Frequency of Beijing family of Mycobacterium tuberculosis in Mashhad, Northeast of Iran

Background: Beijing family of Mycobacterium tuberculosis (M. tuberculosis) is widespread in Asia and has been involved in outbreaks of multidrug-resistant tuberculosis in various parts of the world. The aim of the current study was to evaluate the frequency of Beijing family of M. tuberculosis in patients with tuberculosis in Mashhad, Iran.Materials and Methods: Totally, 72 specimens of M. tuberculosis were collected from pulmonary samples of patients at Ghaem hospital in Mashhad (Iran) between April 2011 and May 2012. The authors used IS6110-based polymerase chain reaction (IS6110-based PCR) method to identify Beijing family of M. tuberculosis. Based on PCR results, strains belonging to Beijing and non-Beijing families were detected. Also, among members of Beijing family, ancient and modern subfamilies were distinguished.Results: Beijing genotype was observed in five (6.9%) of 72 culture positive samples. In the present study, no cases of modern subfamilies were detected. M. tuberculosis had a higher frequency in men (61.1%) compared to that of women (38.9%). Our data demonstrated that IS6110-based PCR can be used to distinguish Beijing family from non-Beijing family, with high specificity and sensitivity.Conclusion: The improvement of convenient and quick methods to detect and control Beijing family of M. tuberculosis in clinical samples is an interesting subject in areas where M. tuberculosis is prevalent. This method has the advantages of being quick, cost-effective, and requires comparatively less clinical laboratory equipment

Inducible Clindamycin Resistant Staphylococcus aureus in Iran: A Systematic Review and Meta-analysis

<p><strong><em>Introduction</em></strong>: <em>S</em><em>taphylococcus aureus </em>is a prominent human pathogen. One of the drugs used in the treatment of staphylococcal infections (particularly infections of skin and soft tissue), is clindamycin. Resistance to clindamycin includes two types: inducible and constitutive. Routine laboratory methods of antibiotic susceptibility testing cannot detect the inducible type and D- test is required for its detection. The purpose of this systematic review was to determine the relative prevalence of this type of resistance in Iran.</p><p><strong><em>M</em></strong><strong><em>e</em></strong><strong><em>thods</em></strong>: Search terms "inducible clindamycin resistant", "D-test", "<em>Staphylococcus aureus</em>" and "Iran" were used to find relevant articles in PubMed, Google Scholar and two Persian search engines. Also, the abstracts of the recent national microbiology congresses were checked.All studies used D-test to find iMLSB  (inducible macrolide, lincosamide and streptograminB resistance) phenotype among clinical isolates (not nasal swabs) of <em>S. aureus</em>, were included. In order to perform meta-analysis, we used “comprehensive meta-analysis” software (ver. 2).</p><p><strong><em>Results</em></strong>: In total, 9 articles and 8 abstracts related to the topic of the study were found. Random effects meta-analyses showed a pooled estimate for percentage of iMLSB  phenotype among 2683 samples of <em>S. aureus </em>was about 10% (95% confidence interval: 0.07-0.12). Using the fixed effect model, the odds of positive iMLSB  in methicillin-resistant <em>S. aureus </em>was about 5 times more likely to occur in comparison with methicillin-susceptible <em>S. aureus </em>(95% CI: 3.49 to 7.76).</p><p><strong><em>Conclusion</em></strong>: Fortunately, the relative frequency of inducible resistance to clindamycin in our country is relatively low. However, we believe that D-test should be performed for all erythromicin-resistant  isolates  in  order  to  identify  inducible  resistance  to  clindamycin.Moreover, reevaluation of inducible reistance to clindamycin in forthcoming years is highly recommended.</p