Background and aims: Carbapenems are the final-line treatments for multidrug-resistant, gram-negative infections. The patterns of resistance to carbapenems among hospital bacterial pathogens vary widely across different hospitals in a country. Considering that Escherichia coli is one of the most important causes of nosocomial infections, it is essential to study its drug resistance. Methods: In this descriptive-analytical study, a total of 80 samples of E. coli isolated from inpatients with urinary tract infections (UTIs) were collected in different wards (i.e., women, urology, infectious, and ICU) of Shahrekord hospitals. After the diagnosis and confirmation of bacteria by standard bacteriological methods, their sensitivity to imipenem and meropenem was investigated by the antibiogram (diskdiffusion) method. Then, the minimum inhibitory concentration (MIC) was determined by the E-test strip according to the Clinical and Laboratory Standards Institute (CLSI) standard. Results: In this study, resistance to meropenem and imipenem by antibiogram (disc diffusion) was observed in 21 (25.26%) and 20 (25%) of the isolates, respectively. Twenty isolates had MIC ≥4 μg/mL for meropenem, 13 isolates demonstrated MIC≥4 μg/mL for imipenem, and 14 isolates had 1≤MIC<4 μg/mL and were semi-sensitive. Conclusion: In general, E. coli had significant resistance to carbapenems. Therefore, rapid and accurate identification of these strains can be a major step to the treatment and control of these strains and prevention of the spread of the resistance.
Background: Klebsiella is one of the Enterobacteriaceae family that causes infections such as pneumonia, urinary tract infections (UTI), and meningitis. Klebsiella strains are capable of producing enzymes that can degrade the third-generation of cephalosporins known as broad-spectrum beta-lactamase enzymes. The resistance of Klebsiella strains to β-lactam antibiotics is related to the presence of β-lactamase genes.
Methods:In this study, 90 isolates of Klebsiella were isolated from two inpatient and outpatient groups, each of them was 45 isolates, which were collected from patients with urinary tract infection in educational hospitals of Shahrekord. The isolates were identified using phenotypic agar diffusion, disc phenotypic confirmation tests, and E-test of extended-spectrum beta-lactamase (ESBL). The PCR molecular method was used to diagnose and determine the strains containing broad-spectrum β-lactamases. Results: Thirty (66%) inpatients and 8 (17.8%) outpatients had broad-spectrum β-lactamase enzymes. The frequency of β-lactamase OXA-10 genes and PER in inpatients were 90% and 33%, respectively and also in outpatients were 50% and 12.5%, respectively.
Conclusions:This study showed that the prevalence of isolated Klebsiella producing broad-spectrum β-lactamases is higher in inpatients in comparison to outpatients. Therefore, the rapid and accurate identification of bacteria and their resistance genes in clinical microbiology labs are highly recommended.
Extended spectrum β-lactamases (ESBLs) are enzymes that capable of destroying the antibiotics of βlactam, and cephalosporin, and Metallo-β-lactamase enzymes (MBL) can also deactivate all β-lactams and carbapenems. This study aimed to determine ESBLs and MBLs enzymes and the frequency of NDM-1 gene. In this study, 200 Escherichia coli isolates of women with urinary tract infection were collected (100 inpatients and 100 outpatients). Minimum inhibitory concentration (MIC) for ceftazidime and meropenem was determined by E-test. A phenotypic confirmation test was used to detect ESBL enzymes. MBLs production was performed with modified Hodge test (MHT) and EDTA disk synergy (EDS) test. PCR was used for detecting the presence of NDM-1 gene. From 200 isolates, 93 isolates produce ESBL enzymes. Overall, 97 isolates were resistant to ceftazidime, and 38 isolates resistant to meropenem. The results of the MHT and EDS positive tests were 41 and 16 isolates, respectively. NDM-1 was not found in any of the patients. The prevalence of E. coli isolates producing both ESBLs and MBLs enzymes, is a serious threat to clinical infections. Accordingly, for the control and treatment of these strains, rapid and accurate identification can be greatly helpful.
Background: Nosocomial infections are acquired during hospital treatment or in a hospital environment. One such infecting agent is uropathogenic Escherichia coli and many virulence genes enable it to become pathogenic, thereby causing damage to the host. Objectives: This study aimed to identify aer, traT, and PAI genes in E. coli isolates collected from fecal and urinary tract infection (UTI) specimens and determine the relationship between them in both populations studied in a center in Iran by multiplex polymerase chain reaction (PCR) assay. Methods: Seventy-five isolates of E. coli from the urine of inpatients and 75 isolates from commensal fecal without UTI and diarrhea were collected. The E. coli bacteria were detected and isolated, using biochemical techniques and supplementary tests in the Microbiology Laboratory of Shahrekord University of Medical Sciences. Antibiotic susceptibility pattern for 14 antibiotics was done utilizing the disc diffusion method. The existence of aer, traT, and PAI virulence genes among all isolates was investigated by multiplex PCR. Results: Among the urinary pathogenic E. coli isolates, the highest antibiotic resistance was observed in cefazolin, ampicillin, and cotrimoxazole antibiotics. The prevalence rates of aer, traT, and PAI genes in the fecal isolates were 92%, 90.6%, and 46.6%, respectively. Further, their prevalence rates in urine isolates were 96%, 97.3%, and 41.3%, in that order. Conclusions: The presence of the high frequency of pathogenic islands (PAIs), especially in fecal samples, is important because these genes are easily transmitted and convert a commensal bacterium into a pathogen. Because only the genome of pathogenic bacteria has been unwrapped, little attention has been paid to PAIs in commensal bacteria.
Background and aims: Klebsiella is an opportunistic organism that is the cause of severe diseases such as pneumonia, septicemia, and urinary tract infections (UTIs). In addition, high antibiotic resistance has challenged the treatment of this bacterium. However, carbapenem antibiotics are considered as the therapeutic agents for selecting the treatment of penicillin- and cephalosporin-resistant gram-negative bacterial infections. The present study aimed to determine the resistance and minimum inhibitory concentration (MIC) of meropenem and imipenem. Methods: A total of 80 Klebsiella spp isolated from UTIs were collected in various educational wards (i.e., urology, obstetrics, and gynecology, as well as the units of infectious diseases, internal medicine, and intensive care) in different hospitals of Shahrekord. The isolates were then identified by using biochemical tests. Further, disc diffusion method was employed to determine the antibiotic resistance. Furthermore, MIC was estimated by the Epsilon-test strip. Moreover, P=Q=0.50, an error of 0.05, and an accuracy of 0.11 were considered for determining the sample size (n=80). Results: Based on the results of disc diffusion method, 24 strains were resistant to meropenem and imipenem. Additionally, the MIC was 24 (30%) by the E-test. In addition, 24 isolates had a MIC of ≥4 μg/mL for meropenem and imipenem and thus were resistant while 18 isolates were found to have a MIC of 1≤ MIC<4 μg/mL and therefore, were considered semi-sensitive (P<0.001). Conclusion: In general, Klebsiella strains were found to be resistant to meropenem and imipenem. Therefore, rapid and accurate identification of these strains and the selection of appropriate antibiotics can help quickly eradicate the infections caused by these bacteria. Accordingly, a waste of time, the consumption of medication, or even an increased resistance are prevented.
Objectives: Eye infections can be caused by several microorganisms and the most common causative bacterial agents are staphylococci, streptococci, and Pseudomonas aeruginosa. This study aimed to estimate the prevalence of Staphylococcus aureus, Staphylococcus epidermidis, viridans group streptococci, and P. aeruginosa as the cause of ocular infections in Iran. Methods: We conducted a systematic search on the studies published by Iranian authors from January 2000 to December 2020 in Web of Science, PubMed, Scopus, and Embase. Eligible studies were selected according to the defined inclusion/exclusion criteria. Statistical heterogeneity between and within groups was estimated by the Q-statistic and I2 index. The funnel plots, Duval and Tweedie trim, and fill methods were obtained to evaluate the evidence of publication bias. Results: Twenty-seven studies were included in this review. According to the meta-analysis results, the prevalence of S.epidermidis was 19.1% (95% CI: 12.5–28.1). It was estimated 6.9% (95% CI: 4.4–10.6), 6.7% (95% CI: 4.6–9.6), and 3.3% (95% CI: 1.8–5.8) for P.aeruginosa, S. aureus, and viridans streptococci, respectively. Conclusions: S. epidermidis is the prevalent bacterial agents responsible for eye-associated infections in Iran.
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