https://iem.modares.ac.ir/ Infection Epidemiology and Microbiology en daily 1 Sun, 01 Feb 2026 00:00:00 +0330 Sun, 01 Feb 2026 00:00:00 +0330 https://iem.modares.ac.ir/article_28095.html Background: We investigated the prevalence, diversity, and antibiotic susceptibility profiles of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant S. aureus (VRSA) strains isolated from ICU patients in Tehran, Iran.Materials & Methods: A total of 247 S. aureus isolates were collected from patients admitted to the ICU of a referral hospital in Tehran between June and August 2022. Antimicrobial susceptibility testing was done on all isolates using the disc diffusion method. MRSA was identified by cefoxitin screening and mecA gene detection. Vancomycin resistance was assessed by E-test and confirmed by the detection of vanA and vanB genes. A combination of Staphylococcal cassette chromosome mec (SCCmec), pulsed-field gel electrophoresis (PFGE), and ccr typing methods was used to measure the genetic diversity of the strains. Findings: Our results revealed that 60 (24%) and 7 (3%) isolates were identified as MRSA and VRSA, respectively. vanA and vanB genes were detected in 100% and 29% of VRSA isolates, respectively. There was a high level of resistance to penicillin, ciprofloxacin, and tobramycin. Out of 205 (83%) strains showing SCCmec, 96 (47%) belonged to type III SCCmec. Typing of the isolates with PFGE showed the presence of 32 pulsotypes consisting of 19 common (CTs) and 13 single types (STs) among the studied strains, with CT3 comprising 43% of VRSA strains. Conclusion: The detection of a dominant VRSA clone and a considerable prevalence of MRSA among ICU patients underscores the role of ICUs as potential reservoirs for MRSA dissemination. https://iem.modares.ac.ir/article_28715.html Background: Due to recent reports of resistance to β-lactams and macrolides, the use of fluoroquinolones (FQs) for treating Streptococcus pneumoniae infections has increased. This study aimed to evaluate the molecular mechanisms of FQ resistance in pneumococcal isolates.Materials & Methods: This study was conducted on 131 pneumococcal isolates (67 nasopharyngeal isolates from healthy individuals and 64 clinical isolates) collected in Tehran, Iran, in 2023. Susceptibility to FQs was determined, and quinolone resistance–determining regions (QRDRs) of gyrA, gyrB, parC, and parE in resistant isolates were amplified and sequenced.Findings: Disk diffusion testing showed that 23 (17.5%) and five (3.8%) isolates were resistant to norfloxacin (5µg) and ofloxacin (5µg), respectively. Minimum inhibitory concentration (MIC) test confirmed resistance in 22 of 23 norfloxacin-resistant isolates. All five ofloxacin-resistant isolates were distinct from the norfloxacin-resistant group, and their resistance was also confirmed by MIC testing. Overall, 28 non-overlapping resistant isolates were selected for sequencing. Among these isolates, mutations in parC and gyrA were detected in four (14.28%) and five (17.85%) isolates, respectively, while two (7.14%) isolates harbored simultaneous mutations in both genes. The most frequent substitutions were Ser81→Leu in parC and Glu85→Lys and Ser81→His/Thr in gyrA. No statistically significant difference was observed between nasopharyngeal (healthy flora) and clinical isolates regarding FQ resistance patterns.Conclusion: This study identified key molecular mechanisms of fluoroquinolone resistance in S. pneumoniae, primarily involving mutations in parC and gyrA, including double mutations. Notably, all isolates remained susceptible to moxifloxacin, supporting its effectiveness in treating pneumococcal infections. https://iem.modares.ac.ir/article_28717.html Background: Salmonella enterica serovar Typhimurium is a major foodborne pathogen with growing resistance to antibiotics. Plant-derived essential oils (EOs) have emerged as potential alternatives due to their antimicrobial and anti-virulence properties. This study aimed to investigate the antibacterial, anti-biofilm, and quorum sensing (QS) inhibitory effects of EOs derived from Thymus daenensis and Satureja hortensis.Materials & Methods: The antibacterial activity of the EOs was evaluated by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) using standard microbiological assays. Biofilm inhibition and disruption were assessed via crystal violet staining. Gas chromatography-mass spectrometry (GC-MS) was used to analyze the chemical composition of the EOs. Real-time PCR was performed to measure the expression of QS-related genes.Findings: Both EOs exhibited antibacterial activity against S. Typhimurium, with MICs of 6.25 µg/mL (T. daenensis) and 12.5 µg/mL (S. hortensis) and MBCs of 25 µg/mL for both. GC-MS analysis revealed carvacrol, thymol, γ-terpinene, p-cymene, and α-terpinene as major constituents. At sub-MIC concentrations, T. daenensis EO inhibited biofilm formation by 68% and disrupted mature biofilms by 54%, while S. hortensis EO showed 45 and 37% inhibition, respectively. Both EOs significantly downregulated QS-related genes, indicating strong anti-QS activity.Conclusion: The EOs derived from T. daenensis and S. hortensis exhibited strong antibacterial, anti-biofilm, and anti-QS properties against S. Typhimurium. These findings support their potential as natural therapeutic agents for combating resistant Salmonella infections. https://iem.modares.ac.ir/article_28716.html Background: Efflux pump-mediated antibiotic extrusion is a key mechanism of multidrug resistance in Mycobacterium tuberculosis (MTB). Inhibiting these pumps is a promising strategy for resensitizing resistant strains to conventional antibiotics.Materials & Methods: An integrated in silico approach was employed to evaluate the interaction of drug-like ligands, primarily phytochemicals, with key MTB efflux pumps. Homology models of DrrA, DrrB, and DrrC proteins and the crystal structure of Rv1819c were used for molecular docking. Top-scoring ligands were subsequently analyzed for drug-likeness, toxicity profile, and binding stability via molecular dynamics (MD) simulations to identify the most promising efflux pump inhibitors (EPIs).Findings: Molecular docking revealed high-affinity binding of several phytochemicals. The top-scoring ligands were curcumin, rosmarinic acid, and pracinostat for DrrA; curcumin, kanzonol C, and Skf-100330A for DrrB; and rosmarinic acid, curcumin, and kanzonol C for DrrC. For the Rv1819c protein, the top-scoring compounds were crocetin, curcumin, and kanzonol C, which were found to bind specifically to the ATP-interacting pocket. An integrated analysis of docking affinity, molecular dynamics stability, toxicity, and drug-likeness identified curcumin, kanzonol C, rosmarinic acid, and crocetin as the most promising candidate EPIs.Conclusion: The present in-silico study identified curcumin, kanzonol C, rosmarinic acid, and crocetin as promising phytochemical inhibitors of key MTB efflux pumps. These compounds exhibited potential for synergistic activity with conventional anti-tuberculosis drugs. Therefore, preclinical and experimental validation is warranted to confirm their efficacy as efflux pump inhibitors. https://iem.modares.ac.ir/article_28720.html Background: Acinetobacter baumannii is a crisis-causing opportunistic pathogen with a high capacity for clonal spread. blaOXA-51-like and ampC sequence-based typing (SBT) is a cost-effective and reliable technique to identify global and widespread lineages of A. baumannii strains. This research aimed to study circulating A. baumannii clones using single-locus sequence typing (SLST) as a reliable and cost-effective method.Materials & Methods: A total of 119 A. baumannii clinical isolates were collected from hospital inpatients from February to September 2024. The antibiotic resistance profile of A. baumannii isolates was determined, and genotyping was performed using SBT of blaOXA-51-like and ampC genes.Findings: All A. baumannii isolates were specified as multidrug-resistant (MDR), and 78.1% were identified as carbapenem resistant. Resistance to colistin was observed in 5% of isolates with a minimum inhibitory concentration (MIC) of ≥128 μg/mL. SBT of the blaOXA-51-like gene revealed four various blaOXA-51-like allele variants: including blaOXA-69 (n=47, 39.5%), blaOXA-64 (n=21, 17.6%), blaOXA-383 (n=44, 37%), and blaOXA-441 (n=7, 5.9%). SBT of the ampC specified two alleles, including ampC-1 (n=47, 39.5%) and ampC-25 (n=21, 17.6%), and 51 (42.9%) isolates showed an undetermined allele variant of the ampC gene. blaOXA-69 /ampC-1 and blaOXA-64 / ampC-25 pertained to sequence type 1/ clonal complex 1 (ST1/CC1) and ST25/CC25, respectively. Conclusion: SBT of the blaOXA-51-like and ampC genes revealed a relatively high prevalence of the international ST1/CC1 clone in MDR A. baumannii isolates in our region. However, the blaOXA-383 allele variant, which could possibly be associated with endemic clones, also had an approximately significant frequency. https://iem.modares.ac.ir/article_28721.html Background: The rapid rise in antibiotic resistance is a grave worldwide concern, with tigecycline being a key treatment here. Inherent resistance is making this common yet sometimes fatal bacterium, Streptococcus pyogenes, difficult to treat. This study looks at whether the liquid from the probiotic Bifidobacterium bifidum can lower the activity of important tigecycline resistance genes: tet(M), tet(O), and tet(X1) in clinical samples of S. pyogenes.Materials and Methods: A total of 60 S. pyogenes isolates were identified from 100 clinical samples using biochemical methods. The tigecycline susceptibility test was carried out, following standard antibiogram procedures. The antimicrobial potential of the supernatant of B. bifidum was assessed by determining the MIC and MBC values of it.Findings: About 58.3% (35 of 60) of isolates were resistant to tigecycline. The most common resistance-associated gene was tet(M) (16.67%), followed by tet(O) (11.67%) and tet(X1) (1.67%). No isolate carried all three genes together. MIC and MBC values of probiotic supernatant were within the range of 8-128 and 16-128 μg/mL, respectively. Crucially, real-time PCR showed that the supernatant significantly reduced the expression of all three resistance genes in treated isolates.Conclusion: These results suggest that B. bifidum supernatant may help suppress tigecycline resistance in S. pyogenes by downregulating the expression of critical resistance genes. This highlights its potential as a natural, supportive strategy to help combat antibiotic resistance and lays the groundwork for future clinical or therapeutic research. https://iem.modares.ac.ir/article_28719.html Background: Increased antibiotic resistance due to the overuse and misuse of antibiotics is a severe threat to both the aquaculture industry and human health. This study aimed to determine the antibiotic resistance pattern of bacteria isolated from rainbow trout. Materials & Methods: A total of 79 and 120 fish samples were collected in 2022 and 2023, respectively. Swab samples were enriched in TSB (tryptic soy broth) and cultured on TSA (tryptic soy agar). The grown colonies were evaluated for Aeromonas hydrophila, Lactococcus garvieae, Streptococcus iniae, and Yersinia ruckeri. Antibiotic resistance patterns against 10 common antibiotics were evaluated. Findings: In this study, four types of bacteria (A. hydrophila, L. garvieae, S. iniae, and Y. ruckeri) were isolated. The results of antibiotic resistance analysis during 2022-2023 showed that in all isolated bacteria, the percentage of antibiotic resistance against enrofloxacin and florfenicol was higher in 2023 than in 2022. Conclusion: The isolated bacteria had different resistance patterns, these patterns could be used as a guide for selecting appropriate antibiotics to control infectious diseases in rainbow trout. This finding may be due to improper administration of these antibiotics in rainbow trout production. https://iem.modares.ac.ir/article_28718.html Background: Dengue virus infection is a severe systemic condition primarily transmitted by its main vector, Aedes aegypti. Skin rash may be the initial symptom in patients with dengue virus infection, which could be helpful for clinical diagnosis. This research aimed to evaluate the prevalence of skin manifestations associated with dengue virus infection worldwide. Materials & Methods: Electronic resources such as Scopus, Medline (via PubMed), and Web of Science were searched to identify studies focusing on skin manifestations in patients with dengue virus infection between 2000 and 2024. Statistical analysis was conducted using Stata software, and sources of heterogeneity were assessed using I2. Findings: A total of 24 papers (six prevalence studies and 18 case reports/case series) were included. A meta-analysis of prevalence studies revealed that skin manifestations were reported in patients with dengue virus infection in three countries (India, Pakistan, and France), with an overall prevalence of 63.2% (95% CI: 54.4-71.1) among 962 dengue virus infected patients. Analysis of case reports/case series showed that among 19 dengue virus infected cases, skin rash and thrombocytopenia were the most common skin manifestations and laboratory indications, respectively.Conclusion: Dengue virus infection could result in various dermal manifestations with distinct clinical symptoms and laboratory findings. These skin involvements may aid in the timely diagnosis of patients with dengue virus infection. https://iem.modares.ac.ir/article_29036.html Background and Aims: Antimicrobial resistance among uropathogenic Escherichia coli represents a growing global health concern and is largely driven by the dissemination of resistance genes through mobile genetic elements such as integrons. This study aimed to investigate antimicrobial resistance patterns and determine the prevalence of class 1 and class 2 integrons among E. coli isolates recovered from patients with urinary tract infections (UTIs).Methods: A total of 100 non-duplicate E. coli isolates were obtained from urine samples collected from hospitalized patients at Al-Hilla Teaching Hospital, Babylon, Iraq. Antimicrobial susceptibility testing was performed using standard methods, and the presence of intI1 and intI2 genes was determined by polymerase chain reaction (PCR). Findings: High resistance rates were observed to ampicillin (75%), nalidixic acid (69%), and co-trimoxazole (52%), whereas gentamicin (67%) and amikacin (69%) showed the highest susceptibility rates. Multidrug resistance was detected in 65% of the isolates. PCR analysis revealed that 75% of isolates carried the intI1 gene, while intI2 was detected in 5%. The presence of intI1 was significantly associated with resistance to ampicillin, ciprofloxacin, and co-trimoxazole (P < 0.05). Conclusions: The high prevalence of integron-associated multidrug resistance among E. coli isolates underscores the need for continuous surveillance and strengthened antimicrobial stewardship programs to optimize the management of UTIs. https://iem.modares.ac.ir/article_29037.html Aims: Biofilm formation supports the persistence of Acinetobacter baumannii (A. baumannii) in hospital environments and can reduce antimicrobial effectiveness. Therefore, phenotypic and genotypic studies of this bacterium in intensive care units (ICUs), can be helpful in the control and containment of infection. This study aimed to investigate the phenotypic and genotypic characteristics of biofilm formation in Acinetobacter baumannii isolates obtained from ICUs.Methods: Between March and September 2021, 81 sputum-derived A. baumannii isolates were recovered from ICU patients. Species confirmation was performed by polymerase chain reaction (PCR) targeting the blaOXA-51-like gene. Antibiotic susceptibility testing was used to determine the phenotypic resistance pattern. Biofilm formation was assessed phenotypically for all isolates. The presence of the ompA, csuE and bap genes was determined by PCR.Findings: Among the 81 patients, 42 (51.9%) were male and 39 (48.1%) were female. Piperacillin-tazobactam (96.3%, n=78/81) and imipenem (93.8%, n=76/81) showed the highest rates of resistance, and cefotaxime (56.8%, n=46/81), followed by gentamicin (46.9%, n=38/81), were the most susceptible antibiotics among the isolates. The ability to produce biofilm can be described as follows: 5 (6.17%) had no ability, while 76 (93.8%) were able to form biofilm. Moderate formation was the most common biofilm pattern (42 isolates, 51.85%), followed by weak (32, 39.50%) and strong formation (2, 2.47%). PCR detected bap, csuE, and ompA in 93.8%, 86.4%, and 82.7% of isolates, respectively.Conclusion: Phenotypic and genotypic information on biofilm production in isolates commonly found in ICUs could strengthen infection-control measures and antimicrobial stewardship. https://iem.modares.ac.ir/article_29038.html Rapid detection of carbapenemase-producing Gram-negative bacteria is critical for timely antimicrobial stewardship and infection control interventions. This study evaluated the analytical diagnostic performance of KarbaDia, a new multiplex lateral flow immunochromatographic assay for rapid detection of KPC, NDM, VIM, IMP, and OXA-48-like carbapenemases. An analytical diagnostic accuracy evaluation study was conducted using 78 non-duplicate, well-characterized Gram-negative bacterial isolates obtained from publicly available diversity panels. The collection included carbapenemase-producing and carbapenemase-negative isolates of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Whole genome sequencing (WGS) served as the reference standard. KarbaDia (GaDia SA, Switzerland) was evaluated in parallel with the Carbapenemase Detection Kit (Colloidal Gold; Macro & Micro-Test). Sensitivity, specificity, and 95% confidence intervals (CI) were calculated for each carbapenemase family and for overall assay performance. KarbaDia demonstrated sensitivities of 100% for KPC (6/6), NDM (13/13), VIM (3/3), and IMP (2/2), and 90.0% for OXA-48-like enzymes (9/10). Overall sensitivity was 97.1% (95% CI: 85.1–99.9), while specificity reached 100% (95% CI: 99.0–100). No false-positive results were observed. The comparator assay demonstrated similar overall sensitivity (97%) but produced four invalid results (4.8%), mainly associated with viscous Klebsiella pneumoniae colonies and incomplete chromatographic migration. KarbaDia demonstrated high analytical accuracy for rapid multiplex detection of major carbapenemase families. The assay combines rapid turnaround time, multiplex capability, and ease of visual interpretation without dedicated instrumentation. These characteristics support its potential applicability in routine clinical microbiology laboratories; however, prospective multicenter clinical validation studies remain necessary before routine implementation. https://iem.modares.ac.ir/article_29039.html Objectives: To investigate the antimicrobial resistance profile and the occurrence of multidrug resistance (MDR) among Escherichia coli isolates recovered from urine cultures of outpatients attending a public teaching hospital in Brazil and to assess the association of sex and age with MDR.Methods: A cross-sectional study was conducted based on a retrospective analysis of urine cultures collected from outpatients between January and December 2024. Descriptive statistics were applied, and univariate and multivariate logistic regression analyses were performed to identify factors associated with MDRResults: Among the 1,955 urine cultures analyzed, 418 (21.4%) demonstrated significant bacterial growth, with E. coli accounting for 202 (48.3%) of the positive isolates. Resistance rates were highest for ampicillin (56.9%), ciprofloxacin (37.6%), and trimethoprim–sulfamethoxazole (35.0%), whereas low resistance rates were observed for nitrofurantoin (8.3%) and fosfomycin (3.1%). MDR was identified in 71 (35.1%) isolates, among which 24 (33.8%) exhibited an extended-spectrum β-lactamase phenotype and three (4.2%) produced carbapenemases. In the multivariate analysis, age above the median was independently associated with MDR (adjusted OR = 2.27; 95% CI: 1.24–4.14)Conclusion: A substantial proportion of E. coli isolates from community-acquired urinary tract infections presented multidrug resistance, particularly among older patients. These findings emphasize the importance of local antimicrobial resistance surveillance and the periodic review of empirical treatment protocols in outpatient settings. https://iem.modares.ac.ir/article_29040.html Background: The present study was designed to assess the global prevalence of HGV/HIV coinfection and the impact of HGV on HIV viral load and CD4 cell count. Methods: A literature search was performed in PubMed, Scopus, EMBASE, Web of Science, ProQuest, Cochrane, and Global Index Medicus (GIM) up to January 2026. Two researchers independently assessed eligibility and extracted the data. The I2 statistic and Cochran's Q test were used to assess heterogeneity. To find potential causes of heterogeneity, subgroup analyses were carried out. The funnel plot and Egger’s tests were used to assess publication bias.Results: A total of 86 studies with 19050 HIV-positive published from 1997 to 2023 and covering 36 different countries were included for further analysis. The overall prevalence of HGV among HIV-positive patients was 25.3% (95% CI 23.6–27%). The prevalence of HIV/HGV coinfection in different continents was as follows: 26.5% in Africa, 21.9% in Asia, 26.7% in Europe, 24.6% in North America, and 25.1% in South America. The overall mean of CD4 was significantly different between HGV-positive and HGV-negative patients (p =0.004), while the overall mean of HIV viral load was not significantly different between HGV-positive and HGV-negative patients (p =0.25).Conclusion: This meta-analysis found a 25.3% global prevalence of HGV/HIV coinfection, with higher CD4 counts in coinfected patients (p=0.004) but no viral load impact (p=0.25). Results suggest HGV may modulate HIV progression, though mechanisms remain unclear. Larger longitudinal studies are needed to confirm clinical significance and explore genotype-specific effects. https://iem.modares.ac.ir/article_29041.html ABSTRACTBackground: Fever is a common presenting symptom in developing countries. Epidemics of acute febrile illness (AFI) have caused major public-health concerns in India and abroad. Dengue, Typhoid, acute viral hepatitis, Chikungunya, Scrub Typhus, and Malaria are frequent causes. Each year, particularly during and after the rainy season, the northern region experiences AFI outbreaks with undocumented aetiologies. Significant gaps remain in knowledge of the aetiological spectrum and risk factors. This study aimed to bridge these gaps and generate evidence for public-health action.Materials and Methods: A prospective observational study was conducted in the Department of Microbiology over 18-month period (July 2023 – December 2024) at the Punjab Institute of Medical Sciences, Jalandhar. Samples of patients from OPDs and IPDs with acute fever were evaluated.Serological tests for Dengue, Typhoid, Hepatitis A & E, Chikungunya, Scrub Typhus, and Malaria as prescribed by physician were performed.Findings: A total of 8127 samples were evaluated. Typhoid and Dengue were the leading causes (10.02% and 9.75%, respectively), followed by Hepatitis A (5.2%), Chikungunya (2.5%), Hepatitis E (2.34%), and Malaria (0.3%). Mixed infections were detected in 351 (4.32 %) samples.Conclusion: The similarity of AFI symptoms complicates diagnosis without laboratory confirmation. A detailed history, careful examination, and appropriate laboratory tests facilitate timely diagnosis, rational treatment, and prevention of fatal outcomes.Keywords: Acute febrile illness; Dengue; Typhoid; Hepatitis A; Scrub typhus; Surveillance https://iem.modares.ac.ir/article_29042.html AbstractBackground:The presence of pathogenic Escherichia coli in unpasteurised milk increases the danger of infection. This study investigates the prevalence, extended-spectrum beta-lactamase (ESBL) indicators, and antibiotic susceptibility of pathogenic E. coli in unpasteurised milk from the Ohimini Local Government Area in Benue State.Methods:One hundred milk samples were collected from the Ohimini Local Government Area, and E. coli isolates were identified through various methods including morphological, biochemical, serological analysis, and PCR. ESBL production was screened with the double-disc diffusion method, and β-lactamase genes (bla_TEM, bla_SHV, bla_CTX-M) were detected through simplex PCR. Antibiotic susceptibility was assessed using the Kirby–Bauer disc diffusion method against multiple antibiotics.Findings:13% of samples tested positive for E. coli, with 4(30.8%) classified as non-sorbitol fermenting (NSF) and 9(69.2%) as sorbitol fermenting (SF). All isolates were resistant to gentamicin. SF isolates showed significant resistance to ceftazidime 6(66.7%), aztreonam 4(44.4%), and amoxicillin–clavulanate (42%), but were less resistant to imipenem 1(11%) and other β-lactams. In contrast, NSF isolates exhibited higher resistance rates across multiple agents, with 3(75%) resistance to aztreonam, ceftazidime, and Augmentin, and 2(50%) resistance to ciprofloxacin and meropenem. All isolates were multidrug-resistant, and NSF isolates tested positive for at least one ESBL gene (bla-TEM, bla-SHV, or bla-CTX-M) when analyzed via PCR.Conclusion:Multidrug-resistant E. coli with ESBL genes detected in unpasteurized milk in Ohimini LGA emphasizes the necessity of mandatory pasteurization, enhanced dairy hygiene, and stricter veterinary antibiotic regulations to protect public health. https://iem.modares.ac.ir/article_29043.html Background: Helicobacter pylori is one of the most common pathogenic bacteria in the human gastrointestinal tract, which is associated with chronic gastritis, peptic ulcers, and an increased risk of gastric carcinoma. The decrease in the effectiveness of standard treatments due to antibiotic resistance, side effects, and patient non-adherence has attracted the attention of researchers to the use of medicinal plants and phytochemical compounds. This study aimed to systematically review the most important medicinal plants with anti-H. pylori effects.Materials and Methods: In this review, PubMed, Scopus, Web of Science, and Google Scholar SID databases were searched without time limits until 2025. The keywords “Helicobacter pylori”, “medicinal plants”, “phytopharmacology”, “anti-H. pylori activity” and their Persian equivalents were used. Results: Based on the findings, several Iranian and non-Iranian medicinal plants have significant inhibitory activity against H. pylori. The most important of them are Thymus kotschyanus, Terminalia chebula, Scrophularia striata, Thymus caramanicus, Commiphora myrrha, Punica granatum, Origanum syriacum.Conclusion: The present review suggests that medicinal plants and their active metabolites can be considered as potential complementary or alternative options for the treatment of H. pylori infection, especially in the era of increasing drug resistance. However, further studies are necessary to determine the dosage, safety, pharmacokinetics, and synergistic effects with standard treatments before entering the clinical stage. https://iem.modares.ac.ir/article_29046.html Background: This study aimed to explore the virulence factors associated with Helicobacter pylori and develop a multi-epitope vaccine. Materials & Methods: Several antigenic proteins derived from the H. pylori proteome were analyzed, including CagA, FlaA, FlaB, OipA, SabA, UreA, HSP, BabA, and FecA. B and T cell epitopes were predicted for HTL, CTL, and B cells. Predicted stability and immunological responses to the vaccine were assessed using molecular binding analysis, thermodynamic sketching, in silico expression assessments, and agent-based modeling. Findings: This study identified and selected B-cell epitopes from eight H. pylori proteins using the ABCpred web server, resulting in 19 epitopes after filtering for allergenic, toxic, and homologous properties. Computationally, the epitopes from BabA, CagA, and FlaA showed favorable scores and no adverse characteristics. Additionally, 20 CTL epitopes and 17 HTL epitopes were selected based on their IC50 values and conservation within protein sequences. Molecular docking predicted that the epitope LSDGAAAGY had the highest binding affinity to the MHC allele HLA-A*01:01, achieving -643.6 kcal/moL, suggesting potential for vaccine development. Conclusion: This computational study supports the strategic assembly of epitopes for multi-epitope vaccine design, providing in silico insights requiring experimental validation for future H. pylori interventions. https://iem.modares.ac.ir/article_29047.html Aims: The aim of this study was to assess the efficacy of selected disinfectants at Benghazi medical center hospital. Methods: A total of 64 hand swabs were collected from healthcare workers and 96 samples from the hospital environment. Five bacterial species were selected from the collection to test the bactericidal efficacy of five disinfectant products. Bacterial suspensions were prepared in 9 mL of broth medium and mixed with 1 mL of each disinfectant. All inoculated nutrient agar and MacConkey agar plates were incubated at 37 °C overnight. Bactericidal efficacy was assessed based on colony growth. In addition, the phenotypic expression of ESBL and MBL was assessed in all bacterial isolates. Antimicrobial resistance genes were detected by PCR.Findings: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Micrococcus spp and Klebsiella pneumonia were isolated and identified by microbiological examinations and biochemical tests. All isolates were found to be multidrug-resistant (MDR). The tested disinfectants demonstrated high bactericidal efficacy against these isolates. However, P. aeruginosa was not affected by hydrogen peroxide and alcohol and the methicillin resistant S. aureus survived in iodine-containing medium. Notably, P. aeruginosa isolates, along with their resistance profiles, were detected as MDR strains in various hospital environments, including floors, wash basins, and even on people’s hands and disinfectant bottles. Conclusion: The selection of appropriate disinfectants (or chemical sterilants) is crucial and should be based on their proven efficacy against microbial agents. Proper testing is essential to ensure effectiveness and to prevent the dissemination of disinfectant-resistant and antibiotic-resistant bacteria within hospital environments.