Genetic Variability of Methicillin Resistant Staphylococcus Aureus Strains Isolated from Burns Patients

OBJECTIVES: Staphylococcus aureus is a nosocomial pathogen that provides a major challenge in the healthcare environment, especially in burns units where patients are particularly susceptible to infections. In this study, we sought to determine molecular types of S. aureus isolates collected from burns patients, based on staphylococcal protein A and coagulase gene polymorphisms. METHODS: Antibiotic susceptibility testing of 89 S. aureus strains isolated from burn wounds of patients was assessed using the Kirby-Bauer disk diffusion method. Strains were characterized by spa typing, coa typing, and resistance and toxin gene profiling. RESULTS: A total of 12 different spa types were identified with the majority being t790 (18%). Panton-Valentine leucocidin encoding genes were identified in spa types t044 (5.6%), t852 (2.2%) and t008 (2.2%). The most commonly detected antibiotic resistance gene was ant (4′)-Ia (60.7%). Ten different coa types were detected and the majority of the tested isolates belonged to coa III (47.2%). All the high-level mupirocin-resistant and low-level mupirocin resistant strains belonged to coa type III. CONCLUSION: The present study illustrated that despite the high frequency of coa III and spa t790 types, the genetic background of S. aureus strains in Iranian burns patients was diverse. The findings obtained are valuable in creating awareness of S. aureus infections within burns units.

clinical importance of emerging ESKAPE pathogens in nosocomial infections

In the last decade, along with the problem of nosocomial infections, multidrug-resistant bacteria in community and hospitals have soared. High frequencies of multidrug-resistant bacteria have been grouped under the acronym ESKAPE: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp. The ESKAPE pathogens are responsible for the majority of nosocomial infections and capable of 'escaping' the biocidal action of antimicrobial agents. The objective of this review is to consider the clinical importance of emerging of ESKAPE pathogens in nosocomial infections to prepare feasible data about tracing and treatment of infection related to ESKAPE pathogens that may be beneficial to clinicians at the bedhead. It can be said that healthcare-associated, community-acquired, and nosocomial infections should be clearly considered annually. The awareness of residential antimicrobial resistance can support selecting a convenient empirical therapeutic diet in diseases due to ESKAPE pathogens

Detection of inducible clindamycin resistance [MLSBi] among methicillin-resistant Staphylococcus aureus [MRSA] isolated from health care providers

Methicillin-resistant Staphylococcus aureus [MRSA] is one of the most important agents producing nosocomial diseases in hospitalized children. Then, screening of health care providers who are in direct contact with patients in hospital is necessary. The objective of this study was to investigate MRSA collected isolates for MLSB phenotypes, in particular inducible clindamycin resistance [MLSBi]. Two hundred and twenty nine health care providers were examined and nasal samples for S. aureus culture and sociodemographic data were obtained from them during one year august 2012 - july 2013. After MRSA identification, all isolates were examined for antibiotic resistant pattern. Staphylococci were isolated from 27 samples. Twenty one of them were MRSA. All isolates sensitive to linezolid and vancomycin. D-tests identified 6 isolates [28.6%] with inducible resistance to clindamycin [MLSBi phenotype]. Carrier samples screening are considered less than clinical samples. Treatment of variety of infectious diseases due to resistant bacteria is difficult. So, annual screening of these individuals, detecting the carriers and decolonizing them to reduce transmission of S. aureus in the hospital is necessary

Clinical outcomes of Torque teno virus-infected thalassemic patients with and without hepatitis C virus infection

BACKGROUND: Although a marked proportion of thalassemic patients acquire Torque teno virus (TTV) through blood transfusion, its clinical importance is unclear. This study was designed to investigate the clinical importance of TTV infection in thalassemic patients with and without hepatitis C virus (HCV) co-infection in Iran. METHODS: In this case-control study, 107 thalassemic patients on chronic transfusion and 107 healthy individuals were selected. According to HCV and TTV infection status (detected by semi-nested PCR), patients were categorized into 4 groups: TTV and HCV negative, TTV positive, HCV positive, and TTV and HCV positive. Blood ferritin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels in these 4 groups were assessed. RESULTS: Approximately half of the thalassemic patients (50.5%) and 27.1% of controls had TTV infection. Thalassemic patients had a greater chance of TTV infection compared to the control group with a sex-adjusted OR of 4.13 (95% CI=2.28-8.13). The increased levels of ALT, AST, and ferritin in the TTV and HCV-infected group were not significantly different from those in the TTV and HCV negative group. Co-infection with TTV and HCV did not significantly increase ALT, AST, and ferritin levels compared to infection with TTV alone. CONCLUSION: Although common in thalassemic patients, TTV infection appears to have a negligible role in increasing the severity of liver disease, even when co-infection with HCV occurs.

[Bacterial agents in patients with conjunctivitis in Labbafinejad hospital in 2006]

Conjunctivitis, one of the most prevalent eye complications, is usually self limited but may result in optical disorders. Classification is based on the cause including bacterial, viral, fungal, allergic or chemical. Considering antimicrobial resistance, determining the exact cause may lead to improved medical therapy. In this descriptive-analytic survey, 92 patients with conjunctivitis, who attended Shaheed Labbafi Nezhad medical center were enrolled. Samples were accurately collected by the physician working in the center and were transported in a sterile condition to the Laboratory of Pediatric Infectious Research Center of Mofid hospital. Determination of mycobacteria, aerobic and anaerobic bacteria was accomplished using standard methods. Data was analyzed using SPSS 13. Samples were obtained from 49 men [61.4%] and 43 women [38.6%], [median age 36.2]. 85% of patients with bacterial conjunctivitis had mucoplurant discharge as a main symptom. 45[58.5%] cultures were positive. Aerobic organisms were isolated from 40 patients [57.1%] and anaerobic ones from 5 [7.1%], of which 4 were mixed with aerobes. No mycobacterium was found. The most common aerobic organism cultured was staphylococcus epidermidis [30%] and the other aerobic ones were: Staphylococcus aureus [12.9%], E coli [7.1%], Bacillus cereus [5.7%], Moraxella catarrhalis [4.3%], Diphteroid [4.3%], Acientobacter baumanii [2.9%], Citrobacter fraundii [2.9%], Staphylococcus oricularis [1.4%], Streptococcus viridans [1.4%], Bacillus subtilis [1.4%], Pseudomonas aeruginosa [1.4%], and Proteus mirabilis [1.4%]. Anaerobic organisms cultured were Peptostreptococcus [4.3%] and Bacteroides fragilis [2.9%]. Since various organisms are responsible for bacterial conjunctivitis, therapeutic strategies should be based on the results of microbiological investigations