Publications by authors named "Zahra Jafarpour"

8 Publications

  • Page 1 of 1

Interleukin-27 gene variant rs153109 is associated with enhanced cytokine serum levels and susceptibility to Behçet's disease in the Iranian population.

Eur Cytokine Netw 2020 Dec;31(4):140-146

Autoimmune Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran.

Behcet's disease (BD) is a systemic vasculitis, characterized by recurrent oral aphthous, genital ulcers, ocular lesions, and other organ involvement. Interleukin (IL)-27 with its pro- and anti-inflammatory effects might be an important effective cytokine in this disease. The aim of this study was to investigate the association of IL-27 serum concentration and a single-nucleotide polymorphism (SNP) rs153109 (-964 A > G) with the risk and clinical features of the patients with BD. IL-27 Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and the IL-27 serum levels were measured using enzyme-linked immunosorbent assay (ELISA). It is shown that AG, GG, and AG + GG genotypes, as well as G allele of rs153109, can significantly increase the risk of BD in total and in male individuals. Significantly higher frequencies of AG and GG genotypes and G allele were observed in total and male patients with an active form of BD. AG and GG genotypes were associated with joint (p = 0.046) and vascular (p = 0.02) involvement. The frequency of the G allele was higher in all patients, as well as in female patients with vascular involvement (p = 0.02). Serum cytokine analysis indicated an increased level of IL-27 in BD patients compared to healthy subjects (p = 0.038). Additionally, a higher level of IL-27 was detected in patients carrying the rs153109 GG genotype (p = 0.04) and those with renal (p = 0.009) and skin (p = 0.05) involvement. In conclusion, this study underscores the involvement of IL-27 rs153109 variants and increased serum level in BD susceptibility and pathogenesis.
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http://dx.doi.org/10.1684/ecn.2020.0458DOI Listing
December 2020

Bacterial infections in the early period after liver transplantation in adults: A prospective single-center cohort study.

Microbiol Immunol 2020 Jun 18;64(6):407-415. Epub 2020 May 18.

Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran.

Liver transplantation (LT) is a potentially curative treatment for terminal stage hepatic diseases. Bacterial infections are the main causes of mortality and morbidity in the early period after LT. Identifying the risk factors could help in minimizing their development. We prospectively investigated the incidence, characteristics, and risk factors of bacterial infections among the recipients during hospitalization after LT and assigned a predictive score. All 389 consecutive adults who underwent LT at the main referral hospital of LT in Iran during 1 year were enrolled prospectively in a cohort study. Infection group consisted of 143 recipients (36.8%). Urinary tract and surgical site infections were the most frequent ones. Gram-negative bacteria were more prevalent than Gram-positive ones. Independent risk factors were female sex (relative risks = 2.13), age ≤ 43.5 years (3.70), hospital stay ≥ 9.5 days (5.22), abdominal reoperation (3.03), vancomycin-resistant Enterococci colonization (5.52), hospitalization 3 months prior to LT (3.25), mechanical ventilation ≥48 hr (4.93), and renal replacement therapies (13.40). We developed a risk score for the prediction of bacterial infections with an area under the receiver operating characteristic curve of 0.85 (95% CI, 0.81-0.89) with sensitivity of 88% and specificity of 64%. In the infection group, mortality was higher than in controls (18.9% vs. 2.0%) with longer hospitalization (16 vs. 10 days; P < 0.001). We detected a high rate of bacterial infections leading to longer hospital stay and higher mortality rate. The formulated risk score can help predict bacterial infections; however, it requires clinical validation in further studies.
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http://dx.doi.org/10.1111/1348-0421.12785DOI Listing
June 2020

Bacterial infections in pediatric patients during early post liver transplant period: A prospective study in Iran.

Transpl Infect Dis 2019 Feb 2;21(1):e13001. Epub 2018 Oct 2.

Shiraz Organ Transplant Center, Abu-Ali Sina Hospital, Shiraz, Iran.

Background: Bacterial infection in early period after liver transplant (LT) is the main cause of morbidity and mortality; however, data on children is limited.

Methods: To investigate the frequency, characteristics, and the associated factors of bacterial infection during hospitalization after LT, we prospectively enrolled all consecutive children with LT for a one-year, case-control study at the unique referral center of pediatric LT in Iran.

Results: Eighty-five events of bacterial infection were detected among 51 out of 94 LT recipients (54.3%) (infection group). Forty-three patients without bacterial infection constituted the control group. The frequency of bacterial infection based on the 51 microbiologically documented events was 31.9% (30 out of 94 patients). Major site of bacterial isolation were abdomen (43.6%). The following variables were associated with bacterial infection in univariate analysis: younger age (5.6 vs 8.9 years old), longer duration of JP Drain (13.4 vs 6.3 days), central venous catheter (14.6 vs 7.6 days), and Foley catheter insertion (7.3 vs 4.5 days), reoperation (57% vs 12% of patients), mean frequency of reoperation (1.1 vs 0.1 times), and intensive care unit stay (12.1 vs 6.5 days). In multivariate analysis, only longer hospital stay after transplant (23.6 vs 10.9 days) was independently associated with bacterial infection. All ten deaths occurred within the infection group and half of which directly caused by infection.

Conclusions: These infections were associated with longer hospital stay and higher mortality rate. Conducting further studies with larger sample size and investigating more effective prophylactic measures should be considered in future studies.
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http://dx.doi.org/10.1111/tid.13001DOI Listing
February 2019

A 25-year surveillance of disseminated Bacillus Calmette-Guérin disease treatment in children in Southern Iran.

Medicine (Baltimore) 2017 Dec;96(52):e9035

Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Disseminated Bacillus Calmette-Guérin (BCG) disease is one of the most serious complications of BCG vaccination, mainly among immunocompromised children with high morbidity and mortality.Currently, there is no any consensus with regard to the standard regimen of antituberculosis (anti-TB) agents and duration of treatment in healthy or immunocompromised host in children. The aim of this study is to investigate the effect of various combination treatment strategies for disseminated BCG disease in children.In this cross-sectional study, the outcome of 3 different combination protocols was investigated in 59 patients.All patients were younger than 6 years old. Both possible immunocompetent and proven immunodeficient children were included in a period of 25 years (1991-2014) in a Nemazee referral teaching hospital.The minimum age was 1 month and the maximum was 60 months. The average age of patients was 8 months (8.26 ± 9.73). Out of 59 cases, 32 (54.2%) were female and 27 (45.8%) were male. Based on the primary work up, 52.5% of cases were classified as definite immunodeficient and 47.5% were classified as possible immunocompetent. Overall mortality rate was 50.8%. Mortality rate of disseminated BCG disease in immunocompetent and immunodeficient children was 28.6% and 71%, respectively. The mortality rate was not statistically different between patients treated with different treatment protocols. These results were not affected by immune status and the type of immunodeficiency.More than 2 anti-TB drugs combination will not change outcome of patient with disseminated BCG disease.
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http://dx.doi.org/10.1097/MD.0000000000009035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6393028PMC
December 2017

Molecular Characterization of Isolates from Surface Resting Waters in Northwest Iran.

Iran J Parasitol 2017 Jul-Sep;12(3):355-363

Dept. of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: is an opportunistic amphizoic protozoan found in different fresh water sources. The aim of this study was to identify and characterize isolates from surface resting waters, in Northwest Iran.

Methods: Samples were collected from twenty-two different areas, between May and Sep 2014. After filtration, samples were cultivated on non-nutrient agar. The extracted DNAs were amplified and sequenced using partial 18S rRNA in order to genotype and phylogenetic analyses.

Results: Thirty-four (68%) out of 50 collected samples were positive for free-living amoebae based on both culture and morphological characterizations but 28 samples were identified as spp. by PCR. Sequentially, one isolate was identified as , (T5) (AN: KP940443, identity 99.7%-100%, and divergence 0.3%) whilst other sequenced isolates identified spp. (AN: KP940444-45) as very similar to and with identity 100% and divergence 0%.

Conclusion: Surface resting waters in Northwest Iran, were potentially contaminated with pathogenic amphizoic protozoan. Further studies will be required to determine other species and genotypes in the region.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623915PMC
October 2017

Urinary Tract Infections Among Hospitalized Adults in the Early Post-Liver Transplant Period: Prevalence, Risk Factors, Causative Agents, and Microbial Susceptibility.

Exp Clin Transplant 2017 Feb;15(Suppl 1):190-193

Alborzi Clinical Microbiology Research Center, Shiraz, Iran.

Objectives: Urinary tract infections are among the most common infections after liver transplant, especially soon after surgery. This study analyzed urinary tract infections or bacteriuria, their causative agents, and related risk factors in the early period after liver transplant in hospitalized adult transplant recipients in the main liver transplant referral center in Iran.

Materials And Methods: In this prospective study, 389 consecutive adult patients who underwent liver transplant at the Nemazee Teaching Hospital were enrolled between October 2014 and October 2015. Risk factors were compared for patients who developed urinary tract infections or bacteriuria ("infection group "; n = 63 [16.2% ]) and patients without evidence of infection ("control group "; n = 211 [54.2% ]). Patients with sites of infection other than the urinary tract were excluded. Antimicrobial sus ceptibility testing was performed using the Kirby-Bauer disk-diffusion method. Univariate and multivariate analyses compared variables between the 2 groups.

Results: Seventy-nine episodes of urinary tract infections or bacteriuria occurred in the infection group. Multiple logistic regression analysis showed that female sex, hospitalization 2 to 7 days before transplant, and frequency of abdominal exploration were 11.0, 5.9, and 3.0 times more common in the infection group than in the control group. The chance of infection rises 1.1 times with each one unit increase of body mass index. The most common infection causes were gram-negative bacteria (n = 50; 63.3%), predominantly Escherichia coli (n = 24; 30.4%); followed by gram-positive bacteria (n = 20; 25.3%), predominantly Enterococcus species (n = 14; 17.8%) that had a high incidence of vancomycin resistance (n = 10; 71.4%); and non-Candida albicans species isolates (n = 9; 11.4%).

Conclusions: Urinary tract infections are a common infection in hospitalized adult patients soon after liver transplant. Female sex, hospitalization shortly before transplant, more frequent abdominal exploration, and higher body mass index substantially increased the risk of developing such infections in this period.
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http://dx.doi.org/10.6002/ect.mesot2016.P68DOI Listing
February 2017

Effectiveness of Short-Course Meglumine Antimoniate (Glucantime®) for Treatment of Visceral Leishmaniasis: A 13-Year, Multistage, Non-Inferiority Study in Iran.

Am J Trop Med Hyg 2017 Jan 22;96(1):182-189. Epub 2016 Nov 22.

Professor Alborzi Clinical Microbiology Research Center, Department of Paediatrics, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

The World Health Organization's (WHO) recommendation is 28-day course of meglumine antimoniate (Glucantime, Sanofi Aventis, France) for the treatment of visceral leishmaniasis (VL). The aim of this study was to evaluate the effectiveness of a shorter duration of treatment in regions with low level of resistance to Glucantime. During 13 years, this study was conducted in three phases on 392 patients. In the pilot first phase, we performed splenic punctures in seven patients to assess the correlation between the changes in the parasite load during treatment with Glucantime and defervescence. With defervescence, parasite density was dramatically dropped (P = 0.014), propounding defervescence as a marker of parasitological response. On the basis of the results, we conducted a randomized trial on 75 patients, comparing the efficacy of continuation of Glucantime therapy for 1, 2, or 3 weeks after defervescence. The treatment course of 1 week after defervescence (mean = 11.7 days) was non-inferior to that of 3 weeks (final cure rate, 96% versus 100%; P = 0.023). The third phase was a retrospective cohort study of 302 patients treated either with the WHO's regimen or for 7 days after defervescence (intervention group). Relapse was detected in 8.3% patients of the intervention group and in 5% patients following the WHO's regimen (P = 0.006 for non-inferiority). The final duration of treatment in intervention group was significantly shorter than standard course (13.3 ± 2.6 versus 28 days; P < 0.001). In summary, treatment of VL with Glucantime for 1 week after defervescence was non-inferior to and appears to be an acceptable alternative to the standard 28-day course for patients in Iran who show a response to antimonial therapy.
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http://dx.doi.org/10.4269/ajtmh.16-0345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5239690PMC
January 2017

Autoantibodies in a Three-Year-Old Girl with Visceral Leishmaniasis: A Potential Diagnostic Pitfall.

Case Rep Infect Dis 2016 23;2016:2081616. Epub 2016 Jun 23.

Professor Alborzi Clinical Microbiology Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Visceral leishmaniasis (VL), a life-threatening parasitic infection, is endemic in the Mediterranean region. Diagnosis of VL is based on epidemiologic, clinical, and laboratory findings. However, sometimes, clinical features and laboratory findings overlap with those of autoimmune diseases. In some cases, autoantibodies are detected in patients with VL and this could be a potential diagnostic pitfall. In this study, we have reported on a three-year-old girl from a VL-endemic area in Iran, who presented with prolonged fever and splenomegaly. Bone marrow examination, serologic tests, and the molecular PCR assay were performed; however, results were inconclusive. The levels of anti-double stranded DNA, cytoplasmic antineutrophil cytoplasmic autoantibody, and perinuclear antineutrophil cytoplasmic autoantibody were elevated and, at the end, splenic biopsy was performed. The splenic tissue PCR test detected the DNA of Leishmania infantum. The patient's condition improved with anti-Leishmania therapy, and the autoantibodies disappeared within the following four months. Clinical presentations and laboratory findings of VL and autoimmune diseases may overlap in some patients.
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http://dx.doi.org/10.1155/2016/2081616DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935904PMC
July 2016