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Soheila Habibi Ghahfarokhi, 1 Mehrdad Mosadegh, 1 Ali Ahmadi, 2 Mohammad Reza Pourmand, 1 Mohammad Azarsa, 3 Mohammad Rahbar, 4 Bahram Nikmanesh 5 1Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 2Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; 3Department of Microbiology, Khoy University of Medical Sciences, Khoy, Iran; 4Department of Microbiology, Reference Health Laboratories Research Center, Ministry of Health and Medical Education, Tehran, Iran; 5Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IranCorrespondence: Mohammad Reza PourmandDepartment of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Poursina St., Keshavarz Blvd., Tehran 1417613151, IranTel/Fax +98 21-88-95-4910Email mpourmand@tums.ac.irIntroduction: Encapsulated Streptococcus pneumoniae strains cause high morbidity and mortality, mainly in countries with no pneumococcal conjugate vaccines (PCVs) immunization program. This study investigated the epidemiological changes of S. pneumoniae isolates including serotype distribution and antimicrobial susceptibility in Tehran, Iran.Methods: A total of 80 S. pneumoniae samples were collected from patients admitted to Shariati hospital over two periods. Half of the isolates were collected from February to September 2017 and the other half from July 2018 to March 2019. The antimicrobial susceptibility testing and PCV-13 serotype coverage of S. pneumoniae isolates were evaluated among patients with invasive and non-invasive infections.Results: The most common serotypes were 23F (17.5%), 14 (16.3%), 3 (16.3%) 19F (12.5%), and 19A (12.5%) in the present study. The vaccine coverage rates of PCV-7, PCV-10 and PCV-13 were 52.6%, 52.6%, and 83.7%, respectively. S. pneumoniae isolates with the serotype of the PCV-13 showed an increasing trend during the study. Nearly half of the S. pneumoniae strains were MDR, while MDR serotype 19A increased (40%) during the study periods. A small minority of isolates (16%) belonged to non-vaccine serotypes, 65% of which were assigned to MDR. In general, the frequency of penicillin resistant and MDR strains were estimated about 27.5% and 51%, respectively. An increase was observed in resistance to erythromycin and co-trimoxazole.Conclusion: The results showed that majority of the circulating serotypes in our study are related to PCV-13 serotypes. The use of conjugate vaccine in the immunization program and surveillance of antimicrobial resistance can be effective in reducing the pneumococcal clinical burden.Keywords: Streptococcus pneumoniae, serotype, pneumococcal conjugate vaccine, PCV, antibiotic susceptibility, multi-drug resistance, MDR

Roghayeh Samadi,1 Zohreh Ghalavand,1 Reza Mirnejad,2 Bahram Nikmanesh,3 Gita Eslami1 1Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Molecular Biology Research Center, Systems Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; 3Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IranCorrespondence: Gita EslamiDepartment of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranTel +98-2123872556Email g_eslami@yahoo.comIntroduction: Methicillin-resistant Staphylococcus aureus (MRSA) causes high rates of mortality and a substantial burden to health systems worldwide. Here, we investigated the antimicrobial susceptibility and molecular characteristics of MRSA isolated from children referred to Children’s Medical Center in Tehran.Materials and methods: A total of 98 MRSA isolates were collected from children. Antimicrobial resistance patterns were determined using the disk diffusion and E-test methods. The presence of biofilm encoding genes and the pvl gene were determined by PCR. We used the microtiter plate method to assess the ability of biofilm formation. The MRSA isolates were further analyzed using PFGE and SCCmec typing.Results: Antibiotic susceptibility testing showed that the highest and the lowest antibiotic resistance percentage were related to erythromycin (62%) and minocycline (10%), respectively. Overall, 63% of MRSA isolates were biofilm producers. Resistance to two antibiotics such as erythromycin (72% vs 28%, P=0.01) and clindamycin (71% vs 29%, P=0.04) was higher among biofilm producers than non-biofilm producers. All strains had biofilm-forming genes and the prevalence of pvl gene was 41%. Most MRSA isolates belonged to SCCmec IVa (75%) and SCCmec III (18%). In PFGE technique, 5 common types and 2 single types were identified; Common type 1 with 37 isolates was dominant clone.Conclusion: We thus report preliminary data on the prevalence and distribution of MRSA genotypes in Tehran Children’s Hospital. These findings characterize the MRSA colonization dynamics in child patients in Iran and may aid the design of strategies to prevent MRSA infection and dissemination.Keywords: MRSA, biofilm formation, antibiotic resistance, SCCmec typing, PFGE

Background and Objective: Yersinia is a gram-negative bacillus that cause diarrhea through consumption of contaminated food and water. This study was performed to identify the atypical Yersinia virulence markers isolated from children with diarrhea. Methods: This descriptive cross -sectional study was done on 384 fecal samples of 0- 14 years old children admitted at children medical center from August 2011 to August of 2012. Fecal samples, for the enrichment, after 21 days of incubation in alkaline buffer with pH=7.2 at 4degree C, on days 7, 14 and 21 samples were cultured on CIN agar and Mac agar and then confirm the differentiation atypical Yersinia from other typical Yersinia species from fermentation of different sugars. Isolates were tested for marker of virulence including calcium dependence, auto agglutination, Congo red uptake and binding of crystal violet. Results: Out of 384 stool samples, 4 (1.04%) were infected with Yersinia (Yersinia frederikseni, Yersinia kristensenii and Yersinia enterocolitica). Out of these three, only two samples in association was positive with virulence markers. Conclusion: Phenotypic markers can be used to study the properties of phenotypic strains of Yersinia.

Background and Objective: Yersinia enterocolitica is a worldwide pathogen belong to genus Yersinia. The association between acute childhood diarrhea and other diseases caused by Yersinia enterocolitica has been established by several researchers. Due to the lack of sufficient information on other pathogenic Yersinia species, this study was done to determine the prevalence and the pattern of antibiotic susceptibility of atypical Yersinia spp isolated from children, less than 14 years old. Methods: This descriptive cross - sectional study was carried on 384 children with diarrhea whom referred to the Tehran children medical center, Tehran, Iran during August 2011 to August 2012. 384 fecal specimens of children were transferd to the laboratory and cold enrichment in alkaline buffer with pH of 7.2 for 21 days. The samples were cultured in Cefsulodin-Irgasan-Novobiocin Agar (CIN) differential media in 7, 14, and 21 days. The identification of Yersinia species were carried out by conventional procedure. Antibiotic susceptibility test to Ciprofloxacin, Co-trimoxazole, Tetracycline, Chloramphenicol, Erythromycin, Ampicillin, Gentamicin, Penicillin were determined by standard disk diffusion method. Results: Out of 384 fecal samples, 3 (0.7%) were infected with Yersinia. Three species of Yersinia were Y.enterocolitica, Y.Kristensenii and Y.frederiksenii. All three strains were sensitive to Cotrimoxazole, Tetracycline, Chloramphenicol, Ciprofloxacin and Gentamicin. Conclusion: This study showed that atypical Yersinia play important role in diarrhea. Therefore, more attention should be noticed to atypical Yersinia species in addition to Yersinia enterocolitica.

Background and Objective: Attention has largely been focused on appearance of multiple drug resistance enterococci in the last 20 years. One of the methods to overcome this problem is to combine different antibiotics in order to increase antimicrobial activity and reduce toxicity. The combination of fluor quinolones with other antibiotics has been widely investigated. The aim of this study was to investigate the synergistic effect of ciprofloxacin in several antibiotics Beta-lactam (piperacillin, ceftazidime and imipenem) on isolated enterococci. Materials and Methods: In this cross sectional study, 67 Streptococci strains were isolated from clinical samples from March to September 2012. The serial broth dilution method in test tubes was used for the MIC, and the check board Format was used for the synergistic effect of ciprofloxacin with Beta-lactam antibiotics. The synergistic effect was determined with four- fold reduction of initial MIC. Results: Totally, 67 strains of Streptococci were used, in which 50 strains (74.6%) were enterococci, 6(9%) were group B streptococcus, 5(7.5%) were non-group A streptococci, 2 (3%) were pneumococci, and 2 were strains of alpha streptococci (3%), respectively. All results were determined by the MIC and MBC of each antibiotic individually and also in combination with ciprofloxacin. Conclusion: The effect of ciprofloxacin on other antibiotics was indifferent, and the synergistic effect was not observed. [ABSTRACT FROM AUTHOR]

Background: Septicaemia is a leading cause of morbidity and mortality of infant's and childerens espicially in first week of their life, both in developed and underdeveloped countries.The aim of this research was to study of bacterial agents causing septicaemia and to determine their antibiotic suseptibility patternes. Materials and Methods : This was a descriptive study, it was performed during eight months from October 2011 till May 2011. In total 216 blood culture samples of children suspected of septicaemia in children health centre hospital were send to the laboratory for investigation. The bacterial identification was carried out by culturing and conventional biomedical tests. The antibiotic sensitivity tests were performed by disk diffusion method. These data are analyzed by SPSS and the results Expressed as relative frequencies. Results: Out of 216 tested samples 55(25.6%) were positive and 161 (74.54%) negative. The dominated bacteria was Escherichia coli (31.42%), followed by Staphylococcus aureus (22.86 %), Klebsiella pneumonia (20%)), Staphylococcus epidermidis (14.28%), Streptococcus pneumonia (2.86%), Salmonella typhi (2.86%), Enterobacter cloacae (2.86%) and Stenotrophomonas maltophilia (2.86%). In general gram-negative bacteria were isolated more than gram-positive. Staphylococcus bacteria were more resistant to antibiotics than other isolated bacteria, and were 100% resistant to penicillin. The enterobacteriaceae were more sensitive to norfloxacin, amikacin, tobramycin, and they were 100% resistant to ampicillin. Conclusion: The results obtained in this study showed that gram-negative bacteria are more responsible in septicaemia in children ward, and norfloxacin is the more effective antibiotic in comparison with others. [ABSTRACT FROM AUTHOR]

Persistent diarrhea is a major manifestation of Acquired Immunodeficiency Syndrome (AIDS) which might be more complicated in Human Immunodeficiency Virus (HIV) infected children especially those from developing countries. There are numerous reports showing the emergence of intestinal opportunistic coccidian parasites, mostly Cryptosporidium parvum and Isospora belli in HIV-infected individuals. The prevalence of isosporiasis is probably underestimated in developing countries because routinely not all HIV-infected patients are examined for the presence of this protozoan infection. Here we report a case of HIV-infected isosporiasis presenting with failure to thrive and persistent diarrhea. Since I. belli infection in children responds well to therapy with trimethoprim-sulfamethoxazole, isosporiasis should be considered as a treatable infection in AIDS, if it is detected at proper time. [ABSTRACT FROM AUTHOR]