fa شیوع ژن های ویرولانس مقاوم به چند دارو در ایزوله های جدا شده از سودوموناس آئروژینوزا در نمونه های بالینی ایرانی: مروری- متا آنالیز ميکروبيولوژي Microbiology مروری Review <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><span lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" style="font-family:" zar="">&nbsp;</span></span></span></span></span></span></span></span><span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:97%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">عفونت سودوموناس شامل عفونت دستگاه ادراری (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%"><span style="letter-spacing:-.1pt">UTIs</span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">)، عفونت تنفسی، عفونت بافت نرم، درماتیت،</span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> باکتریمی، عفونت</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">های گوارشی، استخوانی و مفصلی و انواع سیستمیک عفونت</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">ها به ویژه در بیماران بستری شده در بیمارستان با سوختگی شدید، یا بیماران سرکوب شده سیستم ایمنی مبتلا به سرطان یا ایدز است</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">.</span></span><b> </b><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">با توجه به اهمیت ژن</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">های ویرولانس باکتری <i>سودوموناس آئروژینوزا</i> و هم</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">چنین مقاومت دارویی که می</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">تواند توسط این باکتری صورت گیرد، این مطالعه با هدف بررسی شیوع ژن</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">های ویرولانس مقاوم به چند دارو در ایزوله</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">های جدا شده از <i>سودوموناس آئروژینوزا</i> در نمونه</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">های بالینی ایرانی، انجام پذیرفت.</span></span><span lang="AR-SA" style="line-height:97%"><span style="font-family:"B Zar""></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:97%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">در این مطالعه مروری، با استفاده از پایگاه</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">های اطلاعاتی </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">Scopus, ISI, Web of sciene</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">Pubmed</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، کلید واژه</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">های مرتبط </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzM</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzH</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzII</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzI</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzS</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">plcH</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">plcN</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">algD </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">algU </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">pilB </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">pilA</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> مورد جستجو قرار گرفت. پس از محدود نمودن استراتژی جستجو و حذف موارد تکراری، مطالعات باقیمانده با بررسی عنوان و چکیده مورد غربالگری قرار گرفتند</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">.</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> در نهایت شاخص هتروژنیتی بین مطالعات با استفاده از آزمون کوکران (</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">Q</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">) و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">I2</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> تعیین گردید. بر اساس نتایج هتروژنیتی از مدل اثر تصادفی برای برآورد شیوع عفونت استفاده گردید.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:97%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">در 26 مطالعه وارد شده به متاآنالیز، </span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">فراوانــی ژن</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">های </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzM</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzH </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzII</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzI</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzS</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">plcH</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">plcN </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">algD</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">algU</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">pilB </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span> <span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">pilA</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> و براساس مدل اثر تصادفی </span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">ترتیب 39/6، 38/5، 57، 53/1، 41، 77/8، 58/3، 61/6، 74، 25/5 و 25/5درصد بوده است.</span></span><span lang="AR-SA" style="line-height:97%"><span style="font-family:"B Zar""></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:97%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">در</span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">مجموع، نتایج</span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">مطالعه</span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">حاضر نشان</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">دهنده</span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">حضور انواع</span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">ژن</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">های کدکننده</span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">فاکتورهای ویرولانس</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzM </span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzH</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzII</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzI</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">phzS</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">plcH</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">plcN</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">algD</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">algU </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">pilB </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span> <span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">pilA</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> در</span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">سویه</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">های بالینی</span></span> <i><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">سودوموناس آئروژینوزا </span></span></i><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">بوده است. به</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">طور کلی انواع مختلفی از ژن</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">های ویرولانس این باکتری نشان</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">دهنده این است که این ژن</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">ها با شدت بیماری</span></span><span lang="AR-BH" style="line-height:97%"><span b="" style="font-family:" zar="">&lrm;</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">زایی ارتباط دارند.</span></span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:11pt"><span style="line-height:107%"><span calibri="" style="font-family:">&nbsp;</span></span></span><span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%">Pseudomonas infections include urinary tract infections (UTIs), respiratory infections, soft tissue infections, dermatitis, bacteremia, gastrointestinal, bone and joint infections, and systemic types of infections, especially in hospitalized patients with severe burns, or patients with immunosuppression such as cancer or AIDS. Considering the importance of the virulence genes of <i>Pseudomonas aeruginosa</i> and the drug resistance that can be caused by this bacterium, the purpose of this study was to investigate the prevalence of multidrug-resistant virulence genes in isolates of <i>P. aeruginosa</i> in Iranian clinical samples.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:150%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%">Using Scopus, ISI, Web of science, Pubmed, and Web of science databases, the following were used as keywords:<i> phzM</i>, <i>phzH</i>, <i>phzII</i>, <i>phzI</i>, <i>phzS</i>, <i>plcH</i>, <i>plcN</i>, <i>algD</i>, <i>algU</i>, <i>pilB</i>, and <i>pilA</i>. After limiting the search strategy and removing duplicates, the remaining articles were screened by examining the titles and abstracts. Finally, the heterogeneity index between studies was determined using Cochran&#39;s test (Q) and I2. Based on this information, the fixed effect model was used to estimate the prevalence of <i>Pseudomonas</i> infection.</span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Results:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%">In 26 studies included in the meta-analysis, the frequencies of <i>phzM</i>, <i>phzH</i>, <i>phzII</i>, <i>phzI</i>, <i>phzS</i>, <i>plcH</i>, <i>plcN</i>, <i>algD</i>, <i>algU</i>, <i>pilB</i>, and <i>pilA</i> genes based on random effect model were 39.6%, 38.5%, 57%, 53.1%, 41%, 77.8%, 58.3%, 61.6%, 74%, 25.5%, and 25.5%, respectively.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span style="vertical-align:top"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Conclusion:</span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%">This study showed presence of genes encoding virulence factors (<i>phzM</i>, <i>phzH</i>, <i>phzII</i>, <i>phzI</i>, <i>phzS</i>, <i>plcH</i>, <i>plcN</i>, <i>algD</i>, <i>algU</i>, <i>pilB</i>, and <i>pilA</i>) in clinical strains of <i>P. aeruginosa</i>. In general, different types of virulence genes of this bacterium indicate that these genes are linked to severity of pathogenicity.</span></span><i><span style="font-size:10.0pt"><span style="line-height:150%"></span></span></i></span></span></span></span><br> &nbsp; ژن‎های ویرولانس, مقاومت دارویی, سودوموناس آئروژینوزا, نمونه‎های بالینی, متاآنالیز virulence genes, drug resistance, Pseudomonas aeruginosa, clinical samples, meta-analysis 176 188 http://jmums.mazums.ac.ir/browse.php?a_code=A-10-1466-145&slc_lang=fa&sid=1 Negin Mesgar Saravi نگین مسگر ساروی saravi_negin@yahoo.com 1003194753284600150207 1003194753284600150207 No دانشجوی کارشناسی ارشد ژنتیک، مرکز تحقیقات بیولوژی سلولی مولکولی، دانشگاه علوم پزشکی مازندران،‌ ساری، ایران Tahoora Mousavi طهورا موسوی stm.jmums@gmail.com 1003194753284600150208 1003194753284600150208 Yes Assistant Professor, Molecular and Cell Biology Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran استادیار، مرکز تحقیقات بیولوژی سلولی مولکولی، پژوهشکده هموگلوبینوپاتی، دانشگاه علوم پزشکی مازندران،‌ ساری، ایران