Prevalence of extended-spectrum beta-lactamase-producing Klebsiella Pneumoniae isolates in nosocomial and community-acquired urinary tract infections

Background: Klebsiella pneumoniae is a family member of Enterobacteriaceae. Isolates of K. pneumoniae produce enzymes that cause decomposition of third generation cephalosporins. These enzymes are known as extended-spectrum beta-lactamase (ESBL). Resistance of K. pneumoniae to beta-lactamase antibiotics is commonly mediated by beta-lactamase genes. Objectives: The aim of this study was to identify the ESBL produced by K. pneumoniae isolates that cause community-acquired and nosocomial urinary tract infections within a one-year period (2013 to 2014) in Kashani and Hajar university hospitals of Shahrekord, Iran. Patients and Methods: From 2013 to 2014, 150 strains of K. pneumoniae isolate from two different populations with nosocomial and community-acquired infections were collected. The strains were then investigated by double disk synergism and multiplex polymerase chain reaction (PCR). Results: The study population of 150 patients with nosocomial and community-acquired infections were divided to two groups of 75 each. We found that 48 of the K. pneumoniae isolates in the patients with nosocomial infection and 39 isolates in those with community-acquired infections produced ESBL. The prevalence of TEM1, SHV1 and VEB1 in ESBL-producing isolates in nosocomial patients was 24%, 29.3% and 10.6%, and in community-acquired patients, 17.3%, 22.7% and 8%, respectively. Conclusions: Theprevalence of ESBL-producing K. pneumoniae isolate is of great concern; therefore, continuous investigationseems essential to monitor ESBL-producing bacteria in patients with nosocomial and community-acquired infections. © 2016, Ahvaz Jundishapur University of Medical Sciences

The study of antibiotic resistance of extended-spectrum beta-lactamase-producing Klebsiella strains isolated from urinary tract infections in teaching Hospitals in Shahrekord

زمینه و هدف: سویه ‌های کلبسیلا به ویژه کلبسیلا پنومونیه، از جمله پاتوژن ‌های فرصت طلب در ایجاد عفونت ادراری به عنوان یکی از شایع ترین عفونت‌ ها در انسان محسوب می ‌شوند. این مطالعه به منظور بررسی مقاومت آنتی ‌بیوتیکی در سویه ‌های کلبسیلا مولد ESBL که از عفونت ادراری بیماران بستری و سرپایی مراجعه کننده به بیمارستان ‌های آموزشی شهرکرد جدا شدند، صورت پذیرفت. روش بررسی: مطالعه حاضر در سال ‌های 1393-1392 بر روی 150 ایزوله کلبسیلا جدا شده از عفونت ادراری بیماران بستری و سرپایی انجام گرفت. با انجام تست ‌های تشخیصی بیوشیمیایی و استفاده از محیط ‌های افتراقی، هویت ایزوله‌ های جدا شده تعیین گردید. شناسایی ارگانیسم ‌های مولد ESBL با انجام تست ‌های غربالگری و تست ‌های فنوتیپی تأییدی صورت پذیرفت. به منظور ارزیابی الگوی مقاومت آنتی ‌بیوتیکی، از روش دیسک دیفیوژن بهره گرفته شد. یافته ها: از مجموع 150 ایزوله جدا شده از عفونت ادراری، فراوانی سویه ‌های مولد ESBL، در بیماران بستری و سرپایی مراجعه کننده به بیمارستان ‌های آموزشی شهرکرد به ترتیب 64 و 48 گزارش شد. نتایج الگوی مقاومت آنتی‌ بیوتیکی در بیماران بستری و سرپایی به ترتیب برای آنتی ‌بیوتیک ‌های آمیکاسین 49 و 31، تری متوپریم سولفامتوکسازول 61 و 52، جنتامایسین 59 و 39، نیتروفورانتوئین 55 و 32، نورفلوکساسین 59 و 44، نالیدیکسیک اسید 72 و 53، سفپیم 45 و 33، ایمی ‌پنم 8 و 3، سفتریاکسون 41 و 35، سیپروفلوکساسین 60 و 48، سفتازیدیم 64 و 48 گزارش شد. نتیجه گیری: بر اساس مطالعه حاضر، سویه‌ های کلبسیلا جدا شده از عفونت ‌های ادراری بیماران بستری به میزان بالاتری ESBL تولید کردند که می‌تواند به علت مصرف بی رویه و مکرر سفالوسپورین‌ های نسل سوم و عدم تشخیص سویه‌ های کلبسیلا مولد ESBL در محیط ‌های درمانی باشد

Immunomodulatory effects of human umbilical cord wharton's Jelly-Derived mesenchymal stem cells on differentiation, maturation and endocytosis of monocyte-derived dendritic cells

The Wharton's jelly of the umbilical cord is believed to be a source of mesenchymal stem cells (MSCs) which can be therapeutically applied in degenerative diseases. In this study, we investigated the immunomodulatory effect of umbilical cord derivedmesenchymal stem cells (UC-MSCs) and bone marrow-derived-mesenchymal stem cells (BM-MSCs) on differentiation, maturation, and endocytosis of monocyte-derived dendritic cells in a transwell culture system under laboratory conditions. Monocytes were differentiated into immature dendritic cells (iDCs) in the presence of GM-CSF and IL-4 for 6 days and then differentiated into mature dendritic cells (mDCs) in the presence of TNF-for 2 days. In every stage of differentiation, immature and mature dendritic cells were separately cocultured with UC-MSCs and BM-MSCs. The findings showed that UC-MSCs and BM-MSCs inhibited strongly differentiation and maturation of dendritic cells at higher dilution ratios (1:1). The BM-MSCs and UC-MSCs showed more inhibitory effect on CD1a, CD83, CD86 expression, and dendritic cell endocytic activity, respectively. On the other hand, these cells severely up-regulated CD14 marker expression. We concluded that UC-MSCs and BM-MSCs could inhibit differentiation, maturation and endocytosis in monocyte-derived DCs through the secreted factors and free of any cellcell contacts under laboratory conditions. As DCs are believed to be the main antigen presenting cells for naive T cells in triggering immune responses, it would be logical that their inhibitory effect on differentiation, maturation and function can decrease or modulate immune and inflammatory responses. Copyright © Spring 2013, Iran J Allergy Asthma Immunol. All rights reserved

Temporomandibular Joint Disorder Complaints in Tinnitus: Further Hints for a Putative Tinnitus Subtype

OBJECTIVE: Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ) disorder complaints and compared the two groups with respect to etiologic factors. METHODS: 1204 Tinnitus patients from the Tinnitus Research Initiative (TRI) Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan. RESULTS: Tinnitus patients with TMJ complaints (22% of the whole group) were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt), onset related events (whiplash etc.), character (pulsatile or not), hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.). CONCLUSION: Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical features that are highly relevant for specific therapeutic management

The role of nitric oxide, reactive oxygen species, and protein kinase C in oxytocin-induced cardioprotection in ischemic rat heart

Ischemia-reperfusion injury is a common complication of heart disease that is the leading cause of death worldwide. Here, we plan to elucidate oxytocin cardioprotection effects against ischemia-reperfusion via nitric oxide (NO), reactive oxygen species (ROS), and protein kinase C (PKC) in anesthetized rat preconditioned myocardium. Forty-eight Sprague-Dawley rats were equally divided into eight groups. All animals were subjected to 25 min ischemia and 120 min reperfusion. Oxytocin (OT), L-NAME (LNA, a nitric oxide synthase inhibitor), chelerythrine (CHE, a PKC enzyme inhibitor), and N-acetylcysteine (NAC, a ROS scavenger) were used prior to ischemia. Results showed that mean arterial pressure significantly reduced during the first 10 min of ischemia and reperfusion in IR, LNA, CHE, and NAC groups (p < 0.05). OT prevented mean arterial pressure decline during early phase of ischemia and reperfusion. Cardioprotective effects of OT in infarct size, plasma levels of creatine kinase-MB and lactate dehydrogenase, severity and incidence of ventricular arrhythmias were abolished by L-NAME, chelerythrine, and N-acetylcysteine (p < 0.05). The present study showed that OT pretreatment reduces myocardial infarct size and ventricular arrhythmias, and improves mean arterial pressure via NO production, PKC activation, and ROS balance. These findings provide new insight into therapeutic strategies for ischemic heart disease. © 2012 Elsevier Inc