نشریه بیماریهای عفونی و گرمسیری
پیاپی 64 (بهار 1393)

Acinetobacter is common in nosocomial pathogen and it is a health care associated opportunistic multidrug resistant pathogen. The purpos e of this study is to determine the sensivity and resistance of Acinetobacter strains that was isolated from clinical samples of patients who was admitted to Arad hospital in Tehran. In this descriptive examination, after extracting Acinetobacter derivations from clinical samples (Urine, sond fuli, sputum, wound, blood and bronchial), Their sensitivity was measured using standard Kirby - Bauer test, in contract with following antibiotics Amikacin,Ciprofloxacin, Gentamicin, Imipenem, Ce ftriaxone Sulfametoxazole Trimetoprime, Piperacilin and Cefotaxime and then the results analayzed. In this study of 225 samples of Acinetobacter derivation isolated from clinical specimens, the most amount of sensivity was Piperacilin and Ciproflo xacin and the most amount of resistance was to Gentamicin and Amikacin. The results of this study are indicating that Acinetobacter strains resistance has increased against Gentamycin and Amikacin; presumably due to excessive consumption of the se antibiotics. It is obvious that, with increasing consumption of antibiotics, and consequently, augmentation of antibacterial resistance, control of this resistance factor is necessary and inevitable, we recommended to avoid unnecessary usage of antibiot ics.

Mycoplasmas, particularly sp ecies of the genera Mycoplasma and Acholeplasma, are known to be occasional microbial contaminants of cell cultures that produce biologics. The aim of this study is to alternate a specific, sensitive and rapid method for detection of a variety of Mycoplasm a species in cell lines by PCR - ELISA. This method was based on a PCR - ELISA reaction using genus, specific primer and species specific primers for Mycoplasma species that labeled with Digoxigenine and specific probe, which labeled by b iotin. Mycoplasma contamination using PCR - ELISA was examined for 183 different cell line deposited in national cell bank of Iran. PCR - ELISA showed that 48.6 % of cell lines were contaminated whit Mycoplasma while 27.3% of them were found to be inf ected with microbial culture. PCR and PCR - ELISA methods, both of them showed the same results. In comparison to microbiological culture, PCR - ELISA method was shown to be 100% sensitive and 70.7% specific. Microbial culture and staining are com mon methods for detection of cell lines Mycoplasma contamination. These methods are time - consuming and so rapid contamination detection is critical for cell lines. For this reason PCR - ELISA method is recommended for rapid mycoplasma detection.

Satureja is belongs to Lamiaceae family. About 14 species have been reported in Iran. The aim of this study was to determine antimicrobial effect of the aqueous and ethanolic extracts of Satureja bachtiar ica (different concentrations) on Listeria monocytogenes PTCC 1297، Bacillus cereus PTCC 1154، Enterobacter aerogenes PTCC 1221، Enterococcus faecalis PTCC 1237 & Salmonella typhi PTCC 1609” in vitro”. In this study, antimicrobial effect of the extracts evaluated by two methods, “Collins method” (spreading of the extract on medium surfac e) and “disk agar diffusion method”. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) for both species determined by using a dilution method. The results showed that in "disk agar diffusion test ", ethanolic extract had inhibition effect on Listeria monocytogenes، Bacillus cereus and Enterococcus faecalis. The result shows that MIC of Satureja bachtiarica leaves of the aqueous and ethanolic extracts for Enterobacter aerogenes was 64 and 32 mg/ml respectively. The MBC aqueous and ethanolic extracts of Satureja bachtiarica leaves for Enterobacter aerogenes was 128 and 64 mg/ml respectively. The ethanolic extract of Satu reja bachtiarica leaves “in vitro” have a significant antimicrobial effect on gram - negative bacteria Salmonella typhi and Enterobacter aerogenes and the gram - positive bacteria Listeria monocytogenes، Bacillus cereus and Enterococcus faecalis. Enterobacter aerogenes was resistant to most of the aqueous and ethanolic Satureja bachtiarica extracts.

Staphylococcus aureus is a common cause of infection among human and animals and known as community - acquired and nosocomial pathogen. Most of the isolates contain lysogenic phages which are responsible for production of various vir ulence factors. Methicillin resistance in S. aureus is related to mecA gene. mecA gene, it’s regulatory genes, resistance genes to other antibacterial agents and recombinase enzyme gene locus (ccr) are located on staphylococcal cassette chromosome (SCCmec). The aim of this study was to analyze the antibiotic resistance pattern, and typing of mecA gene cluster and ccr gene locus of MRSA strains isolated from patients in Isfahan from 2012 - 2013. Totally 293 Staphylococcus aureus isolate s were collected from 1 hospital in Karaj. All isolates were identified at the species level using specific primers. Susceptibility to 15 antibiotics was determined using disc diffusion method according to guidelines of Clinical Laboratory and Standard ins titute (CLSI). Minimum inhibitory concentration (MIC) of oxacillin and vancomycin in MRSA isolates were also detected using broth micro dilution assay according to CLSI recommendation. Primers for identification of 6 classes of prophages were used in a Mul tiplex - PCR assay. mecA gene was detected using specific primers. Multiplex - PCR assays were used for ccr and SCCmec typing. Among S. aureus isolates, 101 strains (34.5%) were selected as MRSA. The highest antibiotic resistance was observed to eryt hromycin (88%) and followed by ciprofloxacin (85%), clindamycin (84%) and tobramycin (81%) respectively. None of the isolates were resistant to vancomycin, linezolid and synercid. High (MIC≥128 μg/ml) level resistance to oxacillin was observed in 70% of th e isolates. Two different prophage types and 2 sub - types were found in MRSA isolates. All isolates contained mecA gene and 100% of MRSA isolates harbored SCCmecc type III and also type 3 ccr. High prevalence of different classes of prophages e ncoding a variety of virulence factors and high oxacillin resistance provide an important role for phages in the evolutionary development of virulence factors and also diversity in methicillin resistance cassette in MRSA isolates. The presence of SCCmec ty pe III indicating the high prevalence of hospital acquired MRSA isolates. Prevalence of these highly virulent isolates with high resistance to first and second lines of treatments is a potential treat for public health.

Tuberculosis (TB) constitutes a major public health problem in most developing countries of the world. About one third of the world's population is infected with the disease, 95% of which are in the developing countries and 98% of all TB related deaths occur in these regions.The aim of this study was to assess beliefs of tuberculosis patients regarding tuberculosis disease and its treatment via on Health Belief Model (HBM) in refer ring to anti - TB center Zabol city in 2011. A descriptive cross - sectional study was conducted on all thetuberculosis patients (110 people), referred to anti - TB center Zabol. Sampling method was non probability. Data were collected throug h a questionnaire which was designed based on HBM and included some additional information such as demographic variables and practice checklist. SPSS software (Version 18) was used for statistical analysis. In this study 66 female (60%) and 44 men (40%)participated. The mean age ofparticipants was 55.7±18.6.Tuberculosis smear positive (SP) and smear negative (SN) incidence rate was 50% and 39% respectively. Statistically significant relationships were found between treatment behavior and self - effic acy (r=0.45, p<0.01); perceived benefit (r=0.40, p<0.05), perceived barriers(r=0.39, p<0.05), perceived susceptibility(r=0.38, p<0.05), and perceived severity (r=0.34, p 0.01). An overwhelming majority of the patients had poor knowledge and mis conceptions concerning Tuberculosis,so our study highlights the need to changepatientsattitudes about TB via HBM.

This study was established to determine the lymnaea stagnalis snails’ infection with trematodes larval stage in one of the springs of the Shahrekord city in Chahar Mahal and Bakhtiari. To determine the snail infection to trematodes larval stages, the snails were caught from the field, and transferred to the Parasitology department of Razi Vaccine and Serum research Institute. Then stimulating of snails by light, tubing and squ ashing of them were used to detection and identification of the isolated cercariae. Of 400 collected Snails from the referred springs, 320 of them identified as lymnaea stagnalis. Observed cercariae were identified and classificated as order Plagi orchis, family plagiorchiidae and genus opisthioglyphe and plagiorchis. In Chahar Mahal and Bakhtiari province due to having more than 10% of water content of country, ecological conditions can play important role to developing sensitive snail especially L ymnaeidae and be considered as a critical and suitable habitat for them.

This study was designed to determine the fauna and bio - ecology of Sand flies in Kahak country, the endemic focus of cutaneous leishmaniasis in Qom Province during 2012. The present study was a cross - sectional one that conducted on sand flies. It was carried out in Kahak district of Qom province during 2012. Sand flies were collected biweekly from indoors and outdoors (rodent burrows) of three villages, using 180 sticky traps from the beginning May to the end November of the active season. For species identification, sand flies were identified using the valid keys, fauna and seasonal activity also were determined. A total of 4 164 sand flies (1295 from indoors and 2869 from outdoors) were collected and identified. The thirteen species, including three species of the genus phlebotomusand three species of the genus Sergentomyia.The most common sand flies in indoors resting places were P.papatasi (43.47%). Two active peaks of sand flies were observed in late May and late August. Based on findings, sand flies peak activity in this area was late June and late August. P.papatasi was the dominant species in indoors and outdo ors. It seems this species can be probable vector for CL in the study area.

Ventilator - Associated Pneumonia (VAP) is one of the subgroup of Healthcare - Acquired Pneumonia (HCAP) of which is one of the causes of death in hospitalized patients. The aim of this study is evaluation of epidemiological factors of Ventilator - Associated Pneumonia among ICU (Intensive Care Units) patients in Valiasr Hospital of Arak in 2012 summer. this cross - sectional study was conducted for 3 months (2012 June to August) and included all patients had been hospitalized in ICU wards of valiasr Hospital and in this time VAP diagnosis was made for them. Patients by using of checklist of which was included demographic, physical and laboratory results inf ormationwere studied and fallow up at study entry, during hospitalization and after hospital discharge. Finally the data were analyzed by using SPSS 16 statistical softwareandChi2test. Of the 67patients surveyed during the study, 60patients (89.6%) with VAP (Internal ICU (26.8%), Surgery ICU (62.7%)) were diagnosed. The most common pathogens cause s of VAP in patients were Acinetobacter spp(40%), Staphylococcus aureus(38.3%), Pseudomonas aeruginosa(8.3%) and Citrobacter (1.6%), respectively. Acinetob acters ppes the most common pathogens isolated from patients with VAP had the highest resistance and susceptibility to gentamicin with 69.6% and to imipenemwith90.9%, respectively. Among the60 patients with VAP in this study, at the end and after discharge from the hospital 11.7% full recovery, 18.3% partial recovery and 20%hadnorecoveryand also 50 % of whom were died. Results indicated that the frequency of VAP is high in the ICU of hospital. Consequently, Observance of appropriate standards is recommended to prevent of VAP in the ICU of hospitals in each center, separately.

Because of clinical importance of Mycoplasma hominis especially in gynecology and difficulties related to diagnosis of this organism in our laboratories, it is essential to more accurately evaluation of the menti oned bacteria frequency in Iran. In this study the technique of culture and formulation of media have been designed in order to increasing the probability of bacterial isolation from the patient’s clinical specimens favorably. Moreover, frequency of Mycopl asma hominis in the studied population and also relationship between presence of organism and clinical signs has been evaluated. This research was a descriptive epidemiological study which wasperformed on 226 patients referred to women clinic of Qazvin Kowsar hospital in 2012 - 13. The specimen was endo - cervical mucosa which was collected by dacron swabs. The swabs were initially placed in broth culture media and then maximum after 24 hours were transferred on agar plates. In this study observation of fried egg shaped colonies on the surface of agar culture media was considered as a positive culture and color change of broth media alone was reported as negative. Among the 226 specimens obtained form patient’s cervical m ucosa, 30 cases (13.2%) were positive for Mycoplasma hominis based on colony formation on agar media. Frequency of Mycoplasma hominis in Qazvin is considerable and more investigations are necessary. The technique of culture and formulation of medium used in this study can improve sensitivity of the culture method.

Back ground and This study was done to determine the recent resistance rate of E.coli strains isolated from urinary tract infections of p atients of Imam khomanin hospital to common antibiotics especially quinolons and screening the frequency of qnrA gene among them. During 6 months, 100 E.coli strains collected randomly from urine samples. All confirmed based on b acteriologic tests and their sensitivity to common antibiotics were determined based on CLSI 2011 protocol. Continuously, DNA extraction was done and frequency of qnrA gene was determined by PCR. Based on antibiogram, their resistant was 100% to amoxicillin and penicillin, 77% to amoxiclauve, 72% to ceftazidim, 69% to cephotaxim, 51% to ciprofloxacin, 47% to cefexim, 46% to ceftriaxone, 43% to cephalexin, 27% to axtreonam, 14% nalidixic acid and 2% to imipenem. Among 39.5% of E.coli isolated a 51 6bp band related to qnrA was detected by PCR. Doing antibiogram in all clinical laboratories as a simple and cheap test before any antibiotic prescription especially quinolons to prevent drug resistant is recommended.

Due to environmental problems and public concerns arising from the use of chemical insecticides in the residential, safer alternative for urban pest controlling is considered seriously. So, the toxicity of essential oil of Eucalyptus sp. (Eucalyptus oil) was evaluated against the brown - banded cockroach, Supella lingipalpa (F.) in the present study. For this evaluation continuous contact to xicity, fumigant toxicity and repellency test were applied against older nymph instars of the brown - banded cockroach. The results showed that Eucalyptus oil caused 100% mortality in the cockroach nymph population at concentrations higher than 5% after 24 h using continuous contact bioassay, while no mortality was observed in control. The concentration of 2.8% (LD 50) and 5.7% (LD 95) were need for killing 50% and 95% of nymph population at 24 h after contact exposure. The fumigation bioassay also c aused 100% mortality of the nymph in less than 24h at concentration of 50 μl of pure essential oil per 1 - lit glass jar. Eucalyptus essential oil resulted in different repellency values of the cockroach at different concentrations. The highest repellency occurred in the concentration of 5%, resulting in 49.5% of the cockroach repellency. Compatibility of the Eucalyptus plant with the climate conditions of many areas of Iran including Khuzestan province, the essential oil of this plant can be c onsidered as a potential alternative to control of the cockroach in an integrated management program.