First report of Klebsiella pneumonia carbapenemase-producing Pseudomonas aeruginosa isolated from burn patients in Iran: Phenotypic and genotypic methods

Wound infection associated with carbapenem-resistant Pseudomonas aeruginosa in burn patients is a growing problem. One of the main mechanisms of resistance to carbapenem antibiotics is the ability of P. aeruginosa to produce carbapenemase enzymes. Klebsiella pneumonia carbapemenase (KPC) is an important type of carbapenemase which can hydrolyze carbapenem antibiotics. The Modified Hodge Test (MHT) and boronic acid as a KPC inhibitor are two phenotypic methods used for detection of carbapenemase. The sensitivity and specificity of these two phenotypic tests for the identification of KPC can be measured by PCR. In this study, 241 P. aeruginosa strains were isolated from wounds of hospitalized burn patients. Carbapenem-resistant P. aeruginosa isolates were determined by the disk diffusion method. KPC-producing carbapenem-resistant strains were examined using the Modified Hodge Test, followed by boronic acid. Further, strains with positive responses to MHT and boronic acid tests were analyzed with the PCR molecular method. One hundred eighty-six of 241 isolates were resistant to carbapenems and 75 were positive in the MHT. Three exhibited an at least 5-mm diameter difference when meropenem was combined with boronic acid vs meropenem alone in the boronic acid test. Two strains had a specific band with primer No.1 after gel electrophoresis. This study showed that MHT, despite excellent sensitivity, has variable specificity independent of bacterial species. Further, the use of KPC inhibitors such as boronic acid did not yield favorable sensitivity and specificity among the specimens from Iranian patients. Thus, it seems that sequencing after PCR should be considered the gold standard for the detection of KPC-producing P. aeruginosa

Nosocomial Infections in Burned Patients in Motahari Hospital, Tehran, Iran

Burn patients are at high risk of developing nosocomial infection because of their destroyed skin barrier and suppressed immune system, compounded by prolonged hospitalization and invasive therapeutic and diagnostic procedures. Studies on nosocomial infection in burn patients are not well described. The objective of the present study was to identify the causative bacterial of nosocomial infection and to determine the incidence of nosocomial infection and their changing during hospitalization in burned patients admitted to in the Motahari Hospital, Tehran, Iran. During the second part of 2010, 164 patients were included in this study. Samples were taken the first 48 hours and the fourth week after admission to Motahari Burn hospital. Isolation and identification of microorganisms was performed using the standard procedure. Of the 164 patients, 717 samples were taken and 812 bacteria were identified, 610 patients were culture positive on day 7 while 24 (17.2%) on 14 days after admission. The bacteria causing infections were 325 Pseudomonas, 140 Acinetobacter, 132 Staphylococcus aureus, and 215 others. The percentage of mortality was 12%. All of patients had at least 1 positive culture with Pseudomonas and/or with Acinetobacter. Hospitals suggest continuous observationof burn infections and increase strategies for antimicrobial resistance control and treatment of infectious complications

Using Biochemical Findings to Study the Effect of Silymarin on the Liver of Pregnant Rat that Consumed Ethanol

"nIn pregnancy period, there is high risk of hepatic diseases and alcohol consumption increases such risk. Some pregnant mothers are not able to quit the habit of drinking alcohol or they are unaware of its dangers. Finding a drug which is effective and efficient in reducing ethanol misuse consequences during pregnancy can assist the decrease of harmful effects of this habit. The purpose of the current research is to investigate the effects of oral administration of silymarin in preventing consequences of ethanol consumption on the liver during pregnancy, using the rat animal model as well as biochemical findings and clinical symptoms. 45 female rats were randomly divided into 3 groups, each composed of 15 rats. After the first day of pregnancy, the study was performed as follows. The first group received distilled water. The second group was given ethanol equivalent to 35% of their total required calorie. Furthermore, the third group received the same amount of ethanol plus 200 mg/kg silymarin. In order to evaluate liver's activity, biochemical analysis was performed at days 1, 7, 14, and 21, to measure the amount of the enzymes ALT, AST, ALP, and bilirubin. The nutrition and clinical status of animal in the groups was studied and recorded 2 times daily. This study showed that silymarin's protective effects are expressed from the first day of treatment

Analysis of antibiotic consumption in burn patients

Infection control is very important in burn care units, because burn wound infection is one of the main causes of morbidity and mortality among burn patients. Thus, the appropriate prescription of antibiotics can be helpful, but unreasonable prescription can have detrimental consequences, including greater expenses to patients and community alike. The aim of this study was to determine the effect of antibiotic therapy on the emergence of antibiotic-resistant bacteria. 525 strains of and were isolated from 335 hospitalized burn patients. Antibiotic susceptibility tests were performed after identification the strains. The records of patients were audited to find the antibiotic used.The results indicated that is the most prevalent Gram-negative bacteria. Further, it showed a relation between abuse of antibiotics and emergence of antibiotic resistance. Control of resistance to antibiotics by appropriate prescription practices not only facilitates prevention of infection caused by multi-drug resistant (MDR) microorganisms, but it can also decrease the cost of treatment

Analysis of antibiotic consumption in burn patients

Infection control is very important in burn care units, because burn wound infection is one of the main causes of morbidity and mortality among burn patients. Thus, the appropriate prescription of antibiotics can be helpful, but unreasonable prescription can have detrimental consequences, including greater expenses to patients and community alike. The aim of this study was to determine the effect of antibiotic therapy on the emergence of antibiotic-resistant bacteria. 525 strains of and were isolated from 335 hospitalized burn patients. Antibiotic susceptibility tests were performed after identification the strains. The records of patients were audited to find the antibiotic used.The results indicated that is the most prevalent Gram-negative bacteria. Further, it showed a relation between abuse of antibiotics and emergence of antibiotic resistance. Control of resistance to antibiotics by appropriate prescription practices not only facilitates prevention of infection caused by multi-drug resistant (MDR) microorganisms, but it can also decrease the cost of treatment

Humidifying, heating and trap-density effects on triple-cation perovskite solar cells

Abstract The effect of moisture and heat are important challenges in perovskite solar cells (PSCs). Herein we studied the performance of triple-cation PSCs in different operating environmental conditions. Humidified cells exhibited a hopeful character by increasing the open-circuit voltage (V OC ) and short-circuit current density (J SC ) to 940 mV and 22.85 mA cm−2 with a power conversion efficiency (PCE) of 14.34%. In addition, further analyses showed that hysteresis index and charge transfer resistance decrease down to 0.4% and 1.67 kΩ. The origin of superior stability is ion segregation to the interface, which removes the antisite defect states. Finally, the effect of operating temperature and trap density on structure and performance was also studied systematically

Identification of KPC-Producing Pseudomonas Aeruginosa and Acinetobacter Baumanniiin a Burned Infant: A Case Report

The objective of this study was to determine the phenotypic characteristics of KPC-producing Pseudomonas aeruginosa and Acinetobacter baumannii isolates. A case report study was performed at a tertiary burn care centre in Tehran, Iran. Nine isolates of Pseudomonas aeruginosa and Acinetobacter baumannii from a hospitalized case were isolated. The identity of isolates was confirmed and their antibiotic susceptibility testing was performed. Eight out of nine Pseudomonas aeruginosa and Acinetobacter baumannii isolates were resistant to Imipenem. Three out of 8 imipenem resistant isolates were also positive for KPC test. Findings of this study highlight the importance of implementation of an effective infection control strategy in order to prevent and reduce the emergence and spread of gram negative Carbapenemase-producing organisms in Iran

Investigated of ampC in Carbapenem Resistant Gram-Negative Bacteria Isolated from Burned Patients

Background: Gram-Negative bacteria are the most cause of nosocomial infection especially in burned patients. Carbapenem resistant strains can limit seriously the choice of antibiotic therapy. AmpC can make resistance to carbapenem and detection of that can be useful for identification of carbapenem resistant. The aim of this study was identification of ampC in most prevalent cause of nosocomial infection. Methods: boronic acid combined with meropenem in combination disc method was used for phenotypic method and PCR was used for molecular identification of ampC. Results: Fifty one strains showed positive results in phenotypic method but 119 strains were harbored ampC gene. Combination disc method with meropenem and boronic acid showed 34.4% sensitivity and 78.5% specificity according to the results of this study. Conclusions: the results of this study were indicated the more prevalent of ampC in carbapenem resistant Gram-Negative bacteria. On the other hand use of boronic acid combined with meropenem showed low sensitivity for detection of ampC

The Role of Milk Thistle Extract in Breast Carcinoma Cell Line (MCF-7) Apoptosis with Doxorubicin

Breast cancer is the most commonly diagnosed invasive malignancy and first leading cause of cancer-related deaths in Iranian women. Based on silymarin's unique characteristics, its application in chemotherapy combined with doxorubicin can be effective to enhance the efficacy together with a reduced toxicity on normal tissues. The present study focus on evaluate the efficacy of silymarin in combination with doxorubicin, on viability and apoptosis of estrogen-dependent breast carcinoma cell line (MCF-7). After being cultured, MCF-7 cells were divided into 8 groups and treated as follows: 1st group received 75 μg silymarin, groups 2, 3, and 4 were treated with 10, 25, and 50 nM doxorubicin, respectively, and groups 5, 6, and 7 respectively received 10, 25, and 50 nM doxorubicin as well as 75 μg silymarin. Viability percentage and apoptosis of the cells were assessed with Trypan Blue staining after 16, 24, and 48 hours. Silymarin has a synergistic effect on the therapeutic potential of doxorubicin. Use of silymarin in combination with doxorubicin can be more effective on the therapeutic potential of doxorubicin and decreases its dose-limiting side effects