This study was conducted to determine the composition of staghorn stones and to assess the proportion of infected stones as well as the correlation between infection in the stones and bacteria grown in urine. Samples of 45 consecutive stones removed through anatrophic nephrolithotomic procedures were taken from the operation site and samples of urine were obtained by simultaneous bladder catheterization. The frequency of infection in the stones and correlation between infection of stone and urine samples were determined with respect to the composition of the stones. Twenty-two males and 23 females, with respective mean ages of 48.3 ± 15.6 years and 51 ± 7.4 years, were studied. The stone and urine cultures yielded positive results in ten and 16 patients, respectively, of a total of 45 patients (22.2% and 35.5%, respectively). Calcium oxalate was the main constituent of staghorn stones, seen in 31 patients (68.8%), uric acid in 12 patients (26.6%) and struvite and/or calcium phosphate in 11 patients (24.4%). In seven of ten stones with bacterial growth, bacteria were isolated from urine cultures as well, which accounted for a concordance rate of 70%. The bacteria grown in the stone were the cause of urinary tract infection (UTI) in 43.5% of the cases. Stone infection was significantly associated with UTI (OR = 6.47; 95% CI 1.43-31.7, P = 0.021) and presence of phosphate in the stones (OR = 18, 95% CI 3.28-99.6, P = 0.0006). E. coli was the most common bacteria grown from the stones, and was isolated in 50% of the cases; Ureaplasma urealyticum was the most common organism causing UTI, grown in 62.5% of the urine samples. There was a high concordance rate between bacteria in the stones and urine. These findings indicate that the urine culture can provide information for selection of an appropriate anti-microbial agent for stone sterilization. In addition, preventing re-growth or recurrence of stones and treatment of post-surgical infections would be facilitated based on the results of the urine culture.

IntroductionThe Aloysia citriodora plant from the family of Verbenaceae has many uses in traditional medicine. The aim of the current study was to determine the effects of the aqueous and ethanolic extracts of A. citriodora on Streptococcus mutans and Streptococcus sobrinus, which cause tooth decay.MethodsThis 2016 study was performed on standardized strains of S. mutans PTCC1683 and S. sobrinus PTCC1601 and clinical isolates. Twenty clinical samples were obtained from the dental caries of children admitted to the pediatric ward at the Faculty of Dentistry of Babol University of Medical Sciences (Babol, Iran). The aqueous and ethanolic extracts of A. citriodora leaves were prepared in several concentrations ranging from 625–20,000 μg/ml. These concentrations of the extracts were applied to the bacteria by disk diffusion, agar well diffusion, and macrotube dilution. The antibacterial effects of amoxicillin and chlorhexidine digluconate 0.2% (CHX) were also carried out. Data were analyzed by SPSS version 18 software using independent-samples t-test.ResultsStreptococcus spp. was successfully isolated from nine out of 20 (45%) specimens. Of the 9 positive samples cultured, 8 (88.8%) were S. mutans and 1 was S. sobrinus (11.2%). No inhibitory zone was observed around the disks and wells containing all concentrations of A. citriodora extracts. The minimum concentrations for inhibition of growth (MIC) resulted in turbidity in all tubes and were negative except for the control tubes. Inhibition zones were observed for amoxicillin and CHX disks (p < 0.001).ConclusionThis study found that all studied bacteria were resistant to both types of the extracts; therefore, they are not a suggested replacement for chemical agents in mouthwash. It also shown that CHX is less effective than amoxicillin.

Background: Bacterial resistance to beta-lactam is a major problem in all developed and developing countries. The genera of Klebsiella and Enterobacter are associated with opportunistic and nosocomial infections. All beta-lactamase genes can cause dissemination of resistance to beta-lactams. Objectives: The present study aimed to investigate the phenotypic detection of beta-lactamases in Enterobacter and Klebsiella species isolated from clinical specimens. Materials and Methods:This cross-sectional study was performed on 59 Klebsiella spp. and 49 Enterobacter spp. isolated from clinical samples. They were confirmed using API 20E. These bacteria were evaluated for the production of extended-spectrum beta lactamase (ESBL), metallo-beta-lactamase (MBL) (IMP-1), and the pAmpC and iAmpC enzymes. This was done using the Clinical and Laboratory Standards Institute (CLSI) method, 2-mercaptopropionic acid, the cefoxitin method, and the use of imipenem as an enzyme inducer, respectively. Mask-ESBL production was also identified, using different concentrations of 3-amino-phenyl boronic acid compound. Data were analyzed with SPSS version 22. Results: In total, 38 (64.4%) Klebsiella spp. and 41 (83.7%) Enterobacter spp. produced at least one type of beta-lactamase. AmpCproducing Enterobacter spp. (71.4%), and ESBL-producing Klebsiella spp. (42.4%) had the highest prevalence of beta-lactamase types in each genus. There were two bacteria in both types that were resistant to all antibiotics without producing any type of beta-lactamase. Conclusions: According to our findings, it is necessary to pay special attention to ESBL production in Klebsiella spp., while in Enterobacter spp., it is essential to search for AmpC production (chromosomal and plasmid). In addition, the genotypic evaluation of beta-lactamase variety in these bacteria may be necessary in different geographical areas.

Backgrounds: One of the fundamental needs of a community is to have an access to healthy and safe drinking water. The lack of a concentrated accessibility to health facilities and services is among the serious problems facing villagers in the rural areas. The aims of this research was to investigate the drinking water quality of the villages in Babol township suburbs in north of Iran. Materials and Methods: In this cross-sectional descriptive study, a total of 140 water samples were taken from the water distribution network in16 villages for the low and high-rain seasons in sterile glass bottle. The microbial quality of gathered samples were determined based on standard methods in laboratory. Statistical analysis of the results was performed using a SPSS16 statistical software. Findings: Based on obtained results 13.6% of the samples were contaminated to coliform and 20% to fecal coliform bacteria. The residual chlorine in 12.5% of the samples were between 0.2 to 0.8 mg·L^-1 and the PH in total samples were between 6.8 to 7.8. There were no signs of any contamination for 32.86% of the analysed samples which water resources is located to a distance of more than 30 m to the contamination sources. In addition, 43.1% of the samples taken from the water resources with no plumbing system, have had a fecal contamination. Conclusions: Considering the results achieved, the microbial quality of the drinking water of the studied villages classified as “moderate” status. For more water supply there is not sufficient residual chlorine in most cases. Poor sanitation of water supply is most causes of water contamination. It is therefore strongly recommended that sanitation measures are made to protect water resources from the contamination

Background: Otitis externa is an inflammatory in external auditory canal, with the presentation of otalgia, otorrhea, and pruritus. Bacteria and fungi are the most causative agents of the disease. Although several antifungal and antibacterial agents are usually used to treat it, combination therapy plays an important role in good treatment efficacy. Objectives: According to the problems associated with the treatment of mixed otitis externa, the current study aimed at evaluating the efficacy of ceftazidime powder and topical miconazole (as the case group) versus topical miconazole only (as the control group) to treat mixed otitis externa. Methods: Seventy-two patients with mixed otitis externa were divided into two groups; the case group was treated with ceftazidime powder and topical miconazole, and the control group was treated only with topical miconazole. Both groups were evaluated after two weeks. The diagnosis of mixed otitis externa was based on signs, symptoms, and the presence of bacterial and fungal elements in direct examination and culture. Results: Swelling, itching, and canal discharge were observed in 67.7%, 64.7%, and 90.3% of the patients, respectively in the case group, and 47.1%, 26.3% and 93.1% of the patients, respectively in the control group. Complete resolution of all clinical signs and symptoms occurred in 23 (67.6%) patients in the case group and 11 (28.9%) patients in the control group (P = 0.001). Staphylococcus epidermidis and Pseudomonas aeruginosa were the most common bacteria, and Aspergillus spp. and Candida spp. were the most common fungi identified in the cultures. Conclusions: According to the complete resolution of clinical signs, the application of ceftazidime powder and topical miconazole was better than topical miconazole to treat mixed otitis externa.