Jundishapur Journal of Microbiology
Volume:6 Issue: 7, Sep 2013

Resistance in enteric Gram-negative bacteria is of a great concern and concise local data are lacking.. To determine prevalence and antimicrobial susceptibility pattern of Extended Spectrum Beta-Lactamase (ESBL) and non-ESBL producing enteric Gram-negative bacteria.. In a descriptive study in Tehran, patients’ samples have been obtained and were inoculated on blood and MacConkey agar plates at microbiology laboratory hospital, and a total of 292 Gram-negative species were isolated at Microbiology Laboratory from patients’ specimens. Susceptibility pattern was determined by disk diffusion method based on Kirby-Bauer method on Mueller-Hinton agar plate. SPSS 16 software (descriptive analysis, Chi-square) was used for statistical analysis of this study.. Escherichia coli was the most common organism [189 (64.7%)], followed by Acinetobacter baumannii [40 (13.7%)], Pseudomonas aeruginosa [32 (11%)], Klebsiella pneumoniae [26 (8.9%)], Proteus mirabilis [4 (1.4%)], and Serratia marcescense [1 (0.3%)]. 122 (41.8%) of isolates were classified as ESBL - producers. E. coli accounted for most of the ESBL-producer bacteria, followed by K. pneumoniae. 170 (58.2%) of isolates were non-ESBL producers. All of the ESBL producer isolates were sensitive to imipenem, piperacillin-tazobactam and colistin whereas resistance to these antibiotics in the non-ESBL group was seen. The rate of resistance to nitrofurantoin in ESBL group was lower than of that in non-ESBL group. The majority of the ESBL isolates of resistant to trimethoprim-sulfamethoxazole, ciprofloxacin, the third generation cephalosprins (ceftriaxone, cefixime, and cefotaxime), gentamicin and amikacin, were sensitive to nitrofurantoin.. Although all ESBL producer Gram-negative bacteria were sensitive to imipenem, piperacillin-tazobactam, and colistin, non-ESBL isolates showed resistant pattern. Interestingly, notable percent of mentioned resistant isolates were sensitive to nitrofurantoin..

Multidrug-resistant (MDR) strains of Acinetobacter baumannii have been increasingly reported as a major cause of nosocomial infections, and have created major therapeutic problems worldwide.. The aim of the present study was to evaluate the role of proton motive force (PMF)-dependent efflux mechanism in the multiple resistance phenotype of A. baumannii clinical strains.. A total of 65 A. baumannii clinical strains were collected from hospitals in Tehran. These were tested for antimicrobial susceptibility using disc agar diffusion and broth microdilution methods. Active efflux was assessed by ethidium bromide accumulation assays. Further evaluations were performed by the determination of the minimum inhibitory concentrations and the accumulation of ciprofloxacin against selected MDR A. baumannii in the presence and absence of carbonyl cyanide m-chlorophenylhydrazone (CCCP), an inhibitor of PMF.. Ninety five percent of strains were MDR, with high rate of resistance to ciprofloxacin (92.3%), gentamicin (89.2%), and ceftazidime (93.8%). Colistin and imipenem were the most effective antibiotics with resistance rates of 1.5% and 44.6%, respectively. MDR strains showed a four-fold reduction in the MIC of ciprofloxacin when tested in the presence of the efflux pump inhibitor (CCCP). The addition of CCCP led to a significant increase in the accumulation of ethidium bromide and ciprofloxacin.. PMF-dependent efflux mechanism appears to play an important role in the MDR phenotype of A. baumannii clinical strains..

The emerge of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli caused problems in antibiotic treatments. The more than 50 variants of CTX-M type ESBLs enzymes are available worldwide. Rapid and discriminative typing methods are essential for epidemiological analysis of clinical CTX-M-producing isolates.. To assess the frequency and genetic diversity of extended-spectrum CTX-M β -lactamases in E.coli isolates from Tehran.. During 2009 - 2010, 200 non-duplicate clinical isolates of E. coli were collected from five hospitals in Tehran. Antibacterial susceptibility was determined using disk diffusion and MIC methods. ESBL production was confirmed by Combined Disk and MIC. CTX-M encoding genes were identified by PCR, and blaCTX-M -carrying isolates were genotyped by rep-PCR.. A total of 140(70%) non-duplicate ESBL positive E. coli were determined. Imipenem and Amikacin were effective against 100% and 85% of all tested isolates respectively. Co-resistance of ESBL positive isolates to Erythromycin, Tetracycline, Co-trimoxazole and Ciprofloxacin were found in 93%, 75%, 63% and 43% of the strains, respectively. The rate of cefotaxime and ceftazidime resistant isolates dramatically decreased from 72% to 8.5% and 39% to 4.5% respectively, in the presence of clavulanic acid. Eighty nine (44.5%) E. coli isolates carried the blaCTX-M-1 group alleles. The levels of similarity of the rep-PCR fingerprints of blaCTX-M-1 isolates ranged from 40 to 90%.. The rapid dissemination of non clonal multi-resistant CTX-M-1 producing E. coli isolates approved the need for further studies in our medical centers..

Metallo-β-lactamase (MBL) producing Pseudomonas aeruginosa is responsible for many important nosocomial outbreaks including pneumonia and septicemia. Various studies have reported the separation of P. aeruginosa producing MBLs enzymes resulted in increases in multiple traditional antibiotics resistance including carbapenems, cephalosporins and penicillins.. In this study, based on the standard phenotypic and genotypic methods, we examined the MBLs possible production of a P. aeruginosa isolate. The main objective was exploring the dissemination of resistant MBL P. aeruginosa in south-west of Iran, Shiraz.. During a six-month period-from October 2011 to March 2012-240 P. aeruginosa isolates, collected from four teaching hospitals in Shiraz located in southwest of Iran, were examined. The isolates were mainly collected from wound, urine, and sputum. Minimum inhibitory concentration (MIC) ≥4 µg/mL to imipenem was determined by micro-dilution broth. Identification of P. aeruginosa with MBL was detected using double disk synergy test (DDST) and polymerase chain reaction (PCR) using specific primers for blaIMP1, blaVIM2, blaSIM1, blaSPM1. All laboratory procedures was according to clinical and laboratory standards institute (CLSI) recommendations.. From 240 P. aeruginosa isolates, 82 (34.16%) isolates were imipenem-resistant (minimum inhibitory concentration (MIC) ≥4 µg/mL). Among these imipenem-resistant isolates, 19 (23.3%) MBL-producing P. aeruginosa isolates were screened using DDST. A specific PCR test confirmed the presence of 18 (21.95%) P. aeruginosa producing blaIMP1 and blaVIM2.. Beside our study, the detection of MBL genes were reported in a few studies conducted in Iran. The spread of detected MBLs producing P. aeruginosa were unprecedented in the region due to the lack of independent related researches or the novel incidence of these genes. This detection must be noted by associated clinical and health care services..

The Vaccination programs to control avian influenza (AI) infection in poultry, have limitations due to the difficulty in differentiating the vaccinated and naturally infected birds AI vaccination would bring greater global acceptance if a reliable test, which could clearly distinguish the naturally infected and vaccinated-only animals (DIVA), was available. Since the nonstructural protein (NS1) is expressed in influenza infected cells, and it is not presented as a virion, it could be a proper candidate for DIVA differential diagnostic test.. Vaccination programs for the control of avian influenza (AI) in poultry have limitations due to the problem of differentiating between vaccinated and virus-infected birds. The use of AI vaccination in poultry would have greater worldwide acceptance if a reliable test were available that clearly discriminated between naturally infected and vaccinated-only animals (DIVA). Because the nonstructural protein (NS1) is expressed in influenza virus–infected cells, and it is not packaged in the virion, it is an attractive candidate for a DIVA differential diagnostic test.. A total of 300 day-old broiler chicks (Ross 308) divided into three equal groups (1 to 3). The chicks in group 1 were immunized with killed AIV H9N2. The chicks in group 2 were infected with AI virus subtype H9N2. The chicks in group 3 were kept as controls and did not receive any vaccined or lived virus. Chicks sera were collected at day 42 usingrNS1-ELISA and Commercial ELISA kit.. Designed ELISA test for detection of antibody against influenza NS1 could experimentally distinguish the chicks infected with AIV and chicks immunized with killed influenza viruswith93.3% sensitivity and 100 ℅specificity. 3 weeks after infection or vaccination, sera from all two treated groups were positively tested using commercial ELISA kit (IDEXX). In contrast, by NS1-ELISA, only infected groups sera were tested and the result was positive, and all sera samples from the vaccinated group were NS1-antibody titer were evaluated and the result were negative.. It was concluded that antibodies against AIV NS1 protein was only detected in the sera of chickens experimentally infected with AIV, not in the sera of chickens immunized with inactivated vaccine..

Aspergillus species produce the highly toxic and carcinogenic metabolite, Aflatoxin B1 (AFB1), on food and agricultural commodities. Some natural products are known to inhibit aflatoxin production.. With the aim of controlling aflatoxin production, the essential oils of Cuminum cyminum L. from the best known regions of Iran i.e. Alborz Mountain and Kerman region, were obtained by hydrodistillation.. Antifungal activities of the oils to inhibit growth and aflatoxin productivity of A. flavus PICC-AF39, A. flavus PICC-AF24, and A. parasiticus NRRL-2999 were studied. Minimal inhibitory (MIC) and minimal fungicidal (MFC) concentrations of the oil were determined. Sub-MIC was selected for the measurement of aflatoxins B and G concentration. Samples were analyzed either using a high performance liquid chromatography (HPLC) method with some minor modifications. Aflatoxins (AFs) were determined by reverse-phase HPLC and fluorescence detector with post column derivatization (PCD) involving bromination.. A significant reduction in Aflatoxin production was noted which was not due to the inhibitory effect but because of antifungal property of the oil. Interestingly, the oil promoted toxin production for the reasons yet to be investigated. The extent of aflatoxin production was dependent on the concentration of essential oil used. All toxin-producing fungi in this study produced higher amount of aflatoxin at low concentrations of the oil. 400 ppm concentration of C. cyminum L. from Alborz Mountain increased aflatoxin production to over fourfold. Aflatoxin productivity was declined at high concentration of the oil.. Antimicrobial and antitoxigenic properties of natural products need a firmly established criterion before they could be offered to application..

The development of an effective subunit vaccine against brucellosis is a research area of intense. But optimization of recombinant proteins production in Escherichia coli and content of endotoxins associated with final recombinant proteins are very important.. In the present study, expression and purification of Brucella melitensis rHSP and rTF were optimized to reduce endotoxin contaminants.. pDEST-tf and pDEST-hsp were transformed into E. coli BL21 (DE3), and then B. melitensis recombinant HSPA and TF proteins were overexpressed. Purification of these proteins was optimized to remove most of endotoxin contaminants from the end product using 0.1% Triton X-114 in washing buffers.. An endotoxin reduction of less than 0.05 EUmg/1 was achieved with protein recovery close to an 80% yield.. As this new protocol requires only one step to simultaneously purify tagged proteins and eliminate endotoxins, it represents a substantial advantage in time, effort, and expense..

Bovine viral diarrhea (BVD) is an economically important disease of cattle with a worldwide distribution. Diagnosis of BVD relies on laboratory-based detections of its viral causing agent or virus specific antibodies. The most common laboratory method used for this purpose is the ELISA. Bovine viral diarrhea virus (BVDV) nonstructural protein 3 (NS3) is one of the most highly conserved immunogenic proteins of BVDV, thus, it is a proper candidate antigen to detect antibodies against the virus in the sera from infected animals.. The aim of this study was to synthesize a plasmid construct for high-level expression of NS3 with more solubility in Escherichia coli.. A segment of BVDV genome encoding the NS3 protein was amplified using RT-PCR and cloned into pMAL-c2X expression vector, under the control of the lac promoter. After sequencing of the amplified gene, the recombinant protein was expressed in E. coli strain BL21 and analyzed by SDS-PAGE and western blotting.. The strong promoter of pMAL-c2X vector allowed a high level expression of NS3 as a maltose binding protein-NS3 (MBP-NS3) fusion protein. Expression of the expected fusion protein was confirmed by electrophoresis on SDS-PAGE and immunoblotting, using a BVDV positive bovine serum.. Based on our results, it appears that this plasmid construct may be suitable for the production of NS3 recombinant antigen to develop BVDV laboratory diagnostic assays..

Toxoplasmosis is a worldwide disease caused by an obligate intracellular protozoan, Toxoplasma gondii and can cause severe infections in immune- compromised individuals.. The aim of this study was to determinate the anti- Toxoplasma antibodies in hemodialysis patients of Abadan and Khoramshahr, Southwest of Iran.. Sera of 150 patients (test group) aged 21 to 87 years referred regularly to hemodialysis departments in Abadan and Khoramshahr cities, and 150 healthy individuals (control group) were examined for anti- Toxoplasma (IgG and IgM) antibodies using ELISA kits and the results were analyzed using Chi-square and fisher exact test.. 61 (40.67%) out of 150 sera of patients were positive, 6 (4%) were borderline and 83 (55.33%) were negative for anti-Toxoplasma IgG. For anti- Toxoplasma IgM, 13 (8.67%) of 150 were positive, 21 (14%) were borderline and 116 (77.33%) were negative. In control group 39 (26%) of 150 individuals were positive, 14 (9.33%) were borderline and 97 (64.67%) were negative for anti- Toxoplasma IgG. In the sera of individuals in control group, anti- Toxoplasma IgM was not detected. In hemodialysis patients, 7 (4.66%) cases were positive for anti- Toxoplasma IgG and IgM and 8 (5.33%) cases were IgG positive and IgM borderline. There were significant differences in IgG and IgM level of the test and control groups (P 0.05). Hemodialysis patients are high risk group for toxoplasmosis and should be tested periodically to prevent the dissemination of toxoplasmosis during dialysis..

Malassezia species as skin microflora of humans and other warm-blooded vertebrates are the lipophilic yeasts associated with various human diseases, especially pityriasis versicolor (PV).. The objective of this study was to identify the Malassezia species of scraped skin of PV patients in Yazd, Iran, using morphological, biochemical and physiological methods. We also compared the obtained results of PV patients with normal healthy volunteers.. A total of 200 persons, including 100 patients (with skin lesion) referred to Yazd Central Laboratory and 100 healthy volunteers as controls, were evaluated for Malassezia infection by morphological and biochemical methods.. The most commonly isolated species from PV lesions, were M. globosa (38.3%), M. furfur (29.4%), M. sympodialis (14.9%), M. pachydermatis (9.6%) and M. slooffiae (5.3%). Also the most commonly isolated species from healthy skins were M. furfur (37.2%), M. globosa (25.6%), M. sympodialis (16.3%), M. pachydermatis (13.9%) and M. slooffiae (4.6%). Totally M. globosa and M. furfur were the most frequented isolated.. Highest prevalence of PV in our study was observed in the 20 – 39 years old group, suggesting that the peak of the infection is coincided with ages and increasing sebum production in the highest level. M. globosa was the most commonly isolated Malassezia species of the patients group and M. furfur is the most common isolated species obtained from normal individuals skin samples. We couldn’t find any significant differences between groups. The rate of isolated Malassezia species from patients was higher than normal individuals..

500,000 new cases with progressive cancer of cervix are reported worldwide annually. This malignant cancer is the second common cancer among females. Human papillomavirus (HPV) is considered as the major cause of cervical cancer and dysplasia. PCR Application to detect the HPV DNA in clinical specimens besides microscopic examination of cervical biopsy (Papanicolaou smear) (Pap smear) are valuable prognostic indicators in cervical cancer management.. Due to the absence of epidemiological data on prevalence and distribution of HPV genotypes in Khuzestan province, the authors decided to conduct a research to determine the HPV genotypes in cases with a degree of cervical dysplasia.. In this study, 60 samples of paraffin-embedded biopsy samples archived in the library of pathology laboratory of Ahvaz Imam Khomeini hospital were selected for further experiments. After DNA extraction of each specimen, the infection of the tissue with HPV was confirmed by PCR. PCR products were sequenced to detect HPV genotypes.. Out of 60 cervical biopsy samples, 8 (%13.3) cases were HPV DNA positive. Four (%50) were genotype 16 positive, 2 (%25) were genotype 6 positive, 1(%12.5) sample was detected as the genotype 18 and 1 of the positive cases was genotype 11 of HPV.. Our study shows that prevalence of HPV infection in cervical biopsy samples collected from suspected patients in Khouzestan province is slightly higher than other provinces of Iran. Since HPV cervical infection, is an indicator for the host cervical cancer progression, parallel with Pap smear test, PCR detection of HPV DNA in biopsy of suspected cases is recommended..

Spirulina is one of the most profitable known microalgae in the world, which is used as food and superfood. In the other hand, Spirulina is a useful source of healthy components. It seems that the Spirulina is transformable so that the introduction of a selectable marker is needed.. The purpose of this study was to determine a suitable selection marker for Spirulina platensis. Thus, this experiment was designed to survey the response of Spirulina to different concentrations of candidate antibiotics including kanamycin, hygromycin, phosphinothricin, chloramphenicol and streptomycin in standard Zarrouk medium.. S. platensis culture matched to 1 McFarland standard and its resistance to different antibiotics was studied by serial dilution of kanamycin, hygromycin, phosphinothricin, chloramphenicol and streptomycin. Biomass was detected after 7days using spectrophotometer and related growth graphs were illustrated.. Fresh culture of S. platensis reached to exponential phase on day 4 of experiment. While this phase was presented on day 5 for cultures containing kanamycin or hygromycin. The Spirulina cultured in medium supplied with basta, did not reach to growth phase however, chloramphenicol can stop the growth of Spirulina cells. Spirulina showed resistance to streptomycin with the concentration of 40 mg/L and higher. Therefore, streptomycin can use as selectable marker to detect GM (Genetic Modified) Spirulina spp.. The streptomycin can be used as suitable selection marker in comparison with other introduced markers. For using this selectable marker, integration of a streptomycin resistant gene is needed. The gene aadA is a potential candidate. The aadA gene can be expressed under the control of upstream and downstream elements of S. platensis..

Leptin is a cytokine/hormone produced mainly by the adipocytes which regulates the body weight. The normal level of Leptin is required for optimal immune system function, and high leptin levels are shown to affect the Th1-Th2 balance. Leptin is able to stimulate monocytes, dendritic cells and Neutrophils.. The aim of this study was to evaluate the effect of leptin on neutrophils phagocytosis and lymphocytes apoptosis stimulated by Listeria monocytogenes and Escherichia coli.. Blood samples were taken from healthy volunteers and were treated with either leptin or PBS in presence or absence of L. monocytogenes or E. coli. In order to evaluate the activation of neutrophils and their phagocytosis activity, the expression of CD11b by these cells were assessed using flow cytometry. The ability of leptin to induce apoptosis in lymphocytes was investigated using Annexin V and PI staining method by flow cytometry.. Our data demonstrates that leptin is able to induce CD11b expression on neutrophils but this induction is significantly less than L. monocytogenes. Indeed, cells treated with leptin had lower amounts of apoptosis compared with untreated cells. The highest amount of apoptosis was seen in cells treated with L. monocytogenes vs. E. coli. Leptin can be used as a potent agent for induction of effective bacterial phagocytosis and lymphocytic apoptosis in cases with sever immune-deficiency.. The Leptin can also be used for the treatment of severe and intractable L. monocytogenes and E. coli infection..

Pseudomonas aeruginosa is an opportunistic pathogen that infects people with immunocompromised defenses like neutropenic, burned, hospitalized, and cystic fibrosis (CF) patients.. The main aim of this study was to explore the possibility of the recombinant type A flagellin (r-fla-A) in combination of Montanide ISA 70 as a candidate vaccine to promote the humoral and cellular immune responses against r-fla-A.. Recombinant flagellin was prepared in Montanide ISA 70 adjuvant; Mice were divided into two groups one of six. The lymphocyte proliferation assay was performed with Brdu/ELISA and IL-4 and IFN-γ cytokine level assay was carried out to determine the pattern of immune response (Th1 vs. Th2). Specific antibody responses were measured with an optimized in direct ELISA and finally different isotype-specific antibodies including IgG1, IgG2a, IgG2b, IgG3, and IgM was measured with ELISA.. Immunized mice with adjuvanted flagellin showed a considerably increased lymphocyte proliferation compared with the control group (P = 0.004). High level of IL-4 and IFN-γ secretion was observed in immunized mice compared with the control group (P = 0.003 and P = 0.006, respectively) with Th1 profile. In addition to the strong antibody-mediated immune response, we found that immunization of mice with r-fla-A induces specific IgG1, IgG2a, IgG2b, IgG3 and IgM antibodies that indicates a statistically significant difference with the control group (P = 0.003, P = 0.004, P = 0.004, P = 0.006 and P = 0.004 respectively).. Our results demonstrated that r-fla-A could induce cellular and humoral immune response as proper stimulant of poly-isotypic humoral responses..

Petroleum hydrocarbons are mix compounds and divided into four groups: Saturates, Aromatics, Resins and Asphalten. Among various phases of crude-oil, the alkanes with medium length chain are favorable substrates that rapidly degraded, although short-chain alkanes are very toxic and long-chain alkanes have low solubility in water that reduce its bioavailability and make resistant to biodegradation.. The main goal of this study is the isolation, molecular identification and degradation properties of hexadecane degrading bacteria from contaminated soils.. In this research to isolate aliphatic degrading bacteria, sampling from hydrocarbon contaminated soil with of petroleum reservoirs regions, Tehran were performed. Alkane degrading bacteria were isolated by enrichment in Bushnel-Hass medium with hexadecane as sole source of carbon and energy. The isolated strains were identified by amplification of 16S rDNA gene and sequencing. Alkane hydroxylase gene (alk-B) was identified in all strains by PCR with specific primers.. Among 8 strains three strains with high growth rate on hexadecane selected for further study. These three selected strains identified as Stenotrophomonas maltophilia strain M2, S. maltophilia strain Q2 and Tsukamurella tyrosinosolvens strain Q3. In comparison to the other bacteria, these bacterial strains can degrade hexadecane 2 times more; with a high emulsification activity.. The 2.5% concentration of hexadecane was the best concentration that supports the growth of these strains. Among these strain T. tyrosinosolvens strain Q3 was the best strain for biodegradation of hexadecane. Alk-B gene was identified in all strains..

There is a worldwide concern about the life quality, in this way, one of the most important requirements is safe and nutritious foodconsumption. The administration of antibiotics to cattle in order to treat several infectious diseases has contributed to the contamination of industrialized dairy farms.. Milk antibiotic contamination is an important problem worldwide, and the quality control of milk samples is essential. Therefore, the aim of this study was to monitor antibiotic contamination in milk samples.. Samples were collected from six different farms and milk factories in Iran, and were tested by beta-star and cylinder-plate methods.. Among 992 raw milk samples, 236 positive samples, 9 suspected and 747 negative samples in respond to beta-star test and among 236 samples, which had positive responses to beta-star test, 28 positive, 0 suspected and 208 negative results of cylinder-plate test were gained. Among 652 pasteurized milk samples, 67 positive, 9 suspected and 576 negative beta-star test results and among 67 samples which had positive responses to beta-star test, 1 positive, 0 suspected and 66 negative results to cylinder-plate test were achieved.. The results revealed that cylinder-plate method accompanied with beta-star test can be considered as an appropriate sensitive and selective method for the milk and dairy products quality control. According to the results, it look as if the process of pasteurization reduces the amount of penicillin G in milk samples considerably..

Hepatitis A and E virus (HAV and HEV) infections are acute and self-limited diseases that usually spread through oral-fecal route. Also, blood transfusion as a possible route of entrically transmitted hepatitis has been suggested. Hemophilia and thalassemia patients are highly at risk of transfusion-transmissible viruses (HBV, HCV, and HIV). Any superimposed infection with other viral hepatitis (in particular hepatitis A) cause active liver failure in hemophilia and thalassemia patients.. The aim of this study is to consider seroprevalence of anti HAV and HEV antibodies (Ab) in thalassemia and hemophilia patients with chronic hepatitis C in Iran..Patients and In a cross-sectional study and under general census sampling, sera of 219 thalassemia and hemophilia patients infected with HCV were examined in Tehran Hepatitis Center (THC) between 2009 and 2010. Enzyme-linked immunisorbentassey (ELISA) was done to observe anti HAV and HEV IgG Ab. Patients were chosen from all provinces of Iran.. Anti-HAV IgG antibodies were observed more frequently in thalassemia patients (60/64; 93.8%) than in hemophilia patients (104/155; 67.1%, P < 0.001). The seroprevalence of both antibodies increased with age. Among thalassemia patients, there was no significant association between HAV seropositivity and other variables, but in hemophilia group, seropositive patients were significantly older than seronegative group (P < 0.05). Totally, anti HEV Ab (1/64; 1.6% thalassemia and 5/155; 3.2% hemophilia) was seropositive in six patients. There was no significant association between HEV infection and other variables in thalassemia patients, however, in hemophilia patients, HEV positive ones were significantly older than HEV negative group (P=0.01).. Vaccination of non-immune individuals against HAV infection in high risk groups especially hemophilia and thalassemia patients is recommended. Results did not show any differences about seroprevalence of HEV among Iranian general population..

Streptococcus dysgalactiae subspecies equisimilis is one of the pyogenic group C and G streptococcus, which may be found in the normal gastrointestinal and genitourinary flora of a healthy human. Many cases have been reported in literature; however, reports of septic arthritis due to this agent without predisposing factors are extremely rare. Diagnosis of this agent is possible in advanced laboratories. Appropriate treatment for septic arthritis caused this agent is made by parenteral antibiotherapy without debridement following accurate diagnosis.