Aminoglycosides play an important role in the treatment of staphylococcal infections, despite the emerging widespread resistance among Staphylococcus. To determine the prevalence of aminoglycoside resistance and aminoglycoside modifying enzyme (AME) genes among infected patients at a teaching hospital in Tehran, Iran, we tested 585 Staphylococcus isolates, of which 322 were Staphylococcus aureus and 263 were coagulase-negative staphylococci, as determined by the disk diffusion method and multiplex PCR. The minimum inhibitory concentration of gentamicin for each isolate was determined by microbroth dilution. All methicillin-resistant staphylococci were mecA-positive by PCR. Of the 585 isolates, 27.6% were susceptible to gentamicin and kanamicin, 27.1% to tobramicin and amikacin, and 21.3% to netilmicin. The most prevalent AME genes included aac(6')-Ie-aph(2'') (93.7%) followed by aph(3')-IIIa (84.3%) and ant (4')-Ia (28.1%). More than 90% of aminoglycoside-resistant staphylococci contained at least one AME gene. The coexistence of two or three AME genes was detected in most gentamicin-resistant isolates. These results suggest an alarming rate of aminoglycoside resistance in this test location in Tehran, Iran. Continued surveillance at the genotypic and phenotypic levels, and adherence to well-designed antibiotic and infection-control policies are necessary to limit the spread of antimicrobial resistance.

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Background/aim: More than 50% of Iranian children are infected with Helicobacter pylori; however, no data exist about the association of vacA/cagA genotype/status with disease outcomes in them. We analyzed association of vacA/cagA genotypes/status of children's isolates with gastric inflammation status as the first step in H. pylori pathogenesis. Materials and methods:Antral biopsies for culture and histopathology were taken from 328 children in 1997-2009. vacA (s, m) alleles and cagA statuses of the isolates were determined by PCR. Histopathology was performed according to the Sydney system; gastritis was scored as normal, mild, moderate, severe, and follicular.Results: A total of 159 culture-positive cases, with no mixed infections, were enrolled in the study. Of them, 60% were cagA-positive; 21.4%, 37.1%, 16.3%, and 25.2% cases were s1m1, s1m2, s2m1, and s2m2, respectively. Histopathology showed normal (4.4%), mildchronic (31.4%), moderate-chronic (38.4%), severe-chronic (10.7%), and follicular gastritis (15.1%) cases. Thirty-four (21.4%) of the children had ulcers. Correlation (P < 0.05) was observed between more severe (moderate, severe, follicular) status and both vacAs1 allele and cagA-positive status. No significant relation was observed between genotype/status of vacA/cagA and ulcers (P > 0.05). Conclusion: vacAs1and cagA are associated with more severe gastric inflammation in Iranian children. Association of vacAs1 and cagA with more severe pathology in Iran may be similar to that of other parts of the world.