Identification of a novel cassette array in integron-bearing Helicobacter pylori strains isolated from Iranian patients

Helicobacter pylori as the second most common cause of gastric cancer in the world infects approximately half of the developed countries population and 80 of the population living in developing countries. Integrons as genetic reservoirs play major roles in dissemination of antimicrobial resistance genes. To the best of our knowledge, this is the first study to report carriage of class 1 and 2 integrons and associated gene cassettes in H. pylori isolates from Iran. This cross-sectional study was conducted in Tehran among 110 patients with H. pylori infection. Antimicrobial susceptibility testing (AST) for H. pylori strains were assessed by the micro broth dilution method. Class 1 and 2 integrons were detected using PCR. In order to determine gene cassettes, amplified fragments were subjected to DNA sequencing of both amplicon strands. The prevalence of resistance to clarithromycin, metronidazole, clarithromycin, tetracycline, amoxicillin, rifampin, and levofloxacin were 68.2 (n=75), 25.5 (n=28), 24.5 (n=27), 19.1 (n=21), 18.2 (n=20) and 16.4 (n=18), respectively. Frequency of multidrug resistance among H. pylori isolates was 12.7. Class 2 integron was detected in 50 (45.5) and class 1 integron in 10 (9.1) H. pylori isolates. The most predominant gene cassette arrays in class 2 integronbearing H. pylori were included sat-era-aadA1, dfrA1-sat2-aadA1, blaoxa2 and, aadB whereas common gene cassette arrays in class 1 integron were aadB-aadA1-cmlA6, aacA4, blaoxa2, and catB3. The high frequency of class 2 integron and multidrug resistance in the present study should be considered as a warning for clinicians that continuous surveillance is necessary to prevent the further spread of resistant isolates

Comparison of antimicrobial sensitivity to older and newer quinolones versus piperacillin-tazobactam, cefepime and meropenem in febrile patients with cancer in two referral pediatric centers in Tehran, Iran

Background: Infection in pediatric cancer patients has become a concerning problem due to increasing antimicrobial resistance. The goal of this study was to determine the antimicrobial resistance patterns of blood isolates from pediatric oncology patients in Iran to determine if there was significant resistance to quinolones. Methods: Children with cancer who were admitted with or developed fever during admission to Aliasghar Children's Hospital or Mahak Hospitals July 2009 through June 2011 were eligible for enrollment. Two blood cultures were obtained. Antimicrobial sensitivity test was performed for ciprofloxacin, moxifloxacin, gatifloxacin, meropenem, cefepime, and piperacillin-tazobactam on isolates from children who were bacteremic. Results: Blood cultures were positive for 38 episodes in 169 enrolled children but 9 episodes were excluded as blood cultures were thought to be contaminated, yielding a bacteremia rate of 29/160 (18). The mean age of children and the stage of malignancy did not differ between those with and without bacteremia. Meropenem was the most likely antibiotic to cover isolates (97) with cefepime having the lowest coverage rate (21). Quinolone coverage ranged from 63 to 76. Conclusion. Quinolones may not be suitable for use as empiric therapy in febrile pediatric oncology patients in Iran

COMPARISON OF ANTIMICROBIAL SENSITIVITY TO OLDER AND NEWER QUINOLONES VERSUS PIPERACILLIN-TAZOBACTAM, CEFEPIME AND MEROPENEM IN FEBRILE PATIENTS WITH CANCER IN TWO REFERRAL PEDIATRIC CENTERS IN TEHRAN, IRAN

Infection in pediatric cancer patients has become a concerning problem due to increasing antimicrobial resistance. The goal of this study was to determine the antimicrobial resistance patterns of blood isolates from pediatric oncology patients in Iran to determine if quinolones are appropriate for empiric therapy. Methods Children with cancer who were admitted with or developed fever during admission to Aliasghar Children’s Hospital or Mahak Hospitals July 2009 through June 2011 were eligible for enrollment. Two blood cultures were obtained.  Antimicrobial sensitivity test was performed for ciprofloxacin, moxifloxacin, gatifloxacin, meropenem, cefepime, and piperacillin-tazobactam on isolates from children who were bacteremic. Results Blood cultures were positive for 39 episodes in 169 enrolled children but 9 episodes were excluded as blood cultures were thought to be contaminated,  yielding a bacteremia rate of 29/160 (18%). The mean age of children and the stage of malignancy did not differ between those with and without bacteremia. Meropenem was the most likely antibiotic to cover isolates (97%) with cefepime having the lowest coverage rate (21%). Quinolone coverage ranged from 63%  to 76%. Conclusion Quinolones are not suitable for use as empiric therapy in febrile pediatric oncology patients in Iran

Improving protein glycan coupling technology (PGCT) for glycoconjugate vaccine production.

INTRODUCTION: Vaccines are one of the great success stories of modern medicine and an increasingly important strategy in the fight against antimicrobial resistance. Glycoconjugate vaccines, consisting of a protein component covalently linked to a glycan antigen, are extremely efficacious in preventing infectious disease. However, glycoconjugates have yet to reach their full potential, with currently licensed glycoconjugate vaccines available against only four pathogens. Protein glycan coupling technology, where glycoconjugates are biologically produced in purpose engineered bacterial cells, has the potential to revolutionize the field by lowering manufacturing cost and increasing flexibility for tailor-made vaccines. AREAS COVERED: This review gives an overview of the past 20 years of PGCT research, discusses the key developments and current status of the technology, and speculates on the future of PGCT-based vaccinology. EXPERT OPINION: PCGT has the potential to overcome some of the limitations of chemical conjugation production methods. The technology has undergone significant development since its inception, and new discoveries are continually driving the field forward. Vaccines currently in clinical trials have demonstrated the potential of the PGCT to deliver effective glycoconjugate vaccines for unmet medical needs