hesam alizade

To provide data on the occurrence of classical K. pneumoniae (cKp) and hypervirulent Klebsiella pneumoniae (hvKp) strains harboring the gene encoding regulator of mucoid phenotype A (rmpA) and evaluated characteristics of virulence biomarkers, carbapenemase, extended-spectrum-β-lactamase (ESBL)-producing, and capsule serotypes among K. pneumoniae clinical isolates collected in the south of Iran.

A total of 400 K. pneumoniae isolates were collected. First, the K. pneumoniae isolates were screened for rmpA gene by PCR, and then they were characterized for the presence of the virulence genes (pagO, iucA, iroB, luxR), capsular serotype genes (K1, K2, K5, K20, K54, and K57), carbapenemase (blaNDM, blaIMP, blaVIM, blaKPC, blaSPM, blaOXA-48, and blaOXA-181) and ESBL (blaCTX-M, blaSHV and blaTEM) genes. For all K. pneumoniae isolates phenotypic tests include of string test and disk diffusion test were performed.

In total, 16 (4%) hvKp-rmpA+ and 384 (96%) cKp were observed. Of hvKp-rmpA+ strains, 16 (100%) were carried pagO, iroB, and luxR genes, and 13 (81.3%) strains harbored iucA gene. The most prevalent capsular type genes were K1 (62%) and K2 (19%) in hvKp-rmpA+ strains. The incidence of blaSHV gene in hvKp and cKp was 94% (15/16) and 87.5% (336/384), respectively. The cKp isolates carried blaNDM (30/384; 7.8%) gene.

Our data suggest that the incidence of hvKp was low. Also, hvKp-rmpA+ strains have less antibiotic resistance than cKp isolates. Serotypes K1 and K2, and blaSHV gene were strongly associated with hvKp-rmpA+.

Cigarette smoke and nicotine interact with drugs by affecting the absorption, distribution, metabolism, or elimination of other drugs, causing a change in drug response. Therefore, smokers usually need higher doses of medications. Articles were searched through advanced search in ScienceDirect, PubMed, Google Scholar, and SciELO databases. Finally, 28 articles were used in this study. We found that drugs may interact with each other when taking multiple medications, but these interactions are not always related to medications. Sometimes these interactions result from drugs reacting with food, beverages, and tobacco. Smokers have to take more doses of the drug for treatment in the long run, which can cause more side effects. In the long run, the person’s body becomes resistant to the drug and the dose has to be increased. Overuse of the drug causes the person to suffer more emotional and physical symptoms. Cigarettes can also have pharmacokinetic effects on some drugs (clozapine, olanzapine, and haloperidol). Tobacco causes nausea and the drug does not work well enough. In severe cases, the drug has to be injected intravenously, which makes the treatment much more difficult. Therefore, according to the studies, the patient’s history of smoking and alcohol consumption should be studied and medications should be prescribed according to it in order to treat in the best way.

In recent years, Enterococcus species have emerged as a leading cause of nosocomial infections worldwide. The aim of this study was to determine the virulence biomarkers and antibiotic resistance profiles of Enterococcus spp. collected from a main tertiary teaching hospital in Bandar Abbas, Iran.

A total of 71 Enterococcus were isolated from clinical specimens of patients in different wards of a hospital. Enterococcus spp. were verified by detecting ddl gene using PCR-based method. Virulence-encoding genes including gelE and cylA were detected using PCR. Antibiotic resistance was assessed using the disk diffusion assay, and vancomycin resistance was identified using the E-test method.

Among Enterococcus isolates, 50 and 21 isolates were identified as E. faecalis and E. faecium, respectively. Most of the Enterococcus species were isolated from urine, followed by wound samples. The most prevalent virulence genes among E. faecalis isolates were cylA (60%) and gelE (30%); also, 19 and 14% of E. faecium isolates were positive for cylA and gelE genes, respectively. Many isolates of E. faecalis (84%) and E. faecium (76%) were resistant to one or more antibiotics and showed high resistance to gentamicin and ciprofloxacin.

This study revealed a high prevalence of ciprofloxacin and gentamicin resistance and a high frequency of virulence genes among E. faecalis isolates. Due to the high prevalence of MDR Enterococcus strains, control measures are necessary to prevent the emergence and transmission of these strains in different hospital wards.

The coronavirus, which leads to coronavirus disease 19 (COVID-19), may affect various systems of the body (including respiratory, heart, blood circulation, gastrointestinal, nervous, urinary, and renal systems). Similar to COVID-19, first- and second-hand smoking also endanger the immune system and affect a wide range of systems. Therefore, considering the adverse effects of tobacco on different systems of the body, this study aimed at investigating the effects of tobacco on the onset, transmission, prognosis, and severity of COVID-19 in patients. Related articles were selected through advanced searching in Scopus, PubMed, and ScienceDirect databases and Google search engine while including no time limit and using three keywords derived from Mesh (COVID-19, smoking, and tobacco). Most studies have indicated that the incidence of COVID-19 was extremely lower in patients with a history of active smoking compared to patients with no smoking history. According to the results, smoking has an impact on the prognosis and outcome of COVID-19, increases the severity of the disease, the need for hospitalization and the intensive care unit (ICU), and the death rate, as well as challenging the treatment process and changing the attitude of smokers, enhancing their desire to quit smoking. Therefore, smokers are less likely to develop COVID-19, but the rate of transmission, disease severity, and mortality and the need for hospitalization increase in these subjects, and thus treatment will be challenging. Thus, quitting smoking may help improve the function of the respiratory system.

The present study attempted to determine the antibiotic susceptibility of bacteria isolated from endotracheal tube culture on patients admitted to the intensive care units (ICUs) of Shahid Mohammadi hospital in Bandar Abbas.

This cross-sectional study was conducted on 114 patients hospitalized in the pulmonary ICU of Shahid Mohammadi hospital in Bandar Abbas from March 2018 to March 2019. The samples of the patients’ endotracheal tube secretions were collected for the culture purpose on the first and fifth days of hospitalization in the ICU where the disk diffusion method was used to determine antibiotic susceptibility.

The most common isolated microorganisms from the first day of culture were 26 Acinetobacter spp. isolates (22.8%), 10 Candida isolates (8.8%), and 9 Pseudomonas aeruginosa isolates (7.9%). The most common microorganisms which were isolated on the fifth day comprised Acinetobacter spp. with 57 isolates (51.8%), Candida with 6 isolates (5.5%), and P. aeruginosa with 6 isolates (5.5%). The highest resistant bacteria isolated from Acinetobacter spp. samples on the first-day were amikacin (92.3%) and meropenem (84.6%). The highest resistance of P. aeruginosa was against meropenem (77.8%), while the highest resistance of Acinetobacter spp. isolates was found to be amikacin (94.7%) and meropenem (86%) from the fifth-day samples. Further, P. aeruginosa isolates had the highest resistance in meropenem (83.3%), co-trimoxazole, and cefepime (66.7% for each of them).

Ventilator-associated pneumonia (VAP) is considered a warning condition due to multidrug-resistant bacteria. According to the present study, the most common VAP-causing bacteria are gram-negative, especially Acinetobacter, with high antibiotic resistance.

Due to the significant use of vancomycin antibiotic in hospitals and the need for rational use of this antibiotic to prevent the occurrence of antibiotic resistance, the present study was conducted to evaluate the administration and pattern of vancomycin antibiotic use in the Payambar-e-Azam Hospital of Bandar Abbas.

The present study was a retrospective descriptive study in the 2017 year. Patients treated with vancomycin during one year were selected by reviewing the information of patients admitted to the Payambar-e-Azam Hospital of Bandar Abbas. Then, referring to the records of these patients in hospital medical records, the required information was extracted. The information was then reviewed by an infectious disease specialist according to the Infectious Diseases Society of America (IDSA) and Defined Daily Dose (DDD) guidelines.

In this study, 189 patients receiving vancomycin antibiotics in different wards of the Payambar-e-Azam Hospital of Bandar Abbas were evaluated. Of the patients studied, 49 (26%) received vancomycin in the first line of treatment. 170 (90%) were prescribed antibiotics based on experience and 19 (10%) on antibiogram testing. Among the recipients of vancomycin antibiotics, antibiotic use for 92(48/7%) patients was based on a defined daily dose (DDD).

In the present study, about half of the prescribed vancomycin was administered according to DDD guidelines, but most of the treatments are experimental without regard to antibiogram and culture results.

Urinary tract infection (UTI) is one of the most commonly encountered diseases in clinical settings and uropathogenic Escherichia coli (UPEC) is the major causative pathogen of UTI. The increase of antibiotic resistance among isolates of E. coli has become a main concern worldwide. The purposes of this study were to determine the phylogenetic background, prevalence and characterize of extended-spectrum β-lactamases and metallo-β-Lactamase produced by E. coli from UTIs.

Two hundred and sixteen E. coli isolates were isolated from UTI. The isolates were screened to determine the phylogenetic background and prevalence of CTX-M-15, PER, VEB, IMP and VIM genes by PCR. The antimicrobial susceptibility of isolates was determined by disk diffusion and broth micro-dilution methods. The isolates were screened using a double-disc synergy test.

Phylotyping of isolates revealed that isolates segregated in phylo-groups A (40.74%), B1 (7.87%), B2 (18.05%) and D (33.34%). By disk diffusion test 61.57% of isolates were resistant to cefotaxime, 35.64% to ceftazidime, 26.38% to aztreonam, 16.66% to cefepime and 6.48% to imipenem. Among the studied ESBL isolates, 72.41% isolates were positive for the CTX-M-15 gene. None of the isolates were positive for IMP, VIM, PER and VEB genes.

The ESBL-producing strains were associated with shifts in phylogenetic distribution toward none-B2 phylo-groups and they mainly belonged to A and D groups.

Diarrheagenic Escherichia coli (DEC) is a common enteric pathogen that causes a wide spectrum of gastrointestinal infections, particularly in developing countries. This is a systematic review and meta‑analysis to determine the prevalence of DEC in various geographical regions in Iran. English (PubMed, Web of Science, Scopus, Embase, Cochrane Library, and Google Scholar) and Persian (IranMedex, SID, Magiran, and Iran Doc) databases were comprehensively searched from January 1990 to April 2017. Study selection and data extraction were performed by two independent reviewers. After assessing heterogeneity among studies, a random effects model was applied to estimate pooled prevalence. Data analyses were done with the Stata software (version 12.0). This meta‑analysis was registered with PROSPERO, number CRD42017070411. A total of 73 studies with 18068 isolates were eligible for inclusion within the meta‑analysis. The results of random effects model showed that the most prevalent DEC pathotypes were enterotoxigenic E. coli (ETEC) (16%; 95% confidence interval [CI]: 11%–23%), enteroaggregative E. coli (11%; 95% CI: 8%–15%), atypical enteropathogenic E. coli (EPEC) (11%; 95% CI: 8%–14%), Shiga toxin‑producing E. coli (9%; 95% CI: 6%–13%), diffuse adherent E. coli (6%; 95% CI: 6%–12%), enteroinvasive E. coli (4%; 95% CI: 2%–6%), and typical EPEC (3%; 95% CI: 1%–5%). This study showed that DEC infections in the Iranian population have low frequency. Our data suggest that the ETEC pathotype can be regarded as one of the most important etiological agents of diarrhea in this country. However, the prevalence of DEC pathotypes is diverse in different regions of Iran.

A newly emerged hypervirulent strain of Klebsiella pneumoniae has caused great concern globally; however, its molecular characteristics have been rarely reported in Iran.
The goal of this study was to detect the virulence determinants and serotypes of K. pneumoniae and to evaluate the association among selected virulence traits and blaCTX-M-15 gene in southeastern Iran.
One hundred and three non-duplicate K. pneumoniae strains were isolated from clinical samples. The isolates were identified by standard bacteriological tests. Confirmed isolates were examined to detect a selection of virulence genes (wabG, rmpA and iucB) and serotypes (K1, K2, K5 and K20) by PCR. The isolates were studied foe the presence of beta-lactamase (blaCTX-M-15) gene. SPSS software (version 19.0) was used for data analysis.
Among the 103 K. pneumoniae isolates, 61 (59.2%) isolates were positive for wabG, 4 (3.9%) for iucB and 3 (2.9%) for rmpA genes. The presence of K20 in 3.9% (4/103) of the isolates represented the most prevalent. Only 3 (2.9%) isolates possessed the K1 serotype, while K2 and K5 serotypes were not detected in any isolate. The blaCTX-M-15 gene was detected in 47 (45.6%) isolates. blaCTX-M-15-positive isolates showed a higher prevalence of wabG among the studied isolates (P Our data indicate a correlation between presence of virulence gene and blaCTX-M-15 in K. pneumonia isolates. Further research should be undertaken to unravel aspects of both virulence factors and antibiotic resistance which may probably contribute to managing future spread of infectious diseases.

Aim: The present study was conducted to detect the occurrence, serogroups, virulence genes and phylogenetic relationship of shiga toxin-producing Escherichia coli (STEC) in human, clave and goat in Kerman (southeast of Iran).
STEC have emerged as the important foodborne zoonotic pathogens causing human gastrointestinal disease and confirming the risk to public health.
A total of 671 fecal samples were collected from diarrheic patients (n=395) and healthy calves (n=156) and goats (n=120) and screened for the presence of stx gene. Furthermore, the prevalence of stx1 and stx2 variants, serotypes (O157, O145, O103, O26, O111, O91, O128, and O45), phylogenetic groups and the presence of ehxA, eae, hylA, iha and saa virulence genes were studied.
Prevalence of STEC in human diarrheic isolates was 1.3% (5 isolates), in claves was 26.3% (41 isolates) and in goats was 27.5% (33 isolates). stx1 gene was the most prevalent variant and detected in 75 isolates. Furthermore, stx1c was the most predominant stx subtype, found in 56 isolates. The ehxA identified in 36 (45.6%) isolates, followed by iha 5 (6.3%), eaeA 4 (5.1%), hlyA 2 (2.5%) and saa 2 (2.5%). Most of the isolates belonged to phylogroup B1. Only two O26 and one O91 isolates were detected in our study.
Our results show that STEC strains were widespread among healthy domestic animals in the southeast of Iran

Escherichia coli is the most prominent cause of infectious diseases that span from the gastrointestinal tract to extra-intestinal sites such as urinary tract infection, septicaemia, and neonatal meningitis. The emergence and spread of antibiotic resistance in E. coli is an increasing public health concern across the world. Rising resistance in E. coli isolates is also observed in Iran. This review summarizes the status of antibiotic resistance of E. coli isolates in Iran from 2007 to 2016.
The data of the prevalence of E. coli antibiotic resistance were collected from databases such as Web of Science, PubMed, Scopus, Embase, Cochrane Library, Google Scholar and Scientific Information Database.
Antibiotic resistance in E. coli is on the rise.
Prevalence of antibiotic resistance of E. coli varies from region to region in Iran.

Colibacillosis caused by avian pathogenic Escherichia coli (APEC) is an economic threat to the poultry industry throughout the world. Some of the virulence genes may enhance the ability of E. coli isolates to grow in the tissues of broilers. The APEC strains are assigned to a few distinct phylogenetic groups. The purpose of the present study was to detect the virulence genes and phylogenetic groups of E. coli isolates from colibacillosis cases in Japanese quail in 2014 in Kerman, Iran. In the present study, one hundred and two E. coli isolates were obtained from dead Japanese quails with colibacillosis. E. coli isolates were confirmed by standard biochemical and bacteriological methods. DNA of E. coli isolates was extracted by boiling method. The confirmed E. coli isolates were investigated to detect the phylogenetic groups and virulence genes including sfa/focDE, afaIBC, papEF by PCR methods. E. coli isolates were classified into A (62 isolates), B1 (24 isolates), B2 (12 isolates) and D (four isolates) phylogenetic groups. Among examined isolates nine isolates (8.82%) were positive for papE-F, five isolates (4.90%) for afaIB-C and two isolates (1.96%) for sfa/focD-E genes. Based on our findings, E. coli isolates from colibacillosis of Japanese quail could be assigned to various phylogenetic groups (mostly A and D), and they may contain the adhesion genes in a low prevalence.

One of the main tasks of clinical microbiology laboratories is to determine antibiotic resistance profiles in common pathogens and ensure the selection of effective antibiotics for certain infections. The aim of this study was to compare the methods of disk diffusion, broth microdilution and modified Hodge test in Escherichia coli isolates from urinary tract infection and diarrhea for susceptibility testing against beta-lactam antibiotics in Kerman, Iran.

In this study, 432 E. coli isolates were collected from diarrhea (216 isolates) and urinary tract infection samples (216 isolates). The antibiotic susceptibility testing methods of disk diffusion, broth microdilution and modified Hodge test were performed according to the Clinical and Laboratory Standards Institute guidelines.

The findings of disk diffusion method showed that resistance to cefotaxime, ceftazidime, aztreonam, cefepime and imipenem was 51.15%, 30.55%, 24.30%, 15.27% and 1.85%, respectively. In the disk diffusion test, 51.15% of the isolates were resistant to at least one antibiotic, all of which were later evaluated by the broth microdilution method. Moreover, 52.94%, 17.19%, 13.12% and 0.90% of the isolates were resistant to cefotaxime, ceftazidime, cefepime and imipenem, respectively. All of the isolates were evaluated for the production of carbapenemase enzyme by the modified Hodge test and none of the isolates were found as positive.

This study shows that performing carbapenem tests is very challenging, and laboratories are recommended to use secondary and independent antibiotic susceptibility tests such as modified Hodge test to confirm the carbapenem-resistant results.

E. coli is regarded as a reservoir for antibiotic resistance in foods of animal origin. E. coli can be categories into four main phylogenetic groups (A, B1, B2 and D). The commensal E. coli strains mostly are assigned to the phylo-groups A and B1.. The purposes of this study were to determine the phylogenetic group/subgroups and antibiotic resistance patterns of ostrich E. coli isolates in Iran.. A total of 126 E. coli isolates were obtained from cloacae swabs of the healthy ostrich in Kerman, Iran. The E. coli isolates were confirmed using biochemical API 20E identification system. The confirmed isolates were studied to determine phylogenetic background by PCR. The isolates were tested for antibiotic resistance against 12 different antibiotic disk by disk diffusion method.. Phylotyping of E. coli isolates indicated that 74 isolates belonged to A, 27 isolates to B1, 7 isolates to B2, and 18 isolates to D groups. Also the isolates fell into six phylogenetic subgroups, including 34 isolates in A0, 40 isolates in A1, one isolate in B22, 6 isolates in B23, 11 isolates in D1 and 7 isolates in subgroup D2. In the examined E. coli isolates, the maximum rate of resistance was against tetracycline, and the minimum rate of resistance was against amoxicillin. Twenty three antibiotic resistance patterns were detected among the isolates. The cefoxitin and tetracycline resistance pattern was the most prevalent in the isolates that belonged to phylo-group A.. In conclusion, the result of the present study revealed a low frequency of antibiotic resistance in ostrich E. coli isolates. The antibiotic resistance patterns were in relation to A and D phylogenetic groups. Further studies are needed to better understand the distribution of phylogenetic groups in poultry isolates..

Purposes of this study were to determine the phylogenetic groups، prevalence of enterotoxigenic pathotype and antibiotic resistance of Escherichia coli (E. coli) isolates from diarrheic cases in Bam city. In this study 155 E. coli were isolated from diarrheic samples in Bam city. Phylogenetic groups of isolates and enterotoxigenic pathotype were determined by detection of chuA، yjaA، TspE4C2 and ST، LT genes respectively. One hundred fifty five examined isolates were distributed in phylogenetic groups: A (71. 60%)، B1 (3. 22%)، B2 (9. 67%) and D (15. 48%). The genes for enterotoxigenic pathotype were detected in 52 isolates (33. 54%)، which ST gene were found in 29 isolates، LT in 16 isolates and LT، ST genes in 7 isolates. Twenty nine ST gene positive isolates were distributed in three phylogenetic groups A (48. 28%)، D (41. 38%) and B2 (10. 34%). According to the antibiotic susceptibility tests maximum and minimum antibiotic resistance rate was against to trimethoprim/sulfamethoxazole (74. 19%) and ciprofloxacin and gentamycin (9. 67%). Fifteen multiple antibiotic resistance patterns were detected in four phylogenetic groups. Escherichia coli isolates from enterotoxigenic pathotype have a considerable antibiotic resistance rate in Bam city and were distributed in different phylogenetic groups. Since a considerable number of isolates were negative for LT and ST genes، it is necessary to study the other virulence genes and their phylogenetic background in E. coli isolates from diarrheic cases in Bam city.

Shiga toxin-producing Escherichia coli (STEC) have emerged as the important zoonotic food-borne pathogens and confirming the risk to public health. Enteropathogenic Escherichia coli (EPEC) is a major cause of children diarrhoea in developing countries. E. coli strains can be assigned to four main phylogenetic groups, A, B1, B2 and D.. The aim of the current study was to analyze the distribution of phylogenetic groups and presence of STEC and atypical EPEC pathotypes in E. coli isolated from human diarrhea and fecal samples of healthy cattle in Kerman, Iran by PCR.. A total of 188 E. coli isolates were isolated from human diarrheic (94 isolates) and fecal healthy cattle (94 isolates) samples. The isolates were confirmed by standard bacteriological tests. The confirmed isolates were examined to detect the phylogenetic groups and a selection of virulence genes including stx1, stx2 and eae by PCR.. Phylotyping of isolates from diarrheic human showed that 38.29% belonged to A, 20.21% to B1, 14.89% to B2 and 26.59% to D phylo‐groups. The isolates of healthy cattle distributed in A (34.04%), in B1 (47.88%), in B2 (7.44 %) and in D (10.64%) phylo-groups. Prevalence of eae gene in human diarrheic isolates was 5.32% (5 isolates), whereas none of the human diarrheic isolates were positive for stx1 and stx2 genes. Among isolates of cattle 7.44% (7 isolates) were positive for stx1 gene and 5.32% (5 isolates) possessed eae gene. Of the all isolates examined, none were positive for the stx2 gene. The eae gene were positive for isolates of human diarrhea distributed in A and B2 phylo-groups and isolates possessed stx1 and eae genes from healthy cattle fell into A (4 isolates), B1 (7) and B2 (one isolate).. The isolates of human diarrhea samples and fecal healthy cattle were distributed into different phylogenetic groups, which mostly distributed in A and B1 phylo-groups. In addition, results of this study revealed the lower prevalence of SETC and aEPEC in isolates..