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Showing 17 results for Antibiotic Resistance

Tajaddin Akbarzadeh Khiavi , Mohammadreza Nahaei , Ahmad Rahmati , Mohammad Asgharzadeh, Javid Sadegi ,
Volume 7, Issue 1 (4-2007)
Abstract

  Background and Aims: Staphylococcus aureus as aGram- positive coccus causes a variety of infections in humans. It is one of the infectious agents in hemodialysis patients. Those patients who carry this organism at their nose are exposed to infection and possible morbidity and mortality due to this bacterium. Resistance to antibiotics in staphylococci is increasing. Resistance development is due to mutation and by plasmid DNA transmission. The aim of this study was to determine plasmid profile and antibiotic resistance of Staphylococcus aureus strains isolated from nasal carriers in dialysis patients in Imam Khomeini Medical Center. Susceptibility testing to antibiotics, plasmid extraction and analysis and epidemiologic relationship of these isolates were investigated.

  Methods: In this study nasal specimens of 107 patients in dialysis ward of Imam Khomeini Medical Center were collected and cultured on blood agar plates. The colonies were identified as S.aureus strains. The susceptibility of 50 strains isolated from the patients against 12 antibiotics were tested using Kirby- Bauer standard method. A standard S.aureus strain (ATCC29213) was used to control quality of antibiotic discs. The isolates were cultured on LB medium and plasmid DNAs were extracted and electrophoresed on agarose gel using Parisi et al method.

  Results : The results of resistance rate against 12 used antibiotics were as follows: resistance of the strains against gentamicin, oxacillin, neomycin, clindamycin, erythromycin, cotrimoxazole, choloramphenicole, tetracycline, and ciprofloxacin were 20%, 28%, 30%, 26%, 30%, 44%, 32%, 36%, and 10%, respectively. All of the strains were resistant to amoxycillin and penicillin and none of them were resistant to vancomycin. Of 50 S. aureus strains, only 27 strains contained plasmid DNA. Most of the strains revealed a big plasmid. Plasmid profiles of the strains will be presented.

  Discussion: Our results showed that there was a close relationship between high resistance to antibiotics and presence of plasmids in S. aureus strains. Similarities among resistance to antibiotics and plasmid profiles in our strains isolated from the same ward showed that these strains were from the same sources and indicated a unique clonal possibility. The resistance to antibiotics of the strains lacking plasmids could be from choromosomal resistance


Mohammadreza Nahaei , Reza Bohloli Khiavi , Mohammad Asgarzadeh, Alka Hasani , Javid Sadeghi, Mohammad Akbari Dibavar ,
Volume 7, Issue 1 (4-2007)
Abstract

  Background and Objectives: Pseudomonas aeruginosa is a nosocomial pathogen that presents high antibiotic resistance.There are phenotyping and genotyping methods for epidemiologic study of Pseudomonas aeruginosa such as antibiotic resistance pattern and plasmid profile analysis. Plasmid analysis provides useful information concerning the source of the strains and number of clones present in the epidemies. Thus, this study was conducted to evaluate antibiotic and plasmid profiles of P. aeruginosa strains isolated from in-patients of the Sina Medical Centre of Tabriz to clarify epidemyological correlation among isolated strains.

  Methods: During 13 months, 135 strains of P. aeruginosa were isolated from different infections in hospitalized patients at Sina Medical Center of Tabriz. Antibiotic susceptibility tests were performed using disc agar diffusion test. For plasmid DNA extraction and detection of open circular bands from supercoiled ones, modified alkaline lysis procedure and two dimensional electrophoresis were used, respectively. Enzymatic digestion of plasmids was carried out by EcoRI and HincII restriction enzymes.

  Results: Resistance rates of strains against antibacterial agents were recorded as: Aztreonam (77%), colistin (74%), ceftazidime (69%), pipracillin (67%), ofloxacin (62%), tobramycin (56%), carbenicillin (54%), gentamicin (51%), ciprofloxacin (22%), amikacin (15%), polymixin B (13%) and imipenem (2%). Plasmid profiles of our test strains revealed that only 67 strains harbored plasmid(s). Number of isolated plasmids ranged 1-6 in each strain with molecular mass of 0.5kb-21kb. When the isolated plasmids were digested using restriction endonuclease enzymes (EcoRI and HincII), in 32% of them similar digestion profiles were obtained by EcoRI indicating a unique source for them.

  Conclusion : Our findings suggest high antibiotic resistance and plasmid presence in P. aeruginosa strains isolated from different infections, and there were remarkable similarities among isolated plasmids. Since our test strains had been isolated from various wards in a short period of time, the results raise the possibility of unique source for some strains or high prevalence of genetic exchange among P. aeruginosa strains.


Mojtaba Nikbakht , Siyamak Hassan Nagad , Babak Rezazade, Abbas Nagizadeh Baghi , Faiiaz Gorbani , Fatemeh Faraji, Nasim Karimvand ,
Volume 9, Issue 1 (4-2009)
Abstract

  Background and Objective: Staphylococcus aureus is known as an important pathogen causing a variety of bacterial infections. Treatment of this bacterium with antibiotics has led to antibiotic-resistancey, especially against methicillin (MRSA) and more recently rare resistance against vancomycin. The aims of this study were to determine nasal carriage rates of S. aureus in Meshgin Shahar Valiasr hospital’s personnel and to determine antibiotic-resistance patterns in the mentioned isolates.

  Methods: Staphylococcus aureus isolates were collected from the nose of 200 hospital personnel in Meshgin Shahar Valiasr hospital in a 2 month period in 2006. Antibiotic sensitivity of the collected strains were tested against antibiotics used in routine treatment of S. aureus infections. Oxacillin agar was also used to screen for MRSA according to NCCLS recommendation.

  Results: Our results showed there were 45% and 16% nasal carrier rate for S. aureus and MRSA (methicillin resistant staphylococcus aureus) strains, respectively in hospital personnel. Thirty two isolates were able to grow in oxacillin agar media, indicating 35% MRSA strains. Antibiotic resistant pattern of strains in disks method were recorded as follows: 35% to oxacillin, 97.8% to penicillin, 34% to erythromycin, 2.1% to chloramphenicol, 39.36% to tetracycline, 11.7% to gentamicin, 30.85% to trimetohoprim sulfamethoxazol and 19% to clindamycin. All of the isolates were sensitive to vancomycin and ciprofloxacin.

Conclusion: In this study, nasal carriage rate of Staphylococcus aureus among hospital Personnel was more than community expected rate (%40) and lower than hospital expeeted rate (%50-80). All of the test strains were sensitive to Vancomycin.
Abbasali Imani Foolad , Zahra Rostami , Reza Shapouri,
Volume 10, Issue 3 (9-2010)
Abstract

  Background and Objectives: Detection of TEM and SHV genes in ESBL producing Pseudomonas aeruginosa and their antimicrobial resistance pattern can provide useful information about the epidemiology and risk factors of associated infections. In this study we determined the antimicrobial susceptibility pattern and prevalence of ESBLs in clinical isolates of Pseudomonas aeruginosa by phenotypic and genotypic methods.

  Methods: In this analytic-descriptive study, 110 Pseudomonas aeruginosa strains isolated from different clinical specimens were used. The pattern of antimicrobial resistance was determined by disk diffusion (Kirby-buer) method. The ESBL production was determined by combination disk method using disks containing ceftazidim and cefotaxim alone and in combination with Clavulanic acid. SHV and TEM types of ESBL producing genes was detected by PCR.

  Results: In this study Co-trimoxazole and Amoxicilin with 96.4% and 92.7% and Amikacin with 17.3% showed the highest and lowest resistance against isolates respectively. According to PCR results 37.5% and 12.5% of isolate were carried SHV and TEM genes respectively and 12.5% of isolate were carried both the SHV and TEM genes.

  Conclusion: According to the results most of the isolates are drug resistant and among the ESBL producing strains the frequency of SHV type is higher than TEM . The isolate ceftazidim resistance was contains SHV (37.5%) and TEM gene (12.5%), that showed SHV and TEM genes play more important role in create of ceftazidim resistance than cefotaxim resistance.


Abbasali Imani Foolad, Maryam Hosainzadeh, Seiyed Fazlollah Mousavi ,
Volume 11, Issue 1 (4-2011)
Abstract

  Background & Objectives: Pseudomonas aeruginosa is a Gram-negative and aerobic bacterium. Exotoxin A is one of the important toxins produced by the bacterium and it is the main cause of mortality. About 90% of P. aeruginosa strains produce this toxin. Biofilm is a functional consortium of microorganisms attached to the body surfaces and bacteria are embedded in extracellular polymeric substances produced by the microorganisms. This bacterium is nontoxic in the planktonic form, but as a biofilm is highly toxic. In this study, we examined the association between the presence of exo-A gene and antibiotic resistance patterns with biofilm formation in Pseudomonas aeruginosa strains.

  Methods: In this study 110 strains of Pseudomonas aeruginosa isolated from various infections with defined antibiotic resistance patterns were used. The PCR method was used to detect the presence or absence of Exotoxin A gene (exo-A). Ability of biofilm formation was evaluated by spectrophotometry. Association between exo-A gene and antibiotic resistance patterns with biofilms formation was analyzed statistically by Fishers and Chi-square tests.

  Results: exo-A gene was detected in 93 strains (84.5%). Sixty two strains were multidrug resistant and they produced broad spectrum beta-lactamase enzyme. Results showed that, exo-A positive strains had significantly higher ability to biofilm formation in comparison with exo-A negative strains (p<0.05). Also the biofilm formation was significantly higher in multidrug resistant and ESBL producing strains (p<0.05).

  Conclusion: The results of this study indicate that there is a significant association between exo-A gene as well as antibiotic resistance pattern and ESBl producing with biofilm formation in Pseudomonas aeruginosa. Because of importance of biofilms in the pathogenesis of this bacterium, our study could open a new window for investigation of the molecular processes involved in the formation of biofilms.


Parviz Mohajeri , Babak Izadi , Mansour Rezai , Badie Falahi , Hosna Khademi , Roya Ebrahimi ,
Volume 11, Issue 1 (4-2011)
Abstract

  Background & Objectives: Nowadays, appearance of ESBL producing bacteria is medical problem in the treatment of infections. Uropathogenic Escherichia coli like many other bacteria can produce these types of enzymes. T he assessment of the ESBL production by clinical isolates is not done routinely in laboratories. The aim of this study was to determine the prevalence of ESBL producing E.coli and its antibiotic resistance pattern in Kermanshah.

  Methods: This cross - sectional study was done on 200 Uropathogenic E. coli strains isolated from people in Kermanshah. Sensitivity of isolates to different antibiotics was determined by disk diffusion test and ESBL production was assessed by DDST method.

  Results: The E. coli strains showed high susceptibility to imipenem (100%), amikacin (97%), nitrofurantoin (95.5%), gentamicin (85%), cefepime (75%), ceftazidime (74%), ofloxacin (73.5%), ciprofloxacin, ceftriaxone and aztreonam (71%) and cefotaxime (70%) respectively. The highest resistance was seen to ampicillin (77%), carbenicillin (76%), pipracillin (74%) and SXT (62.5% ). Resistance rate to third generation cephalosporins was 63-75%. Fifty seven isolates (27%) were ESBL producers and 47 isolates (87%) produced all four types of ESBL enzymes.

  Conclusion: There are some similarities and differences in the antibiotic resistance pattern and ESBL production among the isolates in different areas of Iran and other countries. Identification of ESBL producing bacteria and determining its antimicrobial resistance pattern are recommended to effective treatment of infections.


Maryam Chavoshi Frooshani , Abbasali Imani Fooladi , Sara Saadatmand,
Volume 11, Issue 3 (9-2011)
Abstract

  Background & Objectives: Escherishia coli O157:H7 is one of the most important diarrhea causing agents in developing countries . Using antibiotics cause adverse effects as promoting emergence of antibiotic resistance, fading the microflora of intestine and enhancement of verotoxin (VTEC) production by this bacterium. So, a modern treatment protocol is needed for treatment of infections caused by this bacterium. In this study, Lactobacillus casei (L. casei) was isolated from yogurt and antibacterial effects of bacterial cell debris and its culture supernatant were tested against E.coli O157:H7.

  Methods: Several different samples of yoghurt were cultured in MRS agar in anaerobic conditions at 37 ºC. L. casei was identified by common microbiological and molecular methods. Antimicrobial effects of bacterial cell debris and its culture supernatant were tested against E. coli O157:H7 by using Agar Well Diffusion (AWD) and Broth macrodilution methods. In addition, standard growth curves of pathogenic bacterium and L. casei were obtained by turbidometery and colony count procedures. The MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bactericidal Concentration) of supernatant originated from culture of L. casei were determinded. The stability of antimicrobial effects of the supernatant in different conditions of pH and temperature were studied.

  Results: Lactobacillus casei was isolated from two different samples of yoghurts, and confirmed by phenotypic and genotypic methods. The results showed that antimicrobial effects of culture supernatant were stable at 56, 70, 80and 100 ºC for 30 and 60 minutes. Furthermore, they were stable in pH of 3, 7 and 10. The MIC and MBC of supernatants were 1:16 and 1:8 respectively.

  Conclusion: According to the results of this study, culture supernatant of L. casei can be used as a biological preservative in food industries. Also due to antimicrobial effect of L. casei, it can be used in treatment of diseases associated with E. coli O157:H7.


Shahram Abdoli Oskouie, Mohammad Ahangarzadeh Rezaee , Ali Ajhangh , Babak Abdinia,
Volume 13, Issue 1 (4-2013)
Abstract

  Background & Objectives: Staphylococci are among common causes of community acquired and nosocomial infections around the world. Over the last decade, the resistance of these bacteria in hospital environments is increasing to various antibiotics such as vancomycin. The aim of present study was to determine the antimicrobial resistance pattern and Minimum Inhibitory Concentration (MIC) values among a clinical collection of staphylococci isolated from hospitalized children in Tabriz.

  Methods: In this prospective and descriptive study, 88 staphylococcal isolates including 53 S. aureus and 35 coagulase-negative staphylococcus species were recovered from various clinical specimens referred to microbiology laboratory of Children Hospital during study period (April 2011 to March 2012). Susceptibility of the isolates against 15 different antimicrobial agents and MIC values of vancomycin was tested using standard disk diffusion and E-test methods respectively.

  Results: According to the results of drug susceptibility testing, vancomycin and rifampin were the most effective but clindamycin and penicillin were the least effective drugs against tested isolates. Accordingly, the prevalence of methicillin resistant Staphylococcus aureus (MRSA) strains was determined more than 80%. According to MIC values, 13.2% of S. aureus and 3.3% of coagulase-negative staphylococcus isolates showed intermediate resistance to vancomycin. None of the isolates was fully resistant to vancomycin isolates in this study.

  Conclusion: Although fully vancomycin resistant staphylococci was not found among tested isolates in this study, there was VISA strains. Since there are reports on the emergence of VRSA strains from Iran and other countries, it is necessary for the clinician to care in prescription of vancomycin as a selective drug against staphylococcal infections. Moreover, the necessity of MIC measurement in determining of vancomycin susceptibility is more apparent.


Delsuz Rezaee , Gholamreza Zarrini , Mohammad Ahangarzadeh Rezaee,
Volume 14, Issue 1 (4-2014)
Abstract

  Background & Objectives : Acinetobacter baumannii is an opportunistic Gram-negative pathogen with increasing relevance in a variety of hospital-acquired infections especially among intensive care unit patients. A. baumannii is mostly a cause of septicemia, pneumonia and urinary tract infection following hospitalization of patients. In this study antibiotic susceptibility pattern of A.baumannii isolates and molecular typing among isolates resistant by REP-PCR were determined.

  Methods : During study, the A. baumannii, were isolated from hospitals in Tehran. The isolates were identified using standard biochemical tests and antibiotic susceptibility was determined by the disk diffusion method. Extraction of DNA and molecular typing of isolates performed using CTAB method and REP-PCR, respectively.

  Results : In this study 75 A. baumannii isolates separated from patients with an average age of 51 ± 18.45 years . The highest resistance rate was against azteronam (97%), ceftazidim (93%), cefepime (93%), piperacillin-tazobactam (93%), ciprofloxacin (93%) and ticarcillin (93%) while the lowest resistance rate was against tigecycline (n= 51, 68%), followed by tobramycin (n=24, 32%), ampicillin-sulbactam (n=21, 28%), amikacin (n=16, 21%), and carbapenems (n=11, 15%). The REP-PCR in resistant of A. baumannii isolates showed that the genotypes of A, B and C are the predominant genotypes in the resistant antibiotics.

  Conclusion: This study showed a high percentage of resistance to antimicrobial agents among genotypes A, B, and C of the A. baumannii isolates therefore strategies to control the spread of A. baumannii isolates must be designed and evaluated.


Maryam Adabi, Mahshid Talebi Taher , Leila Arbabi, Mastaneh Afshar , Sara Fathizadeh, Sara Minaeian, Niloofar Moghadam-Marageh, Ali Majidpour ,
Volume 15, Issue 1 (4-2015)
Abstract

  Background & objectives: Wound infection is a predominant cause of death in burned patients who are clearly at increased risk of nosocomial infections. Pseudomonas aeruginosa is the most common cause of burn infections and is difficult to treat because of having high level of resistance to antibiotics. The aim of this study was to perform isolation, identification and determination of antibiotics resistance pattern of P. aeruginosa strains isolated from wounds of hospitalized burn patient.

  Methods: Biochemical and molecular tests were used for identification of the P. aeruginosa and antibacterial susceptibility test was performed using disk diffusion (Kirby- Bauer) methods. Then, the minimum inhibitory concentration (MIC) was performed for four representatives of different groups of antibiotics.

  Results: Among 94 evaluated strains of P. aeruginosa, 83 isolates (88.3%) were multi drugs resistant. Based on Kirby-Bauer method, the most resistance was seen to cefepime (89.5 %) and among the antibiotics studied to determine the MIC, the most resistance was observed to ciprofloxacin (89 %).

Conclusion: These results indicate high range of resistance to different antibiotics among strains of P. aeruginosa isolated from burn wounds of patients. So, the fast and accurate measurement and evaluation of antibiotic resistance for appropriate antibiotic therapy of burned patients is imperative.


E Raeisi, M Ghiamirad,
Volume 15, Issue 3 (9-2015)
Abstract

Background & Objectives: Salmonellosis is the most common food-borne disease in the world. The purpose of this study was to determine the prevalence of salmonella serogroups and their antimicrobial susceptibility patterns in chicken meat and viscera in Ardabil, Iran.

Methods: In this cross-sectional study done in spring and summer of 2014,260 samples) 160 chicken meat, 50 gizzard and liver) were collected for isolation and identification of salmonella. The technique used in this study was recommended by Iran standard organization andKirby-bauer method was also used for detection of antibiotic resistance.

Results: Amongallthe samples,the range of detected salmonella was 10%I n which the 42.3% of them detected in spring and 57.7% in the summer.92.3% of samples belong to C serogroup and 3.8% of them were serogroup B and 3.8% serogroup D. All isolates show resistance to at least two antibiotics. Concurrent resistance to 2-6 antibiotics was detected in 70% of the isolates. The highest resistance was to Nalidixicacid�and Streptomycin (100%)and toTetracyclin (92.3%), Penicillin (88.5%), Neomycin, Kanamycin and Furazolidon (84.6%), cloramfenicol (73.1%), Ofloxacin (15.4%), Co-Amoxi clave and Ampicillin (11.5%) and Siprophloxacin 7.7%. The lowest levels of resistance were for Gentamycin and Amikacin (3.8%). No salmonella isolates were resistant to ceftazidime, Azitromicin, Meropenem, Imipenem and cefixime.

Conclusion: According to 10% pollution to salmonella and prevalence of serogroup C and salmonella importance in the human&rsquos health, as well as high rate of antibiotic resistance of isolates, applying a health strategy for reduction of contamination level is necessary.


Roqiyeh Nouri, Mohammad Ahangarzadeh Rezaee , Alka Hasani, Mohammad Aghazadeh, Mohammad Asgharzadeh, Morteza Ghojazadeh,
Volume 16, Issue 2 (7-2016)
Abstract

Background & objectives: Fluoroquinolones have important role in treatment of P. aeruginosa infections. The main mechanism of fluoroquinolones resistance in P. aeruginosa is mutations in the quinolone-resistance-determining region (QRDR) of gyrA and parC genes. The aim of this study was to investigate the role of these mutations in ciprofloxacin resistance in different clinical isolates of P. aeruginosa.

Methods: A total of 75 clinical P. aeruginosa isolates were collected from different university-affiliated hospitals in Tabriz. Minimum inhibitory concentrations (MICs) of ciprofloxacin were evaluated by Etest assay. DNA sequences of the QRDR of gyrA and parC were determined by dideoxy chain termination method.

Results: From 75 isolates, 77.33% were resistant to ciprofloxacin. No amino acid changes were detected in gyrA or parC genes of the ciprofloxacin susceptible isolates. Thr-83→Ile substitution in gyrA was observed in all ciprofloxacin resistant isolates. About 90% of them had Ser-87→Leu substitution in parC. Geometric mean MICs of ciprofloxacin were different for various clinical isolates of P. aeruginosa which had the same situation in type and location of gyrA and parC mutations. Moreover, the geometric mean MIC in isolates from urine was significantly (p<0.05) higher than isolates from tracheal aspirates.

Conclusion: Mutations in gyrA and parC genes are the major mechanisms for ciprofloxacin resistance in clinical isolates of P. aeruginosa. Moreover, the role of different effective factors in fluoroquinolone resistance can be different in various clinical isolates of P. aeruginosa.


Behnam Mohammadi-Ghalehbin , Hannane Javanpour Heravi , Mohsen Arzanlou, Mohammadreza Sarvi ,
Volume 16, Issue 4 (1-2017)
Abstract

Background & objectives: Candidiasis is a fungal infection which is caused by Candida spp. Candida albicans is the most common agent of candidiasis. This infection may cause various side effects during pregnancy including prematurity, chorioamnionitis, candidal pneumonia, and systemic candidiasis of infants. This research was conducted for determining the prevalence and antibiotic resistance pattern of Candida spp, collected from pregnant women admitted to health centers in Ardabil, Iran.

Methods: Totally, 408 subjects were included in this study. Demographic data and risk factors were recorded using a questionnaire. Two swab samples were taken from vulvovaginal mucus. One swab was used for preparing smear and direct microscopic examination and the second one used for cultivating the specimen. After identification of Candida spp., antimicrobial resistance pattern was determined by disk diffusion method against Fluconazole, Ketoconazole, Clotrimazole, Nystatin and Amphotericin B. Results were interpreted according to CLSI guidelines. The data were analyzed by χ2 and t-test using SPSS-19.

Results: Out of 408 subjects, 143 cases (35%) were positive for candida spp. The Candida albicans with 119 (83.2%) cases was the most prevalent species followed by Candida glabrata, Candida krusei, Candida parpsilosis and Candida tropicalis.According to disk diffusion test, overall 116 (81.1%) isolates were resistant to Fluconazole, 100 (69.9%) to Ketoconazole, 67 (46.9%) to Clotrimazole and 25 (17.5%) to Amphotericin B. Candida spp. had a highest sensitivity (118, 82.5%) to Nystatin. For Candida albicans 97(81.5%) isolates were resistant to Fluconazole and 99(83.2%) isolates to Nystatin. For Candida glabrata 10 (90.9%) isolates were resistant to Fluconazole, and 9(81.8%) sensitive to Nystatin.

Conclusion: According to the results of this study, vulvovaginal candidiasis is prevalent among pregnant women in Ardabil and isolates were significantly resistant against commonly used antifungal drugs. Nystatin was the most effective against Candida spp. As antibiogram for fungal agents is not routinely performed, the similar periodical studies could be useful for choosing appropriate antibiotics in treatment of vulvovaginal candidiasis. 


Hosseini Fatemeh, Mohammad Kargar,
Volume 17, Issue 2 (7-2017)
Abstract

Background & objectives: Enterococcus spp. are predominant in the faecal microflora which enter the environment directly or through wastewater. These bacteria play an important role in the development of nosocomial infections due to their ability to acquire resistance genes and their transmission to other bacteria, particularly Staphylococcus aureus. The aim of this study was to identify the prevalence of vancomycin-resistant enterococci (VRE) and to detect van A, van B and van C1/C2 genes in VRE strain isolated from environmental samples of the in southern Fars province.
Methods: This cross-sectional study was carried out on 155 Enterococcus spp isolates collected from environmental samples (hospital wastewaters and surface waters) in different areas of Larestan and Jahrom cities. Isolates were identified and confirmed as Enterococcus spp. using the membrane filtration method, selective growth on Kenner Fecal Streptococcus Agar (KF) medium and biochemical tests. The disk diffusion test and Macro Broth dilution method based on CLSI guidelines were used to determine antimicrobial susceptibility against conventional antibiotics and vancomycin and to measure the minimum inhibitory concentration (MIC), respectively. Finally, the presence of van A, van B and van C1/C2 genes in VRE strains was determined by multiplex PCR technique.
Results: Out of all of Enterococcus spp. isolates, 41 cases (26.45%) were belonged to E.faecalis, 6 cases (3.87%) to E.faecium and 108 cases (69.68%) to non-faecalis and non-faecium. In total, 46 isolates (29.67%) were resistant to vancomycin and 4 isolates showed MIC ≥128 μg/ml. Resistant to all types of antibiotics was observed in 4 isolates (8.70%). Further, 2 isolates (50%) had vanA gene and 2 isolates (50%) had vanB gene, but vanC1/C2 genes were detected in none of them.
Conclusion: The results indicated that the VRE strains are widespread in the studied area, therefore there is an urgent need for prudent use of vancomycin and implementation of control measures to prevent the environmental spread of VRE strains.
Hoosna Sarvazad, Mojtaba Darbouy,
Volume 17, Issue 3 (10-2017)
Abstract

Background & objectives: One of the main problems in the control of nosocomial infections due to Klebsiella pneumoniae is increase of antimicrobial resistance and prevalence of extended spectrum β-lactamase (ESBLs) producing isolates. The aim of this study was to investigate the correlation of antibiotics resistance with SHV, CTX-M and TEM extended-spectrum beta lactamases genes among Klebsiella pneumoniae isolates isolated from the patients in Kermanshah hospital.
Methods: The clinical isolates of Klebsiella pneumoniae were collected during the spring from Kermanshah hospitals, and identification of Klebsiella pneumoniae strains was performed using standard microbiological and biochemical tests. Antibiotic resistance of Klebsiella pneumoniae isolates was determined using disk diffusion method. Then, the presence of CTX-M, SHV, and TEM was investigated using multiplex-PCR method. Finally, the relationship between variables was analyzed by SPSS-22 software using logistic regression and chi-square.
Results: A total of 98 isolates out of 112 samples were identified as Klebsiella pneumonia. Also, 82.8% of isolates were resistant to cefotaxime, 40.2% to ceftriaxone, 62.88% to ceftazidime, 3.9% to imipenem, 39.17% to cefepime, 64.94% to cefixime and 26.8% to amikacin. Further, 35.55% of isolates had CTX-M gene, 63.91% of isolates had SHV gene and 9.27% of samples had TEM gene.
Conclusion: The presence of CTX-M, SHV and TEM genes along with high antibiotic resistance are very concerning, indicating the importance of rational use of antibiotic for the treatment of infectious diseases.
 
Atefe Sarafan Sadeghi , Najmeh Ansari, Farzad Khademi, Reza Mir Nejad , Behnam Zamanzad ,
Volume 19, Issue 1 (4-2019)
Abstract

Background & objectives: In recent years, Acinetobacter baumannii has been shown to be associated with several nosocomial infections, including pneumonia, bacteraemia, urinary tract infections, wound infection and meningitis. This organism can survive in the hospital environment and rapidly develops resistance to many antibiotics. The molecular genotyping can increase our knowledge about the spread of A. baumannii strains from one hospital to another and their drug resistance. Therefore, this study aimed to determine the prevalence of antibiotic resistance profile as well as phylogenetic relationships of A. baumannii strains in Shahrekord teaching hospitals.
Methods: In this study, antibacterial susceptibility patterns of A. baumannii strains isolated from different clinical specimens (urine, blood, sputum) to amikacin, ampicillin/sulbactam, aztreonam, cefepime, ceftazidime, ciprofloxacin, gentamycin, imipenem, meropenem, norfloxacin, ofloxacin, piperacillin/tazobactam, tobramycin were tested using disk diffusion )Kirby-Bauer( method. Finally, genotyping of A. baumannii strains was performed using REP-PCR method.
Results: During this study, 50 samples of patients were identified as A. baumannii) 71%(, and their drug resistance rates were assessed. All A. baumannii strains were resistant to ceftazidime and cefepime and also a high rate of resistance to aztreonam, norfloxacin, ciprofloxacin, amikacin, imipenem, gentamycin, and ampicillin-sulbactam were observed. On the other hand, our results demonstrated nine genotype groups among A. baumannii strains based on REP-PCR method.
Conclusion: Due to the high prevalence of antibiotic resistance among isolated A. baumannii strains, similarities between different genotypes and the dispersion of these genotypes in different parts of Shahrekord hospitals, the implementation of infection control programs in different parts of the hospital is necessary.
 
Moien Zakavati, Shahram Habibzadeh, Saeed Sadeghieh, Perham Mohammadi, Sara Mostafalou,
Volume 19, Issue 1 (4-2019)
Abstract

 
Background & objectives: Nowadays, bacterial resistance and the increase in the therapeutic costs are considered as the most important global concerns of medical care system regarding complicated infections. Imipenem is a member of the carbapenem class of beta-lactam antibiotics prescribed mostly in our hospitals because of its broad activity against bacterial infections. Drug Utilization Evaluation (DUE) process is an official, ongoing and systemic program that collects information in order to identify and improve the adverse effect of drugs and the cost of medicalization. The objective of this study was to evaluate the administration and use of imipenem in the educational Imam Khomeini hospital in Ardabil in 2018.
Methods: In this prospective, descriptive, cross- sectional study, 110 hospitalized patients, who received imipenem from September to December of 2018, were included in this study. Patient's demographic data, dosing, dosage adjustment in renal failure and other co-prescribed antimicrobial drugs were extracted from current medical file of hospitalized patients and evaluated with medical guidelines.
Results: 64% of patients received imipenem in the first day of hospitalization and 75.5% of patients were empirically received imipenem while antibiogram test was ordered for only 24.5% of patients. Serum creatinine were ordered for most of the patients, but correct dose regimens for patients who get non-empiric antibiotic therapy were only 25.5%.
Conclusion: High rate of empiric prescription without considering the result of antibiogram test and immediate initiation of antimicrobial therapy at the time of admission were the most important aspects of irrational use of imipenem observed in this study. Paying more attention to sampling, culturing and sensitivity test and prescription of imipenem based on specific guidelines are recommended.
 

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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