Molecular characterization and functional analysis of the PilQ380-705: a novel secretin domain in Pseudomonas aeruginosa

Background: Type 4 pili [T4P] is an important virulence factor of Pseudomonas aeruginosa [P. aeruginosa]. T4P pass the outer membrane through a large oligomeric channel made of a single PilQ protein that is most highly conserved at their C-termini. To develop a functional vaccine that can be used in clinical application, the secretin domain of the PilQ [PilQ380-706] was produced as a recombinant protein

Methods: A 981 bp fragment of C-terminal of the pilQ secretin [pilQ1138-2118] from was designed into the prokaryotic expression vector pET28a. The presence of the pilQ1138-2118 gene in the recombinant construct [pET28a/pilQ] was assessed by double digestion and PCR. After transformation, expression of the recombinant PilQ was induced by addition of IPTG. The expressed recombinant protein was purified by a modified method using a HisTrap affinity column and finally confirmed by SDS-PAGE. The functional activities of the produced PilQ380-706 confirmed by Western blot analysis and twitching inhibition assay

Results: The PCR and enzymatic digestion results showed the presence of the pilQ1138-2118 gene in the construct. The protein electrophoresis showed that the molecular weight of the recombinant PilQ380-706 is approximately 37 kDa. The Western blot analysis confirmed the specificity of specific IgG against the PilQ380-706 protein. The PilQ380-706 protein showed high biological activity in all of these standard assays

Conclusion: Since, the PilQ380-706 protein plays an important role in the biogenesis of pili; and thus, the primary establishment of P. aeruginosa; it seems that it can be used as a candidate vaccine or an adjuvant in the future studies

Reduction in labor pain by intrathecal midazolam as an adjunct to sufentanil / 대한마취과학회지

BACKGROUND: Anesthesia today has strived to decrease labor pain in a tolerable and controllable fashion. Intrathecal midazolam has been introduced as an adjunct to analgesics. The study was planned to assess the efficacy, safety and duration of analgesia produced by intrathecal midazolam adjunct to sufentanil in decreasing labor pain. METHODS: In a randomized clinical trial 80 parturient included in the study. The two groups were matched for age, cervical dilation, gravid, gestational age, and other demographic characteristics. Combination of sufentanil and midazolam administered intrathecally to experimental group and compared to sufentanil group. Time to reach maximum block, and pain score was measured and recorded. RESULTS: Groups were matched for age and weight and other demographic characteristic. No significant adverse effect was seen in both groups including decrease in Apgar score. Duration of analgesia was 92.0 +/- 12.7 in sufentanil group and 185.2 +/- 15.2 minutes in midazolam and sufentanil group which was significantly different (P = 0.002). Numeric rating scale score was significantly lower in midazolam group compare to sufentanil group at 120 min (P = 0.01), 150 min (P = 0.0014), and 180 min (P = 0.001). CONCLUSIONS: Intrathecal midazolam as an adjunct to opioid could significantly enhance analgesia in labor pain with no significant adverse effect. Intrathecal injection of midazolam is an appropriate alternative to parenteral or epidural analgesia in small hospital settings.

Multidrug-resistant Acinetobacter baumannii infection in intensive care unit patients in a hospital with building construction: is there an association? / 대한마취과학회지

BACKGROUND: Acinetobacter baumannii (A. baumannii) has emerged globally as a significant pathogen in hospitals. It is also present in soil and water. In a previous study, we discovered that the A. baumannii class 2 integron occurred most frequently. Here, we determined whether the A. baumannii class 2 integron is in the soil around our hospital, and if the soil is the cause for increasing numbers of A. baumannii infections in our intensive care unit (ICU) patients. METHODS: This cross-sectional prospective study was conducted in two ICUs at Loghman-Hakim Hospital, Tehran, Iran, from November 2012 to March 2013. Patient, soil, and hospital environment samples were collected. All isolates were identified using standard bacteriologic and biochemical methods. The phenotypes and genotypes were characterized. The standard disc diffusion method was utilized to test antimicrobial susceptibility. Integron identification was performed by multiplex polymerase chain reaction. RESULTS: A total of 42 A. baumannii clinical strains were isolated, all from patient samples; 65% of the isolated species were classified as class 2 integrons. The strains were 100% resistant to piperacillin, piperacillin-tazobactam, ceftazidime, ceftriaxone, cotrimoxazole, cefepime, ceropenem, and cefotaxime. However, all of the strains were sensitive to polymyxin B. A. baumannii was detected around the lip of one patient. CONCLUSIONS: Further research is necessary to establish a relationship between A. baumannii and soil, (especially in regards to its bioremediation), as well as to determine its importance in nosocomial infections and outbreaks in the ICU.

Seroprevalence of toxoplasmosis among pregnant women referring to the reference laboratory of Zahedan, Iran

Zahedan is a tropical region in southeast of Iran. Due to importance of congenital Toxoplasmosis and absence of study evidences in this field in Zahedan, this research was accomplished. 221 serum samples were collected from pregnant women referring to reference laboratory of Zahedan. The IgG and IgM antibody levels against were examined using ELISA method. 30.8% cases out of all samples were IgG positive and in 1.4% cases IgG and IgM were both positive for toxoplasmosis. 69.2% of pregnant women were serologically negative against toxoplasmosis; therefore hygiene education to eliminate risk factors especially during pregnancy period seems to be imperative

Vibrio cholerae and changing of microbial resistance patterns in Sistan and Balouchestan province

Cholera is a diarrheal disease in tropical regions that exclusively affects humans. This study conducted to compare changes in antibiotic resistance patterns in 2011with that of the period of 2008-2010 on cholera patients in the area covered by Zahedan University of Medical Sciences. In this descriptive study, rectal swab samples within Blair working environment of all suspected patients of each region were sent to the laboratory of each region and diagnostic procedures were performed, and Antimicrobial Susceptibility Testing [AST] was performed trough distribution methods on agar disk. Disks were prepared from Iranian Padtan Teb Company and the results were evaluated and reported using NCCLS table and the other experimental antimicrobial susceptibility determination tables. In this study, antimicrobial susceptibility testing was performed on 81 positive samples including Ogawa or Inaba during 4 years. The samples in 2008, 2009 and 2010 followed a similar susceptibility pattern and all these samples were resistant to co-trimoxazole, nalidixic acid and ampicillin, had intermediate sensitivity to furazolidone, were sensitive to tetracycline, ciprofloxacin, doxycycline, erythromycin and susceptibility pattern of cases in 2011 included sensitivity to erythromycin and ciprofloxacin and have shown no sensitivity to doxycycline and tetracycline and halo of their lack of growth were placed in the intermediate range. Vast border between the province and Afghanistan and Pakistan and inevitability of the occurrence of regional cholera epidemics may cause a serious problem in control of the possible epidemics and recalls the need to perform drug sensitivity tests during epidemics before any remedial action more than ever.

Comparison of the role of intrapleural bupivacaine injection with intravenous morphine in the management of post-operative pain after open cholecystectomy

Post-operative pain after open cholecystectomy can result in increased oxygen consumption, increased risk of myocardial ischemia, atelectasis, pneumonia, decreased vital capacity, and increased morbidity and mortality. In this study we compared the analgesic effects of intrapleural bupivacaine with intravenous morphine post-operatively. Sixty patients who were candidates for elective open cholecystectomy were randomly divided into two groups based on randomized numbers for a double-blinded randomized clinical trial. Anesthesia technique was precisely the same for all patients. At the end of surgery, 20 cc of 0.5% bupivacaine and epinephrine with a concentration of 1/200, 000 was injected intrapleurally for group B patients; whereas, 0.1 mg/kg intravenous morphine and 20cc normal saline was injected intrapleurally for group M cases. In order to obtain a visual analog scale[VAS] <3, morphine consumption up to 12 hours post-op was 10.5 +/- 3.2 mg in group M which was much more than that of group B, in which this amount was 4.3 +/- 1.5 mg. This difference was statistically significant [P<0.05]. The mean frequency of morphine injection was 3.7 +/- 1.3 times in group M and 1.2 +/- 0.7 times in group B and the difference in this regard was statistically significant. The patients' first demand for morphine was 1.8 +/- 0.6 and 4.2 +/- 0.3 hours postoperatively for groups M and B respectively. The difference in this regard was statistically significant [P<0.05]. In this study we realized that a single shot of intrapleural bupivacaine can provide an almost favorable analgesia for the management of post-operative pain due to open cholecystectomy compared to other current analgesic methods. It may reduce the related complications as well. We observed no complication due to the single shot of intrapleural bupivacaine