Publications by authors named "Jalal Mardaneh"

39 Publications

Development of a SYBR Green Multiplex Real Time PCR for Simultaneous Detection of and in Respiratory Samples.

Ethiop J Health Sci 2021 Mar;31(2):241-246

Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

Background: Nocardia asteroides and Mycobacterium tuberculosis are worldwide-distributed bacteria. These infectious agents can cause many infections in humans, especially in immunocompromised individuals. Pulmonary infections are more common and have similar clinical symptoms. Proper diagnosis and treatment of these patients are important for accurate treatment and could be lifesaving.

Methods: In this study, a multiplex real-time PCR assay was established for the simultaneous detection of the N. asteroides and M. tuberculosis. Both this homemade multiplex real time PCR and routine commercial tuberculosis tests were performed on 150 pulmonary specimens collected from individuals suspected to have tuberculosis.

Results: From 150 specimens, 20 samples were acid fast positive, 14 positives for M. tuberculosis by singleplex real time PCR, 10 positives for N. asteroides by singleplex real time PCR and 2 positives for M. tuberculosis and N. asteroides by multiplex real time PCR whereas 14 samples were positive for M. tuberculosis with commercial test. Differential diagnosis of pulmonary tuberculosis is useful for their proper treatment.

Conclusion: Our test had good performance for differential diagnosis of tuberculosis and nocardiosis. Therefore, it is recommended to be used to diagnose such patients.
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http://dx.doi.org/10.4314/ejhs.v31i2.6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188082PMC
March 2021

The Iranian Newborn Multiples Registry (IRNMR): a registry protocol.

J Matern Fetal Neonatal Med 2021 Jun 14:1-4. Epub 2021 Jun 14.

Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.

Over the last decades, several twin/multiples registries have been developed worldwide, mostly concentrated in Europe and high-income countries (HICs). In Iran, we lack accurate nationwide epidemiological and biobank data on twins. We established the Iranian Newborn Multiples Registry (IRNMR) to evaluate the role of genetics and environmental factors in the variation of phenotypes among newborn monozygotic (MZ) and dizygotic (DZ) twin pairs. IRNMR is a multicenter hospital-based registry. In the pilot phase, we collected epidemiological data from multiples born in Imam Khomeini Hospital complex and Aban Hospital located in Tehran, the capital of Iran, with a population exceeding 8 million, Allameh Bohlool Gonabadi Hospital, Gonabad, Razavi Khorasan, and Shahid Sadoughi Hospital, Yazd, Iran. The IRNMR has recruited 457 sets of newborn twins and multiples so far. We hold follow-up sessions by mother and child health professionals to monitor multiples' growth, development, diseases, and mortality. We successfully developed a newborn multiples registry in Iran. This registry will create an invaluable database to study the relative influence of genes and environmental factors on various chronic diseases, growth, development, and behavioral disorders. We intend to collaborate with other centers to develop a large multicenter nationwide multiple birth registry and biobank in Iran.
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http://dx.doi.org/10.1080/14767058.2021.1875445DOI Listing
June 2021

Prevalence and Subtype Analysis of Isolated from Patients in the Northeast of Iran.

J Parasitol Res 2021 13;2021:8821885. Epub 2021 Jan 13.

Department of Microbiology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.

is the most common intestinal parasite found in humans and many other hosts. Pathogenicity of spp. remains controversial, and it has been suggested that it may be associated with specific subtypes of the organism. This study identified the subtypes and their prevalence rates in the northeast of Iran. A total of 1878 samples were collected from the northeast of Iran from January to December 2017. The patients' demographic details were recorded. Samples were examined by a wet mount, and genomic DNA was extracted from positive samples. Also, PCR was done on the positive samples, and sequencing and phylogenetic analysis were subsequently performed. From 1878 collected stool samples, 152 (8.1%) Blastocystis samples were detected by the microscopic method. Of the 152 samples, spp. were found in 53.6% of the men and 28.9% of the women who showed clinical gastrointestinal symptoms, and a significant relationship was observed between gender and clinical symptoms ( = 0.002). A meaningful relationship was found between the season and infection with this parasite ( value = 0.003). The results of the sequencing of 22 PCR products showed the dominance of ST3, which was isolated from 10 (45.45%) patients, while ST1, ST2, and ST7 were found in 4 (18.19%), 7 (31.81%), and 1 (4.55%) patients, respectively. In this study, ST7 had a low prevalence in the northeast of Iran, and similar to previous studies, ST3 was the dominant subtype.
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http://dx.doi.org/10.1155/2021/8821885DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7822675PMC
January 2021

Antimicrobial resistance patterns and their encoding genes among clinical isolates of in Ahvaz, Southwest Iran.

MethodsX 2020 14;7:101031. Epub 2020 Aug 14.

Infectious and Tropical Diseases Research Center, Health Research Institue, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

is one of the most important organisms in nosocomial infections. Antibiotic resistance in this bacterium causes many problems in treating patients. This study aimed to investigate antibiotic resistance patterns and resistance-related genes in clinical isolates of This descriptive study was conducted on 124 isolates of collected from clinical samples in two teaching hospitals in Ahvaz. The antibiotic resistance pattern was determined by disk diffusion. The presence of genes coding for antibiotic resistance was determined using the polymerase chain reaction method. Out of 124 isolates, the highest rate of resistance was observed for rifampin (96.8%). The resistance rate for imipenem, meropenem, colistin, and polymyxin-B were 78.2%, 73.4%, 0.8% and 0.8%, respectively. The distribution of and genes were 52.6%, 0%, 3.2%, 93.5% 69.2%, and 6.42%, respectively. High prevalence of and genes among isolated strains in this study indicate the important role of these genes in multidrug resistance in this bacteria. • is an important human pathogen that has attracted the attention of many researchers Antibiotic resistance in this bacterium causes many problems in treating patients. • The resistance rate for imipenem, meropenem, colistin, and polymyxin-B were 78.2%, 73.4%, 0.8% and 0.8%, respectively. The distribution of and genes were 52.6%, 0%, 3.2%, 93.5% 69.2%, and 6.42%, respectively.
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http://dx.doi.org/10.1016/j.mex.2020.101031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492985PMC
August 2020

Prevalence of β-lactamase genes, class 1 integrons, major virulence factors and clonal relationships of multidrug-resistant isolated from hospitalized patients in southeast of Iran.

Iran J Basic Med Sci 2019 Jul;22(7):806-812

Department of Microbiology and Virology, Kerman University of Medical Sciences, Kerman, Iran.

Objectives: is one of the most important nosocomial pathogens causing a high rate of mortality among hospitalized patients. Herein, we report the prevalence of antibiotic resistance genes, class 1 integrons, major virulence genes and clonal relationship among multidrug- resistant (MDR) , isolated from four referral hospitals in the southeast of Iran.

Materials And Methods: In this study, 208 isolates of were collected from four referral hospitals in southeast of Iran. Disk diffusion method was used to determine susceptibility to 13 antibacterial agents. AmpC was detected by phenotypic method and β-lactamase genes, virulence genes and class 1 integrons were detected by PCR. Clonal relationship of the isolates was determined by RAPD-PCR.

Results: All the isolates were susceptible to polymyxin-B and colistin. Overall, 40.4% of the isolates were MDR, among which resistance to third generation cephalosporins, aminoglycosides, and carbapenems was 47.5%, 32.3% and 40%, respectively. None of the isolates was positive for genes, while 84.5% and 4.8% were positive for the and , metallo-β-lactamase genes, respectively. Incidence of class 1 integrons was 95% and AmpC was detected in 33% of the isolates. Prevalence of and were 98.8%, 44%, 26%, 8.3% and 33.3%, respectively. RAPD profiles identified four large clusters consisting of 77 isolates, and two small clusters and three singletons.

Conclusion: The rate of MDR isolates was high in different hospitals in this region. High genetic similarity among MDR isolates suggests cross-acquisition of infection in the region.
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http://dx.doi.org/10.22038/ijbms.2019.35063.8340DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196353PMC
July 2019

Anti-Inflammatory and Immunomodulatory Effects of Barberry () and Its Main Compounds.

Oxid Med Cell Longev 2019 19;2019:6183965. Epub 2019 Nov 19.

Lung Diseases & Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.

is a well-known herb in Iran that is widely used as a medicinal plant and a food additive. The aim of this study was to investigate the anti-inflammatory and immunomodulatory effects of Barberry and its main compounds. This narrative review was conducted by searching keywords such as . , Barberry, immunomodulatory, anti-inflammatory, medicinal herbs, plants, and extract, separately or combined in various databases, such as Web of Sciences, PubMed, and Scopus. According to the inclusion and exclusion criteria, just English language articles, which reported effective whole plants or herbal compounds, were included. 21 articles were reviewed in this study. In the models (mice, rats, and human cells) and in the models (some organ cells such as the spleen, kidney, blood, and brain), . and its main components showed anti-inflammatory effects in both models. The main mechanisms were the shift of cell immune response to Th2, T reg induction, inhibition of inflammatory cytokines (IL-1, TNF, and IFN-), and stimulation of IL-4 and IL-10. The induction of apoptosis in APCs and other effector cells was another important mechanism.
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http://dx.doi.org/10.1155/2019/6183965DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885761PMC
April 2020

Prevalence of antibiotic resistance and integrons, and genes in clinical isolates of from a tertiary care hospital in Southwest Iran.

Iran J Basic Med Sci 2019 Aug;22(8):872-877

Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Objectives: has emerged as an important opportunistic nosocomial pathogen due to its intrinsic and acquired resistance to a wide range of antimicrobial agents. The present study aimed to investigate the occurrence of antibiotic resistance and resistance mechanisms among clinical isolates of from Iranian patients.

Materials And Methods: This cross-sectional study was performed on 44 isolates that were recovered from different clinical specimens in 2015 and 2016. Conventional microbiologic methods were used for primary identification of isolates and confirmed by specific polymerase chain reaction (PCR) primers. Minimum inhibitory concentrations (MICs) were determined by the E-test. PCR was applied to determine antibiotic resistance genes.

Results: All of isolates were susceptible to trimethoprim/sulfamethoxazole (TMP/SMX) and colistin. Moreover, the susceptibility rates of isolates toward ceftazidime and ciprofloxacin were 93.2%, and 84.1%, respectively. Class 1 integrons was detected in 24 (54.5%) isolates by the presence of gene. Moreover, the prevalence of antibiotic resistance genes , , and were found in 16 (36.4%), 15 (34.1%), and 29 (65.9%) isolates, respectively.

Conclusion: In summary, the prevalence of and genes in integrons-contained isolates point out the significant risk of sulfonamides and fluoroquinolones resistance among clinical isolates of in our region.
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http://dx.doi.org/10.22038/ijbms.2019.31291.7540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760486PMC
August 2019

Investigation of the Physical, Chemical Characteristics and Microbial Contamination of the Indoor Swimming Pools

Turkiye Parazitol Derg 2019 Sep;43(3):130-134

Shiraz University of Medical Sciences, Prof. Alborzi Clinical Microbiology Research Center, Shiraz, Iran

Objective: The aim of this study was to investigate the physical, chemical and microbiological contamination of indoor swimming pools.

Methods: Pool water specimens were collected using a plastic polypropylene sterilized bottle. The physical and chemical qualities of the waters were analyzed in terms of temperature, turbidity, pH, and free residual chlorine, with the standard methods for the examination of water. Bacteriological (routine methods) and parasitological (molecular methods) tests were carried out on pools water.

Results: The mean temperature, pH, and residual chlorine of the indoor pools were 31.2 °C, 7.6 and 1.5 mg/L, respectively. Turbidity was not observed in any of the pools. The pH and temperature values were in standard ranges in 92.3% and 15.4% of the waters of swimming pools, respectively. The prevalence rates of bacterial and amoebic contaminations of the water in the swimming pools were 53.8% and 46.2%, respectively. One pool (7.7%) was contaminated with both bacteria and amoeba. and spp. were isolated from the pool waters.

Conclusion: In this study, some microorganisms were identified from the water pools. Effective management of swimming pools and proper control of the physical, chemical and microbiological property of water pools can produce the healthy recreational activity.
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http://dx.doi.org/10.4274/tpd.galenos.2019.6112DOI Listing
September 2019

Characterization of Phenotypic and Genotypic Diversity of Strains Isolated From Selected Hospitals in Iran.

Front Microbiol 2019 29;10:1191. Epub 2019 May 29.

Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

is an environmental Gram-negative bacterium that has rapidly emerged as an important nosocomial pathogen in hospitalized patients. Treatment of infections is difficult due to increasing resistance to multiple antibacterial agents. The purpose of this study was to determine the phenotypic and genotypic characterization of isolates recovered from patients referred to several hospitals. A total of 164 clinical isolates of were collected from hospitals in various regions in Iran between 2016 and 2017. Antibiotic susceptibility testing was performed by disc diffusion method and E-test assay according to the Clinical and Laboratory Standards Institute (CLSI) guideline. The ability of biofilm formation was assessed with crystal violet staining and then, biofilm-associated genes were investigated by PCR-sequencing method. The presence of (a metallo-β-lactamase), (a clavulanic acid-sensitive cephalosporinase), and (resistance to Trimethoprim/Sulfamethoxazole), Sm (intrinsic resistance to quinolones), and genes (dihydrofolate reductase enzyme that contributes to trimethoprim resistance) was also examined by PCR-sequencing. Relative gene expression of efflux pump was assessed by real-time PCR. Genotyping was performed using the multi-locus sequencing typing (MLST) and repetitive extragenic palindromic-PCR (Rep-PCR). Isolates were resistant to imipenem (100%), meropenem (96%), doripenem (96%), and ceftazidime (36.58%). Notably, 5 (3.04%) isolates showed resistant to trimethoprim-sulfamethoxazole (TMP-SMX), an alarming trend of decreased susceptibility to TMP-SMX in Iran. Minocycline and levofloxacin exhibited the highest susceptibility of 91.46 and 99.39%, respectively. Using the crystal violet staining, 157 (95.73%) isolates had biofilm phenotype: 49 (29.87%), 63 (38.41%), and 45 (27.43%) isolates were categorized as strong-, moderate- and weak-biofilm producer while 7 isolates (4.26%) were identified a non-biofilm producer. Biofilm genes had an overall prevalence of 145 (88.41%), 137 (83.53%), and 164 (100%) of , , and , respectively. , , , , and resistance genes were detected in 145 (88.41%), 156 (96.12%), 103 (62.80%), 89 (54.26%), and 92 (56.09%) isolates, respectively. None of the isolates were positive for , , and genes. Gene expression analysis showed that efflux system was overexpressed in two out of the five clinical isolates (40%) that showed resistance to TMP-SMX. Most of the isolates were genetically unrelated. Two new sequence types (ST139 and ST259) were determined. Our results showed that TMP-SMX was still an effective antibiotic against . The findings of the current study revealed an increasing prevalence of antibiotic resistance and biofilm genes in clinical isolates in Iran.
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http://dx.doi.org/10.3389/fmicb.2019.01191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6548850PMC
May 2019

Antibody-drug conjugates (ADCs) for cancer therapy: Strategies, challenges, and successes.

J Cell Physiol 2019 05 27;234(5):5628-5642. Epub 2018 Nov 27.

Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.

Targeted delivery of therapeutic molecules into cancer cells is considered as a promising strategy to tackle cancer. Antibody-drug conjugates (ADCs), in which a monoclonal antibody (mAb) is conjugated to biologically active drugs through chemical linkers, have emerged as a promising class of anticancer treatment agents, being one of the fastest growing fields in cancer therapy. The failure of early ADCs led researchers to explore strategies to develop more effective and improved ADCs with lower levels of unconjugated mAbs and more-stable linkers between the drug and the antibody, which show improved pharmacokinetic properties, therapeutic indexes, and safety profiles. Such improvements resulted in the US Food and Drug Administration approvals of brentuximab vedotin, trastuzumab emtansine, and, more recently, inotuzumab ozogamicin. In addition, recent clinical outcomes have sparked additional interest, which leads to the dramatically increased number of ADCs in clinical development. The present review explores ADCs, their main characteristics, and new research developments, as well as discusses strategies for the selection of the most appropriate target antigens, mAbs, cytotoxic drugs, linkers, and conjugation chemistries.
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http://dx.doi.org/10.1002/jcp.27419DOI Listing
May 2019

The data of strains genes in different types of wastewater.

Data Brief 2018 Dec 31;21:763-766. Epub 2018 Aug 31.

Department of Environmental Health Engineering, School of Public Health, Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.

From April 2016 to March 2017, a number of 99 isolates of were collected from three types of wastewater including urban wastewater (33 isolates), livestock slaughterhouse wastewater (33 isolates) and poultry slaughterhouse wastewater (33 isolate). The specimens were cultured on microbiological media. The bacterial identification was performed by morphological and biochemical tests. Polymerase chain reaction (PCR) method was carried out to detect 2 virulence genes (, and ) and 4 antibiotic resistance genes ( , and ). The data showed that the prevalence rate of genes were 89.9%, 91.9%, 79.8%, 40.4%, 6.1%, and 91.9%, respectively.
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http://dx.doi.org/10.1016/j.dib.2018.08.167DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6216088PMC
December 2018

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections among pregnant women and eye colonization of their neonates at birth time, Shiraz, Southern Iran.

BMC Infect Dis 2018 Sep 24;18(1):477. Epub 2018 Sep 24.

Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Chlamydia trachomatis and Neisseria gonorrhoeae are the two common transmissible pathogens from pregnant women to their neonates. Given the lack of routine screening and treatment of pregnant women in some areas, the possibility of transmission rises. This study seeks to determine the prevalence of C. trachomatis and N. gonorrhoeae in the pregnant women with no clinical symptoms and the vertical transmission rate to their neonates.

Methods: The study was conducted on endocervical and eye swab samples of 239 pregnant women and their neonates. Identification was based on PCR method.

Results: The prevalence rates of C.trachomatis in women and neonates were 37/239 (15.5%) and 28/239 (11.7%), and for N. gonorrhoeae 3/239 (1.3%), 1/239 (0.4%), respectively. The vertical transmission rates to the neonates were 28/37(75.6%) for C. trachomatis and 1/3 for N. gonorrhoeae.

Conclusions: In the areas with a high prevalence of chlamydial or gonococcal infections, and in the absence of screening and treatment of the pregnant women, ocular prophylaxis with antibiotics is suggested as a part of routine neonatal care program for the prevention of chlamydial and gonococcal ophthalmia.
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http://dx.doi.org/10.1186/s12879-018-3382-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154405PMC
September 2018

Molecular characteristics of multiple and extensive drug-resistant Acinetobacter baumannii isolates obtained from hospitalized patients in Southwestern Iran.

Infez Med 2018 Mar;26(1):67-76

Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences Shiraz, Iran; Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

The emergence of multiple drug-resistant (MDR) Acinetobacter baumannii strains has become a global problem. This study aimed to evaluate the occurrence of antibiotic resistance and to investigate the presence of antibiotic resistance determinants among A. baumannii isolates obtained from hospitalized patients in Iran. This cross-sectional study was performed on 92 A. baumannii isolates in the years 2015-2016. Antimicrobial susceptibility testing was carried out by the disk diffusion method. The presence of antibiotic resistance determinants was detected by the PCR method. All the A. baumannii isolates were resistant to tested carbapenems, fluoroquinolones and sulfonamide agents, and susceptible to polymixins. Of the isolates 92.4% were extensive drug-resistant (XDR) and 7.6% were MDR. PCR screening for the presence of integron genes revealed that class 1 integron presented in 46.7% of isolates and class 2 in 18.5% isolates. Of the investigated antibiotic resistance genes, bla vim, bla imp, bla spm, sul1 and sul2 were positive in 75%, 12%, 12%, 47.8%, and 67.4% of isolates, respectively. The high prevalence of metallo-beta-lactamase (MBL) and sul genes in our results may indicate the importance of these genes in the dissemination of carbapenem- and sulfonamide-resistant A. baumannii isolates. Rational and restricted prescription of carbapenems may be an effective way to minimize the emergence and spread of MBL-harboring strains.
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March 2018

Feasibility of applying the LED-UV-induced TiO/ZnO-supported HPMoO nanoparticles in photocatalytic degradation of aniline.

Environ Monit Assess 2018 Mar 3;190(4):188. Epub 2018 Mar 3.

Department of Microbiology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.

In the present study, TiO/ZnO-supported phosphomolybdic acid nanoparticles are investigated by the impregnation method, followed by analyzing their photocatalytic activity under UV-LED light and degradation kinetics degrading aniline as an organic pollutant model. Nanoparticle characteristics and the remaining Keggin structure in the nanocomposites were confirmed by means of FESEM, FTIR, and XRD analyses. Heterogenization of phosphomolybdic acid on TiO and ZnO nanoparticles resulted in the improved light absorption intensity and decreased band gap of nanocomposites. Photocatalytic degradation of aniline was also improved for composite nanoparticles and reached to 25.62, 43.48, and 38.25% for TiO/HPMo, ZnO/HPMo, and TiO/ZnO/HPMo, respectively. Overall, the results showed a good fit to the Langmuir-Hinshelwood kinetic model.
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http://dx.doi.org/10.1007/s10661-018-6565-yDOI Listing
March 2018

Emerge of bla and bla harboring carbapenem-resistant Klebsiella pneumoniae isolates from hospitalized patients in southwestern Iran.

J Chin Med Assoc 2018 Jun 10;81(6):536-540. Epub 2017 Oct 10.

Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Background: One of the most important emerging carbapenem-resistant bacteria is Klebsiella pneumoniae (K. pneumoniae). The present study aimed to investigate the antibiotic susceptibility pattern of K. pneumoniae isolates and detection of carbapenemase producing K. pneumoniae obtained from Iranian hospitalized patients.

Methods: This cross-sectional study was performed on 211 K. pneumoniae isolates which were recovered from different clinical specimens from 2014 to 2015. Modified Hodge test (MHT) and double disk synergy test (DDST) were done for detection of carbapenemase and metallo-beta-lactamase (MBL) producing K. pneumoniae. The presence of antibiotic resistance determinants was investigated by polymerase chain reaction (PCR) method.

Results: The results of antibiotic susceptibility showed that all isolates were resistant to ampicillin, and then mostly resistant to piperacillin and ceftazidime with 76.3% and 66.8%, respectively. On the other hand, the highest sensitivity was toward polymyxin B, followed by carbapenems. Of 29 carbapenem-resistant isolates, all were high-level imipenem-resistant isolates (Minimum inhibitory concentration ≥4), except 4 isolates. The results of MHT and DDST showed that 93.1% (27/29) of carbapenem-resistant isolates were carbapenemase and MBL producing isolates, respectively. The presence of bla and bla genes was detected in 27 (10.9%) and 2 (0.9%) isolates, respectively.

Conclusion: This is the first identification of bla and bla in K. pneumoniae in Southwestern Iran and the highest reported prevalence of bla in this bacterium from Iran. Since carbapenem-resistant isolates containing New Delhi metallo-beta-lactamase 1 (NDM-1) were almost resistant to all the tested antibiotics, the resistance due to this gene may be increased in the near future as a potential health threat.
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http://dx.doi.org/10.1016/j.jcma.2017.08.015DOI Listing
June 2018

Occurrence of Enterococcus faecalis and Enterococcus faecium in Various Clinical Infections: Detection of Their Drug Resistance and Virulence Determinants.

Microb Drug Resist 2018 Jan/Feb;24(1):76-82. Epub 2017 May 19.

5 Department of Microbiology, School of Medicine, Gonabad University of Medical Sciences , Gonabad, Iran .

The aim of this study was to characterize virulence determinants and antibiotic resistance profiles in enterococci obtained from various clinical sources in the northwest of Iran. A total of 160 enterococcal clinical isolates from various wards of University Teaching Hospitals were collected and specified by biochemical test, from September 2014 to July 2015. Identification of enterococci was confirmed by multiplex PCR in the genus and species level. Antibiotic resistance properties and virulence determinants were examined by phenotypic and molecular methods. Of 160 enterococcal isolates, 125 (78.12%) and 35 (21.88%) isolates were identified as Enterococcus faecalis and Enterococcus faecium, respectively. The most common antibiotic nonsusceptible pattern observed was resistance toward rifampicin [n = 122 (76.25%)] followed by erythromycin [n = 117 (73.12%)]. Among all isolates, gelE [n = 140 (87.5%)], cpd [n = 137 (85.6%)], and asa1 [n = 118 (73.8%)] were the most prevalent virulence genes studied. Thirty isolates (11 E. faecalis, 19 E. faecium) were found to be resistant to vancomycin, with minimum inhibitory concentration of ≥256 μg/ml. Twenty-seven isolates carried the vanA gene, whereas none of the isolates carried vanB. E. faecalis had a considerable ability to show virulence genes and drug resistance. Emergence of antibiotic-resistant enterococci and the high prevalence of virulence traits in our study could be regarded as an alarming situation.
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http://dx.doi.org/10.1089/mdr.2017.0049DOI Listing
August 2018

Systematic Review of Antimicrobial Resistance of Clinical Acinetobacter baumannii Isolates in Iran: An Update.

Microb Drug Resist 2017 Sep 13;23(6):744-756. Epub 2017 Jan 13.

3 Department of Microbiology, Faculty of Medicine, Gonabad University of Medical Sciences , Gonabad, Iran .

Treatment of Acinetobacter baumannii has become a medical challenge because of the increasing incidence of multiresistant strains and a lack of viable treatment alternatives. This systematic review attempts to investigate the changes in resistance of A. baumannii to different classes of antibiotics in Iran, with emphasis on the antimicrobial activity of polymyxin B (PMB) and colistin (COL). Biomedical databases were searched for English-published articles evaluating microbiological activity of various antimicrobial agents, including PMB and COL. Then, the available data were extracted and analyzed. Thirty-one studies, published from 2009 to 2015, were identified which contain data for 3,018 A. baumannii clinical isolates. With the exception of polymyxins and tigecycline (TIG), there was a high rate of resistance to various groups of antibiotics, including carbapenems. The minimum inhibitory concentration (MIC) ranges for PMB and COL on A. baumannii isolates tested were 0.12-64 μg/ml and 0.001-128 μg/ml, respectively. Polymyxins showed adequate activity with no significant trends in the resistance rate during most of the study period. The incidence of resistance to TIG was estimated low from 2% to 38.4% among the majority of A. baumannii. The present systematic review of the published literatures revealed that multidrug-resistant (including carbapenem-resistant) strains of A. baumannii have increased in Iran. In these circumstances, the older antibiotics, such as COL or PMB, preferably in combination with other antimicrobials (rifampicin, meropenem), could be considered as the therapeutic solution against the healthcare-associated infections. Designing rational dosage regimens for patients to maximize the antimicrobial activity and minimize the emergence and prevalence of resistance is recommended.
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http://dx.doi.org/10.1089/mdr.2016.0118DOI Listing
September 2017

Campylobacter jejuni Bacteremia in a Patient With Acute Lymphocytic Leukemia.

Iran Red Crescent Med J 2016 Jun 17;18(6):e23992. Epub 2016 May 17.

Department of Microbiology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, IR Iran.

Introduction: Campylobacter jejuni is a slender, motile, non-spore-forming, helical-shaped, gram-negative bacterium. It is one of the most common causes of human gastroenteritis in the world. The aim of this study was to present a patient with acute lymphocytic leukemia (ALL), who was infected with Campylobacter jejuni.

Case Presentation: We describe the medical records of a pediatric ALL patient with bacteremia caused by C. jejuni, who was diagnosed at Amir hospital, Shiraz, Iran. This 14-year-old male visited the emergency department of Amir hospital with night sweats, severe polar high-grade fever, reduced appetite, and nausea in August 2013. Given the suspected presence of an anaerobic or microaerophilic microorganism, aerobic and anaerobic blood cultures were performed using an automated blood cultivator, the BACTEC 9240 system. In order to characterize the isolate, diagnostic biochemical tests were used. Antibiotic susceptibility testing was done with the disk diffusion method. The primary culture was found to be positive for Campylobacter, and the subculture of the solid plate yielded a confluent growth of colonies typical for Campylobacter, which was identified as C. jejuni by morphological and biochemical tests. The isolate was resistant to ciprofloxacin, cefotaxime, cephalexin, piperacillin/tazobactam, nalidixic acid, aztreonam, cefuroxime, cefixime, ceftazidime, and tobramycin.

Conclusions: C. jejuni should be considered in the differential diagnosis as a potential cause of bacteremia in immunosuppressed patients. In cases where the BACTEC result is positive in aerobic conditions but the organism cannot be isolated, an anaerobic culture medium is suggested, especially in immunocompromised patients.
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http://dx.doi.org/10.5812/ircmj.23992DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002924PMC
June 2016

Detection of Salmonella spp. with the BACTEC 9240 Automated Blood Culture System in 2008 - 2014 in Southern Iran (Shiraz): Biogrouping, MIC, and Antimicrobial Susceptibility Profiles of Isolates.

Jundishapur J Microbiol 2016 Apr 17;9(4):e26505. Epub 2016 Apr 17.

Department of Microbiology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, IR Iran.

Background: Human salmonellosis continues to be a major international problem, in terms of both morbidity and economic losses. The antibiotic resistance of Salmonella is an increasing public health emergency, since infections from resistant bacteria are more difficult and costly to treat.

Objectives: The aims of the present study were to investigate the isolation of Salmonella spp. with the BACTEC automated system from blood samples during 2008 - 2014 in southern Iran (Shiraz). Detection of subspecies, biogrouping, and antimicrobial susceptibility testing by the disc diffusion and agar dilution methods were performed.

Patients And Methods: A total of 19 Salmonella spp. were consecutively isolated using BACTEC from blood samples of patients between 2008 and 2014 in Shiraz, Iran. The isolates were identified as Salmonella, based on biochemical tests embedded in the API-20E system. In order to characterize the biogroups and subspecies, biochemical testing was performed. Susceptibility testing (disc diffusion and agar dilution) and extended-spectrum β-lactamase (ESBL) detection were performed according to the clinical and laboratory standards institute (CLSI) guidelines.

Results: Of the total 19 Salmonella spp. isolates recovered by the BACTEC automated system, all belonged to the Salmonella enterica subsp. houtenae. Five isolates (26.5%) were resistant to azithromycin. Six (31.5%) isolates with the disc diffusion method and five (26.3%) with the agar dilution method displayed resistance to nalidixic acid (minimum inhibitory concentration [MIC] > 32 μg/mL). All nalidixic acid-resistant isolates were also ciprofloxacin-sensitive. All isolates were ESBL-negative. Twenty-one percent of isolates were found to be resistant to chloramphenicol (MIC ≥ 32 μg/mL), and 16% were resistant to ampicillin (MIC ≥ 32 μg/mL).

Conclusions: The results indicate that multidrug-resistant (MDR) strains of Salmonella are increasing in number, and fewer antibiotics may be useful for treating S. enterica infections. Routine investigation and reporting of antibiotic MICs in patients presenting with Salmonella infections is suggested.
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http://dx.doi.org/10.5812/jjm.26505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897598PMC
April 2016

Health care associated infections, antibiotic resistance and clinical outcome: A surveillance study from Sanandaj, Iran.

World J Clin Cases 2016 Mar;4(3):63-70

Jafar Soltani, Department of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj 6617713446, Iran.

Aim: To study the antibiotic susceptibility patterns of gram-negative healthcare associated bacterial infections at two tertiary hospitals in the Sanandaj city, Kurdistan Province, Iran.

Methods: From January 2012 to December 2012, all positive cultures from potentially sterile body fluids were gathered. They sent to professor Alborzi clinical microbiology center in Shiraz for further analysis and susceptibility testing. The antibiotic susceptibility was determined using the Kirby-Bauer method (disk diffusion technique). The Results were interpreted according to Clinical and Laboratory Standards Institute guidelines against a series of antimicrobials. World Health Organization definitions for Healthcare associated infections were followed.

Results: Seven hundred and thirty-two positive cultures were reported from both hospitals. Seventy-nine isolates/patients fulfilled the study criteria for health-care associated gram-negative infections. The most frequent bacterial cultures were from the pediatric wards (52%). Serratia marcescens (S. marcescens) (38%) Escherichia coli (E. coli) (19%), Klebsiella pneumoniae (K. pneumoniae) (19%), Acinetobacter baumannii (6%), Enterobacter species (6%), Serratia odorifera (4%) and Pseudomonas species (5%) were the most frequently isolated organisms. The susceptibility pattern of common isolates i.e., S. marcescens, E. coli and K. pneumoniae for commonly used antibiotics were as follows: Ampicillin 3.3%, 6.7%, 20%; gentamicin 73.3%, 73.3%, 46.7%; ceftazidim 80%, 73.3%, 33.3%; cefepim 80%, 86.7%, 46.7%; piperacillin/tazobactam 90%, 66.7%, 86.7%; ciprofloxacin 100%, 73.3%, 86.7%; imipenem 100%, 100%, 100%, respectively.

Conclusion: The most effective antibiotics against gram-negative healthcare associated infections are imipenem followed by ciprofloxacin. The resistance rate is high against ampicillin and cephalothin. The high mortality rate (46.1%) associated with S. marcescens is alarming.
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http://dx.doi.org/10.12998/wjcc.v4.i3.63DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792166PMC
March 2016

Post-Vaccination Disseminated Bacillus Calmette Guerin Infection Among Children in Southern Iran.

Jundishapur J Microbiol 2015 Nov 21;8(11):e25663. Epub 2015 Nov 21.

Professor Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.

Background: Disseminated bacillus calmette guerin (BCG) infection is a rare but life threatening complication of BCG vaccination. It has been mainly seen in severe immune deficiency. A precise and rapid diagnosis is crucial for prompt initiation of an aggressive anti-mycobacterial treatment. Polymerase chain reaction (PCR) is directly applicable to smear-positive clinical specimens, proven to be a rapid and specific diagnostic test.

Objectives: The aim of this study was to investigate disseminated BCG infection among 34 children in southern Iran, mainly confirmed by PCR.

Patients And Methods: We included all the patients hospitalized with disseminated BCG infection at a referral teaching hospital in southern Iran between years 1990 and 2007. The clinical and laboratory data including the immunological workups were obtained through a review of the medical files. We recalled all pathology samples from pathology specimen banks and used an in-house PCR specific for Mycobacterium bovis BCG substrain to confirm the diagnosis.

Results: From the total of 34 children hospitalized with disseminated BCG infection, 21 were categorized as definite and 13 probable. Thirty-one patients (91%) were under two years of age and 41% were male. The most common clinical findings were fever in 31 (91.2%), axillary's lymphadenopathy in 26 (76.5%), hepatosplenomegaly in 25 (73.5%), stunted growth in 21 (61.8%), and distant lymphadenopathy in 16 (47.1%). Polymerase Chain Reaction positivity rate was 100% (9 of 9) in bone marrow smear slides and 84.2% (16 of 19) for formalin-fixed and paraffin-embedded tissue specimens. Immunodeficiency state was detected in 50% and the overall mortality rate was 58.8% (20 of 34).

Conclusions: Disseminated BCG infection should be considered in the differential diagnosis of infants and young children with fever, hepatosplenomegaly, lymphadenopathy, and history of BCG vaccination. The PCR method has a high positivity rate and can serve as a useful tool for the rapid and specific identification of M. bovis BCG substrain infection.
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http://dx.doi.org/10.5812/jjm.25663DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740899PMC
November 2015

Isolation and Identification Enterobacter asburiae from Consumed Powdered Infant Formula Milk (PIF) in the Neonatal Intensive Care Unit (NICU).

Acta Med Iran 2016 Jan;54(1):39-43

Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Divison of Bacteriology, Department of Pathobiology and Microbiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Enterobacter asburiae (E. asburiae) is a facultative anaerobic, non-spore-forming gram-negative rod-shaped bacterium belonging to the family of Enterobacteriaceae. It is an opportunistic pathogen that its strains are isolated from a variety of clinical and environmental specimens. Since powdered infant formula milk (PIF) is not a sterile product, it is an excellent medium for bacterial growth. The aim of this study was to isolate and identify E. asburiae from PIF in the neonatal intensive care unit (NICU) and determine antimicrobial susceptibility patterns of this bacterium. A total 125 PIF samples were purchased from drug stores between June 2011 to March 2012. E. asburiae was isolated according to FDA method. For final confirmation, biochemical tests embedded in the API-20E system were used. The drug susceptibility test was performed using the disc diffusion method according to CLSI recommendations. Out of the 125 PIF samples investigated, 2 (1.6%) samples were positive for E. asburiae. All isolated strains were uniformly susceptible to aztreonam, cefotaxim, amikacin, streptomycin, nalidixic acid, meropenem, tetracycline, ceftazidime, and colistin. Variable susceptibility was seen to the some antimicrobial agents tested. Each country should categorize its own designed guidelines for the preparation and handling of PIF adapted to the local environment. Moreover, the pathogenesis of the E. asburiae in infants hospitalized in NICU and other groups such as immunosuppressed patients and HIV infected individuals is uncertain and requires further study.
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January 2016

Isolation and Antibiotic Susceptibility of the Microorganisms Isolated from Diabetic Foot Infections in Nemazee Hospital, Southern Iran.

J Pathog 2015 30;2015:328796. Epub 2015 Dec 30.

Department of Microbiology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.

Background. Diabetic foot infections (DFIs) are a major public health issue and identification of the microorganisms causing such polymicrobial infections is useful to find out appropriate antibiotic therapy. Meanwhile, many reports have shown antibiotic resistance rising dramatically. In the present study, we sought to determine the prevalence of microorganisms detected on culture in complicated DFIs in hospitalized patients and their antibiotic sensitivity profiles. Methods. A cross-sectional study was conducted for a period of 24 months from 2012 to 2014 in Nemazee Hospital, Shiraz, Iran. The demographic and clinical features of the patients were obtained. Antimicrobial susceptibility testing to different agents was carried out using the disc diffusion method. Results. During this period, 122 aerobic microorganisms were isolated from DFIs. Among Gram-positive and Gram-negative bacteria, Staphylococcus spp. and E. coli were the most frequent organisms isolated, respectively. Of the isolates, 91% were multidrug while 78% of S. aureus isolates were methicillin resistant. 53% of Gram-negative bacteria were positive for extended-spectrum β-lactamase. Conclusion. Given the involvement of different microorganisms and emergence of multidrug resistant strains, clinicians are advised to consider culture before initiation of empirical therapy.
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http://dx.doi.org/10.1155/2015/328796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710915PMC
February 2016

Nosocomial Infections: Multicenter surveillance of antimicrobial resistance profile of Staphylococcus aureus and Gram negative rods isolated from blood and other sterile body fluids in Iran.

Iran J Microbiol 2015 Jun;7(3):127-35

Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.

Background And Objective: Antibiotic resistance is increasing, especially in healthcare-associated infections causing significant public health concerns worldwide. National information is required to make appropriate policies, update list of essential drugs for treatment, and evaluate the effects of intervention strategies. A nationwide surveillance of antimicrobial resistant bacteria in nosocomial infections was established in Iran in 2008, so that the data obtained through the surveillance would enable us to construct a database.

Materials And Methods: Seven major teaching hospitals in Shiraz, Tabriz, Sari, Mashhad, Sanandaj, Ahwaz and Isfahan participated in this study. A total of 858 strains isolated from blood and other sterile body fluids were tested. Identification at the species level was performed with conventional biochemical methods and the API system. Susceptibility tests were done using disk diffusion method. The methicillin-resistance in S. aureus (MRSA) was determined by the oxacillin agar screen plate and respective MIC values were assessed using the E-test strips. The confirmatory disk diffusion methods were applied for phenotypic identification of extended-spectrum β- lactamase (ESBL) production for E. coli and K. pneumoniae, according to CLSI guidelines.

Results: Cultivation and re-identification of the strains yielded 858 isolates, consisting of 224 S. aureus, 148 Klebsiella spp., 105 Serratia spp., 146 E. coli, 67 Acinetobacter spp., 38 Enterobacter spp., 95 Pseudomonas spp., 71 P.aeruginosa. 35 Stenotrophomonas sp., and 8 other organisms. MRSA was detected in 37.5% of the isolates. No vancomycin-resistant or vancomycin-intermediate resistant S. aureus was detected. With the exception of Acinetobacter and Stenotrophomonas, 85% of the Gram-negative isolates were found to be susceptible in vitro to imipenem. Overall, about 61% of K. pneumoniae and 35% of E. coli isolates were ESBL producing.

Conclusion: Multidrug resistant isolates of Gram-negative organisms and methicillin-resistant strains of S. aureus have been detected in many hospitals in this study.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676981PMC
June 2015

Isolation of Methicillin-Resistant Staphylococcus aureus (MRSA) from HIV Patients Referring to HIV Referral Center, Shiraz, Iran, 2011-2012.

Iran J Med Sci 2015 Nov;40(6):526-30

Shiraz HIV/AIDS Research Center (SHARC), Shiraz University of Medical Sciences, Shiraz, Iran ; Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Extension of drug resistant Staphylococcus aureus strains is one of the problems of modern society. Presence of methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected individuals is an important cause of severe infections. Therefore, the main goal of this study was to determine the prevalence rate of MRSA carriage rate among HIV patients referring to the Shiraz HIV referral center (Shiraz, Iran) during 2011-2012. Nasal swabs were obtained from HIV positive patients and were cultured on differential and selective media to isolate Staphylococcus aureus, which was confirmed by standard biochemical tests. For isolation of MRSA isolates, bacterial suspensions were cultured on Muller-Hinton Agar containing NaCl and Oxacillin. Finally, data were analyzed by the SPSS software. Of 180 HIV patients, MRSA was isolated from nasal cavity of 23 (12.8%) patients. Most of the isolates were recovered from male subjects who were under 40 years old. No variables such as skin disease, history of hospitalization or infectious disease had significant association with the MRSA colonization rate. The presence of MRSA isolates in the nasal cavity of HIV patients in such a rate warns us about the potential spreading of MRSA among HIV patients in our society and emphasizes on establishing better prevention strategies.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4628144PMC
November 2015

Characterization of Shiga-toxin producing E.coli (STEC) and enteropathogenic E.coli (EPEC) using multiplex Real-Time PCR assays for stx1 , stx2 , eaeA.

Iran J Microbiol 2014 Jun;6(3):169-74

Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Background And Objective: Diarrheal disease is still a major health problem, especially in developing countries, where it is considered as one of the leading causes of morbidity and mortality especially in children. Studies showed that Diarrheagenic E. coli (DEC) such as STES and EPEC strains are among the most prevalent causative agents in acute diarrhea, particularly in children. Aim of the present study was to investigate the presence and the frequency of STEC and EPEC as etiologic agent of diarrhea in children less than 2 years of age with diarrhea in Shiraz.

Materials And Methods: A total of 285 stool samples were collected from patients with diarrhea in Shiraz, in 2012. Diarrheagenic E. coli (DEC) strains were isolated by standard biochemical analysis. In this study, we used multiplex Real time PCR and single PCR to detect the presence of indicator genes stx1 , stx2 and eaeA for STEC and EPEC strains, respectively.

Results: A total of 285 stool samples were tested in which 49 (17%) were identified as contaminated with E. coli by biochemical tests. Out of total samples, 15 STEC (31%) and 13 EPEC (27%) were identified using multiplex Real-Time PCR assay. Among STEC isolates, 2 strains were stx1 (+), 8 isolates stx2 (+), 3 isolates were stx1 (+) , stx2 (+) and 2 isolates were stx1 (+) , stx2 (+), eaeA (+).

Conclusion: In this study, we found rather high occurrence of STEC and EPEC virulence genes in children with diarrhea. The results of this study showed that, real time PCR can be used as a replacement for conventional PCR assay in the detecting virulence genes of STEC and EPEC strains. Real-time PCR offers the advantage of being a faster, more robust assay, because it does not require post-PCR procedures to detect amplification products.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393493PMC
June 2014

Effects of probiotic Lactobacillus acidophilus and Lactobacillus casei on colorectal tumor cells activity (CaCo-2).

Arch Iran Med 2015 Mar;18(3):167-72

Immunology Researches Department, Avicenna Research Cente, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: The probiotic microorganisms are live normal flora that provide nutritional benefits. When probiotic administered in adequate amounts, they also confer a health benefit on the host. Different mechanisms of probiotic effects include the following: stimulating the immune system, modifying the composition of normal intestinal flora and preventing the carcinogenic activity of fecal enzymes. In this study, direct effects of probiotic lactobacilli on tumor cells were investigated.

Methods: Supernatants and bacterial extracts of two standard Lactobacillus species (L. acidophilus and L. casei) were prepared and CaCo-2 cells were treated with them. Probiotic effects on cell proliferation, necrosis, apoptosis, migration and invasion were assessed.

Results: The supernatants of Lactobacilli decreased cell proliferation and increased cell apoptosis, however, no significant effect on cell necrosis was reported. In contrast, Lactobacilli extract, reduced cell proliferation and increased cell apoptosis. Lactobacilli extract also led to cell necrosis. Furthermore, both supernatants and cell extracts of the probiotic agents resulted in decreased cells' migration and invasion.

Conclusion: In this study, it was shown that Lactobacilli probiotics useful effects are not confined to the enhancement of the immune system; however, they effectively suppress the malignant phenotypes of colorectal cancer cells.
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http://dx.doi.org/0151803/AIM.006DOI Listing
March 2015

Isolation and Identification of E. cowanii from Powdered Infant Formula in NICU and Determination of Antimicrobial Susceptibility of Isolates.

Iran J Pediatr 2014 Jun;24(3):261-6

Department of Bactriology, Department of Pathobiology and Microbiology, School of Public Health ; Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Enterobacter cowanii is a genus of common gram-negative, facultatively anaerobic, rod-shaped, non-spore-forming bacterium of the Enterobacteriaceae family. This organism can be potentially a powdered infant milk formula-borne opportunistic pathogen. The aim of this study was to isolate and identify E. cowanii from consumed powdered infant formula milk (PIF) in intensive care units (NICU) and to determine antimicrobial susceptibility patterns of this bacterium.

Methods: E. cowanii was isolated according to FDA method in 125 samples of PIF milk purchased from drug stores between Jun 2011 and March 2012. For final confirmation, biochemical tests embedded in API-20E system were used. The drug susceptibility test was performed using the disc diffusion method according to CLSI recommendations. Findings : Out of the 125 PIF samples investigated, 4 (3.2%) samples were positive for E. cowanii. All four isolates from PIF samples were uniformly susceptible to imipenem, meropenem, ceftazidime, ciprofloxacin, and colistin. Fifty percent of isolates were resistant to ampicillin, amoxicillin, and cotrimoxazole Conclusion: Analysis of the results indicated that complementary studies are necessary to clarify the possible role of E. cowanii as a food contaminant, in common NICU infections and high risk groups including persons with underlying disease and immunocompromised individuals.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276579PMC
June 2014

Isolation, Identification and Antimicrobial Susceptibility Pattern of Tatumella ptyseos Strains Isolated From Powdered Infant Formula Milk Consumed in Neonatal Intensive Care Unit: First Report From Iran.

Jundishapur J Microbiol 2014 Jun 1;7(6):e10608. Epub 2014 Jun 1.

Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.

Background: Tatumella ptyseos is a rod-shaped, Gram-negative, facultative, and anaerobic bacteria categorized in the Enterobacteriaceae family. It is a rare food-borne opportunistic pathogen which causes neonatal sepsis, bacteremia, and urinary tract infections. T. ptyseos has been also cultured from various food sources around the world.

Objectives: It is difficult to determine the source of the infection in the patients (especially newborns) due to low information about the epidemiology of T. ptyseos. The current study aimed to investigate the isolation, identification and antimicrobial susceptibility pattern of T. ptyseos strains from the consumed powdered infant formula milk (PIF) in hospital neonatal intensive care unit (NICU).

Materials And Methods: A total of 125 powdered infant formula milk (PIF) samples were purchased from drug stores from June 2011 to March 2012. T. ptyseos was isolated according to food and drug administration (FDA) method. For final confirmation, biochemical testes embedded in API-20E system were used. Drug susceptibility test was performed using the disc diffusion method, according to clinical and laboratory standard institute (CLSI) recommendations.

Results: Results of the study showed that, out of 125 samples, T. ptyseos was isolated from four (3/2%) PIF samples. All isolated strains (100%) were resistant to ampicillin, carbenicillin, cotrimoxazole and amoxicillin.

Conclusions: The present study was the first report on the isolation and identification of T. ptyseos from PIF in Iran. T. ptyseos are frequently present in various kinds of foods; therefore, further investigation on these samples is required. It is necessary to track the T. ptyseos in a wide variety of foods and individuals especially in immunocompromised people such as human immunodeficiency virus (HIV)-positive patients to reveal the possible routes of transmission of this pathogen to humans. In addition, molecular studies are required to determine the genetic relationship between T. ptyseos strains isolated from different sources.
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http://dx.doi.org/10.5812/jjm.10608DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217668PMC
June 2014

Burn Patients Infected With Metallo-Beta-Lactamase-Producing Pseudomonas aeruginosa: Multidrug-Resistant Strains.

Arch Trauma Res 2014 Jun 1;3(2):e18182. Epub 2014 Jun 1.

Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.

Background: Metallo-beta-lactamase (MBL) producing Pseudomonas aeruginosa in the burn patients is a leading cause of morbidity and mortality and remains a serious health concern among the clinicians.

Objectives: The aim of this study was to detect MBL-producing P. aeruginosa in burn patients and determine multidrug-resistant (MDR) strains, and respective resistance patterns.

Patients And Methods: In this cross-sectional study, 270 strains of P. aeruginosa were isolated from the burn patients referred to Ghotbeddin Burn Hospital, Shiraz, Iran. Among them, 55 MBL-producing P. aeruginosa strains were isolated from 55 patients hospitalized in burn unit. Minimum inhibitory concentrations (MICs) and MBLs were determined by the E-test method.

Results: Of the 55 burn cases, 29 (53%) were females and 26 (47%) males. Injured burn patients' ages ranged from 16 to 87 years, with maximum number of cases in the age group of 16 to 36 years (n, 40; 72.7%). Overall, 32 cases were accidental (60%), and 22 were suicidal burns (40%). Of the 55 burn patients, 17 cases were expired (30%). All deaths were due to chemical exposures. In antibiotic susceptibility testing by E-test method, ceftazidime was the most effective one and 35 isolates (63.5%) were resistant to all the 11 tested antibiotics.

Conclusions: Routine microbiological surveillance and careful in vitro testing of antibiotics prior to prescription and strict adherence to hospital antibiotic policy may help to prevent, treat, and control MDR and pandrug-resistant (PDR) P. aeruginosa strains in burn units.
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http://dx.doi.org/10.5812/atr.18182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139692PMC
June 2014
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