Journal of Pathogens The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Antibiotic-Resistant Acinetobacter baumannii Increasing Success Remains a Challenge as a Nosocomial Pathogen Thu, 04 Feb 2016 07:09:42 +0000 Antibiotic-resistant infectious bacteria currently imply a high risk and therefore constitute a strong challenge when treating patients in hospital settings. Characterization of these species and of particular strains is a priority for the establishment of diagnostic tests and preventive procedures. The relevance of Acinetobacter baumannii as a problematic microorganism in inpatient facilities, particularly intensive care units, has increased over time. This review aims to draw attention to (i) the historical emergence of carbapenem-resistant Acinetobacter baumannii, (ii) the current status of surveillance needs in Latin America, and (iii) recent data suggesting that A. baumannii continues to spread and evolve in hospital settings. First, we present synopsis of the series of events leading to the discovery and precise identification of this microorganism in hospital settings. Then key events in the acquisition of antibiotic-resistant genes by this microorganism are summarized, highlighting the race between new antibiotic generation and emergence of A. baumannii resistant strains. Here we review the historical development of this species as an infectious threat, the current state of its distribution, and antibiotic resistance characteristics, and we discuss future prospects for its control. Ana Maria Gonzalez-Villoria and Veronica Valverde-Garduno Copyright © 2016 Ana Maria Gonzalez-Villoria and Veronica Valverde-Garduno. All rights reserved. Multidrug Resistant and Extensively Drug Resistant Bacteria: A Study Thu, 28 Jan 2016 08:50:45 +0000 Background and Objective. Antimicrobial resistance is now a major challenge to clinicians for treating patients. Hence, this short term study was undertaken to detect the incidence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacterial isolates in a tertiary care hospital. Material and Methods. The clinical samples were cultured and bacterial strains were identified in the department of microbiology. The antibiotic susceptibility profile of different bacterial isolates was studied to detect MDR, XDR, and PDR bacteria. Results. The antibiotic susceptibility profile of 1060 bacterial strains was studied. 393 (37.1%) bacterial strains were MDR, 146 (13.8%) strains were XDR, and no PDR was isolated. All (100%) Gram negative bacterial strains were sensitive to colistin whereas all (100%) Gram positive bacterial strains were sensitive to vancomycin. Conclusion. Close monitoring of MDR, XDR, or even PDR must be done by all clinical microbiology laboratories to implement effective measures to reduce the menace of antimicrobial resistance. Silpi Basak, Priyanka Singh, and Monali Rajurkar Copyright © 2016 Silpi Basak et al. All rights reserved. Prevalence of Methicillin Resistant Staphylococcal Bioaerosols in and around Residential Houses in an Urban Area in Central India Tue, 26 Jan 2016 06:38:46 +0000 Methicillin resistant staphylococci (MRS) commonly found in clinical samples or associated environment pose a major health challenge globally. The carriage rate of MRS in human population is high, especially in India but research on airborne distribution of MRS is scanty. The present study aimed to evaluate the prevalence of MRS in indoor and outdoor environment of residential houses. Air samples were collected using impactor air sampler. The total counts of viable bacteria, staphylococci, and MRS along with the particles of various sizes were determined from indoor and outdoor environment of 14 residential houses. MRS bacteria were identified as methicillin resistant S. aureus (MRSA) or coagulase negative staphylococci (CNS) employing biochemical and PCR assays. The average concentration of MRS inside and outside of the houses was 5.9% and 4.6% of the total bacteria, respectively. The maximum correlation of total indoor and outdoor bacteria with particulate matter was 10 μm () and 5 μm (), respectively. Statistically, significant positive correlation of staphylococci and MRS was found with particles of 10–25 μm inside the houses. Molecular surveillance, antibiotic stewardship programme, and infection control policies can help to manage increasing MRS burden in developing countries. P. Kumar and A. K. Goel Copyright © 2016 P. Kumar and A. K. Goel. All rights reserved. Emergence of Tetracycline Resistant Vibrio cholerae O1 Biotype El Tor Serotype Ogawa with Classical ctxB Gene from a Cholera Outbreak in Odisha, Eastern India Sun, 03 Jan 2016 14:06:22 +0000 In September 2010, a cholera outbreak was reported from Odisha, Eastern India. V. cholerae isolated from the clinical samples were biochemically and serologically confirmed as serogroup O1, biotype El Tor, and serotype Ogawa. Multiplex PCR screening revealed the presence of various genes, namely, ompW, ctxB, zot, rfbO1, tcp, ace, hlyA, ompU, rtx, and toxR, in all of the isolates. The isolates were resistant to co-trimoxazole, nalidixic acid, polymyxin B, spectinomycin, streptomycin, sulfamethoxazole, tetracycline, trimethoprim, and vibriostatic agent 2,4-diamino-6,7-diisopropylpteridine (O/129). Minimum inhibitory concentration of tetracycline decreased in the presence of carbonyl cyanide m-chlorophenylhydrazone (CCCP), suggesting the involvement of efflux pumps. PCR analysis confirmed the presence of class I integrons as well as SXT elements harbouring antibiotic resistance genes in all isolates. Sequencing revealed the presence of ctxB gene of classical biotype in all the isolates. The isolates harboured an RS1-CTX prophage array with El Tor type rstR and classical ctxB on the large chromosome. The study indicated that the V. cholerae El Tor variants are evolving in the area with better antibiotic resistance and virulence potential. M. Jain, P. Kumar, and A. K. Goel Copyright © 2016 M. Jain et al. All rights reserved. Susceptibility Pattern and Distribution of Oxacillinases and blaPER-1 Genes among Multidrug Resistant Acinetobacter baumannii in a Teaching Hospital in Iran Thu, 31 Dec 2015 08:19:51 +0000 Acinetobacter baumannii (A. baumannii) is an important nosocomial pathogen in healthcare institutions. β-Lactamase-mediated resistance is the most common mechanism for carbapenem resistance in A. baumannii. The aim of this study was to determine the antibiotic resistance pattern, to detect OXA encoding genes, class A, , and to detect the presence of ISAba1. A total of 124 A. baumannii isolates were collected from hospitalized patients in a teaching hospital in Kashan, Iran. The susceptibility of isolates to different antibiotics was determined by disk-diffusion method. PCR was used to detect , , , , , and ISAba1 genes. All isolates were resistant to ceftazidime, ceftriaxone, and cefotaxime. All of the isolates revealed susceptibility to polymyxin B and colistin. Ninety-six percent of the isolates were extensive drug resistance (XDR), 5.6% extended spectrum beta-lactamase (ESBL), and 54.8% metallo-beta-lactamase (MBL). All isolates were positive for and ISAba1. ,, and were found in 79.8%, 25%, and 3.2%, respectively. The frequency rate of gene was 52.4%. Multidrug resistant A. baumannii isolates are increasing in our setting and extensively limit therapeutic options. The high rate presence of class D carbapenemase-encoding genes, mainly carbapenemases, is worrying and alarming as an emerging threat in our hospital. Sareh Bagheri Josheghani, Rezvan Moniri, Farzaneh Firoozeh, Mojtaba Sehat, and Yasaman Dasteh Goli Copyright © 2015 Sareh Bagheri Josheghani et al. All rights reserved. Isolation and Antibiotic Susceptibility of the Microorganisms Isolated from Diabetic Foot Infections in Nemazee Hospital, Southern Iran Wed, 30 Dec 2015 12:48:42 +0000 Background. Diabetic foot infections (DFIs) are a major public health issue and identification of the microorganisms causing such polymicrobial infections is useful to find out appropriate antibiotic therapy. Meanwhile, many reports have shown antibiotic resistance rising dramatically. In the present study, we sought to determine the prevalence of microorganisms detected on culture in complicated DFIs in hospitalized patients and their antibiotic sensitivity profiles. Methods. A cross-sectional study was conducted for a period of 24 months from 2012 to 2014 in Nemazee Hospital, Shiraz, Iran. The demographic and clinical features of the patients were obtained. Antimicrobial susceptibility testing to different agents was carried out using the disc diffusion method. Results. During this period, 122 aerobic microorganisms were isolated from DFIs. Among Gram-positive and Gram-negative bacteria, Staphylococcus spp. and E. coli were the most frequent organisms isolated, respectively. Of the isolates, 91% were multidrug while 78% of S. aureus isolates were methicillin resistant. 53% of Gram-negative bacteria were positive for extended-spectrum β-lactamase. Conclusion. Given the involvement of different microorganisms and emergence of multidrug resistant strains, clinicians are advised to consider culture before initiation of empirical therapy. Mojtaba Anvarinejad, Gholamreza Pouladfar, Aziz Japoni, Shahram Bolandparvaz, Zeinab Satiary, Pejman Abbasi, and Jalal Mardaneh Copyright © 2015 Mojtaba Anvarinejad et al. All rights reserved. Endemicity of Acinetobacter calcoaceticus-baumannii Complex in an Intensive Care Unit in Malaysia Sun, 27 Dec 2015 10:16:58 +0000 Introduction. Acinetobacter calcoaceticus-baumannii complex (ACB complex) is a leading opportunistic pathogen in intensive care units (ICUs). Effective control of spread requires understanding of its epidemiological relatedness. This study aims to determine the genetic relatedness and antibiotic susceptibilities of ACB complex in an ICU in Malaysia. Methodology. Pulsed field gel electrophoresis (PFGE), E-test, and disk diffusion were used for isolates characterization. Results. During the study period (December 2011 to June 2012), 1023 patients were admitted to the ICU and 44 ACB complex (blood, , and blind bronchial aspirates, ) were recovered from 38 ICU patients. Six isolates were from non-ICU patients. Of the 44 ICU isolates, 88.6% exhibited multidrug-resistant (MDR) patterns. There was high degree of resistance, with minimum inhibitory concentration90 (MIC90) of >32 μg/mL for carbapenems and ≥256 μg/mL for amikacin, ampicillin/sulbactam, and cefoperazone/sulbactam. Isolates from the main PFGE cluster were highly resistant. There was evidence of dissemination in non-ICU wards. Conclusion. High number of clonally related MDR ACB complex was found. While the ICU is a likely reservoir facilitating transmission, importation from other wards may be important contributor. Early identification of strain relatedness and implementation of infection control measures are necessary to prevent further spread. Amreeta Dhanoa, Ganeswrie Rajasekaram, Soo Sum Lean, Yuet Meng Cheong, and Kwai Lin Thong Copyright © 2015 Amreeta Dhanoa et al. All rights reserved. Restriction Profiling of 23S Microheterogenic Ribosomal Repeats for Detection and Characterizing of E. coli and Their Clonal, Pathogenic, and Phylogroups Tue, 22 Dec 2015 11:22:19 +0000 Correlating ribosomal microheterogenicity with unique restriction profiles can prove to be an efficacious and cost-effective approach compared with sequencing for microbial identification. An attempt to peruse restriction profiling of 23S ribosomal assemblage was ventured; digestion patterns with Bfa I discriminated E. coli from its colony morphovars, while Hae III profiles assisted in establishing distinct clonal groups. Among the gene pool of 399 ribosomal sequences extrapolated from 57 E. coli genomes, varying degree of predominance (I > III > IV > II) of Hae III pattern was observed. This was also corroborated in samples collected from clinical, commensal, and environmental origin. K-12 and its descendants showed type I pattern whereas E. coli-B and its descendants exhibited type IV, both of these patterns being exclusively present in E. coli. A near-possible association between phylogroups and Hae III profiles with presumable correlation between the clonal groups and different pathovars was established. The generic nature, conservation, and barcode gap of 23S rRNA gene make it an ideal choice and substitute to 16S rRNA gene, the most preferred region for molecular diagnostics in bacteria. Parvathi Jayasree Rajagopalan Nair and Sunita Singh Copyright © 2015 Parvathi Jayasree Rajagopalan Nair and Sunita Singh. All rights reserved. Evaluation of Antibiotic Susceptibility of Gram-Positive Anaerobic Cocci Isolated from Cancer Patients of the N. N. Blokhin Russian Cancer Research Center Mon, 21 Dec 2015 08:55:42 +0000 In total, 81 nonduplicate gram-positive anaerobic cocci (GPAC) were involved in this study. The GPAC were isolated from samples collected from cancer patients between 2004 and 2014. Species identification was carried out by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS). The majority of isolates were identified as Finegoldia magna (47%) and Peptoniphilus harei (28%). The susceptibility of six species of GPAC was determined for eight antibiotics according to -test methodology. Furthermore, all isolates were susceptible to imipenem, vancomycin, and linezolid. Susceptibility to penicillin G, amoxicillin/clavulanate, metronidazole, ciprofloxacin, and levofloxacin varied for different species. One Finegoldia magna isolate was multidrug-resistant (i.e., parallel resistance to five antimicrobial agents, including metronidazole, was observed). Two Parvimonas micra isolates were highly resistant to metronidazole (MIC 256 μg/mL) but were sensitive to other tested antibiotics. Irina I. Shilnikova and Natalia V. Dmitrieva Copyright © 2015 Irina I. Shilnikova and Natalia V. Dmitrieva. All rights reserved. Ziziphora clinopodioides Essential Oil and Nisin as Potential Antimicrobial Agents against Escherichia coli O157:H7 in Doogh (Iranian Yoghurt Drink) Sun, 13 Dec 2015 07:29:44 +0000 The aim of the present study was to evaluate the effects of Ziziphora clinopodioides essential oil (0.1 and 0.2%) and nisin (250 and 500 IU/mL) separately and in combination on survival of Escherichia coli O157:H7 inoculated in Doogh (Iranian yoghurt drink) during storage under refrigerated temperature (4 ± 1°C) for 9 days. Viability of Lactobacillus casei at different concentrations of Z. clinopodioides essential oil (0.1 and 0.2%) in Doogh was also examined. The major components were carvacrol (64.22%), thymol (19.22%), -terpinene (4.63%), and -cymene (4.86%). There was no significant difference () between samples treated with nisin and those of untreated samples. Samples treated with both concentrations of the essential oil (0.1 and 0.2%) showed populations of E. coli O157:H7 significantly () lower than those of untreated samples. The essential oil of Z. clinopodioides in combination with nisin had a potential synergistic effect against E. coli O157:H7 in Doogh samples after 5 days. The count of L. casei was not inhibited by different concentrations of the Z. clinopodioides essential oil. It is concluded that the leaf essential oil of Z. clinopodioides in combination with nisin can be applied as alternative antimicrobial agents in Doogh to inhibit the growth of E. coli O157:H7. Yasser Shahbazi Copyright © 2015 Yasser Shahbazi. All rights reserved. Iron Deprivation Affects Drug Susceptibilities of Mycobacteria Targeting Membrane Integrity Tue, 08 Dec 2015 07:28:30 +0000 Multidrug resistance (MDR) acquired by Mycobacterium tuberculosis (MTB) through continuous deployment of antitubercular drugs warrants immediate search for novel targets and mechanisms. The ability of MTB to sense and become accustomed to changes in the host is essential for survival and confers the basis of infection. A crucial condition that MTB must surmount is iron limitation, during the establishment of infection, since iron is required by both bacteria and humans. This study focuses on how iron deprivation affects drug susceptibilities of known anti-TB drugs in Mycobacterium smegmatis, a “surrogate of MTB.” We showed that iron deprivation leads to enhanced potency of most commonly used first line anti-TB drugs that could be reverted upon iron supplementation. We explored that membrane homeostasis is disrupted upon iron deprivation as revealed by enhanced membrane permeability and hypersensitivity to membrane perturbing agent leading to increased passive diffusion of drug and TEM images showing detectable differences in cell envelope thickness. Furthermore, iron seems to be indispensable to sustain genotoxic stress suggesting its possible role in DNA repair machinery. Taken together, we for the first time established a link between cellular iron and drug susceptibility of mycobacteria suggesting iron as novel determinant to combat MDR. Rahul Pal, Saif Hameed, and Zeeshan Fatima Copyright © 2015 Rahul Pal et al. All rights reserved. Evaluation of In Vivo Acaricidal Effect of Soap Containing Essential Oil of Chenopodium ambrosioides Leaves on Rhipicephalus lunulatus in the Western Highland of Cameroon Sun, 06 Dec 2015 08:50:52 +0000 A study on the acaricidal properties of foam soap containing the essential oil of Chenopodium ambrosioides leaves was carried out on Rhipicephalus lunulatus. Four doses (0.03, 0.06, 0.09, and 0.12 µL of essential oil per gram of soap) and a control (soap without essential oil) with four replications for each treatment were used for in vitro trial. Each replication consisted of 10 ticks in a Petri dish with filter paper impregnated with the foam soap on the bottom. Following in vitro trials, three doses (0.06, 0.09, and 0.12 µL/g) and the control in two replications were selected for in vivo test based on mortality rate recorded from the in vitro trial. Each replication was made up of 10 goats naturally infested with ticks. Results show that soap containing essential oil is toxic to R. lunulatus. The in vivo mortality rate in the control on day 8 was 22.69% whereas the highest dose (0.12 µL/g) killed 96.29% of the ticks on day 8. The LD50 of the foam soap containing essential oil was 0.037 and 0.059 µL/g on day 2 in the laboratory and on the farm, respectively. This indicates the potentially high efficiency of this medicated soap on this parasite. Marc K. Kouam, Vincent K. Payne, Emile Miégoué, Fernand Tendonkeng, Jules Lemoufouet, Jean R. Kana, Benoit Boukila, E. Tedonkeng Pamo, and Bertine MNM Copyright © 2015 Marc K. Kouam et al. All rights reserved. Clinical Presentation and Antibiotic Susceptibility of Contact Lens Associated Microbial Keratitis Thu, 03 Dec 2015 08:59:03 +0000 Introduction. In recent years, the number of contact lens wearers has dramatically increased in Iran, particularly in youngsters. The purpose of current study was to assess the clinical presentation and antibiotic susceptibility of contact lens related microbial keratitis in Ahvaz, southwest of Iran. Methodology. A cross-sectional investigation of 26 patients (33 eyes) with contact lens induced corneal ulcers who were admitted to Imam Khomeini Hospital, Ahwaz City, from June 2012 to June 2013 was done. In order to study microbial culture and susceptibility of corneal ulcers, all of them were scraped. Results. Eight samples were reported as sterile. Pseudomonas aeruginosa (80%) in positive cultures was the most widely recognized causative organism isolated. This is followed by Staphylococcus aureus 12% and Enterobacter 8%. The results showed that 84% of the microorganism cases were sensitive to ciprofloxacin, while imipenem, meropenem, and ceftazidime were the second most effective antibiotics (76%). Conclusion. Results of current study show the importance of referring all contact lens wearers with suspected corneal infection to ophthalmologists for more cure. The corneal scraping culture and contact lens solution should be performed to guide antibiotic therapy. Hesam Hedayati, Mahboubeh Ghaderpanah, Seyed Ahmad Rasoulinejad, and Mohammad Montazeri Copyright © 2015 Hesam Hedayati et al. All rights reserved. Comparative Response of the West African Dwarf Goats to Experimental Infections with Red Sokoto and West African Dwarf Goat Isolates of Haemonchus contortus Mon, 30 Nov 2015 11:42:50 +0000 Response of the West African Dwarf (WAD) goats to two different isolates of Haemonchus contortus, the Red Sokoto (RS) goat isolate (RSHc) and the WAD goat isolate (WADHc) (isolated from WAD goats), was studied by experimental infections of 4–6-month-old male WAD goat kids. Group 1 and Group 2 goats were each infected with 4500 infective larvae (L3) of RSHc and WADHc, respectively. Group 3 animals served as uninfected control. Prepatent period (PPP), faecal egg counts (FEC), worm burden (WB), body weight (BW), packed cell volume (PCV), and body condition score (BCS) were determined. WAD goats infected with RSHc isolate and the ones infected with WADHc isolate had mean PPP of and , respectively. Goats infected with WADHc isolate had significantly higher FEC () and WB (). BW were significantly higher () both in the controls and in Group 2 goats infected with WADHc isolate than in Group 1 goats infected with the RSHc isolate. BCS of animals in both infected groups dropped significantly (). There was a significant drop in PCV () of both infected groups in comparison. Both isolates of H. contortus were pathogenic to the host. Lucas Atehmengo Ngongeh and Amaechi Onyeabor Copyright © 2015 Lucas Atehmengo Ngongeh and Amaechi Onyeabor. All rights reserved. No Polymorphism in Plasmodium falciparum K13 Propeller Gene in Clinical Isolates from Kolkata, India Wed, 25 Nov 2015 11:31:14 +0000 Molecular markers associated with artemisinin resistance in Plasmodium falciparum are yet to be well defined. Recent studies showed that polymorphisms in K13 gene are associated with artemisinin resistance. The present study was designed to know the pattern of polymorphisms in propeller region of K13 gene among the clinical isolates collected from urban Kolkata after five years of ACT implementation. We collected 59 clinical isolates from urban Kolkata and sequenced propeller region of K13 gene in 51 isolates successfully. We did not find any mutation in any isolate. All patients responded to the ACT, a combination of artesunate + sulphadoxine-pyrimethamine. The drug regimen is still effective in the study area and there is no sign of emergence of resistance against artemisinin as evidenced by wild genotype of K13 gene in all isolates studied. Moytrey Chatterjee, Swagata Ganguly, Pabitra Saha, Biswabandhu Bankura, Nandita Basu, Madhusudan Das, Subhasish K. Guha, and Ardhendu K. Maji Copyright © 2015 Moytrey Chatterjee et al. All rights reserved. Prevalence of Plasmid-Mediated Quinolone Resistance Genes among Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Human Isolates in Iran Wed, 04 Nov 2015 12:06:57 +0000 The purpose of this study was to determine the prevalence and molecular characterization of plasmid-mediated quinolone resistance (PMQR) genes (qnrA, qnrB, qnrS, aac(6′)-Ib-cr, and qepA) among ESBL-producing Klebsiella pneumoniae isolates in Kashan, Iran. A total of 185 K. pneumoniae isolates were tested for quinolone resistance and ESBL-producing using the disk diffusion method and double disk synergy (DDST) confirmatory test. ESBL-producing strains were further evaluated for the genes. The PCR method was used to show presence of plasmid-mediated quinolone resistance genes and the purified PCR products were sequenced. Eighty-seven ESBL-producing strains were identified by DDST confirmatory test and majority (70, 80.5%) of which carried genes including CTX-M-1 (60%), CTX-M-2 (42.9%), and CTX-M-9 (34.3%). Seventy-seven ESBL-producing K. pneumoniae isolates harbored PMQR genes, which mostly consisted of aac(6′)-Ib-cr (70.1%) and qnrB (46.0%), followed by qnrS (5.7%). Among the 77 PMQR-positive isolates, 27 (35.1%) and 1 (1.3%) carried 2 and 3 different PMQR genes, respectively. However, qnrA and qepA were not found in any isolate. Our results highlight high ESBL occurrence with CTX-M type and high frequency of plasmid-mediated quinolone resistance genes among ESBL-producing K. pneumoniae isolates in Kashan. Ehsaneh Shams, Farzaneh Firoozeh, Rezvan Moniri, and Mohammad Zibaei Copyright © 2015 Ehsaneh Shams et al. All rights reserved. General Overview on Nontuberculous Mycobacteria, Biofilms, and Human Infection Wed, 04 Nov 2015 09:33:57 +0000 Nontuberculous mycobacteria (NTM) are emergent pathogens whose importance in human health has been growing. After being regarded mainly as etiological agents of opportunist infections in HIV patients, they have also been recognized as etiological agents of several infections on immune-competent individuals and healthcare-associated infections. The environmental nature of NTM and their ability to assemble biofilms on different surfaces play a key role in their pathogenesis. Here, we review the clinical manifestations attributed to NTM giving particular importance to the role played by biofilm assembly. Sonia Faria, Ines Joao, and Luisa Jordao Copyright © 2015 Sonia Faria et al. All rights reserved. Human Papillomavirus Infection, Infertility, and Assisted Reproductive Outcomes Sun, 01 Nov 2015 09:15:59 +0000 The human papillomavirus (HPV) is a sexually transmitted infection common among men and women across all geographic and socioeconomic subgroups worldwide. Recent evidence suggests that HPV infection may affect fertility and alter the efficacy of assisted reproductive technologies. In men, HPV infection can affect sperm parameters, specifically motility. HPV-infected sperm can transmit viral DNA to oocytes, which may be expressed in the developing blastocyst. HPV can increase trophoblastic apoptosis and reduce the endometrial implantation of trophoblastic cells, thus increasing the theoretical risk of miscarriage. Vertical transmission of HPV during pregnancy may be involved in the pathophysiology of preterm rupture of membranes and spontaneous preterm birth. In patients undergoing intrauterine insemination for idiopathic infertility, HPV infection confers a lower pregnancy rate. In contrast, the evidence regarding any detrimental impact of HPV infection on IVF outcomes is inconclusive. It has been suggested that vaccination could potentially counter HPV-related sperm impairment, trophoblastic apoptosis, and spontaneous miscarriages; however, these conclusions are based on in vitro studies rather than large-scale epidemiological studies. Improvement in the understanding of HPV sperm infection mechanisms and HPV transmission into the oocyte and developing blastocyst may help explain idiopathic causes of infertility and miscarriage. Nigel Pereira, Katherine M. Kucharczyk, Jaclyn L. Estes, Rachel S. Gerber, Jovana P. Lekovich, Rony T. Elias, and Steven D. Spandorfer Copyright © 2015 Nigel Pereira et al. All rights reserved. Protective Effects of Tinospora crispa Stem Extract on Renal Damage and Hemolysis during Plasmodium berghei Infection in Mice Tue, 27 Oct 2015 07:23:37 +0000 Renal damage and hemolysis induced by malaria are associated with mortality in adult patients. It has been speculated that oxidative stress condition induced by malaria infection is involved in its pathology. Thus, we aimed to investigate the protective effects of Tinospora crispa stem extract on renal damage and hemolysis during Plasmodium berghei infection. T. crispa stem extract was prepared using hot water method and used for oral treatment in mice. Groups of ICR mice were infected with parasitized erythrocytes of P. berghei ANKA by intraperitoneal injection and given the extracts (500, 1000, and 2000 mg/kg) twice a day for 4 consecutive days. To assess renal damage and hemolysis, blood urea nitrogen (BUN), creatinine, and hematocrit (%Hct) levels were then evaluated, respectively. Malaria infection resulted in renal damage and hemolysis as indicated by increasing of BUN and creatinine and decreasing of %Hct, respectively. However, protective effects on renal damage and hemolysis were observed in infected mice treated with these extracts at doses of 1000 and 2000 mg/kg. In conclusion, T. crispa stem extract exerted protective effects on renal damage and hemolysis induced by malaria infection. This plant may work as potential source in the development of variety of herbal formulations for malarial treatment. Narain Nutham, Sakuna Sakulmettatham, Suwit Klongthalay, Palatip Chutoam, and Voravuth Somsak Copyright © 2015 Narain Nutham et al. All rights reserved. An Additive Effect of Oral N-Acetyl Cysteine on Eradication of Helicobacter pylori Wed, 02 Sep 2015 09:17:43 +0000 Background. Helicobacter pylori is highly adapted to the gastric environment where it lives within or beneath the gastric mucous layer. The aim of this study was to evaluate whether the addition of N-acetyl cysteine to the treatment regimen of H. pylori infection would affect eradication rates of the disease. Methods. A total of 79 H. pylori positive patients were randomized to two therapeutic groups. Both groups received a 14-day course of three-drug regimen including amoxicillin/clarithromycin/omeprazole. Experimental group (38 subjects) received NAC, and control group (41 subjects) received placebo, besides three-drug regimen. H. pylori eradication was evaluated by urea breath test at least 4 weeks after the cessation of therapy. Results. The rate of H. pylori eradication was 72.9% and 60.9% in experimental and control groups, respectively (). By logistic regression modeling, female gender (OR 3.68, 95% CI: 1.06–5.79; ) and treatment including NAC (OR 1.88, 95% CI: 0.68–3.15; ) were independent factors associated with H. pylori eradication. Conclusion. The results of the present study show that NAC has an additive effect on the eradication rates of H. pylori obtained with three-drug regimen and appears to be a promising means of eradicating H. pylori infection. Seyed Mohammad-Taghi Hamidian, Najmeh-sadat Aletaha, Reza Taslimi, and Mohammad Montazeri Copyright © 2015 Seyed Mohammad-Taghi Hamidian et al. All rights reserved. Prevalence of Virulence Factors and Drug Resistance in Clinical Isolates of Enterococci: A Study from North India Sun, 23 Aug 2015 11:24:33 +0000 Along with emergence of multidrug resistance, presence of several virulence factors in enterococci is an emerging concept. This study was undertaken to determine the prevalence of various virulence factors phenotypically and genotypically in enterococci and study their association with multidrug resistance. A total of 310 enterococcal isolates were studied, comprising 155 E. faecium and 155 E. faecalis. Antimicrobial susceptibility testing was done by disc diffusion and agar dilution method. Hemolysin, gelatinase, biofilm production, and haemagglutination were detected phenotypically and presence of virulence genes, namely, asa1, gelE, cylA, esp, and hyl, was detected by multiplex PCR. Of the total, 47.41% isolates were high level gentamicin resistant (HLGRE) and 7.09% were vancomycin resistant (VRE). All the virulence traits studied were found in varying proportions, with majority in E. faecalis (). Strong biofilm producers possessed either asa1 or gelE gene. gelE silent gene was detected in 41.37% (12/29). However, increase in resistance was associated with significant decrease in expression or acquisition of virulence genes. Further, acquisition of vancomycin resistance was the significant factor responsible for the loss of virulence traits. Though it is presumed that increased drug resistance correlates with increased virulence, acquisition of vancomycin resistance might be responsible for reduced expression of virulence traits to meet the “biological cost” relating to VRE. Tuhina Banerjee and Shampa Anupurba Copyright © 2015 Tuhina Banerjee and Shampa Anupurba. All rights reserved. Chemical Composition and In Vitro Antibacterial Activity of Mentha spicata Essential Oil against Common Food-Borne Pathogenic Bacteria Sun, 16 Aug 2015 12:03:14 +0000 The aim of the present study was to investigate chemical composition and antibacterial activity of essential oil from the leaf of Mentha spicata plant against common food-borne pathogenic bacteria (Staphylococcus aureus, Bacillus subtilis, Bacillus cereus, Listeria monocytogenes, Salmonella typhimurium, and Escherichia coli O157:H7). Chemical composition of the essential oil was identified by gas chromatography coupled with mass spectrometer detector (GC-MS). The antibacterial activity of the essential oil was evaluated by broth microdilution method and agar disk diffusion assay. According to the result of GC-MS analysis, 18 components were identified, accounting for 99.89% of the whole essential oil. The main components were carvone (78.76%), limonene (11.50%), β-bourbonene (11.23%), cis-dihydrocarveol (1.43%), trans-caryophyllene (1.04%), menthone (1.01%), menthol (1%), and terpinen-4-ol (0.99). The essential oil exhibited moderate level of antibacterial activity against all test microorganisms. In general, Gram-positive bacteria were more susceptible to M. spicata essential oil than Gram-negative bacteria. L. monocytogenes was the most sensitive of the microorganisms to the antibacterial activity of M. spicata essential oil (inhibition zone = 22 mm and MIC and MBC = 2.5 µL/mL). Based on our results, the essential oil of M. spicata plant collected from Kermanshah province, west of Iran, has a potential to be applied as antibacterial agent. Yasser Shahbazi Copyright © 2015 Yasser Shahbazi. All rights reserved. Chlamydia trachomatis and Genital Mycoplasmas: Pathogens with an Impact on Human Reproductive Health Wed, 31 Dec 2014 00:10:19 +0000 The most prevalent, curable sexually important diseases are those caused by Chlamydia trachomatis (C. trachomatis) and genital mycoplasmas. An important characteristic of these infections is their ability to cause long-term sequels in upper genital tract, thus potentially affecting the reproductive health in both sexes. Pelvic inflammatory disease (PID), tubal factor infertility (TFI), and ectopic pregnancy (EP) are well documented complications of C. trachomatis infection in women. The role of genital mycoplasmas in development of PID, TFI, and EP requires further evaluation, but growing evidence supports a significant role for these in the pathogenesis of chorioamnionitis, premature membrane rupture, and preterm labor in pregnant woman. Both C. trachomatis and genital mycoplasmas can affect the quality of sperm and possibly influence the fertility of men. For the purpose of this paper, basic, epidemiologic, clinical, therapeutic, and public health issue of these infections were reviewed and discussed, focusing on their impact on human reproductive health. Sunčanica Ljubin-Sternak and Tomislav Meštrović Copyright © 2014 Sunčanica Ljubin-Sternak and Tomislav Meštrović. All rights reserved. Clostridium difficile with Moxifloxacin/Clindamycin Resistance in Vegetables in Ohio, USA, and Prevalence Meta-Analysis Sun, 14 Dec 2014 00:10:12 +0000 We (i) determined the prevalence of Clostridium difficile and their antimicrobial resistance to six antimicrobial classes, in a variety of fresh vegetables sold in retail in Ohio, USA, and (ii) conducted cumulative meta-analysis of reported prevalence in vegetables since the 1990s. Six antimicrobial classes were tested for their relevance as risk factors for C. difficile infections (CDIs) (clindamycin, moxifloxacin) or their clinical priority as exhaustive therapeutic options (metronidazole, vancomycin, linezolid, and tigecycline). By using an enrichment protocol we isolated C. difficile from three of 125 vegetable products (2.4%). All isolates were toxigenic, and originated from 4.6% of 65 vegetables cultivated above the ground (; outer leaves of iceberg lettuce, green pepper, and eggplant). Root vegetables yielded no C. difficile. The C. difficile isolates belonged to two PCR ribotypes, one with an unusual antimicrobial resistance for moxifloxacin and clindamycin (lettuce and pepper; 027-like, A+B+CDT+; tcdC 18 bp deletion); the other PCR ribotype (eggplant, A+B+ CDT−; classic tcdC) was susceptible to all antimicrobials. Results of the cumulative weighted meta-analysis (6 studies) indicate that the prevalence of C. difficile in vegetables is 2.1% and homogeneous since the first report in 1996 (2.4%). The present study is the first report of the isolation of C. difficile from retail vegetables in the USA. Of public health relevance, antimicrobial resistance to moxifloxacin/clindamycin (a bacterial-associated risk factor for severe CDIs) was identified on the surface of vegetables that are consumed raw. Alex Rodriguez-Palacios, Sanja Ilic, and Jeffrey T. LeJeune Copyright © 2014 Alex Rodriguez-Palacios et al. All rights reserved. Type I Diabetes Mellitus: Genetic Factors and Presumptive Enteroviral Etiology or Protection Wed, 10 Dec 2014 06:33:31 +0000 We review type 1 diabetes and host genetic components, as well as epigenetics and viruses associated with type 1 diabetes, with added emphasis on the enteroviruses, which are often associated with triggering the disease. Genus Enterovirus is classified into twelve species of which seven (Enterovirus A, Enterovirus B, Enterovirus C, and Enterovirus D and Rhinovirus A, Rhinovirus B, and Rhinovirus C) are human pathogens. These viruses are transmitted mainly by the fecal-oral route; they may also spread via the nasopharyngeal route. Enterovirus infections are highly prevalent, but these infections are usually subclinical or cause a mild flu-like illness. However, infections caused by enteroviruses can sometimes be serious, with manifestations of meningoencephalitis, paralysis, myocarditis, and in neonates a fulminant sepsis-like syndrome. These viruses are often implicated in chronic (inflammatory) diseases as chronic myocarditis, chronic pancreatitis, and type 1 diabetes. In this review we discuss the currently suggested mechanisms involved in the viral induction of type 1 diabetes. We recapitulate current basic knowledge and definitions. Jana Precechtelova, Maria Borsanyiova, Sona Sarmirova, and Shubhada Bopegamage Copyright © 2014 Jana Precechtelova et al. All rights reserved. Sesamol: A Natural Phenolic Compound with Promising Anticandidal Potential Tue, 09 Dec 2014 12:37:53 +0000 We investigated the antifungal effects of sesamol (Ses), a natural phenolic compound, and exemplified that it could be mediated through disruption of calcineurin signaling pathway in C. albicans, a human fungal pathogen. The repertoire of antifungal activity not only was limited to C. albicans and its six clinical isolates tested but also was against non-albicans species of Candida. Interestingly, the antifungal effect of Ses affects neither the MDR efflux transporter activity nor passive diffusion of drug. We found that C. albicans treated with Ses copies the phenotype displayed by cells having defect in calcineurin signaling leading to sensitivity against alkaline pH, ionic, membrane, salinity, endoplasmic reticulum, and serum stresses but remained resistant to thermal stress. Furthermore, the ergosterol levels were significantly decreased by 63% confirming membrane perturbations in response to Ses as also visualized through transmission electron micrographs. Despite the fact that Ses treatment mimics the phenotype of compromised calcineurin signaling, it was independent of cell wall integrity pathway as revealed by spot assays and the scanning electron micrographs. Taken together, the data procured from this study clearly ascertains that Ses is an effectual antifungal agent that could be competently employed in treating Candida infections. Moiz A. Ansari, Zeeshan Fatima, and Saif Hameed Copyright © 2014 Moiz A. Ansari et al. All rights reserved. Antihemolytic Activities of Green Tea, Safflower, and Mulberry Extracts during Plasmodium berghei Infection in Mice Tue, 18 Nov 2014 09:09:34 +0000 Malaria-associated hemolysis is associated with mortality in adult patients. It has been speculated that oxidative stress and inflammation induced by malaria parasite are involved in its pathophysiology. Hence, we aimed to investigate the antihemolytic effect of green tea, safflower, and mulberry extracts against Plasmodium berghei infection. Aqueous crude extracts of these plants were prepared using hot water method and used for oral treatment in mice. Groups of ICR mice were infected with 6 × 106 infected red blood cells of P. berghei ANKA by intraperitoneal injection and given the extracts (500, 1500, and 3000 mg/kg) twice a day for 4 consecutive days. To assess hemolysis, hematocrit levels were then evaluated. Malaria infection resulted in hemolysis. However, antihemolytic effects were observed in infected mice treated with these extracts at dose-dependent manners. In conclusion, aqueous crude extracts of green tea, safflower, and mulberry exerted antihemolysis induced by malaria infection. These plants may work as potential source in the development of variety of herbal formulations for malarial treatment. Suthin Audomkasok, Waraporn Singpha, Sukanya Chachiyo, and Voravuth Somsak Copyright © 2014 Suthin Audomkasok et al. All rights reserved. Effective Concentration and Detection of Cryptosporidium, Giardia, and the Microsporidia from Environmental Matrices Wed, 10 Sep 2014 08:17:45 +0000 Cryptosporidium spp., Giardia spp., and members of Microsporidia are enteropathogenic parasites of humans and animals, producing asymptomatic to severe intestinal infections. To circumvent various impediments associated with current detection methods, we tested a method providing multistage purification and separation in a single, confined step. Standard real-time PCR was used as a detection method. Samples spiked with C. parvum and G. intestinalis were split for comparison to standard Method 1623. Results were equivalent to immunomagnetic procedures for Cryptosporidium, and Giardia. Overall percent recovery for Cryptosporidium with Method 1623 averaged 26.89% (std 21.44%; min = 0%; max = 73%) and was similar but less variable for qPCR method at an estimated average of 27.67 (std 17.65%; min = 5%; max = 63%). For Giardia, Method 1623 had an overall average recovery of 27.11% (std 17.98%; min = 1%; max = 58%), while multistage purification and qPCR had an estimated lower overall recovery at 18.58% (std 13.95%; min = 0%; max = 35%). Microsporidia were also readily detected with an estimated recovery of 46.81% overall (std 17.66%; min = 18%; max = 70%) for E. intestinalis and 38.90% (std 14.36%; min = 13%; max = 62%) for E. bieneusi. Joseph A. Moss, John Gordy, and Richard A. Snyder Copyright © 2014 Joseph A. Moss et al. All rights reserved. Prevalence and Diversity among Anaplasma phagocytophilum Strains Originating from Ixodes ricinus Ticks from Northwest Norway Sun, 24 Aug 2014 05:45:39 +0000 The tick-borne pathogen Anaplasma phagocytophilum causes great concern for livestock farmers. Tick-borne fever is a widespread disease in Norway, and antibodies have been produced amongst sheep, roe deer, red deer, and moose. The main vector Ixodes ricinus is found along the Norwegian coastline as far north as the Arctic Circle. A total number of 1804 I. ricinus ticks were collected and the prevalence of the pathogen was determined by species-specific qPCR. The overall infection rate varied from 2.83% to 3.32%, but there were no significant differences () in the overall infection rate in 2010, 2011, or 2012. A multilocus sequencing analysis was performed to further characterise the isolates. The genotyping of 27 strains resulted in classification into 19 different sequences types (ST), none of which was found in the MLST database. The nucleotide diversity was for every locus <0.01, and the number of SNPs was between 1 and 2.8 per 100 bp. The majority of SNPs were synonymous. A goeBURST analysis demonstrated that the strains from northwest Norway cluster together with other Norwegian strains in the MLST database and the strains that are included in this study constitute clonal complexes (CC) 9, 10, and 11 in addition to the singleton. Ann-Kristin Tveten Copyright © 2014 Ann-Kristin Tveten. All rights reserved. Concomitant Colonization of Helicobacter pylori in Dental Plaque and Gastric Biopsy Wed, 09 Jul 2014 10:49:34 +0000 Frequently reported H. pylori antimicrobial therapy failures suggest that there might be a different niche where the bacteria can stay safe. Current study aims to examine potential role of oral colonization of H. pylori to feed reinfection after primary therapy. However, patients who were admitted to the gastroscopy section were chosen and gastric biopsy and dental plaque specimens were collected. Molecular and biochemical tests were applied to confirm H. pylori identity in different colonization niches. Results showed that 88.8% of dyspeptic patients had epigastric pains with nocturnal awakening when they were hungry (). All patients who received therapy already were again H. pylori positive while they are still carrying H. pylori in dental plaque (). Moreover, H. pylori infection was sought in 100% of gastric biopsy’s dyspeptic patients who had ulcerated esophagitis and erosive duodenitis and who were H. pylori positive, and 75% of dyspeptic patients with duodenum deformity had this bacterium in gastric biopsies (). Present study showed that only successful eradication of gastric H. pylori cannot guarantee prevention of reinfection. Conclusively, a new strategy which indicates concomitant eradication in oral and gastric colonization can result in clearance of H. pylori infection. Amin Talebi Bezmin Abadi, Ashraf Mohabati Mobarez, Omid Teymournejad, and Mona Karbalaei Copyright © 2014 Amin Talebi Bezmin Abadi et al. All rights reserved.