Research Article: Study of Various Virulence Genes, Biofilm Formation and Extended-Spectrum β-lactamase Resistance in Klebsiella pneumoniae Isolated from Urinary Tract Infections

Author: Maysaa E. S. Zaki

Journal: The Open Microbiology Journal

Abstract:

Objective:

The aims of the current study were to evaluate the capacity of K. pneumoniae isolated from hospital-acquired urinary tract infection to form biofilm, the relation of this capacity to various virulence genes and the prevalence of Extended Spectrum β-lactamases (ESBL) among these isolates by phenotypic and genotypic methods.

Material and Methods:

The study included 100 non-duplicate strains of K. pneumoniae isolated from 100 different urine samples from patients with hospital-acquired urinary tract infection. The isolated strains were studied for biofilm formation, ESBL production by phenotypic methods. Molecular studies were applied for the detection of ESβLs genes blaTEMblaSHVblaCTXM and for detection of virulence genes fimH, uge, rmpA, mag A, wzy, kfa and aerobactin genes.

Result:

The majority of the isolates had the capacity to form a biofilm (81%), with ESBL prevalence rate 41%. The most prevalent gene among ESBL producing K. pneumoniae was blaCTX-M (73.2%) followed by blaSHV (53.6%) and blaTEM (51.2%). Among the virulence genes studied in K. pneumoniae isolates, the most prevalent gene was fimH (76%), uge (70%). There was significant association between ESBL production, and resistance to amikacin, cefepime, ceftazidime, gentamicin, imipenem and meropenem and biofilm production in K. pneumoniae isolates. There was significant association between blaCTX-MblaSHVfimH, magkfawzy, rmpA and aerobactin and biofilm production in K. pneumoniae.

Conclusion:

The present study highlights the prevalence of virulence genes among biofilm-forming strains of K. pneumoniae isolated from hospital-acquired urinary tract infection. Moreover, there was association between biofilm formation and ESBL production. Further studies are required to elucidate the clinical impact of the association of these different mechanisms.

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Research Article: Study of Antifungal Susceptibility, Virulence Genes and Biofilm Formation in Candida albicans

Author: Maysaa El Sayed Zaki

Journal: The Open Microbiology Journal

Abstract:

Background:

Candida albicans has emerged as an important nosocomial pathogen. The morbidity and mortality associated with this pathogen are related to the presence of virulence genes and antifungal resistance. The objective of the present study was to investigate the prevalence of antifungal resistance, biofilm formation and some virulence genes such as ALS1PLB1, INT1, SAP1 and HWP1, among clinical isolates of Candida albicans recovered from immunocompromised patients.

Methods:

The study included one hundred C. albicans isolates identified phenotypically and by a molecular technique using Polymerase Chain Reaction (PCR). The identified C. albicans was further subjected to antifungal study by the microdilution method, biofilm study and molecular study for virulence genes by PCR.

Results:

The resistance to antifungal drugs, fluconazole, caspofungin and itraconazole was 8% for each of them and for amphotericin B, it was 9%. The prevalence of the studied virulence genes was HWP1 77%, INT1 72%, ALS1 65%, SAP1 65% and PLB1 52%. The biofilm capacity was identified by the microplate method in 58% of C. albicans. The OD was intense in 20 isolates, moderate in 21 isolates and mild in 17 isolates. There was a statistically significant increase in the prevalence of the studied virulence genes INT1, ALS1, HWP1, SAP1 and PLB1 among biofilm forming C. albicans as compared to non-biofilm forming isolates (P=0.0001). Additionally, the resistance to fluconazole, itraconazole and caspofungin was statistically, significantly higher in C. albicans with the capacity to form biofilm as compared to non-biofilm forming C. albicans.

Conclusion:

The present study highlights the prevalence of resistance to antifungal drugs among C. albicans which are not uncommon. Moreover, there was a high prevalence of INT1, ALS1, HWP1, SAP1 and PLB1 genes in C. albicans. The resistance to antifungal drugs was common among isolates with the capacity to form the biofilm. There was an association between the biofilm formation and virulence genes.

 

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Research Article: Propensity to Sexual Response among Adults with Obsessive-Compulsive Disorder

Author: Nguyen T. Kien

Journal: The Open Urology & Nephrology Journal

Abstract:

Aims:

To evaluate the predictive value of urine Neutrophil Gelatinase-Associated Lipocalin (NGAL) measured at the time of admission during the recovery from Acute Kidney Injury (AKI) after 90 days.

Materials and Methods:

This study includes 101 adult patients admitted to the Intensive Care Unit (ICU) who were diagnosed as AKI (96 patients had been collected 24-hour urine and 5 patients with anuria). Acute kidney injury was diagnosed using the Acute Kidney Injury Network (AKIN) criteria. Urine NGAL was measured at admission using the BioVendor Human Lipocalin-2/NGAL ELISA.

Results:

The ratio of complete recovery patients after 90 days reached 71.9%. The mean of urine NGAL concentration in the recovery group was 242.04 ng/ml, lower significantly than that of non-recovery patients (371.1 ng/ml), p=0.007. At the cut-off value for 740.03 ng/ml, urine NGAL measured at admission predicted complete recovery with the area under the curve of ROC for urine NGAL = 0.888, p<0.001. Based on the multivariate regression analysis, serum urea, serum creatinine and urine NGAL were independent factors that effected the proportion of recovery in AKI patients (OR=0.856, p=0.023; OR=1.014, p=0.012 and OR=0.993, p<0.001, respectively).

Conclusion:

Serum urea, serum creatinine and urine NGAL were independent factors that effected the proportion of recovery in AKI patients. Urine NGAL in AKI patients measured at the time of the admission time to ICU can be used as a prognostic biomarker of recovery.

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Letter: Propensity to Sexual Response among Adults with Obsessive-Compulsive Disorder

Author: Andrea Pozza

Journal: Clinical Practice & Epidemiology in Mental Health

Abstract:

Background:

Propensity to sexual excitation and inhibition is one of the key dimensions of sexuality. Clinicians working with Obsessive-Compulsive Disorder (OCD) patients rarely assess this and other aspects of sexuality, since treatment targets generally symptom reduction. Literature on sexual functioning in OCD patients is scarce and no study has focused on symptom subtypes, nor investigated the psychological processes related to sexual response.

Objective:

In the present short report, we describe an exploratory study investigating the association between symptom subtypes and propensity towards sexual excitation/inhibition in OCD patients, controlling for gender, age and antidepressant treatment.

Methods:

Seventy-two OCD patients (mean age = 34.50 years, 37.50% women) completed the Obsessive-Compulsive Inventory-Revised and the Sexual Inhibition/Sexual Excitation Scales.

Results:

Patients with more severe compulsive washing habit had a lower propensity towards excitation and a higher one towards inhibition due to threat of performance consequences (i.e., contamination with sexually transmitted diseases/having an unwanted pregnancy). Patients with more severe symptoms of checking showed a higher propensity towards inhibition due to the threat of performance consequences. Gender, age and antidepressant treatment were not related to sexual functioning.

Conclusion:

Specific OCD symptom subtypes may be associated with some psychological processes involved in sexual response. Sexual well-being should be carefully evaluated by practitioners and should be regarded as a treatment target. Future studies should investigate more comprehensively the processes involved in sexuality.

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https://benthamopen.com/ABSTRACT/CPEMH-15-126

Research Article: Panic Disorder and Chronic Caffeine Use: A Case-control Study

Author: Rafael Christophe Freire

Journal: Clinical Practice & Epidemiology in Mental Health

Abstract:

Background:

Acute administration of caffeine produces panic attacks in most Panic Disorder (PD) patients, but little is known about chronic caffeine use in these patients.

Objective:

To assess caffeine use in patients with PD and to ascertain if caffeine consumption is associated with sociodemographic or clinical features.

Methods:

65 adults with PD and 66 healthy controls were included in the current study. Their caffeine intake within the previous week was quantified with a questionnaire and compared. Harmful caffeine use was defined as consumption above 400 mg/day of caffeine. We tested for correlations between caffeine intake, demographic and clinical features.

Results:

Patients consumed significantly more caffeine than controls (P < 0.001). 14% (N = 9) of the PD patients made harmful use of caffeine. The use of caffeine-containing medications was observed in 40% (N = 26) of the PD patients and 6% (N = 4) of controls. Consumption of energy drinks was observed in 11% (N = 7) of PD patients and in none of the healthy subjects. Patients reported sleeping significantly less than controls (P < 0.001). In PD patients, caffeine consumption was not correlated with the presence of panic attacks or comorbidity with depression. The use of benzodiazepines or sedative medications was not correlated with caffeine intake.

Conclusion:

High caffeine consumption in PD patients could be explained by the development of tolerance with regular use of this substance. Subtypes of sensitive and non-sensitive PD patients could also explain why some of these patients are able to tolerate high doses of caffeine.

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Research Article: The Effects of Glycopyrrolate as Premedication on Post-Operative Nausea and Vomiting: A Propensity Score Matching Analysis

Author: Hyun Kang

Journal: The Open Anesthesia Journal

Abstract:

Background:

Glycopyrrolate is often used as a premedication for anesthesia as it has anti-sialogogue and vagolytic effect. Patients undergoing laparoscopic gynecologic surgery have high-risk of Post-Operative Nausea and Vomiting (PONV).

Objectives:

This retrospective study investigates the effect of glycopyrrolate as a premedication for PONV in patients receiving fentanyl-based Intravenous (IV) Patient-Controlled Analgesia (PCA) after laparoscopic gynecological surgery.

Methods:

We reviewed the medical records of adult patients who received fentanyl-based IV-PCA after laparoscopic gynecological surgery at Chung-Ang University Hospital between January 1, 2010, and June 30, 2016. We classified patients into two groups on the basis of glycopyrrolate premedication: non-premedicated group (Group N; n = 316) and glycopyrrolate premedicated group (Group P; n = 434). The Propensity Score Matching Method (PSM) was used to select 157 subjects in Group N and P, on the basis of their covariates which were matched with a counterpart in the other group.

Results:

Prior to PSM, the necessities for rescue anti-emetics were lower on Postoperative Day (POD) 0 (58[18.4%] vs. 45[10.4%], P = 0.002) and POD1 (60[19.0%] vs. 59[13.6%], P = 0.046), and Visual Analogue Scale (VAS) of pain on POD 1 (2.86 ± 1.49 vs. 3.13 ± 1.53, P = 0.017) was higher in group P. After PSM, the Numerical Rating Scale (NRS) score for nausea (0.38 ± 0.75 vs. 0.21 ± 0.62, P = 0.027) and rescue anti-emetics (27 [17.2%] vs. 15 [9.6%], P = 0.047) on POD 0 were both lower in the group P.

Conclusion:

In patients receiving fentanyl-based IV-PCA after laparoscopic gynecological surgery, the severity of nausea and necessity for rescue ant-emetic was lower in the glycopyrrolate premedication group.

 

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Clinical Trial Study: Impact of Sub-Anesthetic Dose of Ketamine on Post Spinal Hypotension in Cesarean Delivery

Author: Dina Salah

Journal: The Open Anesthesia Journal

Abstract:

Background:

Spinal anesthesia is the commonest technique used in Cesarean Section (CS) and most frequently associated with maternal hypotension, for which a lot of techniques have been described to prevent but an effective method is yet to be found.

Objectives;

The aim was to study the effect of using a sub-anesthetic dose of ketamine to prevent post-spinal hypotension in CS delivery.

Methods:

This double-blinded randomized controlled study was conducted on 80 participating parturients who were ASA І, П term pregnant. All the parturients received spinal anesthesia. The parturients were then randomly divided into two equal groups (n= 40 in each); ketamine group received a sub-anesthetic dose of ketamine of 0.5 mg/kg IV bolus in 3 ml saline and control group received the same volume of normal saline IV bolus. Heart Rate (HR) and Mean Arterial blood Pressure (MAP) were recorded at baseline (5 minutes prior to the intrathecal injection), at 5, 10, 15 and 20 minutes after the injection and then every 15 minutes till the end of the operation. Incidences of hypotension and severe hypotension were recorded. The total dose of ephedrine was recorded. Ramsay sedation score was recorded at baseline then 5, 10, 15, 30, 45 minutes after injection and then at the end of the operation.

Results:

Compared to the control group, sedation score was significantly higher among ketamine group at 5, 10 and 15 minutes. MAP and HR were significantly higher among ketamine group at 5, 10, 15, and 20 minutes. Total ephedrine dose was significantly lower among the ketamine group. Mild hypotension and severe hypotension were significantly less frequent among the ketamine group, as all the patients in the control group had an attack of mild hypotension and 55% of this group had an attack of severe hypotension. No significant difference between both the groups regarding diplopia, nystagmus, hallucination, nausea and vomiting.

Conclusion:

It is concluded that ketamine in a sub-anesthetic dose is an effective agent that can be used in preventing post-spinal hypotension in parturients undergoing CS delivery.

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Research Article: Airborne Carcinogenic Trace Elements Distribution Associated with Long Term Exposure in Makkah Population

Author: Saleh A. K. Saleh

Journal: The Open Environmental Research Journal

Abstract:

Background:

More than 4 million international pilgrims visit Makkah each year during the Hajj and Umrah seasons. Since trace elements are natural ingredients that endure general biogeochemical cycling, conversion functions between environmental loadings, mass levels, and exposed receptors.

Objective:

This study aimed to evaluate the distribution of carcinogenic trace element levels related to long term exposure.

Methods:

Particulate Matter (PM10) sampling was conducted at six locations (Al-Haram, Arafat, Muzdalifah, Aziziyah, Al Nuzhah, and Al Awali). On-site measurement parameters included ambient temperature, wind speed, and direction over 37 weeks. Samples were investigated for Cd, Cr, As, Be, and Ni levels with inductive coupled plasma mass spectrometry. Quality assurance measures were achieved separately by analyzing a control sample to certify reliability, reproducibility, and linearity for each analysis.

Results:

Average particulate matter concentration for a one-year period presented significant variability, which exceeded the WHO guidelines for average exposure (25.0 µgm-3). PM10 average concentrations during round-1 (Spring), round-2 (Summer), round-3 (Autumn) and round-4 (Winter) were 120.1 ± 52.2 µgm-3, 223.4 ± 30.4 µgm-3, 77.6 ± 36.72, and 89 ± 62.7 µgm-3, respectively. The concentrations of Cd, Cr, As, Be, and Ni were found to be 0.098, 0.008, 0.26, 0.03, and 0.012 µgm-3, respectively.

Conclusion:

PM10 concentration was highly correlated (p-value <0.005) with Cd, Cr, As, Be, and Ni; thereby indicating the influence of manufacturing discharges and pollutants transported over long-distances. Higher ambient air temperatures may cause atmospheric instability in low air dispersion around Makkah. This highlights the importance of continuous air monitoring and calculation of dose exposure levels of both PM10 and trace elements.

 

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Bentham Open Announces the Relaunch of the Journal, “The Open Inflammation Journal”

Bentham Open is pleased to announce the relaunch of The Open Inflammation Journal. The first volume of the relaunched journal will be available online by the start of the year, 2020.

With a fresh design and more focused content, The Open Inflammation Journal will publish research articles, reviews/mini-review, letters, case reports and guest edited single topic issues in all areas of scientific experimental and clinical research on inflammation.

Dr. Carmela Rita Balistreri is the Editor-in-Chief of this journal. Dr. Balistreri serves as Assistant Professor in the Department of Pathobiology and Medical Biotechnologes, University of Palermo, Italy. For brief information about the Editorial Board of the journal, please visit: https://benthamopen.com/TOINFJ/editorial-board/.

For article contribution, please refer to Instruction for Authors and Editorial Policies of the journal and write to us at beena@benthamopen.net. For more information about the journal, please visit https://benthamopen.com/TOINFJ/home/.

 

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