mohammad ali noshak

CoNS, as opportunists, are responsible for severe nosocomial and health-care related infections. This study aimed to investigate the prevalence and distribution of aminoglycoside resistance genes encoding aminoglycoside-modifying enzymes (AMEs) and to simultaneously address the SCCmec types in CoNS isolated from patients and healthcare workers.

A total of 130 isolates including 80 clinical isolates and 50 healthcare worker isolates (HCWs), were collected from two hospitals examined for their susceptibility to gentamicin, tobramycin and amikacin using disc diffusion. AME genes and SCCmec types were detected by the Multiplex PCR assay.

The resistance rate to gentamicin, tobramycin and amikacin was 67.5%, 56.3%, and 40% respectively. In addition, resistance to gentamicin was predominant among both patients and healthcare workers isolates. Also, aac(6`)-aph(2”)-Ia gene was the most prevalent, occurring in 56.3% of isolates, followed by ant(4`)-Ia gene at 18.8%. In contrast, 23.8% isolates lacked any AMEs genes. SCCmec types I, II, III, IV, and V were identified in 62.5%, 1.6%, 29.7%, 1.6%, and 6.3% of isolates, respectively. The combinations of types I + III and III + V were found in 18.8% and 4.7% of isolates, respectively, while 21.9% of isolates were non-typeable.

In this study, the emergence of aminoglycoside resistant strains was observed among clinical and health care workers isolates. Furthermore, SCCmecI was the most abundant type detected, demonstrating that there are different types among the isolates in different regions.

Invasive Aspergillosis (IA) is an important cause of mortality and morbidity in the immunocompromised host such as، neutropenic individuals، chronic granulomatous disorder، leukemia، those undergoing solid organ transplantation، patients using broad spectrum antibiotics and steroids، patients with severe underlying diseases and patients with chronic pulmonary obstructive disease are among the main risk groups. Successful management in the treatment of IA depends on early diagnosis and treatment، the adequate choice of therapy، and antifungal resistance. The diagnosis of IA remains difficult and significant proportions of cases of IA remain undetected، thus in case of IA treatment should be considered as early as possible and carried out until the improvements. The treatment is usually based on surgery، antifungal therapy and reduction of immunosuppression. Azole-resistant Aspergillus fumigatus was first observed in Netherlands in 1999. Full mechanism of evolution of azole resistance is not completely known، however، increasing evidence indicates a role for azole fungicide used in agriculture. Due to the presence of A. fumigatus as an agent of IA in our environment and risk for patients، understanding the evolution of the increasing azole resistance in A. fumigatus is crucially recommended. Therefore، induction of azole resistance or its spread can be possibly prevented to allow future treatment of IA due to A. fumigatus.