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Abstract Background & aim: Infection with resistant microorganisms in intensive care units (ICUs) is more prevalent than other parts of the hospital. The aim of this study was to determine the relationship between the daily dose of the antibiotic resistance and patterns of microorganisms isolated from patients with nosocomial infections. Methods: This cross-sectional study was conducted in a period of 9 months in three wards of ICU, internal medicine, neurosurgery of Namazi Hospital of Shiraz. The World Health Organization definition was used for determining the daily Dose. The sensitivity test of microorganisms to antibiotics was determined by E-test. The collected data were analyzed with Pearson test. Results: The highest incidences of nosocomial infection were observed in intensive care medicine and surgery, respectively. The total amount of consumed antibiotics were seen in intensive care of surgery, internal medicine and neurosurgery were 100.29 DDD/100 bed days. Uses of cephalosporins, especially third generation cephalosporins show the highest amount. The resistance rate of gram-negative bacteria such as Acinetobacter, Pseudomonas and Enterobacter to ceftriaxone were100, 100 and 82.4% respectively. Conclusion: The results of study showed that there was a relationship between antibiotic consumption and resistance of microorganisms. Although other variables than the antibiotic consumption causing antibiotic resistance should not be ignored. Key words: Defined daily dose, Intensive care unit, Antibiotics, Antibiotic resistance, Nosocomial infection

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Abstract Background & aim: Infection with resistant microorganisms in intensive care units (ICUs) is more prevalent than other parts of the hospital. The aim of this study was to determine the relationship between the daily dose of the antibiotic resistance and patterns of microorganisms isolated from patients with nosocomial infections. Methods: This cross-sectional study was conducted in a period of 9 months in three wards of ICU, internal medicine, neurosurgery of Namazi Hospital of Shiraz. The World Health Organization definition was used for determining the daily Dose. The sensitivity test of microorganisms to antibiotics was determined by E-test. The collected data were analyzed with Pearson test. Results: The highest incidences of nosocomial infection were observed in intensive care medicine and surgery, respectively. The total amount of consumed antibiotics were seen in intensive care of surgery, internal medicine and neurosurgery were 100.29 DDD/100 bed days. Uses of cephalosporins, especially third generation cephalosporins show the highest amount. The resistance rate of gram-negative bacteria such as Acinetobacter, Pseudomonas and Enterobacter to ceftriaxone were100, 100 and 82.4% respectively. Conclusion: The results of study showed that there was a relationship between antibiotic consumption and resistance of microorganisms. Although other variables than the antibiotic consumption causing antibiotic resistance should not be ignored. Key words: Defined daily dose, Intensive care unit, Antibiotics, Antibiotic resistance, Nosocomial infection

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Abstract Background and aim: In recent decades, inappropriate antibiotic therapy has been led to the emergence of strains resistant to methicillin and vancomycin. Since the main source of infection and transmission of Staphylococcus aureus is by hospital staff, the aim of this study was to determine the antimicrobial susceptibility of S.aureus strains isolated from hospital staff of Jahrom. Undo edits Methods: In this cross - sectional study, 397 of the anterior nasal samples of medical personnel and hospital services were collected by swab. The identification of S.aureus was determined by biochemical tests and microbiology, and the antibiotic resistances of isolates were determined by disk diffusion method for 13 antibiotics. In this method, the inhibition zone for methicillin-resistant strains was ≤ 10 mm the minimum inhibitory concentrations (MIC) against antibiotic vancomycin, ticoplanin, linezolid and synercid were determined by E-test method. Results: In the present study, 11.3% of personals carried S. aureus in the nose. Among them, 90% were health care workers and 10% were health service workers. The most sensitivity was observed resistance to Ciprofloxacin, rifampin, linezolid and synercid (91.1%), but the lowest sensitivity was to penicillin (4.7%). of 9 MRSA strains, 1 strain was resistance to vancomycin and 2 strains were resistant to teicoplanin and linezolid. Conclusion: Because of S. aureus strains isolated from hospital staffs were resistant to most common antibiotics, identification and treatment of health care and health service workers can prevent nosocomial infections. Key words: Staphylococcu aureus carriers, hospital personnel, antibiotic resistance.

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Background & aim: Urinary tract infection (UTI) is one of the most common bacterial infections, which affected the majority of community. Escherichia coli as a most frequent causative agent of UTI have high resistant rate to antibiotic therapy. The aim of this study was to investigate the prevalence of antimicrobial resistance pattern of E. coli isolated from patients with UTI in Yasuj city. Methods: In the present descriptive study, over a 6 months period, 120 samples of E. coli were collected from patient with UTI and confirmed by biochemical tests. Susceptibility pattern of bacterial isolates against 11 antibiotics carried out by disc diffusion method. Data were analyzed by SPSS software version 16. Results: Among 120 isolated E. coli, the greatest resistance to cephalothin (100%) and the least resistance to imipenem (83/0%) were seen respectively. Susceptibility pattern to other antibiotics is as follow: amoxicillin-clavulanic acid (78.3%), cotrimoxazole (62.5%), tetracycline (55%), nalidixic acid (48.3%), ceftazidime (41.6%), ciprofloxacin (28.3%), gentamicin (20.8%), chloramphenicol (7.5%) and amikacin (5%). Conclusion: It is recommended to treat urinary tract infections by using fewer antibiotics such as Amoxicillin / Clavulanic acid and co-trimoxazole, and administration of ciprofloxacin and gentamicin should be used with caution.

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Background & aim: Urinary tract infection is the most common childhood infections after upper respiratory tract infection. Early diagnosis, proper treatment and appropriate patient follow-up can lead to a significant reduction in symptoms. The purpose of this study was to determine the antimicrobial resistance of urinary tract infection in children under 14 years admitted to the pediatric clinic of Imam Sajjad (AS) Yasooj. Methods: Methods: In this cross-sectional study antibiotic sensitivity of 145 positive urine cultures were evaluated by disc diffusion method. Urine specimens were collected by suprapubic aspiration and catheterization urethral in children without urinary incontinence and Mid Stream Clean-Catch method. Data were analyzed by chi square test. Results: Among the patients were studied, 60.68% female and 39.31% were male. The most common cause of urinary tract infections in children, Escherichia coli (72.41%), followed by Klebsiella (34/10.34%). Antibiotic resistance patterns including ampicillin (85.51%), amoxicillin (/83.44%), cephalexin (69.65%), cephalothin (62.06%), cotrimoxazole (37.61%), nalidixic acid (44.82%), cefixime (24.37%), nitrofurantoin (36.55%), gentamicin (35.17%), ceftriaxone (28.27%), ciprofloxacin (26.89%), amikacin (25.51%), and cefotaxime (24.82%) were respectively. Conclusion: Conclusion: Antibiotic resistance in urinary tract infections of children in Yasuj in 2012 was higher than previous years except for amikacin, But it was a remarkable increase in ciprofloxacin and co-trimoxazole. The use of nitrofurantoin, cefotaxime, third generation cephalosporins and aminoglycosides is recommended for empirical treatment.

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Background & aim: EnteroinvasiveEscherichia coliis one of the important agents of invasion to intestinal epithelial cells, damage and cell death which due to dysentery. The aim of this study wastoDetection of EnteroinvasiveEscherichia coli by PCR technique from Children’s Diarrheain yasuj. Methods:This cross-sectional study was performed on 200 stool samples taken from children with diarrhea in Yasuj. After initial identification of E.coli strains by culture and biochemical tests, EIEC gene such as ipaH detected by PCR technicque and antibiotic susceptibility of isolates was evaluated by using disc diffusion (CLSI) method. Results: Out of all examined samples, 16(8%) EIEC were separated. Antibiotic susceptibility test showed that the most susceptible antibiotic is ciprofloxacin for EIEC and also most resistant antibiotic is ceftizoxime. Conclusion: Results showed that EIEC strains have a moderate prevalence than other studies in our study area. Therefore, for importance of this strain to producing dysentery, hospital-wide surveillance using molecular techniques hase been proposed in other regions of country.

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Background & aim: Resistance to Extended Spectrum Beta-Lactamase (ESBL) is one of the most widespread enzymatic beta-lactamase in those bacteria which cause infections in hospitals. One major reason for this type of resistance seems to be the arbitrary and/or excessive use of antibiotics. At present, there is no resistance pattern for bacterial strains which cause infections in hospitals with ESBL mechanism in different regions of Iran, they spread differently in different seasons, and more and more cases of the resistance are being reported. Hence, the present study aimed to determine the antibiotic resistance patterns and bacterial strains and to investigate the presence of Beta-lactamase SHV, TEM , CTX-M genes in those Klebsiella strains which produce ESBL. The clinical samples of the study were collected from Yahyanejad Hospital in Babol. 

Methods: The present descriptive-analytical study was carried out in six-months in 2014, and  2075 clinical samples( of blood, urine, respiratory discharge, throat culture, wound culture, pleural fluid culture, CSF, Ascitic fluid culture, Synovial culture, and bone marrow smear) were gathered. 39 Klebsiella strains were identified among the hospitalized and out-patients of Yahyanejad Hospital using disk diffusion method and CLSI instructions. Antibiotic allergy tests were given for all the strains, and all the strains were separated using synergic double discs to check the presence of ESBL. In the next phase of the study, the extracted DNA were examined in terms of the presence of SHV, TEM , CTX-M by using specific primers and employing PCR method. The collected data were analyzed using, SPSS and K² tests.

Results: The frequencies of the identified strains were: isolated Klebsiella Pneumonia: 31(79.49%), isolated Klebsiella Oxytoca: 5(12.82%), and isolated Klebsiella Ozaenae: 3(7.69%). Among  the isolated Klebsiella stains  19(48.72%) were resistant to cefotaxime , 14(35.90%) to ceftazidime, 18(46.16%) to Amikacin, 13(33.34%) to Meropenem, 18(46.15%) to Ciprofloxacin, 26(66.67%) to Ceftriaxone, 12(30.77%) to Piperacillin Tazobactam, and 16(41.03%) to Ampicilin sulbactam. Also, among the 39 isolated Klebsiella Pneumonia, there were 10(25.64%) isolated positive ESBL,  all the 10(100%) isolated strains  having Beta-Lactamase SHV gene, there were 6(60%) isolated positive TEM gene and there were 4(40%) isolated positive CTX-M gene.

Conclusion: Considering the high rate of resistance to third generation cephalosporin, it is imperative to perform accurate antibiogram and avoid irrational prescription of antibiotics in treating infections due to organisms which produce ESBL. In addition, it is of vital importance to screen the clinical samples in terms of resistance to ESBL, and to prepare guidelines for physicians to help realize the disease and to treat the patients properly. Also , the extracted DNA were examined samples purified in identifying genes SHV ,TEM  ,CTX-M in Klebsiella Pneumonia is possible PCR method.

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Background & aim: Panton-Valentine leukocidin (PVL) is a Staphylococcus aureus gamma toxin. There may be a link between Meticillin-Resistant Staphylococcus aureus and Panton-Valentine leukocidin (PVL), as an important cytotoxin found particularly in severe infections. The purpose of this study was to isolate and identify Staphylococcus aureus virulence Panton-Valentine leukocidin (PVL) and methicillin resistance genes in clinical samples using PCR techniques.

Methods: In the present cross-sectional study, 89 isolates were collected from blood samples and detected as Staphylococcus aureus during the period of 6 months at Ali Ebne AbiTaleb Hospital, Zahedan, Iran. Initially, the case study examples were examined by biochemical tests. Then, based on recognized standards, Staphylococcus aureus isolates were isolated. Afterwards, isolates obtained were confirm by using 16srRNA gene. Subsequently, the antibiotic susceptibility of all isolates to methicillin was determined using Cefoxitin(30µg) disk diffusion and agar screening methods. Finally, the PCR method was used to determine PVL and mecA genes. All results were analyzed by the Chi-square test.

Results: Out of the total 89 isolates of Staphylococcus aureus blood isolates, 26 isolates from wounds and 63 were isolated. Most samples were obtained from female patients. According to the molecular analysis, 47 isolates (82/52%) were mecA gene and resistant to methicillin and 42 strains (47/2%) was methicillin-sensitive. Resistance to vancomycin wasn’t observed in isolates. Erythromycin and Penicillin had the highest prevalence of antibiotic resistance among isolates, respectively. Multi-resistant strains were the most PLV genes frequent. A significant relationship was observed between the resistance and the presence of Pantone Valentin (P≥0 / 05).

Conclusions: Due to the frequency of mecA and PLV genes in resistant and susceptible strains of Staphylococcus aureus, and also the distribution of Pantone Valentin gene in resistant strains; therefore, based on the statistical analysis, we can conclude that there may be a connection between these two factors (P≥0 / 05).

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Abstract

Background and Aim:With respect to the increasing of antibiotic resistance in pathogenic bacteria, identification of new antimicrobial compounds is necessary. Bacterial pigments as bioactive products are one of the agents for identifying new antimicrobial agents. Microorganisms have been considered for the production of new microbial products such as pigments.

Methods: In the present research, a total of 37 pigmented bacterial strains were obtained from soil samples of different regions of Fars province, Iran. These strains contained a wide variety of pigmentation including: red, yellow and green. Strains with different pigmentation were selected for further studies. Pigments were extracted by methanol-water or methanol for secreted and non-secreted pigments, respectively. In order to evaluate the antibacterial activity of pigments, disc diffusion and macrodilution assay were used on MDR Klesiella isolated from clinical samples. Finally, microorganism with anti-bacterial pigment was identified by molecular method. 

Results: Based on the morphology of isolated pigment colonies in different environments and carrying out biochemical tests, the presence of bacteria such as, Pseudomonas aeroginosa, Serratia marcescens, Enterobacter sakazakii, Flavobacter mizutaii, Micrococcus luteus and Staphylococcus aureus were identified. The total frequency of Klebsiella isolates was 8.5%. Of the 17 isolated isolates, 12 isolates were completely resistant to all antibiotics, and six isolates were sensitive to the imipenem antibiotic.

All of Klebsiella isolates were multi drug resistance. A Red pigment from Serratia marcessence was the most potent and showed inhibitory effects on MDR Klebsiella.

Conclusion: Isolated microorganisms from environmental resources contained a very diverse collection of pigments, where different pigment structures with different antimicrobial properties can be searched. The present study indicated that bacterial pigments can be effective against MDR Klebsiella isolates.

 

 

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Objective: Escherichia coli is one of the most important causes agents of urinary tract infection in human. Thus, identification of Escherichia coli resistance patterns seems to be necessary. traT gene has been reported variable in Escherichia coli strains isolated from urinary tract infection. Therefore, the aim of this study was to investigate the prevalence of uropathogenic Escherichia coli and detection of traT gene in isolated from patients referred to Abadan hospitals.
Methods: Totally, of 138 urine samples collected from patients with urinary tract infection in Abadan hospitals, 100 Escherichia coli strains were identified using microbiological and biochemical tests. The drug sensitivity definition test was done via the disk diffusion antibiogram method. Finally, the prevalence of traT gene was investigated by molecular PCR method.
Result: Among isolates isolated from Escherichia coli, 15 isolates were resistant to all used antibiotics. The highest resistance rates of Escherichia coli isolates to Nalidixic acid and Tetracycline were 92% and 91%, respectively. The least resistance was observed for Nitrofurantoin and Cefoxitin (23% and 24%). Also, in 11 isolates, the presence of traT gene was confirmed, therefore, the prevalence of the traT gene was 73.33%
The highest resistance rates of Escherichia coli isolates to Nalidixic acid and Tetracycline were 92% and 91%, respectively. Also, the prevalence of traT gene was 73.33%.
Conclusion: Based on the results, the traT virulence gene was highly prevalent among strains isolated from Abadan hospitals. Therefore, traT gene could be considered as a therapeutic target in the future.

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Armaghane-danesh, Yasuj University of                                                                                   Original Article


 
Molecular Identification of CTX-M and SHV Betalactamase Genes in Escherichia Coli Clinical Isolates in Isfahan
 
Moradi A, Ghiasian M*, Ghandehari F
 
¹Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
 
Received: 25 Dec  2021       Accepted: 04 Jul 2022
 
Abstract
Background & aim: Antimicrobial resistance is a worldwide problem causing health threats. Escherichia coli is one of the most important bacteria that causes resistance problems. The aim of the present study was to evaluate the frequency of Escherichia coli, a extended spectrum beta-lactamase producing CTX-M and SHV, in hospital and non-hospital clinical specimens in Isfahan.
 
Methods: In the present cross-sectional descriptive study conducted in 2019, 100 samples of hospital and non-hospital of Escherichia coli strains were collected and confirmatory biochemical tests were performed to identify these strains.  Resistance of strains to common antibiotics was assessed by disk diffusion method according to CLSI instructions. To perform phenotypic confirmation test of extended spectrum beta-lactamase producing strains, the combined disk method based on CLSI instructions was used.  PCR  was performed with specific primers to examined of encoding genes presence of  SHV and CTX-M. The collected data were analyzed using statistical tests based on one-way analysis of variance and independent t-test.
 
Results: From the studied samples, the highest antibiotic resistance was related to cefotaxime (45%) and the least antibiotic resistance was related to cefepime (39%). The results of the initial screening test showed that out of 100 Escherichia coli approved by differential tests, 38 (38%) were resistant to cephalosporin representatives and possibly produced extended-spectrum beta-lactamase. Among these samples, 33 (86.8%)  after Combined disk method were confirmed as extended spectrum beta–lactamases (ESBL) producing, of which 69.7% (23 strains) had both genes encoding CTX- M and SHV had 15.2% (5 strains) of the gene encoding CTX-M and 12.1% (4 strains) had the gene encoding SHV. In one sample (3%) none of the genes encoding CTX-M and SHV were present.
 
Conclusion: Based on the performed experiments and statistical analysis on hospital and non-hospital isolates, it was concluded that the SHV and CTX-M beta-lactamase genes in  Escherichia coli had a significant increase in frequency. There was a significant relationship between SHV and CTX-M genes in hospital and non-hospital samples, so that the frequency of SHV and CTX-M genes in  Escherichia coli was higher in hospital samples than non-hospital samples. There was no significant relationship between the genes identified and the type of isolates collected.
 

 

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Background & aim: Bacillus cereus and Enterococcus faecalis are pathogenic bacteria that are abundant in nature and can produce toxins that cause food poisoning in consumers. The aim of the present study was to investigate the contamination of Bacillus cereus, Enterococcus faecalis, and coliforms in spices sold in Shahrekord market.

Methods: In this study, first, 100 samples of spices including turmeric, cinnamon, spices, black pepper and red pepper (20 samples each) were randomly sampled and transferred to the food hygiene laboratory. To detect Bacillus cereus and Enterococcus faecalis, linear culture method, determination of the frequency of virulence genes by Multiplex PCR method, evaluation of antibiotic resistance by Disk-Diffusion method and coliform enumeration by standard method were used.

Result: The results showed that 45 samples (45%) and 12 samples (12%) were contaminated with Bacillus cereus and Enterococcus faecalis, respectively. In Bacillus cereus, the frequency of virulence genes CytK, Ces and hblC was 25%, 11% and 4%, respectively. The results obtained from the coliform enumeration showed that the highest amount of coliform was counted in turmeric and the lowest amount of coliform contamination was counted in cinnamon. The results of the antibiogram showed that the highest resistance of Bacillus cereus was related to penicillin and ampicillin and the highest resistance of Enterococcus faecalis was related to erythromycin.

Conclusion: According to the results obtained from the present study, the presence of Bacillus cereus and Enterococcus faecalis in spices sold in Shahrekord city can be a warning for consumers and endanger public health.

 

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Background: Controlling the use of antibiotics is necessary to prevent the development of antibiotic resistance in patients. The antibiotic stewardship plan aims to maintain and improve health standards with the systematic design of prescribing antibiotics. This project has been implemented in Iran since 2017. The purpose of the research is to investigate the achievements and challenges of the antibiotic stewardship plan in the hospitals of Qom City.
Methods: 21 experts working in Qom hospitals were interviewed. The questionnaire's validity was determined using the CVR method, and its reliability was determined using the Kappa coefficient. Finally, the interviews were coded and analyzed using the grounded theory method.
Results: The achievements of the plan include more coordination of the treatment staff, improvement of the treatment method, better monitoring of the consumption and treatment method, and more acceptance of the treatment staff. The challenges of the plan also include causal conditions (weak training, weak infrastructure, lack of specialists, lack of profitability, lack of trust in the plan, weak implementation, and non-compliance with the law), intervening conditions (coronavirus, inconsistency of doctors, time-consuming and weak performance of the active doctor (background conditions) Absence of pharmacists, lack of proper reporting and lack of patient involvement with the plan) strategies (manpower training, technological innovation, more supervision, reassuring doctors, considering financial resources for doctors) and outcomes (improving antibiotic use, reducing drug resistance, reducing Drug use and innovation in the treatment system).
Conclusion: The research findings show that the antibiotic stewardship plan's challenges are currently greater than its achievements. However, with the passage of time and the necessary training, the volume of these problems will decrease.