Global Dilemma and Needs Assessment Toward Achieving Sustainable Development Goals in Controlling Leishmaniasis

Leishmaniasis is a disease of poverty that imposes a devastating medical, social, and economic burden on over 1 billion people nationwide. To date, no in-depth study to analyze the major global challenges and needs assessment has been carried out. This investigation aimed to explore a comprehensive narrative review of leishmaniasis's main challenges and initially highlight obstacles that might impede the implementation of control measures. Also, we propose a specific list of priorities for needs assessment. The presence of socioeconomic factors, multiple clinical and epidemiological forms, various Leishmania species, the complexity of the life cycle, the absence of effective drugs and vaccines, and the lack of efficient vector and reservoir control make this organism unique and sophisticated in playing a tangled role to react tricky with its surrounding environments, despite extensive efforts and implementation of all-inclusive former control measures. These facts indicate that the previous strategic plans, financial support, and basic infrastructures connected to leishmaniasis surveillance are still insufficient. Strengthening the leishmaniasis framework in a context of accelerated programmatic action and intensification of cross-cutting activities along with other neglected tropical diseases (NTDs) is confidently expected to result in greater effectiveness, cost-benefit, and fruitful management. Sensitive diagnostics, effective therapeutics, and efficacious vaccines are vital to accelerating advancement toward elimination, and reducing morbidity/mortality and program costs. Collective actions devoted by all sectors and policy-makers can hopefully overcome technical and operational barriers to guarantee that effective and coordinated implementation plans are sustained to meet the road map for NTDs 2021- 2030 goals.

Cutaneous Leishmaniasis Hampers COVID-19: A Controlled Cross-Sectional Study in High-Burden Endemic Areas of Iran

INTRODUCTION

Emerging infectious diseases such as SARS-CoV-2 can cause pandemics and create a critical risk for humans. In a previous pilot study, we reported that the immunological responses induced by cutaneous leishmaniasis (CL) could decrease the incidence and severity of COVID-19. In this large-scale case-control study, we assessed the possible relationship between mortality and morbidity of COVID-19 in healed CL persons suffering scars compared to cases without CL history.

METHODS

This controlled cross-sectional study was conducted between July 2020 and December 2022 in the endemic and high-burden areas of CL in southeastern Iran. In the study, 1400 previous CL cases with scars and 1,521,329 subjects who had no previous CL were analyzed. We used R 4.0.2 to analyze the data. Firth's bias reduction approach corresponding to the penalization of likelihood logistic regression by Jeffreys was also employed to influence the variables in the dataset. Also, a Bayesian ordinal logistic regression model was performed to explore the COVID-19 severity in both case and referent groups.

RESULTS

The occurrence and severity rate of COVID-19 in CL scar cases are significantly less than in the non-CL control group, while in the CL scar subjects, patients with critical conditions and mortality were not observed. The morbidity (OR = 0.11, CI 0.06-0.20 and P < 0.001) and severity of COVID-19 in previous cases with CL scars were significantly diminished than that in the control group (credible interval - 2.57, - 1.62).

CONCLUSIONS

The results represented a durable negative relationship between cured CL and COVID-19 incidence and severity. Additional studies seem necessary and should be designed to further validate the true impact and underlying mechanistic action of CL on COVID-19.

A prospective longitudinal study on the elimination trend of rural cutaneous leishmaniasis in southeastern Iran: Climate change, population displacement, and agricultural transition from 1991 to 2021

Leishmaniasis is a complex disease. Any change in weather conditions affects the humans' social and agricultural expansion and, consequently, the parasite's life cycle in terms of ecology, biodiversity, social stigma, and exclusion. This population-based prospective longitudinal investigation was conducted between 1991 and 2021 in a well-defined CL (cutaneous leishmaniasis) focus in Bam County, southeastern Iran. A robust health clinic and health surveillance system were responsible for the ongoing systematic documentation, detection, identification, and management of CL cases. The exponential smoothing method via the state space model was used in the univariate time series. The TTR, smooth, and forecast packages were used in R software. Landsat satellite images from 1991, 2001, 2011, and 2021 were employed in the physical development. During this period, the temperature increased while the rainfall and humidity decreased. The findings showed a downward trend in the standardized drought index. Also, the results showed that climate warming and ecological changes profoundly affected the area's agricultural patterns and topographical features. Furthermore, the last three decades witnessed an elimination trend for zoonotic CL (ZCL) and the predominance of anthroponotic CL (ACL). The present findings showed that the critical factors in the predominance of ACL and elimination of ZCL were rising temperature, drought, migration, unplanned urbanization, earthquake, and agrarian reform. The wall-enclosed palm tree gardens excluded the primary ZCL reservoir host. They controlled the disease while providing suitable conditions for the emergence/re-emergence of ACL in the newly established settlements and the unplanned ecozone. Therefore, robust health infrastructures, sustained financial support, and evidence-based research studies are crucial to facilitating the necessary surveillance, monitoring, and evaluation to control and eliminate the disease.

Electrochemical detection of carmoisine in the presence of tartrazine on the surface of screen printed graphite electrode modified with nickel-cobalt layered double hydroxide ultrathin nanosheets

Toxic effluents containing azo dyes are discharged from various industries and they adversely affect water resoures, soil, aquatic ecosystems. Also, excessive use of food azo dyes can be carcinogenic, toxic, and adversely affect human health. Therefore, the determination of food azo dyes is significant from the perspective of human health and aquatic organisms. In the present work, nickel-cobalt layered double hydroxide nanosheets were prepared and analyzed by various techniques (field emission-scanning electron microscopy, X-ray diffraction, and fourier Transform-Infrared spectroscopy). Then, the screen printed graphite electrode modified with nickel-cobalt layered double hydroxide nanosheets was used for the detection of carmoisine. The nickel-cobalt layered double hydroxide nanosheets/screen printed graphite electrode significantly improved the oxidation of carmoisine by increasing the response current and lowering potentials compared to unmodified screen printed graphite electrode. Based on the findings from differential pulse voltammetry, the nickel-cobalt layered double hydroxide nanosheets/screen printed graphite electrode sensor response towards carmoisine was linear (0.3-125.0 μM) with a detection limit of 0.09 μM. A sensitivity of 0.3088 μA μM^-1 was achieved. Also, the nickel-cobalt layered double hydroxide nanosheets/screen printed graphite electrode was used for voltammetric detection of carmoisine in the presence of tartrazine. Due to the catalytic activity of prepared layered double hydroxide, the prepared sensor exhibited remarkable separation of the peaks when carmoisine and tartrazine coexist. In addition, the prepared sensor showed good stability. Finally, the proposed sensor had promising applicability for analysis of study analytes in powdered juice and lemon juice, with commendable recoveries between 97.3% and 104.8%.

Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Iran has invariably been under the growing public health threat of cutaneous leishmaniasis (CL), a significant barrier to local development that hinders the prevention and control efforts toward eliminating the disease. So far, no comprehensive and in-depth epidemiological analysis of the CL situation has been carried out nationwide. This study aimed to employ advanced statistical models to analyze the data collected through the Center for Diseases Control and Prevention of Communicable Diseases during 1989-2020. However, we emphasized the current trends, 2013-2020, to study temporal and spatial CL patterns. In the country, the epidemiology of CL is incredibly intricate due to various factors. This fact indicates that the basic infrastructure, the preceding supports, and the implementation plan related to preventive and therapeutic measures need crucial support. The leishmaniasis situation analysis is consistent with desperate requirements for efficient information on the control program in the area. This review provides evidence of temporally regressive and spatially expanding incidence of CL with characteristic geographical patterns and disease hotspots, signifying an urgent need for comprehensive control strategies. This information could be a suitable model and practical experience in the Eastern Mediterranean Region, where over 80% of CL is reported.

Voltammetric folic acid sensor based on nickel ferrite nanoparticles modified-screen printed graphite electrode

In this study, an electrochemical sensor for the quantification of folic acid with voltam­metric detection in physiological conditions was constructed. For this purpose, nickel ferrite (NiFe2O4) nanoparticles were used to modify the surface of a screen-printed graphite electrode (NiFe2O4/SPGE) and applied in the determination of folic acid. The modified electrode displays a strong electrochemical response to folic acid. Folic acid was determined electrochemically using the differential pulse voltammetry (DPV) technique with a detection limit of 0.09±0.001 µM in 0.2–147.0 µM linear range in phosphate buffer solution (PBS) at pH 7.0 with this NiFe2O4/SPGE sensor, which has the best electron transfer rate. Also, the sensitivity of the modified electrode was obtained as 0.1139 µA µM-1. The NiFe2O4/SPGE sensor was successfully applied for the determination of folic acid in real samples.

Prophylactic effect of cutaneous leishmaniasis against COVID-19: a case-control field assessment

INTRODUCTION

We assessed the potential relationship between COVID-19 and laboratory-confirmed cutaneous leishmaniasis (CL)-registered cases with a history of scarring, compared with volunteer participants without history of CL.

METHODS

This case-control retrospective study was conducted in southeastern Iran with a high anthroponotic cutaneous leishmaniasis (ACL) burden.

RESULTS

Overall, n=1010 CL cases (n=479 male, n=531 female) were evaluated for infection with SARS-CoV-2. In the CL case group, 2 men and 1 woman (0.3% in total) had a mild form of COVID-19 disease; none were hospitalized or died. In contrast, of n=2020 participants without history of CL, n=57 (2.9%) contracted laboratory-confirmed COVID-19, including mild (66.7%), hospitalized (26.3%), critical (3.5%) and fatal (3.5%). There was a strong negative association between CL infection and COVID-19. The burden of COVID-19 in CL-cured participants significantly reduced the morbidity (odds ratio: 0.12; CI: 0.03-0.30; P <0.001) and mortality (percentile: -4.10, -0.02).

CONCLUSION

Participants with a history of CL scar had significantly reduced incidence of COVID-19 morbidity and mortality. The cross-protection mediated by CL may retard COVID-19 in endemic countries. However, further longitudinal studies are needed to explore the potential profile and duration of this protection offered by CL against COVID-19.

Glutathione detection at carbon paste electrode modified with ethyl 2-(4-Ferrocenyl-[1,2,3]Triazol-1-yl)acetate, ZnFe2O4 nanoparticles and ionic liquid

The purpose of the present study was to introduce a newly designed approach for determi­nation of glutathione using modified carbon paste electrode with ZnFe2O4 nanoparticles,  ionic liquid (1-butyl-3-methylimidazolium hexafluorophosphate) and ethyl 2-(4-ferrocenyl-[1,2,3]triazol-1-yl)acetate (EFTA/ZFO/IL/CPE). According to the results from the electro­chemical experiments, oxidation current of glutathione on the modified electrode surface was incremented and its oxidation was decreased compared to bare CPE. A linear response was observed for the electrode at different methyldopa concentrations (0.2 to 300.0 μM).

A sensitive Cu(salophen) modified screen-printed electrode for simultaneous determination of dopamine and uric acid

T This research applied a nanostructured electrochemical sensor with a screen-printed electrode (SPE) for examining the dopamine (DA) electrocatalytic oxidation when uric acid (UA) was present. Cu(salophen) nanostructured modified SPE Cu(salophen)/SPE was employed to investigate the electrochemical behavior of DA. At optimal pH (pH 7.0), oxidation of DA at the modified electrode takes place at a potential around 100 mV less positive than at the unmodified SPE. Chronoamperometry was used to determine the diffusion coefficient of DA (D = 1.96×10-5 cm2 s-1). Differential pulse voltammetry (DPV) showed linear response in the range between 0.2-450.0 μM for DA. The limit of detection (LOD) of DA was computed to be 0.05 μM. Moreover, Cu(salophen)/SPE was employed for determining DA in the presence of UA using DPV. The DPV results showed that at the modified electrode, two well-separated oxidation peaks of DA and UA could be obtained at potentials of 180 and 325 mV, respectively. This separation forms the basis for the co-detection of these two materials on the surface of Cu(salophen)/SPE. This sensor was  then employed to determine DA and UA in real specimens.

Recent Advantages of Mediator Based Chemically Modified Electrodes; Powerful Approach in Electroanalytical Chemistry

Background:

Modified electrodes have advanced from the initial studies aimed at understanding electron transfer in films to applications in areas such as energy production and analytical chemistry. This review emphasizes the major classes of modified electrodes with mediators that are being explored for improving analytical methodology. Chemically modified electrodes (CMEs) have been widely used to counter the problems of poor sensitivity and selectivity faced in bare electrodes. We have briefly reviewed the organometallic and organic mediators that have been extensively employed to engineer adapted electrode surfaces for the detection of different compounds. Also, the characteristics of the materials that improve the electrocatalytic activity of the modified surfaces are discussed.

Objective:

Improvement and promotion of pragmatic CMEs have generated a diversity of novel and probable strong detection prospects for electroanalysis. While the capability of handling the chemical nature of the electrode/solution interface accurately and creatively increases , it is predictable that different mediators-based CMEs could be developed with electrocatalytic activity and completely new applications be advanced.

Electrochemical sensor for determination of hydroxylamine using functionalized Fe3O4 nanoparticles and graphene oxide modified screen-printed electrode

A simple strategy for determination of hydroxylamine based on Fe3O4 nanoparticles function­nalized by [2-(4-((3-(trimethoxysilyl)propylthio)methyl)1-H1,2,3-triazol-1-yl)acetic­acid] (FNPs) and graphene oxide (GO) modified screen-printed electrode (SPE), denoted as (Fe3O4 FNPs/GO/SPE), is reported. The electrochemical behavior of hydroxylamine was investigated at Fe3O4FNPs/GO/SPE by cyclic voltammetry (CV), differential pulse voltammetry (DPV) and chro­noamperometry (CHA) techniques in phosphate buffer solution (pH 7.0). Fe3O4 FNPs/GO/SPE as a novel electrochemical sensor exhibited catalytic activity toward the oxidation of hydroxyl­ami­ne. The potential of hydroxylamine oxidation was shifted to more negative potentials, and its oxidation peak current increased on the modified electrode, also indicating that under these conditions, the electrochemical process is irreversible. The electrocatalytic current of hydroxyl­amine showed a good relationship in the concentration range of 0.05–700.0 μM, with a detection limit of 10.0 nM. The proposed electrode was applied for the determination of hydroxyl­amine in water samples, too.

The impact of diabetes on cutaneous leishmaniasis: a case-control field assessment

This study aimed to assess the associated-risk determinants for cutaneous leishmaniasis (CL) in patients with diabetes mellitus (DM) compared to patients without DM. This case-control study was performed between 2017 and 2019 in southeastern Iran. Overall, 206 participants were selected from patients with DM without CL (11.2%), patients with CL without DM (6.2%), and DM patients concomitance with CL (27.6%) as case groups and healthy individuals as a control group 64 (76%). These cases were compared for parasitological, immunological, biochemical, and hematological parameters. The findings demonstrated that parasitological factors regarding the number, duration, and size of the lesion in CL patients showed a significant difference among patients with and without DM (p < 0.05). Data analysis showed that six major risk factors, including female (odds ratio (OR) = 3.47, confidence interval (CI) = 1.84-6.53, p < 0.001), total protein in CL group (OR = 4.9, CI = 2.3-10.44, p < 0.001), alanine aminotransferase (ALT) concentration in CL group (OR = 0.87, CI = 0.81-0.93, p < 0.001) and DM co-infected with CL group (OR = 0.8, CI = 0.72-0.88, p < 0.001) than healthy group, aspartate aminotransferase (AST) concentration in DM group (OR = 0.86, CI = 0.76-0.98, p = 0.02), transforming growth factor beta)TGF-β( level in the CL group (OR = 1.03, CI = 1.003-1.05, p = 0.02), and presence of diabetes disease (OR = 2.07, CI = 1.16-3.7, p < 0.05), were significantly linked with the induction of CL lesion. The findings demonstrated a significant relationship between DM and CL in distinct risk determinants. Also, the study revealed that DM enhanced the severity of active CL.

Clinical and laboratory evaluation of cured and non-cured patients with cutaneous leishmaniasis treated by Glucantime

BACKGROUND & OBJECTIVES

Insufficient treatment of cutaneous leishmaniasis (CL) by conventional drugs is a major barrier in control strategies. This study was aimed to evaluate Glucantime efficacy and the susceptibility of Glucantime unresponsive and responsive CL isolates in the field and laboratory.

METHODS

Chi-square test (x^[2]) was used to determine the significance of difference between proportions in Glucantime-treated patients. The inhibitory activity of various concentrations of Glucantime against Leishmenia tropica stages was evaluated by a colorimetric cell viability MTT and macrophage assays. Mixed model, t-test and ANOVA were performed to determine the significance of difference between various concentrations of Glucantime unresponsive or responsive isolates and untreated control group and p <0.05 was defined as significant level. Altogether, 89.8% of the patients were cured by Glucantime, whilst 10.2% remained non-cured.

RESULTS

The overall Glucantime efficacy in different age groups and genders was similar. The IC₅₀ values of promastigotes and amastigotes for Glucanime unresponsive isolates were 2.1 and 2.6 times higher than the equivalent rates obtained for responsive cases, respectively. The overall mean number of amastigotes within macrophages in unresponsive isolates was significantly higher (32.68 ± 1.24) than that in responsive ones (18.68 ± 1.52, p <0.001). Glucantime unresponsive and responsive field isolates of anthroponotic CL (ACL) caused by L. tropica strongly correlated to in vitro assays.

INTERPRETATION & CONCLUSION

Monitoring of Glucantime unresponsiveness by the health surveillance system is extremely important, where anthroponotic transmission occurs in humans. Hence, physicians should be aware of such clinical unresponsive presentations with ACL for antimonial therapeutic failure to improve management of disease in endemic regions.

The Hepatoprotective mechanisms of 17β-estradiol after traumatic brain injury in male rats: Classical and non-classical estrogen receptors

Protective effects of estrogen (E2) on traumatic brain injury (TBI) have been determined. In this study, the hepatoprotective effects of E2 after TBI through its receptors and oxidative stress regulation have been evaluated. Diffuse TBI induced by the Marmarou method in male rats. G15, PHTPP, MPP, and ICI182-780 as selective antagonists of E2 were injected before TBI. The results indicated that TBI induces a significant increase in liver enzymes [Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Glutamyl transferase (GGT)], and oxidants levels [Malondialdehyde (MDA), Nitric oxide (NO)] and decreases in antioxidant biomarkers [Glutathione peroxidase (GPx) and Superoxide dismutase (SOD)] in the brain and liver, and plasma. We also found that E2 significantly preserved levels of these biomarkers and enzymatic activity. All antagonists inhibited the effects of E2 on increasing SOD and GPx. Also, the effects of E2 on brain MDA levels were inhibited by all antagonists, but in the liver, only ICI + G15 + E2 + TBI group was affected. The impacts of E2 on brain and liver and plasma NO levels were inhibited by all antagonists. The current findings demonstrated that E2 probably improved liver injury after TBI by modulating oxidative stress. Also, both classic (ERβ, ERα) and non-classic [G protein-coupled estrogen receptor (GPER)] receptors are affected in the protective effects of E2.

Dirofilariosis caused by Dirofilaria immitis in the south of Kerman province, Iran

BACKGROUND

Dirofilariosis due to Dirofilaria immitis is endemic in various areas of Iran. Domestic dogs are the main reservoirs and represent a major potential infection source for the vector and humans.

OBJECTIVE

This study aimed to explore the prevalence of dirofilariosis due to D.immitis and its public health importance in domestic dogs in the Jiroft district, south of Kerman province, Iran, by serological and parasitological methods.

METHODS

This descriptive study was carried out as a cross-sectional investigation. A questionnaire was completed for 100 domestic dogs from May 2017 to February 2018 and recorded their age, sex, and clinical features. Also, we used enzyme-linked immunosorbent assay (ELISA) to identify antigens of heartworms in the bloodstream, with 98% sensitivity and 100% specificity, and parasitological techniques (Knott's test) to detect microfilariae in canine blood in Jiroft district, south of Kerman province, Iran.

RESULTS

Overall, 10 (10%) and 4 (4%) domestic dogs were infected as confirmed by ELISA and modified Knott's tests, respectively. The rate of occult infections in the ELISA test than Knott's test was 60%. No significant difference was found between dirofilariosis and gender. In contrast, there was a significant difference between dirofilariosis infection and age (P < 0.05).

CONCLUSION

The present findings could help understand the epidemiological aspects of D. immitis for future control programs and take appropriate preventive and therapeutic strategies against the disease.

A long-lasting emerging epidemic of anthroponotic cutaneous leishmaniasis in southeastern Iran: population movement and peri-urban settlements as a major risk factor

Background

Epidemics of cutaneous leishmaniasis (CL) are occurring more frequently and spreading faster and farther than before in many areas of the world. The present study aimed to assess a long-lasting emerging epidemic (2005–2019) of 5532 cases with anthroponotic CL (ACL) in peri-urban areas of Kerman city in southeastern Iran.

Methods

This descriptive-analytical study was carried out for 15 years in Kerman province, southeastern Iran. The data were passively obtained through the health surveillance system and the Kerman Leishmaniasis Research Center. Every subject was diagnosed using direct smear microscopy. The representative causative agent was further examined by ITS1-PCR, PCR-RFLP, 7SL RNA gene sequencing and phylogenetic analyses. For each subject, a case report form designating demographic and clinical data was recorded.

Results

A different pattern of ACL incidence was found in peri-urban areas compared to that in the city of Kerman. The incidence rate of ACL cases has significantly increased (P < 0.001) from 2005 to 2016 in new settlements with a gradual decline after that. The overall average risk of contracting the disease was 7.6 times higher in peri-urban areas compared to Kerman city, an old endemic focus. All isolates consisting of six variants were confirmed to be Leishmania tropica. The overall pattern of the ACL infection indicates that the etiological agent of ACL is propagated and transmitted by the bite of female Phlebotomus sergenti sandflies from person to person from dissimilar clones as reflected by the complexity of the migrants’ backgrounds in the province.

Conclusions

The movement of populations and establishment of new settlements in peri-urban areas close to endemic areas are major risk factors for and are directly linked to CL. The underlying factors of this emerging ACL epidemic caused by L. tropica were disasters and droughts, among others. A robust commitment to a multilateral approach is crucial to make improvements in this area. This will require decisive coordinated actions through all governmental factions and non-governmental organizations. Furthermore, active and passive case detection strategies, early diagnosis, and effective treatment could help control the disease.

Major risk factors and histopathological profile of treatment failure, relapse and chronic patients with anthroponotic cutaneous leishmaniasis: A prospective case-control study on treatment outcome and their medical importance

Over the last years, there has been a remarkable increase in the number of unresponsive patients with anthroponotic cutaneous leishmaniasis (ACL) reported worldwide. The primary objective of this study was to explore the role of demographic, clinical and environmental risk related-factors in the development of treatment failure, relapse and chronic cases compared to responsive patients with ACL. Moreover, molecular, histopathological and immunohistochemical (IHC) findings between these forms were explored. This work was undertaken as a prospective and case-control study in southeastern Iran. Culture media and nested PCR were used to identify the causative agent. Univariate multinomial and multiple multinomial logistic regression models and the backward elimination stepwise method were applied to analyze the data. A P<0.05 was defined as significant. Also, for different groups, skin punch biopsies were used to study the histopathological and immunohistochemical (IHC) profile. All samples showed that L. tropica was the only etiological agent in all unresponsive and responsive patients with ACL. Data analysis represented that 8 major risk factors including nationality, age groups, occupation, marital status, history of chronic diseases, duration of the lesion, the lesion on face and presence of domestic animals in the house were significantly associated with the induction of unresponsive forms. The histopathological and immunohistochemical findings were different from one form to another. The present findings clearly demonstrated a positive relation between ACL and distinct demographic, clinical and environmental risk determinants. Knowledge of the main risk factors for ACL infection is crucial in improving clinical and public health strategies and monitor such perplexing factors.

Negligible data are present related to anthroponotic cutaneous leishmaniasis (ACL) treatment outcome and resultant unresponsiveness risk determinants. The role of demographic, clinical, and environmental risk associated-factors in the development of treatment failure, relapse, and chronic forms of ACL has not been studied. We carried out a case-control study for a period of 4 years (2015–2019) using culture media and nested PCR to identify the causative agent. Afterward, we analyzed the data by univariate multinomial and multiple multinomial logistic regression models and the backward elimination stepwise method. Also, we examined skin punch biopsies to study the histopathological and immunohistochemical (IHC) profile for different comparative groups. The findings identified 8 major risk factors were significantly associated with the creation of unresponsive forms. Clinical practitioners and health surveillance systems should be aware of and monitor such perplexing factors. Awareness of the major determinants for unresponsiveness to the treatment of ACL is critical to improving clinical strategies and public health measures. These multidisciplinary approaches need to address specific barriers that directly affect the treatment outcome.

Detection of zoonotic diarrheagenic pathotypes of Escherichia coli in healthy household dogs

Background and Objectives

Intestinal pathotypes of Escherichia coli belong to the companion animals may poses potential risk to public health following zoonotic transmission. Therefore, this study was proposed to determine the virulence genes associated to diarrheagenic E. coli strains isolated from healthy pet dogs and their owners in the southeast of Iran, Kerman province.

Materials and Methods

Totally 168 E. coli isolates were collected from 49 healthy household dogs and their owners. Seventy isolates were obtained from non-pet owners as control group. Presence or absence of the virulence genes including eae, stx1, stx2, st1, lt1, ipaH, cnf1 and cnf2 were screened by conventional polymerase chain reaction (PCR) and dissemination pattern of the genes were studied among the various hosts.

Results

PCR examinations showed that the most frequent virulence gene was ipaH (6.1%) in dogs followed by eae in dog owners (6.1%) and in controls (8.6%). The most frequent pathotypes in dogs, their owners and controls were EIEC (6.1%), EHEC (4.08%) and EPEC (8.5%), respectively. In one of studied houses, both of dog and its owner harbored E. coli strains with same virulence profile (stx1/eae) and pathotype (EHEC).

Conclusion

These results collectively indicate that healthy household dogs probably are the mild reservoir of potential virulent E. coli strains with possible active transmission to their contact owner. However, even non-pet owners seemed to be a notable source of intestinal pathotypes, especially EPEC, for their environment. Transmission of E. coli pathotypes may occurs by direct contact with the reservoirs or ingestion of contaminated food. These pathotypes are potentially virulent and creates public health hazards. Further studies are needed for better understanding of dissemination mechanisms of E. coli pathotypes among humans and their pets.

A Screen-Printed Electrode Modified With Graphene/Co3O4 Nanocomposite for Electrochemical Detection of Tramadol

In this paper, graphene (Gr)/Co₃O₄ nanocomposite was synthesized and utilized for the development of a novel electrochemical sensor to detect tramadol. Tramadol determination was examined by linear sweep voltammetry, differential pulse voltammetry, cyclic voltammetry, and chronoamperometry on Gr/Co₃O₄ nanocomposite-modified screen-printed electrode (Gr/Co₃O₄/SPE) in phosphate-buffered saline (PBS). Under the optimized condition, the detection limit of tramadol is 0.03 μM (S/N = 3) in the linear ranges of 0.1–500.0 μM. Furthermore, Gr/Co₃O₄/SPE was satisfactorily utilized to detect tramadol in tramadol tablet and urine specimens.

Evaluation of Different Attractive Traps for Capturing Sand Flies (Diptera: Psychodidae) in an Endemic Area of Leishmaniasis, Southeast of Iran

Background:

The attraction of phlebotomine sand flies to plant and animal hosts is due to the produced chemical compounds, affecting the olfactory receptors of the insects. Therefore, novel and effective methods, such as Attractive Toxic Sugar Baits (ATSB) and Attractive Toxic Baits (ATB), are based on the effective materials that attract sand flies toward the host. The present study was designed to identify the attractive materials in plants and animals for using in ATSB and ATB.

Methods:

This cross-sectional study was carried out in July 2018 on endemic areas of leishmaniasis in Iran. Different baits, including mango, nectarine, grape, banana, melon and watermelon, defibrinated blood of cattle, sheep, goat and chicken, urine of cattle, sheep, goat and ultimately, simple and complex chemicals, such as CO₂, 1-octanol, lactic acid and human sweat were placed inside the traps, and the rate of the sand flies attraction to these materials was studied. Furthermore, data were analyzed using the Kruskal-Wallis test and Mann Whitney U test.

Results:

There was a significant difference in the sand flies attraction between the traps containing watermelon, urine of cattle, and sheep, and chemicals such as CO₂ and human sweat and the control trap (p< 0.05).

Conclusion:

This study showed that watermelon and CO₂ are the potential candidates for using in ATSB and ATB, respectively.

Domestic and game pigeons as reservoirs for Escherichia coli harbouring antimicrobial resistance genes

OBJECTIVES

In Iran, pigeons are kept and bred on the roofs of houses, which indicates the potential significance of pigeons in the dispersal of antimicrobial resistant Escherichia coli strains. Here we characterized antimicrobial resistance genotypes in relation to phenotypic presentations and phylogenetic backgrounds of the E. coli isolates from household pigeons in Kerman in southeast Iran.

METHODS

Totally, 152 faecal E. coli isolates from domestic and household pigeons were screened for 13 antimicrobial resistance genes, bla_TEM, bla_SHV, bla_CTX-M, sulI, sulII, dhfrI, dhfrV, aadA, aac(3)-I, tetA, tetB, floR and qnrA, by conventional polymerase chain reaction (PCR) technique. Clermont phylogenetic background of E. coli strains was studied and antibiotic resistance of all strains was assessed for seven antibiotics.

RESULTS

The antimicrobial resistance genes bla_TEM, tetA, tetB and aadA were detected in 52.6%, 6.5%, 6.5% and 5.9% of the isolates, respectively. PCR phylotyping revealed that a significant number of isolates within A₀ (54%), A₁ (70%), B1 (57.6%), B2₂ (75%) and D1 (87.5%) phylogroups were positive for the studied resistance genes. One phenotypic resistance pattern (trimethoprim-sulfamethoxazole) was associated with the presence of the corresponding gene sul2.

CONCLUSIONS

An alarming rate of phenotypic resistance was observed in this study. Many isolates were positive for the screened resistance genes. According to the phylogenetic background, most resistant isolates belonged to the commensal phylotypes, representing significant role of commensal strains as a source of resistance genes. These findings highlight the role of the pigeon as disseminator of resistant E. coli strains.

Fabrication of magnetic iron oxide-supported copper oxide nanoparticles (Fe3O4/CuO): modified screen-printed electrode for electrochemical studies and detection of desipramine

The present investigation examines a sensitive electrochemical technique to detect desipramine through Fe₃O₄/CuO nanoparticles (NPs). Fe₃O₄/CuO NPs were synthesized via a coprecipitation procedure, and the products were characterized via energy disperse spectroscopy, X-ray diffraction, transmission electron microscopy, scanning electron microscopy, and vibrating sample magnetometer. The voltage–current curve and differential pulse voltammetry examinations of Fe₃O₄/CuO-modified screen-printed electrode (Fe₃O₄/CuO/SPE) were followed by the determination of electro-catalytic activities toward desipramine oxidation in a phosphate buffer solution (pH = 7.0). In addition, the value of diffusion coefficient (D = 3.0 × 10⁻⁶ cm² s⁻¹) for desipramine was calculated. Then, based on the optimum conditions, it was observed that the currents of the oxidation peak were linearly proportionate to the concentration of desipramine in the broad range between 0.08 and 400.0 μM and LOD of 0.03 μM (S/N = 3). Finally, our new sensor was successfully utilized to detect desipramine in the real samples, with reasonable recovery in the range of 97.2% to 102.7%.

The present investigation examines a sensitive electrochemical technique to detect desipramine through Fe₃O₄/CuO nanoparticles.

Direct electrochemical detection of clozapine by RuO2 nanoparticles-modified screen-printed electrode

This study introduces the sensitive electrochemical detection of clozapine with the use of a ruthenium(iv) oxide nanoparticle (RuO₂ NP)-modified screen-printed electrode (RuO₂ NPs/SPE).

Efficacy and safety of Curcuma longa essential oil to inactivate hydatid cyst protoscoleces

Background

One of the most important ways to cure hydatid cysts is surgery. Today, available chemical drugs have shown severe complications during hydatid cyst surgery. Here we investigated theefficacy and safety of Curcuma longa (C. longa) essential oil (CLEO) against hydatid cysts protoscoleces.

Methods

Here, the collected protoscoleces from fertile hydatid cysts were exposed to different concentrations of the CLEO (50–200 μl/mL) for 5–30 min in vitro and ex vivo. In addition, male NIH mice (48 mice) were applied to examine the safety of CLEO.

Results

All protoscoleces were completely killed in 5th min of treatment to the doses of 200 μl /mL of CLEO. On the other hand, in the 10th min of treatment, CLEO entirely killed 100% of protoscoleces at the dose of 100 μL/mL. Other doses of CLEO, but, revealed a postponed activity. Although CLEO at the doses of 50, and 100 μL/mL exhibited no similar effect in the ex vivo analysis; but, at the dose of 200 μL/mL and an exposure time of 5 min, approximately 100% of protoscoleces were destroyed into the cyst. We found that after intra-peritoneal injection of the CLEO for 14 days, although blood and biochemical parameters were changed; but there was no significant difference in comparison with the control group (p > 0.05).

Conclusion

This research demonstrated that C. longa revealed the promising scolicidal effects against protoscoleces in vitro and in vivo, of course, after additional tests; it might be considered as an herbal scolicidal drug in order to decrease the threat of discharge of protoscoleces through hydatid cyst surgery. Nevertheless, supplementary studies will be desired to prove the current findings by examination the essential oil in a clinical setting.

Associated-risk determinants for anthroponotic cutaneous leishmaniasis treated with meglumine antimoniate: A cohort study in Iran

Background

The control of cutaneous leishmaniasis (CL) is facilitated by knowledge of factors associated with the treatment failures in endemic countries. The aim of this evaluation was to identify the potential risk determinants which might affect the significance of demographic and clinical characteristics for the patients with anthroponotic CL (ACL) and the outcome of meglumine antimoniate (MA) (Glucantime) treatment.

Methodology/Principal findings

This current was executed as a cohort spanning over a period of 5 years which centered in southeastern part of Iran. Altogether, 2,422 participants were evaluated and 1,391 eligible volunteer patients with ACL caused by Leishmania tropica were included. Overall, 1,116 (80.2%) patients received MA intraleisionally (IL), once a week for 12 weeks along with biweekly cryotherapy, while 275 (19.8%) patients received MA alone (20 mg/kg/day for 3 weeks) (intramuscular, IM). The treatment failure rate in ACL patients was 11% using IL combined with cryotherapy plus IM alone, whilst 9% and 18.5% by IL along with cryotherapy or IM alone, respectively. Multivariate logistic regression model predicted 5 major associated-risk determinants including male (odds ratio (OR) = 1.54, confidence interval (CI) = 1.079–2.22, p = 0.018), lesion on face (OR = 1.574, CI = 1.075–2.303, p = 0.02), multiple lesions (OR = 1.446, CI = 1.008–2.075, p = 0.045), poor treatment adherence (OR = 2.041, CI = 1.204–3.46, p = 0.008) and disease duration > 4 months (OR = 2.739, CI = 1.906–3.936, p≤0.001).

Conclusions/Significance

The present study is the original and largest cohort of ACL patients who treated with MA. A comprehensive intervention and coordinated action by the health authorities and policy-makers are crucial to make sure that patients strictly follow medical instructions. Early detection and effective therapy < 4 months following the onset of the lesion is critical for successful treatment of the patients. Since a significant number of patients are still refractory to MA, reducing man-vector exposure and development of new effective alternative drugs are essential measures against ACL due to L. tropica.

Cutaneous leishmaniasis (CL) is a serious neglected tropical disease with social stigma and associated disfiguring with health burden, especially in poor endemic regions of the world. Iran is among the seven high burden CL-infected countries. Limited data are available in regarding to CL treatment and related risk determinants. Parasitologically confirmed ACL patients caused by Leishmania tropica were treated over a 5-year period (2012–2016), with IL meglumine antimoniate (MA) (Glucantime), combined with cryotherapy or with IM MA alone. The objective of this study was to identify the potential risk factors that are associated with response to treatment. The ensuing results with both therapeutic routes identified 5 major risk determinants namely male patients, lesion on face, multiple lesions, poor treatment regimen and disease duration >4 months. The extent to which medical instructions related to patients, therapy and the healthcare system should be seriously monitored. This requires multidisciplinary actions to address specific barriers which directly threaten the treatment outcome. Furthermore, early detection and prompt treatment <4 months following the disease duration together with implementations of public health education and prophylactic measures should receive priority in high risk areas.

A novel dopamine electrochemical sensor based on La3+/ZnO nanoflower modified graphite screen printed electrode

Flower-like La3+/ZnO nanocomposite was facile synthesized. A simple and ultrasensitive sensor based on graphite screen printed electrode (SPE) modified by La3+/ZnO nanoflower was developed for the electrochemical determination of dopamine. The electrochemical behavior of dopamine was studied in 0.1 M phosphate buffer solution (PBS) using cyclic voltammetry (CV), chronoamperometry (CA) and differential pulse voltammetry (DPV). Compared with the unmodified graphite screen printed electrode, the modified electrode facilitates the electron transfer of dopamine, since it notably increases the oxidation peak current of dopamine. Also, according to CV results the maximum oxidation of dopamine on La3+/ZnO/SPE occurs at 150 mV which is about 140 mV more negative compared with unmodified SPE. Under optimized conditions, the modified electrode exhibited a linear response over the concentration range from 0.15 to 300.0 μM, with a detection limit of 0.08 μM (S/N = 3). The proposed sensor exhibited a high sensitivity, good stability and was successfully applied for dopamine determination in dopamine ampoule, with high recovery.

Electrochemical measurements of ascorbic acid based on graphite screen printed electrode modified with La3+/Co3O4 nanocubes transducer

Electrochemical characterization of ascorbic acid oxidation on a graphite screen printed electrode (SPE) modified with La3+/Co3O4nanocubes is performed by applying cyclic voltammetry (CV), chronoamperometry (CHA), and differential pulse voltammetry (DPV) techniques. Synthesized La3+/Co3O4nanocubes for SPE modification, La3+/Co3O4/SPE, enhance the ascorbic acid electrooxidation kinetics by reducing the anodic overpotential. Excellent La3+/Co3O4/SPE electrochemical properties provide sensitive ascorbic acid voltammetric determination with low detection limit, good stability and quick response towards electrooxidation of ascorbic acid as compared to bare SPE. Under optimized conditions, DPV current demonstrates a linear response for ascorbic acid over a concentration range of 1.0 to 900.0 mM with a correlation coefficient of 0.9997, and detection limit (LOD) (S/N = 3) = 0.3 mM. The proposed procedure offers a potential application for producing the sensor with good repeatability. Also, fast response of fabricated sensor can allow a real-time analysis of real samples.

Expansion of urban cutaneous leishmaniasis into rural areas of southeastern Iran: Clinical, epidemiological and phylogenetic profiles explored using 7SL high resolution melting-PCR analysis

Cutaneous leishmaniasis (CL) has increased remarkably in Iran and has expanded into new areas. The present study aimed to assess the emerging CL outbreak in southeastern Iran using high resolution melting-polymerase chain reaction (HRM-PCR) and phylogenetic analysis using the 7SL RNA gene marker. A cross-sectional and analytical survey was conducted during a house-to-house census of 11,021 inhabitants in Narmashir County in southeastern Iran in 2016. The cases were detected by direct smear microscopic examination and sequencing and were characterized using the 7SL RNA gene. All age groups and sexes were equally affected. Most were single lesions (70.7%). The hands (55.2%) and face (37.9%) were the main sites of involvement. The disease was more common among illiterate persons. Sequencing and HRM-PCR revealed that Leishmania tropica (accession no. MH632168 Qale-Shahid) was the principal causative agent of anthroponotic CL (ACL) in new areas of expansion. This is the first emergence of ACL in rural areas of Narmashir County. Based on the molecular data, the causative parasite species confirmed to be L. tropica. Sequencing and phylogenetic analysis indicated that a single clone of the organism derived from a single source has spread into the affected villages. Construction of a main road, population movement and recent urbanization in the area are likely the major factors associated with the establishment of this new outbreak. This study was essential to enable the planning of effective therapeutic and prophylactic measures to control the disease.

Host's immune response in unresponsive and responsive patients with anthroponotic cutaneous leishmaniasis treated by meglumine antimoniate: A case-control study of Th1 and Th2 pathways

The objective of the present study was to compare the host's immune responses between unresponsive and responsive patients with anthroponotic cutaneous leishmaniasis (ACL) treated by meglumine antimoniate. A case-control study was carried out in an endemic focus in Iran. Blood samples were taken from patients and peripheral blood mononuclear cells (PBMCs) were isolated. Two wells were considered for each isolate of unresponsive and responsive patients; one was exposed to L. tropica (Lt-stimulated cells) and the other remained non-exposed (non-stimulated cells). After 24 h of incubation, whole RNA was extracted from each sample. Real-time quantitative PCR was carried out to confirm the differences in expression levels of IL-12 P40, IFN-γ, IL-1β, IL-4 and IL-10 among isolates. Data were analyzed and P < 0.05 was considered to be statistically significant. In our study, Lt-stimulated cells and non-stimulated cells in unresponsive groups demonstrated significantly lower expression levels of IL-1β, IL-12 P40 and IFN-γ genes and higher expression levels of IL-4 and IL-10 genes, compared to Lt-stimulated cells and non-stimulated cells in responsive groups. There was a negative correlation between IL-12 P40 with IL-10 and IL-1β with IL-10 in ACL Lt-stimulated cells in unresponsive group, while a positive correlation between IL-12 P40 with IL-1β and IL-12 P40 with IFN-γ in ACL Lt-stimulated cells in responsive group. Probably, different immune responses caused by various factors play a major role in the pathogenesis and development of unresponsiveness in ACL patients. The profile and timing of cytokine production correlated well with the treatment outcome of Leishmania infection.

A newly emerged focus of zoonotic cutaneous leishmaniasis in South-western Iran

Leishmaniasis is rising in many countries, including Iran, due to climate change, refugee crises, urbanization and etc. The aim of this study was to explore the epidemiology, extent and identity of Leishmania species in a newly emerged focus in Abdanan County, Ilam Province, South-western Iran. This study was performed as a descriptive cross-sectional study by a systematic house-to-house approach. The Leishmania species was identified by RFLP-PCR and sequencing. Altogether, 46799 individuals consisting of 22907 (48.9) female and 23892 (51.1%) male were interviewed and physically examined for the presence of skin lesions. Overall, the incidence rate was 0.34% (n = 160). All age groups were affected and the incidence rate was the highest in <10 years of age group (0.49%) and the lowest in >50 years old individuals (0.15%), although there was no significant difference regarding the sex and age. The majority of patients had one lesion (47.5%) on hands (56%) and most of the cases occurred in Abdanan city (%54) in summer. Based on the RFLP-PCR analysis, all the Leishmania isolates were L. major of single genotype. A newly emerged focus of zoonotic CL caused by L. major occurred in South-western of Iran. Multiple risk factors created this epidemic area. Further studies on the vector and reservoir are crucial needed to provide evidences to select the prophylactic and therapeutic measures for future control strategies.

Geographical distribution and molecular characterization for cutaneous leishmaniasis species by sequencing and phylogenetic analyses of kDNA and ITS1 loci markers in south-eastern Iran

This study aimed to explore geographic distribution and molecular characterization of cutaneous leishmaniasis (CL) species by amplifying two popular markers in kinetoplast DNA and internal transcribed spacer 1 loci by nested-PCR, and characterized by sequencing and phylogenetic analyses. Findings demonstrated that two species co-existed in the province: L. tropica (88.5%) and L. major (11.5%). All gender and age groups were equally infected, although males, 21-30 years old, exhibited a significantly higher infection. Sequencing and phylogenetic analyses of 34 randomly selected samples showed that L. tropica isolates exhibited some degree of heterogeneity. Both anthroponotic CL and zoonotic CL are present in south-eastern Iran with predominance of L. tropica species. Some level of heterogeneity was observed in L. tropica isolates which possibly reflects different colonies in the area. Implementation of diagnostic tools directly from clinical samples could be an important strategic approach for exploration of spatial distribution, molecular characterization and phylogenetic analyses.

Risk factors for anthroponotic cutaneous leishmaniasis in unresponsive and responsive patients in a major focus, southeast of Iran

Cutaneous leishmaniasis (CL) is a serious health challenge at the global level due to Leishmania tropica. This study was conducted to evaluate the risk factors associated with anthroponotic CL (ACL) in unresponsive (patient who does not heal and remains with an active lesion, despite receiving two courses of intra-lesional Glucantime along with cryotherapy and one cycle of systemic Glucantime) and responsive patients in a major focus in southeastern Iran. A case-control study was conducted from April 2015 to October 2016 in the southeast of Iran. Patients were recruited in a major ACL focus from unresponsive and responsive cases. These patients were compared for environmental, clinical, and demographic characteristic factors. Twenty-five risk related factors were analyzed using multivariate logistic regression and backward elimination stepwise models. P<0.05 was defined to be statistically significant. In general, 340 patients with ACL comprising 72 (21.2%) unresponsive cases and 268 (78.8%) responsive cases with active lesions or scars were analyzed by estimating odds ratio (OR). All isolates from 15 responsive and 15 unresponsive patients were characterized as Leishmania tropica based on the BLAST and phylogenic analyses by PCR sequences of the Hsp70 and ITS1 loci. Among the 25 variables, 4 major risk factors including poor interior housing conditions (OR = 1.99, confidence interval (CI) = 1-3.93, P<0.04), history of chronic diseases (OR = 6.22, CI = 2.51-15.44, P≤0.001), duration of lesion in the patients referred ≥13 months (OR = 74.99, CI = 17.24-326.17, P≤0.001), and 5-12 months (OR = 7.42, CI = 3.07-17.92, P≤0.001) than lesions with ≤4 months of age and age groups ≥51 years (OR = 3.85, CI = 1.04-14.22, P<0.04) than those ≤7 years, were significantly associated with unresponsive forms. Improving interior house construction protecting high risk individuals and those with debilitating diseases from being bitten by sand flies, together with the early detection and effective treatment of older age groups with history of chronic diseases are highly important measures for preventing unresponsive forms in patients with ACL in southeastern Iran.

Evaluation of Antibacterial Activity of Iron Oxide Nanoparticles Against Escherichia coli

Introduction: Considering the usefulness of metal oxide nanoparticles in biology and biomedicine, iron oxide nanoparticles were biosynthesized using bioresource engineering to evaluate its antibacterial activity against Escherichia coli. Methods: Macrodilution method was used for calculating the lowest concentration which prevented the growth of bacteria (minimum inhibitory concentration [MIC]), and the lowest concentration that destroyed all bacterial cells (minimum bactericidal concentration [MBC]). Results: The lowest concentration of iron oxide nanoparticles that inhibited the growth of E. coli (MIC) was recorded at 250 µg/mL. On the other hand, the MBC of iron oxide nanoparticles was calculated at 500 µg/mL. Conclusion: Iron oxide nanoparticles were produced by a green and eco-friendly, simple and inexpensive method. The results showed the inhibitory effect of iron oxide nanoparticles on E. coli at 250 µg/mL. This may suggest using these nanoparticles as potential antibacterial agents.

In vitro Protoscolicidal Effects of Cinnamomum zeylanicum Essential Oil and Its Toxicity in Mice

BACKGROUND

This study investigates the scolicidal effects of Cinnamomum zeylanicum essential oil against the protoscoleces of hydatid cysts and its toxicity in the mice model.

MATERIALS AND METHODS

Gas chromatography/mass spectroscopy analyses were used to identify the constituents of essential oil. Protoscoleces were treated with different concentrations of the essential oil (6.25-100 µL/mL) in each test tube for 5-30 min. The viability of protoscoleces was confirmed using eosin exclusion test (0.1% eosin staining). Forty-eight male NMRI mice were also used to determine the toxicity of C. zeylanicum essential oil (0.5-4 mL/kg).

RESULTS

The main components were found to be cinnamaldehyde (91.8%), ρ metoxicinamate (1.57%), and α pinene (1.25%). Findings indicate that C. zeylanicum essential oil with the concentrations of 100 and 50 µL/mL killed 100% of protoscoleces after 5 min of exposure. Also, the lower concentrations of C. zeylanicum essential oil motivated a late protoscolicidal effect. The LD50 value of intraperitoneal injection of C. zeylanicum essential oil was 2.07 mL/kg body weight after 48 h, and the maximum nonfatal dose was 1.52 mL/kg body weight. The results also showed that there was no significant toxicity following oral administration of C. zeylanicum essential oil for 2 weeks.

CONCLUSION

The results exhibited the favorable scolicidal activity of C. zeylanicum, which could be applied as a natural scolicidal agent in hydatid cyst surgery.

SUMMARY

We evaluated the efficacy of Cinnamomum zeylanicum essential oil against hydatid cyst protoscolecesThe viability of protoscoleces was confirmed using eosin exclusion test (0.1% eosin staining)Forty-eight male NMRI mice were also used to determine the toxicity of C. zeylanicum essential oilC. zeylanicum with potent scolicidal activity could be applied as a natural scolicidal agent in surgery. Abbreviations used: GC/MS: Gas chromatography/mass spectrometry analysis; CE: Cystic echinococcosis; LD50: Lethal dose 50%; I.p: Intraperitoneally.

Prevalence of antibiotic resistance and genetic relatedness of Escherichia coli isolates in HIV and thalassemia patients in southeastern Iran

The present study was carried out to evaluate the prevalence of antibiotic resistance genes in Escherichia coli isolates from HIV and thalassemia patients and to determine the phylogenetic group distribution and to genotype the isolates in southeastern Iran. This cross-sectional study was performed in E. coli isolates taken from fecal and urine samples of 43 HIV and 62 thalassemia patients. The E. coli isolates were examined for 13 antibiotic resistance genes and determine the phylogroups. The Rep-PCR DNA fingerprinting method was utilized to determine the genotype of the isolates. Among the 105 E. coli isolates, 66.7% isolates were positive for qnrS, 55.2% for dhfrI, 40.9% for sulI, 33.3% for sulII and 31.4% for bla_TEM genes. A bla_CTX-M-15 gene was detected in 20.9% isolates, aac(3)-I in 14.3% isolates and aadA in 12.4% isolates, whereas bla_SHV and qnrB genes were identified in 10.5% and 8.6% isolates, respectively. Out of the isolates, only 2.8% isolates possessed the bla_OXA-1 gene, and no IMP and VIM genes were detected. The significant phylogroup was A (37.2%), B2 (15.3%), B1 and unknown (each 14.3%), D (13.4%) and C, F and clade I (each 2%). Phylogroup A accounted for the highest antibiotic resistance. The results of Rep-PCR indicated that the isolates were closely related. These results showed a high prevalence of genes encoding antibiotic resistance in the E. coli isolates. The majority of E. coli isolates distributed among phylogroup A, whereas positive isolates for antibiotic resistance genes were disseminated among various phylogroups (A, B2, and D).

Topical terbinafine in the treatment of cutaneous leishmaniasis: triple blind randomized clinical trial

Leishmaniasis is a spectrum of disease condition with considerable health impacts, caused by different species of Leishmania. This disease is currently endemic in 98 countries and territories in the world. There are many treatment modalities for cutaneous leishmaniasis. The use of topical terbinafine in the treatment of cutaneous leishmaniasis has recently been considered. Eighty-eight participants more than two years old with proven acute CL by a positive direct smear were randomly allocated to one of the two study arms: first group received meglumine antimoniate (Glucantime) 20 mg/kg/day intramuscular injection (IM) plus a placebo ointment (Mahan Vaseline) for 20 days. The second group received meglumine antimoniate (Glucantime) 20 mg/kg/day IM plus topical terbinafine, for 20 days and were monitored closely by dermatologist during the course of the study. Crude regression analysis showed that there was no significant difference between placebo and intervention group regarding partial or complete treatment (partial treatment: HRcrude = 1.1, CI 95 % = 0.7-1.7; complete treatment: HRcrude = 1.1, CI 95 % = 0.8-1.7). Although, there was no statistically significant different between the two treatment groups, but clinically it seems that the treatment rate in those who receive glucantime plus terbinafine was more effective than the other group. However this rate depended on the type of lesions. As data indicated ulcerated nodules, papules and plaque in experimental group have been completely improved two times faster than placebo group. Ulcerated nodules, nodules and plaque were partially improved faster in those used tebinafine than placebo ointment.

A Review of Impact of Bam Earthquake on Cutaneous Leishmaniasis and Status: Epidemic of Old Foci, Emergence of New Foci and Changes in Features of the Disease

BACKGROUND

Global findings indicate that incidence rate of cutaneous leishmaniasis (CL) has significantly increased during the past decade, as documented in many countries. This review was aimed to evaluate the trend of CL cases in terms of demographic and clinical characteristics during a decade after the earthquake (2003-2012) compared to the corresponding period before the earthquake in Bam (1993-2003).

METHODS

Direct smear preparations along with different intrinsic methods were used for detection and identification of the causative agents.

RESULTS

Overall, 20999 cases of CL have occurred during the last 20 years (1993-2012), 6731 cases before and 14268 cases after the earthquake (P< 0.001).

CONCLUSIONS

Following a major earthquake, several risk factors could activate epidemics of cutaneous leishmaniasis in old foci and induce emerging foci in new areas.

A collagen-poly(vinyl alcohol) nanofiber scaffold for cartilage repair

Articular cartilage has a limited capacity for self-repair. Untreated injuries of cartilage may lead to osteoarthritis. This problem demands new effective methods to reconstruct articular cartilage. Mesenchymal stem cells (MSCs) have the proclivity to differentiate along multiple lineages giving rise to new bone, cartilage, muscle, or fat. This study was an animal model for autologous effects of transplantation of MSCs with a collagen-poly(vinyl alcohol) (PVA) scaffold into full-thickness osteochondral defects of the stifle joint in the rabbit as an animal model. A group of 10 rabbits had a defect created experimentally in the full thickness of articular cartilage penetrated into the subchondral space in the both stifle joints. The defect in the right stifle was filled with MSCs/collagen-PVA scaffold (group I), and in the left stifle, the defect was left without any treatment as the control group (group II). Specimens were harvested at 12 weeks after implantation, examined histologically for morphologic features, and stained immunohistochemically for type-II collagen. Histology observation showed that the MSCs/collagen-PVA repair group had better chondrocyte morphology, continuous subchondral bone, and much thicker newly formed cartilage compared with the control group at 12 weeks post operation. There was a significant difference in histological grading score between these two groups. The present study suggested that the hybrid collagen-PVA scaffold might serve as a new way to keep the differentiation of MSCs for enhancing cartilage repair.

Ehrlichiosis in Household Dogs and Parasitized Ticks in Kerman-Iran: Preliminary Zoonotic Risk Assessment

BACKGROUND

Ehrlichiosis is an emerging tick-borne zoonotic disease caused by the family of Anaplasmatacea. Recently, outbreak of human monocytic ehrlichiosis was reported in northern part of Iran. Besides, serological evidence of canine monocytic ehrlichiosis caused by Ehrlichia canis was reported from southeastern of Iran but the epidemiology of this disease is almost undetermined in Iran. The present study was designed to use PCR for detection of Ehrlichia spp. in tick infested household dogs and determination of risks of disease transmission to dog's owners.

METHOD

Blood samples were prepared from 100 tick infested household dogs after complete clinical examination. Complete cell blood count was done for each sample. DNA extraction was done and PCR was carried out by a commercial kit afterwards. Regarding to PCR results, blood samples were collected from owners and family members who were exposed to infected and non-infected dogs. A similar method was utilized for DNA extraction and PCR in human samples.

RESULT

Ehrlichial DNA was detected by PCR in six percent of Rhipicephalus sanguineus tick pools and 9% of the examined dogs. No positive sample was detected among the 67 examined human bloods.

CONCLUSION

Ehrlichiosis could be considered as an emerging canine disease but owning a dog should not be considered a major risk factor for ehrlichiosis in humans. Further serological and molecular studies in different parts of Iran are required to clarify the epidemiology of ehrlichiosis in canine, ticks, and human population.

High Frequency of Diarrheagenic Escherichia coli in HIV-Infected Patients and Patients with Thalassemia in Kerman, Iran

This study was conducted on patients with thalassemia and HIV-infected patients to determine the frequency of diarrheagenic Escherichia coli in Kerman, Iran. We analyzed 68 and 49 E coli isolates isolated from healthy fecal samples of patients with thalassemia and HIV-infected patients, respectively. The E coli isolates were studied using a multiplex polymerase chain reaction to identify the enterotoxigenic E coli (ETEC), enterohemorrhagic E coli (EHEC), and enteropathogenic E coli (EPEC) groups. Statistical analysis was carried out to determine the correlation of diarrheagenic E coli between HIV-infected patients and patients with thalassemia using Stata 11.2 software. The frequency of having at least 1 diarrheagenic E coli was more common in patients with thalassemia (67.64%) than in HIV-infected patients (57.14%; P = .25), including ETEC (67.64% versus 57.14%), EHEC (33.82% versus 26.53%), and EPEC (19.11% versus 16.32%). The results of this study indicate that ETEC, EHEC, and EPEC pathotypes are widespread among diarrheagenic E coli isolates in patients with thalassemia and HIV-infected patients.

Phylogenetic groups, extended-spectrum β-lactamases and metallo-β-lactamase in Escherichia coli isolated from fecal samples of patients with diarrhea in Iran

AIM

The aims of this study were to investigate the phenotypic and genotypic of extended-spectrum β-lactamase (ESBL) and metallo-β-lactamases (MBLs) and determine phylogenetic background E. coli isolates from fecal samples of patients with diarrhea in Kerman, southeast of Iran.

BACKGROUND

The emergence of ESBLs and MBLs-producing E. coli caused problems in antibiotic treatments. E. coli strains can be assigned to four main phylog-groups, including: A, B1, B2 and D.

PATIENTS AND METHODS

E. coli isolates (n=216) were obtained from fecal samples of patients with diarrhea between June and December 2013. ESBLs and MBLs were confirmed by disk-diffusion and broth micro-dilution methods. Using PCR, the ESBL-positive isolates were screened to determine the phylo-groups and the presence of bla CTX-M-15, bla OXA-1, bla PER-1, bla VIM and bla IMP genes.

RESULTS

ESBL-positive isolates (n= 56) were detected. Among ESBL-positive isolates, 51 isolates were positive for bla CTX-M15 and one isolate was positive for both bla CTX-M-15 and bla OXA-1 genes. None of the isolates were positive for bla PER-1, bla VIM and bla IMP genes. PCR assay for phylotyping of isolates indicated that the isolates were belonged to groups A (54.16%), B1 (11.11%), B2 (12.96%) and D (21.75%). The isolates possessed bla CTX-M-15 gene were belonged to A (35 isolates), B1 (5), B2 (3) and D (8) phylo-groups.

CONCLUSION

Our results indicate that bla CTX-M-15 gene is widespread among diarrheagenic E. coli isolates. ESBL-producing E. coli isolates were disseminated among a diversity of phylo-groups. Further studies are necessary to identify the ESBL genes in relation to phylogenetic groups.

Seroprevalence of bovine leptospiral antibodies by microscopic agglutination test in Southeast of Iran

OBJECTIVE

To evaluate serological findings of bovine leptospirosis which is a zoonotic disease with worldwide distribution caused by Leptospira interrogans.

METHODS

One hundred and sixty seven sera were collected from 9 commercial dairy herds in jiroft suburbs, from July to October 2011. Microscopic agglutination test (MAT) was used to evaluates serological findings of bovine leptospirosis in Jiroft suburb dairy farms, Kerman province, Iran.

RESULTS

Antibodies were found by MAT at least against one serovar of Leptospira interrogans in 29 samples (17.36%) among 167 sera at a dilution 1:100 or higher, and Leptospira pomona was the most prevalent serovar. Positive titers against more than one serovar were detected in 6 sera of the positive samples.

CONCLUSION

This study is the first report of leptospirosis in Southeast Iran and showed that Leptospira pomona was the most and Leptospira icterohaemorrhagiae the least prevalent serovars in Southeast Iran.

Scolicidal effects of biogenic selenium nanoparticles against protoscolices of hydatid cysts

Cystic echinococcosis (hydatid cyst, CE) as a zoonotic parasitic infection caused by the larval stage of the dog tapeworm Echinococcus granulosus is still an important economic and public health concern in the world. One of the treatment options for CE is surgical removal of the cysts combined with chemotherapy using albendazole and/or mebendazole before and after surgery. Currently, many scolicidal agents, which have some complications, have been used for inactivation of the cyst contents. Therefore the development of new scolicidal agents with low side effects and more efficacies is an urgent need for surgeons. The present study was aimed to investigate the in vitro scolicidal effect of selenium nanoparticles biosynthesized by a newly isolated marine bacterial strain Bacillus sp. MSh-1 against protoscoleces of E. granulosus. Protoscolices were aseptically aspirated from sheep livers having hydatid cysts. Various concentrations (50-500 μg/ml) of Se NPs (in size range of about 80-220 nm) were used for 10-60 min. Viability of protoscoleces was confirmed by 0.1% eosin staining. The results indicated that biogenic Se NPs at all concentrations have potent scolicidal effects especially at concentrations 500 and 250 μg/ml after 10 and 20 min of application, respectively. In conclusion, the findings of present study proven that Se NPs have potent scolicidal effects, therefore may be used in CE surgery. However, the in vivo efficacy of these NPs remains to be explored.

The severity of cutaneous leishmaniasis before and after the earthquake in Bam, southeastern Iran

Cutaneous leishmaniasis (CL) is a major disease with significant public health concerns in Iran. The objective of this study was to compare the severity of CL among the patients before and after the earthquake in the city and suburbs of Bam, southeastern Iran. This study was carried out as a descriptive-analytical manner by house-to-house visits in 2010 in Bam, southeastern Kerman province of Iran, where a massive earthquake has recently occurred. Overall, 1,481 individuals were selected as a cluster random sampling. Suspected lesions were detected by direct smear preparation and X(2) test was used for statistical significance at P < 0.05. Overall, 1,481 individuals (mean age; 25.7 ± 17.6 years) consisting of 51.4 % males and 48.6 % females were randomly selected. 549 individuals showed history of CL; 23.4 % belonged to before and 13.7 % belonged to after the earthquake. When the overall severity in terms of location, number, size and duration of lesions was considered, the lesions were less severe in the time period after the earthquake (P < 0.05) than those before the earthquake. Cutaneous leishmaniasis is currently considered as a growing public health concern worldwide, mainly due to creation of various risk factors particularly after a major natural disaster. Possibly the establishment of the CL health clinic to serve patients and to coordinate various activities had a major role in planning control strategies and thus reduction in severity of the CL disease.