Introduction: Urinary tract infection (UTI) due to extended spectrum beta-lactamase (ESBL)-producing bacteria including Escherichia coli has become widespread. Studies have shown a trend toward higher mortality, longer hospitalization, greater hospital expenses and reduced rates of clinical and microbiologic response in ESBL UTI. Objectives: The aim of this study is to determinate the prevalence and antibiotic resistance pattern of ESBL producing E. coli isolated from UTI. Patients and Methods: This cross-sectional study was conducted on 3126 samples. Urine specimens were cultured on Eosin Methylene Blue (EBM) and blood agar. The disk diffusion standard method (Kirby Bauer) was used to test the susceptibility of the drug on MullerHinton agar plates and results were reviewed based on Clinical and Laboratory Standards Institute (CLSI) criteria. The reviewing of ESBL-producing uropathogens was carried out using Combined Disk Test (CDT) by using cefotaxime (CTX; 30 µg) and cefotaximeclavulanic acid (CTX; 30 µg /CA:10 µg) disks and CLSI protocol. Results: Out of 291 E. coli isolates, 108 (37.11%) are ESBL-producer and 183 (62.89%) are non–ESBL-producer. Among ESBL-producing E. coli, the highest antibiotic resistance was observed with cefotaxime (100%), amoxicillin (97.22%) and piperacillin (96.3%) and the highest antibiotic sensitivity was observed with meropenem (93.5%), nitrofurantoin (81.48%) and gentamicin (55.56%). Conclusion: We recommended that cephalosporins, penicillins and cotrimoxazole are not suggested in the treatment of ESBL-producing E. coli. On the other hand, carbapenems as a first line and aminoglycosides as the next step in the treatment of ESBL-producing E. coli are recommended.

Introduction: Delayed diagnosis and treatment of breast cancer leads to the presentation of the disease in advanced stages necessitating more invasive surgical interventions, increasing health care costs and mortality rate, and finally reduced patients’ survival. Objectives: This study aimed to investigate the factors associated with delayed diagnosis of breast cancer in the north-west of Iran. Patients and Methods: This retrospective cross-sectional study was conducted on 70 breast cancer patients referred to the cancer registry of Ardabil city, north-west of Iran. The time from the presentation of clinical symptoms to the initiation of treatment was determined by interviews to identify the system and patients’ delays. The data was analyzed in SPSS 19 with the level of significance as P<0.05. Results: The mean age of the patients was 43.3 ± 13.2 years. The means of total, patient, and system related delays were 9.4±1.6 weeks, 6.3 ± 9.9 weeks, and 3.1 ± 2.8 weeks respectively. Regression analysis showed that age, marital status, educational level, monthly income, fear of cancer, and residency were significantly associated with patients’ delay. Conclusion: Our results highlighted the important role of patients’ related factors in delayed diagnosis of breast cancer. Therefore, it is essential to educate individuals for timely referrals to physicians.

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