Prevalence, antibiotic resistance and virulence of Enterococcus spp. isolated from traditional cheese types

BACKGROUND: Enterococci are naturally found in the gastrointestinal (GI) tract of animals and humans, as well as animal-derived foods and vegetables. We here aimed to determine the prevalence, antibiotic resistance, and virulence determinants of E. faecium and E. faecalis in traditional cheese in the North-west of Iran.MATERIALS AND METHODS: Fifty specimens of popular traditional cheese from dairy stores of Urmia and Tabriz, Iran, were collected. Identification of the genus and species of enterococci was done using molecular and phenotypic techniques.RESULTS: Forty-eight (96 %) of 50 traditional cheese samples were harboring Enterococcus spp, including Enterococcus faecalis (n= 40; 83.33 %) and E. faecium (n= 8; 16.67 %). The prevalence of enterococci ranged from 1.1×105 to 9.7×104 CFU/g, and 1.1×103 to 9.8×103 CFU/g in Urmia and Tabriz samples, respectively. Rifampicin resistance (n= 38; 79.2 %) was the most common pattern observed in the susceptibility test, which was followed by quinupristin/dalfopristin (n= 33; 68.75 %). Among E. faecalis isolates, cpd (100 %), ace (92.5 %) and gelE (87.5 %), and among E. faecium isolates, gelE (100 %) and asa1 (75 %) were found to have the most common virulence genes.CONCLUSION: E. faecalis was the predominant species, displaying more virulence determinants. It also had high antibiotic resistance, as compared to E. faecium. The enterococci identified here commonly expressed virulence and antibiotic resistance determinants. So, it is required to improve the maintenance and production quality of traditional cheese to avoid enterococci contamination

Distribution of Serogroup and Antibiotic Resistance Patterns of Shigella Species in Iran, 1984-2018: A systematic Review

Background: Shigellosis is recognized as a global concern by the WHO. Shigella genus includes 4 species of Shigella dysenteriae, Shigella flexneri, Shigella boydii and Shigella sonnei. Geographic distribution and antimicrobial susceptibility patterns of Shigella species are different. Methods: We searched published studies in Science Direct, PubMed, PubMed Central (PMC), Scopus, Google Scholar, and ISI Web of Science, Medlib, Magiran, Iranian Scientific Information Database (SID) and 'IranMedex between 1984 and 2018. Results: Many studies in Iran and elsewhere in the world emphasize the emergence of Shigella resistant species. Most of them have shown high resistance to TMP/STX, tetracycline, ampicillin and streptomycin , and some have resistance to antibiotics such as ciprofloxacin, azithromycin, and tetracyclines have reported. Conclusions: The frequency of Shigella species is very different in different countries. The distribution and prevalence of Shigella species in different countries may depend on the level of economic development, age, and environmental factors

Neonatal conjunctivitis caused by Trichomonas vaginalis, a systematic review

Amongst sexually transmitted infections in the world, Trichomonas vaginalis is of the most common. Most of the infections are asymptomatic. It can infect women more than men because of genital tracts condition. The mother’s birth canal and perineum are common sources of infants’ eye infection. Some studies noted the possibility of T. vaginalis transmission through the birth canal to infants. Such an event can lead to neonatal conjunctivitis. By following Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, a systematic review conducted to assess the possibility of neonatal conjunctivitis caused by T. vaginalis. Several factors can play a role in T. vaginalis transmission, such as low sanitary level, physical contact by contaminated biological fluids and infant’s opened eyes during the delivery. Through the review of different studies, it is inferred, although the probability of neonatal conjunctivitis caused by T. vaginalis is low, but it is possible. Finally, metronidazole is an approved drug for treatment of trichomoniasis and needs to consider in neonatal conjunctivitis caused by T. vaginalis

Characterization of Phenotypic and Genotypic Diversity of Stenotrophomonas maltophilia Strains Isolated From Selected Hospitals in Iran

Stenotrophomonas maltophilia is an environmental Gram-negative bacterium that has rapidly emerged as an important nosocomial pathogen in hospitalized patients. Treatment of S. maltophilia infections is difficult due to increasing resistance to multiple antibacterial agents. The purpose of this study was to determine the phenotypic and genotypic characterization of S. maltophilia isolates recovered from patients referred to several hospitals. A total of 164 clinical isolates of S. maltophilia were collected from hospitals in various regions in Iran between 2016 and 2017. Antibiotic susceptibility testing was performed by disc diffusion method and E-test assay according to the Clinical and Laboratory Standards Institute (CLSI) guideline. The ability of biofilm formation was assessed with crystal violet staining and then, biofilm-associated genes were investigated by PCR-sequencing method. The presence of L1 (a metallo-β-lactamase), L2 (a clavulanic acid-sensitive cephalosporinase), sul1 and sul2 (resistance to Trimethoprim/Sulfamethoxazole), Smqnr (intrinsic resistance to quinolones), and dfrA genes (dihydrofolate reductase enzyme that contributes to trimethoprim resistance) was also examined by PCR-sequencing. Relative gene expression of smeDEF efflux pump was assessed by real-time PCR. Genotyping was performed using the multi-locus sequencing typing (MLST) and repetitive extragenic palindromic-PCR (Rep-PCR). Isolates were resistant to imipenem (100%), meropenem (96%), doripenem (96%), and ceftazidime (36.58%). Notably, 5 (3.04%) isolates showed resistant to trimethoprim-sulfamethoxazole (TMP-SMX), an alarming trend of decreased susceptibility to TMP-SMX in Iran. Minocycline and levofloxacin exhibited the highest susceptibility of 91.46 and 99.39%, respectively. Using the crystal violet staining, 157 (95.73%) isolates had biofilm phenotype: 49 (29.87%), 63 (38.41%), and 45 (27.43%) isolates were categorized as strong-, moderate- and weak-biofilm producer while 7 isolates (4.26%) were identified a non-biofilm producer. Biofilm genes had an overall prevalence of 145 (88.41%), 137 (83.53%), and 164 (100%) of rmlA, rpfF, and spgM, respectively. L1, L2, Smqnr, sul1, and sul2 resistance genes were detected in 145 (88.41%), 156 (96.12%), 103 (62.80%), 89 (54.26%), and 92 (56.09%) isolates, respectively. None of the S. maltophilia isolates were positive for dfrA12, dfrA17, and dfrA27 genes. Gene expression analysis showed that smeD efflux system was overexpressed in two out of the five clinical isolates (40%) that showed resistance to TMP-SMX. Most of the isolates were genetically unrelated. Two new sequence types (ST139 and ST259) were determined. Our results showed that TMP-SMX was still an effective antibiotic against S. maltophilia. The findings of the current study revealed an increasing prevalence of antibiotic resistance and biofilm genes in clinical S. maltophilia isolates in Iran

Characterization of blaCTX gene and Cross-resistance in Klebsiella pneumoniae Isolated from Hospitalized Patients

Background and Aim: Klebsiella pneumoniae is a member of the Enterobacteriaceae family. There is a global emergence of multidrug-resistant (MDR) strains of K. pneumoniae, a Gram-negative enteric bacterium that causes nosocomial and urinary tract infections. The aims of the present study were to identify the Klebsiella pneumoniae infections in hospitalized patients, characterization of blaCTX gene, detection cross-resistance and cefepime susceptible-dose dependent (SDD) in isolates. Materials and Methods: In present study, 111 strains of Klebsiella pneumoniae were isolated from patients hospitalized in Ghotbadden, Faghihi and Nemazee hospitals (Shiraz, Iran). The isolates were identified as K.pneumoniae, based on biochemical tests embedded in the API-20E system. Susceptibility testing (disc diffusion) was performed according clinical and laboratory standards institute (CLSI) guidelines. Detection cefepime susceptible-dose dependent (SDD) was performed. The detection of AmpC β-lactamases producing strains was done based on cefoxitin and cefepime disk tests. The blaCTX gene was detected in the isolates by PCR molecular method. Results: Total 111 Klebsiella pneumoniae isolates were studied. The less effective drug was ceftazidime (37.8% isolates were sensitive). All SDD strains were susceptible to colistin and imipenem. Colistin (96.4%) and imipenem (88.3%) were the most effective antibiotics against isolates. Respectively, 41.4% and 35.1% isolates displayed resistance to gentamicin and amikacin. All colistin resistant isolates were imipenem sensitive. The results of PCR on blaCTX gene showed that 70.3% of the isolates possess the gene. Conclusion: Carbapenem drugs are effective against Klebsieella pneumoniae infections. These results indicate that multidrug-resistant (MDR) and extensively drug resistant (XDR) strains of K.pneumoniae are rising, and fewer antibiotics may be useful for treating infections caused by these strains. Routine investigation and reporting of antibiotics resistance profile in patients presenting with Klebsiella infections is suggested

Determination antimicrobial resistance profile of Acinetobacter strains isolated from hospitalized patients in Different Part of Taleghani Hospital (Ahvaz, Iran)

Background: The members of the genus Acinetobacter are Gram-negative cocobacilli that are frequently found in the environment but also in the hospital setting where they have been associated with outbreaks of nosocomial infections such as meningitis, endocarditis, skin and soft tissue infections, urinary tract infection, conjunctivitis, burn wound infection and bacteremia. This organism has been shown resistance to different antimicrobial agents. The aim of this study was to determination antibiotic resistance profile of Acinetobacter strains isolated from hospitalized patients in Taleghani hospital (Ahvaz, Iran). Materials and Methods: This cross-sectional study was conducted on 43 Acinetobacter strains isolated from hospitalized patients. Clinical specimens were cultured on microbiological media. Subsequently, drug susceptibility test was performed using the disc diffusion method according to CLSI recommendations. Results: Acinetobacter strains were isolated from different specimens consisting biopsy 24 (55.8%), wound 13 (30/2%) and blood 6 (14%). In antimicrobial susceptibility testing, colistin exhibited the greatest activity (60.5%) against isolated strains. 33 (76/7%) isolates demonstrated resistance to imipenem. Conclusion: In outbreak situations, surveillance cultures of patients involved in the outbreak or who are deemed at risk for colonization/infection with the outbreak organism are often parts of the planned intervention

The Survey for AmpC beta-lactamase Production and Characterization of Antibiotic Resistance Profile in Clinical Isolates of Klebsiella oxytoca

Background: Klebsiella oxytoca is opportunistic pathogen that in­criminated in many nosocomial infections. There is an increase in the prevalence of resis­tance to different classes of antibiotics in Kleb­siella species. In some isolates resistance is mediated by the production of AmpC beta-lactamases. The goal of this study was the survey for AmpC β-lactamase production and characterization of antibiotic resistance profile in Iranian (Shiraz) clinical isolates of Klebsiella oxytoca. Materials & Methods: In this cross-sectional study, thirty-five Klebsiella oxytoca strains were isolated from patients hospitalized in Shiraz (Iran) hospitals, and subculture was performed on microbiological media including MacConkey agar. The isolates were identified based on biochemical tests embedded in the API-20E system. Standard susceptibility testing (disc diffusion) was performed according clinical and laboratory standards institute (CLSI, 2014) guidelines. Phenotypic detection of AmpC beta-lactamasec was performed by cefepime and cefoxitin disk test. Results: Total 35 Klebsiella oxytoca isolates were examined that among them 4 (11.4%) isolates were AmpC beta-lactamase producing. Among examined antimicrobials, imipenem (100%) and colistin (100%) were most effective drugs against isolates. Respectively, 88.6%, 88.6%, 85.7% and 85.7% isolates were resistant to amikacin, cefoxitin, ciprofloxacin and cefepime. Strains showed the most frequent resistance to ceftazidime (20%). All AmpC beta-lactamase positive isolates were sensitive to amikacin, imipenem and colistin. Conclusion: Results of current study showed third-gerneration cephalosprins are not effective against 20% of infections caused by Klebsiella oxytoca. Resistance to two major classes of antibiotics (aminoglycosides and beta-lactams) was seen among studied strains and treatment of infections causing by this isolates are major problem in future

An overview of the role of bacterial infection in male infertility

An important cause of male infertility is the bacterial infections of the genitourinary tract. These infections affect sperm cell function and whole spermatogenesis and also cause deterioration in spermatogenesis, obstruction of the seminal tract, and impairment of spermatozoa function. The most important bacteria associated with genitourinary tract infections include chlamydia trachomatis, Neisseria gonorrhoeae, and genital mycoplasma species. Inappropriate or delayed therapy of the bacterial infections of the genitourinary tract will lead to reduced fertility and, subsequently in severe cases, infertility. In other words, a good understanding of the interaction between bacterial infections and the reproductive system plays an important role in the treatment of infertile men. In this review article, we will discuss clinical and laboratory findings related to the bacterial infection of the genitourinary tract and its effects on male infertility

The survey of shigellosis frequency and determination of antibiotic resistance profile of isolated strains from infected children in Tehran

Background: Shigellosis is endemic throughout the world and it is among the most common causes of bacterial diarrheal diseases. Antibiotic resistance of Shigella is becoming a progressive problem in world. The aim of this study was the survey of shigellosis frequency and determination of antibiotic resistance profile of isolated strains from infected children in Tehran. Material and Methods: This study conducted on 9131 patients with acute diarrheal disease. For isolation of Shigella spp. from stool samples, culture performed on different selective and differential media. After confirmation of bacteria by biochemical tests, susceptibility testing was done by disc diffusion method according to clinical and laboratory standards (CLSI) recomendations. Results: Among 9131 stool samples, Shigella spp. was isolated from 90 cases. Shigella sonnei was the most common isolated species. 92/2 % of isolates were resistant to cotrimoxazole. In contrast, most of the Shigella spp. was founded to be sensitive to ciprofloxacin, imipenem and third-generation cephalosporins. Conclusion: Surveillance programs on antimicrobial resistance not only identify pathogenic bacterial species, by reporting data like serotyping, microorganisms incidence rates, and susceptibility to the antimicrobial agents currently used for treatment, but also contribute to monitoring the intervention strategies including removing organism from reservoirs

Isolation and Identification Enterobacter asburiae from Consumed Powdered Infant Formula Milk (PIF) in the Neonatal Intensive Care Unit (NICU)

Enterobacter asburiae (E. asburiae) is a facultative anaerobic, non-spore-forming gram-negative rod-shaped bacterium belonging to the family of Enterobacteriaceae. It is an opportunistic pathogen that its strains are isolated from a variety of clinical and environmental specimens. Since powdered infant formula milk (PIF) is not a sterile product, it is an excellent medium for bacterial growth. The aim of this study was to isolate and identify E. asburiae from PIF in the neonatal intensive care unit (NICU) and determine antimicrobial susceptibility patterns of this bacterium. A total 125 PIF samples were purchased from drug stores between June 2011 to March 2012. E. asburiae was isolated according to FDA method. For final confirmation, biochemical tests embedded in the API-20E system were used. The drug susceptibility test was performed using the disc diffusion method according to CLSI recommendations. Out of the 125 PIF samples investigated, 2 (1.6%) samples were positive for E. asburiae. All isolated strains were uniformly susceptible to aztreonam, cefotaxim, amikacin, streptomycin, nalidixic acid, meropenem, tetracycline, ceftazidime, and colistin. Variable susceptibility was seen to the some antimicrobial agents tested. Each country should categorize its own designed guidelines for the preparation and handling of PIF adapted to the local environment. Moreover, the pathogenesis of the E. asburiae in infants hospitalized in NICU and other groups such as immunosuppressed patients and HIV infected individuals is uncertain and requires further study