross-Resistance to Bedaquiline and Clofazimine following Treatment for Tuberculosis in Pakistan. Int J Mycobacteriol 2021. [DOI: 10.4103/2212-5531.307111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
15
|
Kardan-Yamchi J, Kazemian H, Ghodousi A, Cirillo D, Douraghi M, Abtahi H, Hamzelou GR, Amini S, Feizabadi M. Phenotypic and genotypic resistance of drug-resistant Mycobacterium tuberculosis isolates to first and second-line anti-TB drugs in Iran. Int J Mycobacteriol 2021. [DOI: 10.4103/2212-5531.307073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
16
|
Ghodousi A, Borroni E, Peracchi M, Palù G, Fallico L, Rassu M, Manfrin V, Mantegani P, Monzillo V, Manganelli R, Tortoli E, Cirillo DM. Genomic analysis of cardiac surgery-associated Mycobacterium chimaera infections in Italy. PLoS One 2020; 15:e0239273. [PMID: 32976495 PMCID: PMC7518601 DOI: 10.1371/journal.pone.0239273] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/02/2020] [Indexed: 11/21/2022] Open
Abstract
One hundred and twenty-two Mycobacterium chimaera strains isolated in Italy from cardiac surgery-related patients, cardiac surgery-unrelated patients and from heater-cooler units, were submitted to whole-genome sequencing and to subsequent SNP analysis. All but one strains isolated from cardiac surgery-related patients belonged to Subgroup 1.1 (19/23) or Subgroup 1.8 (3/23). Only 28 out of 79 strains isolated from heater-cooler units belonged to groupings other than 1.1 and 1.8. The strains isolated from cardiac surgery-unrelated patients were instead distributed across the phylogenetic tree. Our data, the first on isolates from Italy, are in agreement with a recent large genomic study suggesting a common source, represented by strains belonging to Subgroups 1.1 and 1.8, of cardiac surgery-related Mycobacterium chimaera infections. The strains belonging to groupings other than 1.1 and 1.8 isolated from heather-cooler units evidently resulted from contaminations at hospital level and had no share in the Mycobacterium chimaera outbreak. One Mycobacterium chimaera strain investigated in this study proved distant from every previously known Mycobacterium chimaera Groups (1, 2, 3 and 4) and we propose to assign to a novel group, named “Group 5”.
Collapse
Affiliation(s)
- Arash Ghodousi
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuele Borroni
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | | | | | - Paola Mantegani
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzina Monzillo
- U.O.C Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Enrico Tortoli
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
17
|
Kardan-Yamchi J, Kazemian H, Battaglia S, Abtahi H, Rahimi Foroushani A, Hamzelou G, Cirillo DM, Ghodousi A, Feizabadi MM. Whole Genome Sequencing Results Associated with Minimum Inhibitory Concentrations of 14 Anti-Tuberculosis Drugs among Rifampicin-Resistant Isolates of Mycobacterium Tuberculosis from Iran. J Clin Med 2020; 9:jcm9020465. [PMID: 32046149 PMCID: PMC7073636 DOI: 10.3390/jcm9020465] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/15/2019] [Accepted: 12/18/2019] [Indexed: 01/30/2023] Open
Abstract
Accurate and timely detection of drug resistance can minimize the risk of further resistance development and lead to effective treatment. The aim of this study was to determine the resistance to first/second-line anti-tuberculosis drugs in rifampicin/multidrug-resistant Mycobacterium tuberculosis (RR/MDR-MTB) isolates. Molecular epidemiology of strains was determined using whole genome sequencing (WGS)-based genotyping. A total of 35 RR/MDR-MTB isolates were subjected to drug susceptibility testing against first/second-line drugs using 7H9 Middlebrook in broth microdilution method. Illumina technology was used for paired-end WGS applying a Maxwell 16 Cell DNA Purification kit and the NextSeq platform. Data analysis and single nucleotide polymorphism calling were performed using MTBseq pipeline. The genome-based resistance to each drug among the resistant phenotypes was as follows: rifampicin (97.1%), isoniazid (96.6%), ethambutol (100%), levofloxacin (83.3%), moxifloxacin (83.3%), amikacin (100%), kanamycin (100%), capreomycin (100%), prothionamide (100%), D-cycloserine (11.1%), clofazimine (20%), bedaquiline (0.0%), and delamanid (44.4%). There was no linezolid-resistant phenotype, and a bedaquiline-resistant strain was wild type for related genes. The Beijing, Euro-American, and Delhi-CAS were the most populated lineage/sublineages. Drug resistance-associated mutations were mostly linked to minimum inhibitory concentration results. However, the role of well-known drug-resistant genes for D-cycloserine, clofazimine, bedaquiline, and delamanid was found to be more controversial.
Collapse
Affiliation(s)
- Jalil Kardan-Yamchi
- Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran 1417653911, Iran;
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran 1417653911, Iran;
| | - Hossein Kazemian
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran 1417653911, Iran;
| | - Simone Battaglia
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (S.B.)
| | - Hamidreza Abtahi
- Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran 1417653911, Iran;
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 1417653911, Iran;
| | - Gholamreza Hamzelou
- Tehran Regional Reference Laboratory for Tuberculosis, Tehran University of Medical Sciences, Tehran 1417653911, Iran;
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (S.B.)
| | - Arash Ghodousi
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (S.B.)
- Correspondence: (A.G.); (M.M.F.)
| | - Mohammad Mehdi Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran 1417653911, Iran;
- Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran 1417653911, Iran;
- Correspondence: (A.G.); (M.M.F.)
| |
Collapse
|
18
|
Abstract
Violence against nurses is a serious problem that can affect negatively the quality of nursing care. The extent of violence against nurses in Iran and the factors leading to this violence have not been known. Thus, the aim of this study was to investigate all forms of violence against nurses in Shahrekord hospitals in 2014. In this 2014 study, 100 nurses working in Shahrekord's Hajar, Kashani, and Social Security branch hospitals were studied. Data were collected through standardized questionnaires on workplace violence, as well as demographic data, in health units on five types of violence, including physical and verbal violence, intimidation and bullying, ethnic violence, and violation of chastity. The analysis was done by SPSS (Version 19) software. All nurses indicated that during some period of their work, they had been subjected to at least one type of violence; the highest prevalence of mental violence was belonged to the subtype of intimidation and bullying (91%). The primary agents of violence against nurses were patients and their relatives. Factors such as gender, age, work experience, and nursing shifts played important roles in the distribution of violence. In ethnic violence, the only factor affecting nurses was race (p < .05). The highest rate of violence against nurses was due to mental or psychological violence. To minimize violence in hospitals, authorities should consider appropriate preventive strategies, good management, proper protective measures, and public education.
Collapse
Affiliation(s)
- Sahar Dehghan-Chaloshtari
- Faculty of Nursing and Midwifary, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Arash Ghodousi
- Forensic Medicine Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| |
Collapse
|
19
|
Hosseini SN, Ghodousi A, Sadeghi N, Abbasi S. Comparing Neonatal Intensive Care Unit Nursing Support in Mothers With Newborn Abstinence Syndrome (NAS) and Mothers of Healthy Neonates . Int J Med Toxicol Forensic Med 2019. [DOI: 10.32598/ijmtfm.v9i4.26184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The experience of having neonates in the Neonatal Intensive Care Unit (NICU) is a psychological crisis. It might cause many emotional problems for parents. Entire parental support is among the duties of the healthcare team. Therefore, this study aimed to compare the nursing support received by the mothers with Newborn Abstinence Syndrome (NAS) and the mothers of other neonates admitted to the NICU. Methods: The present cross-sectional descriptive-analytic study was conducted in the selected hospitals in Kerman Province, Iran. In total, 62 mothers with NAS and 61 non-addicted mothers with neonates admitted to the NICU were selected through convenience sampling method. The inclusion criteria were neonates under the care of parents, neonate admitted to the NICU for at least 24 hours, opiate dependence in the case group mothers, and no substance dependence in the control group mothers. The amount of nursing support for mothers having neonates with NAS was compared with that of the control mothers. The study groups were homogenized in terms of the study variables (neonate age, gender, and the duration of hospitalization). The required data were collected by the Nurse-Parent Support Tool (NPST) and analyzed in SPSS. Results: The study results revealed that among the neonates of 123 mothers, 75(60.97%) were boys, and 58(39.02%) were girls. The majority of neonates in both groups were breastfed. The mean±SD age of the mothers in the case and control group were 31.93±7.25 and 28.99±4.36 years, respectively. The nursing support level was desirable in both groups, and no significant difference was found in this regard (P>0.05). Furthermore, the level of nursing support in emotional, information-communication, self-esteem, and quality caregiving support dimensions was desirable in both groups. Conclusion: The obtained results revealed that nurses’ support was desirable in both groups. The prevalence of maternal addiction and the impact of this social harm on neonates who were admitted are essential. Furthermore, families having neonates with NAS need more support from the healthcare staff and nurses, in comparison with healthy parents; thus, the importance of this issue should be addressed in training and briefing courses for nurses.
Collapse
|
20
|
Heidary M, Zaker Bostanabad S, Amini SM, Jafari A, Ghalami Nobar M, Ghodousi A, Kamalzadeh M, Darban-Sarokhalil D. The Anti-Mycobacterial Activity Of Ag, ZnO, And Ag- ZnO Nanoparticles Against MDR- And XDR- Mycobacterium tuberculosis. Infect Drug Resist 2019; 12:3425-3435. [PMID: 31807033 PMCID: PMC6839584 DOI: 10.2147/idr.s221408] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 10/02/2019] [Indexed: 01/04/2023] Open
Abstract
Background Nowadays, tuberculosis (TB) is one of the top ten leading causes of mortality worldwide. The emergence of multidrug-resistant (MDR) - and extensively drug-resistant (XDR) - Mycobacterium tuberculosis (M. tuberculosis) is identified as one of the most challenging threats to TB control. Thus, new and safe nano-drugs are urgently required for the elimination of TB. The aim of this study was to investigate the anti-bacterial effects of Ag, ZnO, and Ag-ZnO nanoparticles (NPs) on MDR- and XDR-M. tuberculosis. Materials and methods In this study, Ag, ZnO, and Ag-ZnO NPs were synthesized by the chemical reduction and chemical deposition methods. NPs were characterized using ultraviolet-visible spectroscopy, dynamic light scattering, and transmission electron microscopy. Then, various dilutions of NPs were prepared and their minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined against M. tuberculosis strains using the broth microdilution and agar microdilution methods. Finally, MTT test and cell culture assay were performed. Results The effects of concentrations of 1-128 µg/mL Ag NPs, ZnO NPs, 2Ag: 8ZnO, 8Ag:2ZnO, 3Ag: 7ZnO, 7Ag:3ZnO, and 5Ag:5ZnO on M. tuberculosis strains were investigated. MIC results showed the inhibitory effect of 1 µg/mL of all NPs against XDR-M. tuberculosis. In addition, the concentrations of 4 µg/mL Ag, 8 µg/mL 5Ag:5ZnO, 8 µg/mL 7Ag:3ZnO, 32 µg/mL 3Ag:7ZnO, 16 µg/mL 8Ag:2ZnO, and 64 µg/mL 2Ag:8ZnO inhibited MDR-M. tuberculosis growth. However, MBC results indicated the inability of Ag, ZnO and Ag-ZnO NPs, either in combination or alone, to kill MDR- or XDR-M. tuberculosis. Conclusion To the best of our knowledge, this is the first study to evaluate the effects of Ag and ZnO NPs against MDR and XDR strains of M. tuberculosis. According to the results, Ag and ZnO NPs showed bacteriostatic effects against drug-resistant strains of M. tuberculosis. Therefore, these NPs may be considered as promising anti-mycobacterial nano-drugs. However, further studies are required to affirm the bactericidal effects of these NPs against TB.
Collapse
Affiliation(s)
- Mohsen Heidary
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Zaker Bostanabad
- Microbiology Department, Islamic Azad University-Parand Branch, Tehran, Iran.,Mycobacteriology Department, Massoud Laboratory, Tehran, Iran
| | - Seyed Mohammad Amini
- Radiation Biology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Alireza Jafari
- Inflammatory Lung Diseases Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mostafa Ghalami Nobar
- Mycobacteriology Department, Massoud Laboratory, Tehran, Iran.,Reference Health Laboratory of Iran (RHL), Ministry of Health and Medical Education, Tehran, Iran
| | - Arash Ghodousi
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Morteza Kamalzadeh
- Quality Control, Department, Razi Vaccine and Research Institute, Agricultural Research Education and Extension Organization, Karaj, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
21
|
Affiliation(s)
- Andrea Spitaleri
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Arash Ghodousi
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Miotto
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
22
|
Cabibbe AM, Trovato A, De Filippo MR, Ghodousi A, Rindi L, Garzelli C, Baretti S, Allodi G, Mannino R, Rossolini GM, Bartoloni A, Tortoli E, Cirillo DM. Countrywide implementation of whole genome sequencing: an opportunity to improve tuberculosis management, surveillance and contact tracing in low incidence countries. Eur Respir J 2018; 51:13993003.00387-2018. [DOI: 10.1183/13993003.00387-2018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 04/02/2018] [Indexed: 11/05/2022]
|
23
|
Ghodousi A, Abedzadeh M, Ketabi M, Zarean P, Zarean P. Adherence to confidentiality principles from the viewpoint of Iranian dental students: A multicenter study. Eur J Dent Educ 2018; 22:e88-e93. [PMID: 28276614 DOI: 10.1111/eje.12262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Confidentiality is a basic ethical principle appreciating human autonomy, relationships, and dignity and in medical research has a long history. In dental practice, it has the same importance as medical field. Therefore, providing patients with information about the confidentiality will promote their confidence in dental professionals and prevent legal conflicts. The present study sought to evaluate the knowledge and viewpoints of dental students about patient confidentiality. METHODS AND MATERIALS In this multicenter applied research, the participants were recruited from schools of dentistry of Isfahan, Tehran, Tabriz, Shiraz, and Mashhad Universities of Medical Sciences and Isfahan Islamic Azad University during 2013. Ultimately, data were collected randomly with a researcher-made questionnaire from 180 dental students of fifth-sixth-year. The collected data were entered into SPSS 20.0. Independent t-tests and one-way analysis of variance (ANOVA) were performed to analyze the data. RESULT Overall, 60.3% of the participating students were concerned about acquiring adequate knowledge on the concept of patient confidentiality and 59.0% felt obliged to participate in related educational courses. Most students (66.5%) were careful not to share patient information with their friends. According to one-way ANOVA, students of Tehran University of Medical Sciences scored significantly higher than other participants. However, no significant differences were detected between the students of other schools. CONCLUSION The confidentiality laws imposed by the Ministry of Health and Medical Education seem to adequate details, but needs more education for dentists. Also it should be accentuated, due to state of confidentiality in patients' rights guidline and courses on ethics should be tailored based on the specific subjects raised in each field of dentistry.
Collapse
Affiliation(s)
- A Ghodousi
- Forensic Medicine Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - M Abedzadeh
- Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - M Ketabi
- Department of Periodontology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Parichehr Zarean
- Member of Young Researchers and Elite Club, Isfahan (khorasgan) branch, Islamic Azad University, Isfahan, Iran
| | - Paridokht Zarean
- Member of Young Researchers and Elite Club, Isfahan (khorasgan) branch, Islamic Azad University, Isfahan, Iran
| |
Collapse
|
24
|
Sadeghi N, Davaridolatabadi E, Rahmani A, Ghodousi A, Ziaeirad M. Quality of life of adolescents and young people arrive at an addiction treatment centers upon their admission, and 1, 4 and 8 months after methadone maintenance therapy. J Educ Health Promot 2017; 6:95. [PMID: 29114562 PMCID: PMC5651645 DOI: 10.4103/jehp.jehp_297_13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 05/14/2015] [Indexed: 06/07/2023]
Abstract
BACKGROUND Drug abuse influences the quality of life significantly. Thus, the present study is designed to compare the quality of life of adolescents and young adults who have voluntarily referred to addiction treatment centers at different time slots of upon admission, and 1, 4, and 8 months after maintenance therapy. METHODS The present paper is a longitudinal study on 141 of adolescents and young adults who had referred to various addiction treatment centers throughout Isfahan voluntarily. The population was selected through convenience sampling method and 137 of adolescents and young adults continued the research until the end. The results were analyzed using descriptive and analytic statistics (frequency, mean, standard deviation, repeated measure test, and post-hoc test) in SPSS 17. RESULTS Results showed that the average of quality of life total score was sequential and not the same in the 4 times slots under study. The total quality of life score upon admission was significantly different from 1, 4, and 8 months after maintenance treatment. However, quality of life at 1-month was not significantly different to that at 4 and 8 months after the treatment; quality of life at 4 months after the treatment was not significantly different to that at 8 months after. DISCUSSION According to the present study, it can be concluded that the quality of life of adolescents and young adults referring to addiction treatment centers increases 1-month after the treatment; nevertheless, it is worth to note that the degree of quality of life increase in 4 and 8 months after the treatment is not as much as that in 1-month after the treatment.
Collapse
Affiliation(s)
- Narges Sadeghi
- Department of Nursing, Elderly Care and Health Promotion Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Elham Davaridolatabadi
- Department of Nursing, Elderly Care and Health Promotion Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Azam Rahmani
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Ghodousi
- Forensic Medicine Research Center, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Marzieh Ziaeirad
- Department of Nursing, Elderly Care and Health Promotion Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| |
Collapse
|
25
|
Sarkoohijabalbarezi Z, Ghodousi A, Davaridolatabadi E. The relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards. Int J Nurs Sci 2017; 4:117-121. [PMID: 31406730 PMCID: PMC6626124 DOI: 10.1016/j.ijnss.2017.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 11/30/2022] Open
Abstract
Background Nurses serve as the primary source of care for minor patients in intensive care units. Even though they support both patients and their relatives, these nurses may experience moral distress from their profession. While managing their daily relationships with their patients, nurses must also be able to control their actions to feel that they are from a social unit and feel their competence in association with others. Objective This study aimed to investigate the relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards. Methods This descriptive/comparative cross-sectional study was conducted in 2015 using 120 nurses as subjects. Subjects were selected using the census method. The research tools used to gain measurable data were the Pankratznursing questionnaire(PNQ) and Corley'sMoral distress scale (MDS). In order to analyze the collected data, descriptive statistic tests such as the relative frequency distribution, mean, standard deviation and the Pearson correlation test, T-test, ANOVA, and regression were used. The SPSSv.20 software was also used to analyze the data obtained. Results The relationship between professional autonomy and moral distress revealed that there was a significant positive relationship between professional autonomy and moral distress in the intensity (r = 0.39; P < 0.001) and the iteration (r = 0.41; P < 0.001). In addition, professional autonomy predicted 18% of changes in intensity of moral distress in total(MR = 0.42, R2 = 0.18) and also professional autonomy predicted 25% of iteration in moral distress in total(MR = 0.507, R2 = 0.25). Conclusions The results of this study revealed that there was a direct positive relationship between professional autonomy and moral distress.
Collapse
Affiliation(s)
- Zahra Sarkoohijabalbarezi
- Faculty of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Arash Ghodousi
- Forensic Medicine Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Elham Davaridolatabadi
- Faculty of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| |
Collapse
|
26
|
Ghodousi A, Bonura C, Di Carlo P, van Leeuwen WB, Mammina C. Extraintestinal pathogenic Escherichia coli sequence type 131 H30-R and H30-Rx subclones in retail chicken meat, Italy. Int J Food Microbiol 2016; 228:10-3. [DOI: 10.1016/j.ijfoodmicro.2016.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 10/22/2022]
|
27
|
Ghodousi A, Bonura C, Di Noto AM, Mammina C. Extended-Spectrum ß-Lactamase, AmpC-Producing, and Fluoroquinolone-Resistant Escherichia coli in Retail Broiler Chicken Meat, Italy. Foodborne Pathog Dis 2015; 12:619-25. [PMID: 26135894 DOI: 10.1089/fpd.2015.1936] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Globally, antimicrobial drug-resistant Escherichia coli is among the most common etiological agents of invasive disease in humans. In Europe, increasing proportions of infections due to third-generation cephalosporins and/or fluoroquinolone-resistant extraintestinal pathogenic E. coli (ExPEC) strains are reported. E. coli from poultry are those more closely linked to human E. coli, but lack of reliable data makes it difficult to assess the attributable risk of different food sources. In the present study, our objective was to investigate the antimicrobial resistance profile, phylogenetic background, and virulence factors of E. coli isolates from broiler chicken meat sold at retail in Palermo, Italy. MATERIALS AND METHODS Isolation of multidrug resistant (MDR) E. coli was performed during April-December 2013 on a total of 163 chicken meat samples. Susceptibility to a panel of nine antimicrobial agents was determined. PCR assays were carried out to detect extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC β-lactamase, and plasmid-mediated quinolone resistance (PMQR) genes, phylogenetic group, and ExPEC-associated traits. A single nucleotide polymorphism (SNP) PCR was done to detect E. coli sequence type (ST)131. RESULTS One hundred thirty-four isolates from 109 meat samples were MDR. B1 was the most prevalent phylogenetic group (47.8%), followed by groups D (25.4%), A (22.3%), and B2 (4.5%). ESBLs and AmpC β-lactamases were detected by PCR in 132 (98.5%) and 15 (11.2%) isolates. PMQR determinants were detected in 122 (91%) isolates. Twenty-two MDR isolates met the molecular definition of ExPEC. SNP-PCR results confirmed that four B2 isolates were ST131. Enterobacterial Repetitive Intergenic Consensus sequence-PCR analysis showed a large heterogeneity with 55 unique profiles and 31 clusters including 2-4 isolates. CONCLUSIONS An alarmingly high prevalence of MDR E. coli from broiler chicken meat is evident in our geographic area. The ongoing use of antimicrobial drugs in livestock should be urgently restricted, particularly in the poultry sector.
Collapse
Affiliation(s)
- Arash Ghodousi
- 1 PhD Course in Molecular Medicine, University of Palermo , Palermo, Italy .,2 Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro," University of Palermo , Palermo, Italy
| | - Celestino Bonura
- 2 Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro," University of Palermo , Palermo, Italy
| | - Anna Maria Di Noto
- 3 Experimental Zooprophylactic Institute of Sicily "A. Mirri," Palermo, Italy
| | - Caterina Mammina
- 2 Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro," University of Palermo , Palermo, Italy
| |
Collapse
|
28
|
Cortegiani A, Russotto V, Capuano P, Tricoli G, Geraci DM, Ghodousi A, Saporito L, Graziano G, Giarratano A. Use of Cepheid Xpert Carba-R® for rapid detection of carbapenemase-producing bacteria in critically ill, abdominal surgical patients: first report of an observational study. Crit Care 2015. [PMCID: PMC4471209 DOI: 10.1186/cc14188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
29
|
Abstract
Objective: Medication errors are the most common medical errors, which may result in some complications for patients. This study was carried out to investigate what influence medication errors by nurses from their viewpoint. Methods: In this descriptive study, 150 nurses who were working in Qazvin Medical University teaching hospitals were selected by proportional random sampling, and data were collected by means of a researcher-made questionnaire including demographic attributes (age, gender, working experience,…), and contributing factors in medication errors (in three categories including nurse-related, management-related, and environment-related factors). Findings: The mean age of the participant nurses was 30.7 ± 6.5 years. Most of them (87.1%) were female with a Bachelor of Sciences degree (86.7%) in nursing. The mean of their overtime working was 64.8 ± 38 h/month. The results showed that the nurse-related factors are the most effective factors (55.44 ± 9.14) while the factors related to the management system (52.84 ± 11.24) and the ward environment (44.0 ± 10.89) are respectively less effective. The difference between these three groups was significant (P = 0.000). In each aforementioned category, the most effective factor on medication error (ranked from the most effective to the least effective) were as follow: The nurse's inadequate attention (98.7%), the errors occurring in the transfer of medication orders from the patient's file to kardex (96.6%) and the ward's heavy workload (86.7%). Conclusion: In this study nurse-related factors were the most effective factors on medication errors, but nurses are one of the members of health-care providing team, so their performance must be considered in the context of the health-care system like work force condition, rules and regulations, drug manufacturing that might impact nurses performance, so it could not be possible to prevent medication errors without paying attention to our health-care system in a holistic approach.
Collapse
Affiliation(s)
- Akram Shahrokhi
- Department of Critical Care Nursing, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Ebrahimpour
- Department of Nursing, Khorasgan (Isfahan) Branch, Islamic Azad University, Isfahan, Iran
| | - Arash Ghodousi
- Department of Nursing, Khorasgan (Isfahan) Branch, Islamic Azad University, Isfahan, Iran
| |
Collapse
|
30
|
Ekhtiari H, Dezfouli A, Zamanian B, Ghodousi A, Mokri A. Treatment outcome predictors in flexible dose-duration methadone detoxification program. Arch Iran Med 2014; 16:599-601. [PMID: 24093142 DOI: 0131610/aim.0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Methadone detoxification is among the widely used treatment programs for opioid dependence. The aims of this study were to identify which patient baseline factors and treatment regimen features are predictors of the treatment outcome in an outpatient flexible dose-duration methadone detoxification program. We studied 126 opioid dependents in a naturalistic nonexperimental clinical setting. The patients were assessed for baseline demographic characteristics, and drug abuse characteristics. Treatment regimen features were recorded during the program. Successful treatment completion was defined as the last daily dose of methadone being less than 15 mg, negative urine analysis in the last two weeks of treatment, and based on the final clinician-client's decision. Out of 126 patients, 60 patients completed detoxification successfully. Younger age, longer duration of the opioid abuse, and higher subjective opiate intoxication severity before treatment entry were all significantly associated with negative treatment outcome. Among treatment regimen features, higher maximum methadone dose had a marginally significant independent effect on treatment failure. Patients with maximum methadone dose of more than 75 mg per day had around ten times worse success rate when compared to those who received lesser doses. The study findings could be used to predict treatment outcome and prognosis in a more individualized and patient-tailored approach in the real clinical setting. Guideline development for treatment selection and outcome monitoring in addiction medicine based on similar studies could enhance treatment outcome in clinical services.
Collapse
Affiliation(s)
- Hamed Ekhtiari
- 1)Neurocognitive Laboratory, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran. 4)Translational Neuroscience Program, Institute for Cognitive Sciences Studies, Tehran,
| | | | | | | | | |
Collapse
|
31
|
Ghodousi A, Nomanpour B, Davoudi S, Maleknejad P, Omrani M, Kashef N, Salehi TZ, Feizabadi MM. Application of fnbA gene as new target for the species-specific and quantitative detection of Staphylococcus aureus directly from lower respiratory tract specimens by real time PCR. INDIAN J PATHOL MICR 2013; 55:490-5. [PMID: 23455786 DOI: 10.4103/0377-4929.107787] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Staphylococcus aureus is a significant cause of hospital-acquired pneumonia (HAP), particularly in mechanically ventilated patients. We used the fibronectin-binding protein A gene (fnbA) for the species-specific and quantitative detection of S. aureus directly from lower respiratory tract (LRT) specimens by a Taq Man real time PCR. For this reason, a total of 269 lower respiratory tract (LRT) specimens collected from patients with hospital-acquired pneumonia were assayed. Amplification of fnbA in serial dilutions ranged from 10(9) CFU/ ml to 10(2) CFU/ml. Standard curve of triplicate every dilution had slope 3.34±0.1 and R2>0.99 with SD 0.1. Based on these data, the sensitivity and specificity of the newly developed real time PCR targeting the fnbA gene were both 100%. The Cohen's Kappa test showed the Kappa value of 1.0. The fnbA gene is a potential marker for the species-specific detection of S. aureus and can be used to detect this bacterium in any clinical specimens by real time PCR. Moreover, this method reduces the time needed for quantitative detection of Staphylococcus aureus from LRT specimens to nearly 2 hours compared to 1 to 4 days for culture and provided sensitivity equal to or greater than culture.
Collapse
Affiliation(s)
- Arash Ghodousi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Haeili M, Ghodousi A, Nomanpour B, Omrani M, Feizabadi MM. Drug resistance patterns of bacteria isolated from patients with nosocomial pneumonia at Tehran hospitals during 2009-2011. J Infect Dev Ctries 2013; 7:312-7. [PMID: 23592640 DOI: 10.3855/jidc.2604] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Revised: 06/06/2012] [Accepted: 06/15/2012] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Nosocomial pneumonia remains an important cause of mortality and morbidity worldwide. Surveillance programs play an important role in the identification of common etiologic agents and local patterns of antimicrobial resistance. METHODOLOGY In this study we determined the frequency and antimicrobial susceptibility of pathogens isolated from patients with nosocomial pneumonia during 2009 to 2011. RESULTS A total of 642 bacteria were isolated from 516 suspected samples. Acinetobacter baumannii (21.1%, n = 136), was the commonest isolated pathogen followed by Pseudomonas aeruginosa (17.4%, n = 112), Staphylococcus aureus (15.8%, n = 102) and enterococci (8.4% n = 54). The most effective therapeutic agents against A. baumannii were polymyxin B (95.5% susceptible), ceftriaxone/tazobactam (72% susceptible) and levofloxacin (52.9% susceptible). Polymixin B (89.2% susceptible), ceftriaxone/tazobactam (89.2% susceptible) and piperacillin-tazobactam (80.3% susceptible) were found to be the most active agents against P. aeruginosa. Extended-spectrum beta-lactamases were detected among isolates of K. pneumoniae (45.4%) and E. coli (20.3%). Overall, the prevalence of methicillin-resistant S. aureus and vancomycin resistant enterococci were 80.4% and 40.7% respectively. Linezolid was found to be the most active antibiotic against these pathogens. The etiology of 50% of the nosocomial infection cases was polymicrobial. CONCLUSIONS The combination of ceftriaxone/tazobactam seems to be beneficial agent against multidrug-resistant Gram-negative bacilli isolated form respiratory tract infections. The results of our study can be used for guiding appropriate empiric therapy in this geographic region.
Collapse
Affiliation(s)
- Mehri Haeili
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | |
Collapse
|
33
|
Eizadi Mood N, Sabzghabaee AM, Ghodousi A, Yaraghi A, Mousavi A, Massoum G, Shemshaki HR. Histo-pathological findings and their relationship with age, gender and toxin amounts in paraquat intoxication. Pak J Med Sci 2013. [DOI: 10.12669/pjms.291(suppl).3543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
34
|
Nomanpour B, Ghodousi A, Babaei T, Jafari S, Feizabadi M. Single tube real time PCR for detection of Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila from clinical samples of CAP. Acta Microbiol Immunol Hung 2012; 59:171-84. [PMID: 22750778 DOI: 10.1556/amicr.59.2012.2.3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We designed a multiplex real time PCR for rapid, sensitive and specific detection of Streptococcus pneumoniae, Legionella pneumophila, Chlamydophila pneumoniae and Mycoplasma pneumoniae. The study cases consisted of 129 patients with community acquired pneumonia (CAP). Bacteriological techniques were implemented for detection of the cultivable organisms. DNA were extracted from sputa, throat swabs, bronchoalveolar lavages and tracheal aspirates and used as templates in real time PCR. The primers and probes were designed for cbpA (S. pneumoniae), p1adhesin (M. pneumoniae), mip (L. pneumophila) and ompA (C. pneumoniae). After optimization of real time PCR for every organism, the experiments were continued in multiplex in a single tube. Of 129 CAP specimens, the positive cultures included 14 (10.85%) for S. pneumoniae, 9 (6.98%) for L. pneumophila and 3 (2.33%) for M. pneumoniae. Four specimens (3.10%) were positive for C. pneumoniae by real time PCR. The sensitivity of our real time PCR was 100% for all selected bacteria. The specificity of the test was 98.26%, 98.34%, 100% and 100% for S. pneumoniae, L. pneumophila, M. pneumoniae and C. pneumoniae, respectively. This is the first report on the use of multiplex real time PCR for detection of CAP patients in the Middle East. The method covers more than 90% of the bacterial pathogens causing CAP.
Collapse
Affiliation(s)
- Bizhan Nomanpour
- 1 Tehran University of Medical Sciences Department of Microbiology, School of Medicine Tehran Iran
| | - Arash Ghodousi
- 1 Tehran University of Medical Sciences Department of Microbiology, School of Medicine Tehran Iran
| | - Toraj Babaei
- 2 Shaheed Rajaie Cardiovascular Medical & Research Center Department of Cardiac Anesthesiology Tehran Iran
| | - Siroos Jafari
- 3 Tehran University of Medical Sciences Department of Infectious Disease, School of Medicine Tehran Iran
| | - Mohammad Feizabadi
- 1 Tehran University of Medical Sciences Department of Microbiology, School of Medicine Tehran Iran
| |
Collapse
|
35
|
Salehi S, Ghodousi A, Ojaghloo K. The spiritual experiences of patients with diabetes- related limb amputation. Iran J Nurs Midwifery Res 2012; 17:225-8. [PMID: 23833617 PMCID: PMC3696216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Confrontation with the consequences of diabetes causes a crisis in physical, mental, and spiritual dimensions. Sometimes the spiritual crisis can be tremendous. Since spiritual health coordinates different aspects of human life, this study aimed to identify the spiritual health of patients with defects caused by diabetes. MATERIALS AND METHODS This was a qualitative-phenomenological and descriptive study and the participants were selected from rehabilitation centers in Isfahan and Valiasr Hospital in Zanjan. A purposive sample of 15 participants underwent deep interviews. Colaizzi's method of analysis was used to analyze the data. FINDINGS outcome of this phase of the study was 173 codes and 2 groups that included hindering factors in spiritual health and the promotion of the relation with God. The concepts that patients had experienced as hindering factors of the treatment process were disappointment and hopelessness, guilt, feeling distant from God, quitting obligatory acts and knowing God as cruel. The concepts that patients had experienced as contributing factors to the healing process were resorting to Imams, God's ordering the disease as a reward, fear of God's punishment, believing in miracles, being closer to God, believing in the mercy of God, returning to religious practice, feeling of enjoying life and knowing that the disease is the atonement of sins. CONCLUSIONS With regard to the importance of spiritual and religious care as one of the tasks of nurses, as the key members of health team, they should respect the patients' beliefs and values in addition to considering their physical and mental conditions.
Collapse
Affiliation(s)
- Shayesteh Salehi
- Associate Professor, School of Nursing and Midwifery, Khorasgan Branch, Islamic Azad University, Isfahan, Iran
| | - Arash Ghodousi
- Assistant Professor, School of Nursing and Midwifery, Khorasgan Branch, Islamic Azad University, Isfahan, Iran
| | - Khadijeh Ojaghloo
- School of Nursing and Midwifery, Khorasgan Branch, Islamic Azad University, Isfahan, Iran
| |
Collapse
|
36
|
Ghodousi A, Maghsoodloo S, Hoseini SMS. Forensic aspect of elder abuse: risk factors and characteristics. J Res Med Sci 2011; 16:1598-604. [PMID: 22973369 PMCID: PMC3434902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 12/05/2011] [Indexed: 12/03/2022]
Abstract
BACKGROUND This study aimed to determine the types of elder abuse, their risk factors and the characteristics of abusers among abused elderly people aged above 60 years in Isfahan. METHODS In a cross-sectional study, abused elderly individuals aged above 60 years that referred to the centers of competent jurisdiction with complaint against a person harassing them were studied during 2008-2009. The demographic profiles of the abused and abusers were collected by physicians who worked in forensic medical centers, using a questionnaire. The type of abuse was classified as physical, emotional, sexual and neglect. RESULTS The prevalence of physical, emotional and sexual abuse as well as neglect in 68 individuals who were intentionally abused was 100%, 100%, 0% and 11.8%, respectively. Abused subjects were healthy, unemployed and illiterate men and women (similar sex distribution) with moderate monthly income who lived with their families, mainly in cities (p < 0.05). The abusers were mainly healthy and illiterate men, mostly the sons of the abused person, living in cities (p < 0.05). Forty six (67.6%) patients had previous history of abuse, 43 (63.2%) had more than one previous record and in 45 ones (66.2%) the previous abuse was repeated. There was no relation between elder abuse and drug and alcohol abuse (p > 0.05). CONCLUSIONS The findings of this study provided a sense about the probably high prevalence of elder abuse in our community and its related risk factors.
Collapse
Affiliation(s)
- Arash Ghodousi
- Assistant Professor, School of Nursing and Midwifery, Khorasgan Branch, Islamic Azad University, Isfahan, Iran.,
Corresponding author: Arash Ghodousi E-mail:
| | - Safa Maghsoodloo
- Psychiatrist, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|
37
|
Nomanpour B, Ghodousi A, Babaei A, Abtahi HR, Tabrizi M, Feizabadi MM. Rapid, cost-effective, sensitive and quantitative detection of Acinetobacter baumannii from pneumonia patients. Iran J Microbiol 2011; 3:162-9. [PMID: 22530083 PMCID: PMC3330178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Pneumonia with Acinetobacter baumannii has a major therapeutic problem in health care settings. Decision to initiate correct antibiotic therapy requires rapid identification and quantification of organism. The aim of this study was to develop a rapid and sensitive method for direct detection of A. baumannii from respiratory specimens. MATERIALS AND METHODS A Taqman real time PCR based on the sequence of bla(oxa-51) was designed and used for direct detection of A. baumannii from 361 respiratory specimens of patients with pneumonia. All specimens were checked by conventional bacteriology in parallel. RESULTS The new real time PCR could detect less than 200 cfu per ml of bacteria in specimens. There was agreement between the results of real time PCR and culture (Kappa value 1.0, p value<0.001). The sensitivity, specificity and predictive values of real time PCR were 100%. The prevalence of A. baumannii in pneumonia patients was 10.53 % (n=38). Poly-microbial infections were detected in 65.71% of specimens. CONCLUSION Acinetobacter baumannii is the third causative agent in nosocomial pneumonia after Pseudomonas aeroginosa (16%) and Staphylococcus aureus (13%) at Tehran hospitals. We recommend that 104 CFU be the threshold for definition of infection with A. baumannii using real time PCR.
Collapse
Affiliation(s)
- B Nomanpour
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ghodousi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Babaei
- Department of Anesthesiology, Shaheed Rajaei Cardiovascular, Medical & Research Center, Vali- Asr Avenue Tehran- Iran
| | - HR Abtahi
- Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - M Tabrizi
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - MM Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran,Pediatric Infection Diseas Research Center, Tehran, University of Medical Science, Tehran, Iran, Corresponding author: Mohammad Mehdi Feizabadi PhD Address: Department of Microbiology, School of Medicine, Poorsina Street, Keshavarz Blvd, Tehran, Iran. Tel/Fax: +98-21-88955810. E-mail:
| |
Collapse
|
38
|
Feizabadi MM, Ghodousi A, Nomanpour B, Omrani M, Shahcheraghi F. Development of a modified DNA extraction method for pulsed-field gel electrophoresis analysis of Staphylococcus aureus and enterococci without using lysostaphin. J Microbiol Methods 2011; 84:144-6. [DOI: 10.1016/j.mimet.2010.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 10/25/2010] [Accepted: 11/05/2010] [Indexed: 11/27/2022]
|
39
|
Hamissi J, Ramezani GH, Ghodousi A. Prevalence of dental caries among high school attendees in Qazvin, Iran. J Indian Soc Pedod Prev Dent 2008; 26 Suppl 2:S53-5. [PMID: 19075448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the prevalence of dental caries among high school students in Qazvin, Iran. MATERIALS AND METHODS Seven hundred and eighty randomly selected high school students participated in this study. There wer 315 (40.38%) boys and 465 (59.62%) girls of the ages of 15 and 16 years. They were examined for dental caries using World Health Organization (WHO) diagnostic criteria. The data were obtained from the epidemiological study of oral health carried out. RESULTS Of the total sample, only 24.5% were caries free, i.e.,the caries prevalence was 75.5%. The mean DMFT value for the total sample was 2.71 (+/- 0.86). Male students had a higher mean DMFT value (2.88 +/- 0.61) than female students (2.54 +/- 0.71) (P > 0.05). The mean DMFT value for the 15-year-old children was 2.66 (+/- 0.85) and for the 16-year-old children it was 2.76 (+/- 0.92). No statistically significant difference was found between male and female students. Also, no significant differences were seen.
Collapse
Affiliation(s)
- J Hamissi
- Department of Periodontics and Preventive Dentistry, Faculty of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran.
| | | | | |
Collapse
|