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Objectives: Staphylococcus aureus, a Gram-positive bacteria, is ranked second among the causes of hospital infections and is one of the three main causes of food poisoning. In recent times, the spread of antibiotic resistance in S. aureus has become very worrisome. Therefore, research for new effective drugs is important. The present study aims to investigate the phytochemical profiles and antibacterial effects of hydroalcoholic extracts of Origanum vulgare (Lamiaceae family) and Hypericum perforatum (Clusiaceae family) and their active compounds on S. aureus (ATCC 12600) in vitro. Methods: The identification of phytochemical compounds in both plants was performed by Highperformance liquid chromatography (HPLC), headspace-solid-phase microextraction (HS-SPME) and Fourier-transform infrared spectroscopy (FTIR). To investigate microbial susceptibility, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and disc diffusion method (DAD) were used. Finally, the results of the study were compared with methicillin. Results: Of the 42 combinations of O. vulgare, carvacrol (48%) and of the 38 combinations of H. perforatum, hypericin (46.2%) were the most abundant. The MIC, MBC and DAD of O. vulgare and H. perforatum, carvacrol, hypericin and methicillin were 625, 625, 312.5, 78.12 and 384 μg/mL, 10000, 10000, 2500, 2500 and 384 μg/mL, and 15.66 ± 4.49, 12.66 ± 0.47 and 22 ± 0.81 mm, respectively. Conclusion: Due to the significant effects of O. vulgare and H. perforatum and their active components against S. aureus, it is expected that in the future, hypericin, carvacrol and their derivatives can be used as effective antibacterial agents against S. aureus.

Carbapenems are the most important therapeutic options that effect against serious infections caused by multidrug resistant Pseudomonas aeruginosa(MDR-PA) isolates. Carbapenems resistant isolates of P. aeruginosaare increasing worldwide. The aim of this study was to determine the carbapenem resistance mechanisms in clinical P. aeruginosaisolates from burn patients, in Tehran, Iran. A total of 53 non-duplicated isolates of carbapenem-resistant P. aeruginosawere collected from burn patients. The presence of carbapenemase genes were determined by PCR. AmpC overproducer isolates were detected by phenotypic method. The mutation and transcription level of oprDwere determined by PCR-sequencing and quantitative Real-time PCR (RT-PCR), respectively. Twenty-seven (50.9%) isolates were positive for carbapenemase (blaVIM=25 and blaIMP=2) and showed high-level resistance to imipenem and meropenem. Twenty-eight isolates were AmpC overproducers. All isolates had a mutation in the oprDgene and down-regulation of oprDwas found in 56.6% of MDR-PA isolates. Although the presence of carbapenemase is the common mechanism of resistant to carbapenem, but carbapenem resistance was found by oprDmutation-driven and the AmpC overproducing isolates in Tehran, Iran.

Carbapenems are the most important therapeutic options that effect against serious infections caused by multidrug resistant Pseudomonas aeruginosa(MDR-PA) isolates. Carbapenems resistant isolates of P. aeruginosaare increasing worldwide. The aim of this study was to determine the carbapenem resistance mechanisms in clinical P. aeruginosaisolates from burn patients, in Tehran, Iran. A total of 53 nonduplicated isolates of carbapenem-resistant P. aeruginosawere collected from burn patients. The presence of carbapenemase genes were determined by PCR. AmpC overproducer isolates were detected by phenotypic method. The mutation and transcription level of oprDwere determined by PCR-sequencing and quantitative Real-time PCR (RT-PCR), respectively. Twenty-seven (50.9%) isolates were positive for carbapenemase (blaVIM= 25 and blaIMP = 2) and showed high-level resistance to imipenem and meropenem. Twenty-eight isolates were AmpC overproducers. All isolates had a mutation in the oprDgene and down-regulation of oprDwas found in 56.6% of MDR-PA isolates. Although the presence of carbapenemase is the common mechanism of resistant to carbapenem, but carbapenem resistance was found by oprDmutation-driven and the AmpC overproducing isolates in Tehran, Iran.

Carbapenems are the most important therapeutic options that effect against serious infections caused by multidrug resistant Pseudomonas aeruginosa(MDR-PA) isolates. Carbapenems resistant isolates of P. aeruginosaare increasing worldwide. The aim of this study was to determine the carbapenem resistance mechanisms in clinical P. aeruginosaisolates from burn patients, in Tehran, Iran. A total of 53 nonduplicated isolates of carbapenem-resistant P. aeruginosawere collected from burn patients. The presence of carbapenemase genes were determined by PCR. AmpC overproducer isolates were detected by phenotypic method. The mutation and transcription level of oprDwere determined by PCR-sequencing and quantitative Real-time PCR (RT-PCR), respectively. Twenty-seven (50.9%) isolates were positive for carbapenemase (blaVIM= 25 and blaIMP = 2) and showed high-level resistance to imipenem and meropenem. Twenty-eight isolates were AmpC overproducers. All isolates had a mutation in the oprDgene and down-regulation of oprDwas found in 56.6% of MDR-PA isolates. Although the presence of carbapenemase is the common mechanism of resistant to carbapenem, but carbapenem resistance was found by oprDmutation-driven and the AmpC overproducing isolates in Tehran, Iran.

Background: Recently, increasing antibiotic resistance is causing serious publichealth concerns worldwide. This phenomenon increased patient's morbidity and mortality rate, particularly in immunocompromised individuals. Methods: Considering that antimicrobial resistance can vary according to geographical location, we investigated the status of antibiotic resistance in Ilam province from 2008 to 2013. Results: The results of our study showed that antibiotic resistance rates to aztreonam, cefotaxime, ceftazidime and ceftriaxone were 38%, 39%, 43% and 48% respectively. Conclusion: Antibiotic resistance had increased (except for aztreonam) during the period from 2008 to 2013.

The use of probiotics and obtained results from some studies and meta-analysis made it essential to search for the literature about probiotics. For this reason, the current review triesto explain and focus on gastrointestinal tract. On the other hand, reliable designing of probiotics takes into consideration the type of strain and diseases, which are discussed, in the current review.

Methicillin-resistant Staphylococcus aureus(MRSA) is one of the most important pathogens worldwide and compared to other staphylococcal species that are associated with higher mortality rate. A total of 500 Staphylococcusspp. was collected from selected hospitals in Ilam, Kermanshah, Khorram Abad and Hamadan cities and, via phenotypic and genotypic methods, was assessed to find MRSA. The presence or absence of prevalent antibiotic resistance genes and virulence genes was evaluated among MRSA isolates, using polymerase chain reaction (PCR) method, and then the SCCmectyping of these isolates was assayed by multiplex PCR. A total of 372 (74.4%) Stapylococcusspp. isolates were identified as S. aureus, among which 200 (53.8%) possessed the mecAgene and were distinguished as MRSA. All of MRSA isolates contained blaZgene. The frequency of ermAand ermCgenes among erythromycin-resistant MRSA isolates was 21.6% and 66.7%, respectively. The frequency of the virulence genes eta, hla and seaamong MRSA isolates was 10%, 80.5% and 100%, respectively. SCCmectype IV accounted for 30.6% of the MRSA isolates and SCCmectype III, SCCmectype II and SCCmectype I accounted for 30%, 22% and 17.5% of the isolates, respectively. The antibiotic resistance genes and the virulence genes of blaZ, hla, sea, etaand ermChad high frequencies among the MRSA isolates. This study showed that the antibiotic resistance genes had higher frequencies among SCCmectypes I and IV, which confirms the previous reports in this field.

Production of metallo-beta-lactamase (MBL) is one of the main mechanisms for resistance in carbapenem antibiotics. Detection of MBL-producer Pseudomonas aeruginosais crucial in preventing its spread to other gram-negative bacteria. The aim of this study was to evaluate combination disc (CD) for identification of MBL-producer P. aeruginosaby polymerase chain reaction (PCR). A total of 255 imipenem resistant P. aeruginosawere collected from burn patients. Antibiotic susceptibility testing was conducted after purification and identification. Double-disc synergy test (DDST) with EDTA and combination disc test (CDT) with dipicolinic acid were performed for phenotypic detection of MBL and the PCR was carried out for blaVIM, blaIMP, blaNDM-1, blaSPM-1genes. DDST with EDTA was negative in all cases, but 161 isolates were positive in CDT with dipicolinic acid. Further, blaVIMand blaIMPwere detected in five and four strains, respectively. None of the isolates were positive for BlaNDM-1and blaSPM-1. The results of this study showed that the prevalence of MBL is low in imipenem resistance P. aeruginosaand that other mechanisms could be involved in resistance to imipenem in this bacterium.

Objectives: Out-hospital Cardiac arrest is considered as a global disease, which causes high rate of morbidity and mortality. Although, the return of spontaneous circulation occurs in 10 to 60 percent of cases in OHCA, with variety of treatment, the most patients faced with multiple organ failure and ultimately death. The investigations demonstrated that endogenous vasopressin levels in patients with successful resuscitation is more than died patients. Therefore, it seems the administration of vasopressin during cardiopulmonary resuscitation could be useful. The current study aimed to investigate the administration of vasopressin and epinephrine on neurological surviving of cardiac-respiratory arrest via evaluation of S100b serum factor. Methods: For this reasons, after collecting of sera from two vasopressin-epinephrine and epinephrine receiving patients, sera were subjected for ELISA to evaluate S100b. Results: The findings demonstrated that the great reductions of S100b in sera of patients that receiving vasopressinepinephrine in comparison with those patients that only got the epinephrine. Although no significant difference was observed between two groups, but survival rates after hospital discharge in group that receiving vasopressin-epinephrine was significantly higher than those patients that only got only epinephrine. Conclusion: Today, no advantages of vasopressin over epinephrine have been observed in clinical trials and more studies needed to improve the OHAC patient's surveillance. But, The combination vasopressin-epinephrine in the current study demonstrated that efficacy of this combination should be noted.

Background: Extensive use of antibiotics and biocide in treatment of patients and cleaning of surfaces and medical equipment has led to the emergence of resistant microorganisms. The current research goals to determine the antiseptics Minimum Inhibitory Concentration value in Staphylococcus aureus (methicillin -resistant Staphylococcus aureus and methicillin sensitive Staphylococcus aureus) isolates from some major hospitals in Iran and to detect qacA/B, norA , smr and blaZ genes. Methods: Two hundred isolates of S. aureus including 100 MRSA and 100 MSSA clinical isolates were collected from 4 hospitals in the west of Iran during period 2012 to 2013. Detection of disinfectant resistant genes (qac A/B, smr and norA), antimicrobial resistance genes (mecA and blaZ) and SCCmec typing of MRSA isolates was performed by PCR. Results: MIC of chlorhexidine digluconate (CHX) in 70% of MRSA and 30% of MSSA strains was 8-16 µg/ml. High level of MIC of citrimide (>2 µg/ml) in MRSA and MSSA isolates was 20% and 5% ,respectively. MIC of benzalkonium chloride (BC) in 80% of MRSA and 83% of MSSA isolates was less than 2µg/ml; only 9% of MRSA had MIC higher than 2µg/ml. Frequency of antiseptic and antibiotic resistance genes norA, blaZ and qacA/B in MRSA isolates were 83%, 98% and 9%, respectively; while this value for MSSA isolates were 62%, 8% and 0%, respectively. The smr gene was not detected in both MRSA and MSSA isolates. In all biocides high MIC were observed in SCCmec type III and IVc. High frequency of qacA/B gene was found in SCCmec type III,Vc and IVb, which were 66.6% ,22% and 11.1% respectively. Conclusion: We found SCCmec types III, Vc was related to high MIC of biocide in MRSA isolates.

Background: Pseudomonas aeruginosa is known as an opportunistic pathogen responsible for nosocomial infections. Multidrug (MDR) resistance bacteria are considered as a worldwide issue. The current research goal to investigate the antibiotic susceptibility pattern in Extended Spectrum beta-lactamase and non Extended Spectrum beta-lactamase producing P. aeruginosa clinical isolates. Methods: A total of 76 P.aeruginosa clinical isolates were collected from Milad hospital in Tehran, Iran, during 8 months period in 2012. P.aeruginosa clinical isolates were subjected for ESBL production by phenotypic methods. The antibiotic susceptibility patterns were identified in ESBL and non-ESBL P. aeruginosa by MIC. Results: our results demonstrated that 76.3% (n =58) isolates were resistant to more than three antibiotics and classified as MDR. The majority of MDR strains were found in ESBL producer P. aeruginosa. ceftazidim as 3rd generation of cephalosporins, ciprofloxacin, Ticarcillin and aztreonam were found as a base for definition of MDR in the current research. The effectiveness antibiotics against ESBL and non-ESBL were meropenem and amikacin, respectively. Conclusion: based on our knowledge obtained from results, both ESBL and non-ESBL P. aeruginosa were resistant to extended antibiotics and this is a major health care problem. On the other hand, MDR strains more identified in ESBL producer P .a eruginosa. Also, carabapenem resistance observed in non-ESBL producer strains. Hence, it is recommended that the MDR strains should be following up. the prescription of ceftazidim, ciprofloxacin, Ticarcillin and aztreonam should be limited.