مجله دانشکده پزشکی اصفهان
پیاپی 680 (هفته چهارم شهریور 1401)

Vancomycin-resistant Enterococci are considered as a serious problem owing to limited selective therapies necessitating alternative antibiotic therapies. The aim of this study was to isolate and identify effective probiotics against vancomycin-resistant Enterococci strains and their biofilms.

In this experimental study, Enterococci samples were isolated from several hospitals in Isfahan and their vancomycin-resistant strains were selected by antibiotic susceptibility testing. The antimicrobial effect of various probiotic bacteria against them was investigated. After selecting the most effective probiotics, various tests including mortality time and minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were performed. The inhibitory mechanism of these probiotics and the amount of lactic acid production as the main inhibitory mechanism were studied using high performance chromatography.

On total, 350 Enterococci samples were isolated, 46 of which were vancomycin resistant in which linezolid was among the few effective antibiotic. Two probiotic bacteria, Pediococcus acidilactici and Lactobacillus plantarum, were isolated which were effective against all vancomycin-resistant Enterococci and their biofilms. The lethal time of these two probiotics was 12 hours and the MIC and MBC were at concentrations of 0.5 µg/ml and 1 µg/ml respectively. Various tests on these two probiotics also showed no pathogenicity and no antibiotic resistance. The amount of lactic acid in Lactobacillus plantarum and Pediococcus acidilactici were 2.5 and 1.1 g per 100 ml respectively.

The optimal antimicrobial and antibiofilm properties of these two probiotics alongside producing high levels of lactic acid against all vancomycin resistant strains demonstrate their desirable and potential properties.

As overweight and obesity in children and adolescents continue to increase, this study was designed to explore the factors that facilitate or hinder weight control in obese and overweight adolescents.

This qualitative study was conducted as a personal interview with 12 adolescents aged between 12 and 18 years who succeeded in losing weight and those who did not, from the clinic at the Pediatric Cardiovascular Research Center at the Isfahan Cardiovascular Research Institute, in 2019. We used a purposeful sampling method and a qualitative analysis method to analyze the data.

Seven categories consisting of willpower and perseverance, support and encouragement of others, tendencies to beauty, lack of a rush to achieve results, adequate physical activity, understanding the disadvantages of obesity, and understanding the benefits of weight loss were identified as facilitating factors in this study. Seven other factors were reported as obstacles of weight loss, including misconceptions,  lack of family cooperation in lifestyle modification, lack of awareness about the effects of obesity, concern about dietary restrictions, lack of management and supervision of school cafeterias, parental misbehavior in handling adolescents with overweight or obesity, and their psychological damages.

The results of the present study show that in order to bring adolescents to the ideal weight, individual, environmental and familial factors and the interaction between them should be considered. The findings of this study could be used by health officials and policymakers to develop programs to prevent and control overweight and overcome obesity.

Candida auris, a multidrug-resistant yeast, can cause primary or secondary infections in a wide range of patients, including those diagnosed with the new coronavirus to even healthy individuals. The fungus has been reported in less than a decade on all six continents and in more than 45 countries. Ease of distribution, long shelf life, and resistance to several antifungal drugs have raised concerns about the prevention and management of patients with C. auris infection. Recent reports indicate serious challenges in identifying, understanding the mechanism of drug resistance, and preventing mortality from the infection with this microorganism. Given the prevalence of COVID-19 infection, it is important to identify patients colonized with C. auris correctly and at the early stages, to control and prevent a possible outbreak. In this article, the widespread occurrence of infections due to C. auris in the world and Iran, its clinical manifestations, risk factors, pathogenic mechanisms, diagnostic enhancements and challenges, drug resistance, treatment options, prevention, and control as well as concomitant C. auris infections in patients with COVID-19 virus, are reviewed.