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Detection of toxigenic bacillus cereus strains in powdered infant formula (PIF) milk by PCR assay
Mohammad Mehdi Soltan Dallal, Shirin Nezamabadi, Jalal Mardaneh, Zahra Rajabi, Abolfazl Sirdani,
Volume 75, Issue 3 (June 2017)
Abstract

Background: In recent years, use of powdered infant formula (PIF) milk for neonates feed is increasing; therefore, the quality control (QC) of PIF products is very important. The aim of present study was detection of toxigenic Bacillus cereus species in PIF milk using PCR assay.

Methods: The cross-sectional study was carried out on 125 samples of powdered infant formula milk (PIF) purchased between March 2015 and April 2016 in Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Briefly, 0.1 dilutions were prepared and inoculated on Bacillus cereus selective media (MYP) and incubated at 30 °C for 24 hours. The suspicious colonies were verified using biochemical tests based on standard methods. Final confirmation of studied isolates was carried out by ITS gene detection using polymerase chain reaction (PCR) assay. Presence of nonhemolytic enterotoxin (NHE) (linked to diarrhoea syndrome) and emetic toxin (EM) (linked to emetic syndrome) virulence genes were investigated using polymerase chain reaction assay. 

Results: In this study, of 125 PIF samples, 84 (67.2%) were contaminated. Of various recovered bacteria from these samples, 110 bacterial isolates were suspected to be Bacillus spp. using phenotypic methods. The ITS PCR results showed that 91.8% of the isolates were B. cereus. Respectively, 53.63 and 79% of B. cereus isolates possessed NHE and EM virulence genes.

Conclusion: Our data revealed that near 80% of Bacillus cereus isolates have emetic toxin (EM) gene, as result virulence potency of this isolates is very high. However, the low number of this organisms in foods is very important and food safety protocols for these opportunistic toxigenic bacteria should be revised. Since the pasteurization process is ineffective on B. cereus spores; therefore, spores can remain in PIF milk and the vegetative bacterial cells can cause food poisoning in neonates. Therefore, modification of foods quality control protocols is essential in order to identify virulence genes in this bacterium.


Evaluation of diagnostic accuracy of RMI and ROMA indices in comparison to HE4 and CA125 parameters for estimating the risk of malignancy of adnexal masses.
Afsaneh Tehranian, Akram Ghahghaei-Nezamabadi, Nasim Yarmohammadi, Maryam Ganjeh, Khadije Maajaani, Reihaneh Aghajani,
Volume 79, Issue 3 (june 2021)
Abstract
Background: Ovarian cancer is the fifth leading cancer-related cause of death in women worldwide and is often diagnosed at advanced stages. Regarding the low sensitivity and specificity of the currently available diagnostic techniques, in the present study, we aimed to evaluate the accuracy of RMI and ROMA indexes and comparing these two indexes with CA-125 and HE4 parameters for the diagnosis and differentiation between benign and malignant ovarian tumors. Also, we determined the optimal cut-off level of these markers in patients who attended Arash Women’s Hospital.
Methods: In this cross-sectional study, we included 137 women with ovarian mass who were attended the gynecology clinic of Arash Women's Hospital, Tehran, Iran (April 2017-April 2019), and were eligible according to the inclusion criteria. We included patients with an adnexal mass over 3 cm. Our exclusion criteria were as the following: pregnancy, age under 18 and over 90 years, taking hormonal agents, renal failure, suspected ovarian torsion, ovarian cancer and taking antibiotics, nitric oxide compounds, and heavy metals. Based on serum CA125, HE4, and ultrasound findings, ROMA and RMI indexes were determined for each patient, and the sensitivity and specificity of HE4, RMI, ROMA, and CA125 were compared with the result of the operative histopathologic assessment.
Results: According to the area under the ROC curve, regardless of the patients' menopausal status, the highest diagnostic value was dedicated to RMI with 89% under the curve area and 95% confidence interval (81.6-96.4%). Diagnostic values of other markers were as the following: 87.7%(95%CI=80.3-95%) for HE4, 87.3(95%CI=79.1-95.4%) for CA125, and 86.2%(95%CI=78.7-93.6%) for ROMA. In terms of menopausal status, HE4 had the highest diagnostic value in premenopausal patients, while in the menopausal group CA125 had the highest diagnostic value.
Conclusion: Measurement of HE4 before menopause and CA125 during menopause seems to be helpful in the early detection of ovarian cancers in women with ovarian masses.

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