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Background: Helicobacter pylori infection and respiratory tract infection at the same time cause pathogenicity increase and death. The aim of this study was to evaluate the co-occurrence of upper respiratory tract disorders and gastrointestinal infections of H. pylori. Methods: The present study was conducted as a systematic review and meta-analysis, from August 2019 to Agusut 2020, at Qazvin University of Medical Sciences. Articles in the international databases (April 2001-December 2018) on the coexistence of upper respiratory tract disorders with H. pylori gastrointestinal infections were examined. The random effect model with a 95% confidence level was used to analyze the data. Results: The highest prevalence of respiratory disorders co-occurrence associated with adenoid tissue (33%), nasal polyps (100%), chronic rhinosinusitis (71%) and gastrointestinal infections of H. pylori was reported in 2006 in Turkey, 2011 in Poland and 2015 in Egypt. Concurrent prevalence of the disease, according to the type of upper respiratory tract disorders in all studies, the estimated effect size according to the random model was 53% in chronic rhinosinusitis, 63% in nasal polyps, 62% in adenoid tissue and 60% in total, which was significant (P=0/000). The prevalence of co-occurrence of upper respiratory tract disorders with gastrointestinal infections of H. pylori in patients was estimated to be 61% at the age of more than 27 years and 60% at the age of fewer than 27 years. Pooled estimation of the concurrent prevalence of infection (in total) was estimated to be 60% and was significant among the studies (P=0/000). Conclusion: The concurrent prevalence of upper respiratory tract disorders with gastrointestinal infections of H. pylori was observed to be almost equal and significant in elderly and young patients. Due to the fact that the simultaneous occurrence of two types of infections and diseases in people is very dangerous, screening of patients with each of these infections is necessary to identify the other infection and prescribe appropriate drugs.

Introduction: The present study was conducted to evaluate the effect of a family-centered sensory diet program on the impulsivity in children with attention deficit hyperactivity disorder (ADHD). Materials and Methods: This is a quasi-experimental study with a pretest-posttest design with a control group. The study population included all children with ADHD aged 6-12 years in Tehran, Iran referred to the clinics of Hasti, Bahar, and Masir-e Sabz in 2020. Of these, 30 children were selected using a convenience sampling method and randomly divided into two groups of intervention and control. The intervention group underwent 12 sessions of a family-centered sensory diet program, 3 days a week, each for 45 minutes based on the Wilbarger protocol. The used tools were the Wechsler intelligence scale for children-Fourth Edition to test intellectual ability and the Conners’ parent rating scale to diagnose ADHD in children. Independent t test and analysis of covariance (ANCOVA) were used in SPSS software v. 20 for data analysis. Results: In this study, the mean age of participants was 9.56±4.38 years, including 11 girls (36.6%) and 19 boys (63.3%), and the mean age of mothers of these children was 34.23±6.9. The mean impulsivity scores of children in the intervention group decreased and the results of the ANCOVA showed a statistically significant difference in the mean posttest scores between the two groups (P=0.001). Conclusion: The family-centered sensory diet program has a positive effect on the impulsivity of children with ADHD. It is recommended that therapists use the sensory diet program as a complementary therapy along with other therapeutic interventions.

Objectives: Bacterial leakage at the implant-abutment interface is one of the main causes of peri-implant inflammation. One of the factors that influences bacterial leakage is the structural design of the interface. Considering the limited studies that have examined slip-joint connections, a comparative study of bacterial leakage was performed on two different systems namely Zimmer (Tapered Screw-Vent, Zimmer Dental) with slip-joint connection and Argon (Konus K3pro, Argon Implants) with conical connection. Materials and Methods: Twenty-two implants were selected in 2 groups (11 Zimmer with slip-joint connection, and 11 Argon with conical connection) with similar platforms. Escherichia coli (E. coli) suspension (2 μL) was pipetted into the internal lumen of implants. The abutments were screwed onto the implants with a closing torque of 30 Ncm. The assemblies were placed in culture broth for 6, 24, 48 and 72 h, and 7 and 14 days. The colonies were counted and analyzed by the Mann-Whitney test (a=0.05). Results: Microleakage was observed in 20% of the samples of conical connection group after 6 h to 2 days, and in 50% of the samples in slip-joint connection group after 3 to 7 days. There was a significant difference in bacterial leakage rate between the two implant groups (P0.05). Conclusion: Type of connection had a significant effect on bacterial leakage, but the rate of bacterial leakage did not significantly change over time.

Background and Aims: According to concerns of technical errors in intraoral radiographs and reports of positive effects of central ray laser pointer on the students, technical errors and shortcomings of earlier research, this study was conducted at Department of Oral and Maxillofacial Radiology of Tehran Azad University to determine the role and use of laser pointer in the technical error made by students. Materials and Methods: This clinical trials study was carried out at the Department of Radiology, Dental School of Azad Tehran University. A total of eighty students were divided into two groups of forty. In the first group the periapical technique was taught without laser guided indicator, while in the second group laser guided indicator was applied in training the students. All students took X-rays from the phantoms. Laser guided indicator is made of one low power red laser diodes.Totally 560 X-rays were taken and the technical errors and the quality of X-rays were evaluated. Data were analyzed statistically using Mann-Whitney and Chi Square tests (&alpha=0.05). Results: The X-rays taken by students showed significant differences in cone cutting (P

Objectives: Many of non-respiratory and respiratory disorders are associated with bioaerosols in indoor and outdoor air. The best conditions for bioaerosols life are high humidity and moderate temperatures, which exist usually in indoor spaces such as the prisons, where density of individual is high. Pathogen spreading centers cause the prisoners health at risk of disease outbreaks through airborne and breathing, sneezing, and coughing. Therefore, the aim of this research work was to measure concentration of particulate matters and also to identify and determine bacteria existing in the prisoners breathing air at high-density areas in one of the prisons and their relationship with each other. Materials & Method: we conducted this research during summer and winter of 2012. We used TSI apparatus for collecting particles (PM2.5 and PM10). Blood agar and EMB agar media were applied to measure bacteria in indoor air (bedchambers and clinical admission wards) of the prison. According to NIOSH 0800 method, High volume pump with 28.3 L/min flow and a Single-stage Anderson Impactor were used for sampling. The time of measuring for each plate was 2.5 min. Finally, the data achieved were analyzed using SPSS after counting and detecting bacterial colonies grown and determining its density (CFU/m³) for two consecutive seasons of summer and winter. The tests analyzed by SPSS were ANOVA, Post hoc, correlation, and Pearson correlation tests. Results: Amounts of particulate matter in bedchambers were exceeded than 24-hour EPA limits, while it was less than the limits in clinical admission wards. Gram-positive and gram-negative bacteria were found in three bedchambers (50% of the bedchambers); however, gram-positive bacteria were cultivated only in three bedchambers. The maximum bacterial contamination was measured at the main Lobby of the prison and bedchamber II and the minimum value was observed in admitted patient and TB patient wards. Results showed that there is no significant relationship between the particulate matters and the bacterial density during neither summer nor winter, but there is a strong and direct relationship between the prisoners population density, ventilation systems, and bacterial density n indoor air of the studied prison. Conclusion: Based on the results, the maximum contamination load and exceeded concentration was observed in public sections and bedchambers. This findings were attributed to the daily entry of new prisoners, high population density in prison, presence of ill prisoners, prisoners with hidden respiratory disease showing no symptoms yet, old building, climatic conditions of the region, low efficiency of ventilation systems, and influx of particulates. To filter and purify prison indoor air, it is crucial to take serious action plans such as reducing criminal population density, sanitary and engineering measures

Nurses are ever-increasingly confronted with complex concerns in their practice. Codes of ethics are fundamental guidance for nursing as many other professions. Although there are authentic international codes of ethics for nurses, the national code would be the additional assistance provided for clinical nurses in their complex roles in care of patients, education, research and management of some parts of health care system in the country. A national code can provide nurses with culturally-adapted guidance and help them to make ethical decisions more closely to the Iranian-Islamic background. Given the general acknowledgement of the need, the National Code of Ethics for Nurses was compiled as a joint project (2009-2011). The Code was approved by the Health Policy Council of the Ministry of Health and Medical Education and communicated to all universities, healthcare centers, hospitals and research centers early in 2011. The focus of this article is on the course of action through which the Code was compiled, amended and approved. The main concepts of the code will be also presented here. No doubt, development of the codes should be considered as an ongoing process. This is an overall responsibility to keep the codes current, updated with the new progresses of science and emerging challenges, and pertinent to the nursing practice.

Background and Objectives: The emergence of plasmid-mediated AmpC (pAmpC) β-lactamases conferring resistance to third-generation cephalosporins has become a major clinical concern worldwide. The aims of this study were to determine the prevalence of pAmpC-producing E. cloacae isolates and typing of them in Qazvin and Tehran provinces, Iran. Materials and Methods: A total of 120 cefoxitin non-susceptible isolates of E. cloacae were obtained from educational hospitals of Qazvin and Tehran, Iran. Bacterial identification was performed by standard laboratory methods and API 20E strips. Susceptibility to cefoxitin was determined by Kirby-Bauer disk diffusion method. PCR and sequencing were employed to detect pAmpC families’ genes (ACC, FOX, MOX, DHA, CIT and EBC) and the clonal relatedness of pAmpC-positive isolates was evaluated by enterobacterial repetitive intergenic consensus (ERIC)-PCR method. Results: In total, 20 (16.7%) isolates of E. cloacae were positive for presence of pAmpC genes among those blaDHA-1 (14.2%) was the most common gene followed by blaCMY-2 (2.5%). Results of ERIC-PCR showed that that the prevalence of DHA-1 and CMY-2-producing E. cloacae isolates was not due to clonal outbreaks. Conclusion: In present study, we showed the first emergence of DHA-1 and CMY-2 types of pAmpC-producing E. cloacae isolates in Iran. The appearance of pAmpC should be considered as a warning for the implementation of appropriate infection control and therapeutic policies in order to prevent the dissemination of these resistant organisms in our hospital settings.

Background: Leishmaniasis is an important public health disease in many developing countries as well in Iran. The main objective of this study was to investigate on leishmania infection of wild caught sand flies in an endemic focus of disease in Esfarayen district, north east of Iran. Methods: Sand flies were collected by sticky papers and mounted in a drop of Puri’s medium for species identification. Polymerase chain reaction techniques of kDNA, ITS1-rDNA, followed by restriction fragment length polymorphism were used for identification of DNA of Leishmania parasites within infected sand flies. Results: Among the collected female sand flies, two species of Phlebotomus papatasi and Phlebotomus salehi were found naturally infected with Leishmania major. Furthermore, mixed infection of Leishmania turanica and L. major was observed in one specimen of P. papatasi. Sequence analysis revealed two parasite ITS1 haplotypes including three L. major with accession numbers: KJ425408, KJ425407, KM056403 and one L. turanica. (KJ425406). The haplotype of L. major was identical (100%) to several L. major sequences deposited in GenBank, including isolates from Iran, (Gen Bank accession nos.AY573187, KC505421, KJ194178) and Uzbekistan (Accession no.FN677357). Conclusion: To our knowledge, this is the first detection of L. major within wild caught P. salehi in north- east of Iran.

Background and Objectives: Pseudomonas aeruginosa is a frequent opportunistic pathogen in health care associated infections that is highly resistant to the majority of β-lactams. The aims of this study were to access the antimicrobial susceptibility pattern of P. aeruginosa isolated from educational hospitals of Qazvin and Alborz provinces, to determine the prevalence of metallo-β-lactamase (MBL) among carbapenem non-susceptible isolates by combined disk (CD) method, and to detect the blaIMP, blaVIM, blaSIM, blaGIM, blaSPM and blaNDM-1-MBL genes. Materials and Methods: In this cross-sectional study, 300 P. aeruginosa isolates were collected from different clinical specimens in two provinces of Qazvin and Alborz hospitals, Iran. After identification of isolates by standard laboratory methods, antimicrobial susceptibility was done against 17 antibiotics according to clinical and laboratory standards institute (CLSI) guideline. CD method was carried out for detection of MBLs and the presence of blaIMP, blaVIM, blaSIM, blaGIM, blaNDM-1 and blaSPM-genes was further assessed by PCR and sequencing methods. Results: In this study, 107 (35.66%) isolates were non-susceptible to imipenem and/or meropenem among those 56 (52.3%) isolates were metallo-β-lactamase producer. Twenty-four of 56 (42.85%) MBL-positive isolates were confirmed to be positive for MBL-encoding genes in which 14 (25%) and 10 (17.85%) isolates carried blaIMP-1 and blaVIM-1 genes either alone or in combination. Three (5.35%) isolates carried blaIMP and blaVIM genes, simultaneously. Conclusion: Considering the moderate prevalence and clinical importance of MBL-producing isolates, rapid identification and use of appropriate infection control (IC) measures are necessary to prevent further spread of infections by these resistant organisms.

Background and Objectives: We developed and evaluated the utility of a quadruplex Taqman real-time PCR assay that allows simultaneous identification of vancomycin-resistant genotypes and clinically relevant enterococci. Materials and Methods: The specificity of the assay was tested using reference strains of vancomycin-resistant and susceptible enterococci. In total, 193 clinical isolates were identified and subsequently genotyped using a Quadruplex Taqman real-time PCR assay and melting curve analysis. Representative Quadruplex Taqman real-time PCR amplification curve were obtained for Enterococcus faecium, Enterococcus faecalis, vanA-containing E. faecium, vanB-containing E. faecalis. Results: Phenotypic and genotypic analysis of the isolates gave same results for 82 enterococcal isolates, while in 5 isolates, they were inconsistent. We had three mixed strains, which were detected by the TaqMan real-time PCR assay and could not be identified correctly using phenotypic methods. Conclusion: Vancomycin resistant enterococci (VRE) genotyping and identification of clinically relevant enterococci were rapidly and correctly performed using TaqMan real-time multiplex real-time PCR assay.

Introduction: The present study was conducted to evaluate the effect of a family-centered sensory diet program on the impulsivity in children with attention deficit hyperactivity disorder (ADHD). Materials and Methods: This is a quasi-experimental study with a pretest-posttest design with a control group. The study population included all children with ADHD aged 6-12 years in Tehran, Iran referred to the clinics of Hasti, Bahar, and Masir-e Sabz in 2020. Of these, 30 children were selected using a convenience sampling method and randomly divided into two groups of intervention and control. The intervention group underwent 12 sessions of a family-centered sensory diet program, 3 days a week, each for 45 minutes based on the Wilbarger protocol. The used tools were the Wechsler intelligence scale for children-Fourth Edition to test intellectual ability and the Conners’ parent rating scale to diagnose ADHD in children. Independent t test and analysis of covariance (ANCOVA) were used in SPSS software v. 20 for data analysis. Results: In this study, the mean age of participants was 9.56±4.38 years, including 11 girls (36.6%) and 19 boys (63.3%), and the mean age of mothers of these children was 34.23±6.9. The mean impulsivity scores of children in the intervention group decreased and the results of the ANCOVA showed a statistically significant difference in the mean posttest scores between the two groups (P=0.001). Conclusion: The family-centered sensory diet program has a positive effect on the impulsivity of children with ADHD. It is recommended that therapists use the sensory diet program as a complementary therapy along with other therapeutic interventions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Carbapenem resistant A. baumannii is an emerging cause of nosocomial infections. The aims of this study were identification of the most prevalent of carbapenem resistant genes, molecular typing and antimicrobial evaluation of A.baumannii in intensive care units. Materials and Methods: Two hundred and six A. baumannii were isolated from tracheal tube discharge of hospitalized patients at different intensive care units in Ahvaz, Iran. Antimicrobial susceptibility test was done on all isolates. Multiplex and singleplex PCR were performed for detection of bla OXA-23-like, bla OXA-24-like, bla OXA-51-like, bla OXA-58-like, bla VIM, bla IMP, bla SPM and bla NDM genes. Genetic relationship of all isolates was determined by REP-PCR method. Results: Out of 206 examined isolates, 198 (96.1%) isolates were resistant to imipenem and meropenem. However 3.9% isolates were sensitive to these antibiotics. The bla OXA-23-like and bla OXA-24-like genes were detected in 85% and 8.7% of strains, respectively. No bla OXA-58- like, bla IMP, bla VIM, bla SPM and bla NDM were detected. REP-PCR results showed that isolates were belonged to five genotypes: Genotype A was the most prevalent (P- value < 0.001): it was observed in 75 of 206 strains (36.4%). Genotype B, and C were found in 28.6% and 27.7%, respectively. The rate of other genotypes was as follows: D (2.4%), E (1%). Conclusion: Based on the obtained results, the rate of carbapenem resistance was high among of A. baumannii which was isolated from intensive care units patients and oxacillinase genes were the most prevalent carbapenem resistant genes. These results revealed that three clones, A, B and C of A.baumannii are common in our hospitals.

Nurses are ever-increasingly confronted with complex concerns in their practice. Codes of ethics are fundamental guidance for nursing as many other professions. Although there are authentic international codes of ethics for nurses, the national code would be the additional assistance provided for clinical nurses in their complex roles in care of patients, education, research and management of some parts of health care system in the country. A national code can provide nurses with culturally-adapted guidance and help them to make ethical decisions more closely to the Iranian-Islamic background. Given the general acknowledgement of the need, the National Code of Ethics for Nurses was compiled as a joint project (2009-2011). The Code was approved by the Health Policy Council of the Ministry of Health and Medical Education and communicated to all universities, healthcare centers, hospitals and research centers early in 2011. The focus of this article is on the course of action through which the Code was compiled, amended and approved. The main concepts of the code will be also presented here. No doubt, development of the codes should be considered as an ongoing process. This is an overall responsibility to keep the codes current, updated with the new progresses of science and emerging challenges, and pertinent to the nursing practice.

Background and Objectives: The emergence of plasmid-mediated AmpC (pAmpC) β-lactamases conferring resistance to third-generation cephalosporins has become a major clinical concern worldwide. The aims of this study were to determine the prevalence of pAmpC-producing E. cloacae isolates and typing of them in Qazvin and Tehran provinces, Iran. Materials and Methods: A total of 120 cefoxitin non-susceptible isolates of E. cloacae were obtained from educational hospitals of Qazvin and Tehran, Iran. Bacterial identification was performed by standard laboratory methods and API 20E strips. Susceptibility to cefoxitin was determined by Kirby-Bauer disk diffusion method. PCR and sequencing were employed to detect pAmpC families' genes (ACC, FOX, MOX, DHA, CIT and EBC) and the clonal relatedness of pAmpC-positive isolates was evaluated by enterobacterial repetitive intergenic consensus (ERIC)-PCR method. Results: In total, 20 (16.7%) isolates of E. cloacae were positive for presence of pAmpC genes among those blaDHA-1 (14.2%) was the most common gene followed by blaCMY-2 (2.5%). Results of ERIC-PCR showed that that the prevalence of DHA-1 and CMY-2-producing E. cloacae isolates was not due to clonal outbreaks. Conclusion: In present study, we showed the first emergence of DHA-1 and CMY-2 types of pAmpC-producing E. cloacae isolates in Iran. The appearance of pAmpC should be considered as a warning for the implementation of appropriate infection control and therapeutic policies in order to prevent the dissemination of these resistant organisms in our hospital settings. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is an important public health disease in many developing countries as well in Iran. The main objective of this study was to investigate on leishmania infection of wild caught sand flies in an endemic focus of disease in Esfarayen district, north east of Iran. Methods: Sand flies were collected by sticky papers and mounted in a drop of Puri's medium for species identification. Polymerase chain reaction techniques of kDNA, ITS1-rDNA, followed by restriction fragment length polymorphism were used for identification of DNA of Leishmania parasites within infected sand flies. Results: Among the collected female sand flies, two species of Phlebotomus papatasi and Phlebotomus salehi were found naturally infected with Leishmania major. Furthermore, mixed infection of Leishmania turanica and L. major was observed in one specimen of P. papatasi. Sequence analysis revealed two parasite ITS1 haplotypes including three L. major with accession numbers: KJ425408, KJ425407, KM056403 and one L. turanica. (KJ425406). The haplotype of L. major was identical (100%) to several L. major sequences deposited in GenBank, including isolates from Iran, (Gen Bank accession nos.AY573187, KC505421, KJ194178) and Uzbekistan (Accession no.FN677357). Conclusion: To our knowledge, this is the first detection of L. major within wild caught P. salehi in north- east of Iran. [ABSTRACT FROM AUTHOR]

Background and Objectives: Pseudomonas aeruginosa is a frequent opportunistic pathogen in health care associated infections that is highly resistant to the majority of β-lactams. The aims of this study were to access the antimicrobial susceptibility pattern of P. aeruginosa isolated from educational hospitals of Qazvin and Alborz provinces, to determine the prevalence of metallo-β-lactamase (MBL) among carbapenem non-susceptible isolates by combined disk (CD) method, and to detect the blaIMP, blaVIM, blaSIM, blaGIM, blaSPM and blaNDM-1-MBL genes. Materials and Methods: In this cross-sectional study, 300 P. aeruginosa isolates were collected from different clinical specimens in two provinces of Qazvin and Alborz hospitals, Iran. After identification of isolates by standard laboratory methods, antimicrobial susceptibility was done against 17 antibiotics according to clinical and laboratory standards institute (CLSI) guideline. CD method was carried out for detection of MBLs and the presence of blaIMP, blaVIM, blaSIM, blaGIM, blaNDM-1 and blaSPM-genes was further assessed by PCR and sequencing methods. Results: In this study, 107 (35.66%) isolates were non-susceptible to imipenem and/or meropenem among those 56 (52.3%) isolates were metallo-β-lactamase producer. Twenty-four of 56 (42.85%) MBL-positive isolates were confirmed to be positive for MBL-encoding genes in which 14 (25%) and 10 (17.85%) isolates carried blaIMP-1 and blaVIM-1 genes either alone or in combination. Three (5.35%) isolates carried blaIMP and blaVIM genes, simultaneously. Conclusion: Considering the moderate prevalence and clinical importance of MBL-producing isolates, rapid identification and use of appropriate infection control (IC) measures are necessary to prevent further spread of infections by these resistant organisms. [ABSTRACT FROM AUTHOR]

Background and Objectives: We developed and evaluated the utility of a quadruplex Taqman real-time PCR assay that allows simultaneous identification of vancomycin-resistant genotypes and clinically relevant enterococci. Materials and Methods: The specificity of the assay was tested using reference strains of vancomycin-resistant and susceptible enterococci. In total, 193 clinical isolates were identified and subsequently genotyped using a Quadruplex Taqman real-time PCR assay and melting curve analysis. Representative Quadruplex Taqman real-time PCR amplification curve were obtained for Enterococcus faecium, Enterococcus faecalis, vanA-containing E. faecium, vanB-containing E. faecalis. Results: Phenotypic and genotypic analysis of the isolates gave same results for 82 enterococcal isolates, while in 5 isolates, they were inconsistent. We had three mixed strains, which were detected by the TaqMan real-time PCR assay and could not be identified correctly using phenotypic methods. Conclusion: Vancomycin resistant enterococci (VRE) genotyping and identification of clinically relevant enterococci were rapidly and correctly performed using TaqMan real-time multiplex real-time PCR assay. [ABSTRACT FROM AUTHOR]

Background and Objectives: Pseudomonas aeruginosa is a frequent opportunistic pathogen in health care associated infections that is highly resistant to the majority of β-lactams. The aims of this study were to access the antimicrobial susceptibility pattern of P. aeruginosa isolated from educational hospitals of Qazvin and Alborz provinces, to determine the prevalence of metallo-β-lactamase (MBL) among carbapenem non-susceptible isolates by combined disk (CD) method, and to detect the bla IMP, bla VIM, bla SIM, bla GIM, bla SPM and bla NDM-1-MBL genes., Materials and Methods: In this cross-sectional study, 300 P. aeruginosa isolates were collected from different clinical specimens in two provinces of Qazvin and Alborz hospitals, Iran. After identification of isolates by standard laboratory methods, antimicrobial susceptibility was done against 17 antibiotics according to clinical and laboratory standards institute (CLSI) guideline. CD method was carried out for detection of MBLs and the presence of bla IMP, bla VIM, bla SIM, bla GIM, bla NDM-1 and bla SPM-genes was further assessed by PCR and sequencing methods., Results: In this study, 107 (35.66%) isolates were non-susceptible to imipenem and/or meropenem among those 56 (52.3%) isolates were metallo-β-lactamase producer. Twenty-four of 56 (42.85%) MBL-positive isolates were confirmed to be positive for MBL-encoding genes in which 14 (25%) and 10 (17.85%) isolates carried bla IMP-1 and bla VIM-1 genes either alone or in combination. Three (5.35%) isolates carried bla IMP and bla VIM genes, simultaneously., Conclusion: Considering the moderate prevalence and clinical importance of MBL-producing isolates, rapid identification and use of appropriate infection control (IC) measures are necessary to prevent further spread of infections by these resistant organisms.

Background and Objectives: We developed and evaluated the utility of a quadruplex Taqman real-time PCR assay that allows simultaneous identification of vancomycin-resistant genotypes and clinically relevant enterococci., Materials and Methods: The specificity of the assay was tested using reference strains of vancomycin-resistant and susceptible enterococci. In total, 193 clinical isolates were identified and subsequently genotyped using a Quadruplex Taqman real-time PCR assay and melting curve analysis. Representative Quadruplex Taqman real-time PCR amplification curve were obtained for Enterococcus faecium, Enterococcus faecalis, vanA-containing E. faecium, vanB-containing E. faecalis., Results: Phenotypic and genotypic analysis of the isolates gave same results for 82 enterococcal isolates, while in 5 isolates, they were inconsistent. We had three mixed strains, which were detected by the TaqMan real-time PCR assay and could not be identified correctly using phenotypic methods., Conclusion: Vancomycin resistant enterococci (VRE) genotyping and identification of clinically relevant enterococci were rapidly and correctly performed using TaqMan real-time multiplex real-time PCR assay.

Background and Objectives: Carbapenem resistant A. baumannii is an emerging cause of nosocomial infections. The aims of this study were identification of the most prevalent of carbapenem resistant genes, molecular typing and antimicrobial evaluation of A.baumannii in intensive care units., Materials and Methods: Two hundred and six A. baumannii were isolated from tracheal tube discharge of hospitalized patients at different intensive care units in Ahvaz, Iran. Antimicrobial susceptibility test was done on all isolates. Multiplex and singleplex PCR were performed for detection of bla OXA-23-like, bla OXA-24-like, bla OXA-51-like, bla OXA-58-like, bla VIM, bla IMP, bla SPM and bla NDM genes. Genetic relationship of all isolates was determined by REP-PCR method., Results: Out of 206 examined isolates, 198 (96.1%) isolates were resistant to imipenem and meropenem. However 3.9% isolates were sensitive to these antibiotics. The bla OXA-23-like and bla OXA-24-like genes were detected in 85% and 8.7% of strains, respectively. No bla OXA-58- like, bla IMP, bla VIM, bla SPM and bla NDM were detected. REP-PCR results showed that isolates were belonged to five genotypes: Genotype A was the most prevalent (P- value < 0.001): it was observed in 75 of 206 strains (36.4%). Genotype B, and C were found in 28.6% and 27.7%, respectively. The rate of other genotypes was as follows: D (2.4%), E (1%)., Conclusion: Based on the obtained results, the rate of carbapenem resistance was high among of A. baumannii which was isolated from intensive care units patients and oxacillinase genes were the most prevalent carbapenem resistant genes. These results revealed that three clones, A, B and C of A.baumannii are common in our hospitals.