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Aim and Background. The aim of this study was to assess the most common bacterial etiology in neonatal sepsis which has been carried out during the years 2005-2006 at Urumiah Shahid Arefian Hospital.

Materials and Methods. In this cross-sectional study, after collecting blood samples from 402 newborns who were suspicious to sepsis and performing microbial culture and bacterial isolation, disk diffusion antibiotic susceptibility test was done according to the CLSI guidelines.

Results. Overall, 36 positive cultures were acquired. The prevalence of sepsis were higher in the male infants (61/1%) than female (38/9%) (P=0) Among these, 63/9% were born with normal vaginal delivery and 36/1% were c-section delivered babies (P=0/093). The mean weight of 36 neonates was 2117837 gr and there was a significant relationship between low birth weight and prevalence of sepsis (p=0). The most common microorganisms of neonatal sepsis were coagulase negative staphylococci (50%) and klebsiella pneumoniea (19/4%). The gram-positive isolates showed the highest sensitivity and resistance rates to vancomycin and to Ampicillin, respectively. The highest sensitivity and resistance rates for the gram negatives were towards ciprofloxacin and cefotaxime, respectively. Low birth weight and prematurity were the major risk factors of sepsis.

Conclusion. With respect to increasing prevalence of neonatal sepsis with coagulase negative staphylococci, in this study and similar studies, with appropriate antibiotical therapy according to antibiogram results, with considering hygienic principles in hospitals and prenatal care, we may able to decrease mortality and morbidity of neonatal sepsis.

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 Aim and Background. Bacteria of the species Bacillus pumilus produce a large number of biological compounds which are active against bacteria and fungi. This study was designed with the aim of isolation, screening and optimization of antimicrobial production of Bacillus pumilus against four pathogenic microorganisms.

 Materials and Methods. For the initial screening of antimicrobial activity against four pathogenic microorganisms , agar disk diffusion method and TSB medium and for the production of antimicrobial compounds, synthetic medium and agar well diffusion method is used. To obtain the maximum production of antimicrobial compounds, pH (6-9), incubation period (0-72 hours) and glucose concentration (1-5 ٪ ) are well considered. Data were analyzed by SPSS and ANOVA tests.

Results. Maximum production of antimicrobial compounds by standard and isolated strain of B. pumilus was observed after 48 hours of incubation at 37^oC, pH 7 and 3% glucose against four microbial strains. 

 Conclusion. B. pumilus species might be a potential candidate for the production of antimicrobial compounds in the future.

 

  

 

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Aim and back ground: In recent years the threat of acquisition of antibiotics resistance caused by over use of antibiotics is growing. The purpose of this study was to survey the pattern of antibiotic resistance and evaluate of Multi-drug resistance Escherichia coli and analyze the plasmid profile of these clinical strains.

Materials and Methods: This study was performed on 83 clinical Escherichia coli, obtained from four hospital (imam Khomeini, Alborz, Kasra, qaem) and two private laboratories (Razi and Kavosh), of Karaj city. Isolates were identified as Escherichia coli based on standard biochemical tests. The isolates were screened for Antimicrobial susceptibility test by 20 antibiotics using Kirby-Bauer disk diffusion method. Plasmid profiles of these isolates have been analyzed by alkaline lysis method.

Result: Antibiotic resistance pattern were observed as follows: Nitrofurantoin 8.4%, Tetracycline 63.8%, Amoxicillin 83%, Ofloxacin 30%, Levofloxacin 30%, Co-trimoxazole 59%, Amikacin 18%, Imipenem 25.3%, Choloramphenicol 16.9%, Cephalexin 61.4%, Gentamycin 28.2%, Norfloxacin 33.7%, Nalidixic acid 56.6%, Cephalothin 48.2%, Ciprofloxacin 32.5%, Ceftazidime 27.7%, Ceftriaxone 37.3%, Ceftizoxime 16.9%, Cefotaxime 38.5%, Amoxycillin/Clavulanic acid 68.7%. Of 83 isolates 92.77% (77) isolates were resistance to more than two unrelated drugs. Of 83 isolates, 65 isolates, (78.3%) showed the presence of plasmid.

Conclusion: The results of this study indicate a growing resistance pattern to the first line antibiotics, prescribed for urinary tract infection. High presence of plasmids in these strains, play an important role in multidrug resistance in these bacteria.

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Aim and Background: One of the most common acquired infections is urinary tract infections (UTI). This problem is associated with the wild antibiotics treatment for UTI. In this study, the effect of zangaber extracts were compared with antibiotics for treatment of UTI . Materials and Methods: 100 samples were isolated from patients with UTI. Bacteria were identified with biochemical tests. Then was used antibiogram with different antibiotics and resistant bacteria were isolated. Antibacterial effect of different concentrations from zangaber extracts were tested on resistant bacteria. Results:From 100 isolates, 46 samples were E. coli, 10 were Proteus mirabilis, 9 were Pseudomonas aeruginosa, 5 were Staphylococcus aureus, and 30 samples were other bacteria. The lowest MIC for E. coli was found Nitrofurantoin and Nalidixica cid, Ceftriaxone and Cephazolin were for Proteus mirabilis, Pseudomonas aeruginos and Staphylococcus aureus. The highest MIC for zangaber was found by methanolic extract of zangaber. Conclusion: Results have shown most of bacteria have become resistant to antibiotics. As also, by increasing of antibiotic application for UTI treatment was produced resistance bacteria, therefore plant drugs with antibacterial effects such as zangaber is required. This plant can be inhibited of uropathogenic bacteria.

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Aim and Background: the efflux  pumps as one of the resistance mechanisms against  antibiotics. So object of this study, is determining the existence of oqxA and oqxB gens in Klebsiella pneumoniae Isolated and their sample of antibiotic resistance.                                                                                                                                                 
Materials and methods: the sample making of 500 referred outpatients to the laboratories of Qom province. For determining of antibiotic sensibility, it was according to instruction CLSI 2014. the existence of oqxA and oqxB genes was detected by PCR.
                                                      
Result: 100 number of  klebsiella pneumonie bacteria separated. Determined. all Klebsiella pneumonia were sensitive to  Ciprofloxacin and Amikacin. The results out of  PCR revealed 46% had oqxA gene and 52% had oqxB gene.                                                                                               
                                                                                                                                                       
Conclusion:. Results out of present study suggest that the klebsiella pneumonia bacteria in strains isolated in hospitals of Qom has got a very significant statisics. Also, efflux pumps oqxAB have got a relatively high quantity.                                                                                                                             
Results:The ways to confront and oppose antibiotic resistance including the efflux pumps oqxAB is important. These findings indicate the need to control the antibiotics treatments and to use new antibiotic agents for the treatment of infections caused by this bacteria and other resistant organisms.                                                                                        

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Aim and Background: Overplay of antibiotics in clinical centers not only did not destroy pathogenic bacterias but also grew a resistance for these kind of compounds in microorganisms such as Pseudomonas aeruginosa that is one of important infection factors in hospitals. The purpose of this study is to investigate the resistant gene to antibiotic, bla_vim gene, which was found among Pseudomonas aeruginosas released from hospitals.
Materials and Methods: 120 strains of Pseudomonas aeruginosas were collected from hospitals. The sensitivity of these strains to antibiotics was determined by Disc diffusion test. PCR was used for identification of bla_vim gene .
Results: Among 120 samples isolated from hospitals 50 cases were Pseudomonas aeruginosa. 35 Pseudomonas aeruginosa samples were resistant to antibiotics. 21 samples (42%) of 35 samples contained bla_vim gene.
Conclusion: The results of this study indicated the presence of bla _vim gene in Pseudomonas aeruginosa. The comparison of the results with the rest of the world indicates the increasing genetic resistance of Pseudomonas aeruginosa to antibiotics especially beta-lactams. These results are important in taking proper health policies and using effective antibiotics for hospital infections.

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Aims and Background:
 Pseudomonas aeruginosais is one of the most important pathogens for nosocomial infections, particularly in ICU and burn. This bacterium causes diseases such as respiratory infections, sepsis and bacteremia. Since the serious infections caused by Pseudomonas resistance against conventional antibiotics is a serious problem and due to the placement of genes coding for antibiotic resistance on their Integrons and quick release feature identification of strains containing Integrons provide useful information on the extent and development of drug resistance. The aim of this study was to evaluate the frequency of class I integrons in Pseudomonas aeruginosa strains isolated from clinical samples and their relationship to antibiotic resistance.
Materials and Methods:
103 strains of Pseudomonas aeruginosa isolated from different clinical specimens were used. The drug susceptibility test, using 12 antimicrobial agents, was performed for all the isolates via agar disk diffusion method. The specific PCR was used to identify class I integrons and the relationship between class I integrons presence and antibiotic resistance was evaluated by χ2 test.
Results:
Analysis of antibiotic resistance patterns showed 75.7% of the isolates were resistant to cefotaxime and 73.7% of the isolates were sensitive to ceftazidime - clavulanic. The PCR results showed that 40.7% of isolates have class I integron. A significant correlation was obtained between the presence of class I integrons and resistance against most common antibiotics (P <0.05).
Conclusion:
Due to the high frequency of class I integrons and connection with drug resistance in Pseudomonas aeruginosa isolates, apply appropriate strategies for infection control and hospital treatment to prevent further spread is essential.

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Aim and Background: Meticillin resistant Staphylococcus aureus (MRSA) has become one of the major public-health concerns in recent years due to resistance to antimicrobial drugs and agents. This Study aims to diagnose of MRSA isolates by molecular and phenotypic methods and to detect of the antibiotic resistance pattern in MRSA strains in clinical patient samples in Rasht.
Material and Methods: This cross-sectional (descriptive-analytical) study was conducted from April to September 2016. 76 isolates of Staphylococcus were collected from some hospitals in Rasht and was characterized by varius biochemical tests of Staphylococcus aureus species. A disc diffusion method was performed to identify MRSA strains. The antibiotic resistance pattern of isolates was done using disc diffusion method against six antibiotics based on Clinical and Laboratory Standards Institute (CLSI) protocol. Then, Polymerase Chain Reaction (PCR) was performed with specific primers to mecA gene. Also, sequencing was done in mecA positive PCR products. Data were analyzed using SPSS 23 software. Conclusion: The findings showed that the presence of MRSA strains were remarkable in the hospital samples in Rasht because of the overuse of antibiotics for the treatment of diseases.
 

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Aim &Background: Klebsiella pneumoniae is a common cause of β-lactamase-associated infections in hospitals. The present study aimed to determine the frequency of antibiotic resistance genes in Klebsiella pneumoniae strains producing IMP-1 and TEM β-lactamase.
 
Materials and methods: The present research identified 94 samples of K. pneumoniae, using antibiogram for the phenotypic confirmation of ESBLs. The antibiotic resistance of the isolates and the prevalence of TEM and IMP-1 genes were determined using PCR method.
 
Findings: Of 94 samples, 77.6% were ESBL-positive and 22.3% ESBL-negative. A total of 4.1% of the samples carried the IMP-1 gene and 43.8% the TEM gene, while 43.8% of the samples carried both genes.
                  
Conclusion: Given that TEM and IMP-1 genes were commonly present in a large number of the resistant samples, physicians are recommended to use therapeutic measures properly, and to prescribe antibiotics rationally.
 

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Staphylococcus aureus is a common cause of nosocomial infections and increased resistance to antimicrobial agents in this bacterium is one of the major problems in health care. We also see resistant strains of this bacterium that are important pathogens in the development of the disease. The control of these bacteria is very important from a health and economic point of view, so the aim of this study was to investigate the prevalence of methicillin mecA resistance gene and determine the pattern of antibiotic resistance in existing samples of Staphylococcus aureus and to evaluate the antibacterial activity of silver nanoparticles against Gram-positive Staphylococcus aureus.
Materials and Methods: In this cross-sectional study, 59 staphylococcus aureus specimens were collected from 11 nature detection laboratories. These samples were identified using standard laboratory methods and specific culture. PCR was used to evaluate the frequency of mecA gene. In order to use the antibiotic susceptibility pattern of the strains, the disk diffusion method is performed based on the CLSI protocol. Silver nanoparticles were made from ginger extract and Real Time PCR was used to evaluate the effect of silver nanoparticles on mecA gene expression.
Results: Out of 59 samples of Staphylococcus aureus, 51 samples were resistant to methicillin. Phenotypic evaluation of antibiotic resistance pattern of methicillin-resistant Staphylococcus aureus strains showed that the results showed that 90% of isolates to penicillin, 85% to erythromycin, 84% to ceftriaxone, 53% to amikacin, 49% to gentamicin, 47% to piracyl 45% were resistant to spirofloxacin 37% to imipetmo 35% to linezolid, ie the highest antibiotic resistance was to penicillin 90%, erythromycin 85% and the lowest to imipetmo 37% and linzolid 35, respectively. Molecular analysis showed the presence of mecA gene in all samples. The results of real-time study showed that the effect of nanoparticles on mecA gene expression is significant.
Discussion and Conclusion: The presence of 51 resistant samples out of 59 samples in the present study indicates an increase in resistance of methicillin-resistant Staphylococcus aureus to other antibiotics, which is a serious warning for the treatment of Staphylococcus aureus infections. And the effectiveness of silver nanoparticles on mecA gene expression shows that we can use this substance instead of existing antibiotics.

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Aim and Background: Klebsiella pneumoniae (K. pneumoniae) is one of the important human pathogens among which emergence of antibiotic resistant results in many problems in therapeutic process. Class 1 integron genes may facilitate the conferring of antibiotic resistance among bacterial population. In the present study, isolation of K. pneumoniae from urine samples, determining the antibiotic resistant pattern, and evaluating the presence of class 1 integron genes were investigated.
Materials and Methods: The obtained isolated bacteria were confirmed via biochemical tests. Evaluating the bacterial resistance against 10 different antibiotics was performed by agar disk diffusion method and antibiotic resistant pattern was also determined. PCR method was used in order to detect the presence of class 1 integron genes among isolates.
Results: 80 K. pneumoniae were isolated from the urine sample of attendees of clinical laboratories in Karaj. Meropenem and Nitrofurantoin were the most and least effective antibiotics, respectively. 16 isolates were considered as multi drug resistance (MDR) among which resistance to all 10 tested antibiotics was also observed. 29 isolates were also positive in terms of class 1 integron genes.
Discussion: Treatment with the following antibiotics; Meropenem, Levofloxacin, Imipenem, and Gemtamicin, may be successful, since more than 80% of the isolates were susceptible to them. However, presence of MDR as well as detecting class 1 integron genes may be an alarming for infections caused by K. pneumoniae.
Conclusion: Knowing about the increase in the antibiotic resistance among K. pneumoniae isolates, the presence of MDR isolates, and also detecting the presence of genes involved in dissemination of resistant isolates may help to choose the more effective therapies.

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Aim and Background: Today, microorganisms have become resistant to drugs by causing gene mutations. The aim of this study was to determine the antibiotic resistance of bacteria isolated from urine culture in the laboratory of Savadkuh city.
Material and methods:A cross-sectional descriptive study was performed on bacteria isolated from urinary tract infections in Savadkuh laboratory. Bacteria in the sample were identified by microscopic method, morphological examination and biochemical tests.
Results: Out of 693 samples, the result of urine culture test was 462 positive. Staphylococcus 45.4%, E.Coli (34.6%), Streptococcus (12.9%) and Klebsiella (7.1%) were the most common isolated bacteria, respectively. In the study performed on the pattern of antibiotic resistance, the most cases of resistance were related to the antibiotics ampicillin, cefazolin, trimethoprim, sulfamethoxazole and ciprofloxacin, respectively. On the other hand, the highest susceptibility of bacteria is related to the antibiotics nitrofurantoin, cephalexin, cefotaxime, gentamicin and ceftriaxone, respectively.
Conclusion: According to the results of the study, the most common microorganisms that cause urinary tract infections have been identified and the most appropriate antibiotics have been introduced for treatment, which is very effective in reducing the resistance of bacteria to antibiotics. Treatment costs are also reduced with the use of appropriate antibiotics in the early stages of infection.
 

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Aim and Background: Acinetobacter baumannii is the cause of a wide range of nosocomial infections. Antibiotic resistance of this organism is a major challenge worldwide. The aim of this study was to identify oxa and ndm genes by multiplex-PCR and to determine the pattern of antibiotic resistance.
Material and Methods: This study was performed in a period of 8 months by collecting 25 bacterial plate isolates. Antibiotic susceptibility testing was performed on Müller Hinton agar medium by disk diffusion method. MPprimer software was used to design the primers. After data collection, the level of significance was assessed at P˂0.05 using SPSS 22.
Results: Except for gentamicin, cefpime, ciprofloxacin and tobramycin, there is a significant relationship between resistance pattern and sensitivity. All A. baumannii isolates were sensitive to ceftazidime. Also, 20% of the isolates were resistant to imipenem, which are considered carbapenem-resistant isolates of A. baumannii. Of the 25 isolates studied, 5 isolates (20%) had oxa58 gene, 5 isolates (20%) had oxa23 gene and three isolates (12%) had ndm gene.
Conclusion: The high prevalence of antibiotic resistance genes in A. baumannii isolates emphasizes the need for a systematic program in the control and treatment of this pathogen and shows necessity for more attention from health centers in prescribing appropriate antibiotics. Multiplex PCR method is a sensitive and reliable method for rapid detection of resistance genes in A. baumannii isolates.