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Background and Aim: Nosocomial infections caused by antibiotic-resistant bacteria and their rapid spread threaten public health. This study aimed to determine the frequency of genes encoding Extended-Spectrum Beta-Lactamase (ESBL) in gramnegative bacteria in Kermanshah city, west of Iran. Materials and Methods: Identification and antibiotic susceptibility pattern of 165 isolates were performed by biochemical and disk diffusion methods, respectively. Screening and confirming the presence of ESBL genes were performed according to the double disk combination test (DDCT) method. The presence of genes encoding ESBL in each isolate was identified by Polymerase Chain Reaction (PCR) method. Results: Out of 165 isolates, 83 strains were resistant to all antibiotics. The lowest frequency of resistance was observed for Gentamicin, while the highest frequency was observed for Cefotaxime and Cefazolin. Among all strains, 50 (30.30 %) and 80 (48.48%) isolates were phenotypically and genotypically ESBL-positive, respectively. The most prevalent genes encoding ESBL were SHVOS and SHV-1, with a frequency of 20.61 % and 21.82 %, respectively. Conclusion: The frequency of producing ESBL bacteria and the prevalence of blaSHV and blaCTX-M genes in our studied Klebsiella pneumoniae and Escherichia coli isolates were high. However, unlike some previous reports from Kermanshah, the prevalence of ESBL-encoding genes in Pseudomonas aeruginosa was low, and the blaVEB gene was not found. [ABSTRACT FROM AUTHOR]

Background and Aim: Nosocomial infections caused by gram-negative bacteria are among the most important healththreatening challenges of the current century, particularly following the emergence and spreading of antibiotic-resistance strains. Extended-spectrum beta-lactamase (ESBL), one of the most important antibiotic resistance mechanisms, is spreading worldwide. Surveillance and gathering data on the prevalence of antibiotic resistance and their associated encoding genes could assist in selecting treatment strategies and policies. This systematic review and meta-analysis was designed to assess the prevalence of ESBL-positive bacteria and their resistance genes in medical centers of Kermanshah city, west of Iran. Materials and Methods: All studies published as original articles were retrieved by searching in EMBASE, Scopus, PubMed/Medline, Google Scholar, and Persian databases of SID and Magiran, using appropriate keywords All published studies in the field were included without time restriction until 30-Mar-2022. Comprehensive Meta-Analysis software was used to analyze the data. Results: The prevalence of ESBL-positive and multidrug resistance (MDR) bacteria in Kermanshah medical centers were 34.8% and 56.1%, respectively. The highest and lowest prevalence of ESBL-positive bacteria was observed for Enterobacter cloacae (59.14%) and Pseudomonas aeruginosa (4.55%), respectively. The highest and lowest prevalence of the resistance genes were observed for blaOXA-51 (99.3%) and blaKPC (0.6%), respectively. The highest resistance was estimated to mezlocillin antibiotic (92.2%). Conclusion: This study showed that the prevalence of ESBL-positive and MDR bacteria is high in Kermanshah medical centers, and it provides significant information to health policymakers to implement appropriate strategies to reduce the prevalence of resistant bacteria. [ABSTRACT FROM AUTHOR]

Today, the spread of vancomycin-resistant strains isolated from Enterococcus faecalis (E. faecalis) has become a major health concern worldwide. Therefore, it is essential to provide a rapid and sensitive assay for identifying vanA gene for timely and appropriate antimicrobial control of resistant enterococcal infections. For this purpose, a cross-sectional study was performed on different clinical specimens of enterococci from Imam Reza hospital, Kermanshah, Iran. The antimicrobial susceptibility testing was determined by disk diffusion and MIC methods. Triplex-PCR and duplex-LAMP assays were also used to identify vanA E. faecalis resistance gene isolates. The results of this study shown that out of 108 Enterococcus isolates, 86, 18, 2, 1, and one isolates of E. faecalis, E. faecium, E. avium, E. psudoavium, and E. raffinosus were identified, respectively. On the other hand, E. faecalis was confirmed in 87 and 88 isolates using duplex-LAMP and triplex PCR, respectively. The LAMP primer set designed in this study can reliably identify seven distinct regions of the vanA gene, and finally the sensitivity, specificity, and the positive and negative predictive values of LAMP assay were shown to be 94.19%, 72.73%, 76.19%, and 93.10%, respectively. In general, sample processing, isothermal reaction and result reporting were completed using the LAMP assay in 75 minutes. Our findings suggest that LAMP assay has been approved as an alternative to the vancomycin resistance Enterococcus genotype (vanA and vanB) compared to other methods and has the advantage of being rapid, time-consuming, and easy for diagnosis. [ABSTRACT FROM AUTHOR]