Identification and molecular epidemiology of nosocomial outbreaks due to Burkholderia cepacia in cystic fibrosis patients of Masih Daneshvary Hospital, Iran

Introduction. B. cepacia complex have emerged as an important opportunistic pathogen in hospitalized and immunocompromised patients. Small hospital outbreaks are frequent and are usually due to a single contaminated environmental source. In this study we were going to investigate the role of B.cepacia complex in those patients suspected to involve with cystic fibrosis and evaluate responsible types in Masih Daneshvary Hospital. Methods. One hundred specimens were collected from all admitted patients who were suspected to cystic fibrosis to Masih Daneshvary hospital during one year April 2011 till end of March 2012. All were culture and identified standard procedure. All samples were checked by API system (API20NE) and by specific PCR method for genus Bulkhorderia and Bcc as well. Identified strains were finally tested by PFGE system to identifying specific involving pulse-types. Results. Isolation and identification methods revealed 5 specimens were B.cepasia, The frequency of the cystic fibrosis detected at this study was lower than other similar study previously reported. All these isolates showed similar pattern by PFGE standard protocol that may have spread from a single source and could not be attributed to cross infections from patient to patients. Discussion. Application of PFGE and identification of pulse-type is a potential tool to enhance the investigation of apparent nosocomial outbreaks of B.cepacia. However it needs to be adjusted with environmental findings. Implementation of educational programs and adherence to infection control policies are obviously the main element for complete elimination of an outbreak

High frequency of methicillin-resistant Staphylococcus aureus (MRSA) with SCCmec type III and spa type t030 in Karaj’s teaching hospitals, Iran

Methicillin-resistant Staphylococcus aureus (MRSA) has been one of the most important antibiotic-resistant pathogen in many parts of the world over the past decades. This cross-sectional study was conducted to investigate MRSA isolated between July 2013 and July 2014 in Karaj, Iran. All tested isolates were collected in teaching hospitals from personnel, patients, and surfaces and each MRSA was analyzed by SCCmec and spa typing. Antibiotic susceptibility testing was accomplished by disk diffusion method. Out of 49 MRSA isolates from the Karaj’s teaching hospitals, 82%, 10%, and 6% of the isolates were SCCmec types III, II, and I, respectively. The main spa type in this study was spa t030 with frequency as high as 75.5% from intensive care unit (ICU) of the hospitals and high rate of resistance to rifampicin (53%) was found in MRSA isolates. In conclusion, high frequency of spa t030 with SCCmec type III and MRSA phenotype illustrated circulating of one of the antibiotic-resistant strains in ICU of Karaj’s teaching hospitals and emphasizes the need for ongoing molecular surveillance, antibiotic susceptibility monitoring, and infection control

Asymptomatic bacteriuria among pregnant women referred to outpatient clinics in Sanandaj, Iran

OBJECTIVES: Determine the prevalence of asymptomatic urinary tract infection (AUTI) among pregnant women. We also determined the antibacterial susceptibility of the isolates to various antibiotics and associated risk factors in AUTI. MATERIALS AND METHODS: One thousand five hundred and five consecutive pregnant women were included in the study. Mid-stream urine specimen for complete examination of urine was obtained. RESULTS: Of 1505 pregnant women, 134 (8.9%) had bacteriuria. The mean age of the all the pregnant women included in the study was 28.40 years with a standard deviation of 6.16. Age ranged from 15 to 45 years of age. The urine culture of the asymptomatic pregnant women (1505 cases) showed growth in only 134 cases (8.9%). Escherichia coli was the commonest organism 79 (58.96%) followed by CN Staphylococcus 22 (16.8%) and S aureus 18 (13.43%). Escherichia coli, which comprised 58.96% (79) of the isolates, were 88.62%, 87.35%, and 83.55% sensitive to cefotaxime, ciprofloxacin and cefotizoxime respectively. Similarly, E. coli were 89%, 70%, and 20% resistant to ampicillin, cotrimoxazole, and nitrofurantoin respectively (OR 1.57 95% CI 1.01, 2.44). After analyzing, four variables, hemoglobin levels seem to be independently associated with asymptomatic bacteriuria (OR = 9.41 (1.65-50.38). CONCLUSION: Prevalence of asymptomatic bacteriuria among pregnant women was 8.9%. The predominant organisms were Escherichia coli 79 (58.96%), followed by CN Staphylococcus 22 (16.8%). Most strains of Escherichia coli showed that they were resistant to ampicillin, tetracycline and gentamicin

Identification of Burkholderia cepacia in patients with cystic fibrosis by pulsed-field gel electrophoresis

Background: Complex of Burkholderia cepacia is one of the main and serious causes of infections in cystic fibrosis patients that can be highly transmissible. Small hospital outbreaks are frequent and are usually due to a single contaminated environmental source. The pulsed-field gel electrophoresis (PFGE) is widely used to identify the strain emission sources in cystic fibrosis patients. The aim of this research was to study genotyping of Burkholderia cepacia using PFGE method, and to evaluate diversity complex of clinical strains isolated from cystic fibrosis patients. Methods: This is a descriptive study, in which 100 pulmonary secretion specimens of cystic fibrosis patients admitted in Masih Daneshvari Hospital, Tehran Iran in period of 12 months 2012 to 2013 were collected. The specimens were cultured on BCSA plate’s. After incubation suspected colonies were isolated and identified by biochemical and phenotypic method. All samples were checked by API system (API20NE) and by specific PCR method for genus Bulkhorderia and Bcc as well. DNA was extracted by alkaline lysis method and confirmed by PCR analysis of recA genes. Genetic diversity of isolate was performed by PFGE analysis according to Pulsenet guideline by using XbaI, SpeI as restriction enzyme which digests infrequently among the Burkholderia cepacia genome. Results: Out of 100 samples five were identified as Burkholderia cepacia. It is obviously different at variously reports. The electrophoresis data of PCR products and comparison of band in samples from patients with standard strain ATCC 25416 Burkholderia cepacia and compare and analyse the PFGE size marker bands of Salmonella choleransuis serotype Braenderup H9812 strain, were the same. Conclusion: Application of PFGE and identification of pulse-type is a potential tool to enhance the investigation of apparent nosocomial outbreaks of B.cepacia. Similar type of pulse patterns was observed in this study means that all of infection has been from one source; therefore the hypothesis of transferring person to person will be rejected. Base on these results environmental sources sampling should be considered in future investigation

Association of Helicobacter Pylori Infection with Cardiometabolic Risk Factors among Iranian Adolescents: the CASPIAN III Study

Background: At least half the world’s population is colonized the stomach by Helicobacter pylori (H. pylori) which are a key constituent of the human microbiome. The aim of this study was to investigate the association of cardiometabolic risk factors with H. pylori infection in Iranian adolescents. Materials and Methods: The current study was conducted along with the third survey of a national school-based surveillance system in Iran, entitled "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease" (CASPIAN) study. Detailed questionnaires on demographic, socioeconomic, dietary, and health-related information of the participants were filled by one of the parents under supervision of trained health-care workers. Trained healthcare professionals measured anthropometric indices, blood pressures according to standard protocols. Fasting venous blood was examined for fasting blood sugar and lipid profile. Results: Overall 882 serum samples were suitable for testing. H. pylori antibody was found in 643 serum samples (72.9%). Among cardiometabolic risk factors, only the mean weight of participants was different between two groups (44.6±11.8 in H. pylori positive and 42.8±11.3 in H. pylori negative group; p=0.04). Overall, 5.1% of adolescents with positive H. pylori tests were overweight or obese, while 1.7% of negative ones were so (p=0.02). In the multivariate regression model, H. pyloriseropositivity increased the risk of overweight (OR, 3.3; 95%CI, 1.2-9.3; p= 0.03). In the multivariate model, association of other cardiometabolic risk factors with H. pylori infection was not statistically significant (p>0.05). Conclusion: Results of present study showed that H. pylori infection was associated with excess weight in adolescents. H. pylori eradication may be decrease the risk of obesity