z. hashemizadeh

Liver transplant recipients are treated with various drugs, the metabolism of which is dependent on the cytochrome P450 polymorphic genotype. To identify the polymorphic variety of CYP2C19 genotype in liver allograft before and after transplantation. The study was conducted on 88 liver recipients. The CYP2C19 genotypes in donors and recipients were the same in 32 and different in 56 recipients. Extracted genomic DNA from the leukocytes and liver graft tissues were analyzed by TaqMan SNP genotyping assay. The distributions of homozygote, heterozygote, poor and ultra-rapid metabolizers’ genotypes were investigated in both groups. The distributions of CYP2C19 genotypes before transplantation in the blood and liver graft were within the normal range. After transplantation, in patients with different CYP2C19 genotype in donors and recipients, the genotypes of homozygote and ultra-rapid metabolizers were significantly decreased (p=0.024); the heterozygotes and poor metabolizer genotypes were significantly increased (p=0.017). The variety in CYP2C19 genotyping must be considered in patients with different genotypes in donor and recipients to predict the dosage regimens, optimize the treatment and decrease toxicity.

Acinetobacter is a gram-negative pathogenic bacterium and an important cause of nosocomial infections especially in immunocompromised patients in the intensive care units. Reports of multi-drug resistant isolates have increased during the last decade. As a result of extensive use of broad-spectrum antibiotics and high prevalence of ESBL producing bacteria especially in ICU ward, Acinetobacter infection is often difficult to treat.

To determine the antibiotic resistance in Acinetobacter and detecting the prevalence of ESBL producing strains in ICU patients of Namazi Hospital in Shiraz (Iran).

This study was carried our on 147 clinical isolates of Acinetobacter collected from ICU patients at Namazi Hospital during October to December (2008-2009). Antibiotic susceptibility test for isolated strains was performed using disk diffusion method. Also, isolation of ESBL Acinetobacter strains was accomplished using double disk synergy test.

The highest antibiotic resistance among 147 Acinetobacter baumannii strains was found against ciprofloxacin, amikacin, and gentamicin. Regarding the results of initial screening tests, 44% of total samples were demonstrated to be ESBL positive

Based on our data, the major reason for emergence of diverse ESBL strains was due to unjustified administration of broad spectrum cephalosporins. Accurate antibiotic susceptibility testing prior to administration of antibacterial agents for patients to reduce the high prevalence of ESBL strains is recommended.