Asian Pacific Journal of Tropical Biomedicine

Issue 5,2016 Table of Contents

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  • 1  Antimalarial qinghaosu/artemisinin: The therapy worthy of a Nobel Prize
    Jerapan Krungkrai Sudaratana Rochanakij Krungkrai
    2016(5):371-375. DOI: 10.1016/j.apjtb.2016.03.010
    [Abstract](40) [HTML](0) [PDF 602.31 K](87)
    Malaria is a major cause of human morbidity and mortality in the tropical endemic countries worldwide. This is largely due to the emergence and spread of resistance to most antimalarial drugs currently available. Based on the World Health Organization recommendation, artemisinin-based combination therapies are now used as first-line treatment for Plasmodium falciparum malaria. Artemisinin or qinghaosu (Chinese name) and its derivatives are highly potent, rapidly acting antimalarial drugs. Artemisinin was discovered in 1971 by a Chinese medical scientist Youyou Tu, who was awarded the Nobel Prize in 2015 on her discovering the antimalarial properties of qinghaosu from the traditional Chinese qinghao plant. Nevertheless, artemisinin resistance in falciparum malaria patients has first emerged on the Thai-Cambodian border in 2009, which is now prevalent across mainland Southeast Asia from Vietnam to Myanmar. Here, we reviewed malaria disease severity, history of artemisinin discovery, chemical structure, mechanism of drug action, artemisinin-based combination therapies, emergence and spread of drug resistance, including the recent findings on mechanism of resistance in the falciparum malaria parasite. This poses a serious threat to global malaria control and prompts renewed efforts for the urgent development of new antimalarial drugs.
    2  Estimating risk factors of urban malaria in Blantyre, Malawi: A spatial regression analysis
    Lawrence N. Kazembe Don P. Mathanga
    2016(5):376-381. DOI: 10.1016/j.apjtb.2016.03.011
    [Abstract](29) [HTML](0) [PDF 1.02 M](80)
    Objective: To estimate risk factors of urban malaria in Blantyre, Malawi, with the goal of understanding the epidemiology and ecology of the disease, and informing malaria elimination policies for African urban cities that have markedly low prevalence of malaria. Methods: We used a case-control study design, with cases being children under the age of five years diagnosed with malaria, and matched controls obtained at hospital and communities. The data were obtained from Ndirande health facility catchment area. We then fitted a multivariate spatial logistic model of malaria risk. Covariate and risk factors in the model included child-specific, household and environmental risk factor (nearness to garden, standing water, river and swamps). The spatial component was assumed to follow a Gaussian process and model fitted using Bayesian inference. Results: Our findings showed that children who visited rural areas were 6 times more likely to have malaria than those who did not [odds ratio (OR) = 6.66, 95% confidence interval (CI): 4.79–9.61]. The risk of malaria increased with age of the child (OR = 1.01, 95% CI: 1.003–1.020), but reduced with high socio-economic status compared to lower status (OR = 0.39, 95% CI: 0.25–0.54 for the highest level and OR = 0.67, 95% CI: 0.47– 0.94 for the medium level). Although nearness to a garden, river and standing water showed increased risk, these effects were not significant. Furthermore, significant spatial clusters of risk emerged, which does suggest other factors do explain malaria risk variability apart from those established above. Conclusions: As malaria in urban areas is highly fuelled by rural-urban migration, emphasis should be to optimize information, education and communication prevention strategies, particularly targeting children from lower socio-economic position.
    3  Anisakiasis in Southeast Asia: A story of new tropical disease?
    Somsri Wiwanitkit Viroj Wiwanitkit
    2016(5):382-383. DOI: 10.1016/j.apjtb.2015.11.011
    [Abstract](32) [HTML](0) [PDF 266.27 K](88)
    Anisakiasis is an important worm infestation. It is seen in some non-tropical countries and becomes an important issue in coastal medicine. However, in the few recent years, there are some reports on occurrence of anisakiasis in tropical countries. In this specific short article, the authors review and present the situation of anisakiasis in Southeast Asia. It can be said that anisakiasis becomes a new focused interest in tropical coastal medicine at present.
    4  An update on microbiological causes of canine otitis externa in Campania Region,Italy
    Luisa De Martino Francesca Paola Nocera Karina Mallardo Sandra Nizza Eleonora Masturzo Filomena Fiorito Giuseppe Iovane Piergiorgio Catalanotti
    2016(5):384-389. DOI: 10.1016/j.apjtb.2015.11.012
    [Abstract](27) [HTML](0) [PDF 317.38 K](91)
    Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region (Italy) and the antibiotic susceptibility patterns of the isolated strains. Methods: A total of 122 dogs were examined by otoscopy, and auricular swab samples were collected from both ears in 74 dogs presenting clinical bilateral otitis and from single ears in 48 dogs displaying clinical unilateral otitis. Cytological examination, bacteriological analysis and antimicrobial susceptibility tests were performed. Results: Thirty-one out of 122 dogs were positive for yeast species (25.4%, 95% con- fidence interval (CI): 18.2%–34.2%) with a higher prevalence of Malassezia pachydermatis (21/31 isolates, 67.7%, CI: 48.5%–82.7%), and a total of 91 out of 122 dogs were positive for bacterial species (74.6%; CI: 65.8%–81.8%) with a higher prevalence of Staphylococcus pseudintermedius (45/143 isolates, 31.5%, CI: 24.1%–39.8%). These results are the first description of Streptococcus agalactiae-associated otitis. The yeasts isolated showed high levels of susceptibility to all antifungal agents tested; on the contrary all the isolated bacterial strains were highly resistant to at least four out of ten antimicrobial classes. Both Gram-positive and Gram-negative bacteria showed high resistance to amoxicillin/clavulanate and kanamycin hence they are not recommended as initial empirical therapy for the otitis treatment. Conclusions: This update illustrates an increase in antibiotic resistances providing an insight into the current knowledge of the therapeutic procedures followed on canine otitis externa in Italy. It also emphasizes the importance of considering the results of the microbiological and sensitivity tests to decide on an appropriate antibiotic therapy.
    5  Insecticide susceptibility in larval populations of the West Nile vector Culex pipiens L. (Diptera: Culicidae) in Saudi Arabia
    Al Thabiani Aziz Jazem Abdullah Mahyoub Hasibur Rehman Shalini Saggu Kadarkarai Murugan Chellasamy Panneerselvam Majed Salum S. Alrefaei Marcello Nicoletti Hui Wei Angelo Canale Giovanni Benelli
    2016(5):390-395. DOI: 10.1016/j.apjtb.2015.12.017
    [Abstract](31) [HTML](0) [PDF 992.57 K](109)
    Objective: To investigate the susceptibility to some conventional and non-conventional insecticides in laboratory and field larval populations of the West Nile vector Culex pipiens L. (Cx. pipiens), the dominant species in Jeddah Province, Saudi Arabia. Methods: The tested conventional insecticides were Actikil and Pesgard, while the nonconventional ones were Bacilod, Dudim and Baycidal. Probit analysis and photomicroscopical observations were carried out to shed light on acute toxicity in laboratory and field Cx. pipiens strains. Results: Cx. pipiens were more susceptible to Pesgard (LC50: 0.045 and 0.032 mg/L) than Actikil (0.052 and 0.038 mg/L) and Bacilod (0.129 and 0.104 mg/L), for the field and laboratory strains, respectively. Results showed that treatments with the chitin synthesis inhibitor Dudim and Baycidal evoked morphological effects similar to those induced by other insect growth regulators. According to IC50 values obtained (concentration which to inhibit the emergence of 50% of mosquito adults), the compound Dudim (0.000 3 and 0.000 1 mg/L) was more effective against Cx. pipiens L. mosquitoes than Baycidal (0.000 4 and 0.000 3 mg/L) for both the field and laboratory strains, respectively. Conclusions: Our results provide baseline data to enhance control programs and orient public health decisions on the selection of pesticides against mosquito vectors in Saudi Arabia
    6  Agave sisalana extract induces cell death in Aedes aegypti hemocytes increasing nitric oxide production
    Louise Helena Guimar?es de Oliveira Patricia Alexandria Paiva Silva de Sousa Fabrine Felipe Hilario Gabriel Joventino Nascimento Jo?o Paulo Saraiva Morais Everaldo Paulo de Medeiros Manoel Francisco de Sousa Fabiola da Cruz Nunes
    2016(5):396-399. DOI: 10.1016/j.apjtb.2015.12.018
    [Abstract](32) [HTML](0) [PDF 452.34 K](80)
    Objective: To investigate the effects of Agave sisalana (A. sisalana) extract on Aedes aegypti (Ae. aegypti) primary cell culture. Methods: Cells of Ae. aegypti were exposed to different concentrations of A. sisalana crude extract (0.18–6.00 mg/mL) for 24 h. Then, the cells were labeled with propidium iodide and subjected to fluorescence microscopy to verify cell viability. In addition, nitric oxide production was measured. Results: Results showed that cells exposed to 6 mg/mL of the crude extract presented a greater percentage of death when compared to control (73.8% ± 9.6% vs. 34.6% ± 9.6%). Furthermore, there was an increase in the nitric oxide production in cells exposed to 6 mg/ mL of A. sisalana crude extract [(0.81 ± 0.08) μmol/L] compared to control group [(0.41 ± 0.18) μmol/L]. Conclusions: The results show that A. sisalana is cytotoxic to Ae. aegypti and may be used as raw material for new eco-friendly and inexpensive insecticides, since sisal industry discards the liquid waste for the extraction of plant fiber.
    7  Antibacterial activity of Bixa orellana L. (achiote) against Streptococcus mutans and Streptococcus sanguinis
    Dyanne Medina-Flores Gabriela Ulloa-Urizar Rosella Camere-Colarossi Stefany Caballero-García Frank Mayta-Tovalino Juana del Valle-Mendoza
    2016(5):400-403. DOI: 10.1016/j.apjtb.2016.03.005
    [Abstract](25) [HTML](0) [PDF 308.34 K](81)
    Objective: To evaluate the cytotoxic and antibacterial effect of Bixa orellana L. (B. orellana) (achiote) methanol extract against Streptococcus mutans (ATCC 25175) (S. mutans) and Streptococcus sanguinis (ATCC 10556) (S. sanguinis). Methods: Two methanol extracts of B. orellana were prepared in vitro, from the seeds and leaves. The antibacterial activity of extracts against S. mutans and S. sanguinis was evaluated using the cup-plate agar diffusion method. The minimum inhibitory concentration (MIC) was determined using the microdilution method and the cytotoxic activity was determinated by using the cell line MDCK. Results: A stronger antibacterial effect was observed with the leaves methanolic extract with an inhibition zone of (19.97 ± 1.31) mm against S. mutans and (19.97 ± 1.26) mm against S. sanguinis. The methanolic extract of the seeds had an activity of (15.11 ± 1.03) mm and (16.15 ± 2.15) mm against S. mutans and S. sanguinis, respectively. The MIC of the leaf and the seed extracts against S. sanguinis was 62.5 and 125 μg/mL, respectively, and the MIC of the leaf extract against S. mutans was 62.5 μg/mL, and for the seed extract it was 31.25 μg/mL. The 50% cytotoxic concentration was 366.45 and 325.05 μg/mL for the leaves and seeds extracts, respectively. Conclusions: The experimental findings demonstrated the antibacterial effect of the methanolic extract of B. orellana (achiote) on S. mutans and S. sanguinis. The extract of this plant is cytotoxic at high concentrations.
    8  Phenolics-saponins rich fraction of defatted kenaf seed meal exhibits cytotoxicity towards cancer cell lines
    Latifah Saiful Yazan Napsiah Abd Rahman Kim Wei Chan Wan Nor Hafiza Wan Abd Ghani Yin Sim Tor Jhi Biau Foo
    2016(5):404-409. DOI: 10.1016/j.apjtb.2016.03.007
    [Abstract](8) [HTML](0) [PDF 2.29 M](76)
    Objectives: To determine the cytotoxicity of crude ethanolic extract, n-butanol fraction and aqueous fraction on selected cancer cell lines, and to observe the morphological changes of the cancer cells treated with n-butanol fraction. Methods: The cytotoxic effect of n-butanol fraction, crude ethanolic extract and aqueous fraction on breast cancer (MCF-7 and MDA-MB-231), colon cancer (HT29), lung cancer (A549), cervical cancer (HeLa) and normal mouse fibroblast (3T3) cell lines was determined using MTT assay. The morphological changes of the treated cells were observed under an inverted light microscope. Results: n-Butanol fraction was the most cytotoxic towards HT29 and MCF-7 cells in a dose-dependent manner compared to crude ethanolic extract and aqueous fraction (P < 0.05). The IC50 of n-butanol fraction for HT29 and MCF-7 was (780.00 ± 28.28) and (895.00 ± 7.07) μg/mL, respectively. Cell shrinkage, membrane blebbing and formation of apoptotic bodies were noted following treatment of HT29 cells with n-butanol fraction. Conclusions: In conclusion, n-butanol fraction was more cytotoxic than crude ethanolic extract and aqueous fraction towards the selected cancerous cell lines and induced apoptosis in HT29 cells.
    9  Comparative investigation of the free radical scavenging potential and anticancer property of Diospyros blancoi (Ebenaceae)
    Muhammad Ali Khan Md. Mahbubur Rahman Md. Nazmul Sardar Md. Saiful Islam Arman Md. Badrul Islam Md. Jahangir Alam Khandaka Mamunur Rashid Golam Sadik AHM Khurshid Alam
    2016(5):410-417. DOI: 10.1016/j.apjtb.2016.03.004
    [Abstract](29) [HTML](0) [PDF 895.50 K](85)
    Objective: To investigate the comparative effects of Diospyros blancoi (Ebenaceae) leaves (DBL), root bark (DBRB) and stem bark (DBSB) on free radicals and cancer. Methods: The polyphenol contents, antioxidant and free radical scavenging properties were determined using standard spectrophotometric methods. Cytotoxicity and anticancer activities were performed on brine shrimp nauplii and Ehrlich ascite carcinoma cells, respectively. Results: Among the extracts, DBSB showed the highest total antioxidant capacity and reducing capacity on ferrous ion. Based on 1,1-diphenyl-2-picrylhydrazyl and hydroxyl radical scavenging activities, DBSB showed (95.760 ± 0.343)% and (67.460 ± 2.641)% scavenging with IC50 of (3.10 ± 0.17) and (50.00 ± 3.11) μg/mL, respectively. The IC50 values of standard butylated hydroxytoluene and catechin (CA) for 1,1-diphenyl-2- picrylhydrazyl and hydroxyl radicals were (8.50 ± 0.25) and (75.00 ± 0.14) μg/mL, respectively suggesting that DBSB had a significant (P < 0.05) radical scavenging activity than standards. In lipid peroxidation inhibition assay, the inhibitory activity of the extracts and the standard was in the following order: DBSB > DBRB > CA > DBL. Also, the phenolic [(139.91 ± 3.924) mg gallic acid equivalent/g] and flavonoid contents [(412.00 ± 16.70) mg catechin equivalent/g)] of DBSB were higher than that of other extracts. In addition, the DBSB showed the moderate cytotoxic and anticancer properties. Conclusions: Our results indicate that Diospyros blancoi stembark had the significant highest antioxidant and free radical scavenging properties as well as moderate anticancer activity. Hence, we assume that the anticancer activity of this plant can be, at least in part, attributed to its content in phenolic compounds as well as its significant free radical scavenging properties.
    10  Antimicrobial properties of sea anemone Anthopleura nigrescens from Pacific coast of Costa Rica
    Henry Borbon Sandra Valdes Javier Alvarado-Mesen Roy Soto Ilena Vega
    2016(5):418-421. DOI: 10.1016/j.apjtb.2016.01.014
    [Abstract](29) [HTML](0) [PDF 313.07 K](81)
    Objective: To evaluate the antimicrobial and antifungal activities of the aqueous and partitioned extract of sea anemone Anthopleura nigrescens (A. nigrescens). Methods: The sea anemone A. nigrescens was collected, minced, homogenized, lyophilized and then further partitioned with diethyl ether, acetone, ethanol and water. These fractions were evaluated for antimicrobial activity against bacterial and fungal pathogens. Results: Acetone extract was found to produce a pronounced inhibition of 7.0 mm against Proteus vulgaris and diethyl ether extract inhibited Pseudomonas aeruginosa with an inhibition zone of 6.5 mm. In antifungal activity, ethanol extract showed good activity against Botrytis cinerea, Trichoderma harzianum and Rhizopus oryzae compared with other strains. Acetone and ethanol extract of A. nigrescens showed activity against all of pathogens tested. Slight activity was observed in the water extract with inhibition zone of 1.5 mm. Conclusions: The present study revealed that sea anemone A. nigrescens may also contain some biologically active agents which have potential activity against pathogenic microorganisms.
    11  Breastfeeding counsel against cancers
    Prameela Kannan Kutty
    2016(5):422-428. DOI: 10.1016/j.apjtb.2015.12.021
    [Abstract](28) [HTML](0) [PDF 487.40 K](83)
    The anticancer potential by breastfeeding is not fully tapped in the light of the present knowledge of the subject. Literature indicates that breastmilk has anticancer action but may underestimate its full capacity. The protective spectrum within breastmilk hints on the need for a more comprehensive understanding of it as an anticancer tool. Exclusive breastfeeding could confer protection from carcinogenesis with a greater impact than realised. A literature review was conducted using four electronic databases. Selected areas were extracted after thorough perusal of the articles. The uninitiated would take exclusive breastfeeding seriously if actively counselled as an anticancer tool. Advice on details of the breastfeeding process and holistic information on breastfeeding may endow a greater impact among the skeptics. Counselling the breastfeeding mother on information sometimes not imparted, such as on maternal nutrition, details of the process of breastfeeding, benefits of direct breastfeeding versus milk expression and her psychosocial well being may make a difference in optimising anticancer action that exists in breastmilk. Additionally, its anticancer potential provides a platform to universally improve physical and psychosocial well being of women who breastfeed. Statistics of protection by breastfeeding in some maternal and childhood cancers are evident. “Bio-geno-immunonutrition” of breastmilk may shield the mother and infant from carcinogenesis in more ways than appreciated. The molecular basis of mother-to-infant signals and their “energies” need to be researched. Breastfeeding as a modifiable behaviour provides cost effective nutrition with potential for both cancer immunoprophylaxis and immunotherapy.
    12  Multiple sclerosis: New insights and trends
    Khaled Mohamed Mohamed Koriem
    2016(5):429-440. DOI: 10.1016/j.apjtb.2016.03.009
    [Abstract](21) [HTML](0) [PDF 1.39 M](142)
    Multiple sclerosis (MS) is the most famous autoimmune disease attacking the central nervous system. It attacks people from age 20–50 years old and the females' attacks double than males' attacks. MS is an autoimmune disease affecting principally the central nervous system that cause nerve sheath demyelination followed by axon damage and paralysis. MS symptoms include muscle weakness, weak reflexes, muscle spasm, difficult in move, miss-coordination and unbalance with others. There are many factors may be responsible for MS: microbial, viral, smoking, stress, environmental toxins, contaminated diet, and gout. MS is wide spread in the populations in North Europe and this related to lack of vitamin D due to decrease of sunlight exposure. MS biomarkers include nitric oxide, interleukin-6, nitric oxide synthase, fetuin-A and osteopontin. MS is not a genetic disease where MS occurs when human leukocyte antigen system related genes are changed in chromosome 6. The physiology of MS is monitored by activation of immuneinflammatory, oxidative, and nitrosative stress pathways. MS is including two main steps: (1) myelin sheath destruction and formation of lesions and, (2) inflammation. Four types of MS can be distinguished: relapsing-remitting, primary progressive, secondary progressive and progressive relapsing. Nine treatments have been accepted for relapsingremitting MS type: interferon β-1a, interferon β-1b, mitoxantrone, natalizumab, glatiramer acetate, fingolimod, dimethyl fumarate, teriflunomide, and alemtuzumab, however, the only treatment used is mitoxantrone for progressive MS but many of MS treatments side effects are recorded. Complementary treatments also used in MS treatments such as: vitamin D, Yoga, medicinal plants, oxygen therapy, acupuncture and reflexology.
    13  Will there be a cure for HIV/AIDS? Making the dream a reality
    Alcides Troncoso
    2016(5):441-442. DOI: 10.1016/j.apjtb.2016.03.008
    [Abstract](20) [HTML](0) [PDF 255.97 K](81)
    It has been more than 30 years since AIDS was introduced in people's daily life, and it is a milestone that causes taboos, myths and prejudices. At that time, a patient told me his feelings, and he was very convincing: “I am horrified of living and afraid of dying.” Three decades later, AIDS infection is not a death sentence anymore. First, doctors could make that infected patients did not die from the disease; then, that the medication which kept them alive was not so toxic. And finally, that the treatments were more comfortable. And once at this point, the possibility that the virus may disappear from the body is a more realistic goal than ever. The story of AIDS has changed and, for the first time, we can foresee in the short term the beginning of the end of the pandemic. Now it is not about whether the cure is possible or not, but about when we will have it. This current momentum, so hard to get, should be maintained. We have never been so close to achieving this goal. Although the end of the pandemic is close, this is not enough. It is worrying that some world leaders have absolved themselves of responsibility for not stopping or at least having understood the explosion of the pandemic as if it was a natural disaster. “Zero tolerance for HIV” requires a profound understanding of the stigma and discrimination of the infected people to finally get rid of the epidemic of fear and the devastation that the pandemic caused.
    14  Primary oral and nasal transmissible venereal tumor in a mix-breed dog
    Mahdieh Rezaei Shahrzad Azizi Shima Shahheidaripour Sara Rostami
    2016(5):443-445. DOI: 10.1016/j.apjtb.2016.03.006
    [Abstract](31) [HTML](0) [PDF 709.03 K](114)
    Transmissible venereal tumor (TVT) is a coitally transmitted tumor of dogs with widespread distribution. The present study describes the occurrence of the primary oral and nasal TVT in a 10-year-old, female, mix-breed dog. The case was presented with a history of anorexia, inability to swallow and dyspnea. Clinical examinations revealed the emaciation, muzzle deformity due to the presence of a friable, fleshy, cauliflower-like mass in the oral cavity and submandibular lymphadenopathy. TVT was diagnosed based on histopathological findings. The dog was discharged with therapeutic intervention with vincristine. Unfortunately, the case died before readmission because of the progressive worsening of the general condition. Our findings highlight the need for considering TVT for the differential diagnosis of the extragenital masses in dogs.
    15  Susceptibility of Aedes flavopictus miyarai and Aedes galloisi mosquito species in Japan to dengue type 2 virus
    Raweewan Srisawat Thipruethai Phanitchat Narumon Komalamisra Naoki Tamori Lucky Runtuwene Kaori Noguchi Kyoko Hayashida Shinya Hidano Naganori Kamiyama Ikuo Takashima Tomohiko Takasaki Ichiro Kurae Narihiro Narita Takashi Kobayashi Yuki Eshita
    2016(5):446-450. DOI: 10.1016/j.apjtb.2016.03.003
    [Abstract](23) [HTML](0) [PDF 312.38 K](82)
    Objective: To evaluate the potential of local mosquitoes to act as vectors for dengue transmission in Japan. Methods: Serotype 2 ThNH28/93 was used to test the dengue susceptibility profiles of Aedes flavopictus miyarai (Ae. f. miyarai), Aedes galloisi (Ae. galloisi) and Aedes albopictus (Ae. albopictus), which were collected in Japan.We used Aedes aegyptifrom Thailand as a positive control. The mosquitoes were infected with the virus intrathoracically or orally. At 10 or 14 days post infection, the mosquitoes were dissected and total RNA was extracted from their abdomens, thoraxes, heads and legs. Mosquito susceptibility to dengue virus was evaluated using RT-PCR with dengue virus-specific primers. Differences in the infection and mortality rates of the different mosquito species were tested using Fisher's exact probability test. Results: The infection rates for dengue virus administered intrathoracically to Ae. f. miyarai, Ae. galloisi and Aedes aegypti mosquitoes were identical by RT-PCR on Day 10 post infection. All of the body parts we tested were RT-PCR-positive for dengue virus. For the orally administered virus, the infection rates in the different body parts of the Ae. f. miyarai mosquitoes were slightly higher than those of Ae. albopictus mosquitoes, but were similar to the control mosquitoes (P>0.05). Themortality rates for Ae.f. miyarai and Ae. Albopictus mosquitoes were similar (P = 0.19). Our data indicated that dengue virus was able to replicate and disseminate to secondary infection sites in all of the four mosquito species (Japanese and Thai). Conclusions: Ae. albopictus is a well-known candidate for dengue transmission in Japan. However, our data suggest that Ae. f. miyarai from Ishigaki Island (near Okinawa Island) and Ae. galloisi from Hokkaido (Northern Japan) should also be regarded as potential vectors for dengue transmission in these regions. Further studies on these mosquitoes should be conducted.
    16  Phylogeny and drug resistance of HIV PR gene among HIV patients receiving RT inhibitors in Iran
    Kazem Baesi Majedeh Moradbeigi Mehrdad Ravanshad Ashrafolnesa Baghban
    2016(5):451-454. DOI: 10.1016/j.apjtb.2015.12.020
    [Abstract](32) [HTML](0) [PDF 304.95 K](83)
    Objective: To survey the level and patterns of reverse transcriptase-based drug resistance and subtype distribution among antiretroviral-treated HIV-infected patients receiving only reverse transcriptase inhibitors in Iran. Methods: A total of 25 samples of antiretroviral therapy experienced patients with no history of using protease inhibitors were collected. After RNA extraction, reverse transcriptase-nested PCR was performed. The final products were sequenced and then analysed for drug-resistant mutations and subtypes. Results: No drug resistant mutations were observed among the 25 subjects. The results showed the following subtypes among patients: CRF 35_AD (88%), CRF 28_BF (8%), and CRF 29_BF (4%). Conclusions: A significant increase in drug resistance has been noted in recently-infected patients worldwide. Subtype distributions are needed to perform properly-designed surveillance studies to continuously monitor rates and patterns of transmitted drug resistance and subtypes to help guide therapeutic approaches and limit transmission of these variants.
    17  Emergence of non-albicans Candida species and antifungal resistance in intensive care unit patients
    Ravinder Kaur Megh Singh Dhakad Ritu Goyal Rakesh Kumar
    2016(5):455-460. DOI: 10.1016/j.apjtb.2015.12.019
    [Abstract](38) [HTML](0) [PDF 414.77 K](82)
    Objective: To evaluate the epidemiology of candidiasis and the antifungal susceptibility profile of Candida species isolated from the intensive care unit (ICU) patients. Methods: The study used a qualitative descriptive design. Relevant samples depending on organ system involvement from 100 ICU patients were collected and processed. Identification and speciation of the isolates was conducted by the biochemical tests. Antifungal susceptibility testing was carried out as per CLSI-M27-A3 document. Results: Ninety Candida isolates were isolated from the different clinical samples: urine (43.3%), tracheal aspirate (31.1%), urinary catheter (12.2%), endotracheal tube (7.8%), abdominal drains (3.3%), sputum (2.2%). The incidence of candidiasis caused by non-albicans Candida (NAC) species (63.3%) was higher than Candida albicans (36.7%). The various NAC species were isolated as: Candida tropicalis (41.1%), Candida glabrata (10%), Candida parapsilosis (6.7%), Candida krusei (3.3%) and Candida kefyr (2.2%). The overall isolation rate of Candida species from samples was 53.3%. Antifungal susceptibility indicated that 37.8% and 7.8% of the Candida isolates were resistant to fluconazole and amphotericin B, respectively. Conclusions: Predominance of NAC species in ICU patients along with the increasing resistance being recorded to fluconazole which has a major bearing on the morbidity and management of these patients and needs to be further worked upon.

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