فهرست مطالب شیلا جلال پور

Immunology is the science of prevention of entry and encounter with internal and external antigenes, with the aim of preserving the body's natural homeostasis. Due to the importance of immunology in prevention and treatment of diseases and concerning the multiplicity of published journals in this field, this study was performed to introduce the most prestigious specialized immunology journals for the first time for Persian language readers. This descriptive study was conducted in 2018 at Rafsanjan University of Medical Sciences. The list of immunology journals was extracted from the SCImago Journal & Country Rank (SJR) and Journal Citation Reports (JCR) WebSites. For this purpose, in the "Subject Area" of the SJR website “Immunology and Microbiology” words and in the "Subject Category" “Immunology” word and in the "Select Categories" of JCR website “Immunology” word were searched. The Journals’ list extracted from SJR and JCR contained 209 and 155 Immunology journals, respectively. Considering the high number of specialized journals in immunology, the journals containing the term of “immunology” in title were studied. The investigated information of the journals included journal’s name, country of presentation, publisher, subject of coverage, the most important indexes of the journal, date of publication of the journal, hirsch index, duration of publishing, and impact factor in 2018. According to the entry of clinical basic field in immunology, a lot of journals published in this science and consequently, immunology journals are categorized in two clinical and basic groups. Despite the high number of immunology journals, most journals tend to publish research and specialized articles.

Prestigious journals are the most important tool for the transfer of scientific information, Physiology is the science of living organisms and medical physiology is the most important branche of physiology. The first step for publishing a paper is identifying specialized journals. Considering the importance of the point, the present study aimed to introduce the most prestigious journals in medical physiology for the first time.
Present descriptive study was conducted in 2016 at the Medical faculty of Rafsanjan University of Medical Sciences. Medical physiology Journals were surveyed in the Scientific Journal Rankings. For this purpose, medicine word in the "Subject Area" and physiology (Medical) word in the "Subject Category" were searched. The journals list extracted from SJR, contained 97 titles. After reviewing the journals titles, 26 journals contained physiology term in their titles. In addition, 17th related physiology journals were also studied. Study information included: name of the journal, country presented the journal, publisher, subject of coverage, important journal indexing, date of publication, Hirsch index, duration of publishing, and impact factor.
Physiology journals publish articles in both general and specific areas. Usually research articles are published in the all, while the review articles are published in the journals which mention “reviews” in their titles.

Studies in the health sciences is comprised of observational and intervention. A major part of health sciences research has been allocated to the observational studies. Designing and doing studies based on scientific guidelines that include the entire process, leads to studies validation and also results can be generalized to the community. Thus, for standardizing the scientific and observational studies, a statement entitled "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) was presented. The purpose of drafting a STROBE statement, is making recommendations to clarify the design, methods, and findings of observational studies and is not requiring researchers to follow a particular methodology. In other words, the purpose of the STROBE statement is better "reporting" of observational studies and not better "doing". According to the importance of designing and scientific reporting of observational articles, this study was performed for presentation of the STROBE statement, history, goals, and weaknesses for Persian speaking readers.
To verify the STROBE statement, STROBE website and published articles on the evaluation of STROBE effectiveness and related articles were studied.
The results of this study showed the lack of adequate use of STROBE statement in the articles published after the presentation of this statement.
Knowledge of the scientific standards for reporting research in Iran to enhance the academic standing and the quality of research, leads to improved academic standing of the Iranian specialists in the world.

Interventional clinical trial is the study in which the participants are simultaneously placed in the intervention and control groups to investigate the cause-effect relationship between an intervention and an outcome. Because of the probability of some bias in human intervention, non-standard clinical trials design produce unreal interventional results. For standardizing the clinical trials, Consolidated Standards of Reporting Trials (CONSORT) statement was presented that is a guideline including the design, implementation and reporting of the results. CONSORT statement includes a flowchart and a Flow Diagram. CONSORT statement has a 25-item list that describes how to write a title, abstract, introduction, methods, results, discussion, registration, and access study protocol and sources of research funding. In the Flow Diagram of CONSORT, the way to access the participants, along the study, is taken into consideration. Of the importance of clinical trials on new diagnostic and therapeutic methods, present study was conducted to survey and evaluate the performance of CONSORT statement.

Today, understanding of systematic reviews and meta-analyses and their practical use is essential for who concerned with society's health. Most of the medical reports invoked to these reviews and statements and it is necessary for scientific experts to be familiar with their performing rules and the way of their writing. The basic sciences specialists and clinical professionals study them to keep up the level of their knowledge on the fields of interest.These articles are often seen as the beginning of the developing clinical guidelines for organizations that provide facilities to carry out a research and it is used to verify and justify further investigation. Some of the journals in the field of health adjust their publishing to this direction. Like other researches, Value of the systematic reviews and meta-analyses of the literature is to answer three questions: 1- what has been done? 2- what has been proven? and, 3- how has been it arranged? Systematic review and meta-analysis of basic sciences and clinical medicine could manage the problems of health system and formulate the guidelines for the collection and conclusions of the completed research, which is contributed to a specific subject or question. Iran is in the position of nineteenth among leading countries in publishing scientific journals related to review and meta-analysis articles. Guidelines developed at the PRISMA; Preferred Reporting Items for Systematic Reviews and Meta-Analyses, included a checklist and a flow chart. Therefore, the present study aimed to inform the Persian language researchers to publish their writing according to PRISMA statement.

The most important goal of clinical researches is publishing the results in order to improve human health. If the results will be accepted by the scientific community، researcher aim would be achieved at improving public health. A published article does not guarantee the acceptance of its findings by the scientific community، hence، research should be done by considering a scientific plan. Due to the increasing amount of research studies، experts attempted to provide guidelines for standardization of a piece of scientific medical research. Researches related to the diagnostic tests، are important studies in medical sciences، it is because of their critical role in detection of many diseases by using laboratory processes such as microbiology، immunology، pathology، etc. Early diagnosis of diseases results in developing the treatment process and therefore controlling and inhibiting the spread of pathogens from patients to others. With regard to the fact that Iran placed among the 30 countries leading in publication of scientific journals related to diagnostic tests and according to important role of standardization of research design and final report of diagnostic tests، the present study was performed to introduce the STandards for the Reporting of Diagnostic accuracy studies (STARD).

Publishing articles in specialized journals that are prestigious indexing with international distribution have led scientists to validate the results of the research area. In this case, it may increase and promote the situation of the scientist and the country that research has been done in it. Considering the importance of this issue, the present study aimed to investigate, for the first time, and introduce the most prestigious journals in medical microbiology. A descriptive study was conducted in 2014 in Rafsanjan University of Medical Sciences. Identifying the Journals of Medical Microbiology performed according to online information sources; Bibliographic databases: Medline, Scopus, Cochrane and EMBASE, Electronic-journals: OVID and MEDLIB, Search engines: Google Scholar and MedlinePlus. After collecting of the Journals from mentioned sources, the 41 most relevant and reiterative journals were selected and withdrawn the duplicate titles. Important information of journals including; name of the Journal, publisher, editor in chief, subject coverage, types of published articles, indexing, abstracting, oldness of the journal,, Hirsch index, duration of publishing, impact factor, number of articles have been published in last issue and the journal website were surveyed. Updating the data of the special journals, reviewing articles, which have been published in recent issues, specially; compliance requirements in the journal, resource utilization "valid and up to date" and also the use of expert and well-known researchers in case of journal selection, may lead to increase the chance of researchers to publish their papers in the prestigious -specialized journals.

Nosocomial infections (NIs), also called hospital-acquired infections are  infections acquired during hospital care which are not present or incubating at  admission. Nosocomial infections remain a major global concern in all countries. Health  care settings are an environment where both infected persons and persons at increased  risk of infection congregate. Patients with infections or carriers of pathogenic  microorganisms admitted to hospital are potential sources of infection for patients and staff. Staff hands and hospital surfaces have important role in produce and controlling nosocomial Infections.

Related papers to importance of staff hands and hospital surfaces in nosocomial infections were extracted of articles in Pubmed, Elsevier Science, and Yahoo from 1995 to 2010 years.
For this study key words which were search include hospital surfaces, staff hand, nosocomial infection and infection control.

About importance of staff hands and ho spital surfaces in nosocomial infections in all of similar original and review articles, there is consensus that control of Bacterial population in these
sources, lead to reduce and control of transfer and spread of Bacterial in hospital and finally nosocomial infection.

Hospital surfaces can serve as reservoirs of potential pathogen Bacteria and have important role in infection chain. Bacteria on hospital surfaces have low potential to spread. Staff hands have very contact with hospital surfaces, especially high contact surface, and are more sources to transmission and spread Bacteria into hospital. Staff Hand and hospital surfaces hygiene has been considered to be the most important tool in NI control.

β-lactamase is an enzyme that can inactivate β–Lactam family antibiotics. High prevalence of β-lactamase producer bacteria on the staff hands, due to antibiotic resistance and nosocomial infection in hospitalized patients. The objective of this study was to assess the frequency of β-lactamase positive bacteria and antibiogram pattern in bacterial flora isolated from staff hands of the Al-Zahra hospital in Isfahan. This laboratory research was performed during of 2005-2007 in Al-Zahra hospital in Isfahan. According to statistical formula, we randomly selected 80 samples from staff hands. Staff hand samples collected with finger print method. Bacterial identification was performed with microbiological methods and β–lactamase production was performed with Acidometric method and antibiogram pattern was performed with Kirby Bauer method. According to the acidometric test results of 80 isolated staff hands, 61.85% of strains produce β–lactamase. Staphylococcus spp., Bacillus spp. and Enterobacteriaceae were the most important producers respectively (70.83%, 64.72% and 50%). According to antibiogram test results, penicillin and vancomycin had the highest and lowest resistance. High frequency of β–lactamase in bacterial survey represents colonization of bacteria in staff hands; may be due to facility transmission β–lactamase plasmid genes in bacteria. We suggest better hand washing in hospitals and prescription of β–lactame antibiotics was based only on antibiogram results.

Bachground and Hospital surfaces can serve as reservoirs of potential pathogen bacteria. Staff hands are the most important source of transmission in hospital. The prevalence of β–lactamase producer bacteria in staff hands and hospital surfaces, increase antibiotic resistance nosocomial infection. The aim of this study was to survey the spread of beta-lactam resistance Staphylococcus sp. in Al-zahar hospital in Isfahan. The research was carried out during 2005-2007 years in Al-zahra hospital in Isfahan. Overall, 274 samples (194 strains from surface and 80 strains from staff hands).The surface samples collected by using swab in Nutrient Broth (NB) and staff hand samples collected using Finger Print method. Bacterial identification was performed by Bacteriological methods, β–lactamase production by acidimetric method and antibiogram pattern by Kirby Bauer method. Of 194 strains isolated from hospital surfaces, 105 (53.7%) strains, and of 80 strains isolated from staff hands, 28 (35%) are related to Staphylococcus sp. According to acidimetric test, 79.8% of S.aureus strains and 68.55% of S.epidermidis strains produce β-lactamase. Results show high frequency of antibiotic resistance and β– lactamase producer Staphylococcus sp. on staff hands and hospital surfaces. Reduction of bacteria in these sources is the most important manner to control transfer of virulence agents in bacteria and create of antibioticresistant strains.

Urinary tract infection (UTI) is the second most common infection in human. Klebsiella pneumoniae is an opportunistic pathogen bacteria, that accounts for nosocomial infections. Prevalence of extended-spectrum beta lactamase (ESBLs) in K. pneumoniae strains led to the spread of antibiotic resistance and mortality in patients. This study was done to evaluate the resistance to antibiotics in K. pneumoniae isolated from urinary tract infections. This study was performed in Alzahra, Shariaty, Kashany, Mahdieh hospitals and References laboratories during 2009-2010 in Isfahan. According to statistical formula, 378 urine samples of patients with UTI were evaluated. Bacterial identification was performed with microbiological methods, including gram staining, differential environment and ESBLs production with screening and confirmatory tests. Antibiotics resistant pattern was performed with Kirby Bauer method. From 378 sample, frequency of ESBLs in K. pneumoniae strains isolated in hospitalized and out patients was 64% and 22% respectively. According to antibiogram results 90.5%, 65%, 57.1%, 60%, 31.6%, 0%, 35%, 78.6% and 19% of K.pneumoniae strains isolated in hospitalized patients were resistant to Ampicillin, Ceftazidime, Cefotaxime, Cefepime, Amikacin, Imipenem, Ciprofloxacin, Trimethoprim/ Sulfamethoxazole and Nitrofurantoin respectively and 70.6%, 41.7%, 24%, 15%, 0%, 21.4%, 28.6%, 18.5%, 25.9% and 34.6% of K. pneumoniae strains isolated in out patients were resistant to Ampicillin, Cefazolin, Ceftazidime, Cefotaxime, Amikacin, Gentamicin, Nalidixic acid, Ciprofloxacin, Trimethoprim/ Sulfamethoxazole and Nitrofurantoin. The results showed that frequency of ESBLs and antibiotic resistant in isolated bacteria from hospitalized patients was more prevalence than isolated bacteria from out patients. Perhaps the most important reason for this problem is unidentifying of ESBLs producer strains in laboratories and cephalosporins and Aztreonam prescription in UTI patients.

Urinary Tract Infection (UTI) is the second most common infection in human. Most of UTIs are due to Escherichia coli (E.coli) and Klebsiella pneumoniae (K.pneumoniae). These bacteria are relevant opportunistic pathogens that account for nosocomial infections. Prevalence of Extended-Spectrum Beta-lactamase (ESBLs) in pathogenic bacteria leads to antibiotic resistance and mortality and morbidity in patients. The best method for controlling strains that produce ESBLs is use of standard method for recognizing ESBLs producer strains. The objective of this study was to evaluate and compare the frequency of ESBLs in Escherichia coli and Klebsiella pneumoniae strains isolated from hospitalized and out-patient with urinary tract infection in selective centers from Esfahan. The research was of descriptive type and performed in Al-zahra, Shariaty, and Kashany hospitals and Reference and Mahdieh laboratories during 2009-2010 in Isfahan. According to statistical formula 378 UTI samples were randomly selected. Bacterial identification was performed with microbiological methods and ESBLs production was performed with screening and confirmatory test. For data analysis, Chi square test and Whonet 5.4 software was used. From 378 samples, 167 bacteria were from hospitalized cases and 211 bacteria were from out-patient samples. Frequency of E.coli in hospitalized and out-patients was respectively 52% and 64% and frequency of K.pneumoniae in hospitalized and out-patient was respectively 64% and 22%. Frequency of ESBLs in E.coli strains in hospitalized and out-patient was respectively 58% and 17% and frequency of ESBLs in K.pneumoniae strains in hospitalized and out-patient was respectively 64% and 22%. The results showed high rate of nosocomial UTI and high frequency of ESBLs in isolated bacteria from hospitalized cases as compared to out-patients that represent high incidence of antibiotic resistant strains in hospitals.

Hospital surfaces and Staff hands are most common sources to transmission and spread Bacteria from hospital. β-lactame antibiotics are very important agents to control nosocomial infections. The spread of β-lactamase bacteria can disrupt the treatment process. This study was done to evaluate the frequency of β-lactamase bacteria isolated from staff hands and hospital surfaces. This study was a laboratory study and was performed in the years 2005 to 2007 in Al-Zahra (SA) hospital in Isfahan. 274 samples were selected randomly from stuff hands and hospital surfaces. Hospital surface samples were collected with swab and NB (Nutrient Broth), from high and low contact surface and staff hand samples were collected with Finger Print method. Bacterial identification was performed with microbiological methods and β–lactamase production survey was performed with Acidometric method. Staphylococcus species were seen in 55% of 194 isolated Bacteria from hospital surface. Other bacteria that isolated from hospital surface were Bacillus species in 26.29%, Enterobacteriaceae in 9.80%, Pseudomonas species in 3.9%, other gram negative Bacteria in 4.51%, Streptococcus species in 0.5% of samples. 60% of 80 isolated Bacteria from staff hand were Bacillus species. Staphylococcus species in 36.25% and Enterobacteriaceae in 3.75% were seen in stuff hands samples. According to β–lactamase test result, respectively 75.43% and 71.23% of isolate Bacteria from hospital surfaces and staff hands, produced β-lactamase The results of this study have shown the high frequency of β–lactamase enzyme in isolated Bacteria from staff hands and hospital surfaces. Improving quality of hand washing and disinfectant agent are very important methods to control nosocomial infections.

Hospital infection is one of important agent morbidity and mortality in patient. According to report of WHO on of average 8.7% of patients in hospital acquired hospital infection. Bacillus cereus is one of agent of hospital infection and cause systemic‚topical and food poisoning. Surface can serve as reservoirs of potential pathogen and is important in chain of infection; staff hands are more source to transmission bacteria from surfaces. Hands of staff are the most sources to transfer bacteria in environment and in patients. The research was performed with laboratory method and performed in 1384/86 years, in Azzahra hospital in Isfahan, according to statistical formula randomly selected 274 (194 sample from surface and 80 sample from staff hand). Environmental samples collected, with swab in NB and staff hand, samples collected whit finger print method, identification bacteria, were performed with microbiological staining, chemical test, use of differential and Bacillus cereus selective media. Survey antibiotic pattern performed with Kirby Bauer method, then data analyzing whit SPSS (ver 14) softwear. Survey result of 247 Bacteria, prevalence of B.cereus strains was %9.49. Prevalence of Bacillus cereus strains in environmental and staff hands were respectively %6.7 and %16.25. According to antibiogram test %81 of strains were resistant to penicillin, %47.6 to cefotaxime and %19 ampicillin. According to high prevalence of B.cereus strains in hospital and their resistance to β-lactame antibiotics, it is necessary for performed grant study in all of hospital in Iran and go on to, controlic methods for reduce prevalence rate, hospital infection and antibiotics resistance.

S-layer is the outer protein layer in the most archaea and bacteria. S-layer protects bacteria against phagocytosis and prohibits entry of some biomolecules and some antibiotics and adhesion to matrix proteins. S-layer is a virulence agent in bacteria. β–lactamase can inactive β-lactame antibiotics. According to role of β-lactame antibiotics in the treatment of infectious diseases with Bacillus spp., increasing frequency of S-layer and β–lactamase producer Bacillus cereus strains in hospitals lead to increase antibiotic resistant nosocomial infections. In this basic study, 274 samples were evaluated with laboratory methods in Alzahra hospital and Isfahan University between 2004 and 2006. Bacterial identification was performed with microbiological methods, such as staining, chemical test, use of differential and selective Bacillus cereus selective agar media. Bacteria cultured in TSA for 16h, and then separated surface proteins, and finally electrophoresis was performed. S-layer in Bacillus cereus has 97KD molecular weight. Production of β-lactamase was evaluated by acidometric method. Of 247 isolated bacteria, frequency of Bacillus cereus strains, S-layer and β–lactamase in S-layer producer Bacillus cereus strains were 9.49%, 46.20% and 100%, respectively. Results showed high prevalence of nano structure S-layer and β-lactamase producer Bacillus cereus strains in hospital. We recommend controlling bacterial population in crowded places and health and therapeutic centers to decrease producing antibiotic resistance bacteria.

The superficial layer is a part of the cellular envelop that is seen in bacteria and archaea. This superficial layer is a single layer structure composed of subordinate proteins or glycoproteins. The superficial layer is the outer most cellular structure that is in the exchange and reaction around environment with bacteria. This structure has very diversity in bacteria different types. The related articles to superficial layer were extracted of these articles: Pubmed, Elsevier Science, and Yahoo, from 1995 to 2010 years. For this purpose keywords were searched including superficial layer, pathogenesis, pathogen bacteria, There is consensus in the case of the superficial layer and about the existence of this superficial structure lead to increased pathogenesis in bacteria, in all of the research articles. S-layers in pathogen bacteria with bacteria protection against bacteriophages and phagocytosis, resistance against low pH, adhesion, stabilisation of the membrane and providing adhesion sites for exoproteins caused pathogenesis, infection resistant and antibiotic resistant in host.The result of this study shows the prevalence of considerable S-layer in pathogen bacteria and this matter identified the bacteria generator importance of this structure in the laboratory

Hospital surfaces can serve as reservoirs of potential pathogen bacteria. β-lactam antibiotics are developed as wide-spectrum antibiotics, however, the emergence of bacteria encompassing β-lactamase was a major challenge for physicians. The present study was conducted to determine the frequency of β-lactamase and antibiotic sensitivity pattern in isolated pathogen bacteria from low and high hospital contact surfaces. This experimental study was conducted on 194 isolated samples in Azzahra hospital in Isfahan. Samples were collected from high and low contact surface with swab in NB (Nutrient Broth). Bacteria were identified with microbiological techniques, however, β–lactamase production was assessed with acidometric and antibiogram pattern was achieved with Kirby Bauer method. Of 194 isolated bacteria, the following organisms were detected: Staphylococcus spp. 55%, Bacillus spp. 26.3%, Enterobacteriaceae 9.8%, Pseudomonas spp. 3.9%, other gram negative bacteria 4.5% and Streptococcus spp. 0.5%. Meanwhile, 61.5% of bacteria produce β–lactamase. According to antibiogram, organisms showed the highest and lowest resistance to penicillin and gentamicin, respectively. Widely spread of β–lactamase represents high spread of bacteria in hospital surfaces. Obviously, improvement in the quality of disinfectant agents could pave the way for better management of antibiotic-resistant nosocomial infections.

S-layer proteins form the outermost cell envelope component of a broad spectrum of bacteria and archaea which inhibits antibiotic entry into the bacterial cells. The aim of this research was to study the role of nanostructured surface layer and production of β– lactamase in penicillin resistant Bacillus cereus strains isolated from staff hands and hospital surfaces. This research was carried out on 274 samples during the years 2005-2007 in Azzahra hospital and Isfahan University. Bacterial strains were cultured in TSA for 16 h then surface proteins were separated using electrophoresis with 10X SDS-PAGE. Antibiogram was performed according to Kirby Bauer method. β–lactamase production was investigated using acidimetric method. Isolation frequency of B. cereus strains was %9.49. Eleven (84/6%) and one (7/7%) strains of B. cereus isolated from staff hands and hospital surfaces were producer of nanostructured surface layer respectively. Unlike to S-layer producer strains, non S-layer producer strains were more sensitive to antibiotics. All S-layer producer strains produced β–lactamase. A high prevalence of β–lactamase and S-layer producer B. cereus strains was observed in our setting that can contribute to an increase of the antibiotic resistance in nosocomial infection.

S-layer is a outer protein in bacteria and archaea which intensifies bacterial pathogenicity due to inhibiting antibiotic’s entrance to cells. Because staffs and hospital surfaces have a major role in nosocomial infections, contaminating this source with S-layer and β–lactamase positive strains of B. cereus can lead to spread the antibiotic resistant nosocomial infections. In this study, in addition to determine the frequency of S-layer and β–lactamase positive strains in hospital environment, their function in inhibition of antibiotic’s entrance has been surveyed. The descriptive research was performed on 274 samples isolated from Azzahra hospital and Isfahan University during 2005/2007. In order to preparation of samples, 16 hours bacterial culture in TSA (Tryptone Soya Agar) were used and then electrophoresis with 10X SDS-PAGE were performed. Antibiogram were performed with Kirby Bauer method and β–lactamase production, with acidimetric method. From 247 isolated bacteria, frequency of B. cereus strains was %9.49. Eleven sample (84/6%) from 13 isolated B. cereus of staff hand and 1 sample (7/7%) from 13 isolated B.cereus from hospital surfaces produce S-layer nano-structure. According to antibiogram result, non producer S-layer strains, in comparative S-layer producer strains, were more sensitive to antibiotics and all S-layer producer B.cereus strains, produce β–lactamase. Result of this study show high prevalence S-layer and β–lactamase producer B. cereus strains in hospital, that lead to increase antibiotic resistance nosocomial infection and is necessary go on to reduce transfer virulence agent and antibiotic resistant in pathogen bacteria.

Hospital surfaces can serve as reservoirs of potential pathogenic bacteria. Staff hands are the main source of bacterial transmission in hospital. The prevalence of bacteria harboring β–lactamase enzyme in staff hands and hospital surfaces, leads to spread of β–lactamase producing bacteria and ultimate increase of antibiotic resistance nosocomial infections. The aim of this study was to investigate the frequency of β-lactamase producing bacteria and susceptibility pattern of isolated bacteria from staff hands and high and low contact hospital surfaces of Alzahra hospital in Isfahan, Iran. This laboratory-based study was performed in Alzahra hospital in Isfahan during 2005-2007 years. Overally, 274 samples (194 strains from surfaces and 80 strains from staff hands) were screened during the study. Environmental samples were collected by using swabs in Nutrient Broth (NB) and samples from staff hands were collected with Finger Print method. Bacterial identification was performed by conventional biochemical identification tests. For determination of β–lactamase production,acidometric method was used, and antibiotic susceptibility testing was performed by Kirby Bauer method. the 194 isolated strains from hospital surfaces were: Staphylococcus spp. 105 (53.7%),Bacillus spp. 74 (24%) Enterobacteriaceae 21 (10.7%), Pseudomonas spp. 9 (4.6%), Streptococcus spp. 2 (1%), other gram negative bacilli 10 (5.15%), and the 80 strains isolated from staff hands were:Bacillus spp. 48 (60%), Staphylococcus spp. 28 (35%), Enterobacteriaceae 4 (0.5%). The isolated bacteria from both sources were highly resistant to tested antibiotics. According to the results from acidometric test, 125 (61.54%) strains isolated from hospital surfaces and 46 (61.85%) strains isolated from staff hands, were β-lactamase producers. The results show the high frequency of antibiotic resistant and β–lactamase producing bacterial strains on staff hands and hospital surfaces in present study.

Over the past 3 decades of research, it has become apparent that one of the most common surface structures on the archaea and bacteria are monomolecular crystalline arrays of proteinaceous subunits, termed surface layer or S-layer. S-layer protects bacteria to the phagocytosis and prohibits the entry of some biomolecules and adhesion molecules to the matrix proteins which increase the stability of infection and antibiotic resistance in virulence agents. Therefore the spread of bacteria which have S-layer in the hospitals should be avoided. Surfaces can serve as reservoirs of potential pathogen and is important in the chain of infection. Surfaces bacteria have low potential to spread, but staff hands have many contacts with hospital surfaces, especially with high contact surfaces. Therefore it could be a potential source of bacteria transmission from surfaces. This research was performed between 2005 to 2007, in the Alzahra hospital of Isfahan university of medical sciences. 274 samples were randomly selected (194 sample from surface and 80 sample from staff hand). Environmental samples collected, from high and low contact surface with swab in NB and staff hand. Samples were collected through finger print method and identification of bacteria, were performed with microbiological staining, chemical test, use of differential and selective media. Isolated Bacillus cereus strains, performed with Bacillus cereus Selective Agar, for preparation samples, in first culture Bacteria in TSA, for 16h, then separated surface proteins and finally, specimen's electrophoresis proximally molecular weight marker. S-layer in Bacillus cereus has 97KD molecular weight. According to the results, the prevalence of Bacillus cereus strains was %9.49. The prevalence of Bacillus cereus strains in environmental and staff hands were respectively %6.7 and %16.25, and of 13 isolated Bacillus cereus from, staff hand 11 strain (84/6%) and from 13 isolated Bacillus cereus from environmental samples 1 strain (7/7%) production S-layer. Result show, high prevalence Bacillus cereus in staff hands and hospital surfaces and frequency surface layer in Bacillus cereus isolated of staff hands into hospital surfaces.

β-lactame antibiotics are very important in the cure of diseases. b -lactamase as a virulence agent causes resistance to these antibiotics. Existence of β-lactamase in the pathogen bacteria can cause delay in the treatment. The aim of this research was to compare the frequency of β-lactamase enzyme existence in different types of isolated nosocomial infection bacteria in Alzahra hospital, Isfahan, Iran. This laboratory study was performed in Alzahra hospital of Isfahan in 2005-2006. According to sample size estimation, 100 infection samples (blood, urine, skin) were randomly selected. Identification of bacteria was performed using microbiological methods such as: staining, chemical test, and use of differential and selective media. To determine β–lactamase production in bacteria, acidimetric method was used. Data was analyzed using descriptive statistics. From the 100 isolated pathogen bacterias, 68.45% produced β-lactamase 83.33% produced Staphylococcus spp. 70.95% produced Enterobacteriaceae spp. and 18.8% produced Pseudomonas 18.8%. Based on the results, the frequncy of β–lactamase Enzyme existence in isolated bacteria of nosocomial infection was very high, which can be due to the increase of resistance of β–lactam antibiotics in pathogen Bacteria.