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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]

Introduction Worldwide, Clostridioides difficile infection is becoming one of the most common healthcare-associated infections. Management and control of this infection in healthcare facilities are associated with screening for environmental and instrumental C. difficile contamination. This systematic review and meta-analysis aimed to assess the overall prevalence of C. difficile in hospital settings, medical devices, and instruments. Methods Four main databases, PubMed, Web of Science, Google Scholar, and Scopus, were searched using the keywords Clostridioides difficile, Clostridium difficile, C. difficile, clostridia, Clostridium spp., hospital environments, antibiotic associate colitis, intensive care unit, and ward in combination as a search strategy. The PRISMA checklist was used for selecting eligible studies. Results A total of 11 eligible articles published between 2012 and 2021 were included. The overall pooled prevalence of C. difficile in hospital environments was 14.9%. The highest and lowest prevalence were reported for India (51.1%) and the USA (1.6%), respectively. The highest prevalence was reported for beds (46.3%). A significant heterogeneity was seen between C. difficile prevalence in hospital environments in different samples. The highest and lowest prevalence was reported for floor corners (63.2%) and privacy curtains (1.4%), respectively. Conclusions In conclusion, hospitals' medical devices and environmental surfaces are considered a crucial source of Clostridioides difficile infection. In this regard, we strongly recommend revising and improving the cleaning and disinfection methods in hospitals and quality control of cleaning adequacy. [ABSTRACT FROM AUTHOR]