The Journal of Infection in Developing Countries 2019-07-16T12:37:59-07:00 JIDC Central Office Open Journal Systems <p>A peer-reviewed open access journal, focusing on global health.</p> Characterization of auto-agglutinating and non-typeable uropathogenic Escherichia coli strains 2019-07-16T12:37:38-07:00 Ulises Hernández-Chiñas Alejandro Pérez-Ramos Laura Belmont-Monroy María E Chávez-Berrocal Edgar González-Villalobos Armando Navarro-Ocaña Carlos A Eslava Jose Molina-Lopez <p>Introduction: Uropathogenic <em>Escherichia coli</em> (UPEC) are the main etiological agent of urinary tract infections (UTIs). Association between different serotypes and UTIs is known, however, some strains are incapable to be serotyped. The aim of this work was to study bthe phenotypical and genotypical characteristics of 113 non-typeable (NT) and auto-agglutinating (AA) <em>E. coli </em>strains, isolated from UTIs in children and adults.</p> <p>Methodology: The 113 UPEC strains were analyzed by PCR assays using specific primers to determine their serogroups, <em>fimH</em>, <em>papC</em>, <em>iutA</em>, <em>sat, hlyCA</em> and <em>cnf1</em>, virulence associated genes, and <em>chuA, yjaA</em> and TSPE4.C2 for phylogroup determination. Additionally, the diffusion disk method was performed to evaluate the antimicrobial resistance to 18 antimicrobial agents.</p> <p>Results: Using the PCR assay, 63% (71) of the strains were genotyped showing O25 and O75 as the most common serogroups. The virulence genes <em>fimH</em> (86%) and <em>iutA</em> (74%) were the most prevalent, in relation to the phylogroups the commensal (A and B1) and virulent (B2 and D) showed similar frequencies (P &gt; 0.05). The antimicrobial susceptibility test showed a high percentage (73%) of multidrug-resistant strains.</p> <p>Conclusions: The genotyping allowed identifying the serogroup in many of the strains that could not be typed by traditional serology. The strains carried virulence genes and were multidrug-resistant in both, commensal and virulent phylogroups. Our findings revealed that, in addition to the classical UPEC serogroups, there are pathogenic serogroups not reported yet.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Molina Lopez Jose, Ulises Hernández-Chiñas, Alejandro Pérez-Ramos, Laura Belmont-Monroy, María E Chávez-Berrocal, Edgar González-Villalobos, Armando Navarro-Ocaña, Carlos A Eslava Seroprevalence and risk factors of Leptospira serovar Pomona and Leptospira serovar Hardjo infection in dairy cows in Jordan 2019-07-16T12:37:35-07:00 Zuhair B Ismail Sameeh M Abutarbush Ahmad M Al-Majali Mohammad H Gharaibeh Batoul Al-Khateeb <p>Introduction: This study was carried out to determine the seroprevalence and risk factors associated with <em>Leptospira</em> serovars Pomona and Hardjo infection in dairy cows.</p> <p>Methodology: Seroprevalence was determined using ELISA using 160 healthy and 80 recently aborted cows. Risk factor assessment was carried out using a pre-validated questionnaire.</p> <p>Results: The true farm seroprevalence of<em> Leptospira</em> serovars Pomona and Hardjo was 92.3% (95% CI: 66%-98%). In healthy cows, the true and apparent cow seroprevalence of <em>Leptospira</em> serovars Pomona and Hardjo were 26.9 (95% CI: 20–34%), 26.25% (95% CI: 20–33%) and 28.75% (95% CI: 22–36%) and 27.5% (95% CI: 21–35%), respectively. Semi-intensive management system (OR = 11.43; P &lt; 0.01), surface water as a source of drinking water (OR = 1.21; P &lt; 0.03), lack of special wear for visitors (OR = 1.39; P &lt; 0.05), and previous history of abortion (OR = 1.02; P &lt; 0.05) were associated with high rate of seropositivity against<em> Leptospira</em> serovars Pomona and Hardjo. In recently aborted cows, the true and apparent seroprevalence rates of <em>Leptospira</em> serovars Pomona and Hardjo were 53.25% (95% CI: 47.5–62%), 53.75% (95% CI: 48.5–63.2%) and 56% (95% CI: 49–61%), 56.25% (95% CI: 49.8–61.2%), respectively.</p> <p>Conclusions: Leptospirosis is an endemic disease in Jordan and further studies are required to effectively control the disease in dairy cows.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Zuhair AH Ismail, Sameeh M Abutarboush, Ahmad M Al-Majali, Mohammad H Gharaibeh Assessing the growth of Staphylococcus aureus and Escherichia coli on fruits and vegetables 2019-07-16T12:37:53-07:00 Caroline I Kothe João P Pessoa Patricia S Malheiros Eduardo C Tondo <p>Introduction: The number of registered foodborne diseases involving fresh produce is a preoccupation in many countries. For this reason, the aim of this study was to better understand the growth of <em>Staphylococcus aureus</em> and <em>Escherichia coli, </em>two indicators of hygienic and sanitary conditions, on fruits and vegetables that were exposed at different temperatures.</p> <p>Methodology: The main salads served at the buffets of commercial restaurants were artificially contaminated with separate pools of both pathogens and subsequently exposed at 10, 20 and 30 °C and at different time intervals. Then, the growth potential of <em>S. aureus</em> and<em> E. coli </em>on each fruit and vegetable was determined.</p> <p>Results: There was no significant <em>S. aureus</em> and <em>E. coli</em> growth on all evaluated foods exposed at 10 °C until 6 hours. When comparing both microorganisms, <em>E. coli</em> demonstrated higher growth potential than <em>S. aureus</em> on all analysed salads. Peculiarly, <em>E. coli</em> had the highest growth rate for the tomato (α = 6.43 at 30 °C), a fruit with low pH.</p> <p>Conclusion: We suggest that fruits and vegetables should be distributed at temperatures equal to or lower than 10 °C and should not be kept for more than 2 hours at room temperature.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Caroline Isabel Kothe, João Pedro Pessoa, Patricia Malheiros, Eduardo César Tondo Antibacterial effect of acrylic bone cements loaded with drugs of different action’s mechanism 2019-07-16T12:37:48-07:00 Lizette Morejón Alonso Iran Fernández Torres Ángela M Zayas Tamayo Oscar Ernesto Ledea Lozano Ivette Durán Ramos José Ángel Delgado García-Menocal Nely Rios-Donato Eduardo Mendizábal <p>Introduction: Antibiotic-loaded bone cements of poly(methyl methacrylate) are considered as very useful biomaterials for the management of corporal deep osseous infections. However, the high prevalence of resistant germs and polymicrobial infections makes it necessary to search for new formulations of bone cements containing antibiotics for local antibacterial therapy. In this work, bone cements loaded with drugs with different mechanism of action were evaluated to determine its antibacterial effectiveness on <em>Pseudomonas aeruginosa</em>.</p> <p>Methodology: Poly(methyl methacrylate) cements loaded with 10 wt.% of Oleozon®, mixtures of Ciprofloxacin/Meropenem and Ciprofloxacin/Meropenem/Oleozon® were prepared. The <em>in vitro</em> drugs release in water was followed by UV-Vis spectroscopy, and their antibacterial activity against <em>Pseudomonas aeruginosa</em> was evaluated for 11 days using the microdilution method.</p> <p>Results: All the extracts demonstrated an inhibitory effect on the growth of the strain during the whole trial period. Extracts from cement with Oleozon® only presented a total antibacterial inhibitory effect during 20 hours for the extracts taken at day 1 while the extracts from the cements loaded with mixtures of Ciprofloxacin/Meropenem and Ciprofloxacin/Meropenem/Oleozon® showed complete inhibition of the growth of the microorganism, even at 11 days. At the end of the trial period, some of the drugs remained inside the matrices, indicating that they can be released for a longer time in treatments.</p> <p>Conclusions: The results indicated a positive antibacterial effect by the combined used of the two or the three drugs tested against the Gram-negative bacilli <em>Pseudomonas aeruginosa</em>, so these proposal may be a valid alternative to be considered by surgeons.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Lizette Morejón Alonso, Iran Fernández Torres, Ángela M. Zayas Tamayo, Oscar Ernesto Ledea Lozano, Ivette Durán Ramos, José Ángel Delgado García-Menocal, Nely Rios-Donato, Eduardo Mendizábal Patient safety culture in the intensive care unit: cross-study 2019-07-16T12:37:33-07:00 Mabel Duarte Alves Gomides Astrídia Marília de Souza Fontes Amanda Oliveira Soares Monteiro Silveira Geraldo Sadoyama <p>Introduction: Patient safety culture has been the reason for great concern for the scientific community due to the high number of failures resulting from the provision of health care. The objective of this study was to evaluate the perception regarding the patient safety culture and their differences between categories, in the professional teams of the adult intensive care unit (ICU).</p> <p>Methodology: This is a cross-sectional descriptive study, with a quantitative approach, to evaluate the patient safety culture developed in the unit adult ICU of a public university hospital.</p> <p>Results: In this survey, 138 employees of the ICU participated, among them: physicians, psychologists, nutritionists, physiotherapists, nurses, nursing technicians, and secretaries. There was a predominance of nursing technicians (76.8%) and work experience time from 5 to ≥ 21 years (62.3%). The overall mean of the safety culture in the ICU was 57.80, and the domains with the best average were stress perception (73.84) and satisfaction at work (72.38) and with the worst mean was the perception of hospital management (42.69). The perception of safety attitudes in the professional category of physicians presented a general average of 61.63, being strengthened to job satisfaction (77,89) and with a higher perception in relation to nurses.</p> <p>Conclusions: The overall ICU average for the patient safety culture was less than 75, which demonstrates a team with weakened safety attitude and, in addition, low perceptions of safety attitudes based on the results of management domains, working conditions and communication failures.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Mabel Duarte Alves Gomides, Astrídia Marília de Souza Fontes, Amanda Oliveira Soares Monteiro Silveira, Geraldo Sadoyama Investigation of carbapenemase and mcr-1 genes in carbapenem-resistant Klebsiella pneumoniae isolates 2019-07-16T12:37:43-07:00 Çiğdem Arabacı Tuba Dal Tuğcan Başyiğit Neslihan Genişel Rıza Durmaz <p>Introduction: Carbapenem-resistant <em>Klebsiella pneumoniae</em> are a major problem. We aimed to investigate carbapenemase-encoding genes and transferable <em>mcr</em>-1 genes among 57 carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) isolates from hospitalized patients.</p> <p>Methodology: Antibiotic susceptibility tests were performed by Phoenix (BD). Results for ertapenem and colistin were confirmed by gradient diffusion and microdilution methods. Carbapenemase and<em> mcr-1</em> genes were investigated by Polymerase Chain Reaction (PCR).</p> <p>Results: Thirty-two (56.14%) isolates were from intensive care units (ICU). Antibiotic resistance rates by Phoenix: 52.63% for amikacin; 73.69% trimethoprim sulfamethoxazole; 91.23% cefepime; 82.46% tigecycline; 59.65% colistin. Carbapenemases positivity: 82.45% (47) for blaOXA-48, 40.35% (23) blaOXA-55, 3.50% (2) blaOXA-51, 1.75% (1) blaOXA-23, 1.75% (1) blaOXA-24, 1.75% (1) blaIMP. blaOXA-58, blaKPC, blaNDM-1, and blaVIM were not detected. Twenty (35.08%) isolates had both blaOXA-48 and blaOXA-55. Three isolates were <em>mcr-1 </em>(+) and <em>bla</em>OXA-48 (+). One <em>mcr-1</em> (+) isolates was <em>bla</em>OXA-51 (+). One colistin sensitive isolate determined by Phoenix, was found colistin resistant by microdilution.</p> <p>Conclusion: OXA-48 and OXA-55 co-harboring isolates and <em>mcr-1</em> gene (+) isolates were spreading. Automated colistin susceptibility results should be confirmed by microdilution method. Resistance mechanisms in <em>Enterobacteriaceae</em> should be determined and the isolates should be monitored by molecular epidemiological methods. Effective infection control measures will contribute to reduce risk of antibiotic resistant bacterial infections and dissemination of antibiotic resistance.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Çiğdem Arabacı, Tuba Dal, Tuğcan Başyiğit, Neslihan Genişel, Rıza Durmaz Tick-borne encephalitis in Serbia: A case series 2019-07-16T12:37:23-07:00 Jasmina Poluga Aleksandra Barac Natasa Katanic Salvatore Rubino Branko Milosevic Aleksandar Urosevic Nikola Mitrovic Ivana Kelic Jelena Micic Goran Stevanovic <p>Introduction: In the Europe, the number of tick-borne encephalitis (TBE) has been increased in the last decade, and the number of endemic areas has been also increased and is still growing. In the present case series, we present clinical and socio-epidemiological data of patients with TBE hospitalized in the period of TBE virus epidemic in Serbia.</p> <p>Methodology: A case series was conducted in Serbia in 2017. Patients with confirmed TBE were included in the study. Biochemical and serological analysis of blood and CSF, as well as radiological imaging (CT and MRI) were done.</p> <p>Results: In total, 10 patients with TBE were included in the study. M:F ratio was 1.5:1, while average age was 45.1 years. Half of the patients had severe clinical picture. Endocranial CT scan and MRI did not reveal any abnormality, except in the patient with the most severe CNS infection (meningoencephalomyelitis). Mean value of sedimentation and CRP was slightly elevated (29.6 mm/1hours and 20.1 mg/L, respectively) in 80% of the patients, although elevation was almost negligible. The average number of leucocytes in the cerebrospinal fluid (CSF) was 171×10<sup>6</sup>/L, the mean value of the CSF protein was 1.1g/L. There were no fatal outcomes.</p> <p>Conclusion: Since other CNS infections have similar clinical picture and CSF finding as TBE, serological analysis for TBE should be included in routine diagnostic practice.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Jasmina Poluga, Aleksandra Barac, Natasa Katanic, Salvatore Rubino, Branko Milosevic, Aleksandar Urosevic, Nikola Mitrovic, Ivana Kelic, Jelena Micic, Goran Stevanovic Awareness of HPV and HPV vaccination in undergraduate students in the North West region of Turkey: Near future outlook 2019-07-16T12:37:28-07:00 Gulden Aynaci Zuhal Gusku <p>Introduction: Cervical cancer is the second most common cancer affecting women in the world. Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide. The aim of this study was to evaluate the awareness about HPV, risk perception, cervical cancer, and HPV vaccines.</p> <p>Methodology: The sample of this descriptive cross-sectional study consisted of 396 undergraduate university students from Turkey. Sociodemographic characteristics, reproductive health, knowledge about HPV, and HPV vaccination were questioned.</p> <p>Results: The percentage of university students with an active sexual life was 10.6%. The knowledge level of families about HPV, and HPV vaccination were not adequate. The awareness of the fact that HPV was a cause of cervical cancer in women and penile cancer in men tended to increase with the increase in the educational level of parents. Those who knew about HPV vaccines were predominantly females.</p> <p>Conclusions: The results of this study demonstrated that more active education is needed to decrease HPV infections among undergraduate students. Increasing awareness of HPV makes it easier to develop positive behaviors in fighting against it. In order to increase the contribution of young people to educational activities for the community, information about HPV and HPV vaccines should first be included in training programs at universities. To support the development of effective and high-quality public health interventions, young people should be educated so that obstacles to HPV vaccination in various cultural groups can be eliminated. Our findings suggest that awareness about HPV, cervical cancer, and HPV vaccines should be increased.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 GULDEN AYNACI, ZUHAL GUKSU IL-28B genotypes as predictors of long-term outcome in patients with hepatitis C-related severe liver injury 2019-07-16T12:37:59-07:00 Jelena Jordovic Jasmina Simonovic-Babic Vladimir Gasic Nikola Kotur Branka Zukic Sonja Pavlovic Ivana Lazarevic Danijela Karalic Natasa Katanic Natasa Nikolic Aleksandar Urosevic Jelena Nestorov Dragan Delic Ksenija Bojovic <p>Introduction: Patients with severe fibrosis or cirrhosis are at high risk for liver-related complications, even after successful antiviral treatment and/or regression of fibrosis. These are the first published results concerning the role of <em>IL-28B</em> genotypes as predictors of the durability of sustained virological response (SVR) and long-term outcome, in patients with baseline severe fibrosis and cirrhosis caused by hepatitis C (HCV) infection.</p> <p>Methodology: Genetic testing for three different single nucleotide polymorphisms (SNP) near the <em>IL28B</em> gene, rs12979860, rs12980275 and rs8099917, was performed in 42 patients with HCV-related advanced fibrosis and cirrhosis, who achieved SVR after successful interferon-based treatment. Baseline clinical and laboratory parameters were analysed, as well as <em>IL28B</em> genotype association with late virological relapse, fibrosis progression and clinical outcomes.</p> <p>Results: The most prevalent genotypes in all three tested SNP positions were: CC<sub>rs12979860 </sub>genotype in 69% of patients, GT<sub>rs8099917 </sub>in 78.6% and GG<sub>rs12980275 </sub>in 47.6% of patients. The presence of <em>IL28B</em> CC<sub>rs12979860</sub> genotype was identified as a negative predictor of late virological relapse. Further analysis did not confirm the association of other <em>IL28B</em> genotypes with the progression of fibrosis and clinical outcomes.</p> <p>Conclusions: Varying long-term prognosis in patients with HCV-related severe fibrosis and cirrhosis is due to multiple interactions between host genetic factors, virus and environment. These are first published results demonstrating the significance of <em>IL28B</em> CC<sub>rs12979860</sub> genotype as a negative predictor of late virological relapse. A further investigation concerning genetic factors is necessary to identify patients under risk for late relapse, complications and unfavorable outcomes, so that they can be reevaluated and offered new treatment options.</p> 2019-05-31T00:00:00-07:00 Copyright (c) 2019 Jelena Jordovic Diversity of Th1/Th2 immunity in mice with acute lung injury induced by the H1N1 influenza virus and lipopolysaccharides 2019-07-16T12:37:56-07:00 Jian-xing Liu Ying Zhang Miao An Qing-guang Wu Ya Zhao Xiong Li Geng Li <p>Introduction: The polarization of T helper (Th) cells plays an important role in the inflammatory response, pathogen removal, and tissue damage processes of infectious acute lung injury (ALI). However, Th cell polarization in viral- or bacterial-mediated ALI is not well defined. Herein, an influenza virus (A/FM/1/47, H1N1) and lipopolysaccharide (LPS) were chosen to induce ALI in mice, and the resultant diversity of Th-cell polarization was explored.</p> <p>Methodology: BALB/c mice were challenged intranasally with the influenza virus or LPS. Edema of the lung, infiltration of inflammatory cells (macrophages, neutrophils, and lymphocytes), oxidative stress, and signature cytokines of Th1 and Th2 cells were detected at 2 days post virus or LPS challenge.</p> <p>Results: The mice exhibited increased capillary permeability accompanied by lung edema and protein-rich alveolar exudation after virus or LPS challenge. Additionally, excessive infiltration of inflammatory cells, robust oxidative stress, and cytokine production were observed in both mouse groups. However, there was conspicuous disparity in the inflammatory cell infiltration and cytokines between the virus- and LPS-challenged mice, where the infiltration in virus-challenged mice was mainly of macrophages and accompanied by robust Th1 cytokine elevation, whereas the infiltration in LPS-challenged mice was primarily of neutrophils and accompanied by robust Th2 cytokine elevation.</p> <p>Conclusions: The Th cell polarization was skewed depending on whether ALI was induced by the influenza virus or LPS. The polarization in the virus-challenged mice was primarily toward a Th1 response, whereas that in the LPS-challenged mice was mainly toward Th2.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Jian-xing Liu, Ying Zhang, Miao An, Qing-guang Wu, Ya Zhao, Xiong Li, Geng Li Isolation of Cryptococcus species from the external environments of hospital and academic areas 2019-07-16T12:37:46-07:00 Murilo de Oliveira Brito Meliza Arantes de Souza Bessa Ralciane de Paula Menezes Denise Von Dolinger de Brito Röder Mário Paulo Amante Penatti João Paulo Pimenta Paula Augusta Dias Fogaça de Aguiar Reginaldo dos Santos Pedroso <p>Introduction<em>:</em> Fungi of the genus <em>Cryptococcus</em> are cosmopolitan and may be agents of opportunistic mycoses in immunocompromised and sometimes immunocompetent individuals. <em>Cryptococcus</em> species are frequently isolated from trees and bird excreta in the environment and infection occurs by inhalation of propagules dispersed in the air. The aim was to investigate <em>Cryptococcus</em> species in bird excreta and tree hollows located in a university hospital area and in an academic area of a university campus.</p> <p>Methodology: A total of 40 samples of bird excreta and 41 samples of tree hollows were collected. The identification of the isolates was done by classical methodology and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.</p> <p>Results: Twenty (62.5%) isolates of <em>Cryptococcus</em> were found in bird excreta and 12 (37.5%) in tree hollows. <em>C. laurentii</em> (currently <em>Papiliotrema laurentii</em>) was the most frequent species in both samples, being found in 5 samples of excreta and in 8 tree hollows. The diversity of species found in excreta (<em>C. laurentii</em>, <em>C. albidus</em> [currently <em>Naganishia albida</em>], <em>C. liquefaciens</em> [currently <em>N. liquefaciens</em>], <em>C. friedmanii</em> [currently <em>N. friedmannii</em>] and others) was higher than in tree hollows (<em>C. laurentii</em>, <em>C. flavescens </em>[currently <em>Papiliotrema flavescens</em>], and other yeasts).</p> <p>Conclusion: Many <em>Cryptococcus</em> species were isolated from excreta and tree hollows, and this fact is important for understanding the environmental epidemiology of those emerging pathogens for public health, as a way to implement surveillance actions and control of cryptococcosis.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Murilo de Oliveira Brito, Meliza Arantes de Souza Bessa, Ralciane de Paula Menezes, Denise Von Dolinger de Brito Röder, Mário Paulo Amante Penatti, João Paulo Pimenta, Paula Augusta Dias Fogaça de Aguiar, Reginaldo dos Santos Pedroso Biological risk assessment of miltefosine in concomitant infection with opportunistic toxoplasmosis 2019-07-16T12:37:41-07:00 Ashraf M Barakat Amal E Saafan Samuel T Melek Tahany S Behour Nehal M Khairy Ahmed S Khairalla <p>Introduction: Although miltefosine is the first line for treatment of leishmaniasis, it could have multiple un-recognized effects if any infection accidentally takes place during therapy. The aim is to precisely evaluate the molecular and biochemical remarks of miltefosine on <em>Toxoplasma gondii</em> accidental infection during miltefosine therapeutic course.</p> <p>Methodology: changes implied by miltefosine daily parenteral administration to<em> Toxoplasma</em>-infected mice, subcutaneously or intraperitoneal, have been investigated. Tumor necrosis factor-Alfa, immunoglobulin G and M, IL-12 and interferon-gamma release assay (IGRA) were measured in the animals’ sera post-miltefosine administration in addition to monitoring Tissue parasite load by measuring the daily changes of copy number of B1 gene using quantitative PCR technique (qPCR).</p> <p>Results: Miltefosine significantly increased inflammatory and immunological markers (TNF-α, IgG and IgM) measured on reference to control untreated group, with a significant increase in the parasite burden and distribution in all tested organs (F = 390.9, df = 9, P &lt; 0.0001), (F = 4478.98, df = 4.75, P&lt; 0.0001) and (F = 247.3, df = 4, P &lt; 0.0001); heart, liver and lung, respectively, using MANOVA<em>. </em>Releasing capability of macrophages significantly increased during the first day of infection, however, it finally declined after seven consecutive doses of miltefosine (t = 7.96, P &lt; 0.001)<em>.</em></p> <p>Conclusion: Miltefosine could not control the pathogenesis and multiplication of accidental <em>Toxoplasma </em>infection. Cumulative low parenteral daily doses of miltefosine (1.5 µM) could inversely affected the normal humoral immunity against toxoplasmosis. Therefore, a periodical screening for accidental <em>Toxoplasma</em> infection during the course of therapy is strongly recommended.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Ashraf Mohammed Barakat, Amal eissa saafan, Samuel tanas Melek, Tahany sayed Behour, Nehal M Khairy, Ahmed samir Khairalla The efficacy of new 2,5-dihydroxybenzyl derivatives against Trypanosoma cruzi, Leishmania infantum and Leishmania braziliensis 2019-07-16T12:37:51-07:00 Miriam Rolón Alejandro Peixoto de Abreu Lima Cathia Coronel Maria Celeste Vega Enrique Pandolfi Antonieta Rojas de Arias <p>Introduction: Chagas disease and Leishmaniasis are among the most important parasitic diseases. They are considered to be within the most relevant group of neglected tropical diseases and have been included as priorities for searching new drugs due to their several treatment limitations. These parasitic diseases caused by flagellated protozoans affect more than 20 million people predominantly in developing countries.</p> <p>Methodology: In this study, we prepared a series of 2-substituted 1,4-benzenediols by an efficient, green, and lithium salt-free synthesis in water/ethanol as solvent to test their anti-parasitic activity. All 36 phenolic derivatives were evaluated <em>in vitro</em> for their activity against <em>T. cruzi</em> epimastigotes, <em>L. infantum</em>, and <em>L. braziliensis</em> promastigotes, as well as their cytotoxicity on macrophage and fibroblast cell lines.</p> <p>Results: Based on the results obtained, the compounds that presented a methyl, trifluoromethyl or bromo group at the para-position of the second benzene ring were found the most active analogs, with higher selective index values on the three parasites assayed.</p> <p>Conclusion: This evidence suggests that the anti-parasitic activity observed in these analogs is affected by the size of the group at the 4-position of the second ring, but not related with electronic factors.This study identified hit compounds with the potential to target several kinetoplastid parasites.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Enrique Miguel Pandolfi, Miriam Rolón, Alejandro Peixoto de Abreu Lima, Cathia Coronel, Celeste Vega, Antonieta Rojas de Arias A Extensively drug-resistant Pseudomonas putida bacteremia that was resolved spontaneously 2019-07-16T12:37:31-07:00 Hanife Usta Atmaca Feray Akbas <p><em>Pseudomonas putida (P. putida) </em>is a rare pathogen that causes various infections in newborns, neutropenic and cancer patients, or in patients with risk factors leading to immunosuppresion. Antibiotic resistance in <em>P. putida</em> is seen in growing numbers. Although it is less virulent compared to <em>Pseudomonas aeruginosa</em>, mortal infections are reported.</p> <p>Here, a <em>P. putida</em> case after an invasive procedure in a patient with gastrointestinal malignancy is reported. Although, it caused an antibiotic resistant bacteremia, it resolved spontaneously without any treatment.</p> <p><em> P. Putida </em>might have lower virulence and a different antibiotic susceptibility when compared to <em>Pseudomonas aeruginosa</em> in different cases. More clinical information is needed for further evaluation.</p> 2019-06-30T00:00:00-07:00 Copyright (c) 2019 hanife Usta-atmaca, Feray Akbas Retrospective multicenter study reveals absence of MRSA-associated bovine mastitis in Brazil (1994 to 2016) 2019-07-16T12:37:26-07:00 Juliana Aizawa Antonio F Souza-Filho Alessandro S Guimarães Carla GC Vasconcelos Maria Aparecida VP Brito Fábio P Sellera Adriana Cortez Marcos B Heinemann 2019-06-30T00:00:00-07:00 Copyright (c) 2019 Juliana de Abreu, Antonio Souza-Filho, Alessandro Sá Guimarães, Carla Gasparotto Chande Vasconcelos, Maria Aparecida Brito, Fábio Parra Sellera, Adriana Cortez, Marcos Bryan Heinemann