ORIGINAL_ARTICLE Antibiotic Resistance Pattern and Evaluation of blaOXA-10, blaPER-1, blaVEB, blaSHV Genes in Clinical Isolates of Pseudomonas aeruginosa Isolated from Hospital in South of Iran in 2014-2015 Background:  Pseudomonas aeruginosa is one of the main causes of nosocomial infections with a mortality rate up to 40-50%. Resistance to antibiotics is a global challenge in the treatment of infections caused by this bacterium.  The Class A beta-lactamases genes, including blaSHV, blaPER, blaVEB, are the most common causes of resistance in this microorganism. This study was conducted to determine antibiotic resistance pattern and the presence of blaper, blaveb, blashv and blaoxa-10 genes in clinical isolates of P. aeruginosa isolated from patients in a hospital in Bandar Abbas. Materials and Methods:  This cross-sectional study was conducted on 72 P. aeruginosa clinical isolates. Antibiotic susceptibility testing was performed by disk diffusion method according to the clinical Laboratory Standard Institute. MIC (Minimum inhibitory concentration) of ceftazidime was performed by E-Test. Polymerase chain reaction (PCR) was performed to identify blashv, blaveb-1, blaoxa-10, and blaper-1 genes. Results:  Most of the isolates were detected from intensive care unit and urine samples. The highest resistance rate which was observed to sulfamethoxazole and ceftazidime, were 68 (94.44%) and 44 (61.11%), respectively.  27.8% of these isolates were multidrug resistance. Among 44 ceftazidime resistance isolates, 15 isolates (34%) showed MIC ≥32 µg.ml in the E- test. The prevalence rates of genes were 4.16, 12.5, 8.33, and 1.38% for blaOxa-10, blaShv, blaVeb-1, and blaPer-1 genes, respectively. Conclusion:  The ceftazidime resistance rate and the prevalence rate of resistance genes in the present study were lower than other Iranian studies.  However, isolation of these genes is alarming that excessive use of antibiotics can lead to over expression of resistance genes and bacterial efflux pumps and the emergence of MDR phenotypes. http://iem.modares.ac.ir/article-1-9838-en.pdf 2017-01-01 1 5 Pseudomonas aeruginosa Beta-Lactamase Genes Multidrug resistance Nahid Bavasheh 1 Department of Microbiology, Jahrom Branch, Islamic Azad University, Jahrom, Iran. AUTHOR Afsaneh Karmostaji 2 Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. AUTHOR
ORIGINAL_ARTICLE Evaluation of a Multiplex PCR Assay for the Identification of Campylobacter jejuni and Campylobacter coli Background: Campylobacter jejuni and Campylobacter coli are identified as the major causes of acute gastroenteritis in humans. Because of the fastidious nature of Campylobacters, many clinical laboratories fail to routinely culture them. The detection of Campylobacter spp. using molecular-based techniques can be useful for diagnostic and epidemiological applications. This study aimed to developa multiplex PCR assay for the simultaneous detection of C. jejuni and C. coli strains from clinical specimens Materials and Methods: During a 19-month period, stool samples were collected from 980 children admitted to a hospital in Tehran, Iran and then examined. The samples were cultured on both Brucella agar and Modified Charcoal-Cefoperazone-Deoxycholate agar (mCCDA) media at 42°C for 48 h. To confirm suspected bacteria, Gram staining and other biochemical tests were carried out. Finally, after extracting DNA from pure cultures using the boiling method, the multiplex PCR assay was performed. Results: The multiplex PCR assay showed that Campylobacter spp. can be detected using 400 bp target product of cadF. It can also accurately distinguish between C. jejuni and C. coli species with different bands of 735 bp and 500 bp using hipO and asp genes, respectively Conclusions: Results showed that the multiplex PCR assay can replace the biochemical assays for differentiating between C. jejuni and C. coli strains in a single-step PCR test. http://iem.modares.ac.ir/article-1-9197-en.pdf 2017-01-01 6 8 Campylobacter jejuni Campylobacter coli Multiplex PCR Saeed Shams 1 Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran And Department of Medical Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran AUTHOR Mehdi Ghorbanalizadgan 2 Department of Bacteriology, Faculty of Medical Sciences, Baqiyatallah University, Tehran, Iran AUTHOR Somayeh Haj Mahmmodi 3 Laboratory of Children's Medical Center. Tehran, Iran AUTHOR Alessandra Piccirillo 4 5Department of Comparative Biomedicine and Food Science, University of Padua, Padova, Italy AUTHOR
ORIGINAL_ARTICLE Evaluation of the Antimicrobial Resistance of Klebsiella pneumoniae by E-Test Method in Khatam_ol_Anbia Hospital, Tehran, Iran, during 2015 Background: Gram-negative organisms producing Extended-spectrum beta-lactamases (ESBLs) are presented as a global problem. Klebsiella pneumoniae is considered as one of the most important microorganism of this group. The prevalence rate of K. pneumoniae species is increasing, and this increase is higher in the ESBL group, indicating the increase in antibiotic resistance. We must have sufficient knowledge about regional antibiotics resistance in order to monitor the prevalence rate and antimicrobial resistance among the isolates by appropriate treatment. In this regard, the objective of our study was to evaluate antimicrobial susceptibility among K. pneumoniae isolates by E-test method in Khatam ol Anbia hospital during 2015. Materials and methods: This descriptive cross-sectional study was carried out during 2015.  All clinical samples were collected from intensive care unit (ICU) and general wards of Khatam ol Anbia hospital. All of the K. pneumoniae strains were detected by biochemical and microscopic tests. Antimicrobial susceptibility and minimum inhibitory concentration (MIC) were determined by disk diffusion and E-test methods. Descriptive statistics was used to analyze data. Results: About 62 K.  pneumoniae strains were isolated from clinical samples of ICU and general wards during one year. Of these, 38 (61.3%) isolates were isolated from intensive care unit, and 24 (38.7%) isolates were isolated from the general wards. In this review, the least resistance was related to colistin (4.8%) and Amikacin (14.5%), respectively, and the most resistance was observed to the antibiotics of ciprofloxacin (66.1%), ceftriaxone (62.9%) and gentamicin (59.7%), respectively. Resistance to imipenem was observed in 38.7% of the isolates. Conclusion: The current study demonstrates that antibiotic resistance pattern is changing, and resistance to imipenem and colistin is rising, so this should be considered as a serious risk for admitted patients in hospital.   http://iem.modares.ac.ir/article-1-4693-en.pdf 2017-01-01 9 11 Klebsiella pneumoniae Antimicrobial resistance E-test Davood Yadegarynia 1 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran AUTHOR Jalal Karimi 2 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran AUTHOR Sara Rahmati Roodsari 3 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran AUTHOR Zahra Arab-Mazar 4 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran AUTHOR
ORIGINAL_ARTICLE Monitoring the Virulence Genes in Campylobacter coli Strains Isolated from Chicken Meat in Tehran, Iran Background: Campylobacter species are the main food-borne pathogens which could cause gastroenteritis in humans. Contaminated chicken products have been documented as the primary sources of Campylobacter transmission to human. This study was done to test raw chicken meat products retailed in local markets in Tehran, Iran for the presence of Campylobacter coli and Campylobacter jejuni species. Materials and methods: A total of 70 raw chicken meat samples were collected during a three-month study. All the Campylobacter species were identified by biochemical and species-specific polymerase chain reaction (PCR). These isolates were investigated further to examine their potential virulence factors. Results: Campylobacter spp. were detected in 56% of the isolates and identified as C. coli. The results indicated that all of the isolates were positive for cadF, cdtA, iam genes. On the other hand, none of the isolates were positive for flaA and pladA virulence genes. Conclusion: Overall, the results showed that Campylobacter species were common contaminants in chicken meat, which should be screened for the presence of virulence determinants and for their involvement in food-borne diseases.   http://iem.modares.ac.ir/article-1-10419-en.pdf 2017-01-01 12 15 Campylobacter coli Campylobacter jejuni PCR Virulance gene Maryam Kalantar 1 Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran AUTHOR Mohammad-Mehdi Soltan Dallal 2 Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran AUTHOR Fatemeh Fallah 3 Pediatric Infection Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran AUTHOR Fatemeh Yektaie 4 Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran AUTHOR
ORIGINAL_ARTICLE Frequency of Seropositive People for brucellosis In Yazd Background: Brucellosis is one of the most prevalent infectious diseases in Iran, which is shared between humans and animals. Brucellosis is caused by Brucella  species and transmitted via unpasteurized milk or dairy products, which has been reported at least in 80 countries.The present study aimed to evaluate the prevalence rate of seropositive cases of brucellosis in Yazd, Iran. Materials and Methods: In this retrospective cross sectional study, seropositivity rate of brucellosis was examined for 12258 patients. The Wright test (1.80 or higher) was used for diagnosing brucellosis. The obtained results were statistically evaluated by chi-square which is a trend analysis method. Results: The seropositivity rate of Wright test was reported to be 178 (1.5%), which was significantly higher in the summer (43.3%) and spring (29.7%) than other seasons (P = .000). It was also significantly higher in men (53.9%) (P = .000) than in women, and in people over 40 years (41%) (P = .000) than in other age groups. Conclusion: Brucellosis seropositive studies provide very good information in order to help us in investigating the impact of brucellosis. http://iem.modares.ac.ir/article-1-9691-en.pdf 2017-01-01 16 18 Brucellosis Prevalence Infectious Diseases Jamshid Ayatollahi 1 Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AUTHOR Abolfazl Dehghanpour Farashah 2 Medicine Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AUTHOR Mahmood Vakili 3 Department of Community Medicine, Medicine Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AUTHOR Seyed Hossein Shahcheraghi 4 Department of Modern Sciences & Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran AUTHOR
ORIGINAL_ARTICLE Laboratory Mycological Study of Visceral Fungal Infection in Tehran, Iran Background: Many comprehensive epidemiological studies have been done about fungal infections, which areone of the publichealth and therapeutic problemsin different communities. Since prevalence rate of fungal diseases and their etiological agents are changing over time,the aim of this study was to provide additional information about visceral fungal infections (VFIs) in order to understand the ways of their dissemination, to prevent disease transmission, to eliminate contamination sources and predisposing factors, and to provide effective ways for their treatment. Materials and Methods: Samples were taken from the lesion of patients referred to medical mycology laboratory of Tehran University of Medical Sciences from 2014 to 2015. After providing direct wet mount of Potassium hydroxide (KOH) smears from these samples and samples sent from other medical centers, culturing on Sabouraud Dextrose agar with chloramphenicol (SC) and brain heart infusion agar (BHI) media was performed. After growth, species were identified. Results: From a total of 295 suspected samples, VFI was proved in 69 cases (23%). Aspergillosis was the most prevalent infection among VFIs. Candidiasis, cryptococcosis and mucormycosis were in the late orders, respectively. Two patients were also infected by Trichosporon. The predominant species in aspergillosis infections was Aspergillus flavus, and the predominant species in candidiasis infections was Candida albicans. Conclusion: According to the obtained results on the prevalence rate and incidence of VFIs between male and female patients in different age groups and also by taking into account the prevalent type of fungi and infectious site of patients’ bodies, it is possible to take appropriate action for the prevention and treatment of these kinds of diseases by using the important keys of these results to research and study etiological and underlying factors involved in these diseases. http://iem.modares.ac.ir/article-1-9778-en.pdf 2017-01-01 19 22 Visceral Fungal Infection Invasive Marzieh Hamedifard 1 Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran AUTHOR Seyed Jamal Hashemi 2 Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran AUTHOR Roshanak Daie Ghazvini 3 Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran AUTHOR Mahdi Zareei 4 Department of Health, Rescue and Treatment of I. R. Iran Police Force, Tehran, Iran AUTHOR Leila Hosseinpour 5 Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran AUTHOR Zeinab Borjian Boroujeni 6 Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran AUTHOR
ORIGINAL_ARTICLE Multiplex PCR for Detection of a Successful Pathogen; Acinetobacter baumanni as a Real Threat in Intensive Care Unit of a University Hospital Multidrug resistance in Acinetobacter baumannii is a growing public health concern all over the world. In the current study, the isolation and antimicrobial resistance pattern and detection of blaOXA-51 and lpxC genes by multiplex PCR method was performed. All the isolates demonstrated high levels of resistance rates to amikacin, ciprofloxacin, meropenem, imipenem, ceftriaxone, gentamicin, and colistin. Screening of two resistance genes by multiplex PCR showed that all the isolates contained blaOXA-51 and lpxC genes. As we previously reported, nosocomial infections caused by A. baumannii isolates are a major cause of morbidity and mortality in our hospital.   http://iem.modares.ac.ir/article-1-7963-en.pdf 2017-01-01 23 24 Acinetobacter baumannii Nosocomial infection multidrug-resistance blaOXA-51 and lpxC genes Enayatollah Kalantar 1 Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran. AUTHOR Majid Madani 2 Diagnostic Laboratory, Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran. AUTHOR Amir Hatami 3 Diagnostic Laboratory, Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran. AUTHOR Mohammad Hossein Dehghan 4 Department of Biochemistry, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran. AUTHOR Monireh Ebadi 5 Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran. AUTHOR Morteza Nazari 6 Diagnostic Laboratory, Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran. AUTHOR Saber Saifei 7 Diagnostic Laboratory, Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran. AUTHOR Seyed Mahmoud Amin Marashi 8 Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran. AUTHOR
ORIGINAL_ARTICLE Middle East Mycobacterium tuberculosis Antibiotic Resistance: A Systematic Review and Meta-Analysis Background: The global control of the drug resistance tuberculosis has remained as major challenge. The present study was the first review study in the Middle East region in order to determine levels of Mycobacterium tuberculosis resistance to the first-line anti-TB drugs among both new and previously treated cases. Materials and Methods: The computer-assisted search was performed by using PubMed, Google Scholar, Scopus databases and related keywords. Within the time span of 1981-2014, a total of 480 articles were collected on the antibiotic resistance rates of M. tuberculosis in different countries of the Middle East region. About 63 relevant articles were selected by applying inclusion and exclusion criteria. Results: By using meta-analyses, we determined mono drug resistance, any drug resistance, and multidrug resistance (MDR-TB) rates in both new and previously treated TB patients living in different parts of the Middle East. Other aspects related to patients, antimicrobial resistance, and methods used to assess the resistance rate were also analyzed. Conclusion: The present study revealed that in comparison with the global average rate, the prevalence rate of drug resistant TB, especially MDR-TB, may be increasing in the Middle East. Therefore, in order to prevent the spread of drug-resistant isolates, detecting primary resistance to anti-TB drugs with the use of new rapid diagnostic methods is necessary. http://iem.modares.ac.ir/article-1-10173-en.pdf 2017-01-01 25 35 Mycobacterium tuberculosis Antibiotic resistance Middle East Farzad Khademi 1 Antimicrobial Resistance Research Center, Department of Medical Bacteriology and Virology, Qaem University Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran AUTHOR Arshid Yousefi-Avarvand 2 Antimicrobial Resistance Research Center, Department of Medical Bacteriology and Virology, Qaem University Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran AUTHOR Mohammad Derakhshan 3 Antimicrobial Resistance Research Center, Department of Medical Bacteriology and Virology, Qaem University Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran AUTHOR Hamid Vaez 4 Microbiology Laboratory, Besat Hospital, Tehran, Iran AUTHOR Ramin Sadeghi 5 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran AUTHOR