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Detection of New Delhi Metallo-β-lactamase-1 among Pseudomonas aeruginosa isolated from adult and Pediatric patients in Iranian hospitals
No full textGram-negative bacteria cause an alarming level of resistance to carbapenems by producing carbapenemases which can become a global epidemic. According to a report about Pseudomonas aeruginosa released by the World Health Organization in 2017, carbapenem resistance is classified as highest priority. The main objectives of the present study are to evaluate the frequency of carbapenem resistance, detect Metallo-β-Lactamases and β-lactamases, identify the molecular characterization of blaNDM-1 in Pseudomonas aeruginosa isolates, and report blaNDM-1 for the first time among children in Iran. This study selected 70 clinical isolates from different cities of Iran during 2019�2020. Disk diffusion method and Minimum Inhibitory Concentration were employed to run antimicrobial susceptibility testing. In order to detect carbapenemases and Metallo-β-Lactamases, mCIM and CDDT were used, respectively. In addition, PCR technique and DNA sequencing were utilized to identify and confirm the genes related to β-lactamases and Metallo-β lactamases (blaNDM, blaVIM, blaIMP, blaSIM, blaGIM, blaSPM, and blaKPC). The highest resistance rates were observed for Meropenem 67.1 (47) and Imipenem 65.7 (46) while the lowest resistance rate was observed for Piperacillin/Tazobactam 35.7 (25). Of all isolates, 55.7 (39) and 54.3 (38) constituted carbapenemase-producing and MBL isolates, respectively. PCR results exhibited blaNDM-1 21.4, followed by blaIMP 7.1 and blaVIM 2.9 of genes. Moreover, 1.4 of these isolates co-produced blaNDM-1 and blaVIM genes. These isolates did not comprise blaSIM, blaSPM, blaGIM, and blaKPC genes. Three isolates of positive blaNDM-1 isolates were notably detected among children. The results showed that Metallo-β-Lactamases, especially blaNDM-1, were highly prevalent among adults and children of Iran. © 2021 Elsevier Inc
Molecular characteristics of antibiotic-resistant Escherichia coli and Klebsiella pneumoniae strains isolated from hospitalized patients in Tehran, Iran
No full textBACKGROUND: We evaluated the distribution of carbapenem and colistin resistance mechanisms of clinical E. coli and K. pneumoniae isolates from Iran. METHODS: 165 non-duplicate non-consecutive isolates of K. pneumoniae and E. coli were collected from hospitalized patients admitted to Iran's tertiary care hospitals from September 2016 to August 2018. The isolates were cultured from different clinical specimens, including wound, urine, blood, and tracheal aspirates. Antibiotic susceptibility testing was performed by disc diffusion and microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) guideline. The presence of extended spectrum β-lactamases (ESBLs) genes, carbapenemase genes, as well as fosfomycin resistance genes, and colistin resistance genes was also examined by PCR-sequencing. The ability of biofilm formation was assessed with crystal violet staining method. The expression of colistin resistance genes were measured by quantitative reverse transcription-PCR (RT-qPCR) analysis to evaluate the association between gene upregulation and colistin resistance. Genotyping was performed using the multi-locus sequencing typing (MLST). RESULTS: Colistin and tigecycline were the most effective antimicrobial agents with 90.3 and 82.4 susceptibility. Notably, 16 (9.7) isolates showed resistance to colistin. Overall, 33 (20), 31 (18.8), and 95 (57.6) isolates were categorized as strong, moderate, and weak biofilm-producer, respectively. Additionally, blaTEM, blaSHV, blaCTX-M, blaNDM-1, blaOXA-48-like and blaNDM-6 resistance genes were detected in 98 (59.4), 54 (32.7), 77 (46.7), 3 (1.8), 17 (10.30) and 3 (1.8) isolates, respectively. Inactivation of mgrB gene due to nonsense mutations and insertion of IS elements was observed in 6 colistin resistant isolates. Colistin resistance was found to be linked to upregulation of pmrA-C, pmrK, phoP, and phoQ genes. Three of blaNDM-1 and 3 of blaNDM-6 variants were found to be carried by IncL/M and IncF plasmid, respectively. MLST revealed that blaNDM positive isolates were clonally related and belonged to three distinct clonal complexes, including ST147, ST15 and ST3299. CONCLUSIONS: The large-scale surveillance and effective infection control measures are also urgently needed to prevent the outbreak of diverse carbapenem- and colistin-resistant isolates in the future
The Iranian Study of Opium and Cancer (IROPICAN): Rationale, design, and initial findings
No full textBackground: The International Agency for Research on Cancer (IARC) recently classified opium use as a Group 1 carcinogen. However, much remains to be studied on the relation between opium and cancer. We designed the Iranian Opium and Cancer (IROPICAN) study to further investigate the association of opium use and cancers of the head and neck, bladder, lung, and colon and rectum. In this paper, we describe the rationale, design, and some initial results of the IROPICAN Study. Methods: The IROPICAN is a multi-center case-control study conducted in 10 provinces of Iran. The cases were all histologically confirmed and the controls were selected from hospital visitors who were free of cancer, were not family members or friends of the cancer patients, and were visiting the hospital for reasons other than their own ailment. The questionnaires included detailed questions on opium use (including age at initiation, duration, frequency, typical amount, and route), and potential confounders, such as tobacco use (e.g., cigarettes, nass and water-pipe), and dietary factors. Biological samples, including blood and saliva, were also collected. Results: The validation and pilot phases showed reasonably good validity, with sensitivities of 70 and 69 for the cases and controls, respectively, in reporting opium use. The results also showed excellent reliability, with intra-class correlation coefficients of 0.96 for ever opium use and 0.88 (95 CI: 0.80, 0.92) for regular opium use. In the main phase, we recruited 3299 cancer cases (99 response rate) and 3477 hospital visitor controls (89 response rate). The proportion of ever-use of opium was 40 among cases and 18 among controls. Conclusion: The IROPICAN study will serve as a major resource in studies addressing the effect of opium on risk of cancers of the head and neck, bladder, lung, and colon and rectum. © 2021 The Author(s)
Spectroscopic, density functional theory, cytotoxicity and antioxidant activities of sulfasalazine and naproxen drugs combination
No full textIn this study, we reported preparation and characterization of a new nano product consisting of the combination of two anti-inflammatory drugs: naproxen and sulfasalazine (Sulfoxen) where both are currently used for the treatment of inflammatory disorders. The nano combination product and its structural characterization were obtained by the Fourier transform infrared (FT-IR) spectroscopy, X-ray powder diffraction (XRPD), Thermogravimetric analysis (TGA), Differential scanning calorimetry (DSC), Dynamic light scattering (DLS), Atomic force microscopy (AFM), and Field emission scanning electron microscopy (FE-SEM), respectively. The hydrogen bonding between the COOH groups of naproxen (NPX) and sulfasalazine (SSZ) drugs were evaluated by the experimental and theoretical spectra. FESEM and AFM techniques represent that the most particles of Sulfoxen have a solid dense cubical or cuboidal structure and they also have size range of 50�100 nm. The objective was to prepare the nano-formulation of the Sulfoxen with improved antioxidant properties with respect to the two compounds administered separately. We have evaluated the anti-cancer effect of Sulfoxen in comparison to sulfasalazine and naproxen drugs on MCF-7 and KYSE30 cell lines. Interestingly, exposure of the zebrafishes to Sulfoxen (12.5 mM) did not exhibit lethal toxicity compared to the control groups. Therefore, Sulfoxen could contribute to more studies for the possible future clinical use. © 2021 The Author
Shelterin complex at telomeres: Roles in cancers
No full textTelomeres, the nucleoprotein structures at the ends of eukaryotic chromosomes, have multiple roles in tumorigenesis. The shelterin complex consists of six telomere-specific proteins that are involved in the protection of the telomeres. The shelterin complex protects the telomeres from degradation, prevents the activation of unwanted repair systems, and regulates the activity of telomerase. However, alteration in the structure and function of the shelterin complex proteins may lead to tumorigenesis and cancer progression. The shelterin complex biology revealed that the manipulation of the shelterin proteins could be a new strategy in cancer therapy. In this review, we focused on shelterin components' roles in the diagnosis, prevention, and treatment of cancers. © 202
Role of point-of-care ultrasound study in early disposition of patients with undifferentiated acute dyspnea in emergency department: a multi-center prospective study
No full textIntroduction: Sonography is a safe and simple diagnostic modality which can help emergency physicians in their clinical decision makings and improve the patient disposition process in emergency departments. Objective: This prospective multi-center study evaluates the role of bedside ultrasound performed by emergency physicians in accelerating the patient disposition process in cases with acute undifferentiated dyspnea. Methods: 103 patients were randomized to �early ultrasound� and �routine assessment� groups. In early ultrasound group, emergency physicians performed bedside ultrasound scans on heart and lungs as soon as possible after triage and randomization. In routine assessment group, ultrasound was used whenever the emergency physician or other consultant services ordered or performed it. Mean randomization-to-diagnosis time was compared in two studied groups. Results: Mean randomization-to-diagnosis time was 79.33 (± 38.90) min in routine assessment and 42.61 (± 19.20) min in early ultrasound groups, showing a statistically significant difference (p value < 0.01). Conclusion: Using early sonography in assessing the patients with undifferentiated acute dyspnea in emergency department decreases the patient turnover time while increasing the diagnostic accuracy. © 2021, Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB)
The Effect of the Web-Based Communication between a Nurse and a Family Member on the Perceived Stress of the Family Member of Patients with Suspected or Confirmed COVID-19: A Parallel Randomized Clinical Trial
No full textThe aim of this study was to identify the effect of web-based communication between a nurse and a family member of a patient with COVID-19 on his/her perceived stress. In this multicenter parallel randomized controlled trial, 67 family members of COVID-19 patients admitted to the Intensive Care Unit (ICU) were investigated. In the intervention group, web-based communication was performed for four consecutive days for 10 to 15 minutes. The Perceived Stress Scale (PSS-14) were completed in both groups before and after the intervention. Mean and standard deviation of perceived stress scores in the two groups were not significantly different (p = 0.26) before the intervention; however, after the intervention, the mean PSS-14 in the intervention group was significantly lower than that of the control group (p < 0.001). Due to the need to follow the physical and social distancing to protect against Coronavirus disease, the use of web-based communication recommended in future studies. © The Author(s) 2021
SARS-CoV-2 outbreak in Iran: The dynamics of the epidemic and evidence on two independent introductions
No full textThe SARS-CoV-2 virus has been rapidly spreading globally since December 2019, triggering a pandemic, soon after its emergence. While Iran was among the first countries confronted with rapid spread of virus in February 2020, no real-time SARS-CoV-2 whole-genome tracking in early phase of outbreak was performed in the country. To address this issue, we provided 50 whole-genome sequences of viral isolates ascertained from different geographical locations in Iran during March�July 2020. The corresponding analysis on origins, transmission dynamics and genetic diversity of SARS-CoV-2 virus, represented at least two introductions of the virus into the country, constructing two major clusters defined as B.4 and B.1*. The first entry of the virus might have occurred around very late 2019/early 2020, as suggested by the time to the most recent common ancestor, followed by a rapid community transmission that led to dominancy of B.4 lineage in early epidemic till the end of June. Gradually, reduction in dominancy of B.4 occurred possibly as a result of other entries of the virus, followed by surge of B.1* lineages, as of mid-May. Remarkably, variation tracking of the virus indicated the increase in frequency of D614G mutation, along with B.1* lineages, which showed continuity till October 2020. The increase in frequency of D614G mutation and B.1* lineages from mid-May onwards predicts a rapid viral transmission that may push the country into a critical health situation followed by a considerable change in composition of viral lineages circulating in the country. © 2021 Wiley-VCH Gmb
Natural Killer Cell Defects in Breast Cancer: A Key Pathway for Tumor Evasion
No full textAs the most important innate immune component cancers invader, natural killer (NK) cells have a magnificent role in antitumor immunity without any prior sensitization. Different subsets of NK cells have distinct responses during tumor cell exposure, according to their phenotypes and environments. Their function is induced mainly by the activity of both inhibitory and activating receptors against cancerous cells. Since the immunosuppression in the tumor microenvironment of breast cancer patients has directly deteriorated the phenotype and disturbed the function of NK cells, recruiting compensatory mechanisms indicate promising outcomes for immunotherapeutic approaches. These evidences accentuate the importance of NK cell distinct features in protection against breast tumors. In this review, we discuss the several mechanisms involved in NK cells suppression which consequently promote tumor progression and disease recurrence in patients with breast cancer. © 2020 Taylor & Francis Group, LLC