Gut microbiota and childhood malnutrition: Understanding the link and exploring therapeutic interventions

Childhood malnutrition is a metabolic condition that affects the physical and mental well-being of children and leads to resultant disorders in maturity. The development of childhood malnutrition is influenced by a number of physiological and environmental factors including metabolic stress, infections, diet, genetic variables, and gut microbiota. The imbalanced gut microbiota is one of the main environmental risk factors that significantly influence host physiology and childhood malnutrition progression. In this review, we have evaluated the gut microbiota association with undernutrition and overnutrition in children, and then the quantitative and qualitative significance of gut dysbiosis in order to reveal the impact of gut microbiota modification using probiotics, prebiotics, synbiotics, postbiotics, fecal microbiota transplantation, and engineering biology methods as new therapeutic challenges in the management of disturbed energy homeostasis. Understanding the host-microbiota interaction and the remote regulation of other organs and pathways by gut microbiota can improve the effectiveness of new therapeutic approaches and mitigate the negative consequences of childhood malnutrition.

Gut microbiota and obesity: an overview of microbiota to microbial-based therapies

The increasing prevalence of obesity and overweight is a significant public concern throughout the world. Obesity is a complex disorder involving an excessive amount of body fat. It is not just a cosmetic concern. It is a medical challenge that increases the risk of other diseases and health circumstances, such as diabetes, heart disease, high blood pressure and certain cancers. Environmental and genetic factors are involved in obesity as a significant metabolic disorder along with diabetes. Gut microbiota (GM) has a high potential for energy harvesting from the diet. In the current review, we aim to consider the role of GM, gut dysbiosis and significant therapies to treat obesity. Dietary modifications, probiotics, prebiotics, synbiotics compounds, using faecal microbiota transplant, and other microbial-based therapies are the strategies to intervene in obesity reducing improvement. Each of these factors serves through various mechanisms including a variety of receptors and compounds to control body weight. Trial and animal investigations have indicated that GM can affect both sides of the energy-balancing equation; first, as an influencing factor for energy utilisation from the diet and also as an influencing factor that regulates the host genes and energy storage and expenditure. All the investigated articles declare the clear and inevitable role of GM in obesity. Overall, obesity and obesity-relevant metabolic disorders are characterised by specific modifications in the human microbiota's composition and functions. The emerging therapeutic methods display positive and promising effects; however, further research must be done to update and complete existing knowledge.

Molecular epidemiology of antibiotic-resistant Escherichia coli among clinical samples isolated in Azerbaijan, Iran

Background and Objectives

The immediate emergence of resistant bacteria poses an increasingly growing problem to human society and the increasing prevalence of antibiotic resistance in Escherichia coli strains is one of the most important health problems. This study aimed to review the molecular epidemiology of drug resistance among clinical isolates of E. coli in north-west portion of Iran Azerbaijan.

Materials and Methods

A complete of 219 clinical isolates of E. coli had been collected from the various clinical samples. The disk diffusion and agar dilution assays were used to determine antimicrobial susceptibility. The presence of antibiotics resistance genes was carried out by the PCR method.

Results

The highest susceptibility was shown to imipenem (3%) and fosfomycin (3%), and the most antibiotic resistance was presented to ampicillin (99%). The highest frequent ESBL gene among isolates was bla _CTXM-15 in 70% followed by bla_CMY-2 in 67%, and bla_TEM-1 in 46%. The most common fluoroquinolone (FQ) resistance genes were oqxB (34%), followed by oqxA (25%), and qnrB (18%). The frequency of tetracycline resistance genes (tetA, tetB, tetC, and tetD) were detected in 24.8%, 31.6%, 1.8%, and 4.2%, respectively. The highest frequent genes to fosfomycin were fosA 10%, fosA3 30%, fosC 40%, and fosX 20%. The dominant founded aminoglycosides resistant genes were armA (12.96%) and npmA (4.93%).

Conclusion

The prevalence of antibiotics resistance in the tested E. coli isolates was high in Azerbaijan, Iran and these findings showed that E. coli is one of the major drug-resistant pathogens.

The gut microbiota and celiac disease: Pathophysiology, current perspective and new therapeutic approaches

Celiac disease (CD) as a chronic gluten-sensitive intestinal condition, mainly affects genetically susceptible hosts. The primary determinants of CD have been identified as environmental and genetic variables. The development of CD is significantly influenced by environmental factors, including the gut microbiome. Therefore, gut microbiome re-programming-based therapies using probiotics, prebiotics, postbiotics, gluten-free diet, and fecal microbiota transplantation have shown promising results in the modification of the gut microbiome. Due to the importance and paucity of information regarding the CD pathophysiology, in this review, we have covered the association between CD development and gut microbiota, the effects of infectious agents, particularly the recent Covid-19 infection in CD patients, and the efficacy of potential therapeutic approaches in the CD have been discussed. Hence, scientific literature indicates that the diverse biological functions of the gut microbiota against immunomodulatory responses have made microbiome-based therapy an alternative therapeutic paradigm to ameliorate the symptoms of CD and quality of life. However, the exact potential of microbiota-based techniques that aims to quantitatively and qualitatively alter the gut microbiota to be used in the treatment and ameliorate the symptoms of CD will be determined with further research in the future.

Severe acute respiratory syndrome coronavirus 2 infection: Role of interleukin-6 and the inflammatory cascade

Since December 2019, a novel coronavirus that represents a serious threat to human lives has emerged. There is still no definite treatment for severe cases of the disease caused by this virus, named coronavirus disease 2019 (COVID-19). One of the most considered treatment strategies targets the exaggerated immune regulator, and interleukin (IL)-6 is a crucial pro-inflammatory mediator. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases show an elevated level of IL-6 related to disease severity. IL-6 activity can be inhibited by the following: IL-6 itself, IL-6 signaling pathways such as Janus kinase and signal transducer and activator of transcription (JAK-STAT), gp130, IL-6R, and downstream activated ILs, such as IL-17 and IL-6 cytokine. Currently, according to these studies and their results, IL-6 blockade with anti-IL-6 or its receptor antibodies such as tocilizumab in COVID-19 is beneficial in severe cases and may reduce the mortality rate. JAK-STAT inhibitors block the cytokine storm by inhibiting several crucial pro-inflammatory mediators such as TNF-α and IL-6 and have shown various results in clinical trials. IL-6 induces IL-17 secretion, and IL-17 is involved in the pathogenesis of inflammatory processes. Clinical trials of anti-IL-17 drugs are currently recruiting, and anti-gp130 antibody is preclinical. However, this agent has shown positive effects in inflammatory bowel disease clinical trials and could be tested for SARS-CoV-2. This study aimed to review the role of IL-6 in the cytokine storm and studies regarding IL-6 and blockade of its inflammatory pathways in COVID-19 to determine if any of these agents are beneficial for COVID-19 patients.

Akkermansia muciniphila: from its critical role in human health to strategies for promoting its abundance in human gut microbiome

Akkermansia muciniphila, a frequent colonizer in the gut mucous layer of individuals, has constantly been recognized as a promising candidate for the next generation of probiotics due to its biological advantages from in vitro and in vivo investigations. This manuscript comprehensively reviewed the features of A. muciniphila in terms of its function in host physiology and frequently utilized nutrition using the published peer-reviewed articles, which should present valuable and critical information to scientists, engineers, and even the general population. A. muciniphila is an important bacterium that shows host physiology. However, its physiological advantages in several clinical settings also have excellent potential to become a probiotic. Consequently, it can be stated that there is a coherent and direct relation between the biological activities of the gut microbiota, intestinal dysbiosis/eubiosis, and the population of A. muciniphila in the gut milieu, which is influenced by various genetical and nutritional factors. Current regulatory barriers, the need for large-scale clinical trials, and the feasibility of production must be removed before A muciniphila can be extensively used as a next-generation probiotic.

Gut microbiota and obesity: an overview of microbiota to microbial-based therapies

The increasing prevalence of obesity and overweight is a significant public concern throughout the world. Obesity is a complex disorder involving an excessive amount of body fat. It is not just a cosmetic concern. It is a medical challenge that increases the risk of other diseases and health circumstances, such as diabetes, heart disease, high blood pressure and certain cancers. Environmental and genetic factors are involved in obesity as a significant metabolic disorder along with diabetes. Gut microbiota (GM) has a high potential for energy harvesting from the diet. In the current review, we aim to consider the role of GM, gut dysbiosis and significant therapies to treat obesity. Dietary modifications, probiotics, prebiotics, synbiotics compounds, using faecal microbiota transplant, and other microbial-based therapies are the strategies to intervene in obesity reducing improvement. Each of these factors serves through various mechanisms including a variety of receptors and compounds to control body weight. Trial and animal investigations have indicated that GM can affect both sides of the energy-balancing equation; first, as an influencing factor for energy utilisation from the diet and also as an influencing factor that regulates the host genes and energy storage and expenditure. All the investigated articles declare the clear and inevitable role of GM in obesity. Overall, obesity and obesity-relevant metabolic disorders are characterised by specific modifications in the human microbiota's composition and functions. The emerging therapeutic methods display positive and promising effects; however, further research must be done to update and complete existing knowledge.

Antisense agents against antibiotic-resistant bacteria

Abstract:

The dramatically increasing levels of antibiotic resistance are being seen worldwide, and is a significant threat to public health. Antibiotic and drug resistance is seen in various bacterial species. Antibiotic resistance is associated with increased morbidity and mortality and increased treatment costs. Antisense-relevant technologies include the utilization of oligonucleotide molecules to interfere with gene expression, as a new technique for the treatment of antibiotic-resistant bacteria has been proposed antisense agents or nucleic acids analogs with antibacterial properties, which are commonly very short and their size almost 10-20 bases and can be hinted to peptide nucleic acids (PNAs), phosphorodiamidate morpholino oligomers (PPMOs) and locked nucleic acids (LNAs). This review highlights that PNAs, PPMOs, and LNAs target the genes that cause destroy the gene and inhibit the growth of bacteria. These results open a new perspective for therapeutic intervention. In future studies, it is necessary to examine different aspects of antisense agents, for example, safety, toxicity, and pharmacokinetic properties of antisense agents to be employed in clinical treatment.

Assessment of The Presence of sas Family Genes and Their Relationship with Biofilm Formation among Clinical Staphylococcus aureus Isolates

Background: The success of Staphylococcus aureus is as an important human pathogen is probably due to possession of various virulence determinants. Attachment and biofilm formation is considered the main step in any infection. The present study aimed to determine the presence of S. aureus surface (sas) genes and their association with biofilm formation and antibiotic resistance. Methods: S. aureus isolates collected were analyzed for biofilm formation using polystyrene microtitre plates. All S. aureus isolates were also examined for the determination of sas genes by PCR assays and antibiotic susceptibility assay by disk diffusion method. Results: Biofilm formation assay revealed that 29 S.aureus isolates were weak biofilm producers, 57 had moderate biofilm production, while only five isolates showed strong biofilm formation. The biofilm production was not revealed among nine isolates. The frequency of sas genes were 95 (88%), 94 (87%), 94 (87%), 92 (85.2%), 98 (90.7%), 93 (86.1%), 97 (89.8%), 87 (80.6%), and 85 (78.7%) for sasF, sasA, sasC, sasE, sasG, sasH, sasI, sasJ, and sasK genes, respectively. Conclusion: High incidence of biofilm production was noticed in S.aureus strains positive for sas genes indicating the precise role of them as virulence-associated genes. Moreover, phenotypically weak or moderate biofilm formation can be well managed by antibiotic therapeutics and allow timely elimination of planktonic cells prior biofilm production.

Bacteriophages: A Possible Choice for Treatment of Viral Respiratory Infections and COVID-19

Abstract:

Viral respiratory infections are a leading cause of illness and mortality in all age groups worldwide. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (COVID-19) has spread throughout the world, igniting the twenty-first century’s deadliest pandemic. Research has shown that phages, which are bacterial viruses, can help treat viral infections with the effect on the immune system and their antiviral activity. Phages have specific activity and affect only the target without any side effects on other parts of the human body. Human phage-related diseases have not been reported yet; therefore, phages can be a very safe treatment, especially in many viral infections. The results of clinical studies have a promising future regarding the use of phages. It is possible that the phages display technique aided in the production of SARS-CoV-2 specific antibodies against its viral protein, which prevented the virus from binding or replicating and preventing secondary microbial infections, which have been linked to many patient deaths. Furthermore, an effective antiviral vaccine can be produced by using the same technique. Given the growing number of coronaviruses cases around the world, in the present paper, we review the possible mechanisms of phages against the COVID-19 disease and the method that may be a solution to eliminate the virus.

The synergistic effect of turmeric aqueous extract and chitosan against multidrug-resistant bacteria

We aimed to investigate the antibacterial and antibiofilm effects of turmeric and chitosan against the planktonic and biofilm forms of multidrug-resistant (MDR) bacteria. A group of MDR bacteria, including clinical isolates of methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas, carbapenem-resistant Enterobacteriaceae and AmpC-producing Enterobacteriaceae, were collected by phenotypic and genotypic assays. The broth microdilution method was used to investigate the MIC of turmeric aqueous extract and chitosan. To investigate the synergistic effect of the combination of these natural compounds, we used the checkerboard assay. According to the results of this study, turmeric and chitosan showed inhibitory effects on MDR bacteria, especially on the planktonic form of methicillin-resistant S. aureus as a Gram-positive compared to tested Gram-negative bacteria (carbapenem-resistant Pseudomonas, carbapenem-resistant Enterobacteriaceae and AmpC-producing Enterobacteriaceae). The antibiofilm effect of turmeric and chitosan was found more often in carbapenem-resistant Pseudomonas isolates. There was no significant difference between the tested Gram-negative bacteria because most of the tested strains were inhibited in 512 and 1024 μg/mL concentrations of chitosan and turmeric aqueous extract. In this study, turmeric aqueous extract and chitosan exhibited significant antibacterial and antibiofilm properties. However, the effect of these compounds should be investigated using in vivo models for use in pharmaceutical and disinfectant formulations.

Management of antibiotic-resistant Helicobacter pylori infection: current perspective in Iran

Helicobacter pylori is a common gastric bacterial pathogen implicated in the pathogenesis of many digestive tract disorders. H. pylori infection prevalence has been reported alarmingly in Iran. A plethora of studies have been conducted to evaluate the efficiency of first-line and second-line eradication attempts in patients diagnosed with H. pylori infections in Iran. The present study, was evaluated the efficacy of first-line and second-line therapy in H. pylori infections in Iran. We aimed to consider the literature review of the various library and electronic databases (Science Direct, PubMed, and Google Scholar) until 2020. The frequency of bacterial resistance to tetracycline, ampicillin, trimethoprim, erythromycin, ofloxacin, and metronidazolewas found to be high in Iran, while the most effective antibiotics were clarithromycin, rifampin, rifampicin, tetracycline, amoxicillin, ciprofloxacin, levofloxacin, moxifloxacin, and azithromycin. The therapeutic choice for H. pylori eradication in Iran could be quadruple therapy using two antibiotics amoxicillin and metronidazole/clarithromycin for the first-line regimen, and a combination of furazolidone plus tetracycline/amoxicillin and bismuth plus proton pump inhibitor for the second-line regimen. Due to increased antibiotic resistance in our region, empirical therapy must be replaced by more targeted treatment based on antimicrobial drug resistance profiles obtained from patients. Although we limited our investigation on the H. pylori eradication regimens in Iran, the results can be generalized to any region as long as the patterns of resistance are the same.

The critical role of Faecalibacterium prausnitzii in human health: An overview

Faecalibacterium prausnitzii (F. prausnitzii) is one of the most abundant bacterial species in the colon of healthy human adults and representing more than 5% of the total bacterial population. Recently, it has been known as a major actor in human intestinal health and a biosensor. Changes in this species population richness and quantity have been observed in many illnesses and several investigations have reported that abundance of F. prausnitzii is reduced in different intestinal disorders. In the current review, we aim to consider literature from various library databases and electronic searches (Science Direct, PubMed, and Google Scholar) which were randomly collected and serve as an overview of different features of F. prausnitzii including metabolites, anti-inflammatory action, and correlation of dysbiosis of this bacterium with various complications in human.

From role of gut microbiota to microbial-based therapies in type 2-diabetes

The incidence of type 2 diabetes mellitus (T2DM) has increased dramatically at an alarming level around the world.T2DM is associated with changeable risk factors in lifestyle as well as genetic and family associated risk factors. More importantly, imbalanced or impaired gut microbial distribution (dysbiosis) has been reported as a contributing risk factor in insulin resistance progression in T2DM. Dysbiosis may restructure the metabolic and functional pathways in the intestine which are involved in the development of T2DM. However, several studies have indicated the constructive and helpful effect of prebiotics, probiotics, and fecal microbiota transplantation (FMT) on the improvement of gut microbiota (GM) and accordingly host metabolism. In this review, the association between GM and T2DM have been evaluated and the role of prebiotics, probiotics and FMT, as potential therapeutic approaches have been discussed. Relevant studies were obtained randomly from online databases such as PubMed/Medline and ISI Web of Science.

Determination of Antimicrobial Resistance Patterns in Bloodstream Infections-Isolated Bacteria From a University Tertiary Hospital Patients

Background: Bloodstream infections are considered a significant medical concern associated with high morbidity and mortality rates. Therefore, physicians should be guided to use antimicrobial susceptibility patterns in order to select appropriate empiric antimicrobial agents to treat the patients who suffer from bacteremia. Objective: The present study aimed to determine antimicrobial resistance and susceptibility patterns in isolates collected from bloodstream infections. Materials and Methods: To achieve this, a total of 710 bacterial blood culture isolates were collected from Sina hospital, and then susceptibility patterns to a number of antibiotics were analyzed according to Clinical and Laboratory Standards Institute guidelines. Results: The identified isolates included Staphylococcus aureus 14 (20.6%), Escherichia coli 14 (20.6%), Acinetobacter baumannii 12 (17.6%), Pseudomonas aeruginosa 11 (16.2%), Coagulasenegative Staphylococcus 8 (11.8%), Klebsiella pneumoniae 6 (8.8%), and Enterobacter spp. 3 (4.4%). The total resistance rate to co-trimoxazole, ceftriaxone, ceftazidime, cefotaxime, ofloxacin, gentamicin, ciprofloxacin, levofloxacin, amikacin, and imipenem was 44 (64.7%), 42 (61.8%), 39 (57.4%), 38 (55.9%), 35 (51.51%), 32 (47.1%), 31 (45.6%), 25 (36.8%), and 27 (39.7%), respectively. Finally, the susceptibility rate to amikacin and imipenem was 43 (63.2%) and 41 (60.3%), respectively. Conclusion: In general, A. baumannii strains isolated from blood cultures were resistant to most antibiotics and the greatest sensitivity was observed to gentamicin (58.3%) compared to other antibiotics. Therefore, gentamicin was found as the most effective antibiotic for treating bloodstream infections caused by A. baumannii.

Risk of gastric cancer in association with Helicobacter pylori different virulence factors: A systematic review and meta-analysis

INTRODUCTION

It has been proposed that specific analysis of Helicobacter pylori virulence factors can be suitable for predicting of post H. pylori infection disorders like gastric cancer (GC). The present study was designed to evaluate the association between different virulence factors of H. pylori and GC.

METHODS

Studies investigated the association between virulence factors of H. pylori and GC were collected from the several databases. All analysis was performed by Comprehensive Meta-Analysis V2.2 software (Biostat, Englewood, NJ, USA).

RESULTS

Based on a comprehensive literature search, 25 eligible studies were included for meta-analyses. Infection with cagA- and vacA s1m1-positive H. pylori strains were significantly associated with increased risk of GC (OR of [2.82 (95% CI 1.96-4.06), P < 0.001]) and ([1.75 (95% CI 1.04-2.96), P 0.034)], respectively.

CONCLUSIONS

Infection by H. pylori strains with positive vacA s1m1 and the cagA genes can significantly increase the risk of GC. The association between the vacA s1m1 and the cagA and GC, suggests that screening of these genes may be helpful for identifying populations at higher risk for GC.

Determination Pattern of Antimicrobial Resistance of Pseudomonas Isolated from Patients in a University Tertiary Hospital

Introduction: Pseudomonas are ubiquitous bacteria widely present in nature. However, they have emerged as an opportunistic pathogen for humans. This bacterium is accountable for many localized and disseminated diseases, especially wounds in burn patients, respiratory infections, septicemia and bacteremia. Among all Pseudomonas species, P. aeruginosa is one of the important and most virulent species in hospital settings, while other pathogenic species include stutzeri, putida and fluorescence. The aim of this study was to assess pattern of antibiotic resistance in these bacteria isolated from a University teaching and treatment center. This cross-sectional study was conducted on 99 Pseudomonas strains (68 strains P. aeruginosa and 31 other Pseudomonas species) isolated from various clinical specimens. Antimicrobial drug susceptibility test was performed using the disc agar diffusion method according to CLSI recommendations. In this study, among various clinical specimens sent to microbiology laboratory, wound (59.59%) was found as a major source of Pseudomonas spp. Among various wards, Pseudomonas spp. was isolated more from patients admitted to burns ward (48.48%). Antibiotic susceptibility assay results revealed non susceptibility pattern towards most of the antibiotics; however, among all antibiotics tested, most common resistance was observed towards ceftazidime (76.76%). The results of this study shows the presence of Pseudomonas infection in the hospital setting and their developed resistance towards many conventional antibiotics, which is a concern at this treatment center. Thus, there exist a need for evaluation of careful and accurate measurement of resistance and assessment of exact drug administration policies. Therefore, to control the infection and prevent from increased prevalence of resistant strains appropriate resolution should be followed.  

EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING GRAM NEGATIVE BACTERIA IN IRAN: A REVIEW

Background:

The emergence and spread of extended spectrum β-lactamase (ESBL)-producing Gram- negative bacteria (GNB), particularly in Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa, have increased all over the world. ESBLs are characterized by their ability to hydrolyze β-lactams, early cephalosporins, oxyimino-thiazolyl cephalosporins, and monobactams, but not cephamycins or carbapenems. The rate of nosocomial infections caused by ESBL-producing GNB in Asia Pacific has increased and several studies have identified their prevalence in the region. The aim of this study is to review the prevalence of ESBL-producing GNB in the West Asia and the Middle East with a particular focus on Iran.

Materials and Methods:

The available evidence from various studies (Microbia and clinical studies, retrieved from the PubMed, and Scopus databases) regarding the ESBL producing Gram negative bacteria in Iran were evaluated.

Results:

In almost all parts of the country, high resistance has been observed, especially in the central part of Iran. Up to 89.8% Escherichia coli, 72.1% Klebsiella pneumonia, 84.2% Acinetobacter baumannii, and 83.8% Pseudomonas aeruginosa isolates are ESBL positive.

Conclusion:

The present study showed the increasing prevalence of ESBLs in different regions of Iran, which could be useful to strategic policy towards reducing reduce their prevalence.

Malassezia species infection of the synovium after total knee arthroplasty surgery

Infection is a serious complication after implantation of total knee-prostheses. However, fungal infection is rarely found in periprosthetic joints, and in most reports, the infecting organism is a Candida species. This is a case report of infection after left knee total arthroplasty caused by Malassezia species. The patient is still undergoing antifungal therapy with voriconazole and is still being followed-up. To the authors’ knowledge, the present case is the first report of Malassezia species in a patient after total knee arthroplasty.

Persistent infection with metallo-beta-lactamase and extended spectrum β-lactamase producer Morganella morganii in a patient with urinary tract infection after kidney transplantation

Organ transplant recipients under immunosuppressive therapy have a highly increased risk of acquiring unusual opportunistic infections. Diagnosis of the etiology of infection may be difficult in clinical manifestations, which need further histological and biological investigations. Here in we report, for the 1^st time in the Iran, a Morganella morganii isolate harboring blaVIM, blaCTX-M, and blaSHV genes after kidney transplantation with persistent urinary infections.

Pulmonary Tuberculosis Diagnosis: Where We Are?

In recent years, in spite of medical advancement, tuberculosis (TB) remains a worldwide health problem. Although many laboratory methods have been developed to expedite the diagnosis of TB, delays in diagnosis remain a major problem in the clinical practice. Because of the slow growth rate of the causative agent Mycobacterium tuberculosis, isolation, identification, and drug susceptibility testing of this organism and other clinically important mycobacteria can take several weeks or longer. During the past several years, many methods have been developed for direct detection, species identification, and drug susceptibility testing of TB. A good understanding of the effectiveness and practical limitations of these methods is important to improve diagnosis. This review summarizes the currently-used advances in nonmolecular and molecular diagnostics.

Helicobacter pylori hopQ alleles (type I and II) in gastric cancer

The Helicobacter pylori (H. pylori) outer membrane protein (HopQ) of is one of the proteins involved in bacterial adherence to gastric mucosa and has been suggested to have a role in the virulence of H. pylori. The aim of the present study was to determine the association between H. pylori virulence types I and II hopQ genotypes and patients with different gastrointestinal diseases. A polymerase chain reaction-based assay was used to determine the presence of type I and type II hopQ genes in 88 H. pylori strains isolated from H. pylori-infected patients. Of the total 88 H. pylori isolates, type I and type II hopQ alleles were detected in 52 (59.1%) and 36 (40.9%), respectively. A significant association was found between type I hopQ gene and gastric cancer [odds ratio, 2.3; 95% confidence interval (CI), 1.3-4.1] and gastric ulcers (odds ratio, 2.5; 95% CI, 1.4-4.3). A significant association was also identified between the type II hopQ gene and gastric cancer (odds ratio, 2.4; 95% CI, 1.1-3.0). The association between hopQ type I and hopQ type II genotypes and clinical status suggest that these genes may be helpful in the universal prediction of specific disease risks.

Viral infections in patients with acute respiratory infection in Northwest of Iran

Introduction

Acute respiratory infection (ARI) is one of the main causes of morbidity and mortality all around the world. The aim of this study was to determine the frequency, mortality and association with clinical entities of influenza virus type A, influenza virus type B, respiratory syncytial virus (RSV), coronavirus, and adenoviruses in patients with ARI.

Materials and Methods

During September 2014 till May 2015, 143 respiratory inpatients samples for viral testing collected from central Hospital in Northwest of Iran. A real-time reverse transcription-PCR (RT-PCR) assay was done to allow in one test the detection of influenza A and B viruses. Also, RSV and adenovirus were identified by Immunochromatography test.

Results

Twenty-four (46%) cases were positive for influenza A, which 11 (46%) of them were subtype H1N1 and 13 (54%) cases were subtype H3N2. Also, 21 (40%) cases were positive for influenza B, 5 (10%) cases were positive for RSV, and 2 (4%) cases were positive for adenovirus. One of the patients was positive for both influenza A and adenovirus. Two of the patients were positive for both influenza A and RSV. None of the patients were positive for coronavirus.

Conclusions

Our findings show the importance of influenza virus type A, influenza virus type B, RSV, and adenoviruses associated with ARI in hospitalized patient and the different epidemiological patterns of the viruses in Tabriz, Iran.

Nosocomial oral myiasis in ICU patients: occurrence of three sequential cases

Myiasis is the infestation of living vertebrates or humans tissues by dipterous larvae. The oral cavity is rarely affected by this infestation and the circumstances which can lead to oral myiasis include persistent mouth opening together with poor hygiene. Such infestations have been reported mainly in developing countries such as in Asia. Although rare, nosocomial myiasis must be noted carefully, especially in case of hospitalized patients. This report describes three cases of nosocomial oral myiasis in hospitalized patients in ICU (intensive care unit) in Tabriz, North West of Iran.

Dissemination of carbapenemases producing Gram negative bacteria in the Middle East

The emergence and spread of carbapenemase-producing bacteria, that hydolyze most β-lactams, including carbapenems, are a major concern of public health system worldwide, particularly in the Middle East area. Since the plasmids harboring resistance genes could be spread across other bacterial populations, detection of carbapenemase-producing organisms has become more problematic. These organisms produce different types of enzymes including the most prevalent types including KPC, VIM, IMP, NDM, and OXA-48. Carbapenemase producers are mostly identified among Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii. This study reviewed almost all papers, which conducted in the Middle East. In order to decrease the spread of resistance, the regional cooperation has been emphasized by the Middle East countries. The highest resistance, which is mediated by KPC has been observed in Afghanistan, Saudi Arabia and Jordan followed by NDM in Pakistan and OXA in Turkey and Pakistan. It is important to mention that the spread of these types have been reported sporadically in the other countries of this area. This review described the widespread carbapenemases in the Middle East area, which have been identified in an alarming rate.

Prevalence of antibiotic resistance in Helicobacter pylori: A recent literature review

AIM: To review previous studies (the last 6 years) about the Helicobacter pylori (H. pylori) antibiotic resistance in order to evaluate the trend in antibiotic resistance.

METHODS: In this study, the PubMed, MEDLINE, Science Direct, Google Scholar and Scielo manuscripts were reviewed from 2009 to 2014.

RESULTS: On the whole rates of H. pylori antibiotic resistance were 47.22% (30.5%-75.02%) for metronidazole, 19.74% (5.46%-30.8%) for clarithromycin, 18.94% (14.19%-25.28%) for levofloxacin, and 14.67% (2%-40.87%) for amoxicillin, 11.70% (0%-50%) for tetracycline, 11.5% (0%-23%) for furazolidon and 6.75% (1%-12.45%) for rifabutin. The frequency of tetracycline, metronidazole and amoxicillin resistance was higher in Africa, while clarithromycin and levofloxacin resistance was higher in North America and Asian, respectively.

CONCLUSION: The most sensitive drug is rifabutin and the lowest sensitive drug is metronidazole in the world. The worldwide H. pylori antibiotic resistance to clarithromycin and levofloxacin has increased during the last 6 years. The present systematic review show alarming results and a novel plan is needed for eradication therapy of H. pylori infections.