Frequency of IMP-1 and VIM Genes among Metallo-beta-Lactamase Producing Acinetobacter spp. Isolated from Health Care Associated Infections inNortheast of Iran

Background: The emergence and rapid spread of metallo-beta-lactamase (MBL) producing Acinetobacter spp. are of great concern worldwide due to limited treatment options. Epidemiologic studies of the causing genes are important for prevention. Methods:  In  this  study,  70  imipenem-resistant  Acinetobacter  strains  were isolated from health care associated infections. These isolates were screened for detection of metallo-beta-lactamase (MBL) using inhibitor potentiated disk diffusion tests with thylenediaminetetraacetic acid (EDTA). PCR was designed for detection of bla vim and bla imp-1 using specific primers. Results: Among these 70 strains, 50 strains appeared to produce metallo-beta-lactamase. Three isolates were detected by PCR to carry metallo-beta-lactamase gene bla vim, but bla imp-1 gene was not detected. Conclusion: These findings suggest that in our area other genetic elements are responsible for resistance against metallo-beta-lactams

Gaps in Patient Education on Safe Handling and Disposal of Oral Chemotherapy Drugs: A Pilot Prospective Cohort Survey Study

Background Oral anticancer chemotherapy (OC) has been misperceived as being safer than intravenous chemotherapy, leading to its increased risk of improper handling and disposal. This survey study assessed the knowledge, practices and attitudes of pharmacists and patients regarding OC handling and disposal, gaps in knowledge and barriers to patient education. Methods Surveys were developed based on literature review and pilot study validation results. Patients completed a 33-item paper or electronic survey whereas pharmacists completed a 38-item electronic survey. Descriptive statistics and Fisher’s exact test computed using the R Project were used for analyses. Results Pharmacist group (16/25, 62.5%) and patient group (14/29, 48.3%) believed that the oral route is safer than IV. Average overall correct response rates for pharmacist and patient groups were 78.3% and 61.9%, respectively. Significant gaps in knowledge between groups were observed in three sections (p \u3c 0.05). Common barriers to providing patient education were insufficient training (70.8%) and insufficient time (50%). Conclusion Pharmacist and patient knowledge, awareness and practices of OC safe handling and disposal are suboptimal. Areas of knowledge gaps and barriers to patient education were identified. Enhanced supports are needed to empower pharmacists to assume an active role in patient education on safe handling and disposal of OC

The Effect of Different Soft Drinks on the Force Degradation of Conventional and Memory Orthodontic Elastic Chains: An In-Vitro Study

Objectives: The aim of this study was to assess how different soft drinks affect the deterioration of conventional and memory orthodontic elastomeric chains. Materials and Methods: We used 500 five-loop segments of elastomeric chains, which were divided into two equal groups of conventional and memory chains. The samples were kept in artificial saliva during the study period. Each group was further divided into 5 subgroups consisting of artificial saliva (controls), Coca-Cola®, non-alcoholic beer (ISTAK®), and carbonated and non-carbonated yoghurt-based drinks (Alis®). Treatment with the soft drinks consisted of immersion in the test liquids twice a day for 3 minutes each time. Force measurements were taken on days 1, 7, 14, 21, and 28. Data were analyzed using One- and three-way ANOVA tests, and independent t-test, with a significance level of 5%. Results: The mean initial force for the conventional and memory elastomeric chains was 3.34±0.112N and 2.49±0.209N, respectively. Conventional chains showed significantly greater degradation than memory chains (P<0.01). Soft drinks had a significant impact on force degradation for both types of chains at all time points (P<0.01). Coca-Cola® had the highest level of force degradation, while non-carbonated yoghurt-based drinks had the lowest (P<0.01). Conclusion: Based on the findings of this study, it is recommended that orthodontic patients choose non-carbonated yoghurt-based drinks during their treatment. Memory elastomeric chains may be more suitable for patients who consume large amounts of carbonated soft drinks, due to their lower amount of force degradation compared to conventional chains

Detection of blaDIM, blaAIM, blaGIM, blaNDM and blaVIM Genes among Acinetobacter baumannii strains isolated from hospitalized patients in Tehran hospitals, Iran

Background and Aim: The rising trend of antibiotic resistance among A. baumannii strains has become a global concern. The most common mechanism of resistance is betalactamase production with genes transferring on mobile genetic elements such as plasmids. The aim of this study was to determine the frequency of blaNDM, blaGIM, blaAIM, blaDIM and   blaVIM type genes among A. baumannii isolates from hospitalized patients in Tehran, Iran. Materials and Methods: from May 2012 to July 2013, 108 A. baumannii strains were isolated from blood, wound, urine, sputum and respiratory tract of hospitalized patients in Loghman hakim and Milad hospitals. Antibiotic susceptibility tests were performed by Kirby-Bauer disc diffusion and broth microdilution methods according the CLSI guidelines. The frequency of MBL (Metallo-Beta-Lactamase) producers was evaluated by CDDT. The &beta;-lactamases genes were detected by PCR method. Results: The resistance of A. baumannii isolates against tested antibiotics were as follows: 103 (95.4%) to ceftazidime, 108 (100%) to cefotaxime, 105 (95.7%) to cefepime, 99 (91.7%) to imipenem, 99 (91.7%) to meropenem, 87 (80.6%) to amikacin, 105 (97.2%) to piperacillin, 100 (92.6%) to ciprofloxacin, 103 (95.4%) to piperacillin/tazobactam, 44 (40.7%) to gentamicin, 106 (98.1%) to ampicillin/sulbactam, 106 (98.1%) to co-trimoxazole, 87 (80.6%) to tetracycline, and 1 (1.8%) to colistin. Using combined disk diffusion test, 86 (86.86%) were MBL producers. The prevalence of blaVIM-1 gene was 15 (17.44%) and other genes were not detected. Conclusions: The prevalence of MBLs-producing A. baumannii strains detected in this study is a major concern and highlights the need for infection control measures such as antibiotic management protocols and rapid identification of resistant strains