Genotypic Diversity of Multidrug Resistant Shigella species from Iran / 감염과화학요법

BACKGROUND: In many developing countries, shigellosis is endemic and also occurs in epidemics and treatment of multidrug-resistant (MDR) isolates are important. The aims of this study were to determine the antimicrobial susceptibility, prevalence of class 1 and 2 integrons and the clonal relatedness of isolates. MATERIALS AND METHODS: Antimicrobial susceptibility tests were performed by disc diffusion method. Polymerase chain reaction (PCR)-sequencing technique was employed for detection and characterization of integrons. The genetic relatedness was evaluated by using enterobacterial repetitive intergenic consensus (ERIC) PCR. RESULTS: There was a high percentage of resistance to trimethoprim-sulfamethoxazole (TMP/SMX) (93.7%), ampicillin (AMP) (87.3%), streptomycin (STR) (84.5%) and tetracycline (TET) (78.9%). Multidrug resistant phenotype was seen in 95.1% of total isolates. Most common MDR profile was TMP/SMX/STR/AMP resistant pattern. Among the 142 Shigella spp. analyzed in this study, 28 isolates were positive for class 1 integron with two types of gene cassette arrays (dfrA17/aadA5 = 31.7% and dfrA7 = 3.8%). The class 2 integron was more frequently detected among the isolates (94.7%) with dfrA1/sat1/aadA1 (69.4%) and dfrA1/sat1 (30.6%) gene cassettes. ERIC-PCR results showed 6, 5, 4 and 3 main genotypes among S. flexneri, S. sonnei, S. boydii and S. dysenteriae isolates, respectively. CONCLUSIONS: Our findings revealed that multidrug resistant Shigella species with high prevalence of class 2 integron were very common in Iran. In addition, ERIC-PCR patterns showed limited variety of clones are responsible for shigellosis in the region of the study.

Genotypic Diversity of Multidrug Resistant Shigella species from Iran / 감염과화학요법

BACKGROUND: In many developing countries, shigellosis is endemic and also occurs in epidemics and treatment of multidrug-resistant (MDR) isolates are important. The aims of this study were to determine the antimicrobial susceptibility, prevalence of class 1 and 2 integrons and the clonal relatedness of isolates. MATERIALS AND METHODS: Antimicrobial susceptibility tests were performed by disc diffusion method. Polymerase chain reaction (PCR)-sequencing technique was employed for detection and characterization of integrons. The genetic relatedness was evaluated by using enterobacterial repetitive intergenic consensus (ERIC) PCR. RESULTS: There was a high percentage of resistance to trimethoprim-sulfamethoxazole (TMP/SMX) (93.7%), ampicillin (AMP) (87.3%), streptomycin (STR) (84.5%) and tetracycline (TET) (78.9%). Multidrug resistant phenotype was seen in 95.1% of total isolates. Most common MDR profile was TMP/SMX/STR/AMP resistant pattern. Among the 142 Shigella spp. analyzed in this study, 28 isolates were positive for class 1 integron with two types of gene cassette arrays (dfrA17/aadA5 = 31.7% and dfrA7 = 3.8%). The class 2 integron was more frequently detected among the isolates (94.7%) with dfrA1/sat1/aadA1 (69.4%) and dfrA1/sat1 (30.6%) gene cassettes. ERIC-PCR results showed 6, 5, 4 and 3 main genotypes among S. flexneri, S. sonnei, S. boydii and S. dysenteriae isolates, respectively. CONCLUSIONS: Our findings revealed that multidrug resistant Shigella species with high prevalence of class 2 integron were very common in Iran. In addition, ERIC-PCR patterns showed limited variety of clones are responsible for shigellosis in the region of the study.

Association between helicobacter pylori, cagA, and vacA status and clinical presentation in Iranian children

Seroprevalence of H. pylori infection in Iran exceeds 65% of pediatric population. In this study, we intended to find association between the virulence genes [cagA and vacA] and clinical presentations. H. pylori isolates were achieved from the gastric mucosa of children. In each case, the gastric biopsy specimens were cultured and the organisms identified. Detection of different genotypes was carried out by PCR method. A total of 106 biopsy specimens were cultured and 33 H. pylori isolates obtained. Among these 33 H. pylori strains 24 [73%] were cog/1-positive. Genotypes of vacA slm2, slml, s2m2, and s2ml were 45.5%, 30.3%, 21.2%, and 3%, respectively. Most female patients were infected with genotype slm2. The vacA-ml strains were significantly more common in patients with nodular gastritis. There were no statistical differences between the vacA and cagA genotypes and clinical outcomes. The frequency of cagA genotype was high. In this study, nodular gastritis was a common finding and was rather significantly associated with ml allele of vacA

Detection of acute childhood meningitis by PCR, culture and agglutination tests in Tabriz, Iran

Meningitis is one of the hazardous and life threatening infections and is associated with mortality and morbidity. The aim of this study was to determine etiological agents of childhood bacterial meningitis. The culture, Gram staining, agglutination and PCR assays were used to examine CSF specimens from 277 patients with presumed bacterial meningitis for the occurrence of 4 most common infectious agents consist of N. meningitis, H. influnsae, S. pneumoniae and S. agalactiae between 2008 and 2009 at different wards of the Children Hospital of Tabriz. The mean age of patients was 35 +/- 2 [Mean +/- SEM] month, [minimum 11 days maximum14 years], of all cases 59.6% male and 40.4% female. Overall the diagnosis was confirmed with a CSF culture in 11/277 [3.97%], by agglutination test in 14/277 [5.05%]. The isolated bacteria included S. pneumoniae 5 cases, H. influnsae 2 cases, N. meningitis 3 cases and P. aeroginusae 1 case. A positive PCR assay allowed us to diagnose bacterial meningitis in 19 patients [6.8%]. In the present study, we found PCR to be a useful and sensitive method for the detection of bacterial DNA in the CSF samples from suspected meningitis patients. Furthermore, to maximize management of meningitis cases, a combination of culture and PCR is necessary

Prevalence of nasal carriage of staphylococcus aureus in Madani Heart Hospital, Tabriz

Staphylococcus aurous has been known as one of the most common nosocomial pathogens which include as much as 30% to 50% of general population. Regarding to the presence of carrier staff can be considered as one of the infection source; remarking of carrier for prevention purposes is important. In a cross-sectional study we determined the prevalence of staphylococcus aurous carriage among 113 edical staff of Madani Heart Hospital, Tabriz [Iran] 28/08/2009 to 28/09/2009 on [Physicians, nurses, technicians, secretaries, the administrative personnel and services], including surgical wards, laboratory, ICU and CCU. In this study, 113 participants comprised of 60 males [53%] and 53 females [47%], and their mean age of participants in this study was 34.8 years [20-55]. Sampling was carried out from nasal of employees. Samples were place on blood agar and mannitol salt agar; suspected colonies have been cultured and identified by catalase, coagulase and DNAase. Generally, of 113 people who entered the study, 30 person [26.5%] had positive cultures and 82 [72.6%] had a negative culture. The incidence of staphylococcus aureus carriage was more in men than women 57% vs. 43% [p<0.05]. In this study staphylococcus carriage incidence in Tabriz heart centre [Madani hospital] was 50%to 80% lower than our estimation, unexpectedly

Hepatitis a virus and coronary artery diseases

Many studies have reported on the association between human coronary artery disease [CAD] and certain persistent bacterial and viral infections. The aim of the present analysis was to investigate the possible association between HAV infection and angiography proven CAD. Blood from 200 patients undergoing coronary angiography was tested for antibodies to HAV by enzyme immunosorbent assay at Madani Heart Hospital, Tabriz University of Medical Sciences, Iran. CAD prevalence was 90% in HAV seropositive and 84.4% in HAV seronegative patients [Pv = 0.2]. This analysis demonstrated that HAV seropositive is not a risk factor for CAD

Intravascular catheter colonization and related bloodstream infection in Madani Cardiac Surgery Center

Venous and arterial catheters are used ordinary for continuous hemodynamic evaluation in cardiac surgery intensive care units. The catheters are one of the most important risk factors for nosocomial infection and mortality of hospitalized patients. The aim of this study was to evaluate the rate of bacterial colonization of intravascular catheters and catheter related bloodstream infection in Shahid Madani intensive care unit. 150 admitted patients that had intravascular catheter for more than 48 hours were enrolled in this study during one year period the tip segment of catheters and insertion site cultures were assessed. The rate of colonization was 13[8.7%]. the isolated bacteria were Escherichia coli [23.1%], Pseudomonas aeruginosa [23.1%] staphylococcus aureus [7.7%], coagulase negative staphylococcus [7.7%], Proteus vulgaris [7.7%], Stenotrophomonas maltophilia [7.7%], Candida albikans [7.7%], nonfermentative gram negative bacilli [7.7%] and Acinetobacter spp [7.7%]. The rate of catheter colonization was acceptable in comparison to the other studies. The most common isolated bacteria were Escherichia coli and Pseudomonas aeroginosa. In this study, the important risk factors were duration of catheter use, duration of hospitalization and positive blood culture

Intravascular catheter colonization and related bloodstream infection in the heart surgery intensive care unit

To study the incidence of catheter tip colonization, catheter-related infections, their risk factors, and to compare these data with other studies. Since 2006, we have had a through program for the insertion and care of all catheters used at cardiac surgical intensive care unit [SICU], Tabriz University of Medical Sciences, Tabriz, Iran, between May 15, 2006 and September 15, 2007. We studied prospectively 183 catheters in 150 patients in relation to insertion data and catheter characteristics, catheterization time and microbiological cultures. These catheters were in place for >48 hours over a 16 months period. Risk factors were analyzed by multivariate analysis. The analysis included 115 central venous catheter [CVCs], 65 arterial catheters [ACs], and 3 pulmonary artery catheters [PACs] inserted in 150 patients. The median time of catheter placement was 4 days. The incidence of positive tip culture was 9.8% and 10 microorganism isolated from 18 colonized catheters. Thirteen Gram-negative bacilli, 4 Gram-positive cocci, and one yeast were isolated. From multivariant analysis, >6 days of catheterization, and insertion site were the variables associated with significantly increased risk of catheter colonization. Gram-negative bacilli and Gram-positive cocci are the most common microorganisms colonizing CVC and AC from cardiac SICU patients. Duration of catheterization and catheter insertion site were independent risk factors of catheter related infection

Hepatitis B virus infection and the risk of coronary atherosclerosis

<p><b>INTRODUCTION</b>Many studies have reported on the association between human coronary artery disease (CAD) and certain persistent bacterial and viral infections. Currently, it is unclear whether hepatitis B virus infection is associated with the risk of the atherosclerosis. The aim of this study was to investigate the possible association between hepatitis B virus infection and angiography-proven CAD.</p><p><b>MATERIALS AND METHODS</b>Sera from 5,004 patients who underwent coronary angiography were tested for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbant assay at Madani Heart Hospital, Tabriz University of Medical Sciences, Iran.</p><p><b>RESULTS</b>Our study population comprised 66% male and 34% female, with an age range of 36 to 86 years. The prevalence of HBsAg positivity tended to be higher in CAD patients than in those without CAD (3.28% versus 2.17%), but the difference was not statistically significant.</p><p><b>CONCLUSION</b>Our results suggest that hepatitis B virus infection is not associated with coronary atherosclerosis in this population.</p>