The current study aimed at finding the frequency of MRSA infections، contamination، and colonization in the teaching hospitals of Karaj city، Iran for the first time.

The current cross sectional study was conducted in Karaj on three teaching hospitals from July 2013 to July 2014. Sample collection from personnel and surfaces was conducted twice and monthly، respectively، during the study period. Also، all Staphylococcus aureus species isolated from patients were included in the study. Antimicrobial susceptibility test was performed by the standard disk diffusion method. All isolates were subjected to mupA and mecA-specific polymerase chain reaction (PCR)to identify high-level mupirocin-resistant and MRSA isolates، respectively. Chi-square test was employed for data analysis.

The majority of S. aureus species were isolated from personnel and surfaces of the hospitals. One hundred sixty-eight S. aureus and 49 MRSA species were isolated from Karaj teaching hospitals. The main frequency of MRSA was isolated from intensive care unit (ICU) (75%) and high rate of resistance to rifampicin (53%) was observed in MRSA isolates. Although 10 S. aureus species were resistant to mupirocin by disk diffusion، no mupA gene was detected in the isolates.

In conclusion، in comparison with the other studies from Iran، low frequency of MRSA was observed in the investigated hospitals. However high frequency (75%) of MRSA in ICU indicated that antibiotic policy is urgently needed to prevent the resistance development. Moreover، antibiotic susceptibility monitoring and regular screening surfaces and personnel of hospitals in terms of MRSA colonization، especially ICU، are indispensable.

Animal bite is an emerging public health problem. Annually، in different parts of the world، more than 15 million people are treated for animal bites. Each year، 140 cases of animal bites per 100،000 population are estimated to occur in Iran، more than 85% of which are dog bites.

The aim of this study was to investigate the epidemiology of animal bites during years 2011 and 2013 in the East of Ahvaz county.

This was a descriptive cross-sectional study performed on whole cases of animal bite registered at the health center of Eastern Ahvaz، Southwestern Iran. According to the current study، a “bitten person” is bitten by an animal، and refers to the rabies prevention centers due to animal bites and fear of rabies. During a three-year period، through a questionnaire-based study، 2493 bitten individuals were enrolled in the research. In this respect، for all cases، demographic and epidemiological data، such as treatment، biting animals، age، gender، occupation، place of residence، month of the year، season and biting site on the body were recorded. Descriptive statistics، including frequency distribution and percentage were used to analyze the data. The analysis was performed using the SPSS version 18 software.

The highest number of bitten individuals were recorded during year 2012. Out of 2493 bitten individuals، 76.6% were male and 23.4% were female. Bites were most frequent among the age group of 21 to 30 years old. Most cases (24.7%) were self-employed. in total، 65% of animal-bite incidents were in the city and 35% were in rural areas. The cases were mostly related to dog bites (78.4%) and cat bites (17.3%)، respectively. Moreover، 100% of cases were vaccinated within the first 24 hours، 61.4% had incomplete while 38.6% had complete vaccination. Lower extremities were the most frequent bite site (46.9%) followed by upper extremities (41.6%)، head and neck (5.7%)، and trunk (5.8%). Animal bites were more common during spring (26.7%) and autumn (25.2%). Maximum number of incidents were reported during the month of April (9.2%) and July (9%).

Dogs were the most common animals causing this problem. Control of stray dog population by animal birth control and domestic animal vaccination is needed. Meanwhile، training people at risk can play an important role in reducing the incidence of animal bites and rabies.

Brucella canis، a member of Brucella species، has been reported as a cause of human brucellosis in a few cases، and routine serologic tests do not identify this species. In spite the fact that Iran is an endemic area for brucellosis، there has not been any report of human brucellosis due to B. canis.

The patient was a 68-year-old female with complaints of fever، foul smelling urine، malaise، vomiting، and arthralgia. Considering significant leucocytosis and pyuria، positive urine culture antibiotic therapy was initiated for urosepsis. However، due to non-suitable response to antibiotic and negative serologic study for brucellosis، supplemental assessments، including bone marrow aspiration and biopsy (BMA&B)، were performed to study malignancy، tuberculosis، and brucellosis. Brucella canis was isolated from BACTEC media and subsequently confirmed by polymerase chain reaction test.

Considering the ineffectiveness of routine serologic study for diagnosis of B. canis in the presence of clinical presentations suggestive for brucellosis، blood or BM culture should be considered.

Hib conjugate vaccine has led to more than 90% decline in the prevalence of severe Hib diseases in countries with universal coverage vaccination program. After the addition of Hib vaccine to the national vaccination program with 3P (three doses of 2، 4، and 6 months) in IR Iran، we decided to study the vaccine efficacy after the last dose of vaccine in Iranian children in 2016.

500 blood samples were collected from one-year-old children who referred to the health care centers in Karaj. Demographic information was gathered by a questionnaire. Blood samples were sent to a laboratory for antibody titer determination by ELISA method.

41.2% of the children (95% CI: 36.89 - 45.51) had a titre of IgG against Hib (0.15 to 1 µg/mL) (short-term protection) and 57.4% of the children had a titre of IgG against Hib (95% CI: 53.07 - 61.73) equal to or greater than 1 µg/mL (long-term protection). Antibody GMT was 6.92 µg/mL (95% CI: 6.76 - 7.08). There was no significant correlation between the titer of H. influaenza antibody and demographic factors.

In spite of the acceptable GMT titer، children who had antibody titer of < 1 µg/mL comprised approximately 40% of the study population، showing the necessity of further investigation to assess the need for H.flu booster administration.

Nowadays، nanocarriers are used for leishmaniasis treatment due to development of drug resistance and several side effects with conventional therapeutics.

In this study we aimed to evaluate in vivo effects of four synthesized nanodrugs including amphotericin B-nanochitosan (AK)، betulinic acid-nanochitosan (BK)، amphotericin B-dendrimer (AD)، and betulinic acid-dendrimer (BD) in the treatment of Leishmania major infection (L. major) in mice model by using pathological analyses to choose the most effective nanodrug in leishmaniasis.

The four nanodrugs efficacy in the improvement of L. major lesion in a mice model was evaluated by using pathological analyses including measurement of organs size and parasite number. Additionally، the nanodrugs toxicity was evaluated by measurement of various blood factors.

The histopathological results of the present study showed that BK، at the dose of 20 mg/kg، and AK، at the dose of 10 mg/kg، were more effective in decreasing the parasite number in the kidney، liver، and spleen. Moreover، BK20 mg/kg and AK10 mg/kg decreased the organs size significantly while AD50 mg/kg and BD40 mg/kg were less effective. However، none of the four nanodrugs had increased the blood factors and they were not toxic.

Overall، the pathologic findings of various mice organs treated with different formulations showed that AK10 mg/kg and BK20 mg/kg were more effective in recovery of L. major’s pathological effects in comparison to AD50 mg/kg and BD40 mg/kg. Therefore، it seems that AK and BK، in this mentioned dosage، could be considered as a proper candidate for treatment of leishmaniasis.

High mortality herpes simplex virus encephalitis (HSVE) presents with fever، headache، changes in personality، focal neurologic findings، and epileptic attacks. It causes common destruction in brain parenchyma with necrotic، inflammatory and hemorrhagic lesions، and neuron losses. Central nervous system vasculitis during HSV infection can develop strokes especially related to both hemorrhagic and ischemic reasons. Ramsay-Hunt syndrome (RHS) is characterized by the re-activation of the latent varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve; it presents with peripheral facial nerve paralysis. Neurogenic pulmonary edema is the situation of respiratory failure occurring hours after the serious neurogenic incident without other reasons causing lung edema، which is developed by increase in sympathetic activity، and progressed by increase in alveolar and interstitial fluid. In the current study، a patient with developed neurologic pulmonary edema with ischemic stroke status as a result of cerebral hematoma and middle cerebral artery (MCA) ischemia following HSVE was followed up and a patient that developed anterior cerebral artery (ACA) and MCA territory infarction after RHS was mentioned.

Fever of unknown origin (FUO) remains a clinical challenge in both emergency and infectious diseases departments. Being clinically updated on probable etiologies helps physicians to narrow their diagnostic and treatment approach.

This study aimed to assess the causes of FUO in an academic setting in the recent 5 years to update the clinicians.

In a cross-sectional study، the files all patients with the primary diagnosis of FUO were extracted and evaluated. The records were assessed with regard to patients & rsquo; age، gender، days of fever before admission، time of admission and discharge، clinical course of the disease، laboratory and other para-clinical findings were documented. The patients were then classified based on the etiology of the disease and the type of test utilized for the diagnosis. Median and frequencies were used for descriptive variables; chi-square test was performed for correlation analysis.

From March 2009 to April 2014، 101 patients were admitted and their files were recruited for the purpose of this study. The median age of our patient population was 39. Infections (23.1%) and non-infectious inflammatory diseases (21.1%) constituted the most common known causes of fever in our patient population. Invasive tests had been documented for 41.1% while non-diagnostic in 20%. Non-invasive tests leading to final diagnoses were performed for 48.4%. There was a significant association between the type of the utilized test for diagnosis and different etiologies of FUO (P = 0.001).

Similar to global trends، non-infectious inflammatory diseases comprised an increasing share of the causes of FUO. However، tuberculosis remains an important infectious cause that may present with FUO or simply be overlooked in primary patient visits. Updating a local database for the causes of FUO in hospitals at certain time intervals may facilitate the diagnostic approach.

Methicillin-resistant Staphylococcus aureus (MRSA) has been considered as an important pathogen with a variety of virulence factors in communities and hospitals worldwide.

In this study، we focused on the detection of different virulence factors and enterotoxin genes of MRSA strains isolated from a referral hospital in Tehran، Iran. Moreover، the presence of different prophage types was studied.

A total of 491 MRSA strains were isolated during three years from a referral hospital in Tehran. The staphylococcal enterotoxin (sea-seq) and pvl، hlb، sak، eta and tst genes were detected. A multiplex-polymerase chain reaction (PCR) assay was used for prophage typing of MRSA isolates.

Totally، 11 enterotoxin and 5 virulence factor genes were detected in MRSA strains. The sea، sek، seq، and hlb genes were present in all the MRSA and other enterotoxin genes. sel، seg، sem، sei، sen، seo، sec and sep were detected in 32.8%، 20.3%، 12.6%، 8.3%، 4.1%، 2.6%، 1.6% and 0.4% of the strains، respectively. A total of 93%، 81%، 15.9% and 5.7% of the strains harbored the sak، eta، tst and pvl genes، respectively. SGF، SGFa and SGFb proghage type genes were detected in 100% of the MRSA strains، and four different prophage patterns were identified among the strains.

The presence of different prophage-encoded virulence factors among MRSA strains enable MRSA to produce a broad range of diseases، indicating MRSA strains as a potential threat to patients’ health.

Cross-contamination between patients and the medical imaging device is a worldwide concern. In the current study، the ability of different molecular typing methods for differentiation of Clostridium difficile isolates from patients and medical devices was compared to show their discriminatory power for molecular epidemiological purposes.

A total of 23 C. difficile strains from fresh stool samples of patients subjected to colonoscopy، medical device، and environmental samples of a gastroenterology unit were used for molecular typing. Similarity of the strains was determined by the polymerase chain reaction (PCR) ribotyping، capillary gel electrophoresis based-ribotyping، and RAPD-PCR and ERIC-PCR methods. Phylogenetic analysis of the molecular patterns was done by the GelCompar II software and discriminatory power of the methods was measured using Simpson’s index diversity.

RAPD-PCR and PCR-ribotyping methods showed the highest discrimination power for differentiation of the studied strains، while genotyping showed the lowest power. Similarity of C. difficile strains between the patients and medical equipment was detected for the strains presenting PCR-ribotypes B and CE-ribotype 150.

Involvement of medical device for transmission of toxigenic strains of C. difficile was determined in this study. Although diversity of C. difficile strains was established in the studied hospital، a discrepancy was detected among these techniques for typing purposes. The results suggested the usage of a combination of two or more typing methods for detection of sources of cross-contamination in each hospital.

Cervical cancer is currently among the most important causes of cancer-related deaths in women. The development of cervical cancer is associated with high-risk human papillomavirus (HPV) infections and a series of epigenetic changes in host cell genome، such as histone acetylation. Furthermore، decreased E-cadherin level has been shown to play a critical role in cancer cell invasion and metastasis. Oxamflatin has been reported to have anti-cancer efficacy.

We aimed to study the effect of this drug on cervical cancer cell lines، HeLa cells، by assessing E-cadherin level as a marker of cancer invasion susceptibility.

HeLa cells were treated with oxamflatin، and total RNA was obtained. Then، quantitative real-time polymerase chain reaction (PCR) was performed to evaluate E-cadherin expression level in cells treated with oxamflatin.

The findings of real-time PCR indicated that oxamflatin increased E-cadherin level in a time- and concentration-dependent manner. The level of E-cadherin significantly increased at the concentrations of 4 mM (for 24 hours after treatment) and 2 and 4 mM (for 48 hours after treatment) in comparison with corresponding control HeLa cells.

The present study proposed that oxamflatin may have anti-migratory and anti-invasive potential against cervical cancer cells، which should be further evaluated in future studies.