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Background:Coagulase-negative staphylococci (CoNS), especially Staphylococcus epidermidis, are considered as normal flora of human epithelia and also important opportunistic pathogens for nosocomial infections. S. epidermidis can also act as a reservoir for mecA, responsible for high-level resistance to methicillin and transferring it to S. aureus.Objectives:The aim of this study was to determine the prevalence of S. epidermidis as well as antibiotic susceptibility pattern and mecA prevalence in S. epidermidis isolated from intensive care unit (ICU) patients.Materials and Methods:A cross-sectional study was conducted from September 2010 to September 2011 and 184 coagulase-negative staphylococci were collected from different clinical samples in three hospitals. S. epidermidis was identified by conventional bacteriological tests. Antibiotic susceptibility testing was performed using disk diffusion method. Frequency of mecA was detected by specific PCR.Results:Frequency of S. epidermidis was 34.8%, the most susceptibility was seen to linezolid and vancomycin, and the least susceptibility was seen to tetracycline.Majority of the S. epidermidis isolates carried mecA (92.2%). The most common resistant pattern was trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and methicillin resistance, found in 23.4% of the isolates, followed by resistance to methicillin as the second-most common resistant pattern, observed in 20.3% of the isolates.Conclusions:Frequency of S. epidermidis was significantly lower, compared to other studies. Presence rate of mecA and susceptibility to linezolid and vancomycin did not show significant differences with other investigations, while resistant to trimethoprim-sulfamethoxazole was significantly lower compared to other investigations, and resistance to tetracycline was significantly higher in comparison to other investigations. Presence of methicillin-resistant S. epidermidis in ICU patients, especially in individuals with compromised immune systems, may cause infection and would be more complicated in the case of antibiotic resistance.

BackgroundStaphylococcus epidermidis, a member of the human flora, is recognized as an opportunistic pathogen and cause of nosocomial infections. Staphylococcus epidermidis surface components are able to establish bacteria on the host surface, and cause infection.ObjectivesThe frequency of icaA, IS256, aap, fbe and bhp in clinical isolates of S. epidermidis were investigated in this study.Materials and MethodsFifty-nine S. epidermidis isolates were collected from blood (50), wound (1), urine (4) and tracheal (4) samples (Tehran, Iran). Staphylococcus epidermidis isolates were identified with conventional bacteriological tests. Virulence-associated genes were detected by specific polymerase chain reactions (PCRs).ResultsOf the 59 S. epidermidis, fbe was found in 89.8%, while aap and bhp were observed in 64.4% and 15.3% of the samples, respectively. Coexistence of aap and fbe was found in 32 isolates, while coexistence of bhp and fbe was observed in five isolates. Two isolates were negative for the investigated genes.ConclusionsPrevalence of fbe and aap was significantly different from similar studies, yet frequency of bhp was in accordance with other studies. Prevalence of icaA and IS256 was not significantly different from some studies while a significant difference was observed when results were compared with some other studies.

Background: Quorum-sensing systems are considered as important mechanisms for pathogenesis and bacterial communication. The accessory gene regulator (agr) is one of the quorum-sensing systems in staphylococci, which is generally conserved. It is believed that there is a correlation between agr groups and infection. Multiple-locus VNTR analysis is a method for bacterial typing, previously applied for several different species of bacteria. This study aimed at determining the diversity of Staphylococcus epidermidis accessory gene regulator and clonality in clinical isolates from intensive care unit patients, Tehran, Iran. Methods: A total of 59 Staphylococcus epidermidis isolates were obtained from intensive care unit patients. The MLVA was performed for S. epidermidis isolates, using seven VNTR loci, including SE2395, SE0331, SE 828, SE1632, SE0175, Se2, and Se4. Specific primers were used for agr diversity determination. Results: The agr type I was observed in 29 (49%), while each of the agr type II and agr type III were observed in 10 (17%). Furthermore, 10 (17%) isolates were untypeable with using primers. In total, 49 MLVA genotypes were discriminated. Isolates were classified to six clonal complexes. Of the 59 isolate, 33 were included in clonal complex 1 (CC1), the largest of which harbored 15 (45.4%) agr type I. Conclusions: Agr type I was observed in the majority of the isolates. The MLVA results of this study suggest that there was a clone with 33 samples, comprised of 56% of isolates; smaller clones each comprised of two to seven isolates, and four isolates in the form of singleton. It seems that big clone isolates were settled in the intensive care unit (ICU), and singleton isolates entered the ward by visitors or medical personnel and caused infection.

Background: CTX-M is the most prevalent and rapidly growing type of the extended-spectrum β-lactamase (ESBL) family and CTX-M1 is the most common type of blaCTX-M. Objectives: The current study aimed at investigating the genetic diversity of CTX-M-1-producing Klebsiella pneumoniae circulating in Semnan, Iran evaluated by multilocus variable-number tandem repeat analysis (MLVA). Methods: A total of 110 isolates of K. pneumoniae were collected from different clinical samples. The antibiotic suceptibility and double disk synergy test were determined according to CLSI (the clinical and laboratory standards institute) guidelines. The polymerase chain reaction (PCR) method was performed to detect CTX-M-1. The eight loci for MLVA genotyping were selected along with the primers previously described. Results: Imipenem, with 84.7% susceptibility, was the most effective antibiotic against K. pneumoniae. Seventy (63.63%) isolates had ESBL positive results and 42 (60 %) of them were positive for CTX-M-1 gene. Totally, 28 MLVA genotypes were discriminated, evaluation of diversity indexes (DIs) for eight loci showed that six different alleles were the most polymorphic and the most DI was 0.807. Conclusions: The findings of the current study demonstrated heterogeneity among CTX-M-1-producing K. pneumonia strains. The presence of CTX-M-1 in different MLVA types demonstrated that a certain clone is not responsible for spreading the isolates.

Background: Klebsiella pneumoniae as an opportunistic pathogen can be the cause of a range of nosocomial and community-acquired infections. Many virulence factors help these bacteria overcome an immune system and cause various diseases. K1 and K2 capsular antigens, also magA, wcaG, and rmpA are well-known K. pneumoniae virulence factors. Klebsiella pneumoniae has been revealed to have the ability to acquire resistance to many antibiotics, which cause treatment failure. Objectives: This study aimed at determining the prevalence of magA, wcaG, rmpA, Capsular type K1, Capsular type K2, TEM, and SHV in K. pneumoniae isolates. Methods: A total of 173 non-duplicate K. pneumoniae isolates were collected from two different hospitals in Semnan, Iran, from urine specimens. Klebsiella pneumoniae was identified by conventional bacteriological tests. Disk diffusion test was performed according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Detection of virulence factors, TEM, and SHV gene was performed by specific primers.

Introduction:Depression, anxiety and self contempt increase in recent years. A number of these patients, who have chest pain, come or refer to cardiovascular clinic without any cardiovascular or other organic disease. Such patients will be deviated from correct therapeutic way. It seems that demographic factors can affect on psychological disorder of these patients and the cause of their refer to cardiovascular clinic.The aim of this study was to determine the correlation of depression, anxiety and self contempt with demographic factors in cardiovascular clinic referrals in Semnan, IRAN.Materials and methods:In this analytical-descriptive study, data were collected in questionnaire from 400 patients who referred to cardiovascular clinic with chest pain and do not have any cardiovascular or other organic disease and analyzed by t-test, chi-square and men-vitni tests.Results:Of the 400 patients, 55.8% of women, 57.1% of divorced and 60% persons with less than one million RLS income showed light depression. Also, 73% of persons with less than one million RLS income, showed light anxiety, 36.1% of women showed light self contempt and 30.8% of divorced showed moderate self contempt.Discussion:In this study, depression was correlated with sex, divorce and low income, anxiety was correlated only with low income, self contempt was correlated with sex and divorce. Results of this study showed similarity with some studies and differ from other studies. It seems that this difference arises from patient's cultural diversity.