Archives of Clinical Infectious Diseases

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ISSN / EISSN : 2345-2641 / 2345-2641
Published by: Kowsar Medical Institute (10.5812)
Total articles ≅ 509
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, , Naghmeh Khadembashi, Ramin Rasouli
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.107919

Abstract:
Context: Some recent reports have indicated that almost 80% of clinical infections in humans have biofilm origin and impose additional healthcare costs. This study was an updated review of extracellular polymeric substance matrix (Biofilm) formation in humans and elaborated on its clinical significance, diagnosis, and therapeutic approaches. Evidence Acquisition: This narrative study reviewed the most recent information on the significance of microbial biofilm formation in clinical settings, common biofilm-producing bacterial species, its diagnosis, antibiotic drug resistance, and new approaches to the treatment of infections associated with biofilm formation. Results: Evidence indicated a permanent increase in the frequency of microbial biofilm in the central venous catheter, mechanical heart valve, and urinary catheter, as well as persistent infections. However, antimicrobial resistance induced by biofilms formation and the antimicrobial treatment of biofilms were problematic. Moreover, several assays and lab devices were described to evaluate biofilm formation. Furthermore, new attitudes towards anti-biofilm treatments were introduced in this paper. Conclusions: The number of different mechanisms were in accordance with the recent knowledge on how biofilms play a critical role in the disease pathogenesis. Biofilm strikes the treatment and surveillance of patients bearing infectious diseases under different conditions. The use of new methods in anti-biofilm treatments is effective for the recovery of infected patients.
Mohammad Reza Shirzadi, Amir Hamta, Leyli Zanjirani Farahani, , Sadegh Rahi
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.112222

Abstract:
Background: Cutaneous leishmaniasis is a worldwide health problem due to the complications in the transmission cycle, treatment failure, and post-healing problems. Objectives: Infected humans are the parasite reservoirs in the transmission cycle of anthroponotic cutaneous leishmaniasis (ACL); thus, the lack of efficient treatment increases the risk of the disease outbreak. The gold standard treatment for CL is mainly the topical or systematic use of antimonial compounds. Much research has been done on the development of topical therapy alone or in combination with cryotherapy. Therefore, this study was conducted to comparatively evaluate the current treatment protocol, cryotherapy, versus combined cryotherapy (Cryo) and intralesional Glucantime® (IG). Methods: This quasi-experimental study was performed on 476 patients with cutaneous leishmaniasis lesions referred to the health centers of a CL endemic area in southern Iran (Bam County, Kerman Province) during 2013 - 2019. A total of 200 cases with 301 lesions received Cryo using liquid nitrogen once every two weeks, and 276 cases with 406 lesions received weekly IG combined with Cryo, once every two weeks. The lesion size was recorded before and after the treatment. At seven and 12 weeks after the treatment, the lesion healing rate was monitored. Healing was defined as complete re-epithelialization. The obtained data were assessed using logistic regression to calculate the relative risk and therapeutic effects. Results: Out of 476 CL patients with 709 lesions, 200 cases with 221 lesions received Cryo, and 276 patients with 292 lesions received Cryo plus IG. At the seventh week after the treatment, complete healing was observed in 100 out of 221 cases (50%) in the group that received biweekly Cryo only and 225 out of 276 cases (81.5%) in the group that received biweekly Cryo plus weekly IG (P = 0.001). Conclusions: This study found that the use of cryotherapy plus intralesional Glucantime® increases the chance of healing for patients by 4.4 times compared to the use of cryotherapy alone.
, , , Mohammad Reza Rajabi, Kamran Bagheri Lankarani
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.101314

Abstract:
Background: Hospital admission for any reason provides the situation for voluntary HIV testing and consultation. Identifying the predictors of positivity may lead to a cost-effective method while enhancing professionalism. Objectives: To find the predictors of HIV-positive test result in a general hospital in Shiraz compared to a control group. Methods: In this case-control study, the records of all patients who received HIV testing upon their hospitalization in a general hospital in Shiraz, south of Iran, from January 2017 to the end of December 2017 were reviewed. For each HIV-positive case, at least one control from the same ward in the hospital with negative HIV test result was randomly selected. Based on the best-fitted model of logistic regression, the probability of positive HIV test results was estimated for each participant according to the risk factors, and a receiver operating characteristic (ROC) curve was drawn. Results: Out of 7333 persons who accepted to be tested, 77 patients tested positive for HIV, of whom 55 (71.4%) were male with the mean age of 41.5 ± 9.5 years. None of the HIV-positive patients were intravenous drug users, nor had they a history of imprisonment. The odds ratio (OR) was 21 for hepatitis-positive patients (hepatitis B and/or C) compared to negative ones, which was seven times higher in opium addicts than non-opium addicts. We developed a model using age, sex, opium addiction, and HBV and HCV status to predict the probability of being positive for HIV with an AUC of 0.853 (95% confidence interval 0.797 to 0.909). Conclusions: Hospital admission could be an appropriate momentum for providing voluntary counseling and testing. Infection with HBV and HCV are important risk factors for HIV infection, and additional testing should be offered, especially to these patients.
Mehri Kargar, Homa Hajjaran, Javad Moazen, Mohammad Reza Shirzadi, Elham Kazemirad, Hamid Kalantari, Aref Teimouri, Mehdi Mohebali
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.82209

Abstract:
Background: Dezful and its suburbs, as the second city in Khuzestan Province, southwest of Iran, has been an endemic area of cutaneous leishmaniasis (CL) with a low incidence rate since the last decades. However, the disease incidence has rapidly increased, and now is considered as a re-emerging parasitic disease in the area. Objectives: The aim of this study was to identify the most prevalent CL species in Dezful Region. Methods: A total of 196 microscopically confirmed slides from CL patients referred to Dezful Health Center were randomly collected in the period of 2015 - 2016. After DNA extraction from microscopically positive slides, polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was carried out on 61 eligible specimens using ribosomal internal transcribed spacer 1 (ITS1) gene. The HaeIII restriction enzyme was used for the identification of species. Results: Samples were randomly collected from 196 acute CL cases, including 110 (56.2%) males and 86 (43.8%) females. Most infections were seen in the age range of 2 - 7 years (65/196, 33.1%). Totally, 60.1% of the cases had only one lesion, and half of the lesions appeared on hands. Furthermore, 162 (82.7%) cases were referred to Dezful Health Center in the cold seasons (autumn and winter). Results of PCR-RFLP on 61 eligible isolates showed that 60 (98.4%) isolates were Leishmania major, and only 1 (1.6%) isolate was Leishmania tropica. Conclusions: Our findings indicated that L. major is the main agent of re-emerged CL in Dezful and its suburbs, and the disease is a zoonosis.
, Mohammad Shekari,
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.103728

Abstract:
Background: Malaria is one of the important infectious blood diseases caused by the protozoan parasite of the genus Plasmodium and transmitted by female Anopheles mosquito bites. A malaria elimination plan is currently being followed in Hormozgan Province. The robust malaria surveillance system with appropriate active case findings, especially asymptomatic cases, plays an important role in the malaria elimination program. Objectives: The main objectives of this research were to determine the presence and prevalence of asymptomatic malaria cases and monitor asymptomatic parasitic reservoirs in Jask District, Hormozgan Province. Methods: This cross-sectional study aimed to evaluate and monitor asymptomatic cases in the Jask District. The purpose and stages of the study were explained to all participants/parents, and written informed consent was obtained. A total of 230 asymptomatic residents (124 females and 86 males) were randomly selected, and their blood samples (3 mL) were taken to assess Plasmodium infection using microscopic, RDT, and molecular (18ssrRNA) methods. Results: Of the 230 studied cases, 54.8% were females, and 454.2% were males. The age range was four to 65 years old, and the mean age was 24.5. None of the diagnostic methods, including the microscopic, serological, and molecular techniques, could find asymptomatic malaria cases in the study area. Conclusions: It can be concluded that Malaria Elimination Program is feasible in the Jask Region irrespective of asymptomatic parasitic reservoirs. The results also emphasize a robust and efficient malaria surveillance system to diagnose and treat positive cases and monitor treated cases successfully. Ongoing and continuous studies are recommended in the high-risk malarious area of Hormozgan Province to monitor asymptomatic cases of malaria.
Bahram Nasr-Esfahani, Sharareh Moghim, Mahshid Salehi,
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.101092

Abstract:
Background: Pyrazinamide is one of the most important first-line medications for the treatment of tuberculosis and an alternative intake for MDR-TB and XDR-TB patients. Objectives: The purpose of this study was to evaluate resistance to pyrazinamide in the isolates resistant to the Mycobacterium tuberculosis drug in patients in the city of Isfahan. Methods: In this study, the drug susceptibility test was performed with pyrazinamide using the proportion method and PZA assay on 47 isolates resistant to Mycobacterium tuberculosis. Then, the mutations of the pncA and rpsA genes of the isolates resistant to pyrazinamide were evaluated by the sequencing method. Results: According to the proportion method, 19 cases were resistant to pyrazinamide, 16 of which had mutations in their pncA and rpsA genes. Besides, five new mutations were recorded, and three isolates lacked mutations in the mentioned genes. Conclusions: Pyrazinamide resistance is high in MDR-TB and INH mono-resistant isolates. Therefore, evaluating the susceptibility to pyrazinamide in patients with MDR-TB before the initiation of treatment with pyrazinamide is considered essential.
, , Shervin Shokouhi, Atousa Hakamifard
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.117088

Abstract:
Keywords Vaccine Hematopoietic Stem Cell Transplantation Transplantation COVID-19, SARS-COV-2
Hossein Hashemi, Mahshid Shakibapour, Hossein Fazeli, , Zahra Aliyari, Hossein Yousofi Darani
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.92537

Abstract:
Background: vaginal infections are common among women referring to gynecological clinics worldwide, but treatment modalities cannot provide complete remission of the disease. Laboratory diagnosis of vaginal infections using more sensitive and specific methods is essential for the best treatment options. Objectives: In this study, diagnosis of bacterial vaginosis (BV) using the polymerase chain reaction (PCR) method was investigated. Methods: vaginal samples were collected from 635 symptomatic women referring to gynecology clinics in Chaharmahal and Bakhtiari, Iran, in 2017. All samples were then diagnosed using microscopy, culture, and PCR methods. Results: Of 635 symptomatic women, 200 cases (31.4%) were diagnosed with BV according to the culture method using the PCR method. However, 3.9% of samples who were negative based on the culture method, were diagnosed to have BV based on PCR results. Conclusions: PCR is more sensitive than culture and microscopy methods for the diagnosis of BV.
Niloofar Deravi, Mobina Fathi, Seyede Nadia Tabatabaeifar, Parichehr Pooransari, Bahram Ahmadi, , Shirin Yaghoobpoor, Kimia Vakili, , Saham Ansari
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.106360

Abstract:
Background: Vulvovaginal candidiasis (VVC) is the most frequent fungal disorder in healthy and normal women. Objectives: The aim of this study was to evaluate the in vitro antifungal susceptibility of clinical isolates Candida albicans and Candida glabrata, the two most common candida species in Iranian patients with VVC. Methods: One hundred and eight clinical isolates of candida, including; C. albicans (n = 77) and C. glabrata: (n = 31) were isolated from the 108 patients with VVC. The in vitro activity of caspofungin (CAS), amphotericin B (AMB), voriconazole (VRC), itraconazole (ITC), fluconazole (FLC), and nystatin (NYS) were determined according to the CLSI M27-A3 and CLSI M27-S4. Results: Our results were shown 8 (25.8 %) and 6 (7.8 %) C. glabrata and C. albicans isolates resistance to FLU, respectively. Furthermore, resistance to VRC and ITC were observed in 8.4%, and 3.7% of all isolates, and six isolates (5.6%) had intermediate MIC to CAS. Conclusions: We reported 8 (25.8 %) and 6 (7.8 %) C. glabrata and C. albicans isolates resistance to FLU, respectively. Furthermore, resistance to VRC and ITC were observed in 8.4% and 3.7% of all isolates, respectively.
, Alireza Koohpaei, , Maryam Rahimi,
Archives of Clinical Infectious Diseases, Volume 16; https://doi.org/10.5812/archcid.108058

Abstract:
Background: The COVID-19 pandemic has affected more than 180 countries and has killed more than half a million people up to now. Risk factors for death are not yet fully identified. Objectives: The present study aimed at comparing the clinical manifestations and risk factors for death between two groups of patients with COVID-19 aged under and above 50 in Qom Province, Iran. Methods: The current retrospective cohort study was conducted on 178 patients with COVID-19 in Qom Province. Patients were followed up until recovery or death. The source population was divided into four groups, of which 45 patients were randomly enrolled in the study. The first group included patients aged less than 50 discharged after recovery; the second group included patients less than 50 years who died from COVID-19; the third group consisted of patients above 50 discharged after recovery, and the fourth group included patients above 50 who died from COVID-19. The data, including COVID-19 clinical symptoms and presumptive risk factors for death, were collected and compared between groups. Results: The most common symptoms in hospitalized patients were shortness of breath (82.6%), cough (73.6%), and fever (71.9%), respectively. In the age group above 50, the prevalence of fever in the recovered subjects was higher than that of the ones who died from the disease (81.8% Vs. 53.3%). Headache and loss of senses of smell and taste were also more common in both age groups in the recovered subjects. In the age group under 50, subjects who died had higher BMI values, but in the age group above 50, subjects who died had lower BMIs. Conclusions: The results of the present study showed that obesity could be a risk factor for death in the age group under 50. The results also indicated that in both age groups, extrapulmonary symptoms were more common in recovered patients.
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