We conclude that the DOX-STR combination should remain the first-line regimen for the treatment of brucellosis in our region; we recommend DOX-RIF and OFX-RIF combinations as the second-line regimens.
Background Pseudomonas aeruginosa is a common co-infecting pathogen recognized among COVID-19 patients. We aimed to investigate the antimicrobial resistance patterns and molecular typing of Pseudomonas aeruginosa isolates among Coronavirus disease-19 patients. Methods Between December 2020 and July 2021, 15 Pseudomonas aeruginosa were isolated from COVID-19 patients in the intensive care unit at Sina Hospital in Hamadan, west of Iran. The antimicrobial resistance of the isolates was determined by disk diffusion and broth microdilution methods. The double-disk synergy method, Modified Hodge test, and polymerase chain reaction were utilized to detect Pseudomonas aeruginosa extended spectrum beta-lactamase and carbapenemase producers. Microtiter plate assay was performed to evaluate the biofilm formation ability of the isolates. The isolates phylogenetic relatedness was revealed using the multilocus variable-number tandem-repeat analysis method. Results The results showed Pseudomonas aeruginosa isolates had the most elevated resistance to imipenem (93.3%), trimethoprim-sulfamethoxazole (93.3%), ceftriaxone (80%), ceftazidime (80%), gentamicin (60%), levofloxacin (60%), ciprofloxacin (60%), and cefepime (60%). In the broth microdilution method, 100%, 100%, 20%, and 13.3% of isolates showed resistance to imipenem, meropenem, polymyxin B, and colistin, respectively. Ten (66.6%) isolates were identified as multiple drug resistance. Carbapenemase enzymes and extended spectrum beta-lactamases were identified in 66.6% and 20% of the isolates, respectively and the biofilm formation was detected in 100% of the isolates. The blaOXA-48, blaTEM, blaIMP, blaSPM, blaPER, blaVEB, blaNDM, blaSHV, and blaCTX-M genes were detected in 100%, 86.6%, 86.6%, 40%, 20%, 20%, 13.3%, 6.6%, and 6.6% of the isolates, respectively. The blaVIM, blaGIM, blaGES, and blaMCR-1 genes were not identified in any of the isolates. The MLVA typing technique showed 11 types and seven main clusters and most isolates belong to cluster I, V and VII. Conclusion Due to the high rate of antimicrobial resistance, as well as the genetic diversity of Pseudomonas aeruginosa isolates from COVID-19 patients, it is indispensable to monitor the antimicrobial resistance pattern and epidemiology of the isolates on a regular basis.
Background Pseudomonas aeruginosa is a common co-infecting pathogen recognized among COVID-19 patients, leading to worsening illness and a high mortality rate. We aimed to demonstrate molecular typing and antimicrobial sensitivity of MDR-Pseudomonas aeruginosa isolated from COVID-19 patients. Methods Between December 2020 and July 2021, 15 P. aeruginosa were isolated from COVID-19 patients in the ICU ward at Sina Hospital in Hamadan, west of Iran. The Antimicrobial resistance of the isolates were determined operating the disk diffusion (DDT) and minimum inhibitory concentration (MIC) tests. The double-disk synergy method, Modified Hodge test, and PCR were utilized to detect P. aeruginosa extended spectrum beta-lactamase (ESBLs) and carbapenemase producers. Microtitre plate assay was operated to evaluate the biofilm formation ability of the isolates. The isolates' phylogenetic relatedness was revealed using the multilocus variable-number tandem-repeat analysis (MLVA) method. Results The results showed P. aeruginosa isolates had the most elevated resistance to imipenem (93.33%), levofloxacin (93.33%), trimethoprim-sulfamethoxazole (93.33%), ceftriaxone (80%), ceftazidime (80%), gentamicin (60%), ciprofloxacin (60%), and cefepime (60%). In the broth microdilution method, 100%, 100%, 13.33%, and 20% of isolates showed resistance to imipenem, meropenem, colistin, and polymyxin B, respectively. Extended-spectrum beta-lactamases and carbapenemase enzymes were detected in 20% and 66.66% of the isolates, respectively. Biofilm formation was seen in 100% of isolates. On the basis of the PCR results, blaOXA−48, blaTEM, blaIMP, blaSPM, blaPER, blaVEB, blaNDM, blaSHV, and blaCTX−M were detected in 100%, 86.67%, 86.67%, 40%, 20%, 20%, 13.33%, 6.67%, and 6.67%, of the isolates, respectively. The MLVA typing technique showed 11 types and seven main clusters. Most isolates belonged to clusters VII, I, and V. Conclusions As to observe high genetic diversity among P. aeruginosa isolates from COVID-19 patients in the ICU, it is indispensable to regularly monitor the epidemiology and genetical relatedness of the isolates to trace any insignificant alteration in the epidemiology of P. aeruginosa isolates in the COVID-19 epidemic.
Background: Hepatitis B is one of the most common chronic viral infections worldwide, especially in developing countries. The insufficient treatment of the disease increases the risk of cirrhosis and hepatocellular carcinoma, which impose heavy costs to the patient and the society. Different studies evaluated several protocols for the treatment of the disease. Objectives: The aim of this study was to evaluate the response rate of the different treatments in patients with chronic hepatitis B (CHB). Patients and Methods:In a cross-sectional study, 89 patients with CHB who were referred to Infectious Diseases Clinics during 2004 to 2009 were studied. Serological and biochemical outcomes to the different treatments were evaluated. The data were analyzed by SPSS 16. Results: CHB was more frequent in men (74.2%) than women (25.8%). The mean age of the patients was 36 ± 1.36 years. Fifty-three patients (59.6%) had active CHB while 36 (40.4%) were asymptomatic carriers. Serologic and biochemical responses to the treatment were 50% and 69.44%, respectively. However, 50% of the patients with positive HBeAg showed serologic response to the treatment, 37.5% showed HBeAb as well as reduced amounts of HBeAg, and 12.5% just showed reduced amounts of HBeAg. Patients treated by lamivudine showed the highest serologic response rate (75%). Conclusions: Serologic and biochemical response to the different treatments in the patients were better than other similar studies. Besides, it is recommended to begin antiviral therapy against CHB infection with lamivudine.
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