Performance of a System for Rapid Phenotypic Antimicrobial Susceptibility Testing of Gram-Negative Bacteria Directly from Positive Blood Culture Bottles

The rapid administration of optimal antimicrobial treatment is paramount for the treatment of bloodstream infections (BSIs), and rapid antimicrobial susceptibility testing (AST) results are essential. Q-linea has developed the ASTar system, a rapid phenotypic AST device. Here, we report the performance of the ASTar BC G- (Gram-negative) kit when assessed according to the ISO 20776-2:2007 standard for performance evaluation of in vitro diagnostic AST devices. The evaluated ASTar BC G- kit uses a broad panel of 23 antimicrobials for the treatment of BSIs caused by Gram-negative fastidious and nonfastidious bacteria across a range of 6 to 14 2-fold dilutions, including cefoxitin as a screening agent for AmpC-producing Enterobacterales. The ASTar system processes blood culture samples to generate data on MICs and susceptible, intermediate, or resistant (SIR) category. The automated protocol includes concentration determination and concentration adjustment to enable a controlled inoculum, followed by broth microdilution (BMD) and microscopy performed continuously to generate MIC values within approximately 6 h once the test is run on the ASTar system. The performance of the ASTar system was assessed against the ISO 20776-2:2007 standard BMD reference method. Testing was performed across three sites, with results from 412 contrived blood cultures and 74 fresh clinical blood cultures. The ASTar system was also tested for reproducibility, with triplicate testing of 11 strains. The accuracy study comprised 8,650 data points of bacterium-antimicrobial tests. The ASTar system demonstrated an overall essential agreement (EA) of 95.8% (8,283/8,650) and a categorical agreement (CA) of 97.6% (8,433/8,639) compared to the reference BMD method. The overall rate of major discrepancies (MDs) was 0.9% (62/6,845), and that of very major discrepancies (VMDs) was 2.4% (30/1,239). This study shows that the ASTar system delivers reproducible results with overall EA and CA of >95%.

Evaluation of the frequency of food allergens based on skin prick test in children in Kurdistan Province - Iran

INTRODUCTION

Food allergy refers to abnormal reactions of the body caused by an immune system response to food. This study was conducted aiming to investigate allergy to food allergens in children with food allergies.

MATERIALS AND METHODS

This study was conducted as a cross-sectional one on 304 children aged six months to seven years with food allergies admitted to the tertiary referral hospital in Kurdistan Province - Iran, during 2014-2015. All the patients were examined for skin prick test using 49 allergens. Finally, the obtained data were analysed using SPSS15 and chi-square and t tests.

RESULTS

The highest percentage of occurrence of bump reaction (wheal) and redness (flare) was due to the consumption of fish, eggs, tomatoes, and cocoa. Moreover, the lowest rate of wheal and flare was caused by exposure to allergens like latex, tea, malt, and wheat flour. The reaction most created due to the consumption of foods was flare which was higher among under three-year-olds group (p<0.05), and between the sexes, girls showed the most common allergic reactions (p<0.05).

CONCLUSION

Since food allergy has a high prevalence in children, it should be considered with great interest. Considering that avoiding food allergens is the first step in the treatment of food allergies, the present study may be a useful guide in this regard.

The relationship between serum levels of vitamin D with asthma and its symptom severity: A case-control study

BACKGROUND

Asthma is a heterogeneous disease characterised by chronic inflammatory airways, and is affected by several immunological factors. One of the most discussed and researched hypotheses is the relationship between vitamin D serum levels with asthma. This study aimed to investigate the relationship between vitamin D serum levels with asthma and pulmonary functions in children in Kurdistan province, Iran.

MATERIALS AND METHODS

In this case-control study, 120 children ranging from 6 to 18 years were referred in summer for investigation. Participants were divided into two groups: asthma group, N=60; and control group, N=60. After serum separation, samples were analysed using vitamin D ELISA kit. Additionally, pulmonary function test and serum IgE levels were measured in both groups. Data were analysed using Chi-square test and multiple regression analysis in SPSS15.

RESULTS

No difference was shown between the groups in terms of gender composition (male: 57.5; female: 42.5) (P>0.05). Average Vitamin D serum level in the case group (17.98±8.68) was less than in control group (22.35±6.26) (P<0.01). In addition, the difference of vitamin D deficiency in level of suboptimal between the asthma (17.77±6.41) and the control group (24.9±3.18) was statistically significant (P<0.0001). Positive correlation existed between vitamin D levels with FEV1, FVC, and FEV1/FVC. Multiple regression analysis showed a reverse relationship between vitamin D levels with IgE serum levels; this remained after adjustment for potential confounders (e.g. age, sex, BMI, FEV1, and FVC).

CONCLUSION

The results showed that serum levels of vitamin D in asthma patients were less than in healthy people, and also reduced lung function in these patients. So, the serum levels of vitamin D in asthma patients must be checked continuously.

Cross cultural adaptation of the menopause specific questionnaire into the persian language

Background:

The menopause-specific quality-of-life (MENQOL) was developed as a specific tool to measure the health-related quality-of-life in menopausal women. Recently, it has been translated into about 15 languages.

Aim:

This study was performed to develop the Persian version of the MENQOL questionnaire from the original English language version.

Subjects and Methods:

This was a cross-sectional study that evaluated 300 menopausal women attending five primary health-care centers in Shiraz. The “forward-backward” procedure was applied to translate the questionnaire from English to Persian by two independent translators and then back translated into English and was checked to ensure the correct translation. Then, participants were interviewed and the questionnaire filled out.

Results:

Over all Cronbach's alpha was 0.9 and in subscales of vasomotor, psychosocial, physical and sexual were 0.8, 0.7, 0.8 and 0.3, respectively. However, the major items were acceptable (Cronbach's alpha > 0.7), but internal consistency in sexual item was poor (Cronbach's alpha = 0.3). The result of internal consistency was acceptable in subgroups of age, disease, education, marital status and smoking habit.

Conclusions:

The Persian MENQOL questionnaire demonstrates good internal consistency in vasomotor, physical and psychosocial domains, but not sexual. Therefore we suggest that, the items: “Vaginal dryness during intercourse” and “weight gain” should be deleted in Persian version of the MENQOL. This questionnaire can be used in Persian language and Iranian culture in different subgroups of age, marital status and educational level as well as in individuals with hypertension and diabetes.

Epidemiological survey on pandemic influenza A (H1N1) virus infection in Kurdistan province, Islamic Republic of Iran, 2009

This study evaluated the epidemiology of suspected cases of pandemic influenza A (H1N1) virus infection in 2009-2010 in Kurdistan province, a frontier province of the Islamic Republic of Iran. A questionnaire covering demographic characteristics, clinical presentation and outcome, and history of exposure and travel was completed by patients attending health centres and hospitals in the province. Nasal and throat swabs were analysed by RT-PCR. A total of 1059 suspected cases were assessed; H1N1 influenza A was confirmed in 157 (14.8%). The highest proportion of confirmed cases was 30.0%, among children aged < 1 year. In multivariate analysis, previous contact with symptomatic influenza patients (OR = 2.17) and hospitalization (OR = 3.88) were the only significant risk factors for confirmed H1N1 infection. Age, sex, residency, presenting symptoms and history of national or international travel were not significant. Influenza A (H1N1) virus has spread in Islamic Republic of Iran; probably transmitted by travellers to Kurdistan.

Wrapping bacteria by graphene nanosheets for isolation from environment, reactivation by sonication, and inactivation by near-infrared irradiation

Bioactivity of Escherichia coli bacteria (as a simple model for microorganisms) and interaction of them with the environment were controlled by their capturing within aggregated graphene nanosheets. The oxygen-containing functional groups of chemically exfoliated single-layer graphene oxide nanosheets were reduced by melatonin as a biocompatible antioxidant. While each one of the graphene (oxide) suspension and melatonin solution did not separately show any considerable inactivation effects on the bacteria, aggregation of the sheets in the melatonin-bacterial suspension resulted in trapping the bacteria within the aggregated sheets, i.e., a kind of inactivation. The bacteria trapped within the aggregated sheets were biologically disconnected from their environment, because they could not proliferate in a culture medium and consume the glucose of their environment. However, after removing the sheets from the surface of the microorganisms by using sonication, they could again interact with their environment. The reactivated bacteria consumed glucose and could be proliferated; i.e., they were alive within the aggregated graphene sheets (here, at least for 24 h). The trapped alive bacteria could be photothermally inactivated forever by near-infrared irradiation at 808 nm. These results suggest that graphene nanosheets may potentially serve as an encapsulating material for delivery of such microorganisms and as an effective photothermal agent for inactivation of the graphene-wrapped microorganisms.