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Background: Bacterial infections are the most common complications in people with HIV/AIDS. There has been no previous report on the prevalence of bacterial co-infections in Iranian HIV/AIDS-positive subjects.

The present study was conducted to investigate the antimicrobial susceptibility profiles of Salmonella serotypes, especially fluoroquinolone-resistant strains, recovered from clinical samples in Iran. A full electronic search using related keywords was conducted in Persian and English languages in ISI Web of Knowledge, PubMed, Scopus, Google Scholar and the Scientific Information Database (SID) search engines to find papers published between 1983 and 1 July 2019. According to the inclusion and exclusion criteria, 46 eligible articles were selected for the final analysis out of the initial 13,186 studies retrieved. The pooled prevalence of quinolone-resistant Salmonella serotypes in clinical specimens in Iran was 2.9% to ciprofloxacin and 48.1% to nalidixic acid. Additional data on antibiotic resistance was as follows: 54.3% to tetracycline, 50.6% to ceftizoxime, 50.2% to streptomycin, 37.9% to ampicillin, 36.5% to kanamycin, 33.5% to trimethoprim-sulfamethoxazole, 27.2% to chloramphenicol, 19.1% to cephalothin, 8.8% to ceftriaxone, 7.6% to cefotaxime, 7.4% to aztreonam, 7.2% to gentamicin, 7% to cefepime, 6.8% to ceftazidime, 5.8% to cefixime, 2.7% to imipenem and 2.2% to meropenem. Findings of the present study showed a rising trend of resistance to the drugs of choice for the treatment of Salmonella infections, i.e. ampicillin, chloramphenicol and trimethoprim-sulfamethoxazole in Iran. However, ciprofloxacin, third-generation cephalosporins and carbapenems are still effective antibiotics especially against multi-drug resistant strains in Iran. [ABSTRACT FROM AUTHOR]

Original article Objective(s): Resistance to carbapenems is the principal reason for the continuing utilization of colistin as a last resort choice for treating the infections resulted from multidrug carbapenem-resistant Pseudomonas aeruginosa (CRPA) isolates. The assessment of antimicrobial resistance pattern, the prevalence of carbapenem-resistance determinants, and molecular epidemiology of colistin-resistant isolates among CRPA strains were the aims of the present research. Materials and Methods: The current cross-sectional research was conducted on 269 CRPA isolates collected from various clinical samples from 2013 to 2016. After performing identification tests, disk diffusion as well as MIC methods were used for testing sensitivity to the antibiotics. Modified Hodge Test (MHT) was utilized to produce carbapenemase. PCR technique identified beta-lactamase classes A, B, and D genes. Results: In total, from 269 CRPA, five isolates (1.3%) were resistant to colistin. It was found that blaNDM-1, blaIMP-1, blaVIM-2, and blaOXA-10 genes were present in 40%, 40%, 20%, and 100% of colistin-resistant isolates, respectively. DLST type 25-11 is a significant cluster of colistin-resistant P. aeruginosa isolates. Conclusion: The appearance of colistin-resistant isolates in CRPA carrying blaNDM-1 with multiple carbapenem-resistant genes shows the great problem in the treatment of P. aeruginosa infections. [ABSTRACT FROM AUTHOR]

Background: Development of drug resistance to Staphylococcus aureus (S. aureus) has led to the use of older antibiotics such as macrolide-lincosamide-streptogramin B (MLSB) for the treatment of infections. MLSB resistance can be caused by several mechanisms, however, one of the predominant reasons is target modification mediated by erm genes. The objective of this study is to determine the prevalence of erm genes and the frequency of constitutive MLSB (cMLSB), inducible MLSB (iMLSB), and MS phenotypes using D-test and polymerase chain reaction (PCR) methods. Methods:D-test was performed on 110 clinical specimens of S. aureus collected from Kashani and Hajar Hospitals in Shahrkord from October 2014 to May 2015. After sampling, DNA extraction was performed by simple boiling method and, in order to detect erm genes, multiplex PCR was carried out on erythromycin resistant isolates using specific primers. Results:The result of this study revealed that among 110 S. aureus isolates examined, 35 (31.8%) were MRSA and frequency of cMLSB, iMLSB, and MS resistant phenotypes were 22 (20%), 9 (8.2%), and 2 (1.8%), respectively. The genes ermA, ermB, and ermC were detected in 27 (24.5%), 28 (25.4%), and 26 (23.6%) isolates. Conclusion:This study demonstrated that cMLSB was the most common phenotype among isolated S. aureus. Moreover, another interesting point to notice in our study was the high frequency of the ermB gene in iMLSB resistant phenotypes. [ABSTRACT FROM AUTHOR]

Background. Staphylococcus aureus (S. aureus) is one of the most common pathogens that cause hospital- and community-acquired infections in the world. The use of molecular typing methods is essential for determining the origin of the strains, their clonal relations, and also in epidemiological investigations. The purpose of this study was to determine the prevalence of antibiotic resistant S. aureus isolates and using spa, agr, and SCCmec typing to determine the dominant types in Iran. Material and Method. Fifty isolates of S. aureus were collected from January to May 2010. S. aureus identification was performed by biochemical tests. Disk diffusion method was employed to assess the sensitivity of S. aureus strains to antibiotics and then genetic analysis of bacteria was performed using SCCmec, agr, and spa typing. Results. S. aureus resistance to tetracycline, cefoxitin, clindamycin, ciproloxacin, gentamicin, Cot: cotrimoxazole, levoloxacin, rifampin, and vancomycin were found to be 36%, 18%, 12%, 12%, 22%, 6%, 6%, and 0%, respectively. The results of this study showed that 16% of the isolates were resistant to methicillin (MRSA) and the majority of isolates were SSC mec type IV. In addition spa and agr typing revealed agr typeI and spa type t7688 to be the most predominant. Conclusion. In this study, spa typing showed 100% reliability and the t7688 spa type had a frequency of 26% compared to the frequency of 0.0% in the Ridom SpaServer. The frequency of t304 spa type was higher than the global average. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus aureus (S. aureus) is an important human pathogen associated with hospital- and community-acquired diseases, a wide range of infectious disease including minor skin disease to more sever and aggressive infections such as septicemia, pneumonia, endocarditis, and deep skin abscess. S. aureus has a high mortality rate of 35%. Therefore, it is crucial to identify the methicillin resistant S. aureus (MRSA) strains and implement the necessary treatment in order to control the spread of hospital infections. Methods: A total of 150 S. aureus isolates were collected from samples of patients admitted to Alzahra and Shariati hospitals in Isfahan, Iran. Polymerase chain reaction (PCR) for mecA gene was performed in all strains. Thereafter, the minimum inhibitory concentration (MIC) for oxacillin was carried out using agar dilution method. Then, antibiogram using disk diffusion for cephoxitin was performed according to Clinical and Laboratory Standards Institute (CLSI) regulations on isolates containing mecA gene. The three methods were then compared. Findings: Of the 150 samples, 62 samples (41.33%) were found to carry mecA gene using PCR. However, agar dilution for oxacillin found 56 of 62 samples (90.33%) to harbor mecA gene. Disk diffusion method revealed that 53 of 62 samples (85.48%) contain mecA gene. Conclusion: Agar dilution method was found to have a higher sensitivity in determining antibiotic sensitivity compared to disk diffusion method. However, PCR was identified as the ideal method for detecting MRSA strains; since a number of strains were found to be sensitive to oxacillin in phenotypic test due to lack of mecA expression while still containing the gene. [ABSTRACT FROM AUTHOR]

Background: The rapid emergence and spread of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has raised considerable public health concern in both developed and developing countries. The current study aimed to address the extent of this phenomenon in healthy preschool children of a developing country., Materials and Methods: We conducted a prospective study from April 2013 to March 2014 on 410 healthy 2-6 years old preschool children in Isfahan, Iran. Demographic medical data and nasal samples were collected from the participating children. Isolates were identified as S. aureus and MRSA based on microbiological and molecular tests, including the presence of eap and mecA genes., Results: The overall prevalence of S. aureus and CA-MRSA nasal carriage was 28% (115/410) and 6.1% (25/410), respectively. The identity of isolates was confirmed by molecular assay. The factors that were independently associated with nasal carriage of S. aureus were: Children crowding in day-care nurseries and income level of families. A total of 20/90 (22.2%) of methicillin-susceptible S. aureus and all 25 CA-MRSA displayed multiple drug resistance to 3-8 antibiotics., Conclusions: The current report reflects issues and concerns that the high rate of colonization by CA-MRSA in Iranian healthy children provides obliging evidence that MRSA have established a foothold in the community and are emerging as important health threatening pathogens. It is suggested that we need more effective infection control measures to prevent transmission of nasal CA-MRSA in healthy preschool children.

Background: The rising frequency of methicillin resistant Staphylococcus aureus (MRSA) has led to an increased use of antibiotics such as macrolide, lincosamide, streptogramin B (MLSB) for the treatment of S. aureus infections. Resistance to MLSB in S. aureus is commonly encoded by erm genes, which can be constitutive MLSB (cMLSB) or inducible MLSB (iMLSB). The purpose of this study was to determine the frequency of cMLSB, iMLSB, and MS phenotypes using D-test and polymerase chain reaction (PCR) methods., Materials and Methods: A total of 215 isolates of S. aureus were collected from January 2010 to May 2012 from Al-Zahra Hospital in Isfahan. PCR was performed for detection of mecA gene on all isolates using specific primers. The frequency of MLSB-resistant isolates was determined using D-test, and then a multiplex PCR was performed for detection of ermA, ermB, and ermC genes., Results: Among 215 S. aureus isolates examined, 82 (40.9%) were MRSA, and iMLSB, cMLSB, and MS resistance phenotypes had a frequency of 9 (4.18%), 58 (26.9%), and 11 (5.1%), respectively. Among nine isolates with iMLSB resistance phenotype, four isolates contained ermC gene, two isolates ermB gene, and one isolate ermA gene. Two isolates did not have any erm gene., Conclusion: In the current study, cMLSB was the most frequent phenotype and ermC was the most common gene in iMLSB resistant phenotypes.