Carbapenems currently serve as the last line of defense when treating serious infections caused by multidrug-resistant Enterobacterale species; however, heteroresistance of these species is thought to cause failure in the treatment with these broad-spectrum antibiotics. This study was designed to determine the prevalence of carbapenem heteroresistance and associated genotypic modifications among phenotypically meropenem-susceptible and isolates. A total of 204 isolates of (: 118) and (: 86) from various clinical samples were included in this prospective experimental study. Identification and antimicrobial susceptibility testing of the isolates were performed by VITEK® (bioMérieux, France). Strains that were found susceptible to carbapenem group antibiotics (meropenem, imipenem, and ertapenem) with automated system were further investigated by disk diffusion method. The isolates with discrete colony growth within the clear inhibition zone among phenotypically meropenem-susceptible strains were tested for heteroresistance with the "gold standard" population analysis profile-area under the curve (PAP-AUC) method. In addition, heteroresistant isolates were analyzed for the presence of carbapenemase genes with in-house PCR method. The heteroresistance prevalence rate was 3.5% for and 18.1% for . The presence of heteroresistance in a total of 10 meropenem-susceptible isolates (, : 4; , : 6) was confirmed by the PAP-AUC method. The most frequently detected carbapenemase in heteroresistant isolates was OXA-48 (6/10), followed by NDM-1 (2/10). Meropenem is frequently preferred as initial empirical monotherapy in most of Gram-negative infections in adult and pediatric patients. The presence of heteroresistance against meropenem is too important to ignore, and for this reason, it seems beneficial to prefer combined treatment regimens in clinical practice.

Influenza is defined in traditional Chinese medicine (TCM) as an epidemic febrile illness and is usually treated with herbal compound formulas under the guidance of the "Qu Xie and Fu Zheng" theories. Ma Xing Shi Gan Tang (MXSGD) is a prominent remedy for clearing heat and detoxifying toxins in the clinical treatment of influenza in TCM, playing the role of "Qu Xie." Si Jun Zi Tang (SJZD) is recognized as one of the "Fu Zheng" formulas for strengthening the spleen and nourishing the stomach, with immunomodulatory effects. In this study, we followed the principles of "Qu Xie and Fu Zheng" to explore the effects of MXSGD combined with SJZD on viral pneumonia and its mechanism. Results showed that the couse of MXSGD and SJZD was effective in reducing the mortality rates and severity of lung pathology in lethally infected FM1 mice compared to the use of either drug alone. Moreover, further research demonstrated that the combined use suppressed TLRs and NLRP3 inflammatory signaling pathways at 4 dpi while promoting them at 7 dpi. At 10 dpi, there was a significant increase in CD11c and CD103 DCs in the lungs. Together, SJZD improved the therapeutic effectiveness of MXSGD in treating influenza virus pneumonia than when used alone. MXSGD and SJZD exhibit synergistic effects in the treatment of influenza, as evidenced by the inhibition of TLR7 and NLRP3 inflammatory pathways early in the infection and facilitation of the response later. They also increase CD11c and CD103 DC levels, as well as balancing Th1/Th2 cytokines.

The emergence of hypervirulent strains of poses a significant threat in intensive care units (ICU). This study aimed to molecularly characterize hypervirulent strains isolated from ICU patients with respiratory infections. Six strains were isolated from ICU patients over one month. Isolates were identified by phenotypic characterization biochemical properties and 16s RNA sequencing. Antibiotic susceptibility testing was conducted followed by resistance genes detection by PCR. MLST, and PFGE were employed to analyse clonal relationships among strains. Plasmid replicon typing and plasmid transmission frequencies were determined. The isolated strains exhibited diverse clinical manifestations, including acute respiratory distress syndrome (ARDS). Antibiotic susceptibility testing revealed multidrug-resistance phenotype. Molecular analysis revealed a complex genetic landscape of antibiotic resistance genes, including ESBLs and carbapenemases, as well as virulence genes such as A, E, and S. The multiple sequence types indicating genetic diversity among the strains as ST1512, ST622, and ST149 (each type two isolates). Plasmid characterization revealed the presence of diverse replicon types associated with multidrug resistance. This study provides comprehensive insights into the phenotypic, molecular, and epidemiological characteristics of hypervirulent outbark in ICU.

Elderly patients with carbapenem-resistant (CRE) infections represent considerable mortality rates. But data on the risk factors for the death of elderly patients following such infection remain limited. We aimed to assess the clinical outcomes, identify mortality-associated risk factors, and determine the antibiotic resistance and resistance genes of isolates for these patients. Hospitalized patients aged ≥65 years with CRE infection from January 2020 to December 2020 were retrospectively reviewed. Isolates identification and molecular characterization of CRE were carried out. Logistic regression analysis was applied to assess the potential factors associated with mortality. Of the 123 elderly patients with CRE infection included in our study, the all-cause mortality rate was 39.8% (49/123). The most prevalent pathogen was carbapenem-resistant (CRKP, 116 of 123). The overall rates of multidrug-resistant (MDR) and extensively drug-resistant (XDR) were 100.0% and 66.7%. All CRE isolates exclusively harbored a singular variant of carbapenemase gene, such as , , , or , while 98.4% of isolates harbored more than one -lactamase gene, of which 106 (86.2%) isolates harbored , 121 (98.4%) isolates harbored , and 116 (94.3%) isolates harbored . Multivariable logistic regression analysis revealed that mechanical ventilation (adjusted odds ratio (AOR) = 33.607, 95% confidence interval (CI): 4.176-270.463, < 0.001), use of tigecycline during hospitalization (AOR = 5.868, 95% CI: 1.318-26.130, = 0.020), and APACHE II score (AOR = 1.305, 95% CI: 1.161-1.468, < 0.001) were independent factors associated with increasing the mortality of patients with CRE infection, while admission to intensive care unit (ICU) during hospitalization (AOR = 0.046, 95% CI: 0.004-0.496, = 0.011) was a protective factor. CRE-infected elderly patients with mechanical ventilation, use of tigecycline during hospitalization, and high APACHE II score were related to poor outcomes. The isolates carried various antibiotic genes and presented high antibiotic resistance. These findings provide crucial guidance for clinicians to devise appropriate strategies for treatment.

Patients with cancer have weakened immune systems, making them more vulnerable to infections. This study was carried out to determine the bacterial origins of enteric disorders in cancer patients and noncancer patients at the Oncology Department of Laquintinie Hospital in Douala. A cross-sectional study was conducted from October 2021 to March 2023. Stool samples from 307 cancer patients with enteric disorders and 200 noncancer patients with enteric disorders were examined to diagnose the presence of bacteria using various techniques. Among all participants in this study, 62.13% were female and 37.87% were male. The average age of the participants was 46.38 ± 15.81 years, with a minimum age of 10 years and a maximum age of 84 years. The average age of participants was significantly higher ( < 0.000) in cancer patients (49.54 ± 14.65 years) compared to noncancer patients (41.53 ± 16.33 years). were more frequently isolated in cancer patients than in noncancer patients, with the respective percentages of 56.25% 43.75%, 50.00% 50.00%, 61.66% 38.34%, 66.66% 33.34%, 72.22% 27.78%, 80.00 20.00%, and 100% 0.00%. Most isolates were sensitive to imipenem (IMP), gentamicin (GEN), and amikacin (AMK). the most prevalent isolate, showed significantly high resistance (with < 0.05) in cancer patients compared to noncancer patients at amoxicillin/clavuranic acid (AMC) (89.13% 41.30%), ceftriaxone (CTR) (63.04% 39.13%), ciprofloxacin (CIP) (65.22% 34.18%), and tetracycline (TET) (93.48% 63.04%). Multidrug resistance was observed in cancer patients compared to noncancer patients for (85.00% 60.00%), (84.62% 60.00%), and (86.49% 43.48%). The increase in the number of Gram-negative infections among cancer patients, as shown in the present study, highlights the need for broad-spectrum therapy and effective planning of control programs to reduce bacterial diseases among cancer patients.

The main objective of this study is to investigate whether there is a difference in the occurrence of MSAF between fever and nonfever-pregnant women during the COVID-19 pandemic. We conducted a multicenter retrospective study including pregnant women during the COVID-19 pandemic. Among the 400 pregnant women included in the final data analysis, 238 had fever during delivery, while 162 nonfever-pregnant women met the inclusion and exclusion criteria and served as controls. We collected various obstetric and neonatal parameters for both groups of patients, compared, and statistically tested the significance of these parameters. For parameters with significant statistical differences and clinical significance, we performed logistic regression analysis to explore potential risk factors for MSAF. In a sample of 400 parturients, a total of 69 individuals (17.25%) were discovered to have MSAF with the prevalence increasing to 21.85% in the fever population. A statistically significant association was observed between fever during pregnancy and MSAF, with a higher risk of development observed in fever-pregnant women compared to nonfever ones. Specifically, the odds of developing MSAF increased by a factor of 0.979 in fever-pregnant women compared to nonfever ones, as determined by a logistic regression model (OR = 1.979, 95% CI = 1.061∼3.693, =0.032). Moreover, pregnant women with COVID-19 infection had a significantly higher risk of developing MSAF, with the odds increasing by a factor of 2.567 compared to uninfected pregnant women (OR = 3.567, 95% CI = 1.622∼7.845, =0.002). In addition, the study also identified abnormal fetal heart monitoring ( < 0.05) and gestational age ( < 0.05) as independent risk factors for the occurrence of MSAF. For pregnant women infected with COVID-19, the rate of MSAF disturbance significantly increases, therefore, it is necessary to pay more attention to fetal heart changes and amniotic fluid conditions, and actively managing labor is beneficial for improving delivery outcomes.

Bloodstream infections (BSIs) caused by are linked to high mortality of the patients. Case-specific details related to this disease and causative strains in different districts remain to be characterized.

In total, 170 chronic HBV patients and 50 healthy controls of comparable age and gender were included in this case-control study. Clinical, laboratory, and imaging evaluations were conducted. ELISA was used to determine serum IL-6 levels, and TLR2 (rs3804099) genotyping allelic discrimination assay was performed using real-time PCR.

The presence of bacteria in the blood of healthy individuals remains controversial. This study explored the comprehensive bacterial profiles and specific biomarkers in different components of healthy Chinese blood donors. A total of 5230 whole blood (WB) specimens were collected. Among them, 5200 random samples were pooled into 26 mixed samples for bacterial profile analysis. The remaining 30 random samples were divided into 4 groups based on components: WB, plasma, red blood cells (RBCs), and buffy coat (BC). Subsequently, the amplicons of the bacterial 16S rDNA V3-V4 fragments were sequenced to measure the diversity and composition of the bacteria using next-generation sequencing. The bacterial DNAs in the blood primarily originated from the Proteobacteria phylum. A total of 301 species of bacterial DNA were found in blood specimens, with 46 species being present among all groups. A significantly higher abundance of bacterial DNA was found in the plasma and RBCs compared to those in BC and WB. However, the plasma and RBC groups showed significantly higher species diversity and richness compared to the BC and WB groups. In addition, the WB group had a significantly different community structure and composition compared to the plasma and RBC groups but was similar to the BC group. The presence of bacterial DNA fragments was confirmed in blood from healthy Chinese donors. The bacterial DNA fragments enriched in plasma showed the highest diversity, followed by RBC, WB, and BC. These results provide a foundation for further research on the microbiome in the blood of healthy individuals.

[This corrects the article DOI: 10.1155/2001/547516.].

Malarial and bacterial coinfections in low-income countries are a serious cause of morbidity and mortality, necessitating coadministration of antibiotics and antimalarials. This study investigated the relationship between malaria infection and bacterial drug resistance in malaria and nonmalaria patients on consultation at the Dschang Regional Hospital. A follow-up study was carried out from October 2020 to December 2021 on 127 malaria and 174 nonmalaria patients having enteric infections. Clinical and haematological parameters were measured using standard methods. CD4 and CD8 cells were determined using flow cytometry. Enteric bacteria pathogens were isolated from stool, and antimicrobial and antimalarial profiles were determined using agar diffusion and microdilution methods, respectively. Significant reduction of RBCs, WBCs, CD4, CD8, granulocytes, monocytes and platelets was seen in coinfected patients compared to monoinfected participants ( ≤ 0.0491). was the main pathogenic bacteria isolated from the digestive tract of coinfected patients (40.63%) and monoinfected patients (59.37%). showed a high level of resistance to AMX (57.69%) and CDA (61.54%) in coinfected patients compared to 55.26% and 41.67%, respectively, in monoinfected patients. Quinine (53[50.00%]; 6[42.86%]) presented a minimal inhibitory concentration (MIC) of 32 μg/mL on the bacteria isolates from coinfected and monoinfected patients, respectively, while Artemether 89 (83.96%), Maloxine 5 (3.94%) and Surquina 250 (39.37%) presented a MIC of 64 μg/mL on bacterial isolates of coinfected and monoinfected patients. showed high resistance against AKI (45.93%), AMX (43.75%) and ERY (59.37%) in malaria patients who were under antimalarial drugs compared to malaria patients who were not under malaria drugs (29.68%, 34.37% and 32.81%, respectively). This study highlights that antimalarial drugs might certainly have an influence on the acquisition and emergence of bacterial resistance in the case of malaria bacterial coinfection, and therefore, adequate management and planning effective control programmes might certainly go a long way to reduce the rate of morbidity and mortality.

Burn patients are more likely to get healthcare-associated infections (HAIs). The current study aimed to investigate the characteristics of HAI and mortality risk factors among burn patients admitted to a tertiary center in Iran. A retrospective study was conducted in 2021 on burn patients who developed HAI after hospitalization in a tertiary center in Ahvaz, Iran. The records of patients admitted and managed between March 2019 and March 2020 were reviewed. Statistical analysis was carried out using IBM SPSS Version 26, with < 0.05 considered statistically significant. Of the 1,659 admitted patients, 395 (23.8%) developed HAI during the study period. After excluding patients with incomplete medical records and those with fungal or viral infections, 363 patients remained. The majority of these cases occurred in male patients. The most common type of HAI was burn wound infection (56.2%). Patients were mainly affected by Gram-negative bacteria, (39.7%), while the most common Gram-positive bacteria was (9.6%). The most common antibiotic resistance among -infected patients was reported against imipenem, followed by gentamicin and ciprofloxacin; however, the mentioned organism was mainly sensitive to colistin. Gender, age, bloodstream infection (BSI), ventilator-associated infection (VAI), ICU admission, and total burned surface area (TBSA) resulted in 3.585, 1.028, 2.222, 7.469, 5.278-, and 1.031 times higher mortality rates, respectively. Female gender, advanced age, BSI, VAI, and ICU admission are risk factors for HAI. These findings emphasize the need for focused infection prevention and management to improve high-risk burn patient survival.

Chronic wounds and prosthetic joint infections are difficult to treat and are associated with a high burden of disease and economic cost. The rise of antibiotic resistance and the understanding of biofilm formation has inflamed an already challenging situation. Bacteriophage therapy has been used throughout the last century to treat bacterial infections. However, in the last 10 years, there has been a resurgence in phage therapy as a novel innovative treatment for nonhealing wounds. This mini systemic review assesses relevant clinical studies, case series and trials over 5 years associated with safety, treatment and success rates of phage therapy concerning nonhealing and prosthetic joint infections. A search of PubMed, Web of Science, Cochrane and Clinical Trials.gov databases resulted in 3151 studies, 27 met the criteria, and a total of 152 bacterial infections were treated from 130 individuals. Most common pathogen isolated in wounds was , and was mostly associated with prosthetic joint infections. Treatment modalities differed across studies, adverse effects were limited, and success rate was deemed to be 91%.

In this study, attempts were made to evaluate the frequency of high-level gentamicin-resistant (HLGR) and vancomycin-resistant enterococci (VRE) and the prevalence and antibiotic resistance profile of enterococcal species isolated from pediatric patients referred to Children's Medical Center Hospital, Tehran, over five years.

Exploring drug susceptibility is a critical endeavor in the scientific community, setting the stage for advancements in understanding and combating various pathogens. has emerged as a significant pathogen, particularly affecting immunocompromised individuals with hematologic malignancies and HIV/AIDS conditions. This study aimed to assess the antifungal susceptibility profile of isolates obtained from clinical samples and dairy products. A total of 134 yeast isolates were retrieved from three distinct groups: (1) healthy individuals ( = 41), (2) patients ( = 24) including hematologic malignancy ( = 9), HIV/AIDS ( = 7), and diabetes ( = 8), (3) dairy products (milk, yogurt, and cheese,  = 69) stored at -70°C in the Shiraz University of Medical Science. All isolates were previously identified using conventional and molecular methods. Susceptibility to antifungal drugs, including caspofungin, fluconazole, itraconazole, voriconazole, and amphotericin B, was determined using the microdilution method following CLSI-M27-A3 protocols, with results interpreted according to CLSI-M27-S4 guidelines. The study emphasizes the clear variation in antifungal susceptibility testing of strains when compared across different groups, including patients, healthy people, and dairy products. According to the results, across all groups, a high minimum inhibitory concentration of fluconazole is evident, and healthy individuals show the highest minimum inhibitory concentration geometric means (4.0681). Also, 79.1% of the isolates were wild type to amphotericin B, with the lowest minimum inhibitory concentration compared to other antifungals tested. This suggests that amphotericin B was more effective against . These findings showed fewer susceptibilities of to both triazole and echinocandin classes of antifungal agents. Additionally, it is noteworthy that individuals without medical conditions exhibited higher minimum inhibitory concentration rates to these antifungal agents in comparison to those with underlying health conditions. Consequently, timely diagnosis and appropriate therapeutic interventions emerge as imperative in the effective management of candidiasis cases.

To identify the most effective dose of filarial rALT-2 and rGST alone or in combination against infection and .

is a pathogen that commonly causes hospital-acquired infections. Bacterial biofilms are structured bacterial communities that adhere to the surface of objects or biological tissues. In this study, we investigated the genome homology and biofilm formation capacity of ESBL-producing . Thirty ESBL-producing isolates from 25 inpatients at Ruijin Hospital, Shanghai, were subjected to pulsed-field gel electrophoresis (PFGE) to estimate genomic relatedness. Based on the chromosomal DNA patterns we obtained, we identified 21 PFGE profiles from the 30 isolates, eight of which had high homology indicating that they may have genetic relationships and/or potential clonal advantages within the hospital. Approximately 84% (21/25) of the clinical patients had a history of surgery, urinary tract catheterization, and/or arteriovenous intubation, all of which may have increased the risk for nosocomial infections. Biofilms were observed in 73% (22/30) of the isolates and that strains did not express type 3 fimbriae did not have biofilm formation capacity. Above findings indicated that a high percentage of ESBL-producing isolates formed biofilms and even though two strains with cut-off of PFGE reached 100% similarity, they generated biofilms differently. Besides, the variability in biofilm formation ability may be correlated with the expression of type 3 fimbriae. Thus, we next screened four ESBL-producing isolates (Kpn5, Kpn7, Kpn11, and Kpn16) with high homology and significant differences in biofilm formation using PFGE molecular typing, colony morphology, and crystal violet tests. Kpn7 and Kpn16 had stronger biofilm formation abilities compared with Kpn5 and Kpn11. The ability of above four ESBL-producing isolates to agglutinate in a mannose-resistant manner or in a mannose-sensitive manner, as well as RNA sequencing-based transcriptome results, showed that type 3 fimbriae play a significant role in biofilm formation. In contrast, type 1 fimbriae were downregulated during biofilm formation. Further research is needed to fully understand the regulatory mechanisms which underlie these processes.

Over the past two decades, scarlet fever has resurged in some countries or areas. Nationwide nonpharmaceutical interventions changed the patterns of other infectious diseases, but its effects on the spread of scarlet fever were rarely studied. This study aimed to evaluate the changes in scarlet fever incidence in Zhejiang Province, China, before and during the COVID-19 pandemic periods and to provide references for scarlet fever prevention and control.

is the main bacterial pathogen that causes foodborne disease, particularly in developing countries. Nontyphoidal (NTS) include and as the most prevalent strains which are one of the significant causes of acute gastroenteritis in children. Therefore, identifying the most predominant serovars, types of common contaminated food, and paying attention to their antibiotic resistance are the main factors in the prevention and control strategy of salmonellosis. This study was undertaken to evaluate the prevalence rate of serovars, the biofilm formation, antimicrobial resistance (AMR) status, and phenotypic virulence factors of strains isolated from diarrhea samples in some cities of Iran. A total of 40 (10.41%) isolates were recovered from 384 diarrhea samples processed and the most common serovar was serovar (82.5). Also, all isolates belonging to serovar showed more virulence factors compared to other serovars. The isolates showed a high resistance rate to ampicillin (95%) and nalidixic acid (87.5%), while a low resistance rate was found for chloramphenicol (2.5%). Moreover, significant variances in the capacity of biofilm formation were found between different serotypes. The resistance of NTS to extant choice drugs is a potential public health problem. Constant monitoring of AMR pattern and virulence profile of NTS serovars is suggested for the prevention of salmonellosis in humans.

Although COVID-19 is not currently a public health emergency, it will affect susceptible individuals in the post-COVID-19 era. Hence, the present study aimed to develop a model for Iranian patients to identify at-risk groups based on past medical history (PMHx) and some other factors affecting the death of patients hospitalized with COVID-19.

species are recognized as the most prevalent free-living amoebae (FLA). They can cause granulomatous amebic encephalitis (GAE) and pulmonary and ocular infections. The present study aimed to isolate and identify genotypes in cancer patients referred to Kashan's hospitals in Central Iran. This cross-sectional study was conducted with oral and nasal swab samples collected from a hundred cancer patients referred to Kashan's Beheshti and Yasrebi hospitals during 2019-2020. The samples were cultured in 1.5% non-nutrient agar (NNA) with heat-killed and examined for "FLA." A polymerase chain reaction (PCR) assay amplifying the 18S rRNA gene was performed, and -positive isolates were subjected to nucleotide sequencing to identify their genotypes. The prevalence of infection was 51% in the oral cavity and 38% in the nasal samples of cancer patients. The most frequent cysts were (51.3%) wrinkled polygonal and sized 9.55-11.5 μm (Group II). genotypes T4, T11, and T5 were identified in the oral cavity samples, whereas T4 and T11 were detected in the nasal samples. The prevalence of infection in oral and nasal cancer patients was higher in Kashan, Iran, compared to other countries. Due to the high rate of oral contamination, oral sampling is recommended for better detection of this protozoan. Since T4 is the predominant genotype that can cause serious diseases in high-risk groups, increasing physicians' awareness of infections associated with and preventive and control measures are strongly suggested.