Detection of extended spectrum beta-lactamases in urinary isolates of klebsiella pneumoniae in relation to bla[SHV] bla[TEM] and Bla[CTX-M] gene carriage

Resistance to contemporary broad-spectrum beta-lactam antibiotics mediated by extended-spectrum beta-lactamases [ESBLs] is increasing worldwide. Klebsiella pneumoniae, an important cause of nosocomial and community acquired urinary tract infections has rapidly become the most common ESBL producing organism. We examined ESBL production in urinary isolates of K. pneumoniae in relation to the presence of bla[SHV], bla[TEM] and bla[CTX-M] genes Antibiotic resistance of 51 clinical isolates of K. pneumoniae was determined to amoxicillin, amikacin, ceftazidime, cefotaxime, cefteriaxon, ceftizoxime, gentamicin, ciprofloxacin and nitrofurantoin by disc diffusion. Minimum inhibitory concentrations were also measured for ceftazidime, cefotaxime, cefteriaxon, ceftizoxime and ciprofloxacin. ESBL production was detected by the double disc synergy test and finally, presence of the bla[SHV], bla[TEM] and bla[CTX-M] genes were shown using specific primers and PCR. Disc diffusion results showed that 96.08% of the isolates were resistant to amoxicillin followed by 78.43% resistance to nitrofurantoin, 49.02% to amikacin and ceftazidime, 41.17% to ceftriaxone, 37.25% resistance to cefotaxime and ceftizoxime, and 29.42% to gentamicin and ciprofloxacin. Both resistant and intermediately resistant organisms were resistant in MIC determinations. Twenty two isolates [43.14%] carried bla[SHV], 18 [35.29%] had bla[TEM] and 16 [31.37%] harbored bla[CTX-M] genes. ESBL production was present in 14 isolates [27.45%] of which, 3 did not harbor any of the 3 genes. Among the non- ESBL producers, 9 lacked all 3 genes and 2 carried them all. No relation was found between gene presence and ESBL expression

[Determine serum zinc level of mothers in neural tube defects in Gorgan]

Introduction: Neural tube defects [NTD] comprise a group of congenital malformation that includes spina bifida, anencephaly and encephalocele. Pervious study has shown that the rate of NTDs is 3.12 per 1000 in Gorgan. Some studies have indicated that Zinc deficiency is one of the causative factors of NTDs

Objective: This study carried out to compare the serum Zinc level in maternal affected NTDs with healthy controls

Materials and methods: This case- control study carried out to compare the serum Zinc level in 23 mothers with affected NTDs newborns and 36 healthy controls in Dezyani Hospital in Gorgan during 2003 by spectrophotometery technique

Results: Zinc deficiency was found in 13[36.5%] of the cases and 7[19.4 %] of the controls. The logistic regression analytic showed the relation between the presence of NTDs with Zinc deficiency [OR=5.06, 95%CI: 1.51-16.99] and drug exposure during 1st trimester in mothers [OR=13.12, 95%CI: 1.31-130.97]

Conclusion: Our findings indicated that maternal Zinc deficiency was thought to be one of the important factors in the NTD etiology