Infection, Epidemiology And Medicine
Volume:3 Issue: 2, Spring 2017

Integrons are considered as to play a significant role in the evolution and spread of antimicrobial resistance genes.
A total of 120 clinical isolates of Pseudomonas aeruginosa (collected from Zanjan hospitals between March 2015 and February 2016) were investigated for molecular characterization of MBLs and Class I and II integrons. Antimicrobial susceptibility testing was also performed based on the CLSI guidelines. The frequency of MBL producing isolates and the susceptibility to various antimicrobial agents were investigated.
Based on the obtained results, BlaIMP was the most frequently detected metallo-β-lactamase. The frequency of blaVIM, blaSPM, and blaSIM, in MBL producing isolates was 17.1, 57.1, and 14.1%, respectively. No blaGIM harboring isolate was detected in our study. We detected two (5.7%) multidrug resistant P. aeruginosa strains isolated from the urine and sputum samples, which harbored blaNDM-1. These isolates also contained blaIMP and blaSPM. Class I integron was detected in 94.3% of the MBL positive isolates while 8.5% of the isolates contained Class II integrons. Of five different gene cassettes identified in Class I and II integrons, cassette encoding resistance to trimethoprim (dfr) was found to be predominant.
These results indicate that Class I integrons are widespread among the MBL producing P. aeruginosa isolates. Therefore, appropriate surveillance and control measures are essential to prevent the further spread of MBL and integron producing P. aeruginosa in hospitals.­­

Pseudomonas aeruginosa has become the most common cause of infections in burn patients. The aim of this study was to investigate the antibiotyping and genotyping of P. aeruginosa strains isolated from burn patients in Mottahari hospital during June-October 2016.
A total of 78 P. aeruginosa strains were collected from wound infected patients. Identification of the isolates was performed by biochemical tests and confirmed by specific 16srDNA PCR. Antimicrobial susceptibility testing was done by disk diffusion method according to the CLSI guidelines. The isolates were then evaluated for genotyping by ERIC-PCR.
From a total of 78 collected isolates, 77 isolates (98.7%) were confirmed as P. aeruginosa by specific PCR. We found 4 antibiotypes. The highest resistance was observed to imipenem and gentamicin (~100%), and the most sensitivity was shown to colistin (100%). Overall, MDR phenotype was observed in most of the isolates (98.7%). The PCR of ERIC box produced 52 different patterns and 3 main clusters. Also, 59 (83%), 2 (3%), and 9 (13%) isolates were included in Cluster A, B, and C, respectively, and Cluster A was the predominant ERIC profile.
The high resistance to antibiotics in our study may be due to their abundant use as the prophylactic or treatment regimen in wound infections. So appropriate use of antibiotics seems necessary, and colistin is a proper choice for treatment of burn infection. In genotyping, 3 main clusters and 52 different patterns were shown. A majority of the P. aeruginosa strains isolated from burn patients were related and belonged to Cluster A.

Klebsiella pneumoniae (K. pneumoniae) causes a wide range of nosocomial and community-acquired infections. In recent decades, K. pneumoniae has been known as the agent of community-acquired primary pyogenic liver abscess. In attempts to find the causes of this disease, researchers found a new virulence gene called magA (mucoviscosity-associated gene A). The present study was performed to determine the prevalence rate of magA gene among the extended-spectrum beta lactamase (ESBL)-positive and ESBL-negative K. pneumoniae strains.

The current cross-sectional study was conducted on 130 K. pneumoniae isolates collected from patients in Imam Reza hospital and its associated clinics in Mashhad city (Iran) from May 2011 to July 2012. The presence of K. pneumoniae species was confirmed by conventional microbio­logical methods. Samples were tested for the production of ESBLs by the double disk diffusion (DDS) test. PCR was performed to detect magA gene. The hypermucoviscosity (HV) phenotype of Klebsiella isolates was char­acterized by the string test.

magA gene was detected in 11(8.5%) out of 130 isolates of K. pneu­moniae. Of 11 isolates with positive result for magA gene, three cases were HV, and 8 cases were HV- phe­notype. Of 130 K. pneu­moniae isolates, 56 isolates were ESBL-positive, and 74 isolates were ESBL-negative. The magA gene was detected in 4 out of 56 (7.14%) ESBL-positive, and 7 out of 74 (9.46%) ESBL-negative samples.

In the present study, no correlation was observed between the presence of magA gene and the production of ESBL in K. pneumoniae strains isolated from different clinical samples in Mashhad.

Accessory colonization factor is located immediately adjacent to and downstream of TCP cluster. These genes (acfA, B, C, D) are involved in bacterial colonization and pathogenesis. The aim of this study was to analyze the ACF cluster prevalence rate and gene content in clinical isolates of Vibrio cholerae.
All of the 21 V. cholerae isolates used in this study were collected during 2011-2012 outbreaks in Iran. All of the isolates were screened by biochemical tests and confirmed by specific PCR for 16srRNA-23srRNA intergenic space. The gene content of ACF cluster in the isolates was analyzed using 4 primer pairs with overlapping sequences and then subjected into Restriction Fragment Length Polymorphism (RFLP) assay.
Among the 21 V. cholerae isolates, all of them (100%) were identified as V. cholerae O1 Inaba, 20 (95%) isolates were determined with El Tor biotype specificity, and 1 isolate (5%) appeared as Classical biotype. A total of 18 strains (85.8 %) contained a complete set of ACF-associated genes, 3 strains (14.2 %) were negative for ACF cluster, and all of the strains showed similar RFLP pattern to each other and to V. cholerae ATCC 14035.
The results showed that O1 Inaba was the dominant serotype and positive for ACF cluster in pathogenic V. cholerae isolates collected during 2011-2012 in Iran. The presence of some ACF negative strains with potentially pathogenic characteristics proposed that other colonization factors might have been involved in causing pathogenicity and diarrhea in these strains.

Rapid test and conventional ELISA are common immunological assays used for the detection of HIV infection. In this study, we evaluated the prevalence rate of HIV infection by rapid test used for screening HIV infection and then confirmed the positive cases with ELISA and western blot tests.
In this analytical descriptive study, 1964 out of 6923 patients who were referred to the Consult Center of Behavior Diseases, West Health Center (Valfajr Clinic), Iran University of Medical Sciences were subjected to rapid test for screening HIV infection from July 2012 to September 2014.
Thirty seven out of 1964(1.88%) cases were confirmed as positive by rapid HIV test. All of the positive cases confirmed by rapid test were also confirmed as positive by ELISA and western blot tests. According to the data analysis of this study, among people diagnosed as HIV positive using rapid test, 12(32.4%) cases had unsafe heterosexual contact, followed by 10 (27%) cases of IDUs with a history of prison, shared injection, and unsafe heterosexual contact.
The use of rapid test as a screening test for diagnosing HIV infection and the confirmation of all the positive and suspected negative cases by the ELISA test or western blot is recommended.

Many studies have been conducted on fungal infections which are known as public health and therapeutic problems. Since the prevalence rate of the fungal diseases and their etiological factors are changing over time, the purpose of this study was to identify the prevalence rate of superficial-cutaneous fungal infections (SCFIs) in order to understand the ways of their dissemination, to prevent diseases transmission, to eliminate contamination sources and predisposing factors, and to take appropriate action for their treatment.
After referral to medical mycology laboratory of Tehran University of Medical Science from 2014 to 2015, the patients were subjected to mycological examinations, and sampling of patients’ lesions was performed. Directsmears were prepared with Potassium hydroxide. Samples were cultured on Sabouraud dextrose agar medium, and species were identified.
From a total of 916 suspected patients, 334 cases (36.5%) had SCFIs. Dermatophytosis was the most prevalent SCFI (55.7%), followed by cutaneous candidiasis (19%), tinea versicolor (14.3%), and non-dermatophytic molds (11%).Tineapedis was the frequent site of involvement. Trichophytonmentagrophytes was the predominant species of dermatophytosis.
According to the obtained results on the prevalence rate of SCFIs between male and female patients in different age groups and also by taking into account the type of the prevalent fungi and the involvement site of the fungal infection, it is possible to take appropriate action for prevention and treatment of these kind of diseases by using important keys of the results to research etiological and underlying factors involved in these diseases.

Tinea versicolor (TV) is a common superficial fungal infection of the skin, characterized by scaling and mild disturbance of the skinpigmentation. It typically affects the chest, upper back, and shoulders. However, the involvement of more unusual regions of the body such as the face and scalp, arms and legs, genitalia, groin and palms and soles has been reported. This report is a case of groin TV caused by Malassezia furfur affecting a 25-year-old man in Iran. After sampling, direct smears with 15% Potassium hydroxide (KOH) and staining with methylene blue were prepared. In direct microscopic examination, budding yeast cells with typical scar and short curved mycelium were observed. To identifying the strains of M. furfur, differential tests and culture on Sabouraud dextrose agar and mDixon agar media were performed. The clinician must be aware of these variations in the location of TV and perform an appropriate diagnostic workup when lesions have the mor­phological characteristics of TV despite an unusual location.

Human papillomavirus (HPV) is one of the most common causes of sexually transmitted disease (STD) in humans. HPV is associated with gynecologic malignancy and cervical cancer among women worldwide. In the current study we sought to determine the prevalence rate of HPV in Iranian women identified with cervical infections.
Prevalence rate of HPV in Iran was investigated from 2000-2016 using several databases including Medline, Web of Science, Embase, Google Scholar, Iranmedex, and Scientific Information Database. Statistical analysis was performed by Comprehensive Meta-Analysis (V2.2, Biostat) software. Random effects models were used by taking into account the possibility of the heterogeneity between the studies, which was tested through the Cochran’s Q-statistic.
The meta-analyses showed that the prevalence rate of HPV infections was 38.6 % (95% CI, 27.9-50.5) among Iranian women with cervical infections. The further stratified analyses indicated that the prevalence rate of HPV was higher in the studies conducted during the 2000-2008 years.
The results of the present study underscore the need for further enforcement of STD control strategies in Iran. Establishing advanced diagnostic facilities for HPV, vaccination of high risk groups, and continuous monitoring of HPV are recommended for HPV prevention and control.