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Background and Objectives: Urinary tract infection (UTI) is one of the most frequent infectious diseases which is caused by Gram-negative bacteria especially Escherichia coli. Multiple resistance to antimicrobial agents are increasing quickly in E. coli isolates and may complicate therapeutic strategies for UTI. The propose of this study was to determine the antibiotic resistance patterns and the multidrug-resistance (MDR) phenotypes in uropathogenic E. coli (UPEC). Materials and Methods: A total of 153 UPEC isolates were collected from both hospitalized patients (95 isolates) and outpatients (58 isolates) from March to October 2018. In order to determine the MDR among UPEC isolates, we have tested 15 antimicrobial agents on Muller Hinton agar by the disk diffusion method. Results: The percentage of MDR isolates (resistant to at least three drug classes such as fluoroquinolones, penicillins and cephalosporins) was 55.5% in the hospitalized patients and the outpatients. Antibiotic resistance to ampicillin, ceftazidime, nalidixic acid and trimethoprim/ sulfamethoxazole was higher than 60%. Meropenem, Imipenem and norfloxacin indicated markedly greater activity (93.3%, 80% and 85.6%, respectively) than other antimicrobial agents. Conclusions: Urinary tract infection due to MDR E. coli may be difficult to treat empirically due to high resistance to commonly used antibiotics, so, empirical antibiotic treatment should be reviewed periodically at local studies.

Background: Leptospirosis is known as a public health problem in developing and developed countries. The aim of this study was to investigate the incidence and geographical distribution of leptospirosis using the Geographic Information System (GIS) and to predict its incidence in Iran in 2021. Methods: This was a descriptive analytical study. Information on leptospirosis was obtained from the Center for Communicable Diseases Control during 2009-2015. In the next step, The ArcGIS 9.3 was used to prepare geographic maps of the disease incidence and frequency. Therefore, using the Raster Calculator tool, the disease prediction map was drawn. Results: The results showed that the highest incidence of leptospirosis during 2009-2015 was observed in Gilan, Mazandaran, and Golestan provinces, respectively. The incidence of the disease had an increasing trend from 2013 to 2015. Based on the results of the modeling in Iran, the provinces of Gilan, Mazandaran, and Golestan, with 72.18%, 8.54%, and 4.95% of their area, respectively, have the largest areas at a high-risk for leptospirosis in the coming years. Conclusion: The prevalence of leptospirosis is affected by geographical and climatic conditions of every region; thus, the incidence of the disease is higher in the provinces located at the Caspian coastal side and in some regions in Semnan province. Hence, if health authorities pay more attention to developing health plans to prevent the disease, the risk of disease in these areas will be reduced in the future.

Background and Objectives: Cervical cancer is considered as a preventable cancer in women. Pap smear test is an effective screening program for diagnosing cervical cancer, but for some reasons its use is low. The purpose of this study was to determine the factors affecting the women's participation in the Pap smear test based on precaution adoption process model and effect of educational program based on model on doing the Pap test with a Mixed Method approach. Materials and Methods: This study was a Mixed Method approach. Thirty women voluntarily participated in this study in sarvabad city of Iran. The sampling began purposefully and continued until saturation. Semi-structured interviews were the primary method of data collection. Data were analyzed using qualitative content analysis and continuous comparisons. Quantitative study was conducted implementing a quasi-experimental method. Participants were divided into two groups as experimental and control groups using Precaution Adoption Process Model (PAPM) among 180 rural females in Sarvabad. In treating the experimental group, the methods of lecturing with question and answer, playing videos, specialized consulting and pamphlet were used. The questionnaire including a demographic characteristic and variables that affecting the stages of the Precaution Adoption Process Model (PAPM). Data analysis was performed using the Mann-Whitney, chi-square and descriptive statistical methods. P

Brucellosis is an important zoonotic disease caused by different species of genus Brucella that are pathogenic for humans and a variety of animals. Accurate detection of Brucella spp. infection is important for control of disease. The aim of this study was to comparison of molecular genotyping of Brucella strains by Pulsed-field gel electrophoresis (PFGE) and polymerase chain reaction -Restriction Fragment Length Polymorphism (PCR-RFLP) techniques.Twenty- seven Brucella spp. were isolated from human and animal samples. The isolates identified by conventional microbiological methods and confirmed using PCR for amplification of omp2a gene. Molecular typing of Brucella strains carried out by PCR-RFLP after PstI and PFGE of chromosomal DNA after XbaI enzyme digestion. The omp2a gene PCR Products with different patterns of PCR-RFLP were sequenced.The omp2a gene amplification of all human and animal Brucella isolates were positive for 1100 bp fragment. By PCR-RFLP analysis two genotypes/patterns for human isolates and four genotypes for animal isolates were obtained. In PFGE analysis totally, 7 common clones/clusters and 3 single clones were obtained.The results of this study showed the PFGE method is the more reliable and useful assay for molecular typing of Brucella strains and is more preferred to PCR-RFLP in determination of genetic similarity among human and animal Brucella isolates. The presented data showed PCR-RFLP analysis was not able to differentiate between B. melitensis biovars and vaccine strain. Keywords: Brucella melitensis, PCR, RFLP, Brucellosis, Molecular typing

Background: Toxoplasma gondii is an opportunistic parasitic protozoan, which is a causative agent of serious complications such as abortion or fetal still birth in pregnant women. The purpose of this study was evaluating the seroprevalence of toxoplasmosis and risk factors in diabetic pregnant women (case) in comparison with non-diabetic pregnant women (control) from Sanandaj, Kurdistan, west of Iran. Methods: In this case-control study Toxoplasma gondii antibodies were tested in 91 cases as well as 90 controls from referred the Toohid hospital diabetes center using ELISA (enzyme-linked immunosorbent assay) method during June 2018 to October 2019 in Sanandaj, Kurdistan, west of Iran. The collected data were analyzed by SPSS 19 and using Chi-Square and Fisher tests.Results: The seropositivity for anti-Toxoplasma IgG in case group was 33% and 15.6% in the control group (p = 0.006) showing a statistically significant difference between groups, while for anti-Toxoplasma IgM (p = 0.31) showing no statistically significant differences between two groups. A significant relationship was observed between age (p = 0.024) and abortion history (p = 0.05) with anti-Toxoplasma IgG antibodies in cases and controls.Conclusion: The results of current study indicated statistically significant relationship between diabetes and toxoplasmosis. The abortion history and increase of age was found to be a major T. gondii infection risk factor.

Background: Toxoplasma gondii is an opportunistic parasitic protozoan, which is a causative agent of serious complications such as abortion in pregnant women or fetal still birth. The aim of this study was evaluating the seroprevalence of toxoplasmosis infection in diabetic pregnant women from Sanandaj, Kurdistan, west of Iran. Methods: In this study 136 serum samples from diabetic pregnant women were collected from referred to the Toohid hospital diabetes center during June 2018 to October 2019 in Sanandaj, Kurdistan, west of Iran. IgM and IgG titers were evaluated by ELISA(enzyme-linked immunosorbent assay) method. The collected data were analyzed by SPSS 19 software and using Chi-Square and Fisher tests. Results: The ELISA method showed 35(25.7%) and 7(5.1%) of diabetic pregnant women were positive for IgG and IgM T.gondii antibodies respectively. There was statistically significant relationship between toxoplasma infection and education, gestational age and number of parity. Conclusion: The results of this study showed that public awareness and education about toxoplasmosis and its transmission routes before pregnancy may be effective in preventing congenital toxoplasmosis.

Background: The Brucellosis is recognized as a significant public health problem, with major economic and financial burdens in countries where the disease remains endemic. The disease is one of the most important worldwide zoonosis affecting livestock and humans. The aim of the present study was to genotypically characterize Brucella strains isolated from human and animal samples in two provinces of Iran. Methods: Twenty seven Brucella strains isolated from patients and animals during April 2015 - December 2016. Thirteen human and fourteen animal strains were identified by biochemical tests and confirmed by amplification of fragment 1100bp omp2a gene using Polymerase Chain Reaction (PCR) method. Isolates were genotypically characterized by XbaI digestion and pulsed-field gel electrophoresis (PFGE) technique. Results: In PFGE analysis totally, 7 common clones and 3 single clones were obtained. In genotyping, in two clones/clusters, human isolates were grouped with genotypes from animal isolates. Also PFGE results indicated 21 Brucella strains an overall similarity higher than 90, and three clusters based on 100 similarity were revealed. Conclusion: According to dendrogram clinical strains had a high degree of homology compared to animal strains. The information of this study indicating a close genetic relatedness or common origin of the isolates in the two geographical region of Iran and it implies that B. melitensis cross-infected between human and livestock.

Background & Objective: Brucellosis is one of the most prevalent bacterial zoonotic diseases which afflicts both humans and animals. Genetic factors play an important role in susceptibility to brucellosis. One of these factors is interferon-gamma (IFN-γ), which is vital in the defense mechanism against infectious diseases such as brucellosis. The purpose of this study was to evaluate the relationship between two single nucleotide polymorphisms (SNPs) at positions-611 and-56 within the promoter region of interferon-gamma receptor-1 gene (IFN-γ R1) and brucellosis. Methods: In this research, the genomic DNA was collected from 60 peripheral blood samples infected with brucellosis and 68 healthy volunteers. DNA was extracted by salting out method. Then, DNA genotypes were analyzed using polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). Results: The results showed that there is a significant difference in-611 SNP frequencies between control and patient groups. At position-611, CC genotype was related to patient group (P=0.024) and TT genotype was related to the control group. According to the results, males had a higher frequency of Brucella infection. Conclusion: The presence of C allele in position-611 in IFNγ R1 gene promoter was related to a higher risk of disease and susceptibility to brucellosis. Moreover, the presence of T allele in position-611 in IFN-γ R1 gene promoter was related to a lower risk of disease. © 2019.

Background: Brucellosis is a zoonotic disease that causes major economic and public health problems. It is one of the most important diseases in humans and domestic animals. Hence, the exact identification of Brucella spp. is important for strategies of treatment and control. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) is one of the molecular techniques characterized by amplification of deoxyribonucleic acid (DNA) sequence and restriction enzyme digestion. Objectives: This study aimed at identifying genetic polymorphisms of omp2a genes among 90 Brucella isolated from humans and animals, using the PCR-RFLP method. Methods: Ninety Brucella spp. isolated from humans and animals in two different regions of Iran were used in this study. Biochemical tests and the Brucella omp2a (1100 bp) gene-PCR was used for identification of Brucella isolates. Polymerase Chain Reaction products were digested by restriction endonuclease enzyme pstI and gene sequencing analysis was carried out for molecular typing of Brucella strains. Therefore, genetic relatedness was revealed by a dendrogram. Results: Analysis of the 90 Brucella strains by biochemical tests, PCR, and PCR-RFLP methods with PstI enzyme and omp2a sequencing showed four unique RFLP Profiles (P1-P4). Seventy-nine (87.8%) of the Brucella isolates belonged to B. melitensis strain 20236. From 30 animal isolates, nine (30%) belonged to B. melitensis biovare1 and two (6.6%) to B. abortus strain. According to the RFLP dendrogram, group 1 and 2 had higher genetic relatedness similarity. Conclusions: The results showed B. melitensis strain 20236 was the predominant strain among human and animal Brucella isolates. Likewise, according to dendrogram results, the PCR-RFLP technique was not able to separate human and animal species of B. melitensis from B. abortus.

Brucellosis is an important zoonotic disease caused by different species of genus Brucella that are pathogenic for humans and a variety of animals. Accurate detection of Brucella spp. infection is important for control of disease. The aim of this study was to comparison of molecular genotyping of Brucella strains by Pulsed-field gel electrophoresis (PFGE) and polymerase chain reaction -Restriction Fragment Length Polymorphism (PCR-RFLP) techniques. Twenty- seven Brucella spp. were isolated from human and animal samples. The isolates identified by conventional microbiological methods and confirmed using PCR for amplification of omp2a gene. Molecular typing of Brucella strains carried out by PCR-RFLP after PstI and PFGE of chromosomal DNA after XbaI enzyme digestion. The omp2a gene PCR Products with different patterns of PCR-RFLP were sequenced. The omp2a gene amplification of all human and animal Brucella isolates were positive for 1100 bp fragment. By PCR-RFLP analysis two genotypes/patterns for human isolates and four genotypes for animal isolates were obtained. In PFGE analysis totally, 7 common clones/clusters and 3 single clones were obtained. The results of this study showed the PFGE method is the more reliable and useful assay for molecular typing of Brucella strains and is more preferred to PCR-RFLP in determination of genetic similarity among human and animal Brucella isolates. The presented data showed PCR-RFLP analysis was not able to differentiate between B. melitensis biovars and vaccine strain.

This study examines the impact of an educational programme on the breastfeeding attitudes and behaviour of pregnant women. It is a case-control study of 100 pregnant women in two hospitals affiliated to Shiraz University of Medical Sciences. The samples were randomly divided into a case and control group. The study looked at the effects of an educational programme based on the BASNEF model, which is a simplified approach to understanding behaviour focused on the beliefs, attitude, subjective norms and enabling factors of participants. The model was applied initially and after four educational sessions mothers’ behaviour towards breastfeeding was analysed. The results were analysed using statistical tests. The independent t-test showed that there were significant differences in the awareness mean score, mothers’perceptions of behaviour results, the score of attitudes towards working and the mean score of immediate enabling factors post-educational intervention, and at one and four months post-intervention (p

This study focused on analyzing the spread of extended-spectrum β-lactamase (ESBL) enzymes among Gram-negative bacteria at intensive care units (ICUs). Between January 2007 and January 2008, 301 consecutive clinical isolates of Gram-negative type were isolated. Of these, 66 strains were collected from patients in ICUs in two major hospitals in Sanandaj (Kurdistan, Iran). The isolates were identified, tested for antimicrobial susceptibility, and analyzed for the presence of ESBL using the double-disk synergy test. Isolates with a positive ESBL phenotype were subjected to PCR for SHV, TEM, OXA and CTX-M β-lactamase gene families. Sixty-six Gram-negative bacteria were isolated from clinical samples of 66 ICU patients. These isolates included 16 Escherichia coli, 28 Enterobacter spp., 5 Pseudomonas spp., 10 Klebsiella pneumoniae, 3 Serratia marcescens and 1 Stenotrophomonas maltophilia. Twenty-three (34.85%) of these isolates were ESBL producing. The ESBL genes detected were SHV, TEM, OXA-1, OXA-2 and CTX-M. The results show the presence of ESBL genes among Gram-negative bacteria in the ICU setting of Sanandaj’s hospitals. There is a need to institute a strict hospital infection control policy and regular surveillance of bacterial resistance to antimicrobial agents.

Objective: Pseudomonas aeruginosa is one of the most important causes of nosocomial infections and can acquire resistant to many antimicrobials, including β-lactams. The aim of this study was to detect the prevalence of SHV type extended-spectrum beta-lactamase (ESBL), antimicrobial resistance patterns of the P. aeroginusa and risk factors in hospitalized patients in two teaching hospitals in Sanandaj, Iran. Methodology: 123 P. aeruginosa were isolated from various clinical specimens. All samples were prepared for double-disk synergy test on the isolates for detection of ESBL. SHV was confirmed by PCR method. Risk factors were evaluated for infection due to P. aeruginosa. Results: The incidence of multiple drug resistance (MDR) in P. aeroginusa isolates was 3.85%. The prevalence of ESBL-SHV gene was 10.57%. Days of hospitalization (OR=14.34 CI95% 2.87-25.8), ICU hospitalization (OR=3.4 CI95% 1.24- 9.29), presence of catheter (OR=3.63 CI 95% 1.34-9.84), use of antimicrobials within previous two weeks (OR=5.51 CI95% 1.85-16.43) and use of ventilator (OR=3.7557 CI95%1.29-9) were risk factors for Pseudomonas nosocomial infection SHV positive ESBL. Conclusion: In this study Prevalence of ESBL, SHV gene and MDR in P. aeroginosa infection was lower than the prevalence reported from other studies in Iran and this indicated appropriate antimicrobial managements strategies and infection control. In addition, our research data indicate that risk factors such as use of ventilator, use of antimicrobials and ICU hospitalization can be effective in managing Pseudomonas infection.