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Yousefi Nojookambari N, Eslami G, Sadredinamin M, Vaezjalali M, Nikmanesh B, Dehbanipour R, Yazdansetad S, Ghalavand Z. Sub-minimum inhibitory concentrations (sub-MICs) of colistin on Acinetobacter baumannii biofilm formation potency, adherence, and invasion to epithelial host cells: an experimental study in an Iranian children's referral hospital. Microbiol Spectr 2024; 12:e0252323. [PMID: 38230925 PMCID: PMC10846280 DOI: 10.1128/spectrum.02523-23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/07/2023] [Indexed: 01/18/2024] Open
Abstract
Here, we described the efficacy of colistin sub-minimum inhibitory concentrations (sub-MICs) on biofilm-forming activity, host epithelial cell adherence, and invasion capacity of Acinetobacter baumannii strains collected from children admitted to the Children's Medical Center Hospital. Biofilm formation potency of A. baumannii clinical isolates was measured using a 96-well microtiter plate assay. Distribution of biofilm-related genes, including bap, abaI, ompA, csuE, and blaPER-1, was detected by PCR. The mRNA expression level of ompA and csuE was measured by qPCR in the presence of ¼ and ½ MICs of colistin. A. baumannii adhesion and invasion to eukaryotic host cells were phenotypically assayed at sub-MICs of colistin. Eighty percent (56/70) and 35.7% (25/70) of A. baumannii isolates were multidrug-resistant (MDR) and extensively drug-resistant (XDR) phenotypes, respectively. The strong, moderate, and weak biofilm producers of A. baumannii were 37.1% (26/70), 32.8%, (23/70), and 22.8% (16/70), respectively. The frequencies of biofilm-associated genes were 100% for abaI, ompA, and csuE, followed by 22.8% (16/70) and 24.3% (17/70) for bap and blaPER-1, respectively. The downregulation of csuE and ompA expression levels was observed in the sub-MIC of colistin. In vitro cell culture study showed a decreased capability of A. baumannii to adhere to the human epithelial cells at sub-inhibitory doses of colistin; however, none of the isolates could invade HEp-2 cells. Our study showed that the genes encoding biofilm-associated proteins undergo downregulation in expression levels after exposure to sub-MICs of colistin in A. baumannii. Longitudinal in vivo studies are needed to fully understand the clinical aspects of pathogenicity mechanisms and evolutionary dynamics of drug resistance.IMPORTANCESince the toxicity of colistin is dose dependent, there is a focus on strategies that reduce the dose while maintaining the therapeutic effect of the drug. Our findings about sub-inhibitory doses of colistin provide a novel insight into the logical use of colistin to treat and control Acinetobacter baumannii-related infections in clinical practice.
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Affiliation(s)
- Neda Yousefi Nojookambari
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gita Eslami
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrzad Sadredinamin
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Vaezjalali
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Dehbanipour
- Department of Microbiology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Sajjad Yazdansetad
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zohreh Ghalavand
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Heydarifard Z, Chegeni AM, Heydarifard F, Nikmanesh B, Salimi V. An overview of SARS-CoV2 natural infections in companion animals: A systematic review of the current evidence. Rev Med Virol 2024; 34:e2512. [PMID: 38282405 DOI: 10.1002/rmv.2512] [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: 07/26/2023] [Revised: 12/10/2023] [Accepted: 01/03/2024] [Indexed: 01/30/2024]
Abstract
This systematic review provides a comprehensive overview of natural SARS-CoV-2 infections in companion animals. The findings show that these infections are relatively rare. Among the examined dogs, only 1.32% tested positive for SARS-CoV-2, while for cats, the rate was 1.55%. Infections in rabbits and ferrets were even less common, at less than 1%. These results support previous research indicating the infrequency of natural infections in companion animals. The review also includes updated studies that involved various pets, such as cats, dogs, ferrets, and rabbits. The majority of the studies analyzed were primarily concerned with screening pets that visited veterinary clinics, regardless of whether they showed any specific signs of SARS-CoV-2 infection. Only a limited number of studies investigated infections in animals suspected of being in contact with owners or other animals that had COVID-19 or were exhibiting symptoms. The most common variant identified among the SARS-CoV-2 variants in the reviewed studies was B.1.1.7 (alpha), followed by B.1.617.2 (delta), B.1.526 (Iota), and others. The emergence of these variants raises concerns about their potential for increased transmissibility and virulence, highlighting the importance of ongoing monitoring of SARS-CoV-2 infections in both humans and animals. Furthermore, most of the reviewed studies indicated that infected pets either showed no symptoms or experienced mild symptoms. This aligns with previous reports suggesting that animals infected with SARS-CoV-2 generally have less severe illness compared to humans. However, it is essential to recognize the possibility of severe illness or death in animals, particularly those with underlying health conditions. Continuous surveillance of SARS-CoV-2 infections in companion animals is crucial for better understanding the virus's epidemiology in animals and developing effective strategies to protect both animal and human health.
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Affiliation(s)
- Zahra Heydarifard
- Department of Virology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ardalan Maleki Chegeni
- Department of Virology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fatemeh Heydarifard
- Department of Veterinary, Faculty of Veterinary Medicine, Lorestan University, Khorramabad, Iran
| | - Bahram Nikmanesh
- Department of Clinical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
- Zoonoses Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Salimi
- Zoonoses Research Centre, Tehran University of Medical Sciences, Tehran, Iran
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Aboutalebian S, Nikmanesh B, Mohammadpour M, Charsizadeh A, Mirhendi H. Candida palmioleophila candidemia and bacterial co-infection in a 3-month-old infant with biliary atresia. Front Cell Infect Microbiol 2023; 13:1277607. [PMID: 38029248 PMCID: PMC10652749 DOI: 10.3389/fcimb.2023.1277607] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Candidemia caused by rare and uncommon Candida species is becoming more prevalent in pediatric healthcare settings, resulting in significant morbidity and mortality. One such species, Candida palmioleophila, is resistant to fluconazole but highly susceptible to echinocandins. Here, we report the first documented case of C. palmioleophila candidemia in Iran that occurred in a male infant with biliary atresia who had been hospitalized for 2 months. The patient's blood and urine cultures were positive for both yeast and bacterial species. Through DNA sequence analysis, the yeast isolate was identified as C. palmioleophila. In vitro antifungal susceptibility testing of the isolate against amphotericin B, fluconazole, itraconazole, voriconazole, isavuconazole, posaconazole, and nystatin revealed MIC values of 2, 16, 0.25, 0.0625, 0.125, 0.25, and 4 μg/mL, respectively, and minimum effective concentration for caspofungin was 0.031 μg/mL. Despite receiving antibacterial and antifungal therapies, the patient unfortunately expired due to bradycardia and hypoxemia. Proper identification and epidemiological surveillance studies are needed to understand the exact prevalence of these emerging yeast pathogens. Previously reported cases of C. palmioleophila infection, primarily associated with bloodstream infections and catheter-related candidemia, were reviewed.
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Affiliation(s)
- Shima Aboutalebian
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Science, School of Allied Medical Science, Tehran University of Medical Science, Tehran, Iran
- Zoonoses Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Mohammadpour
- Pediatric Intensive Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Charsizadeh
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Mirhendi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
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Aboutalebian S, Mirhendi H, Eshaghi H, Nikmanesh B, Charsizadeh A. The first case of Wickerhamomyces anomalus fungemia in Iran in an immuneodeficient child, a review on the literature. J Mycol Med 2023; 33:101351. [PMID: 36413850 DOI: 10.1016/j.mycmed.2022.101351] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/24/2022] [Accepted: 11/09/2022] [Indexed: 11/14/2022]
Abstract
The incidence of invasive candidiasis in pediatric patients is increasing and is associated with significant morbidity and mortality. C. pelliculosa has been rarely reported as a human pathogen, however, it has been associated with serious nosocomial infections and clonal outbreaks with poor clinical outcomes in immunocompromised children were reported. Here, we describe the first case of candidemia due to Candida pelliculosa in a 5-year-old immunocompromised male suffered from Griscelli syndrome with hemophagocytic syndrome hospitalized in the pediatric intensive care unit (PICU), Tehran, Iran. In addition, the history of reported cases or case-series due to C. pelliculosa is reviewed.
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Affiliation(s)
- Shima Aboutalebian
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mirhendi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Eshaghi
- Department of Infectious Disease, Tehran University of Medical Sciences, Tehran Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Science, School of Allied Medical Science, Tehran University of Medical Science, Tehrn, Iran; Zoonoses Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Charsizadeh
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran Iran.
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Haghshenas M, Koosha M, Latifi A, Kazemirad E, Dehghan A, Nikmanesh B, Mowlavi G. Detection of Enterobius vermicularis in archived formalin-fixed paraffin-embedded (FFPE) appendectomy blocks: It's potential to compare genetic variations based on mitochondrial DNA (cox1) gene. PLoS One 2023; 18:e0281622. [PMID: 36758053 PMCID: PMC9910638 DOI: 10.1371/journal.pone.0281622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/27/2023] [Indexed: 02/10/2023] Open
Abstract
Acute appendicitis represents one of the most common causes of emergency abdominal surgery worldwide. Meanwhile, Enterobius vermicularis has been suggested as one of the probable causes of appendicitis. In this study, the morphological characteristics of the remnant pinworms and pathologic changes were explored in old-archived FFPE tissues of appendectomies. Moreover, we provide the first molecular identification, genetic, and haplotype variation of this nematode from the old-archived FFPE tissue section of appendectomy using the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Seventeen FFPE appendectomies with E. vermicularis infection, stored over 12-22 years, were collected from two different geographical areas of Iran. In the histopathological examination, tissue changes were observed in thirteen cases (76.4%) and inflammation in four blocks (23.5%). After DNA extraction, the cox1 gene was amplified in twelve (70.6%) cases using the nested polymerase chain reaction (PCR). Phylogenetic analysis and a median-joining network of 78 available cox1 sequences of E. vermicularis revealed 59 haplotypes. We identified five haplotypes that fell into type B. All Haplotypes are novel except for two haplotypes, Hap32 and Hap37, identical to E. vermicularis sequences from Iran, Greece, and Germany. The ranges of diversity distance and haplotype diversity within the isolates were 0-1.9% and HD:0.643-0.667, subsequently. Overall, the absence of inflammation or even tissue changes in some sections can suggest the possible non-inflammatory role of E. vermicularis in appendicitis. Although FFPE material suffers from PCR inhibition, we could successfully use nested PCR to characterize E. vermicularis in old-archived appendectomy blocks and suggest this method as a complementary diagnosis technique in pathology. While the predominant type was B in the Middle East and Europe, further studies on a larger sample size from different geographical regions could probably confirm the results obtained in the present study.
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Affiliation(s)
- Maryam Haghshenas
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Koosha
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Latifi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Kazemirad
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail: , (EK); (GM)
| | - Arash Dehghan
- Department of Pathology, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Mowlavi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
- * E-mail: , (EK); (GM)
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Davari A, Hedayati MT, Jafarzadeh J, Nikmanesh B, Nabili M, Hamidieh AA, Abastabar M, Ahmadi N, Al-Hatmi AM, Moazeni M. Evaluation of Candida colonization index, molecular identification, and antifungal susceptibility pattern of Candida species isolated from critically ill pediatric patients: A single-center study in Iran. Curr Med Mycol 2022; 8:15-21. [PMID: 37736608 PMCID: PMC10509495 DOI: 10.32598/cmm.2023.1372] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/03/2022] [Accepted: 03/07/2023] [Indexed: 09/23/2023] Open
Abstract
Background and Purpose Given the high mortality rate of invasive candidiasis in hospitalized pediatric patients, it is crucial to establish a predictive system to achieve early diagnosis and treatment of patients who are likely to benefit from early antifungal treatment. This study aimed to assess the Candida colonization index, species distribution, and antifungal susceptibility pattern of Candida strains isolated from pediatric patients with high Candida colonization index (CI). Materials and Methods This study was carried out at the Children's Medical Center in Tehran-Iran. In total, 661 samples were collected from 83 patients. The Candida CI was calculated according to the descriptions of previous studies. The isolates were identified using polymerase chain reaction-based techniques. The Clinical and Laboratory Standard Institute protocol M60 was used to conduct the antifungal susceptibility test. Results A colonization index greater than 0.5 was confirmed in 29 cases (58% of positive samples) with two children developing candidemia. Candida albicans (n=53, 49.5%) was the most common Candida species in patients with CI > 0.5. Except for acute lymphoblastic leukemia, no risk factors were linked to a high index in colonized children (P > 0.05). Twelve isolates (7.01%) were multi-azole resistant with high MICs against both isavuconazole and ravuconazole and seven strains (4.09%) were echinocandins resistant. Conclusion In pediatric intensive care units, patients are at risk of fungal infection, particularly candidemia. In this study, more than half of the children with positive yeast cultures had CI > 0.5, and 6.8% developed candidemia.
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Affiliation(s)
- Amirhossein Davari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Taghi Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jalal Jafarzadeh
- Department of Medical Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Nabili
- Department of Medical Laboratory Sciences, Faculty of Medicine, Sari Branch, Islamic Azad University, Sari, Iran
| | - Amir Ali Hamidieh
- Pediatric Stem Cell Transplant Department, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasim Ahmadi
- Nosocomial Infection Medical Research Centre, Mazandaran University of Medical Sciences, Buali Sina Hospital, Sari, Iran
| | - Abdullah M.S. Al-Hatmi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Maryam Moazeni
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Moazeni M, Davari A, Hedayati MT, Jafarzadeh J, Nikmanesh B, Nabili M. P239 Molecular identification and antifungal susceptibility pattern of Candida species isolated from pediatrics with high colonization index in the Children Medical Center, Tehran. Med Mycol 2022. [PMCID: PMC9509964 DOI: 10.1093/mmy/myac072.p239] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Candidemia is the third leading cause of bloodstream infections whereas it is the second leading cause of sepsis-related mortality in children and subsequently, understanding a link between such infection and Candida colonization is an important issue for clinicians for decades; so, this link has proposed the colonization index as the ‘missing link’. The aim of this study was to evaluate the Candida colonization index in pediatric patients staying at intensive care units (ICUs) as well as bone marrow transplantation (BMT) unit and to determine the species distribution and susceptibility pattern of the isolates against several antifungal drugs. Material and Methods This study was conducted in the Children's Medical Center in Tehran-Iran between March 2019 and September 2019. Totally, 661 samples from 83 patients including oral cavity, skin surrounded catheters; ear, throat, nasal, and urine cultures were collected. Candida colonization index (CI) was calculated according to the previous study's description. CHROMagar Candida medium was applied for primary/multiple species identification and the isolates were then identified by using PCR-based methods to the species-specific complex level. Antifungal Susceptibility test was performed according to the Clinical and Laboratory Standards protocol published as M27-A2 and M60 documents. Fluconazole (FLZ), itraconazole (ITZ), voriconazole (VRZ), ravuconazole (RVZ), and isavuconazole (ISZ), caspofungin (CAS) and anidulafungin (AFG), and amphotericin B were used. Results Of 661 samples, 178 samples from 50 individuals (27%) were considered as positive cultures, amongst CI >0.5 confirmed in 29 cases (58% of positive samples). Candida albicans was reported as the most frequent species in BMT and IICU. Notably, C. krusei was the most prevalent species in PICU and the second in IICU. Candida albicans (n = 53, 49.5%) followed by C. glabrata (n = 20, 18.7%), C. krusei (n = 15, 14%), C. parapsilosis (n = 12, 11.2%) were the most frequent Candida species in patients with CI >0.5. Among FLZ-resistant strains, 12 isolates (7.01%) were multi-azole resistant which showed high MICs against both ISZ and RVZ and 7 strains (4.09%) were resistant to all echinocandins. ISZ, RVZ, and AFG were reported as the most effective antifungals, regarding the values of GM. Conclusion In the present study, more than half of children with positive yeast cultures had CI >0.5 representing the high possibility of developing invasive candidiasis. However, none of the children with CI ≥0.5 developed invasive candidiasis during the time of the study. To the best of our knowledge, there is no study about the evaluation of CI in pediatrics in Iran. More detailed and larger studies should be made to understand the impact of risk factors on CI value in the future.
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Affiliation(s)
- Maryam Moazeni
- Invasive Fungi Research Center , Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari , Iran
| | - Amirhossein Davari
- Student Research Committee , Mazandaran University of Medical Sciences, Sari, Iran;, Sari , Iran
| | - Mohammad Taghi Hedayati
- Invasive Fungi Research Center , Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari , Iran
| | - Jalal Jafarzadeh
- Department of Medical Mycology and Parasitology , School of Medicine, Babol University of Medical Sciences, Babol, Iran, Babol , Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences , School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran, Tehran , Iran
| | - Mojtaba Nabili
- Department of Medical Laboratory Sciences , Faculty of Medicine, Sari Branch, Islamic Azad University, Sari, Iran, Sari , Iran
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Davari A, Jafarzadeh J, Hedayati MT, Shokohi T, Abastabar M, Nikmanesh B, Moazeni M. High frequency of Candida krusei colonization in critically ill pediatrics: A cross-sectional study in children's medical center, Tehran, Iran. Curr Med Mycol 2022; 8:25-31. [PMID: 36654792 PMCID: PMC9825791 DOI: 10.18502/cmm.8.2.10329] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/23/2022] [Accepted: 06/29/2022] [Indexed: 11/15/2022] Open
Abstract
Background and Purpose This study aimed to evaluate the species distribution and susceptibility pattern of the strains isolated from Candida colonization in pediatric patients staying at pediatric intensive care unit (ICU) and infant ICU of Children's Medical Center in Tehran, Iran. Materials and Methods This study was conducted in the Children's Medical Center in Tehran, Iran. In total, 440 samples from 56 patients with oral cavity, skin surrounded catheters, and ear, throat, nasal, and urine cultures were collected. All patients were evaluated in terms of Candida colonization on the admission day as well as the days 7, 14, and 28 according to the previous studies. CHROMagar Candida medium was applied for primary/multiple species identification and the isolates were identified by using polymerase chain reaction-based methods to the species-specific complex level. The antifungal susceptibility test was performed according to the Clinical and Laboratory Standards protocol published as M27-A3 and M60 documents. Results In total, 136 yeast samples from 26 individuals (30.9%) out of 440 samples were considered colonization. The most prevalent species in IICU was C. albicans (27%, n=20) followed by C. krusei (24 %, n=18) and C. parapsilosis (16%, n=12). In PICU, the predominant species was C. krusei (40%, n=24) followed by C. parapsilosis (18%, n=11) and C. dubliniensis (16%, n=10). Among the 40 tested isolates from both units, fluconazole-resistant isolates (n=11, 8.15%) were determined according to the new breakpoints. In the case of echinocandins, 2 isolates, including C. albicans (n=1) and C. krusei (n=1) were resistant against both caspofungin and anidulafungin (totally 1.48%). Conclusion In the present study, since C. krusei is intrinsically-resistance against fluconazole, emphasizing the importance of species-level identification of Candida isolates is outstanding. However, according to the antifungal susceptibility testing results, only 7.2% of the strains were resistant to fluconazole. It would be beneficial to monitor the ICU patients who are at high risk of invasive Candida infection.
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Affiliation(s)
- Amirhossein Davari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran,
Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jalal Jafarzadeh
- Department of Medical Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Taghi Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,
Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Shokohi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,
Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,
Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Moazeni
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,
Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Aboutalebian S, Mahmoudi S, Charsizadeh A, Nikmanesh B, Hosseini M, Mirhendi H. Multiplex size marker (YEAST PLEX) for rapid and accurate identification of pathogenic yeasts. J Clin Lab Anal 2022; 36:e24370. [PMID: 35318737 PMCID: PMC9102616 DOI: 10.1002/jcla.24370] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 10/13/2021] [Revised: 01/26/2022] [Accepted: 02/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background Multiple yeast species can cause human disease, involving superficial to deep‐seated infections. Treatment of these infections depends on the accurate identification of causative agents; however, reliable methods are not available in many laboratories, especially not in resource‐limited settings. Here, a new multiplex assay for rapid and low‐cost identification of pathogenic yeasts is described. Methods A two‐step multiplex assay named YEAST PLEX that comprises of four tubes and identifies 17 clinically important common to rare yeasts was designed and evaluated. The set also provides PCR amplicon of unidentified species for direct sequencing. The specificity of YEAST PLEX was tested using 28 reference strains belonging to 17 species and 101 DNA samples of clinically important non‐target bacteria, parasites, and fungi as well as human genomic DNA. The method was further analyzed using 203 previously identified and 89 unknown clinical yeast isolates. Moreover, the method was tested for its ability to identify mixed yeast colonies by using 18 mixed suspensions of two or three species. Results YEAST PLEX was able to identify all the target species without any non‐specific PCR products. When compared to PCR‐sequencing/MALDI‐TOF, the results of YEAST PLEX were in 100% agreement. Regarding the 89 unknown clinical isolates, random isolates were selected and subjected to PCR‐sequencing. The results of sequencing were in agreement with those of YEAST PLEX. Furthermore, this method was able to correctly identify all yeasts in mixed suspensions. Conclusion YEAST PLEX is an accurate, low‐cost, and rapid method for identification of yeasts, with applicability, especially in developing countries.
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Affiliation(s)
- Shima Aboutalebian
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Mahmoudi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Arezoo Charsizadeh
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Hosseini
- Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mirhendi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
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10
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Fakhkhari P, Tajeddin E, Azimirad M, Salmanzadeh-Ahrabi S, Abdi-Ali A, Nikmanesh B, Eshrati B, Gouya MM, Owlia P, Zali MR, Alebouyeh M. Involvement of Pseudomonas aeruginosa in the occurrence of community and hospital acquired diarrhea, and its virulence diversity among the stool and the environmental samples. Int J Environ Health Res 2022; 32:61-71. [PMID: 32073302 DOI: 10.1080/09603123.2020.1726300] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
Transmission of Pseudomonas aeruginosa along the food chain could cause gastrointestinal infections. To show this involvement, the prevalence, putative virulence genotype, and antibiotic resistance phenotype of P. aeruginosa isolates from stool of 1482 patients with community and hospital acquired diarrhea were compared with 87 isolates from the environmental samples. The results showed infection with P. aeruginosa in 3.4% of the cases, while 57.4% of vegetable samples were contaminated. Significantly higher frequency of lasB (98%), aprA (98%), exoY (98%), and exoS (90%), but lower rate of exoT (39.2%), was detected among the stool isolates. Multi-drug resistance (MDR) phenotype was detected in 25.5% and 4% of the stool and vegetable isolates, respectively. A higher rate of studied virulence genes was detected among the MDR strains vs non-MDR strains. These results indicate P. aeruginosa as a causative agent of diarrhea either among the hospitalized patients and those with community-acquired diarrhea.
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Affiliation(s)
- Parisa Fakhkhari
- Department of Microbiology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran
| | - Elahe Tajeddin
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Azimirad
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ahya Abdi-Ali
- Department of Microbiology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Eshrati
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Mehdi Gouya
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Parviz Owlia
- Molecular Microbiology Research Center (MMRC), Shahed University, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Alebouyeh
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Mirhendi H, Charsizadeh A, Aboutalebian S, Mohammadpour M, Nikmanesh B, de Groot T, Meis JF, Badali H. South Asian (Clade I) Candida auris meningitis in a paediatric patient in Iran with a review of the literature. Mycoses 2021; 65:134-139. [PMID: 34780087 DOI: 10.1111/myc.13396] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 10/28/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 12/29/2022]
Abstract
Candida meningitis is a rare life-threatening yeast infection mostly involving immunocompromised or paediatric patients undergoing neurosurgical procedures or shunt placement. Due to difficulties in diagnosis because of diverse clinical manifestations, the number of patients affected is most likely underestimated. Therefore, the correct diagnosis may be delayed for months, and accurate species identification is highly recommended for administering appropriate antifungal therapy. We report the first case of fluconazole-resistant Candida auris meningitis in a paediatric patient in Iran. This strain was probably imported, as it genotypically belonged to Clade I from South Asia. Furthermore, we include a literature review of C auris meningitis cases, as the number of cases with C auris meningitis has increased with reports from the United Kingdom, India and Iran. This problem might increase further in the era of COVID-19 due to attrition of experienced healthcare personnel and a high workload of hospital healthcare workers. To understand the precise prevalence of this emerging multidrug resistance pathogen, epidemiological surveillance studies are urgently warranted.
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Affiliation(s)
- Hossein Mirhendi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Core Facility Research Laboratory, Mycology Reference Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arezou Charsizadeh
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Aboutalebian
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Mohammadpour
- Pediatric Intensive Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Theun de Groot
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,ECMM Excellence Center for Medical Mycology, Centre of Expertise in Mycology Radboudumc/Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,ECMM Excellence Center for Medical Mycology, Centre of Expertise in Mycology Radboudumc/Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.,Bioprocess Engineering and Biotechnology Graduate Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Hamid Badali
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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12
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Yousefi Nojookambari N, Sadredinamin M, Dehbanipour R, Ghalavand Z, Eslami G, Vaezjalali M, Nikmanesh B, Yazdansetad S. Prevalence of β-lactamase-encoding genes and molecular typing of Acinetobacter baumannii isolates carrying carbapenemase OXA-24 in children. Ann Clin Microbiol Antimicrob 2021; 20:75. [PMID: 34702307 PMCID: PMC8549256 DOI: 10.1186/s12941-021-00480-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/04/2021] [Accepted: 10/11/2021] [Indexed: 12/12/2022] Open
Abstract
Background β-Lactam antibiotics have been broadly used for the treatment of Acinetobacter baumannii infections, resulting in development of β-lactam inactivating β-lactamases. Here, we described antibiotic resistance rate, prevalence of β-lactamase-encoding genes, and clonal relationships of A. baumannii strains isolated from children referred to Children’s Medical Center in Tehran, Iran, during 2019–2020. Methods A total of 60 non-replicate A. baumannii isolates were recovered from clinical specimens of pediatric patients. Antibiotic susceptibility testing was done by the disc diffusion method. Colistin susceptibility of isolates was performed by the broth microdilution method. β-lactamase-encoding genes were characterized by PCR. The presence of ISAba1 element upstream of the several oxacillinase genes was also checked. Genetic relatedness of isolates was determined by using random amplification of polymorphic DNA (RAPD) typing. Results The antimicrobial susceptibility tests showed that 83.3% of A. baumannii isolates were MDR, and 40% XDR. Both MDR and XDR A. baumannii isolates were susceptible to colistin. The frequency of blaOXA-51-like, blaOXA-23-like, blaTEM, blaOXA-24-like, blaPER, blaSHV, blaCTX-M, blaOXA-58-like, and blaIMP was 100, 93.33, 60, 36.67, 28.33, 8.33, 5, 3.33, and 1.67%, respectively. Coexistence of ISAba1/blaOXA-23-like and ISAba1/blaOXA-51-like was observed in 65% and 85% of isolates, respectively. RAPD analysis revealed 4 common types and 2 single types of A. baumannii isolates. Conclusions The multiple clones harboring blaOXA-23-like, ISAba1-blaOXA-51-like, and ISAba1-blaOXA-23-like were responsible for the spread of A. baumannii isolates in our clinical wards. Dissemination of the well-established clones is worrisome and would become therapeutic challenges due to the possible transferring genetic elements associated with resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s12941-021-00480-5.
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Affiliation(s)
- Neda Yousefi Nojookambari
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrzad Sadredinamin
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Dehbanipour
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Ghalavand
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Gita Eslami
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Vaezjalali
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Sajjad Yazdansetad
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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13
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Rasoulinasab M, Shahcheraghi F, Feizabadi MM, Nikmanesh B, Hajihasani A, Aslani MM. Distribution of ciprofloxacin-resistance genes among ST131 and non-ST131 clones of Escherichia coli isolates with ESBL phenotypes isolated from women with urinary tract infection. Iran J Microbiol 2021; 13:294-302. [PMID: 34540167 PMCID: PMC8416580 DOI: 10.18502/ijm.v13i3.6389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives: Escherichia coli (E. coli) sequence type 131 (ST131) is associated with extended-spectrum beta-lactamase (ESBL) production and fluoroquinolone resistance. This study aimed to investigate the prevalence of ST131, ESBL, and plasmid-mediated quinolone resistance (PMQR) genes in the ciprofloxacin-resistant (CIPR) and ESBL producers from women with UTI. Materials and Methods: The CIP-resistant ESBL producing (CIPR/ESBL+) E. coli isolates were screened for ST131-by specific PCR of mdh and gyrB. The ESBL and PMQR genes were screened by single PCR. The ST131 and non-ST131 isolates were selected to determine the mutations of gyrA and parC using PCR and sequencing, and also their genetic background by the Pasteur-MLST scheme. Results: Overall, 55% (33/60) CIPR/ESBL+ isolates were identified as ST131 (94% O25b-ST131). Resistance rate to ampicillin-sulbactam (70%), aztreonam (97%) and gentamicin (61%), the prevalence of aac(6′)-Ib-cr (66%), bla
CTX-M-15 (82%), the profile of qnrS+aac(6′)-Ib-cr (30%), and the double mutation in the parC was significantly higher in ST131 than non- ST131 isolates. The coexistence of PMQR and ESBL genes was found in more than 50% of ST131 and non-ST131 isolates. ST131 isolates differentiated into PST43 and PST506. Conclusion: Management of women with UTI caused by the CIPR/ESBL+ isolates (ST131) co-harbored PMQR, ESBL, and chromosomal mutations, is important for their effective therapy.
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Affiliation(s)
| | | | - Mohammad Mehdi Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Azade Hajihasani
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
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14
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Kodori M, Nikmanesh B, Hakimi H, Ghalavand Z. Antibiotic Susceptibility and Biofilm Formation of Bacterial Isolates Derived from Pediatric Patients with Cystic Fibrosis from Tehran, Iran. Arch Razi Inst 2021; 76:397-406. [PMID: 34223738 DOI: 10.22092/ari.2020.128554.1416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 02/26/2020] [Indexed: 09/30/2022]
Abstract
Cystic fibrosis (CF) is a genetic disease with a high rate of morbidity and mortality. Children with CF commonly suffer from recurrent and persistent pulmonary tract infections caused by diverse bacterial pathogens. This study aimed to investigate the prevalence, antimicrobial susceptibility, and biofilm formation of bacterial isolates in pediatric patients with CF. The study population of this cross-sectional study included 8,908 children suspected to have CF by clinical manifestations from March 2015 to August 2017 who were referred to the Tehran Pediatric Central Hospital, Iran. The tests carried out for each participant included screening sweat test, sputum culture, antibiotic susceptibility test using Kirby-Bauer disk diffusion method, and biofilm formation in microtiter plates method. Based onclinical examination and screening sweat test, 183 (2.05 %( out of 8,908 children, were positive for CF. The mean age of children was estimated at 2.93 years, and the majority of them were male (n=103, 56.2%). No gender-specific difference was observed in CF disease in this study (P>0.05). In addition, the results of sputum culture showed that 153 (83.6%) microorganisms (bacteria and fungi) were collected from CF patients. Normal flora was isolated in 30 (16.4%) patients and more than one bacterial species were isolated in 7.2% of patients. The obtained results indicated that Pseudomonas aeruginosa was the most prevalent isolated bacteria followed by Staphylococcus aureus, and Klebsiella pneumoniae. Based on the antibiotic susceptibility test results, P. aeruginosa and piperacillin/tazobactam had the highest (11.7%) and the lowest (2.3%) resistance rate against gentamicin, respectively. However, all K. pneumoniae isolates were resistant to Cefotaxime. Among S. aureus isolates, 83.4% and 16.6% were methicillin-susceptible Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus respectively. Concerning biofilm formation, 76%, 67%, and 72.5% of P. aeruginosa, S. aureus, and K. pneumoniae isolates were biofilm producers, respectively. Based on the study results, P. aeruginosa was the dominant pathogen in pediatric patients with CF from Tehran, Iran, and most of the pathogens were biofilm producers. No severe antibiotic resistance was observed in the isolates; however, the anti-microbial resistance profile should be carefully checked in CF patients on a regular basis.
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Affiliation(s)
- M Kodori
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - B Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - H Hakimi
- Department of Microbiology, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Z Ghalavand
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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15
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Mirhendi H, Charsizadeh A, Eshaghi H, Nikmanesh B, Arendrup MC. Species distribution and antifungal susceptibility profile of Candida isolates from blood and other normally sterile foci from pediatric ICU patients in Tehran, Iran. Med Mycol 2020; 58:201-206. [PMID: 31111910 DOI: 10.1093/mmy/myz047] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/27/2019] [Accepted: 04/16/2019] [Indexed: 01/23/2023] Open
Abstract
As data on pediatric invasive candidiasis (IC) and the antifungal susceptibility pattern of associated isolates are scarce in Iran, this study aimed to determine species distribution and antifungal susceptibility profile of Candida species isolated from pediatric patients with suspected or documented IC. A total of 235 yeast strains recovered from normally sterile body fluids of patients admitted at the intensive care units of Children's Medical Centre, Tehran, Iran, were identified using CHROMagar Candida, molecular methods (ITS PCR-RFLP and sequencing), and MALDI-TOF. Susceptibility to amphotericin B, fluconazole, voriconazole, micafungin, and anidulafungin was determined according to the European on Antimicrobial Susceptibility testing reference microdilution method (EUCAST E.Def 7.3.1). Candida albicans (53.6%), C. parapsilosis (24.7%), and C. tropicalis (8.5%) were the most common species, followed by C. lusitaniae (4.3%), C. glabrata (3.0%), C. guilliermondii and C. orthopsilosis (each 1.7%), C. kefyr (1.3%), C. dubliniensis (0.8%), and C. intermedia (0.4%). Amphotericin B MICs were ≤1 mg/l for all Candida isolates. C. albicans isolates were susceptible to all five antifungal agents. All C. parapsilosis isolates categorised as intermediate to micafungin and anidulafungin, except two isolates that had the MICs >2 mg/l for micafungin. MIC50, MIC90, and MIC range for fluconazole were 0.25 mg/l, 1 mg/l, and 0.125 - ≥32 mg/l, respectively. Fluconazole and voriconazole showed 100% activity against the most prevalent Candida species. The low resistance rate, favorable safety profile and low cost of fluconazole make it a reasonable choice for treatment of candidemia/invasive candidemia in Iran.
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Affiliation(s)
- Hossein Mirhendi
- Departments of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arezoo Charsizadeh
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran Iran
| | - Hamid Eshaghi
- Infectious Disease Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Maiken Cavling Arendrup
- Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
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16
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Nikmanesh B, Ahmadikia K, Getso MI, Gharehbolagh SA, Aboutalebian S, Mirhendi H, Mahmoudi S. Candida africana and Candida dubliniensis as causes of pediatric candiduria: A study using HWP1 gene size polymorphism. AIMS Microbiol 2020; 6:272-279. [PMID: 33134744 PMCID: PMC7595836 DOI: 10.3934/microbiol.2020017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/18/2020] [Accepted: 08/17/2020] [Indexed: 12/26/2022] Open
Abstract
Background Candida species cause a wide spectrum of disease entities. Candida africana and Candida dubliniensis-members of Candida albicans complex-are currently gaining both clinical and epidemiologic significance. Materials and methods Totally, 150 pediatric isolates that had previously been identified as C. albicans species complex based on a positive germ tube test were included. The isolates were cultured on CHROMagar Candida medium to ensure their purity and the results of germ tube test. For definitive speciation, PCR amplification and size polymorphism of the hyphal wall protein 1 (HWP1) gene was used. The results of HWP1-PCR were confirmed by sequencing the amplified fragments for randomly selected isolates of C. africana and C. dubliniensis. Results All 150 isolates included in this study were reconfirmed as C. albicans complex on chromogenic media. Based on the HWP1 gene size polymorphism, 141 (94%) isolates were identified as C. albicans, 2 (1.33%) as C. africana, and 1 (0.67%) as C. dubliniensis. The remaining 6 (4%) C. albicans complex isolates were a mix of C. albicans and C. africana. All isolates of C. africana and C. dubliniensis have been recovered from cases of candiduria. Conclusion C. africana, either alone or mixed with C. albicans, could be a cause of candiduria among pediatric patients and should not be ignored.
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Affiliation(s)
- Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Ahmadikia
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Ibrahim Getso
- Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, College of Health Sciences, Bayero University Kano, PMB 3011, Kano-Nigeria
| | - Sanaz Aghaei Gharehbolagh
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Aboutalebian
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mirhendi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Mahmoudi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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17
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Rasoulinasab M, Shahcheraghi F, Feizabadi MM, Nikmanesh B, Hajihasani A, Sabeti S, Aslani MM. Distribution of Pathogenicity Island Markers and H-Antigen Types of Escherichia coli O25b/ST131 Isolates from Patients with Urinary Tract Infection in Iran. Microb Drug Resist 2020; 27:369-382. [PMID: 32716242 DOI: 10.1089/mdr.2019.0485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Escherichia coli serogroup O25b-sequence type 131 (E. coli O25b/ST131) is known as a multidrug-resistant organism with high virulence potential and has received attention internationally. We aim to investigate the prevalence of O25b/ST131 and the distribution of blaCTX-M-15, pathogenicity island (PAI) markers, phylogenetic groups, and H-antigen typing in the E. coli O25b/ST131 isolated from patients with urinary tract infection (UTI) in Tehran, the capital of Iran. Seventy (26.9%) E. coli isolates were identified as O25b/ST131. There was also a significant difference in the prevalence of virulence genes, including papA, sfa, sat, cnf1, iutA, kpMII, traT, and usp, in the O25b/ST131 isolates rather than non-O25b/ST131 ones (p ≤ 0.05). Furthermore, 78% of the O25b/ST131 isolates carried four to seven PAIs, while 71% of non-O25b/ST131 isolates carried two to four PAI markers (p ≤ 0.05). Our study showed that in addition to H4, other H-antigens may play a role in the O25b/ST131 virulence potential. Besides, a significant association was found between the history of previous UTIs and infection among the O25b/ST131 clone isolates. Pulsed-field gel electrophoresis revealed circulating of O25b:H4-ST131/PST43 clone in both hospital and community. Approximately one in every three uropathogenic E. coli isolates was the O25b/ST131 clone, representing a significant public health threat. Practical investigation on O25b/ST131 can be helpful in better understanding of ST131 evolution and controlling UTI in hospitals.
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Affiliation(s)
| | | | - Mohammad Mehdi Feizabadi
- Department of Microbiology, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Azade Hajihasani
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Shahram Sabeti
- Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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18
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Habibi Ghahfarokhi S, Mosadegh M, Ahmadi A, Pourmand MR, Azarsa M, Rahbar M, Nikmanesh B. Serotype Distribution and Antibiotic Susceptibility of Streptococcus pneumoniae Isolates in Tehran, Iran: A Surveillance Study. Infect Drug Resist 2020; 13:333-340. [PMID: 32099424 PMCID: PMC7007777 DOI: 10.2147/idr.s234295] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/23/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Encapsulated Streptococcus pneumoniae strains cause high morbidity and mortality, mainly in countries with no pneumococcal conjugate vaccines (PCVs) immunization program. This study investigated the epidemiological changes of S. pneumoniae isolates including serotype distribution and antimicrobial susceptibility in Tehran, Iran. Methods A total of 80 S. pneumoniae samples were collected from patients admitted to Shariati hospital over two periods. Half of the isolates were collected from February to September 2017 and the other half from July 2018 to March 2019. The antimicrobial susceptibility testing and PCV-13 serotype coverage of S. pneumoniae isolates were evaluated among patients with invasive and non-invasive infections. Results The most common serotypes were 23F (17.5%), 14 (16.3%), 3 (16.3%) 19F (12.5%), and 19A (12.5%) in the present study. The vaccine coverage rates of PCV-7, PCV-10 and PCV-13 were 52.6%, 52.6%, and 83.7%, respectively. S. pneumoniae isolates with the serotype of the PCV-13 showed an increasing trend during the study. Nearly half of the S. pneumoniae strains were MDR, while MDR serotype 19A increased (40%) during the study periods. A small minority of isolates (16%) belonged to non-vaccine serotypes, 65% of which were assigned to MDR. In general, the frequency of penicillin resistant and MDR strains were estimated about 27.5% and 51%, respectively. An increase was observed in resistance to erythromycin and co-trimoxazole. Conclusion The results showed that majority of the circulating serotypes in our study are related to PCV-13 serotypes. The use of conjugate vaccine in the immunization program and surveillance of antimicrobial resistance can be effective in reducing the pneumococcal clinical burden.
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Affiliation(s)
- Soheila Habibi Ghahfarokhi
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Mosadegh
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ahmadi
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Pourmand
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Azarsa
- Department of Microbiology, Khoy University of Medical Sciences, Khoy, Iran
| | - Mohammad Rahbar
- Department of Microbiology, Reference Health Laboratories Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Gholipour S, Nikaeen M, Farhadkhani M, Nikmanesh B. Survey of Listeria monocytogenes contamination of various environmental samples and associated health risks. Food Control 2020. [DOI: 10.1016/j.foodcont.2019.106843] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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20
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Besharati S, Sadeghi A, Ahmadi F, Tajeddin E, Mohammad Salehi R, Fani F, Pouladfar G, Nikmanesh B, Majidpour A, Soleymanzadeh Moghadam S, Mirab Samiee S, Rahnamaye Farzami M, Rahbar M, Eslami P, Rakhshani N, Eshrati B, Gouya MM, Fallah F, Karimi A, Owlia P, Alebouyeh M. Serogroups, and drug resistance of nontyphoidal Salmonella in symptomatic patients with community-acquired diarrhea and chicken meat samples in Tehran. Iran J Vet Res 2020; 21:269-278. [PMID: 33584839 PMCID: PMC7871737] [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] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 09/26/2020] [Accepted: 10/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Salmonella is considered as a main cause of community-acquired diarrhea in humans, however, sources of the multi-drug resistant (MDR) strains and their link with the disease are not well known. AIMS This study aimed to investigate the frequency, serogroup diversity, and antimicrobial susceptibility patterns of Salmonella strains in poultry meat and stool samples of patients with community acquired diarrhea in Tehran. METHODS We compared the frequency of non-typhoidal Salmonella serogroups, the similarities of their resistance patterns to 10 antimicrobial compounds, the prevalence of extended spectrum β-lactamase (ESBL) and ampicillinase C (AmpC) genetic determinants, and class 1 and 2 integrons in 100 chicken meat and 400 stool samples of symptomatic patients in Tehran during June 2018 to March 2019. RESULTS Salmonella was isolated from 75% and 5.5% of the chicken meats and human stool samples, respectively. The chicken meat isolates mainly belonged to serogroup C (88%, 66/75), while the human stool isolates were mainly related to serogroup D (59.1%, 13/22). The MDR phenotype and the most common rates of resistance to antibiotics, including tetracycline, trimethoprim/sulfamethoxazole (TS) and azithromycin, were detected in 4.5% and 45.3%, 59% and 13.6%, 43% and 9.1%, 42% and 9.1% of the human stool and chicken meat samples, respectively. Carriage of bla CTX, bla SHV, and bla PER genes in the meat isolate with ESBL resistance phenotype and bla ACC, bla FOX, and bla CMY-2 among the 7 meat strains with AmpC resistance phenotype was not confirmed using polymerase chain reaction (PCR). High prevalence of class 1 and 2 integrons was characterized and showed a correlation with resistance to TS and chloramphenicol. CONCLUSION These findings showed a lack of association between chicken meats and human isolates due to discrepancy between the characterized serogroups and resistance phenotypes.
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Affiliation(s)
- S. Besharati
- MSc in Microbiology, Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - A. Sadeghi
- MSc in Microbiology, Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - F. Ahmadi
- MSc Student in Microbiology, Department of Microbiology, Faculty of Basic Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - E. Tajeddin
- MSc in Microbiology, Division of Microbiology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R. Mohammad Salehi
- Molecular Microbiology Research Center, Faculty of Medicine, Shahed University, Tehran, Iran
| | - F. Fani
- Division of Microbiology, Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gh. Pouladfar
- Division of Microbiology, Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - B. Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Majidpour
- Division of Microbiology, Anti-Microbial Resistance Research Center, Institute of Immunology and Infectious Diseases (IIID), Iran University of Medical Sciences, Tehran, Iran
| | - S. Soleymanzadeh Moghadam
- MSc in Microbiology, Division of Microbiology, Anti-Microbial Resistance Research Center, Institute of Immunology and Infectious Diseases (IIID), Iran University of Medical Sciences, Tehran, Iran
| | - S. Mirab Samiee
- Health Reference Laboratory, Health Reference Laboratory Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | - M. Rahnamaye Farzami
- Health Reference Laboratory, Health Reference Laboratory Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | - M. Rahbar
- Health Reference Laboratory, Health Reference Laboratory Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | - P. Eslami
- MSc in Microbiology, Department of Microbiology, Central Laboratory, Milad Hospital, Tehran, Iran
| | - N. Rakhshani
- Pathology Laboratory, Mehr Hospital, Tehran, Iran
| | - B. Eshrati
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - M. M. Gouya
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - F. Fallah
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A. Karimi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - P. Owlia
- Molecular Microbiology Research Center, Faculty of Medicine, Shahed University, Tehran, Iran
- These authors contributed equally in this study
| | - M. Alebouyeh
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- These authors contributed equally in this study
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Heidari Z, Sharbatkhori M, Mobedi I, Mirhendi SH, Nikmanesh B, Sharifdini M, Mohebali M, Zarei Z, Arzamani K, Kia EB. Echinococcus multilocularis and Echinococcus granulosus in canines in North-Khorasan Province, northeastern Iran, identified using morphology and genetic characterization of mitochondrial DNA. Parasit Vectors 2019; 12:606. [PMID: 31881913 PMCID: PMC6935109 DOI: 10.1186/s13071-019-3859-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 05/14/2019] [Accepted: 12/17/2019] [Indexed: 12/17/2022] Open
Abstract
Background Canids are definitive hosts of Echinococcus multilocularis and Echinococcus granulosus. This study aimed to survey these two Echinococcus species in canids of North-Khorasan Province, northeastern Iran, using morphological criteria and genetic characterization of mitochondrial DNA. Methods The carcasses of 106 canids, namely 61 jackals (Canis aureus), 23 foxes (Vulpes vulpes), 19 dogs (Canis familiaris) and three wolves (Canis lupus) were collected from the study area in 2013–2014 and examined for Echinococcus species. Morphological features were assessed by microscopy of adult worms. For molecular characterization, DNA was extracted, mostly from the adult worms but also from eggs. DNA fragments of the cytochrome c oxidase subunit 1 (cox1) and NADH dehydrogenase subunit 1 (nad1) mitochondrial genes were amplified and sequenced. Sequences were aligned and compared with reference sequences. Intraspecific and interspecific diversity were calculated and phylogenetic analysis was performed. Results Overall, 9.4% of the canids (eight jackals and two foxes) were found infected with E. multilocularis by molecular methods, of which seven cases were also confirmed using morphological description of the adult worms. Echinococcus granulosus was found in 6.6% of the canines (four dogs, two jackals and one wolf) as determined by both molecular methods and adult cestode morphology. All E. granulosus isolates were identified as the G1 genotype. Comparative sequence analysis indicated 0–0.7% and 0% intraspecific divergence within E. granulosus isolates and 0% and 0–0.2% within E. multilocularis isolates for cox1 and nad1, respectively. Conclusions This study revealed the presence of E. multilocularis and E. granulosus in canids of North-Khorasan Province of Iran. Jackals were found infected with both E. multilocularis and E. granulosus, but infection with the former species was higher.![]()
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Affiliation(s)
- Zahra Heidari
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Sharbatkhori
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Iraj Mobedi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Mirhendi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Nikmanesh
- Department of Lab Medical Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Sharifdini
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Zabihollah Zarei
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kourosh Arzamani
- Vector-borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Eshrat Beigom Kia
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran.
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22
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Samadi R, Ghalavand Z, Mirnejad R, Nikmanesh B, Eslami G. Antimicrobial Resistance and Molecular Characteristics of Methicillin-resistant Staphylococcus aureus Isolates from Children Patients in Iran. Infect Drug Resist 2019; 12:3849-3857. [PMID: 31849502 PMCID: PMC6910858 DOI: 10.2147/idr.s229394] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 08/31/2019] [Accepted: 11/11/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction Methicillin-resistant Staphylococcus aureus (MRSA) causes high rates of mortality and a substantial burden to health systems worldwide. Here, we investigated the antimicrobial susceptibility and molecular characteristics of MRSA isolated from children referred to Children’s Medical Center in Tehran. Materials and methods A total of 98 MRSA isolates were collected from children. Antimicrobial resistance patterns were determined using the disk diffusion and E-test methods. The presence of biofilm encoding genes and the pvl gene were determined by PCR. We used the microtiter plate method to assess the ability of biofilm formation. The MRSA isolates were further analyzed using PFGE and SCCmec typing. Results Antibiotic susceptibility testing showed that the highest and the lowest antibiotic resistance percentage were related to erythromycin (62%) and minocycline (10%), respectively. Overall, 63% of MRSA isolates were biofilm producers. Resistance to two antibiotics such as erythromycin (72% vs 28%, P=0.01) and clindamycin (71% vs 29%, P=0.04) was higher among biofilm producers than non-biofilm producers. All strains had biofilm-forming genes and the prevalence of pvl gene was 41%. Most MRSA isolates belonged to SCCmec IVa (75%) and SCCmec III (18%). In PFGE technique, 5 common types and 2 single types were identified; Common type 1 with 37 isolates was dominant clone. Conclusion We thus report preliminary data on the prevalence and distribution of MRSA genotypes in Tehran Children’s Hospital. These findings characterize the MRSA colonization dynamics in child patients in Iran and may aid the design of strategies to prevent MRSA infection and dissemination.
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Affiliation(s)
- Roghayeh Samadi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Ghalavand
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Mirnejad
- Molecular Biology Research Center, Systems Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Eslami
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Farhadkhani M, Nikaeen M, Hassanzadeh A, Nikmanesh B. Potential transmission sources of Helicobacter pylori infection: detection of H. pylori in various environmental samples. J Environ Health Sci Eng 2019; 17:129-134. [PMID: 31321040 PMCID: PMC6582085 DOI: 10.1007/s40201-018-00333-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 12/17/2018] [Indexed: 05/23/2023]
Abstract
PURPOSE Helicobacter pylori is one of the most common human infectious agents which may be transmitted via water. This study was designed to test H. pylori presence via molecular methods in various aquatic environments as well as sewage sludge (SS) to understand the role of these environments in the pathogen's transmission. METHODS specific primers for the 16S rRNA and ureA genes of H. pylori were used in a nested and semi-nested PCR, respectively. Detection sensitivity of H. pylori in environmental samples by semi-nested PCR was also compared with real-time PCR. Analysis of fecal coliforms (FC) as pollution indicator bacteria was also performed. RESULTS H. pylori 16S rRNA gene was detected in 36% (14/39) of wastewater samples and 8% (2/25) of water samples, while amplification of ureA gene yielded only two positive results. None of the SS samples were positive for H. pylori and real-time PCR could not identify H. pylori in any of the samples. The results showed no correlation between the presence of H. pylori and FC. CONCLUSIONS Our result revealed the widespread presence of H. pylori in wastewater samples which indicates wastewater may be a source for dissemination and transmission of H. pylori infection. Further research is needed to determine the risk of H. pylori in wastewater reuse for irrigation of crops.
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Affiliation(s)
- Marzieh Farhadkhani
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Nikaeen
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Hezar Jerib Avenue, Isfahan, Iran
| | - Akbar Hassanzadeh
- Department of Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Hezar Jerib Avenue, Isfahan, Iran
| | - Bahram Nikmanesh
- Department of Laboratory Medical Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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24
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Maleki DT, Ghalavand Z, Laabei M, Nikmanesh B, Houri H, Kodori M, Hashemi A, Kadkhoda H, Eslami G. Molecular analysis of accessory gene regulator functionality and virulence genes in Staphylococcus aureus derived from pediatric wound infections. Infect Genet Evol 2019; 73:255-260. [PMID: 31102739 DOI: 10.1016/j.meegid.2019.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 03/20/2019] [Accepted: 05/14/2019] [Indexed: 12/01/2022]
Abstract
Staphylococcus aureus is a major human pathogen causing infections with high morbidity and mortality in both healthcare and community settings. The accessory gene regulator (Agr) is a key genetic element controlling the expression of numerous virulence factors in S. aureus. The significance of a functional Agr system in clinical S. aureus isolates derived from pediatric wound infections is still unclear. Therefore, the present study was conducted to identify virulence genes and determine Agr functionality from this cohort of patients. A total of 48 S. aureus wound isolates were collected from patients referred to Tehran Children's Medical Center Hospital from April 2017 to April 2018. In addition, in vitro antimicrobial susceptibility of the isolates was assessed using the disk diffusion and E-test methods. Conventional PCR was performed for the detection of toxins (tsst-1, hla, hlb, hld, eta, etb, etd, edin-A, edin-B, edin-C) and Agr typing (agrI, agrII, agrIII, agrIV). Agr functionality was assessed by quantitative reverse transcriptase real-time PCR (qRT-PCR). All S. aureus isolates were found to be susceptible to linezolid and vancomycin. The most frequently detected toxin gene was eta (100%), and the most prevalent Agr type was agrIII (56.3%). Importantly, qRT-PCR revealed that Agr was functional in 28 (58%) of wound isolates. Consequently, our data suggests that a functional Agr system may not be required for the development of S. aureus wound infections.
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Affiliation(s)
- Donya Taghizadeh Maleki
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Ghalavand
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maisem Laabei
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, United Kingdom
| | - Bahram Nikmanesh
- Department of Lab Medical Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Houri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansoor Kodori
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Hashemi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hiva Kadkhoda
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gita Eslami
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Ataei-Pirkooh A, Tehrani M, Keyvani H, Esghaei M, Tavakoli A, Nikmanesh B, Farahmand M, Ghaffari H, Monavari SH. Rotavirus Infection Enhances Levels of Autoantibodies Against Islet Cell Antigens GAD65 and IA-2 in Children with Type 1 Diabetes. Fetal Pediatr Pathol 2019; 38:103-111. [PMID: 30588857 DOI: 10.1080/15513815.2018.1547338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Some studies implicate rotavirus infection as a trigger for the development of type 1 diabetes mellitus (T1DM) in children, however findings are controversial. OBJECTIVES We investigated the link between rotavirus infection and autoantibodies against islet antigens and T1DM in children. METHODS Serum samples from 80 new-onset diabetic and 80 nondiabetic children were screened for anti-rotavirus IgG, anti-GAD65 and anti-IA-2 autoantibodies using ELISA kits. RESULTS Positivity percentages of anti-rotavirus IgG detection in diabetic and nondiabetic children were 51.3% and 35.0%, respectively (p = 0.03). The mean anti-GAD65 and anti-IA-2 antibody titers in anti-rotavirus IgG positive samples were statistically higher than that the anti-rotavirus IgG negative samples. A positive correlation was found between anti-rotavirus IgG and anti-GAD65 antibody levels (p = 0.004; r = 0.22). CONCLUSIONS Our findings support the hypothesis that rotovirus infection may induce T1DM in children.
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Affiliation(s)
- Angila Ataei-Pirkooh
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
| | - Mona Tehrani
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
| | - Hossein Keyvani
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
| | - Maryam Esghaei
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
| | - Ahmad Tavakoli
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
| | - Bahram Nikmanesh
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
| | - Mohammad Farahmand
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
| | - Hadi Ghaffari
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
| | - Seyed Hamidreza Monavari
- a Department of Virology , Faculty of Medicine, Iran University of Medical Sciences , Tehran , The Islamic Republic of Iran
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Karimpour Roshan S, Godini H, Nikmanesh B, Bakhshi H, Charsizadeh A. Study on the relationship between the concentration and type of fungal bio-aerosols at indoor and outdoor air in the Children's Medical Center, Tehran, Iran. Environ Monit Assess 2019; 191:48. [PMID: 30610385 DOI: 10.1007/s10661-018-7183-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
Fungal bio-aerosols are of concern due to their adverse health effects, especially in indoor environments. The aim of this study was to evaluate the relationship between the concentration and type of fungal bio-aerosols in the indoor and outdoor of Children's Medical Center in Tehran, Iran. In the present descriptive-analytical study, the fungal bio-aerosols' concentrations in both indoor and outdoor of the hospital air were measured. The measurements were carried out by the Anderson method using a Quick Take 30 pump at 28.3 L min-1 and 2.5 min sampling that was placed on a Sabouraud dextrose agar with chloramphenicol. The average concentrations of total fungal bio-aerosols in the hospital indoor and outdoor air were 40.48 and 119.6 CFU/m3, respectively. Onco-hematology and bone marrow transplantation wards were the most and least contaminated units, respectively (11.09 CFU/m3 vs 1.47 CFU/m3). The most common fungi isolated from the indoor environment were Penicillium spp. (45.86%) which was followed by Cladosporium spp. (31.92%), Aspergillus section Nigri (6.26%), sterilized mycelia (5.05%), and Aspergillus section Flavi (2.83%). Cladosporium spp. (61.10 CFU/m3) and Penicillium spp. (18.56 CFU/m3) had the highest mean concentrations in outdoor and indoor air, respectively. The indoor-to-outdoor ratio of fungal aerosols was < 1 at most sampling sites, indicating that the indoor fungal bio-aerosols may have originated from the outdoor environment.
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Affiliation(s)
- Sedighe Karimpour Roshan
- Research Center for Health, Safety and Environment (HSE), Alborz University of Medical Sciences, Karaj, Iran
- Department of Environmental Health, School of health, Alborz University of Medical Sciences, Karaj, Iran
| | - Hatam Godini
- Research Center for Health, Safety and Environment (HSE), Alborz University of Medical Sciences, Karaj, Iran.
- Department of Environmental Health, School of health, Alborz University of Medical Sciences, Karaj, Iran.
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Heidar Bakhshi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Charsizadeh
- Immunology, Asthma & Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Salehi B, Goudarzi H, Nikmanesh B, Houri H, Alavi-Moghaddam M, Ghalavand Z. Emergence and characterization of nosocomial multidrug-resistant and extensively drug-resistant Acinetobacter baumannii isolates in Tehran, Iran. J Infect Chemother 2018; 24:515-523. [PMID: 29555392 DOI: 10.1016/j.jiac.2018.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 10/25/2017] [Revised: 02/01/2018] [Accepted: 02/19/2018] [Indexed: 10/17/2022]
Abstract
RATIONALE Acinetobacter baumannii is one of the antibiotic-resistant superbugs that threatens hospitalized patients. Emergence and spread of the multidrug-resistant (MDR) and extensively drug-resistant (XDR) clones cause erratic outbreaks following environmental contamination of hospital settings. OBJECTIVE The present study intended to characterize the antimicrobial resistant profiles and the genotypes of clinical and environmental isolates of A. baumannii as a result of dissemination of resistant strains. METHODS Clinical and environmental isolates of A. baumannii were obtained from patients, staff, and environment of an educational hospital in Tehran. Antimicrobial susceptibility testing was carried out using the disk diffusion and E-test methods. Multiplex PCR was performed for detection of OXA-type genes (blaOXA-23-like, blaOXA-24-like, blaOXA-58-like, and blaOXA-51-like). Genotypic relatedness of the isolates was achieved using repetitive extragenic palindromic element PCR (Rep-PCR) technique. RESULTS All the isolates were found to be susceptible to colistin and most of them (77%) were non-susceptible to tigecycline. A majority of the clinical and environmental isolates (97%) were considered as MDR strains and 41% as XDR. In multiplex detection, blaOXA-23-like was found in 54% of the isolates, which was the most frequent OXA-type gene. In addition, the frequency of the carbapenem-resistant A. baumannii (CRAB) was observed to be high (96%). In addition, molecular typing showed different Rep patterns of clinical isolates and clonal spread of environmental isolates. CONCLUSION The present study highlights the circulation of drug-resistant A. baumannii strains in different wards of hospitals principally in intensive care unit (ICU) as a nosocomial pathogen due to unwise managements.
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Affiliation(s)
- Bahare Salehi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Houri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zohreh Ghalavand
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Ghalavand Z, Heidary Rouchi A, Bahraminasab H, Ravanasa E, Mirsamadi ES, Nodeh Farahani N, Nikmanesh B. Molecular testing of Klebsiella pneumoniae contaminating tissue allografts recovered from deceased donors. Cell Tissue Bank 2018; 19:391-398. [PMID: 29397462 DOI: 10.1007/s10561-018-9684-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 01/15/2018] [Indexed: 11/27/2022]
Abstract
Microbiological screening of tissue allografts is crucial to prevent the transmission of bacterial and fungal infections to transplant recipients. Klebsiella was the most prevalent and resistant contaminating microorganism observed in our setting in the Iranian Tissue Bank. This study was conducted to determine the presence of extended-spectrum β-lactamase (ESBL) genes, antimicrobial resistance patterns of Klebsiella pneumoniae isolates, and their clonal relationships in allograft materials. K. pneumoniae contaminating bone and other tissue allografts recovered from deceased donors were identified and ESBL isolates were detected using a phenotypic confirmatory method. Antimicrobial susceptibility testing was carried out using the disk diffusion method. Distribution of ESBL genes and molecular typing were performed using polymerase chain reaction (PCR) and Repetitive-element (rep-PCR) methods. Of 3828 donated tissues, 51 (1.3%) were found contaminated by K. pneumoniae isolates. Compared to tissue allografts from brain-dead, heart-beating tissue donors, allografts from donors with circulatory cessation were associated with a higher risk of K. pneumoniae contamination [odds ratio (OR), 1.2 (CI 95% 0.9-2.3) (P value < 0.001)]. Half of the isolates produced ESBL, and the rate of susceptibility to cephalosporins was 51%. Among isolates, 22 (43.1%) harbored CTX-M, 31 (60.8%) SHV, and 9 (17.6%) harbored TEM types. The rep-dendrogram indicated that clones having identical or related strains with a similar antibiotype were isolated in the same period. This study provides evidence that a single clone of K. pneumoniae contaminated tissue allografts recovered from many different donors. A single clone found on tissues from several donors suggests contamination of tissues from a single source such as the tissue recovery process and environment. Genomic DNA testing and clonality of contaminating bacteria using molecular methods can focus the epidemiologic investigation on the tissue allograft recovery process including a search for contamination of the tissue recovery room environment, recovery staff, recovery equipment, reagents, solutions and supplies.
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Affiliation(s)
- Zohreh Ghalavand
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Heidary Rouchi
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Bahraminasab
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ravanasa
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Sadat Mirsamadi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narges Nodeh Farahani
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, No. 17, Ghods Ave, Enghelab St., Tehran, 1419733151, Iran.
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Esmaeili Benvidi M, Houri H, Ghalavand Z, Nikmanesh B, Azimi H, Samadi R, Nodeh Farahani N, Eslami G. Toxin production and drug resistance profiles of pediatric methicillin-resistant Staphylococcus aureus isolates in Tehran. J Infect Dev Ctries 2017; 11:759-765. [DOI: 10.3855/jidc.9360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 02/21/2017] [Indexed: 10/31/2022] Open
Abstract
Introduction: Staphylococcus aureus is known to be a major cause of skin and soft tissue infections, pneumonia and invasive diseases. In this study, attempts were made to examine the prevalence of tsst-1, eta, etb, and luk-PV genes among methicillin-resistant S. aureus (MRSA) isolated from children in Tehran.
Methodology: In the present cross-sectional study, a total of 100 MRSA were isolated from children who were referred to a pediatric hospital during 11-month period of September 2014 to August 2015. Isolates were identified using biochemical tests and then, using PCR, the isolates were tested for the presence of mecA, tsst-1, eta, etb, and luk-PV genes. Susceptibility of isolates to cefoxitin, penicillin, erythromycin, clindamycin, gentamicin, rifampin, minocycline, co-trimoxazole, linezolid, and vancomycin were evaluated using standard methods.
Results: It was found that the MRSA isolates had the greatest resistance to clindamycin (72%) and erythromycin (59%), while the lowest rates of resistance were observed to be related to minocycline (6%) and rifampin (12%). All of isolates were sensitive to vancomycin and linezolid. The mecA gene was detected in all the isolates. Moreover, luk-PV and tsst-1 were detected in 18% and 17% of the isolates, respectively. None of the isolates harbored eta and etb genes.
Conclusions: Our data provide specifications about the toxin production status of S. aureus isolates from pediatric children. The current study showed increased resistance to different antibiotics in S. aureus isolates. Therefore, to prevent multi-resistance to other antibiotic classes, it is essential to withhold prescriptions and stop unessential use of available antibiotics.
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Charsizadeh A, Mirhendi H, Nikmanesh B, Eshaghi H, Makimura K. Microbial epidemiology of candidaemia in neonatal and paediatric intensive care units at the Children's Medical Center, Tehran. Mycoses 2017; 61:22-29. [DOI: 10.1111/myc.12698] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/15/2017] [Accepted: 08/20/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Arezu Charsizadeh
- Departments of Medical Parasitology and Mycology; School of Public Health; Tehran University of Medical Sciences; Tehran Iran
| | - Hossein Mirhendi
- Departments of Medical Parasitology and Mycology; School of Medicine; Isfahan University of Medical Sciences; Isfahan Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Science; School of Allied Medical Sciences; Tehran University of Medical Sciences; Tehran Iran
| | - Hamid Eshaghi
- Infectious Disease Research Center of Children's Medical Center Hospital; Tehran University of Medical Sciences; Tehran Iran
| | - Koichi Makimura
- Laboratory of Space and Environmental Medicine; Graduate School of Medicine; Teikyo University; Tokyo Japan
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Taheri M, Baheiraei A, Foroushani AR, Nikmanesh B, Modarres M. Treatment of vitamin D deficiency is an effective method in the elimination of asymptomatic bacterial vaginosis: A placebo-controlled randomized clinical trial. Indian J Med Res 2016. [PMID: 26205023 PMCID: PMC4525405 DOI: 10.4103/0971-5916.160707] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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] [Indexed: 11/25/2022] Open
Abstract
Background & objectives: Bacterial vaginosis (BV) is the most prevalent vaginal infection in women of reproductive age group which has been found to be associated with vitamin D deficiency. The purpose of this study was to investigate the effectiveness of the administration of 2000 IU/day edible vitamin D for 15 wk to eliminate asymptomatic BV among reproductive age women with vitamin D deficiency. Methods: A total of 208 women with asymptomatic BV, who were found to be eligible after interviews and laboratory tests, were randomly assigned to a control group (n=106) or an intervention group (n=105). They used vitamin D drops daily for 105 days. Vaginal and blood samples were taken before and after the second intervention using identical methods (Nugent score for BV diagnosis, serum 25-hydroxyvitamin D for vitamin D determination). Results: The cure rate of asymptomatic BV was 63.5 per cent in the intervention and 19.2 per cent in the control group (P <0.001). The results showed that being unmarried (P=0.02), being passive smoker (P<0.001), and being in the luteal phase of a menstrual cycle during sampling (P=0.01) were significantly associated with post-intervention BV positive results. After these elements were controlled, the odds of BV positive results in the control group was 10.8 times more than in the intervention group (P<0.001). Interpretation & conclusions: Among women in reproductive age group with vitamin D deficiency, the administration of 2000 IU/day edible vitamin D was effective in eliminating asymptomatic BV. This treatment could be useful in preventing the symptoms and side effects of BV.
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Affiliation(s)
| | | | | | | | - Maryam Modarres
- Department of Midwifery, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Ghorbanalizadgan M, Bakhshi B, Kazemnejad Lili A, Najar-Peerayeh S, Nikmanesh B. A molecular survey of Campylobacter jejuni and Campylobacter coli virulence and diversity. Iran Biomed J 2015; 18:158-64. [PMID: 24842142 PMCID: PMC4048480 DOI: 10.6091/ibj.1359.2014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: The aim of this study was to determine the prevalence of virulence-associated genes and enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) analysis of Campylobacter spp. isolated from children with diarrhea in Iran. Methods: A total of 200 stool specimens were obtained from children under 5 years during July 2012 to July 2013. Detection of C. jejuni and C. coli was performed by standard biochemical and molecular methods. The presence of virulence-associated genes and genetic diversity of isolates was examined using PCR and ERIC-PCR analyses. Results: A total of 12 (6%) Campylobacter spp. were isolated from patients including 10 (4.5%) C. jejuni and 2 (1.5%) C.coli. The flaA, cadF and ciaB genes were present in 100% of isolates, while no plasmid of virB11 gene was present in their genome. The prevalence of invasion-associated marker was 100% among C. coli and was not detected in C. jejuni isolates. The distribution of both pldA and the genes associated with cytolethal distending toxin (CDT) was 58.3% in C. jejuni isolates. Seven distinct ERIC-PCR profiles were distinguished in three clusters using ERIC-PCR analysis. Genotyping analysis showed a relative correlation with geographic location of patients and virulence gene content of isolates. Conclusion: To our knowledge, this is the first molecular survey of Campylobacter spp. in Iran concerning genotyping and virulence gene content of both C. jejuni and C. coli. ERIC-PCR revealed appropriate discriminatory power for clustering C. jejuni isolates with identical virulence gene content. However, more studies are needed to clearly understand the pathogenesis properties of specific genotypes.
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Affiliation(s)
- Mahdi Ghorbanalizadgan
- Dept. of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Bita Bakhshi
- Dept. of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Shahin Najar-Peerayeh
- Dept. of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Bahram Nikmanesh
- Children’s Hospital Medical Center, Tehran university of Medical Sciences, Tehran, Iran
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Haghi Ashtiani MT, Sadeghian M, Nikmanesh B, Pourakbari B, Mahmoudi S, Mamishi S. Antimicrobial susceptibility trends among Streptococcus pneumoniae over an 11-year period in an Iranian referral children Hospital. Iran J Microbiol 2014; 6:382-6. [PMID: 25926954 PMCID: PMC4411422] [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] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES The appearance of antibiotic resistance in Streptococcus pneumoniae has raised a global concern over the past three decades. This study was conducted to determine the antimicrobial susceptibility of S. pneumoniae isolated from patients in Children´s Medical Center (CMC) Hospital during 2001 to 2011. MATERIALS AND METHODS During the 11 years period, a total of 194 S. pneumoniae isolates were collected in CMC Hospital. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method and time-series analysis was used to evaluate the antimicrobial susceptibility changes over the time. RESULTS AND CONCLUSION Antimicrobial susceptibility of S. pneumoniae to different antibiotics decreased from 2001 to 2011 as: penicillin from 78% to 32%, erythromycin from 75% to 35%, chloramphenicol from 94% to 55%, ampicillin from 70% to 62%, ceftriaxone from 100% to 87%, sulfametoxazole from 57% to 40%. We did not find any significant difference between the susceptibility of isolates from sterile and non-sterile sources. It would be an important key to consider antimicrobial stewardship as an essential factor to prevent the development of antimicrobial resistance.
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Affiliation(s)
| | - Majid Sadeghian
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Nikmanesh
- Departement of parasitology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Pourakbari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Mamishi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran,Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: Setareh Mamishi, MD, Address: Children’s Medical Center Hospital, 62 Qarib St, Keshavarz Blvd, Tehran, Iran. Tel /fax: +98-21-66428996,
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Sabouni F, Mahmoudi S, Bahador A, Pourakbari B, Sadeghi RH, Ashtiani MTH, Nikmanesh B, Mamishi S. Virulence Factors of Staphylococcus aureus Isolates in an Iranian Referral Children's Hospital. Osong Public Health Res Perspect 2014; 5:96-100. [PMID: 24955319 PMCID: PMC4064634 DOI: 10.1016/j.phrp.2014.03.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 03/03/2014] [Revised: 03/12/2014] [Accepted: 03/13/2014] [Indexed: 12/13/2022] Open
Abstract
Objectives The clinical importance of Staphylococcus aureus (S. aureus) is attributed to notable virulence factors, surface proteins, toxins, and enzymes as well as the rapid development of drug resistance. The aim of this study was to compare the occurrence of virulence factors produced by S. aureus strains isolated from children in an Iranian referral children's hospital. Methods The presence of genes encoding for the enterotoxins A (sea), B (seb), C (sec), D (sed), TSST-1 (tsst), exfoliative toxin A (eta), and exfoliative toxin B (etb) were detected by Multiplex polymerase chain reaction (PCR) using specific primers. In addition, the standardized Kirby-Bauer disc-diffusion method was performed on Mueller-Hinton agar. Results In total, 133 S. aureus isolates were obtained from different patients. Of these S. aureus isolates, 64 (48%) were methicillin-resistant S. aureus (MRSA), and all of these tested positive for the mecA gene. Regarding the classical enterotoxin genes, sea gene (40.6%) was the most prevalent followed by seb (19.6%), tsst (12.8%), eta (11.3%), etb (9%), sed (4.5%), and sec (3%). Among methicillin-susceptible S. aureus (MSSA) isolates, seb and tsst were the more prevalent toxins in comparison with MRSA isolates (p < 0.05), while the frequency of sea, sed, eta, and etb genes were higher among MRSA isolates (p > 0.05). Conclusion In our study enterotoxin A was produced by 40.6% of the isolates (48% from MRSA and 33% from MSSA isolates) which was higher than in previous reports. According to our results, strict hygiene and preventative measures during food processing are highly recommended.
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Affiliation(s)
- Farah Sabouni
- Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Mahmoudi
- Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Pourakbari
- Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Bahram Nikmanesh
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Mamishi
- Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran ; Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Fallahi S, Kazemi B, Seyyed tabaei S, Bandehpour M, Lasjerdi Z, Taghipour N, Zebardast N, Nikmanesh B, Omrani VF, Ebrahimzadeh F. Comparison of the RE and B1 gene for detection of Toxoplasma gondii infection in children with cancer. Parasitol Int 2014; 63:37-41. [DOI: 10.1016/j.parint.2013.08.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 08/07/2013] [Accepted: 08/19/2013] [Indexed: 11/25/2022]
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Haghi Ashtiani MT, Mamishi S, Masoomi A, Nasiri N, Hosseini M, Nikmanesh B, Pourakbari B, Rezaei N. Antimicrobial susceptibility associated with bloodstream infections in children: a referral hospital-based study. Braz J Infect Dis 2013; 17:497-9. [PMID: 23809684 PMCID: PMC9428065 DOI: 10.1016/j.bjid.2013.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 12/30/2012] [Accepted: 01/02/2013] [Indexed: 11/08/2022] Open
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Nateghi Rostami M, Nikmanesh B, Haghi-Ashtiani MT, Monajemzadeh M, Douraghi M, Ghalavand Z, Kashi L. Isospora belli associated recurrent diarrhea in a child with AIDS. J Parasit Dis 2013; 38:444-6. [PMID: 25320501 DOI: 10.1007/s12639-013-0272-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 01/14/2013] [Accepted: 02/23/2013] [Indexed: 10/27/2022] Open
Abstract
Persistent diarrhea is a major manifestation of Acquired Immunodeficiency Syndrome (AIDS) which might be more complicated in Human Immunodeficiency Virus (HIV) infected children especially those from developing countries. There are numerous reports showing the emergence of intestinal opportunistic coccidian parasites, mostly Cryptosporidium parvum and Isospora belli in HIV-infected individuals. The prevalence of isosporiasis is probably underestimated in developing countries because routinely not all HIV-infected patients are examined for the presence of this protozoan infection. Here we report a case of HIV-infected isosporiasis presenting with failure to thrive and persistent diarrhea. Since I. belli infection in children responds well to therapy with trimethoprim-sulfamethoxazole, isosporiasis should be considered as a treatable infection in AIDS, if it is detected at proper time.
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Affiliation(s)
- M Nateghi Rostami
- Department of Public Health, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - B Nikmanesh
- Department of Pathology, Children's Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib St., Keshavarz Blvd., Tehran, Iran
| | - M T Haghi-Ashtiani
- Department of Pathology, Children's Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib St., Keshavarz Blvd., Tehran, Iran
| | - M Monajemzadeh
- Department of Pathology, Children's Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib St., Keshavarz Blvd., Tehran, Iran
| | - M Douraghi
- Division of Bacteriology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Z Ghalavand
- Department of Microbiology, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - L Kashi
- Department of Pathology, Children's Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib St., Keshavarz Blvd., Tehran, Iran
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Ashtiani MTH, Monajemzadeh M, Saghi B, Shams S, Mortazavi SH, Khaki S, Mohseni N, Kashi L, Nikmanesh B. Prevalence of intestinal parasites among children referred to Children's Medical Center during 18 years (1991-2008), Tehran, Iran. Ann Trop Med Parasitol 2012; 105:507-12. [PMID: 22185945 DOI: 10.1179/1364859411y.0000000040] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Epidemiological studies show that parasitic inections are among the most common infections and one of the biggest health problems of the society worldwide. Children at school age have the highest morbidity compared with other ages. Therefore, by treating these children, the disease burden in the total population is reduced. In this study, prevalence of parasitic infection in children referred to Children's Medical Center was compared in different years. In this retrospective cross-sectional study, the subjects were children under 13 years who were referred to Children's Medical Center Laboratory during 18 years (1991-2008) and underwent stool exam by any reason. The specimens were evaluated by different common methods of stool parasitology. In suspected cases, parasites was cultured in specific medium and stained as needed. Required data were obtained from the laboratory files and analysed according to study's purpose. Subjects were 124 366 children. Among them, 0.78% of cases had parasitic infections and 60.54% cases were male. Parasitic infections were related to protozoa in 95.33% cases and intestinal worms in 4.87%. Of them, 50.352% were pathogenic protozoa. The most parasitic infection was Giardia lamblia. Among intestinal worms, the highest prevalence was related to Hymenolepis nana (40.7%). A comparison between the first 10 years and the next 8 years of the study showed that the prevalence of intestinal parasites were 8% and 1% (P < 0.001) and the rate for protozoal infection were 14.9% and 4.3%, respectively (P < 0.001). The prevalence of intestinal parasites was reduced during recent years; however, more attempts should be performed to make it lower.
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Affiliation(s)
- M T H Ashtiani
- Department of Pathology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran
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Douraghi M, Goudarzi H, Nateghi Rostami M, Nikmanesh B. Immune responses to Helicobacter pylori infection in children with intellectual disabilities. Res Dev Disabil 2012; 33:663-669. [PMID: 22186633 DOI: 10.1016/j.ridd.2011.11.010] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 11/17/2011] [Accepted: 11/17/2011] [Indexed: 05/31/2023]
Abstract
Infection with Helicobacter pylori was assessed through serum H. pylori IgG antibody in children with intellectual disabilities (ID). The sero-status of cytotoxin-associated gene A (CagA) was determined as a risk determinant for severe H. pylori-associated diseases. In total, 210 children with ID were included who were permanent resident of three institutes in Tehran. Medical history and demographic data were collected by reviewing the medical file records. The anti H. pylori IgG antibody was detected in serum of 74.8% of children using ELISA. Significant correlations were found between the rate of infection and age (P = 0.001) and duration of institutionalization (P = 0.018). The likelihood of H. pylori IgG positive response increased with age with the highest response in 15-18 years age group (OR = 6.66, 95% CI: 2.14-20.17; P = 0.001). Similarly, the average titers of H. pylori IgG antibody were increased with age. The institutionalization duration of more than 49 months affected the likelihood of H. pylori IgG positive response (OR = 2.437, 95% CI: 1.12-5.26; P = 0.023). Anti-CagA titers were higher than 5arbU/ml in 92 (58.6%) children, indicating a positive response against CagA protein. The titer of H. pylori IgG was significantly higher in CagA-positive (mean ± SE = 51.04 ± 3.41) than in CagA-negative children (38.07 ± 4.18; P = 0.017). In contrast to total H. pylori IgG titers, anti-CagA antibody had non-regular trend of alterations with age. The seropositivity rate of H. pylori infection in ID children was higher than other reports in healthy children from various regions of the country. The risk of H. pylori infection is increased with age and duration of institutionalization. The serostatus of CagA in children with IDs has not been reported so far. The regular monitoring of the CagA-positive carriers is recommended; since CagA positive cases carry the risk of progression of infection toward severe H. pylori associated sequels such as gastric cancer and duodenal ulcers.
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Affiliation(s)
- Masoumeh Douraghi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 19395-4719, Iran
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