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Background and Aim: Klebsiella pneumoniae is a member of the Enterobacteriaceae family. There is a global emergence of multidrug-resistant [MDR] strains of K. pneumoniae, a Gram-negative enteric bacterium that causes nosocomial and urinary tract infections. The aims of the present study were to identify the Klebsiella pneumoniae infections in hospitalized patients, characterization of blaCTX gene, detection cross-resistance and cefepime susceptible-dose dependent [SDD] in isolates
Materials and Methods: In present study, 111 strains of Klebsiella pneumoniae were isolated from patients hospitalized in Ghotbadden, Faghihi and Nemazee hospitals [Shiraz, Iran]. The isolates were identified as K.pneumoniae, based on biochemical tests embedded in the API-20E system. Susceptibility testing [disc diffusion] was performed according clinical and laboratory standards institute [CLSI] guidelines. Detection cefepime susceptible-dose dependent [SDD] was performed. The detection of AmpC beta-lactamases producing strains was done based on cefoxitin and cefepime disk tests. The blaCTX gene was detected in the isolates by PCR molecular method
Results: Total 111 Klebsiella pneumoniae isolates were studied. The less effective drug was ceftazidime [37.8% isolates were sensitive]. All SDD strains were susceptible to colistin and imipenem. Colistin [96.4%] and imipenem [88.3%] were the most effective antibiotics against isolates. Respectively, 41.4% and 35.1% isolates displayed resistance to gentamicin and amikacin. All colistin resistant isolates were imipenem sensitive. The results of PCR on blaCTX gene showed that 70.3% of the isolates possess the gene
Conclusion: Carbapenem drugs are effective against Klebsieella pneumoniae infections. These results indicate that multidrug-resistant [MDR] and extensively drug resistant [XDR] strains of K.pneumoniae are rising, and fewer antibiotics may be useful for treating infections caused by these strains. Routine investigation and reporting of antibiotics resistance profile in patients presenting with Klebsiella infections is suggested
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Extension of drug resistant Staphylococcus aureus strains is one of the problems of modern society. Presence of methicillinresistant Staphylococcus aureus [MRSA] in HIV-infected individuals is an important cause of severe infections. Therefore, the main goal of this study was to determine the prevalence rate of MRSA carriage rate among HIV patients referring to the Shiraz HIV referral center [Shiraz, Iran] during 2011-2012. Nasal swabs were obtained from HIV positive patients and were cultured on differential and selective media to isolate Staphylococcus aureus, which was confirmed by standard biochemical tests. For isolation of MRSA isolates, bacterial suspensions were cultured on Muller-Hinton Agar containing NaCl and Oxacillin. Finally, data were analyzed by the SPSS software. Of 180 HIV patients, MRSA was isolated from nasal cavity of 23 [12.8%] patients. Most of the isolates were recovered from male subjects who were under 40 years old. No variables such as skin disease, history of hospitalization or infectious disease had significant association with the MRSA colonization rate. The presence of MRSA isolates in the nasal cavity of HIV patients in such a rate warns us about the potential spreading of MRSA among HIV patients in our society and emphasizes on establishing better prevention strategies
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Background and Aim: The emergence of nonfermenter bacteria that are resistant to multidrug resistant ESBL are nowadays a principal problem for hospitalized patients. The present study aimed at surveying the emergence of nonfermenter bacteria resistant to multi-drug ESBL producing isolated from patients blood samples using BACTEC 9240 automatic system in Shiraz
Materials and Methods: In this cross-sectional study, 4825 blood specimens were collected from hospitalized patients in Shiraz [Iran], and positive samples were detected by means of BACTEC 9240 automatic system. The isolates containing nonfermenter bacteria were identified based on biochemical tests embedded in the API-20E system. Antibiotic sensitivity test was performed and identification of ESBL producing strains were done using phenotypic detection of extended spectrum beta-lactamase producing isolates [DDST] according to CLSI [2013]guidelines
Results: Out of 4825 blood samples, 1145 [24%] specimen were gram-positive using BACTEC system
Among all isolated microorganisms, 206 isolates were non-fermenting gram- negative bacteria
The most common non-fermenter isolates were Pseudomonas spp. [48%], Acinetobacter spp. [41.7%] ,and Stenotrophomonas spp. [8.2%]. Seventy of them [81.4%] were Acinetobacter spp. which were ESBL positive. Among beta-lactam antibiotics, Pseudomonas spp. showed the best sensitivity to piperacillintazobactam [46.5%]
Conclusion: It was found that ?-lactam antibiotics are not effective against more than 40% of Pseudomonas spp. infections and 78% Acinetobacter infections. Emergence of multi-drug resistant strains that are resistant to most antibiotic classes is a major public health problem in Iran. To resolve this problem using of practical guidelines is critical
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Enterobacter cowanii is a genus of common gram-negative, facultatively anaerobic, rod-shaped, non-spore-forming bacterium of the Enterobacteriaceae family. This organism can be potentially a powdered infant milk formula-borne opportunistic pathogen. The aim of this study was to isolate and identify E. cowanii from consumed powdered infant formula milk [PIF] in intensive care units [NICU] and to determine antimicrobial susceptibility patterns of this bacterium. E. cowanii was isolated according to FDA method in 125 samples of PIF milk purchased from drug stores between Jun 2011 and March 2012. For final confirmation, biochemical tests embedded in API-20E system were used. The drug susceptibility test was performed using the disc diffusion method according to CLSI recommendations. Out of the 125 PIF samples investigated, 4 [3.2%] samples were positive for E. cowanii. All four isolates from PIF samples were uniformly susceptible to imipenem, meropenem, ceftazidime, ciprofloxacin, and colistin. Fifty percent of isolates were resistant to ampicillin, amoxicillin, and cotrimoxazole. Analysis of the results indicated that complementary studies are necessary to clarify the possible role of E. cowanii as a food contaminant, in common NICU infections and high risk groups including persons with underlying disease and immunocompromised individuals
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Oxidative stress in teratozoospermic semen samples caused poor assisted reproductive techniques [ART] outcomes. Among antioxidants, ascorbic acid is a naturally occurring free radical scavenger and as such its presence assists various other mechanisms in decreasing numerous disruptive free radical processes. The main goal of this study was to evaluate potential protective effects of ascorbic acid supplementation during in vitro culture of teratozoospermic specimens. Teratozoospermic semen samples that collected from 15 volunteers were processed, centrifuged and incubated at 37°C until sperm swimmed-up. Supernatant was divided into four groups and incubated at 37°C for one hour under different experimental conditions: Control, 10 micro m A23187, 600 micro m ascorbic acid and 10 micro m A23187+600 micro m ascorbic acid. After incubation sperm motility, viability, acrosome reaction, DNA damage and malondialdehyde levels were evaluated. Our results indicated that after one hour incubation, ascorbic acid significantly reduced malondialdehyde level in ascorbic acid group [1.4 +/- 0.11 nmol/ml] compared to control group [1.58 +/- 0.13 nmol/ml] [p<0.001]. At the end of incubation, progressive motility and viability in ascorbic acid group [64.5 +/- 8.8% and 80.3 +/- 6.4%, respectively] were significantly [p<0.05 and p<0.001, respectively] higher than the control group [54.5 +/- 6.8% and 70.9 +/- 7.3%, respectively]. A23187 significantly [p<0.0001] increased acrosome reaction in A23187 group [37.3 +/- 5.6%] compared to control group [8.5 +/- 3.2%] and this effect of A23187 attenuated by ascorbic acid in ascorbic acid+A23187 group [17.2 +/- 4.4%]. DNA fragmentation in ascorbic acid group [20 +/- 4.1%] was significantly [p<0.001] lower than controls [28.9 +/- 4.6%]. In vitro ascorbic acid supplementation during teratozoospermic semen processing for ART could protect teratozoospermic specimens against oxidative stress, and it could improve ART outcome
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Background and Aim: Citrobacter is a gram-negative, nonsporeforming, facultative anaerobic and motile bacillus within the family of Enterobacteriaceae and is ubiquitous in nature. This opportunistic pathogen causes a wide spectrum of infections. The aim of the present study was to examine the isolation of Citrobacter spp. from blood specimens in patients hospitalized in Kermanshah Imam Khomeini hospital and to determine the isolates sensitivity to antibiotics
Materials and Methods: This cross- sectional study was carried out on 2285 blood specimens collected from hospitalized patients between March 2012 and February 2012. In the beginning, the blood samples were inoculated in blood culture tubes media. The Citrobacter spp. isolates were identified and their identification was confirmed by means of morphological and biochemical laboratory tests. Drug sensitivity test was carried out according to CLSI [2011] recommendations through using the standard disc diffusion method
Results: In this study Citrobacter spp. were isolated from 21 [15.8%] of 133 culture positive blood specimens collected from the hospitalized patients. The most effective antimicrobial agents against Citrobacter isolates were imipenem [90.4%], and amikacin [71.5%], respectively. The most frequent resistance observed was to cephalothin [76.2%], ciprofloxacin [76.2%], ceftazidime [66.6%] and co-trimoxazole [62%]
Conclusion: Citrobacter isolates showed high resistance to betalactam antibiotics. Therefore, it is necessary that these drugs should only be administered to patients whose diagnostic isolates reveal sensitivity in vitro