Background: Multidrug-resistant (MDR) Escherichia coli represent a serious public health risk, leading to higher rates of illness, death, and economic costs. The presence of antibiotics in livestock wastewater contributes to the development of resistance among commensal and environmental bacteria, which can diminish the effectiveness of these drugs in treating both humans and animals. Objectives: This research aimed to examine the patterns of antibiotic resistance and the prevalence of qnrS resistance genes. Methods: This cross-sectional study was conducted on 24 active dairy cattle farms in Hamedan, Iran, selected based on the presence of an accessible wastewater discharge point releasing into residential or agricultural areas. A total of 96 wastewater samples were collected from June to December 2023. Inclusion criteria for samples were a minimum volume of 1 liter, collection within the study period, and processing within 24 hours under refrigerated conditions. Eosin methylene blue agar was utilized to isolate E. coli from wastewater samples. The Kirby-Bauer diffusion susceptibility method was employed to assess the antimicrobial susceptibility and resistance patterns of the isolated E. coli strains. DNA amplification was conducted in polymerase chain reaction (PCR) on a thermos-cycler, for 35 cycles, using a master mix and specific primers for the qnrS gene. Results: Over 60% of 40 strains isolated from 96 wastewater samples were found to be resistant against nalidixic acid (NA), ceftazidime, trimethoprim-sulfamethoxazole (SXT), and piperacillin (PRL). The qnrS resistance gene was identified in 15% of the E. coli. Conclusions: The findings of this study reveal that the wastewater in Hamedan is tainted with antibiotic-resistant E. coli, which poses a significant risk to agricultural communities located downstream. This contamination not only threatens public health by fostering antibiotic resistance among microbial populations but also underscores the need for improved wastewater treatment to lower bacterial levels to safe standards before it is utilized in aquaculture and agriculture.

Context: From pregnancy to age two — the first 1,000 days — are pivotal for shaping the infant’s immune system and microbiome. Both are highly plastic, and their bidirectional crosstalk is crucial for lifelong health. Early absence or dysbiosis of the microbiome has significant health consequences. Evidence Acquisition: All manuscripts were collected from PubMed, Google Scholar, and other relevant databases published from 2021 through 2025. All searches were conducted using specific keywords, including “early-life microbiome”, “gut microbiome”, “oral microbiome”, “immunological development”, and “microbiota composition”. Results: Imbalanced oral bacteria raise risks for oral and systemic diseases since the mouth seeds gut microbiota. The oral-gut microbiome is bidirectional, shaping disease via migration, metabolites, and immune/inflammatory signals. Antibiotic overuse, maternal infection, environmental factors, and genetics reduce beneficial bifidobacteria and increase harmful bacteria, promoting resistance. Probiotics such as Bifidobacterium breve M-16V and B. longum BB536 may lessen eczema, boost immunity, and counter resistance, while improving oral and gut diversity and potentially lowering asthma, allergy, and obesity risk. Microbial ecosystem transplantation (MET) offers precise microbiota restoration, especially for Cesarean-born infants. Conclusions: The MET could tailor age-specific formulas for the first 1,000 days to support infants’ gut microbiota, promoting development and reducing dysbiosis. Custom MET products may yield lasting immune and metabolic benefits. However, safety, efficacy, and long-term effects of probiotics, FMT, and MET in infants require more research, despite their promise for early-life microbiota management and health.

Background: Pneumocystis jirovecii is an opportunistic fungal pathogen primarily affecting immunocompromised individuals, leading to Pneumocystis pneumonia (PCP). The increasing occurrence of PCP in intensive care units (ICUs) demands prompt diagnostic measures. Objectives: This study aims to molecularly identify P. jirovecii in bronchoalveolar lavage (BAL) samples from ICU patients in eastern Iran. Methods: This descriptive study was conducted from May 2023 to January 2024, involving 100 BAL samples from ICU patients at Waliasr Hospital, Birjand University of Medical Sciences. Demographic and clinical data were collected through a checklist. DNA was extracted using the Favorgen Biotech DNA Tissue Kit, and nested-polymerase chain reaction (PCR) targeting the 18S rRNA gene was performed to detect P. jirovecii. Sequencing was conducted using the Applied Biosystems Big Dye terminator cycle sequencing kit. Results: Among the 100 patients examined, 9 (9%) tested positive for P. jirovecii, predominantly in individuals aged 61 to 80 years (66.7%). The most common underlying conditions were hypertension (66.7%) and diabetes (33.3%). The primary hospitalization reasons for positive cases included sepsis and neurological conditions. Genotyping revealed that the majority of positive samples belonged to genotype III. Conclusions: The findings underscore the high prevalence of P. jirovecii in critically ill patients, particularly among older adults with comorbidities. The study highlights the importance of rapid molecular diagnostics in patients admitted to the ICU to improve management and outcomes. The identification of genotype III as the dominant strain necessitates ongoing surveillance to monitor treatment efficacy and resistance patterns.

Introduction: Post-streptococcal glomerulonephritis (PSGN) is a classic immune-mediated renal complication that typically arises 1 - 2 weeks after a streptococcal throat infection. While it is most commonly observed following pharyngitis or skin infections in children, its occurrence in association with deep neck infections, such as retropharyngeal abscess, is extremely rare. Case Presentation: We report a rare case of a 12-year-old boy with type 1 diabetes mellitus (DM1) who presented with edema and signs of acute glomerulonephritis (AGN) one week after symptoms of an upper respiratory tract infection. On examination, he had fever, dysphagia, cervical lymphadenopathy, and imaging confirmed a retropharyngeal abscess. Laboratory findings revealed microscopic hematuria, proteinuria, elevated antistreptolysin O (ASO) titers, low complement (C3) levels, and elevated inflammatory markers, supporting the diagnosis of PSGN. The patient was treated with broad-spectrum intravenous antibiotics and supportive therapy, resulting in complete resolution of the infection and normalization of renal findings within four weeks. Conclusions: This case highlights an unusual presentation of PSGN in association with a retropharyngeal abscess in an older child. Clinicians should maintain a high index of suspicion for post-infectious glomerulonephritis in children presenting with acute kidney injury and deep neck infections, even beyond the typical age range for retropharyngeal abscesses.

Background: Liver and kidney transplant recipients are vulnerable to various infections, particularly central nervous system (CNS) infections, due to immune system suppression. Timely diagnosis of these infections is crucial to reduce mortality rates. Objectives: The present study aimed to investigate the clinical, laboratory, and radiological manifestations of CNS infections in liver and kidney transplant patients admitted to three hospitals in Mashhad, Iran. Methods: A retrospective cross-sectional analysis was conducted using data from liver and kidney transplant patients during 2018 - 2022. Patients diagnosed with CNS infection through clinical examination, lumbar puncture, computed tomography (CT), or magnetic resonance imaging (MRI) were included. Results: Among the transplant recipients, 11 cases of CNS infection were identified (males: Sixty-three percent). Of the males, 36.4% received kidney transplants, 27.3% received liver transplants, and 18.2% experienced transplant rejection. Among the females, 36.4% received kidney transplants, and 18.2% had transplant rejection. Post-transplantation, 18% experienced early infection, while 82% developed late infection. The identified pathogens causing CNS infection included: Herpes simplex virus (18.18%), Aspergillus, Mycobacterium tuberculosis, Cytomegalovirus, Nocardia, toxoplasmosis, Epstein-Barr virus (9.09% for each), and unidentified (27.27%) of cases. The associations of prednisolone, tacrolimus, azathioprine, mycophenolate mofetil, cyclosporine, and sirolimus with infections were indicated. Conclusions: Infections pose a significant risk to transplant recipients, including CNS infections that can have severe clinical manifestations. Close monitoring is necessary for patients with specific risk factors, such as chronic pulmonary contamination, unresponsive fever, high-dose corticosteroid therapy, and frequent transplant rejection. Vigilance and careful examination for even minor neurological signs are vital due to the impact of immunosuppressive drugs on infection presentations.

Introduction: Autoimmune hepatitis (AIH) is classified based on the cause and degree of the disease. Environmental factors, such as pathogens and viruses, can cause this disease in genetically predisposed individuals. Case Presentation: The patient was a 48-year-old woman who developed cholestasis following COVID-19 and was diagnosed with AIH after a liver biopsy. The lab tests showed a rise in liver function enzymes, gamma protein, and IgG. Conclusions: It seems that the loss of immune tolerance against the patient's liver antigens is considered the main pathogenic mechanism.

Introduction: Hepatitis A is typically a benign disease; however, in rare instances, it can progress to a fulminant course. One uncommon complication of this disease is acute kidney injury (AKI), which requires clinicians’ awareness for timely diagnosis and treatment. Case Presentation: We describe a clinical case involving a 34-year-old man with severe hepatitis A, who had no comorbid conditions. His condition was complicated by acute hepatic encephalopathy of the first stage and AKI. Notably, there were no provoking factors contributing to the development of AKI. This case underscores the importance of recognizing and treating atypical manifestations of acute hepatitis A promptly. Conclusions: This clinical case highlights the significance of a differential diagnostic approach when AKI emerges as the leading clinical syndrome. It also indicates the need for increased awareness among relevant specialists regarding atypical presentations of acute hepatitis A.

Background: Acinetobacter baumannii is a major hospital drug-resistant pathogen. Biofilm-related genes (bap)-specific proteins influence biofilm formation in A. baumannii. Objectives: The present study examined the effect of the ethanolic extract, ethyl acetate, chloroform, and water fractions of Acroptilon repens as a novel approach with antimicrobial and antibiofilm properties against A. baumannii. Methods: This study used disk diffusion, well diffusion, and MIC-MBC determination to screen the antibacterial activity of A. repens against A. baumannii. The antibiofilm properties of A. repens extract and its fractions were evaluated using a microtiter plate assay. The expression of the bap genes in sub-MBC-treated and non-treated A. baumannii was assessed using real-time PCR. Results: The results indicated that the extract and fractions of A. repens exhibited significant antibacterial and antibiofilm properties. Among the fractions, the chloroform and water fractions showed the highest antibiofilm effect on A. baumannii compared to the ethanolic extract and ethyl acetate fraction (P < 0.0001). The expression of the bap gene decreased after treatment with sub-MBC fractions of A. repens (P < 0.0001). Conclusions: It can be concluded that A. repens extract and its fractions can be considered a new antibacterial and antibiofilm approach against A. baumannii.

Background: Recent measles outbreaks in Iran underscore the need to monitor vaccination coverage and measles-specific antibody levels. Objectives: This study aimed to evaluate anti-measles IgG seroprevalence and its association with demographic factors in children aged 2 - 6 years in Hormozgan province, southern Iran. Methods: In this cross-sectional study (2022 - 2023), 133 children visiting Bandar Abbas medical centers were enrolled. Serum IgG levels were measured via ELISA. Statistical analysis assessed associations between IgG positivity and variables such as age, gender, residence, and nutrition. Results: Overall, 94.7% of children tested positive for measles IgG. No significant associations were found between IgG positivity and gender (P = 0.072), age (P = 0.653), residence (P = 0.109), nutrition (P = 0.328), or household size (P = 0.390). Conclusions: A high measles IgG seroprevalence (94.7%) was observed, independent of demographic factors. However, regional variations in immunity across Iran warrant further investigation.