Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 10 5 2018 11 23 275 280 EN Vishnu Shenoy Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India Ajay Kumar Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India Kiran Chawla Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India 2017 06 28 2018 08 16 Background and Objectives: Despite high prevalence of MDR-TB in India very limited information about MDR-TB and mutation patterns in rpoB, inhA and katG genes among MDR-isolates of Mycobacterium tuberculosis in south coastal Karnataka region is available; thus present study is an attempt to explore the extent of MDR-TB and mutation patterns prevalent among clinical isolates in this region using GenoType MTBDR plus assay. Materials and Methods: A total of 256 sputum samples from Pulmonary TB patients suspected of MDR-TB were tested by GenoType MTBDR plus as per manufacturer’s guidelines for detection of mutations conferring resistance to rifampicin and isoniazid. The results of GenoType MTBDR plus were recorded and analysed using SPSS version 22. For all analyses, a p value <0.05 was considered statistically significant. Results: Fifty (19.53%) isolates were found MDR, 32 (12.50%) isolates were found mono-resistant to isoniazid and 15 (5.86%) isolates were found mono-resistant to rifampicin. Eleven isolates (4.3%) were found NTM. Mutation in codon S531L, S315T1 and C15T were most common in rpoB, katG and inhA genes respectively. Unknown mutations were found in 50.77% (33/65), 3.66% (3/82) and 26.83% (22/82) isolates for rpoB, katG and inhA genes respectively. Hetero-resistance in MDR, rifampicin monoresistant and isoniazid monoresistant isolates was found to be 26% (13/50), 20% (3/15) and 34.37% (11/32) respectively. Conclusion: Mutation in codon S531L, S315T1 and C15T were most common mutations associated with MDR-TB. Further high number of isolates showed mutations in unknown regions and hetero-resistance thus more elaborate studies based on sequencing are desirable in this region. https://ijm.tums.ac.ir/index.php/ijm/article/view/1409 https://ijm.tums.ac.ir/index.php/ijm/article/download/1409/1077

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 10 5 2018 11 23 281 286 EN Renuka Anegundi Department of Microbiology, Kasturba Medical College, Manipal, Karnataka, India Raghavendra Kulkarni Department of Microbiology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India Satish Patil Department of Microbiology, SS Institute of Medical Sciences and Research Centre, Davangere, Karnataka, India Vidyavathi Chitharagi Department of Microbiology, JSS Medical College, Mysore, Karnataka, India Ganavalli Ajantha Department of Microbiology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India 2016 11 07 2017 07 20 Background and Objectives: Neonatal septicemia can be rapidly fatal if not treated promptly. A speedy laboratory diagnosis would improve the outcome. The BacT/ALERT 3D system (bioMerieux, Durham, North Carolina) is currently being used for laboratory diagnosis of blood stream infections. In the present study, a modified protocol was employed in which the broth was subcultured into two nutrient broth tubes and these tubes were used for biochemical tests and antimicrobial susceptibility testing to decrease the turnaround time. Materials and Methods: A prospective study was conducted in the Department of Microbiology, SDM College of Medical Sciences and Hospital, Dharwad from October 2010 to July 2012 after receiving clearance from the institutional ethics committee. Automated blood cultures of 250 neonates admitted to the Neonatal Intensive Care Unit (NICU), clinically diagnosed to have septicemia, were performed using BacT/ALERT 3D. Bottles flagged positive within 72 hours of loading were processed for identification and antibiotic susceptibility testing using a modified protocol. The results were assessed for time saved in reporting in comparison with standard protocol. Student’s t test was used for statistical analysis. Results: Of the 250 cases studied, 117 cases yielded a positive blood culture giving a yield of 46.8%. The number of cases yielding monomicrobial growth were 73, which were included for further analysis. Of the remaining samples, 133 did not show growth, 11 were polymicrobial while 33 samples were flagged positive after 72 hours. Candida spp. grew in 34 cases, Gram negative bacilli grew in 28 cases and Gram positive cocci grew in 11 cases. In four cases, 66 hours were saved, 60 and 54 hours were saved in 18 cases each, 48 hours were saved in 27 cases, and 24 hours were saved in 6 cases. Methicillin resistant Staphylococcus aureus and Klebsiella pneumoniae were the most common isolates among Gram positive cocci and Gram negative bacilli, respectively, while C. guilliermondii was the most common Candida isolate. All Gram positive isolates were susceptible to vancomycin and linezolid. Most of the Gram negative isolates were susceptible to imipenem. Conclusion: This method can be employed in peripheral laboratory settings where there is no complete automation. Modification in processing blood culture can provide speedy identification and sensitivity report in blood stream infections. Time saved in reporting would play a crucial role in improving morbidity and mortality rates in neonatal septicemia. https://ijm.tums.ac.ir/index.php/ijm/article/view/1187 https://ijm.tums.ac.ir/index.php/ijm/article/download/1187/1078

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 10 5 2018 11 23 287 293 EN Elnaze Zare Mirzaei Infectious Diseases & Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran AND Department of Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran Mahdi Rajabnia Department of Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran Farzin Sadeghi Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Elaheh Ferdosi-Shahandashti Department of Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran Mahmoud Sadeghi-Haddad-Zavareh Infectious Diseases & Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran Soraya Khafri Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran Abolfazl Davoodabadi Infectious Diseases & Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran AND Department of Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran 2018 03 08 2018 09 14 Background and Objectives: Clostridium difficile is responsible for 15-25% of nosocomial antibiotic associated diarrhea (AAD) cases and all cases of pseudomembranous colitis. C. difficile has two major virulence factors, toxin A (enterotoxin) and toxin B (cytotoxin). The aim of this study was to determine the frequency of C. difficile strains in patients with diarrhea in Babol' hospitals with toxigenic culture and PCR assay. Materials and Methods: One hundred stool specimens were taken from diarrheal patients in hospitals of the city of Babol. All patients had a history of antibiotic use. The samples were cultured on CCFA medium. In the next stage, toxigenic culture was performed for isolated C. difficile strains. Then, PCR assay was used to identify gdh, tcdA and tcdB genes among isolated C. difficile strains. Results: From the 100 stool samples, eight (8%) samples were positive in C. difficile culture. In toxigenic culture, two (2%) of these strains had cytopathic effects on Vero cells. All eight strains had the gdh gene. This gene is specific for C. difficile. Two strains that had cytopathic effects on toxigenic culture were positive for toxin genes. Conclusion: The frequency of toxigenic strains in different parts of the world is variable, and needs to be continually investigated. In the present study, the PCR method had a good correlation with toxigenic culture. Thus, it can replace the laborious and costly cell culture method. https://ijm.tums.ac.ir/index.php/ijm/article/view/1672 https://ijm.tums.ac.ir/index.php/ijm/article/download/1672/1068

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 10 5 2018 11 23 294 299 EN Reza Ranjbar Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Mehrdad Ardashiri Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Sakineh Samadi Department of Microbiology, Islamic Azad University, Damghan Branch, Damghan, Iran Davoud Afshar Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran 2017 12 06 2018 10 07 Background and Objectives: Extended-spectrum β-lactamases (ESBLs) and fluoroquinolones are generally used to treat invasive Salmonella infections, but emergence of antibiotic-resistant strains are increasing worldwide. This study was aimed to investigate the distribution of ESBLs among Salmonella serogroups isolated from pediatric patients in Tehran, Iran. Materials and Methods: The study included all Salmonella isolates recovered from pediatric patients admitted to Children’s Medical Center, Tehran, Iran during 2015-2016. Bacterial isolation and identification were performed by standard biochemical and agglutination tests. Antimicrobial susceptibility testing was done according to the Clinical and Laboratory Standards Institute (CLSI). Polymerase chain reaction was used to identify the genetic determinants responsible for ESBL phenotypes. Results: A total of 138 S. enterica serovars were isolated from stool specimens, including serogroup A (1), serogroup B (18), serogroup C (41) and serogroup D (78). Forty isolates out of 138 Salmonella strains had shown ESBL-positive phenotype. All ESBL-positive isolates showed multiple resistant phenotype. Resistance to more than 3 antimicrobial agents was observed among ESBL-positive strains. The frequency of Salmonella strains carrying the blaCTX, blaTEM and blaSHV genes was 17 (12.3%), 40 (29.9%) and 4 (2.89%) respectively. Conclusion: The high rates of ESBLs positive-Salmonella strains recovered from pediatric patients is alarming and indicates a necessity to substitute the cephalosporins with a proper alternative. https://ijm.tums.ac.ir/index.php/ijm/article/view/1571 https://ijm.tums.ac.ir/index.php/ijm/article/download/1571/1069

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 10 5 2018 11 23 300 306 EN Mohadeseh Zarei-Yazdeli Department of Microbiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Gilda Eslami Department of Parasitology and Mycology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Hengameh Zandi Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Masoumeh Kiani Department of Microbiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Kazem Barzegar English Language Department at Medical School of Shahid Sadoughi University of Medical Sciences, Yazd, Iran Hanieh Alipanah Department of Biology, Borujerd Branch, Islamic Azad University, Borujerd, Iran Seyed Morteza Mousavi Department of Microbiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Marzieh Shukohifar Department of Biostatistics and Epidemiology, Faculty of Paramedicine Abarkouh, Genetic and Environmental Adventures Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2018 05 18 2018 08 16 Background and Objectives: Antibiotic resistance in Pseudomonas aeruginosa is an increasing health problem. Integrons are associated with a variety of gene cassettes, which confer resistance to multiple classes of antibiotics. This study aimed at screening the presence of class 1, 2 and 3 integrons in P. aeruginosa in Yazd, Iran. Materials and Methods: This study was carried out on P. aeruginosa strains from March 2016 to March 2017. Clinical specimens were initially identified by the standard biochemical methods and their resistance patterns to antibiotics were studied using the disc diffusion method. PCR was carried out for the detection of class 1, 2 and 3 integrons using intI1, intI2 and intI3 gene primers, respectively. Results: Antimicrobial susceptibility test showed that 75% of isolates were detected as multi-drug resistant (MDR), and lowest resistance was observed in ciprofloxacin (48.6%) and most resistance was in gentamicin (63.2%). Moreover, PCR results showed that 22 (15.3%) and 119 (82.6%) of P. aeruginosa isolates carried intI2 and intI1 genes, but intI3 gene was not found. Conclusion: Since it is customary to observe Class I integrons in P. aeruginosa isolated from clinical samples, they are often responsible for antibiotic resistance gene transfer, which calls for evaluation of integrons as contributing factors in antibiotic resistance. https://ijm.tums.ac.ir/index.php/ijm/article/view/1752 https://ijm.tums.ac.ir/index.php/ijm/article/download/1752/1070

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 10 5 2018 11 23 307 313 EN Siamak Heidarzadeh Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Department of Microbiology and Virology, Zanjan University of Medical Sciences, Zanjan, Iran Mohammad Mehdi Soltan Dallal Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Pourmand Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Reihaneh Pirjani Department of Obstetrics& Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran Abbas Rahimi Foroushani Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Matina Noori Department of Obstetrics& Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran tle> 121 126 Mojtaba Mohammadzadeh-Vazifeh Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran Seyed Masoud Hosseini Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran Ali Mohammadi Department of Microbiology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran Mahdi Jahanfar Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran Hadi Maleki Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran 2020 01 11 2020 03 23 Background and Objectives: In recent years, active packaging has been introduced as a new method to better preserve food. Chitosan and nanoclay have been used for preparation of an active nanocomposite with respect to their antimicrobial properties to investigate its effects on the microbial limitation in Gouda cheese. Materials and Methods: Nanoclay film, chitosan film, chitosan-based nanocomposites and nanoclay-based nanocomposites were prepared and their antimicrobial properties were evaluated to the microbial limitations of Gouda cheese consist of coliforms, Escherichia coli, Salmonella spp., coagulase-positive Staphylococcus, mold and yeast by agar diffusion method. Results: The results indicated, the best antimicrobial effect belonged to nanocomposite film with the composition of chitosan 3 wt% by adding nanoclay 1 wt%, which can prevent microbial characteristics of Gouda cheese. Conclusion: The chitosan and nanoclay nanocomposite had excellent antibacterial activity and performed well against microbial limitations (coliforms, E. coli, Salmonella spp., coagulase-positive Staphylococcus, mold and yeast) of Gouda cheese. Therefore, the nanocomposite may be possibly used as a surface coating in addition to Gouda cheese as well as similar cheeses and other food to enhance microbial characteristics and extend shelf life. https://ijm.tums.ac.ir/index.php/ijm/article/view/2446 https://ijm.tums.ac.ir/index.php/ijm/article/download/2446/1231

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 12 2 2020 04 01 127 137 Rina Pratiwi Department of Mathematics and Natural Sciences, Faculty of Post Graduated, Universitas Indraprasta PGRI, South Jakarta, Indonesia Iman Hidayat Department of Microbiology, Research Center for Biology, Indonesian Institute of Sciences (LIPI), Cibinong, Indonesia Muhammad Hanafi Research Center for Chemistry, Indonesian Institute of Sciences (LIPI), PUSPIPTEK, Serpong, Indonesia Wibowo Mangunwardoyo Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, Indonesia 2019 04 26 2020 03 02 Background and Objectives: Endophytic actinomycetes have been known as a promising source for new antibiotics discovery against susceptible and resistant forms of pathogenic microorganisms. This study was aimed at determining antibacterial compound from Streptomyces sp. strain B-92 isolated from a medicinal plant Neesia altissima. Materials and Methods: Streptomyces sp. strain UICC B-92 was endophytic actinomycetes of N. altissima that obtained from Universitas Indonesia Culture Collection (UICC). Isolation and determination of bioactive compound were carried out using thin layer chromatography (TLC), nuclear magnetic resonance spectroscopy (NMR), and liquid chromatography mass spectrometry (LC-MS) analyses. An in vitro antibacterial assay of pure bioactive compound from the endophytic actinomycetes strain was performed against Bacillus cereus strain ATCC 10876, Escherichia coli strain ATCC 25922, Salmonella typhimurium strain ATCC 25241, Shigella flexneri strain ATCC 12022 and Staphylococcus aureus strain ATCC 25923. Results: The bioactive compound was identified as 4-((3S,4R,5S)-3,4,5-trihydroxy-6-(hydroxymethyl) tetrahydro-2H-pyran-2-yloxy) phenazine-1-carboxylic acid. In vitro antimicrobial assay showed that bioactive compound of Streptomyces sp. strain UICC B-92 exhibited antagonistic activities against two Gram-positive bacteria, viz, B. cereus strain ATCC 10876 and S. aureus strain ATCC 25923. Conclusion: The findings of this research showed that, bioactive compound of Streptomyces sp. strain UICC B-92 is suggested a new compound based on glycoside structure and its position. https://ijm.tums.ac.ir/index.php/ijm/article/view/2107 https://ijm.tums.ac.ir/index.php/ijm/article/download/2107/1232

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 12 2 2020 04 01 138 147 EN Satish Parte Department of Zoology, M. J. S. College, Shrigonda, Ahmednagar, India Ashok Mohekar Department of Zoology, Maharshi Dnyandeo Mohekar Mahavidyalaya, Kallamb, Osmanabad, India Arun Kharat Laboratory of Applied Microbiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India 2019 11 26 2020 03 03 Background and Objectives: Excess use of pesticides in agricultural field not only compromised soil fertility but also posed serious threat to water bodies and life in the surrounding environment. The leftover pesticide residue needs to be remediated effectively. Compared to physical, chemical and enzymatic remediation options the microbial remediation is more practical and sustainable. Materials and Methods: The Pseudomonas stutzeri smk strain was found to use dichlorvos as the solitary carbon source. Minimal medium supplemented with dichlorvos was used to test ability of bacterium to degrade pesticide aerobically. The metabolites produced by the bacterium were studied with UV-Vis spectrophotometry, HPLC, FTIR and GC-MS techniques. The toxicity studies of neat dichlorvos and P. stutzeri smk degraded metabolites were studied by subcutaneous injection in Mus musculus. Results: The P. stutzeri smk strain was found to degrade as high as 80% of dichlorvos on 7th day of incubation, at 30 °C temperature and at pH 7. In five steps complete aerobic degradation of 2,2dicholorvinyl dimethyl phosphate (dichlorvos) resulted in production of free methyl and phosphate. The degradation intermediates produced are 2-Chlorovinyl dimethyl phosphate, vinyl dimethyl phosphate, dimethyl phosphate, methylphosphate and finally free phosphate. The histopathological analysis of liver, spleen and thymus of M. musculus were performed to study toxicity of dichlorvos and degraded metabolites. Conclusion: P. stutzeri smk could result highest aerobic degradation of dichlorvos to produce free methyl and phosphate. Degradation metabolites could reverse largely toxic effects of dichlorvos when studied in M. musculus. https://ijm.tums.ac.ir/index.php/ijm/article/view/2407 https://ijm.tums.ac.ir/index.php/ijm/article/download/2407/1233

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 12 2 2020 04 01 148 155 Andreas Yulianto Department of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia Widya Lokapirnasari Department of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia Rifqi Najwan Department of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia Hana Pramuda Wardhani Department of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia Nabil Noor Rahman Department of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia Khoirul Huda Department of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia Nuria Ulfah Department of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia 2019 05 29 2019 05 31 Background and Objectives: Use of antibiotics as growth promoters in animal feeds has been restricted due to the residues in poultry products such as egg and meat, furthermore to the antibiotic resistant of pathogenic bacteria. The prohibition of their use opens the opportunity for the use of non-antibiotic feed additives such as probiotics. The objectives of this study were to investigate the effect of the addition of Lactobacillus casei WB 315 and crude fish oil (CFO) to diets on growth performance, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), low density lipoproteins (LDL), high density lipoprotein (HDL), and cholesterol levesl of broiler chickens. Materials and Methods: In this research, one-day old male broiler chicks were used and divided equally into four groups, namely a basal diet without L. casei WB 315 and without CFO (P0), basal diet supplemented with 0.5% L. casei WB 315 of total broiler basal feed (1.2 × 109 cfu/ml) and without CFO (P1), basal diet supplemented without L. casei WB 315 and 1% CFO of total broiler basal feed (P2), and basal diet supplemented with 0.5% L. casei WB 315 of total broiler basal feed (1.2 × 109 cfu/ml) and 1% CFO of total broiler basal feed (P3) for 35 days. Results: The results of addition 0.5% Lactobacillus casei WB 315 (1.2 × 109 cfu/ml) and 1% CFO of total broiler basal feed after 35 days showed significant difference among treatment in feed efficiency (p<0.05), feed conversion ratio (p<0.05), feed consumption (p<0.05), EPA (p<0.05), DHA (p<0.05), increase HDL (p<0.05), reduced the LDL (p<0.05), and reduce cholesterol (p<0.05) in meat broiler chicken. Conclusion: It is concluded that the addition of L. casei WB 315 and crude fish oil (CFO) could significant improve the growth performance (feed efficiency, feed conversion ratio, feed consumption) and could significantly improve EPA, DHA and increase HDL and decrease LDL in meat poultry product. https://ijm.tums.ac.ir/index.php/ijm/article/view/2182 https://ijm.tums.ac.ir/index.php/ijm/article/download/2182/1234

Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 12 2 2020 04 01 156 163 Elham Zayedi Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Manoochehr Makvandi Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AND Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Ali Teimoori Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AND Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Ali Reza Samarbaf-Zadeh Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AND Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Shokouh Ghafari Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AND Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Seyed Saeed Seyedian Alimentary Tract Research Center, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Azarakhsh Azaran Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AND Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2019 10 08 2020 03 15