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.

Activation toll-like receptor7 [TLR7] responsiveness associated with mitogen- activated protein kinase [MAPK] activation in HIOEC cell line of oral squamous cell carcinoma

Statement of the Problem: Oral squamous cell carcinoma is the most common oral malignancy. Toll-like receptor [TLR] activation led to alterations in the levels of mRNA encoding the TLR accountable for recognizing the inducing agonist and cross-regulation of other TLR

Purpose: The purpose of this study is determination of mitogen-associated protein kinase [MAPK] activation in human immortalized oral epithelial cell [HIOEC] line via up regulating of TLR7

Materials and Method: expression of TLR7 was measured in HIOEC and normal cells by quantitative real-time polymerase chain reaction [qRT-PCR] and samples were calibrated by Beta-actin

Results: Western blot analysis discovered high expression of TLR7 and MAPK in HIOEC cell lines. TLR7 was over-expressed in HIOEC cell line. Imiquimod-induced expression of interleukin [IL]-6, IL-8, and vascular endothelial growth factor [VEGF] was inhibited by TLR7 siRNA in HIOEC cells as determined by reverse transcription polymerase chain reaction [RT-PCR]. Mean fluorescence intensity of nuclear p38 expression was determined in HIOEC cell lines [p< 0.05]. RT-PCR analysis of IL-6, IL-8, and VEGF mRNA expression in HIOEC cells stimulated with imiquimod [1 Mug/ml] for indicated time points

Conclusion: TLR7 is functionally over-expressed in HIOEC cell line of oral squamous cell carcinoma and development of resistance to cisplatin in human oral squamous cell carcinoma might occur through the mechanism involving activation of TLR7 and its dependent signaling pathway

Antimicrobial effect of Methanolic and Acetonic of Zataria Multiflora, Capsicum Annum L. and Piper Nigrum L. extracts on Pseudomonas aeruginosa strains isolated from patients hospitalized in the burn Ward of Shahid Motahari hospital in Tehran

Background: Pseudomonas aeruginosa [P. aeruginosa] is one of the main causes of nosocomial infection. Burn patients are at high risk of acquiring this bacterium due to skin damage and their immune deficiency, and mortality rate in these infected patients is high [40-50 percent]. Therefore, due to antibiotic resistance of MBL containing strains in this bacterium, the aim of this study is to investigate the effect of methanol and acetone of Zataria multiflora, Capsicum annum L. and Piper nigrum L. on strains containing MBL in this bacterium

Materials and Methods: This lab study was conducted on samples from burn patients, which were gathered between 2015 and 2016. In this study first, disc diffusion and MIC were done based on the CLSI protocol; and using a combined disk, we detected metallo-beta-lactamase. Next, the bla[IMP] and bla[VIM] genes were identified by the PCR method. In order to investigate the effect of three plants extract on bacteria, the bacteria was affected by triple extracts using MIC and disk diffusion

Results: According to the results, all three plants had an acceptable effect on Pseudomonas aeruginosa strains containing metallo-beta-lactamase, and to be more precise, the acetone type of extract of Capsicum Annum L at a concentration of 1.5 mg / ml had the best effect in treating of these bacteria

Conclusion: The results of this study indicate the presence of several mechanisms of resistance to beta-lactam antibiotics among Pseudomonas aeruginosa strains collected from burn patients. The emergence of these types of XDRs has led to health problems, especially in burn patients. According to the results, the methanolic and acetonic extract of all three plants have been shown to be effective in inhibiting the growth of MBL-containing Pseudomonas aeruginosa

Detection of blaNDM, blaDIM, blaIMP, blaVIM and blaCTX-M-15 beta-lactamase genes among pseudomonas aeruginosa and acinetobacter baumannii strains isolated from two hospitals of Tehran, Iran

Background: In this study, we evaluated the existence of blaNDM, blaDIM, blaIMP, blaVIM, blaCTX-M-15 beta-lactamase genes among Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from hospitalized patients

Materials and Methods: From June 2013 to May 2014, thirty-four nonduplicate nonconsecutive isolates of A. baumannii and P. aeruginosa were isolated from blood, respiratory tract, wound, sputum and urine samples of patients from hospitalized in two hospitals in Tehran, Iran. Antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method according to CLSI guidelines. In this study, the frequency of MBL [metallo-beta-lactamase] producers was evaluated by CDDT [Combined disk diffusion test] and prevalence of bla[NDM], bla[DIM], bla[IMP], bla[VIM] and bla[CTX-M-15] genes were evaluated by PCR and sequencing methods among P. aeruginosa and A. baumannii strains isolated from hospitalized patient of Tehran during 2013 -2014 years

Results: Of thirty-four non-fermenter isolates, 24 [70.58%] P. aeruginosa and 10 [29.41%] as A. baumannii were isolated and identified. High rate of resistance to common antibiotics were detected specially among A. baumannii isolates that showed 100% resistance to 4 of tested antibiotics. The CDDT results reveal that 4 [16.66%] of the P. aeruginosa isolates and 1 [10%] of the A.baumannii were positive for production of MBLs. The prevalence of bla[CTX-M-15] gene among 10 A. baumannii isolates was 4 [40%], and for IMP-1, 2 [20%]. The ??????[OXA-51] has been investigated and was detected in all A. baumannii isolates. Also the prevalence of bla[CTX-M-15] gene among 24 P.aeruginosa isolates was 11 [45.83%], and for IMP-1, 3[12.5%]. Fortunately, ??????[NDM], bla[VIM], bla[DIM] gene was not detected in all isolates

Conclusion: The detection of MBL-producing A. baumannii and P. aeruginosa strains detected in this research is of great concern and highlights the need of infection control measures, including antimicrobial management and prompt detection of beta-lactamase-producing isolates

antibacterial activity of Iranian plants extracts against metallo beta-lactamase producing Pseudomonas aeruginosa strains

Metallo beta-lactamases [MBLs] producing Pseudomonas aeruginosa [P. aeruginosa] isolates are becoming an escalating global threat. Among the antibiotics used to treat infections associated with P. aeruginosa, resistance to carbapenem is a serious therapeutic challenge. The aim of the present study was to detect MBL-producing P. aeruginosa and to evaluate the extracts of Urtica. dioica, Carum. copticum, and Zataria multiflora on these clinical pathogens

The study was performed on hospitalized burn patients during 2014

Antibiotic susceptibility testing was assessed by broth micro dilution and disc diffusion methods. The MBLs were detected using combination disk diffusion test [CDDT] phenotypically. Then, PCR and sequencing methods were carried out to detect the MBL encoding genes. Among 83 imipenem resistant P. aeruginosa strains, 48 [57.9%] isolates were MBL-producing P. aeruginosa. PCR and sequencing methods confirmed that these strains were blaIMP-1 positive genes, whereas none were positive for blaVIM genes. Hospitalized burn patients with MBL-producing P.aeruginosa infection had 4/48 [8.3%] mortality rate. It was demonstrated that C. copticum, U. dioica, and Z. multiflora extracts had significant antibacterial effects on regular and IMP-producing P. aeruginosa strains

The prevalence of MBL-producing P. aeruginosa isolates in burn patients is generally very high. All MBL-producing strains encode the blaIMP-1 gene. Therefore, detection of MBL-producing strains has major importance in identifying drug resistance patterns in P. aeruginosa and in controlling of infections. In the current study, the extracts from C. copticum, U. dioica, and Z. multiflora had high antibacterial effects against beta-lactamase producing P. aeruginosa isolates?

Distribution of IL-28B genotypes in patients with hepatitis C and healthy individuals in Jahrom city

The purpose of this study was to compare the distribution of interleukin [IL]-28B genotypes between Iranian healthy individuals and patients with chronic hepatitis C based on the genotype. Polymorphisms in the region of IL-28B gene have been identified as the strongest genetic pretreatment predictor of sustained virological response [SVR] in hepatitis C infection. In this study, 147 patients with chronic hepatitis C and 80 healthy individuals were included. The IL-28B rs12979860 and rs8099917 polymorphisms were genotyped by PCR-RFLP method and the frequency of IL-28B polymorphisms with respect to HCV genotypes was also determined. The frequencies of rs12979860 TT, CC and CT genotypes in the chronic hepatitis C patients and healthy individuals were as follows: 10.8% vs. 11.3%, 38.7% vs. 46.2% and 50.3% vs. 42.5%. Also, the frequencies of rs8099917 TT, GG and GT genotypes in the chronic hepatitis C patients was 61.9%, 6.1% and 32% and in controls was 47.5%, 11.2% and 41.3%. The differences in the distribution of rs12979860 genotypes and alleles between HCV genotype 1 and HCV genotype 3a infected patients were statistically significant. The rs12979860 C allele is the favorable allele for the spontaneous clearance of HCV. It seems that the impact of IL-28B polymorphism on the spontaneous clearance of HCV genotype 3 is more prominent than HCV genotype 1, which results in the observation of higher rs12979860 C allele frequency in chronic hepatitis C patients with HCV genotype 3 than HCV genotype 1

Cementless hip arthroplasty in southern iran, midterm outcome and comparison of two designs

Background: Cementless hip prosthesis was designed to provide biologic fixation, without the use of cement. The second generation components have shown more reliable bone ingrowths and survival rates. We are reporting a midterm result of two designs of cementless prosthesis in a unique culture with different social habits and expectations

Methods: 52 primary cementless total hip arthroplasty in 42 patients with the mean age of 48.8 years were retrospectively studied. Two groups of prosthesis had been implanted: Harris-Galante II [HGII] in 15 and Versys-Trilogy [V-T] in 37 hips, both from Zimmer company. The patients were assessed clinically, radiographically and with Harris hip score, SF36, WOMAC, and MACTAR questionnaires, with 65 months [26-136] mean follow-up

Results: All the V-T prostheses had survived well. Eight of HG II were revised by the last follow-up in 19-102 months. All had undergone acetabular revision and 2 combined with femoral revision. Broken tines of HGII cups were seen in 4 radiographs. The 65 months overall survival was 96.2% for femoral and 84.6% for acetabular components. 90% had good or excellent Harris hip scores. The functional scores were poorer in the HG II group. Pain relief and improved walking were the two main patients' expectations fulfilled in 97.6% and 92.8%, respectively

Conclusions: The outcome of cementless total hip arthroplasty [THA] is satisfactory and comparable with the literature based on the results of function and survival of this small comparative group. The use of HGII acetabular component should be abandoned

[Effects of stem cell factor on activity of glutathione stransferase and recovery from acetaminophen-induced hepatotoxicity in mice]

Objective: Acetaminophen [APAP] overdose causes acute liver injuries. Studies show that stem cell factor [SCF] and its receptor, c-Kit, enhance liver recovery from APAPinduced injuries in mice. In this study we explore the effect of SCF on activity of glutathione S-transferase [GSTs] enzymes which are considered to be important in APAP metabolism

Methods: We divided 45 Balb/c mice into three groups. Within each group there were three sub-groups of five mice per subgroup. The groups included: 1. APAP [300 mg/kg B.W., i.p.]; 2. SCF [40 microg/kg B.W., i.p.] given.30 minutes after APAP [300 mg/kg B.W., i.p.], and 3.control mice treated with normal saline. The mice were sacrificed at 1, 12 and 24 hours, respectively. Hepatotoxicity was evaluated in the 24 hour group by histopathology and assessment of biochemical serum markers [ALT and AST]. We assessed the levels of SCF receptor [c-Kit] protein and GST enzyme activities in the liver tissues

Results: Hepatotoxicity was induced by APAP [300 mg/kg, B.W] as evident by both histopathological observations and a significant [p<0.05] increase in serum ALT and AST levels, which were reversed by SCF administered post-APAP. SCF administration after APAP administration significantly increased GSTs enzyme activity levels by 24 hours, however it led to a significant decrease in c-Kit protein level compared to the control and APAP groups

Conclusion: Our data suggest that SCF binding to its receptor [c-Kit] on liver cells may attenuate APAP-induced liver injuries by increasing GST activities in the livers of mice

Prevalence of blaCTX-M gene in multi-resistant escherichia coli isolated from urinary tract infections, Tehran, Iran

The emergence and increase in the incidence of Extended-spectrum beta lactamase [ESBL] producing Escherichia coli [E. coli] has become an emerging challenge especially in hospitalized patients with urinary tract infection [UTI]. The aim of the present study was to survey the frequency of bla CTX-M genotype in ESBL producing E. coli isolated from hospitalized patients with urinary tract infection and determination of their antibiotic resistance pattern. A total of 135 E. coli isolates were collected and isolated from patients with UTI. The isolates were subjected to confirmatory phenotype tests for the presence of ESBL. 75 E. coli isolates were confirmed as ESBL-positive by double disc synergy test. In vitro susceptibility of ESBL isolates to 15 antimicrobial agents amoxicillin, penicillin, ceftazidime, cefotaxime, cefoxitin, ceftriaxone, cefixime, cephalexin, co-trimoxazole, gentamicin, nalidixic acid, ciprofloxacin, nitrofurantoin, amikacin, and imipenem was performed by Kirby-Bauer's Disk diffusion method according to Clinical and Laboratory Standards Institute [CLSI, 2012] guideline. PCR method was used to identify bla CTX-M gene in 75 ESBL positive strains. PCR and sequence analysis showed that 75 [55.5%] isolates produced bla CTX-M genes. In vitro susceptibility of ESBL producing E. coli showed that all of them were resistant to amoxicillin and penicillin. The rates of resistance to the majority of tested antibiotics varied among 61% to 100%, with the exception of amikacin [14.7%] and imipenem [2.7%]. Our results showed that the frequency of bla CTX-M was strikingly high [93.3%] in patients with UTI. These data confirmed that the frequency of bla CTX-M genes was high among E. coli isolated from patients with UTI. The trend of multidrug-resistant profile has been associated with bla CTX-M gene is alarming. Therefore, it is very important to establish a routine screening of ESBL in clinical isolates to prevent dissemination of resistant isolates in health care settings

[Detection of blaIMP and blaVIM metallo-beta-lactamases genes in pseudomonas aeruginosa strains isolated from wound of burnt patients in Tehran Shahid Motahari hospital during 2011, Iran]

During recent years, metallo-beta-lactamase [MBLs] producing Pseudomonas aeruginosa has been reported as an important cause of nosocomial infection. Also, infection with this bacterium has increased rate of mortality and health care costs. The aim of this study was to determine the antibiotic resistance pattern and to detect blaVIM and blaIMP Metallo-beta-lactamase genes in P. aeruginosa isolated from patients hospitalized in the burn ward. This descriptive study was conducted on P. aeruginosa strains isolated from patients hospitalized in the burn ward of Tehran Shahid Motahari Hospital between September and January 2011. For all MBL-producing strains, antibiotic resistance pattern was determined by disc diffusion method according to CLSI guidelines. CDDT method was used for detection of MBL [imipenem-imipenem+EDTA], and PCR and sequencing techniques were used to detect MBL genes, blaVIM and blaIMP. Eighty-three percent of 100 P. aeruginosa isolates were resistant to imipenem. Using combination disk diffusion test [CDDT] method, 48 isolates were detected to have MBL, of which 6 isolates were positive for blaIMP-1 gene, and all of them did not have blaVIM gene. Also, 4 [8.3%] patients with MBL-producing P. aeruginosa infection died in the hospital. The results of this study revealed that high percentage of P. aeruginosa strains are MBL-producer. Therefore, detection of MBL-producing strains is essential for better control and treatment of burnt patients

Evaluation of brain and cervical MRI abnormality rates in patients with systemic lupus erythematosus with or without neurological manifestations

Central nervous system [CNS] involvement has been observed in 14-80% of patients with systemic lupus erythematosus [SLE]. Magnetic resonance imaging [MRI] is an appropriate method for evaluating CNS involvement in these patients. Clinical manifestations and MRI findings of CNS lupus should be differentiated from other mimicking diseases such as multiple sclerosis [MS]. The aim of this study was to evaluate the prevalence and extent of brain and cervical cord MRI lesions of lupus patients. The relationship between neurological signs and symptoms and MRI findings were evaluated as well. Fifty SLE patients who had been referred to the rheumatology clinic of our hospital within 2009 were included in a cross sectional study. All patients fulfilled the revised 1981 American College of Rheumatology [ACR] criteria for SLE. We evaluated the neurological signs and symptoms and brain and cervical MRI findings in these patients. Forty-one patients [82%] were female and nine [18%] were male. The mean age was 30.1 +/- 9.3 years. Twenty eight [56%] patients had an abnormal brain MRI. No one showed any abnormality in the cervical MRI. The lesions in 20 patients were similar to demyelinative plaques. Seventeen patients with abnormal brain MRI were neurologically asymptomatic. There was only a significant relationship between neurological motor manifestations and brain MRI abnormal findings. Unlike the brain, cervical MRI abnormality and especially asymptomatic cord involvement in MRI is quite rare in SLE patients. This finding may be helpful to differentiate SLE from other CNS disorders such as MS

Detection of TEM, SHV and PER type extended-spectrum B-Lactamase genes among clinical strains of pseudomonas aemginosa isolated from burnt patients at Shafa-Hospital, Kerman, Iran

This study was carried out to evaluate the existence of the TEM, SHY and PER ESBL genes in ESBL producing strains of Pseudomonas aeruginosa isolated from burnt patients at Shafa-hospital, Kennan, Iran. A total of 120 strains of P. aeruginosa were isolated from 245 patients in burn unit of Shafa-hospital during January 2006 to December 2007. MIC of antibiotics was measured using agar dilution test ESBL producing strains were detected by double-disc synergy method containing amoxicillin and amoxicillin+clavulanic acid and phenotypic confirmatory test. All the clinical isolates resistant to imipenem [IMP] were screened for the production of MBL by E-test with IMP/IMP+EDTA strips. PCR and multiplex-PCR performed for the detection of different types of ESBL producing genes in ESBL positive isolates. Of 120 the isolates, 3-5% showed MIC greater than 16 mg/ml to IMP and meropenem, 66% showed MIC greater than 32 mg/ml to ceftazidime, 42% to azteronam and 60% of the isolates showed MIC greater than 64 mg/ml to cefotaxime, 41 [34%] contlnned as ESBL producers. Not any isolate could produce MBL [pœ0.05]. The PCR assay of all ESBL producing isolates revealed that 6.6%, 4.1% and 2.5% of them were positive for SHY, PER and TEM genes, respectively. Many ESBL producing strains of P. aeruginosa isolated from patients in burn unit of Shafa-hospital. However, none could produce MBL enzyme. The genes among ESBL producing strains were SHY, PER as well as TEM type of b-lacatamases