Zulqarnain Baloch

Enterotoxigenicity and Antimicrobial Resistance of Staphylococcus aureus Isolated from Retail Food in China

Staphylococcus aureus is one of the most common causes of zoonotic agent in the world, which are attributable to the contamination of food with enterotoxins. In this study, a total of 1,150 S. aureus isolates were cultured from 27,000 retail foods items from 203 cities of 24 provinces in China in 2015 and were test for antimicrobial susceptibility. Additionally, the role of the genes responsible for the staphylococcal enterotoxins (SEA to SEE), methicillin resistance (mecA) and the toxigenic capabilities were also assessed. The results showed that 4.3% retail foods were contaminated with S. aureus, and 7.9% retail foods isolates were mecA positive. Some 97.6% of S. aureus isolates were resistant to at least one antimicrobial compound, and 57.5% of these were multi drug resistant (MDR). Resistance to penicillin (83.7%, 963/1,150), was common, followed by linezolid (67.7%, 778/1,150) and erythromycin (52.1%, 599/1,150). The isolates cultured from raw meats showed high levels of resistant to tetracycline (42.8%), ciprofloxacin (17.4%), and chloramphenicol (12.0%) and expressed a MDR phenotype (62.4%). A total of 29.7% S. aureus isolates harbored the classical SEs genes (sea, seb, sec, and sed). The sea and seb genes were the most frequent SEs genes detected. Of note, 22% of the SEs genes positive S. aureus harbored two or three SEs genes, and 16 isolates were confirmed with the capacity to simultaneously produce two or three enterotoxin types. Moreover, nearly 50% of the MRSA isolates were positive for at least one SE gene in this study. Therefore, it is important to monitor the antimicrobial susceptibility and enterotoxigenicity of MDR S. aureus and MRSA in the food chain and to use these data to develop food safety measures, designed to reduce the contamination and transmission of this bacterium.

Alcohol Consumption and Gastric Cancer Risk: A Meta-Analysis

Background We sought to determine by meta-analysis the relationship between drinking alcohol and the risk of gastric cancer. Material/Methods A systematic Medline search was performed to identify all published reports of drinking alcohol and the associated risk of gastric cancer. Initially we retrieved 2,494 studies, but after applying inclusion and exclusion criteria, only ten studies were found to be eligible for our meta-analysis. Results Our meta-analysis showed that alcohol consumption elevated the risk of gastric cancer with an odds ratio (OR) of 1.39 (95% CI 1.20–1.61). Additionally, subgroup analysis showed that only a nested case-control report from Sweden did not support this observation. Subgroup analysis of moderate drinking and heavy drinking also confirmed that drinking alcohol increased the risk of gastric cancer. Publication bias analysis (Begg’s and Egger’s tests) showed p values were more than 0.05, suggesting that the 10 articles included in our analysis did not have a publication bias. Conclusions The results from this meta-analysis support the hypothesis that alcohol consumption can increase the risk of gastric cancer; suggesting that effective moderation of alcohol drinking may reduce the risk of gastric cancer.

Knowledge and Awareness of Cervical Cancer, Human Papillomavirus (HPV), and HPV Vaccine Among HPV-Infected Chinese Women

Background It is important to understand the knowledge that various groups of a population have about cervical cancer and human papillomavirus (HPV) and their attitudes toward HPV vaccination, as it will ultimately influence their decision-making for or against the acceptability of vaccines and other preventive methods. This study was designed to determine the level of knowledge and awareness about cervical cancer, HPV, and the HPV vaccine among Chinese women in Yunnan province. Material/Methods A survey was conducted in Yunnan province by the Laboratory of Molecular Virology in collaboration with the Yunnan First People’s Hospital in Feb 2015. A total of 388 women were recruited and asked to participate in a questionnaire-based interview that collected information related to their awareness and knowledge about: (1) cervical cancer, (2) HPV and HPV vaccine and willingness to have their children receive vaccination, and (3) demographic characteristics. Results A total of 388 HPV-positive women were included; 300/388 (73.3%) were Han, and 88/388 (22.7%) were other ethnicities. Overall, 204/388 (52.6%) of the women were aware of cervical cancer, with a significant difference between Han women and women of other ethnic groups (168/388, 56.0% and 36/88, 40.9%; P=0.015). Overall, 26.5% of the women were aware of the role of HPV in cervical cancer; 29.0% of the Han women and 18.2% of women of other ethnic groups were aware of this role of HPV (P=0.05). The knowledge that HPV infection leads to cervical cancer was higher among Han women (29.0%) compared to women of other ethnicities (18.2%). Knowledge about the HPV vaccine was very low in all ethnic groups, but the Han women were more willing to allow their children to be vaccinated before they become sexually active. A similar difference has also been found in women from various regions. Conclusions Although level of awareness and knowledge about cervical cancer was moderate, knowledge and awareness of HPV and the HPV vaccine was very low. Targeted communication is very important among populations in which knowledge gaps exist in order to promote dialogue about the vaccine among patients and their healthcare providers.

The association of triglycerides and total cholesterol concentrations with newly diagnosed diabetes in adults in China

Background It has already been suggested that high abnormal blood lipid concentration is associated with hyperglycaemia. However, no data is available about the roles of triglycerides (TG) and total cholesterol (TC) levels in diabetes. Here, for the first time we investigated the roles of TG and TC levels, gender and abdominal fat in the development of newly diagnosed diabetes in China. Materials and Methods Two population-based cross-sectional surveys were conducted from 2006 to 2009 in Qingdao, China. Newly diagnosed diabetes was defined according to FPG and/or 2 h PG criteria. The associations between diabetes and TG, and TC levels were assessed by multi-variable logistic regression models. Results As compared with non-diabetes, the odds ratio[(95% confidence intervals), OR(95% CI)] for diabetes corresponding to hypertriglyceridemia (HTG) were 1.54 (1.01, 2.35) in men and 2.02 (1.49, 3.10) in women for TG and accompany with Hypercholesterolemia (HTC) 2.93 (1.97, 4.37) and 2.13 (1.49, 3.05) for TC, when both were fitted simultaneously in the model adjusting for age, geographic division, marital status, school years, family history of diabetes, monthly income, systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), high density lipoprotein cholesterol (HDL-C), alanine amino transferase (ALT) and gamma-glutamyltransferase (GGT). Conclusions HTG in both gender, borderline high TC and HTC in men were an independent risk factor for diabetes in this Chinese population, however, HTC was mediated through abdominal fat for diabetes in women. Our findings may help to enhance the current knowledge of diabetes patho-physiology, and the associations between TG, TC level and diabetes is also clinically informative.

Prevalence and risk factors for human papillomavirus infection among Chinese ethnic women in southern of Yunnan, China

BACKGROUND Dai is a major Chinese ethnic minority group residing in rural areas of the southern part of Yunnan. However, no data exist on the Human Papillomavirus (HPV) prevalence and genotype distribution among Dai women. METHOD A total of 793 participants (Dai=324, Han=251, other ethnic=218) were included in this study. PCR was performed to detect the HPV-positive samples, and genotyping was performed with an HPV Geno-Array. RESULT The overall HPV prevalence was very low among Dai women compared to the others. The prevalence of high-risk-HPV infections was significantly higher (p=0.001) among other ethnic women (22.0%) than that among Han (13.1%) and Dai women (7.1%). The overall HPV, high-risk-HPV, single and multiple infection prevalence among rural women were 12.9%, 12.1%, 12.3%, and 0.5%, respectively. HPV-16 (5.5%) was shown to be the most prevalent genotype, followed by HPV-52 (2.6%) and HPV-58 (2.4%). Urban women had relatively higher rates of overall HPV (16.0%), high-risk-HPV (14.1%), single genotype (11.9%), and multiple genotype (4.1%) infections. In urban women, HPV-52 (3.6%) was the most prevalent genotype, followed by HPV-39 (2.7%) and HPV-16 (1.2%). In the urban area, HPV prevalence was highest in women aged <29 years, but declined with increasing age. However, in rural women, the highest HPV prevalence was observed among women at older age (>50 years). Education and smoking habit were significantly associated with HPV infection among both rural and urban area women (p<0.001). CONCLUSION The prevalence and genotype distribution of HPV varied among ethnic women in urban and rural area of Yunnan Province.

The distribution of human papillomavirus genotypes in cervical cancer and intraepithelial neoplasia lesions among Chinese women in Yunnan Province

This study was designed to explore baseline data about the prevalence and distribution of human papillomavirus (HPV) genotypes among Chinese women who had cervical intraepithelial lesions and cervical cancer. A total of 511 patients were recruited, and biopsy samples were collected from these patients. Polymerase chain reaction was used to detect HPV-positive samples, and the HPV GenoArray kit was used for genotyping. A total of 23 genotypes were detected, including 13 that were high risk-HPV (HR-HPV), 3 that were potential high risk-HPV (PHR-HPV) and 7 that were low risk-HPV (LR-HPV). The prevalence rates of HPV infection in Han women diagnosed with cervical intraepithelial lesions (CIN) 1, 2, and 3 and squamous cell carcinoma (SCC) were 98.30%, 97.56, 100% and 90%, respectively. The HPV-positive cases in women of other ethnicities diagnosed with CIN1, CIN2, and CIN3 and SCC were 95%, 90.91%, 88.23% and 83.33%, respectively. The most frequent genotypes in both ethnic groups were HPV-16, 52, and 58. LR-HPV was detected in SCC lesions in the non-Han ethnic group. In the Han ethnic group, the LR-HPV genotype was mostly restricted to CIN1 lesions. Furthermore, we found a high prevalence of PHR-HPV-81 in SCC lesions among Han women. Ethnic background, smoking, sex at an early age, unprotected sex, use of contraceptives, and the withdrawal method were found to be significantly associated with HPV infection. In conclusion, this study explores epidemiological data regarding the prevalence of HPV and the genotype distribution in patients with SCC and CIN lesions in Yunnan Province, China.

Effect of dietary intervention treatment on children with iron deficiency anemia in China: a meta-analysis

BackgroundPrevious studies have shown beneficial effects of dietary approaches for iron deficiency anemia (IDA) control. This study was design to investigate the effect of dietary intervention treatment on children with iron deficiency anemia.MethodsWe performed a systematic review of published dietary interventions effect on IDA treatment through meta-analysis. CBM, CNKI, Wanfang database, EMBASE, VIP, PubMed and Web of science database were searched to identify studies published between January, 1980 and December, 2016. Statistical analysis was performed by Revmen5.2 software.ResultsInitially we retrieved for 373 studies, and then 6 studies with a total of 676 individuals were included in the analysis according to the inclusion and exclusion criteria for meta-analysis. The overall pooled estimate of odds ratio [(OR), 95% confidence intervals (95% CI)] in the dietary intervention on children with iron deficiency anemia was 6.54 (95% CI: 3.48-12.31, Z = 5.82, p<0.001) and funnel plot is symmetric.ConclusionsOur meta-analysis suggested that dietary interventions are effective in improving the iron deficiency in children with iron deficiency anemia (IDA) and should be considered in the overall strategy of IDA management.

Starch-based antimicrobial films functionalized by pomegranate peel

In this work, pomegranate peel (PGP) as an antimicrobial agent as well as a reinforcing agent was utilized in developing starch-based films. Hydroxypropyl high-amylose starch plasticized by water and glycerol was used in this work. The microstructure and performance of films were investigated using scanning electron microscope (SEM), optical microscope (OM), X-ray diffraction (XRD), dynamic mechanical analyzer, tensile testing, drop impact testing and disc diffusion test. Results clearly demonstrated that PGP inhibited the growth of both gram-positive (S. aureus) and gram-negative (Salmonella) bacteria. Meanwhile, PGP also increased Youngs modulus, tensile strength and stiffness of the starch-based films. Both OM and SEM observations indicated reasonably good compatibility between starch and PGP particles. The XRD results indicated that PGP retained its semi-crystalline structure in the film, which can be used to explain the mechanism of mechanical reinforcement. Since all the components are food ingredients, so it is expected that the developed material can be used as an edible film and food grade packaging material.

Prevalence and characterization of Staphylococcus aureus cultured from raw milk taken from dairy cows with mastitis in Beijing, China

The colonization of dairy herds and subsequent contamination of raw milk by Staphylococcus aureus (S. aureus), especially those expressing a multi-drug resistance (MDR), biofilm and toxins producing ability, remains an important issue for both the dairy producer and public health. In this study, we investigated the prevalence, antimicrobial resistance, virulence, and genetic diversity of S. aureus in raw milk taken from 2 dairy farms in Beijing, China. Ninety (46.2%, 90/195) samples were positive for S. aureus. Resistant to penicillin (PEN) (31.3%), ciprofloxacin (18.8%) and enrofloxacin (15.6%) were the most often observed. Isolates cultured from farm B showed significantly higher resistance to penicillin (73.9%), ciprofloxacin (34.8%), enrofloxacin (34.8%), tilmicosin (17.4%), and erythromycin (17.4%) than those from farm A (p < 0.05). Totally, 94.8% S. aureus harbored at least one virulence gene and the pvl (93.8%), sec (65.6%), and sea (60.4%) genes were the most frequently detected. The pvl and sec genes were more often detected in isolates from farm A (97.3% and 84.9% respectively) than those from farm B (p < 0.05). Of all 77 staphylococcus enterotoxin (SE)-positive isolates, more than 90% could produce enterotoxins and 70.1% could produce two types. Biofilm related genes (icaA/D, clf/B, can, and fnbA) were detected in all96 isolates. All 96 isolates could produce biofilm with 8.3, 70.8, and 18.8% of the isolates demonstrating weak, moderate and strong biofilm formation, respectively. A total of 5 STs, 7 spa types (1 novel spa type t17182), 3agr types (no agrII), and 14 SmaI-pulso-types were found in this study. PFGE cluster II-CC1-ST1-t127-agr III was the most prevalent clone (56.3%). Isolates of agr III (PFGE Cluster I/II-CC1-ST1-t127/2279) had higher detection of virulence genes than those of agr I and agr IV. TheMSSA-ST398-t1456-agr I clone expressed the greatest MDRbut with no virulence genes and weakly biofilm formation. Our finding indicated a relatively high prevalence of S. aureus with less antimicrobial resistance but often positive for enterotoxigenicity and biofilm formation. This study could help identify predominant clones and provide surveillance measures to eliminate and decrease the contamination of S. aureus in raw milk of dairy cows with mastitis.

Complete Genomic Analysis of a Salmonella enterica Serovar Typhimurium Isolate Cultured From Ready-to-Eat Pork in China Carrying One Large Plasmid Containing mcr-1

One mcr-1-carrying ST34-type Salmonella Typhimurium WW012 was cultured from 3,200 ready-to-eat (RTE) pork samples in 2014 in China. Broth dilution method was applied to obtain the antimicrobial susceptibility of Salmonella Typhimurium WW012. Broth matting assays were carried out to detect transferability of this phenotype and whole-genome sequencing was performed to analyze its genomic characteristic. Thirty out of 3,200 RTE samples were positive for Salmonella and the three most frequent serotypes were identified as S. Derby (n = 8), S. Typhimurium (n = 6), and S. Enteritidis (n = 6). One S. Typhimurium isolate (S. Typhimurium WW012) cultured from RTE prepared pork was found to contain the mcr-1 gene. S. Typhimurium WW012 expressed a level of high resistance to seven different antimicrobial compounds in addition to colistin (MIC = 8 mg/L). A single plasmid, pWW012 (151,609-bp) was identified and found to be of an IncHI2/HI2A type that encoded a mcr-1 gene along with six additional antimicrobial resistance genes. Plasmid pWW012 contained an IS30-mcr-1-orf-orf-IS30 composite transposon that can be successfully transferred to Escherichia coli J53. When assessed further, the latter demonstrated considerable similarity to three plasmids pHYEC7-mcr-1, pSCC4, and pHNSHP45-2, respectively. Furthermore, plasmid pWW012 also contained a multidrug resistance (MDR) genetic structure IS26-aadA2-cmlA2-aadA1-IS406-sul3-IS26-dfrA12-aadA2-IS26, which showed high similarity to two plasmids, pHNLDF400 and pHNSHP45-2, respectively. Moreover, genes mapping to the chromosome (4,991,167-bp) were found to carry 28 mutations, related to two component regulatory systems (pmrAB, phoPQ) leading to modifications of lipid A component of the lipopolysaccharide structure. Additionally, one mutation (D87N) in the quinolone resistance determining region (QRDR) gene of gyrA was identified in this mcr-1 harboring S. Typhimurium. In addition, various virulence factors and heavy metal resistance-encoding genes were also identified on the genome of S. Typhimurium WW012. This is the first report of the complete nucleotide sequence of mcr-1-carrying MDR S. Typhimurium strain from RTE pork in China.