farshad nojoomi

Antibiotic resistance is a global concern due to the irrational use of antibiotics. Patients hospitalized in intensive care units are exposed to antibiotic resistance due to their high vulnerability. Therefore, this study was performed to investigate the pattern of carbapenem consumption in the intensive care units of Besat Hospital in a period of six months. This study was conducted by studying the records of patients from March 2018 to September 2018 and extracting hospital statistics from the medical records keeping unit and extracting drug consumption data from the pharmacological statistics unit. Occupied bed-day were obtained from the information classification system of the medical records unit and carbapenem consumption statistics from the pharmacological information system. According to evaluation methods of the medicines, the carbapenem use was expressed as DDD/100 bed-day. In total, 203 patients were admitted to intensive care units. The most common cause of carbapenem use was pneumonia (47.8%). In total, 4928.5 grams of meropenem (equivalent to 25.319 in terms of DDD/100 bed-day) and 79.5 grams of imipenem (equivalent to 0.612 in terms of DDD/100 bed-day) were used. From a total of 709 microbial cultures, sensitivity to carbapenems was investigated in only 145 cases (20.45%). 26 cases (17.93%) had sensitivity and 119 cases (82.07%) had resistance to at least one carbapenem (meropenem and imipenem). Acinetobacter baumannii was highly prevalent. Moreover, the consumption of meropenem and imipenem was high. Therefore, there is a need to adhere to the antibiotic monitoring policy for the appropriate use of antibiotics.

Biosurfactants are amphiphilic surface-active agents that mainly produced by various micro- organisms. In this study, the anti-biofilm and inhibition of bacterial adhesion activities of two bacterial biosurfactants were investigated.

After extraction and evaluation of Bacillus cereus and Serratia nematodiphila biosurfctants, inhi- bition of bacterial adhesion and anti-biofilm effects of them on Staphylococcus aureus and Pseudomonas aeruginosa were determined.

On average, the synergistic effect of two bacterial biosurfactants, caused about 60% decrease in adhesion and about 80% decrease in biofilm formation of S. aureus and P. aeruginosa.

The results of this study showed that combination of B. cereus and S. nematodiphila biosurfactants would in- crease the potential of attachment inhibition and biofilm eradication with very low toxicity.

Fluoroquinolones are among the most common types of antibiotics used in hospitalized patients. Accordingly, in this study, we examined the pattern of use of fluoroquinolones in hospitalized patients.

In this descriptive cross-sectional study, 300 patients underwent fluoroquinolones who were hospitalized in Tehranchr('39')s Imam Reza Hospital from April to October 2016, and the consumption pattern was based on available files. Fluoroquinolones were determined in them.

In this study, the possible types of infections including pneumonia, gastroenteritis, urinary tract infections and other infections were 27, 34, 21 and 18%, respectively. Percentages of ciprofloxacin and levofloxacin, both at 67, 31, and 2%, were prescribed. Fluoroquinolones at 26% 750 mg daily, 6% 500 mg daily, 38% 500 mg twice daily, 3% 250 mg twice daily, 11% 400 mg twice daily, 13% 200 mg twice daily The day and 3% were prescribed four times a day.

In general, based on the findings of this study, it is concluded that the pattern of consumption of fluoroquinolones in the study community has few problems that can be solved by providing the necessary training to physicians in the form of training sessions or pamphlets and etc.

Currently, many efforts are directed toward functional Hepatitis B virus (HBV) treatment. This is achievable by suppression of HBV surface antigen (HBsAg) secretion. In this regard, use of natural products has been the areas of interest by scientific communities.

Dried Honey Bee venom was extracted for assessing its anti-HBsAg secretion potential. Hepatoma cell-derived PLC/PRF/5 was propagated in complete medium. The cell line was treated by a serial dilution of Bee venom. Cell cytotoxicity (IC50) was measured by MTT colorimetric assay at three post-treatment times. HBsAg secretion was evaluated from PLC/PRF/5 supernatant treated by under-cytotoxic concentrations of Bee venom by using enzyme-linked immunosorbent assay.

The results indicated that dried Bee venom extract is able to reduce secretion of HBsAg from the cell line with Selectivity Index (SI) of eight. Reduced levels of HBsAg were in dose-dependent manner and it was in its lower concentrations at 8 ppm after 12 hr post treatment. The IC50 was observed to be 63.78 ppm.

The Bee venom has anti-HBV activity. The way we used under-cytotoxic concentration of Bee venom, the HBsAg secretion was restored after 24 hr post treatment. Furthermore, mechanism of action of Bee venom in reducing HBsAg level needs to be further investigated.

Human epithelial cells have been widely used to study the interaction between intestinal cells and pathogens, in vitro. In this study, the effect of probiotic bacteria Bacillus coagulans and its supernatant on the growth inhibition, cytotoxicity and induction of apoptosis caused by Salmonella Typhimurium and its adhesion to HT-29 cells were investigated.

B. coagulans supernatant was used to obtain the minimum inhibitory concentration. To evaluate the cytotoxicity and percent of apoptotic cells, B. coagulans and its supernatant (2, 4, 6 and 8% concentrations) with S. Typhimurium was added to HT-29 cells. The MTT assay was used in order to evaluate the cytotoxicity. Percent of apoptotic cells was reported using a fluorescence staining method. Additionally, the adhesion of S. Typhimurium to HT-29 cells was investigated. The effect of B. coagulans on the level of adhesion was also studied.

The most inhibitory effect was shown at the concentration of 80000 µg/ml supernatant of B. coagulans (54.77% ± 1.43). The simultaneous culture of S. Typhimurium with B. coagulans had the lowest amount of cytotoxicity and induced apoptosis among the all co-culture groups of S. Typhimurium with B. coagulans or its supernatant. The determined cytotoxicity and induced apoptosis were 26.06 % ± 3.79 and 17.63 % ± 2.14 respectively. In the adhesion test, it was observed that B. coagulans can significantly prevent adhesion of S. Typhimurium to HT-29 cell.

B. coagulans can reduce the adhesion, cytotoxicity and induction of apoptosis caused by S. Typhimurium in HT-29 cells in vitro.

In recent years, high attention has been given to the biological activities of natural compounds and their potential antimicrobial properties. In this study, the antibacterial properties of the extracts from tissue and peptides of Cerastoderma and Didacna were studied. samples of Cerastoderma and Didacna were collected and washed. Then, the soft tissues were cut and powdered, and concentrations of 16, 8, 4, 2, 1 and 0.5 of chloroform, ethanol and methanol, and in addition extract of enzymatic hydrolysis were prepared, and their antibacterial activities against Staphylococcus aureus, Escherichia coli and Salmonella paratyphi were investigated. The disc diffusion method was used for the evaluation of strains susceptibility. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were investigated for bacterial growth inhibition. Methanolic and ethanolic extracts from Cerastoderma demonstrated higher growth inhibitory effects compared to those from Didacna on E. coli and S. paratyphi and exhibited similar activities against S. aureus at concentrations 16 and 8 ug/mL. In addition, chloroform extracts of Cerastoderma and Didacna displayed similar inhibitory effects on S. paratyphi and S. aureus at concentrations 16 and 8 ug/mL which was a suitable effect, and the extract from Cerastoderma was more effective. MIC and MBC of methanolic extracts were at the lowest level, especially against S. aureus. It was revealed that Cerastoderma and Didacna extracts were effective as antibacterial compounds on S. aureus, E. coli and S. paratyphi species as natural agents.

the aim of this study was determination of antibiotic resistance profile, investigation of class I and II integrons among Escherichia coli (E. coli) isolates from urinary tract infections. This study was conducted for the investigation of the prevalence of class I and II Integrons among E. coli Isolates from urinary tract infections.
A total of 100 E. coli clinical isolates were collected from urinary tract infections in Borujerd city, Iran, from… to …. All the isolates were identified with standard laboratory procedures as described everywhere. The antibiotic susceptibility profile was conducted against adopted antibiotic disks following CLSI 2016 guidelines. All the isolates were enrolled in the PCR technique for the presence of class I and II integrons.
the highest resistance was against amoxicillin (72%), ciprofloxacin (69%), nalidixic acid (55%) and tetracycline (51%). The prevalence of class I and II integrons was 31% and 21%, respectively. A significant relation was observed between resistance to trimethoprim-sulfamethoxazole (p considering the significant relation observed between the presence of class I integron among multidrug-resistant isolates, establishment implementation of proper procedures to control and suitable treatment strategies in hospitals seems essential for the prevention of more spread of these isolates.

Context: Staphylococci spp, are enterotoxin-producing zoonotic agents causing a variety of infections such as mastitis in animals and wound bite infections in humans. This review was conducted to determine the prevalence of Staphylococci infections especially to uncover enterotoxin-producing species in Iran. Evidence acquisition: for this review, words of "Staphylococcus", "zoonotic", "prevalence", "animals", "human" and "Iran" were searched in the internet engines such as Google Scholar, PubMed, Google, Science Direct and so on. Patients with no history of contact with animals were also included in the study for comparison aims. Both veterinary and human coagulase positive isolates were included. Data was analyzed with Graph Pad Prism 6, meta-analysis section. A total of 20 previous studies (450 clinical samples) were found. S. intermedius was the predominant isolate identified in veterinary sources. Other coagulase positive spp such as S. hycus and S. simulans were isolated with lower prevalence, but S. delphini has not been detected. S. intermedius was the most isolate identified in veterinary sources with potential of causing infections in humans. Other coagulase positive spp such as S. hycus and S. simulans were isolated with lower prevalence, but S. delphini was not detected.

Persian walnut (Juglans regia L.) is a nutritionally rich and also popular nut which is largely consumed throughout the world. In addition to dry fruits (nuts), green walnuts, kernels, shells, green walnut husks (epicarp), barks and leaves have been applied in both cosmetic and pharmaceutical industries. Since ancient times, it has been used in folk medicine for treatment of several diseases and disorders such as diabetes, cancer, skin disease and infections, rheumatoid arthritis. In recent decades, many experimental researches have been done on the composition and characteristics of different parts of Persian walnut tree. These researches showed that walnut has many nutritious components such as phenolic component, unsaturated fatty acids and minerals essential for human health. Using walnut in folk medicine and identification of beneficial components of this fruit prompted many scientists to investigate properties that have traditionally been attributed to this fruit and the researches done in this area showed that walnut has effective antioxidant, antimicrobial, antitumor and anti-inflammatory properties that make it a promising drug for associated diseases.

Context: Anthrax is a zoonotic and occupational disease caused by bacterium Bacillus anthracis. The agent produces spores which persist in the environment for years. This review assessed previous reports on anthrax disease in Iran from 2000 to 2016.
Evidence acquisition: The reports of anthrax from 2000 to 2016 were reviewed. The keywords "Bacillus anthracis", "Anthrax", "clinical signs", "Iran" and "zoonosis" were investigated in the searching databases such as "Google Scholar", "Google", "PubMed" and other sites. The reports of soil isolation and spores from environments were excluded. However, the clinical outcome of the cases, history of animal exposure, wool contaminations and meat in slaughterhouses were included. Results of Persian reports were also included in this review. Data were analyzed using Excel and GraphPad Prism version 6.1. The standardized mean difference (SMD) was used for data analysis.. Overall, 768 cases of anthrax were found in human, sheep, goats and cattle. Six hundred of the human cases aged between 2.5 and 71 years old were included. Four-hundred ten (68.33%) patients were male (mean age=28.1 ± 1.5) and 190 (31.66%) patients were female (mean age = 17±1.5). Clinical manifestations in patients were mostly in 2 cutaneous (56.6%) and gastrointestinal (42.83%) forms. Sporadic anthrax outbreaks occurred in the country in 2007, 2008 and 2011. No molecular typing has been performed for B. anthracis strains countrywide. The virulence factors encoded by the genes located on plasmids pXO1 and pXO2 were detected in various areas with high prevalence.
Cutaneous and gastrointestinal anthrax are 2 main manifestations of the disease in Iran. Male patients were significantly more infected. Although rare, anthrax continues to be a dreadful consequence of herds or soil exposure and consumption of undercooked meat of infected animals. Education plans and proper animal vaccination plans with the consideration of virulence factors are helpful for the prevention of the disease.

The spread of carbapenem-resistant Pseudomonas aeruginosa is a global concern. Metallo-beta-lactamase (MBL) enzymes cause extensive drug resistance among Gram-negative bacteria. The current study aimed at determining the prevalence of MBL-producing P. aeruginosa in Iran.
A total of 43 studies were found out of which 36 were adopted. Data were collected from Google, Google Scholar, Science Direct, PubMed, Scopus, Embase, and Sciverse. The terms “Pseudomonas aeruginosa”, “metallo-beta-lactamase”, “prevalence”, “carbapenems”, and “Iran” were searched. Data from the isolates not producing MBLs were excluded from the study. Data were analyzed with Graph Pad Prism 6, meta-analysis section.
According to the results of the current study, 36 surveys indicated that 55% of the clinically isolated P. aeruginosa in Iran were resistant to imipenem and meropenem, among which 37.72% were the MBL producers. Among genes encoding MBLs, blaVIM and blaIMP were predominant with the prevalence of 12.91%±11.01% and 12.50%±23.56%, respectively. No report of harboring blaNDM1 and blaSPM1 by P. aeruginosa was found, similar to most of the other countries in Asia. The prevalence of blaVIM and blaIMP from burn settings were 11.50%±3.5% and 24.65%±23%, respectively. Furthermore, the prevalence of these genes was not significantly different among burn and non-burn isolates (P=0.942 and P=0.597, respectively). Moreover, no relationship was observed between the MBL production and patients’ age range.
Approximately half of P. aeruginosa isolates were carbapenem-resistant in Iran, and approximately half were the MBL producers. The blaVIM and blaIMP were the predominantMBLs among P. aeruginosa strains, while other genes were not found in P. aeruginosa. Moreover, there was no significant difference between blaVIM and blaIMPamong burn and non-burn isolates. Due to the multiple drug resistance conferred by MBLs, detection and control of their spread alongside proper therapeutic regimens in hospitals and community settings are essential to prevent infection acquisition.

Nowadays, Some frequent medical interventions including the widespread use of immunosuppressive drugs and antibiotics lead to the spread of drug resistance and drug resistant nosocomial infections. This study aimed to evaluate the status of nosocomial infections in two selected hospitals in Tehran.
Methods and Materials: This cross-sectional study was performed on hospitalized patients in two hospitals since March 2013 to September 2014. First of all, suspected cases of nosocomial infections were investigated and clinical specimens were obtained from these patients. Then, direct examination, culture, and specific bacteriological tests were conducted on samples. Finally, data were statistically analyzed by SPSS version 20.
The prevalence of infections caused by Escherichia coli were significantly different from those caused by Acinetobacter baumannii. Urinary tract infections were significantly different from the other nosocomial infections. Moreover, there were statistically significant differences between the hospitalized patients in the intensive unit than those hospitalized in other wards (PDiscussion and The results indicated that long stay of patients in hospital, particularly in the intensive care unit as well as the frequent use of invasive tools such as urinary and vascular catheters are the most significant reasons of nosocomial infections.

Escherichia coli (E. coli) strains are among predominant agents causing nosocomial and community acquired infections. The majority of strains encode numerous virulence factors including fimbrial adhesions, secretory proteins and toxins, siderophores, and capsule. This study aimed to investigate the prevalence rate of virulence encoding genes and carbapenem resistance-encoding genes among imipenem-resistant E. coli isolates collected from patients hospitalized in Tehran, Iran.
In this cross-sectional study (April 2015-December 2017), 50 non-duplicated carbapenem-resistant E. coli isolates were collected from clinical specimens (stool, urine, blood, and wound) of hospitalized patients in three hospitals in Tehran, Iran. The antibiotic susceptibility profile was determined against 15 antibiotics on Mueller Hinton Agar (MHA) as per CLSI guidelines version 2016. The PCR was used to detect virulence and antibiotic resistance encoding genes.
From a total of 50 carbapenem-resistant E. coli isolates, the highest resistance rate was observed to ceftazidime (100%), tetracycline (88%), amoxicillin (100%), sulfonamide (60%), and the least resistance rate was observed against amikacin (14%), gentamicin (22%), and fosfomycin (0%). The genes mediating resistance were as follows: beta-lactams OXA-48 (8%), IMP (16%), VIM (0%), NDM-1 (0%), fosA3 (0%), quinolones (qnrA 48%), and colistin mcr-1(0%). Furthermore, the prevalence rates of of fimA, hlyA, cnf1, vat, pic, crl, and papH were 88, 36, 28, 10, 12, 54, and 88%, respectively.
In this study, all imipenem-resistant E. coli isolates were susceptible to fosfomycin, and all were fosA3 negative. Among carbapenemase genes, IMP and OXA-48 type enzymes associated with higher MIC levels (8 to 32 µg.mL-1) were detected. In this study, data suggest the role of these carbapenemases in resistance to carbapenems. Furthermore, the presence of multiple drug resistant strains encoding adhesive and secretory virulence factors is a concern for the infections treatment.

The prevalence of bacterial drug resistance and consequently the reduction of antibiotic effects on bacteria encourages researchers to seek appropriate and low-risk alternatives for treatment of infectious diseases. Nanoparticles and herbal extracts can be considered as good alternatives to antibiotics. The aim of this study was to investigate the antimicrobial effect of silver nanoparticles in comparison to Seidlitzia rosmarinus extract on multidrug resistant (MDR) strains of Staphylococcus aureus (S. aureus) and Klebsiella pneumoniae (K. pneumoniae).
S. aureus and K. pneumoniae were isolated from urinary tract infections. Doses of 50, 100, 200, and 400 mg/mL of alcoholic extract of Seidlitzia rosmarinus and also 5, 10, 20, and 80 µg/mL of silver nanoparticles were added to Agar with S.aureus or K. pneumoniae. Then, Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were evaluated.
Seidlitzia rosmarinus extracts conferred a noticeable effect on S. aureus (MIC = 100 mg/mL and MBC = 100 mg/mL), while silver nanoparticles were a higher inhibitory effect on K. pneumoniae (MIC = 5 µg/mL and MBC = 10 µg/mL). Both the extract and nanoparticles inhibited dose dependently the growth of S. aureus and K. pneumoniae.
It seems that Seidlitzia rosmarinus extract and silver nanoparticles prevent the growth and proliferation of S.aureus and K. pneumoniae in a dose dependent manner.

Botulinum toxin, the most potent biological toxin, has become a powerful therapeutic tool for a growing number of clinical applications. Molecular studies have identified a family of synaptic vesicle-associated membrane proteins (VAMPs, also known as synaptobrevins) which have been implicated in synaptic vesicle docking and fusion with plasma membrane proteins.
Using the synaptobrevin as a substrate for in vitro assay is the method to detect BoNT activity. We have been working on optimizations of bacterial expression conditions and media for high-level production of synaptobrevin peptide. Statistics-based experimental design was used to investigate the effect of medium components (E. coli strain, peptone, IPTG, yeast extract, ampicillin, and temperature) on synaptobrevin production by E. coli.
A 24 fractional factorial design with center points revealed that IPTG and temperature were the most significant factors, whereas the other factors were not important within the levels tested. This purpose was followed by a central composite design to develop a response surface for medium optimization. The optimum medium composition for synaptobrevin production was found to be: IPTG 29 mM, peptone 10 g/L, yeast extract 5 g/L, temperature 23°C and ampicillin 100 mg/L. This medium was projected to produce, theoretically, 115 mg/L synaptobrevin.
The optimum medium composition synaptobrevin production was found to be: BL21 (E.coli strain), LB medium (peptone 10 g/L, Yeast 5 g/L), Ampicillin (100 mg/L), IPTG (0.29 mg/L) and temperature (23°C).

Plasmid and chromosomal extended-spectrum beta-lactamases (ESBLs) have been increasingly spread everywhere and blaCTX-M1 is one predominant beta-lactamase.
This study was fulfilled to determine the production of ESBL and prevalence of blaCTX-M1, blaSHV, and blaTEM among Escherichia coli blood isolates in Tehran.
Patients and Twenty-three isolates were adopted to be studied during 2015-2016. The antibiotic susceptibility testing was performed using Kirby–Bauer method. The combined disk method was used for the detection of phenotypic ESBL production. The most effective antibiotics were piperacillin, amikacin, and ofloxacin. The minimum inhibitory concentration (MIC) of ceftazidime was determined using micro-broth dilution method. Polymerase chain reaction (PCR) was used for detecting the blaCTX-M1, blaSHV, and blaTEM genes.
In the broth dilution test, 19 (82%) isolates showed MIC ≥1, and 18 (78.3%) isolates were ceftazidime resistant. In the combined disk test, 19 (82%) isolates were ESBL producers. The results of the MIC and ceftazidime resistance were the same for ESBL selection. The results of MIC, in fact confirmed the disk diffusion in determining the phenotypic ESBL production. The frequency of blaCTX-M1, blaSHV, and blaTEM genes among blood ESBL producing isolates was 26% (n = 6), 8.6% (n = 2), and 0%, respectively. Isolates that showed higher MIC were positive for these genes.
The prevalence of multidrug-resistant blood isolates and ESBL phenotype was high in military hospitals. A low number of blood strains amplified blaCTXM1 and blaSHV type beta–lactamases. There was a relationship between the MIC and the presence of beta-lactamase genes.

Context: Bioaerosols are associated with a wide spectrum of health effects, including infections and contagious diseases, acute toxicities, allergies, and even cancer..
Evidence Acquisition: Previous publications describing research conducted in healthcare and community settings during the years 2001 - 2016 were included in this analysis. The words bioaerosol, contamination, bacteria, fungi, viruses, and Iran were explored via the use of search engines such as PubMed, Google, Google Scholar, and Science Direct. A total of 28 studies were found..
The levels of bacterial contamination were higher than those found in the fungal species. The most isolated of the bacterial species were S. aureus (38.24%) and Micrococci (31.6%), and the most isolated of the fungal species were Penicillium (32.28%) and Aspergillus spp (22.78%). The highest levels of contamination were detected in infectious disease (ID) settings (mean = 91 ± 86 cfu/m3 for bacteria and 27 ± 24 for fungi). Moreover, levels of indoor air contamination were lower than the world health organization (WHO) standards, with the exception of S. aureus at 201 cfu/m3 and 189 cfu/m3 in infectious disease (ID) and intensive care unit (ICU) settings, respectively. In terms of geographic area and cultural differences, the numbers of bacterial and fungal agents were not significantly different (i.e., North versus South and East versus West). Moisture levels were significantly related to air contamination (pv = 0.02)..
The levels of air contamination inside hospital and healthcare settings were lower than the WHO mean standard. Active air sampling methods are necessary for measuring bioaerosol contamination. There were no significant differences in the levels of contamination found in various indoor settings in Iran. Efficient ventilation systems and contamination prevention or minimization are necessary for these settings..

Candida spp. are members of a genus, including closely related fungal species that cause a variety of infections..
The aim of this study was the isolation of various Candida species from vulvovaginitis and urethra of patients in Neyshabur, Northeast Iran from 2013 to 2015..
This descriptive-analytical and cross-sectional study was performed to identify Candida spp. causing vulvovaginitis and Urinary Tract Infection (UTI) at a referral laboratory in Neyshabur district, Khorasan Razavi Province. A total of 451 vaginal and midstream urine samples were collected. Ten micro-liters of each specimen was cultured on CHROM agar plates and then incubated at 37°C for 24 to 48 hours, aerobically. Candida species were identified based on colony morphology, germ tube production and micro-morphology on corn meal agar including 1% Tween 80..
The mean age of the patients was 34.7 ± 16.3. Candida albicans was the predominant species isolated. Moreover, age groups of 21 to 30 and 0 to 1 years were the most and the least infected individuals. Moreover, Candida spp. were significantly more common in females compared to males (P value 103..
In this study, C. albicans was the most common species isolated from patients with vulvovaginitis and UTI, and significantly more common amongst females compared to males. The prevalence of candida spp. had significantly declined from 2013 to 2015. Moreover, the candida spp. counts were mostly higher than 103cfu/mL..

Context: The composition and function of the gut microbiota develop with their host from birth. The human microbiome, especially the gut microbiota, plays a critical role in a myriad of health and normal activities. However, the increase or decrease in number of gut bacteria may cause several disorders. This review aimed to assess the importance of human gut microflora and their roles in the health and possible diseases caused by fluctuations in the number of these bacteria..
Evidence Acquisition: For the current review, we searched for the terms “bacterial gut flora”, “role,” “number,” and “increase” and “decrease” on the Google scholar, PubMed, Science Direct, SciVerse, and Scopus search engines and databases. The exclusion criteria were “genetic factors,” “veterinary flora,” “protozoal flora,” “mold,” “fungal,” and “yeast flora”..
The gut microbiota is accompanied by the regulation of several host metabolic pathways, giving rise to interactive host-microbiota signaling, metabolic, and immune-inflammatory responses that physiologically connect the gut, muscle, liver, and brain. A more thorough understanding of these axes is an early essential for reaching therapeutic strategies to use the gut microbiota for combating disease and improving health. Bacterial species of Bacteroides, Clostridia, and Bifidobacterium consist of a large proportion of the gut bacterial flora. Increase in the proportion of these genera in the gut could cause abscess formation, sepsis, inflammatory bowel disease (IBD), Crohn’s disease, toxicity, infection, and malnutrition. However, the decrease in the proportion of these species is accompanied by allergies in infants, inflammation, malabsorption syndrome, carbohydrate/fiber intolerance, atopic eczema, and IBD..
The results showed that although the human gut microbiome plays a pivotal role in health in a normal concentration, fluctuation in their number (increase or decrease) is a possible factor in the appearance of major diseases..

Diarrheal disease is one of the main causes of death in developing countries. This study was performed to the prevalence of bacterial causes of diarrhea in patients admitted to the Military hospitals and Imam Khomeini Medical Center Hospital. This cross-sectional study was conducted in a period of 9 months from June 2014 to February 2015, 435 non-duplicative diarrheal stool samples were collected from the Imam Reza, Besat Nahaja general, Khanevadeh Artesh and Imam Khomeini Medical Center Hospitals. To separation and differentiation bacterial species selective and differential medium was used. Of the 435 stool samples collected, 204 (46.9%) were female and 231 (53.1%) were men. The prevalence of Shigella, C. jejuni, Salmonella and EHEC were 98 (22.5%), 41 (9.4%), 21 (4.8%) and 6 (1.8%), respectively. The frequency of S. flexneri were 56.1% and S. sonnei were 4.9%. The prevalence of bacterial infection among cases of diarrhea was 22.5%, which the most infection rate was related to S. flexneri.

Haemophilus influenzae type b (Hib) is a gram negative bacterium and one of the most common causative agents of acute meningitis in infants and less than 5 years old children worldwide. The production of Hib capsular polysaccharide; polyribosyl ribitolphosphate (PRP) is important for the production of conjugate vaccines against Hib infections. The aim of this study is the improvement of Large-scale PRP production by Hib. Haemophilus influenzae type b standard strain ATCC10211 was cultivated in 2L fermentors contain 1.5L CY (casaminoacid yeast extract) medium with normal or modified concentrations of glucose, yeast extract, hemin and NAD (nicotinamide adenine dinucleotide). Seed culture of two fermentors was inoculated to 50 L fermentor, separately and range of PRP production and Dry cell weight (DCW) were studied. Cultivation of Hib in 50L fermentor contained modified CY medium with 6gl-1 Glucose, 2.5 gl-1 Yeast extract, 0.03 gl-1 Hemin and 0.015 gl-1 NAD, with controlled pH at 7.3 and 30% Dissolved oxygen tension (DOT) resulted to about 5.1 gl-1 DCW and 1.16 gl-1 PRP, that was significantly higher than normal CY medium. In conclusion, by modification in some medium components of CY medium, control of Dissolved oxygen tension and pH, the Large-scale production of PRP is improved. Improvement of PRP production leads to reduce the final cost of Hib conjugate vaccines.