Prevalence of plasmid-mediated AmpC β-lactamases among uropathogenic Escherichia coli isolates in southwestern Iran

Objectives@#This study was undertaken to evaluate AmpC β-lactamase-producing Escherichia coli urine isolates and to characterize the frequency of plasmid-mediated AmpC (pAmpC)-encoding genes. @*Methods@#Antimicrobial susceptibility tests were performed using the disk diffusion technique. AmpC β-lactamase production was assessed with a phenotypic inhibitor-based method. The presence of 6 pAmpC-encoding cluster genes was detected by multiplex polymerase chain reaction (PCR). @*Results@#The proportion of antibiotic resistance of E. coli isolates ranged from 7.4% to 90.5%, and more than half (51.6%) of the total isolates were multidrug-resistant (MDR). Among the 95 E. coli isolates, 60 (63.2%) were found to be cefoxitin-resistant, but only 14 (14.7%) isolates were confirmed as AmpC β-lactamase-producers. In the PCR assay, pAmpC-encoding genes were found in 15 (15.8%) isolates, and blaDHA was the most prevalent type. However, blaFOX, blaMOX, and blaACC genes were not detected in the isolates. @*Conclusion@#Our findings contributed valuable information concerning antibiotic resistance, confirmatory phenotypic testing for AmpC production, and pAmpC β-lactamase gene content in E. coli isolates in southwestern Iran. The level of MDR recorded in AmpC-producing strains of this study was worrying; therefore, implementing strong infection control approaches to reduce the MDR burden is recommended.

Evaluation of the efficacy of surgery for treatment of septal perforation

Background: The majority of septal perforations are caused by trauma either with or without infection. In most cases trauma is related to the surgery

Methods: Twenty patients with nasal perforation who underwent surgery from 2008 to 2011 were retrospectively evaluated. Three different surgical approaches were used: bilateral rotational advancement flap of nose floor with fascia through open rhinoplasty, bilateral rotational advancement flap of nose floor with using cartilage through closed method and inferior turbinate rotational flap

Results: After the surgery, all symptoms disappeared and examinations of healing regions in fifteen patients showed that the perforation was completely healed. In five patients, the perforation size reduced

Conclusion: Inferior turbinate flap in small perforations would be a logical method with ideal results. In cases with perforation size of one centimeter or larger and in more posterior types, the external method is recommended for a better exposure