Background:   Several pre-analytic factors adversely affect the diagnostic accuracy of urine cultures. The aim of our study is to identify and evaluate preanalytic practices associated with urine specimens and assess their impact on the accuracy of urine culture microbiology.

Methods:   A retrospective study was conducted from January 2019 to June 2019 on urine cultures showing discrepant results. This included 225 patients whose culture showed growth of a single pathogen with no pus cells in the Gram stain. The details regarding the sample type, repeat cultures sent, and complete urine analysis (CUE), were analyzed.

Results:   Of the 225 samples, 208(93.4%) were clean catch and 17 (3.1%) were catheter catch. Of 17 patients with catheter catch, urine culture and CUE were done in 12 (70.5%) patients. CUE was normal in 10 (83.3%) of the patients. The culture was sent within 1-7 days in 12 (70.5%) patients. Of 208 patients with clean catch urine culture, CUE was done in 174 (83.6%) patients. CUE was normal in 162 (93.1%) of patients. The culture was sent in 1-7 days in 146 (70.1%) patients. Escherichia coli was the predominant organism isolated in clean and catheter catch. Of 450 polymicrobial cultures, Gram stain showed pus cells with/without organisms in 66(14.6%) of cases.

Conclusion:   In the majority of the urine cultures, there was no correlation between microscopy and culture. The samples would have been sent without proper indication and collected improperly. A positive urine culture alone is insufficient for the diagnosis of UTI, it has to be correlated with microscopy and clinical history.

Background:   Urinary tract infection (UTI) is a common bacterial illness in febrile infants and young children, with a prevalence of 4.1% to 7.5%. Early diagnosis and treatment are crucial to prevent long-term complications, especially in children under two years. This study aimed to assess the prevalence, clinical profile, and risk factors of UTI in febrile children admitted to a tertiary care center and analyze the culture and sensitivity patterns of causative organisms.

Methods:   A prospective study was conducted at Jubilee Mission Medical College, Thrissur, over 18 months, enrolling 504 febrile children aged over one month. Urine samples were analyzed using standard methods, with culture as the gold standard for UTI diagnosis. Exclusion criteria included lack of consent, absence of urine analysis, and treatment discontinuation. Routine investigations were performed for all UTI patients, with specialized imaging reserved for selected cases. Data obtained were statistically analysed.

Results:   The prevalence of UTI among febrile children was 11.3% (p<0.000). The mean age was 2.57 years (SD 1.64), with most cases in children aged 1–5 years and a female predominance. Common risk factors included constipation, phimosis, poor hygiene, diaper usage, and worm infestation. Clinical features included pain during micturition (68.4%), vomiting (22.8%), and decreased urine output (7%). E. coli (87.7%) was the most common causative organism, sensitive to most antibiotics.

Conclusion:   The significant prevalence of UTI in febrile children requires high clinical suspicion, prompt evaluation, and awareness to prevent renal complications.

Background:   Urinary tract infections (UTIs) are a public health concern, mainly for diabetic infections, who are more susceptible due to weakened immunity and high blood sugar. Understanding the role of immune parameters can help improved diagnose and attendant more effective treatment for diabetic mellitus patients with UTIs. This study aims to estimate the serum levels of AGEs, SAA, PCT, CD23 and CD25 in UTIs caused by E. coli in Diabetic Patients.

Methods:   This study had been included 300 samples (blood for Inflammatory parameters and urine for bacterial diagnosis) obtained from Diabetic patients found in Al-Betool Teaching Hospital. And Baquba Teaching Hospital between June 2023 and August 2024. Urine and blood samples were collected from 300 individuals with diabetes mellitus with both type who were suspected of having UTIs. Serum was isolated from the blood, blood glucose and HBA1c test was completed to check the presence of the diabetic illnesses. The serum samples were then stored for used in measuring immunological parameters that includes AGEs, SSA, PCT, CD23 and CD25 that done later by ELISA. Urine samples were culture on the blood agar and MacConkey agar, and then Bacteria diagnoses was done by using an automatic VITEK 2 system.

Results:   The current study showed that 220 samples urinary tract infections, 180 of which were bacterial. Of the 180 samples, 116 have E. coli bacterial isolates and 46 have other bacterial species. The study also shown an increase in the concentration of AGEs, SAA, PCT, CD23 and CD25 in the serum of Diabetic Mellitus patients have UTIs compared with the healthy.

Conclusion:   These inflammatory markers not only serve as diagnostic tools but also help in understanding the complex immune dysfunction present in diabetic patients with UTIs caused by E. coli.

Background:   Bacterial antibiotic resistance is increasing, and using natural alternatives is very important. Medical smoke has been prevalent in the treatment of various diseases for many years. This study investigates the antimicrobial effect of Anbar Nesara (AN) smoke on Enterococcus faecalis, Streptococcus pyogenes, Escherichia coli, and Candida albicans.

Methods:   In this study, AN smoke is considered as a case, and antibiotic and antifungal groups as controls. Standard and clinical strains of Candida albicans, Enterococcus faecalis, Escherichia coli, and Streptococcus pyogenes were prepared. The antibacterial effect of the extract was determined by diffusion in agar and micro-broth dilution.

Results:   This research showed that AN smoke can effectively affect Enterococcus faecalis, Escherichia coli, and Streptococcus pyogenes at concentrations above 100 mg/ml and on Candida albicans at concentrations above 15.62 mg/ml. The most significant effects were related to the concentration above 500 mg/dL, significantly different from antibiotic discs. The most sensitive microorganism to AN smoke is Candida albicans, and the most resistant bacterium to it is Escherichia coli.

Conclusion:   AN smoke has antimicrobial properties and can be considered as complementary treatment.

Background:   Antibiotic resistance is a grave threat to managing bloodstream infections, with MDR gram-negative pathogens like carbapenem-resistant Klebsiella pneumoniae and Escherichia coli escalating globally. This study sought to assess the colistin susceptibility profiles of MDR gram-negative clinical isolates obtained from blood cultures within a high-burden tertiary care facility in Delhi.

Methods:   This cross-sectional study was conducted in the Department of Microbiology at UCMS & GTB Hospital, Delhi, from January 2023 to June 2024. A total of 80 multidrug-resistant gram-negative clinical isolates from blood cultures were included. Carbapenem resistance was confirmed using the Modified Carbapenem Inactivation Method (mCIM), while colistin resistance was determined through Broth Microdilution Testing (BMD).

Results:   A study conducted over one year tested 80 Enterobacterales isolates, with 74 (92.5%) identified as CRE using the Kirby Bauer disc diffusion method and confirmed by mCIM testing. The majority of isolates (44%) were from NICU, with a male predominance (60%). Enterobacter species (40%) was the most prevalent, followed by Klebsiella pneumoniae (26.6%), Citrobacter species (20%), and Escherichia coli (13.4%). The study found high multidrug resistance, with 100% resistance to most antibiotics in Enterobacter and Klebsiella species. All 74 isolates showed intermediate colistin susceptibility, with 43.2% exhibiting an MIC of 0.031 µg/mL.

Conclusion:   This study highlights the urgent need for colistin stewardship programs to address the rise of CRE. The emergence of colistin resistance, especially in NICUs and ICUs, requires enhanced monitoring and rapid diagnostics. Focusing on vulnerable populations like neonates and critically ill patients is crucial to combat multidrug-resistant infections.

Background:   Syphilis is a venereal disease caused by Treponema pallidum affecting 12 million people each year, worldwide. Treponema pallidum cannot be cultivated in vitro and is thus diagnosed clinically by; direct demonstration of treponemes based on dark field microscopy, Polymerase chain reaction (PCR) and/or serology methods.

Methods:   A total of 100 serum samples from women attending antenatal clinic for syphilis screening were taken. VDRL test and syphilis rapid card (POCT) were performed as per the manufacturer’s protocol. TPHA test was performed for the confirmation.

Results:   All the 100 antenatal patients were screened for syphilis using VDRL, Syphilis card test (POCT), and confirmation was done by TPHA. Three samples were reactive by both VDRL and POCT giving a positivity of 3%. Those three samples positive by the VDRL and POCT were also positive by TPHA test.

Conclusion:   Antenatal syphilis screening with immunochromatographic assays, along side the confirmatory tests such as TPHA, offers a cost-effective solution, and further research is recommended to assess its feasibility and wider application in peripheral health settings.

Background:   This study compares the effectiveness of culture and PCR methods in detecting Neisseria gonorrhoeae , a Gram-negative bacterium causing gonorrhea, which can lead to serious health complications, especially in women, and highlights the advantages of nucleic acid amplification tests over traditional culture-based diagnosis.

Methods:   This study involved 70 individuals suspected of gonorrhea who referred to Baqiyatallah Hospital in Tehran between September and February 2022, with ethical approval and informed consent obtained from all participants. Two swab samples were collected from each individual—one for culture and one for molecular testing—and stored appropriately for microbiological and genomic analysis.

Results:   This study examined 70 women suspected of having gonorrhea, with a mean age of 32.32 ± 8.58 years, and found a prevalence of 30% by vaginal culture and 28.57% by PCR testing. Using PCR as the gold standard, the sensitivity and specificity of culture for diagnosing gonorrhea were determined to be 45% and 76%, respectively.

Conclusion:   Of course, the differences could be due to the size of the studied populations, but the important point is the high accuracy and sensitivity of the PCR test in identifying Neisseria gonorrhoeae, which has been mentioned in most studies.

Background:   Nephrolithiasis is a common urological condition often associated with urinary tract infections (UTIs). Identifying the bacteriological profile and antibiotic resistance patterns in such patients is essential for effective management and prevention of recurrence. To determine the bacteriological profile of urine in patients with nephrolithiasis and assess the antibiotic susceptibility patterns of the isolated organisms.

Methods:   This cross-sectional observational study included 200 patients with nephrolithiasis at a tertiary care hospital. Midstream urine samples were collected aseptically and cultured using standard microbiological techniques. Isolated organisms were identified, and antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method in accordance with CLSI guidelines. Demographic data and other characteristics were also documented.

Results:   Out of 200 patients, 136 (68%) showed significant bacteriuria. Escherichia coli was the most common isolate (44.1%), followed by Enterococcus spp. (23.5%) and Pseudomonas spp. (15.4%). E. coli showed high sensitivity to nitrofurantoin (96%) and amikacin (90%) but low sensitivity to ciprofloxacin (23%). Enterococcus spp. exhibited good sensitivity to vancomycin (95%) and linezolid (93%) but high resistance to fluoroquinolones. Pseudomonas spp. demonstrated high susceptibility to imipenem (89%) and piperacillin-tazobactam (80%).

Conclusion:   Urinary tract infections are common among patients with nephrolithiasis, with E. coli being the predominant pathogen. Increasing resistance to commonly used antibiotics underscores the need for routine urine culture and sensitivity testing. Culture-based therapy and antibiotic stewardship are vital to improving outcomes in these patients.

Background:   Water is an important source of numerous infectious diseases in humans. The most important indicator bacteria include Escherichia coli and total coliform species. Clostridium perfringens is a general indicator of treatment efficiency.

Methods:   Diagnosing microbial contamination of water by culture method, in addition to high cost, has low speed and many limitations. The PCR (Polymerase Chain Reaction) method is a promising alternative for simultaneous detection of these bacteria. In this research, we developed multiplex PCR for detection of lacZ, uidA and plc genes as an indicator of the presence of total coliforms, Escherichia coli and Clostridium perfringens. In the following, 33 samples of water and wastewater from Razavi Khorasan province were tested using standard culture methods and this multiplex PCR for comparison.

Results:   Multiplex PCR was not only confirmed by cultural results but also has more accuracy and sharpness. The results of the validation tests showed that our multiplex PCR method had a significant advantage over the conventional culture method.

Conclusion:   The developed multiplex PCR method demonstrated superior accuracy and efficiency compared to traditional culture techniques, offering a reliable alternative for rapid detection of waterborne pathogens.

Background:   Klebsiella pneumoniae is one of the important bacilli of the Enterobacteriaceae family and is considered as the primary pathogen in nosocomial infections, especially septicemia, pneumonia, etc. Widespread resistance to antibiotics is currently a major concern worldwide. The aim of this study is to determine the prevalence of antibiotic resistance and its association with variables such as age, gender, and department.

Methods:   90 strains of Klebsiella pneumoniae were identified by the phenotypic method and BD Phoenix M50, and the Phoenix system determined their antibiotic resistance according to the manufacturer's procedures. Then, a statistical relationship between antibiotic resistance and variables, including age, gender, and patient department, was obtained.

Results:   The findings indicated that the Multidrug-resistant (MDR) and Extended-Spectrum Beta-Lactamase (ESBL) resistance in patients had a high prevalence (above 80%). The intensive care units (ICUs) and burn wards had the highest prevalence of these antibiotic resistance. Comparing drug resistance with gender showed that total drug resistance (TDR) was significantly higher in men. However, no statistically significant relationship was found between them and age.

Conclusion:   Based on the findings, the high prevalence of antibiotic resistance in Klebsiella pneumoniae requires special attention to their control and prevention, especially in critical departments such as ICU and burn units, and therapeutic stewardships may need to be revised accordingly.

Background: Understanding the radiographic and anatomical distinctions in patients with allergic fungal rhinosinusitis (AFRS) is crucial for effective treatment and recurrence prevention. Current study aimed to investigate the presence of Concha bullosa in CT scans of patients with AFRS compared to patients with non-fungal rhinosinusitis with polyposis (NFRP), alongside the culture of the secretions. Materials and Methods: This cross-sectional study involved 86 patients with an average age of 40.91 ± 13.45 years, all suffering from nasal polyps and undergoing endoscopic sinus surgery at the Amir Alam Hospital. Participants were divided into two groups; AFRS group (n=43), and NFRP group (n=43). CT scans of the paranasal sinuses were conducted for all patients. Additionally, assessments were made for fungal cultures from Concha bullosa secretions, sinus secretions, and polyp tissue. Results: The average age of patients in the AFRS group was significantly lower than that of the NFRP group (37.3 years vs. 44.5 years, P=0.012). The incidence of Concha bullosa with secretion was higher than the ones without secretion. Notably, the AFRS group exhibited a significantly greater prevalence of Concha bullosa with secretion compared to the NFRP group (44.2% vs. 18.6%, P=0.034). In terms of fungal cultures, Aspergillus was the only positive finding in the AFRS group (13.5%, n=5) and in the NFRP group (6.1%, n=2). The species Aspergillus flavus (4.3%, n=3) was more frequently identified in fungal cultures from sinus secretions and polyp tissue among AFRS group. Conclusion: Concha bullosa is more common in the AFRS group than in the NFRP group. It suggests a potential association between fungal colonization and disease recurrence. Also, Aspergillus, especially Aspergillus flavus, are frequently found in AFRS group, pointing to the role in the disease. The findings stress the need to consider Concha bullosa when treating AFRS to enhance outcomes and lower recurrence rates.

Background:   Urinary tract infections (UTIs), predominantly catheter-associated (CAUTIs), cause significant morbidity (~380,000 cases), mortality (~9,000-13,000 deaths), and healthcare costs annually. CAUTIs initiate via bacterial biofilm formation on catheters. Current antimicrobial catheters (e.g., silver ions, antibiotics) face limitations like poor efficacy, resistance, and non-adjustability. Nanostructure coatings offer promise; notably, combining Ag/ZnO nanostructures leverages enhanced biocompatibility and potent antibacterial effects for novel CAUTI prevention strategies.

Methods:   AgNPs were chemically synthesized via silver nitrate reduction (sodium citrate/sodium borohydride); ZnO-NPs were prepared from zinc acetate/sodium hydroxide. A lubricant gel containing 2% lidocaine and Ag/ZnO nanostructures (2:8 v/v ratio) was formulated. Nanostructure characterization included DLS, TEM, and ICP-OES. Antibacterial efficacy was assessed via disk diffusion and microdilution (MIC/MBC) against S. aureus and P. aeruginosa. Biocompatibility was evaluated via rabbit ocular irritability and Guinea Pig Maximization Test (ISO 10993-10).

Results:   DLS/TEM characterization showed AgNPs (24.4 nm, spherical) and ZnO-NPs (52.48 nm, clustered) were mono-disperse (PDI ~1 and 0.667). Zeta potential confirmed stability (Ag: -20.7 mV; ZnO: -0.709 mV). ICP-OES quantified concentrations (Ag: 25 ppm; ZnO: 970 ppm). Antibacterial assays revealed weak AgNP activity (MIC/MBC >12.5 µg/mL for both pathogens) but potent ZnO-NP effects (e.g., S. aureus MIC: 0.406 µg/mL). Ag/ZnO hybrids exhibited enhanced efficacy, especially against S. aureus (MIC: 0.02/3.12 µg/mL). The gel was non-irritating (rabbit ocular test) and non-sensitizing (Guinea Pig Maximization Test).

Conclusion:   The active formulation consisting of mixed silver and zinc oxide nanostructures combined with a medical lubricant containing 4% lidocaine demonstrates effective antibacterial activity against Pseudomonas aeruginosa and Staphylococcus aureus, while exhibiting no irritant or sensitizing properties in laboratory animals.

Background:   Port-site infections caused by nontuberculous mycobacteria (NTM) following laparoscopic surgery represent a rare yet increasingly recognized complication in modern surgical practice. These infections, driven by environmental pathogens resistant to standard sterilization methods, pose significant diagnostic and therapeutic challenges due to their insidious onset and resistance to conventional treatments.

Methods:   This retrospective study examined 20 patients who developed infection between May 2024 and August 2024, collecting data on demographics, clinical presentations, latency periods, diagnostic outcomes, and treatment results.

Results:   The cohort, with a mean age of 36.5 years (range: 8-70) and 60% female predominance, most commonly presented with pus discharge (70%), with a median latency period of 39 days from surgery to symptom onset. Diagnostic efforts revealed excisional biopsy as the most effective method, yielding a 25% positivity rate, far surpassing pus swabs and aspirations at 5% each. Treatment involved prolonged combination antibiotic therapy—macrolides paired with linezolid or amikacin—resulting in complete resolution in all cases with no recurrences within a 6-month follow-up.

Conclusion:   These findings underscore the necessity of heightened clinical suspicion, advanced diagnostic techniques, and adherence to extended treatment protocols to manage NTM infections effectively, offering critical insights into their prevention and management in laparoscopic surgery settings.

Vancomycin is an essential glycopeptide antibiotic facing challenges from resistant bacterial strains such as vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA). Timely and precise identification of these strains is vital for efficient infection control. This report explores using aptamer-based biosensors as a novel solution for the rapid detection of hVISA. Aptamers, short, single-stranded nucleic acids, exhibit remarkable specificity and strong affinity for their targets, making them outstanding candidates for biosensor creation. These biosensors offer affordability, ease of customization, and swift performance, making them highly appropriate for medical settings. By utilizing electrochemical detection techniques, aptamer-based biosensors facilitate real-time tracking of vancomycin concentrations and may also contribute to the efficient detection of hVISA, addressing urgent demands in infectious disease control.

Background:   Medicinal plant extracts are widely recognized for their antimicrobial properties, owing to phytochemicals such as flavonoids, terpenes, alkaloids, and phenolic acids. However, their clinical and industrial application is often limited by low solubility, high volatility, instability, and poor bioavailability. Nanoencapsulation has emerged as a promising strategy to overcome these limitations by enhancing solubility, stability, and controlled delivery of bioactives. This review comprehensively examines nanoencapsulation studies conducted in Iran between 2019 and 2024, focusing on the antibacterial and antifungal efficacy of encapsulated plant extracts.

Results:   Five main encapsulation methods are reviewed: liposomes, solid lipid nanoparticles (SLNs), nanoemulsions, polymeric nanoparticles (especially chitosan-based), and mesoporous silica nanoparticles. For each category, the plant extracts used, preparation techniques, physicochemical properties, and antimicrobial outcomes are presented. Overall, nanoencapsulation consistently improved antimicrobial performance. Additionally, encapsulated formulations exhibited improved stability, prolonged release, and in many cases, reduced cytotoxicity. Despite these advances, several internationally recognized techniques remain underutilized in Iranian research. These include dendrimer-based nanocarriers, phytosome systems, protein-based nanoparticles (e.g., zein, gelatin), and metal–organic frameworks (MOFs), all of which have shown promising results elsewhere in enhancing delivery and antimicrobial synergy. Their adoption could broaden the functional potential of Iranian medicinal plants.

Conclusion:   This review highlights nanoencapsulation as a transformative tool in enhancing the efficacy of herbal antimicrobials. It also identifies underexplored nano-carriers as strategic opportunities for future research and application in pharmaceutical, food, and agricultural settings.

Background:   Understanding the immune responses to viral capsids and bacterial pathogens is crucial for improving vaccine design and efficacy. This review explores the complex molecular pathways that underlie vaccine-induced immunity, focusing on the interactions between the immune system and different viral and bacterial antigens.

Results:   By examining the cellular and humoral immune responses elicited by viral capsids and bacterial pathogens, we highlight key factors that influence vaccine effectiveness, such as antigen presentation, immune memory, and immune evasion mechanisms. Furthermore, we discuss how these molecular interactions can be modulated to enhance vaccine strategies, providing insight into future vaccine development against emerging infectious diseases.

Conclusion:   Through a detailed exploration of the molecular dynamics involved, this article aims to deepen our understanding of vaccine-induced immunity and inform the development of more targeted and effective immunotherapies.

Burn injuries present a considerable global health challenge, characterised by intricate healing processes that are exacerbated by infection and impaired tissue regeneration. Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic option due to their regenerative, immunomodulatory, and antimicrobial properties. MSCs have been shown to secrete AMPs such as LL-37 and hepcidin, which have been found to directly target pathogens including Pseudomonas aeruginosa and Staphylococcus aureus. In addition to this direct antimicrobial action, MSCs have also been observed to modulate immune responses through the secretion of cytokines such as IL-10 and TGF-β. Their regenerative effects include the promotion of angiogenesis, re-epithelialization, and extracellular matrix (ECM) remodelling via growth factors such as EGF, KGF, and SDF-1. In-vitro and animal studies have demonstrated enhanced wound closure, reduced scarring, and improved antimicrobial efficacy through novel delivery systems such as hydrogels and preconditioning strategies. As demonstrated by clinical trials, the treatment has been shown to facilitate accelerated healing and reduced reliance on antibiotics. However, challenges such as the heterogeneity of mesenchymal stem cells (MSCs), optimisation of dosing, and safety concerns (e.g. coagulopathy, systemic inflammation) persist. Emerging technologies, including synthetic gene circuits, microbiome-targeted engineering, and bioresponsive delivery systems, offer solutions to enhance the efficacy of MSCs. This review emphasises the potential of MSCs to transform the management of burn wounds, while underscoring the necessity for standardised protocols and advanced engineering to surmount translational barriers.