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Background: Pseudomonas aeruginosa is considered an opportunistic pathogen; several reports indicate that the organism can also cause infections in healthy hosts. Four effector proteins have been described in P. aeruginosa: exoU, exoS, exoT, and exoY. These genes that are translated into protein products related to type III secretion systems. Materials and Methods: A total of 134 samples were isolated, and P. aeruginosa was identified using biochemical tests. Bacterial genomic DNA was extracted, and the presence of the exoSand exoUgenes were detected by PCR. Biofilms were formed by culturing P. aeruginosaon glass slides in rich medium. Results: The exoU(73%), exoS (62%) genes were detected from infections caused by P. aeruginosa in urinary tract infection patients. Among the 119 strains isolated from patients with urinary tract infections. Conclusion: An improved understanding of virulence genes and biofilm formation in P.aeruginosa may facilitate the future development of novel vaccines and drug treatments.

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Background: Streptococcus agalactiae, also known as Group B Streptococcus (GBS) is a commensal organism in the urogenital tract and rectum in approximately 25% of the healthy adult female population. The bacterium is the leading cause of bacterial meningitis, pneumonia, and sepsis in human infants.
Materials and Methods: Our study was performed over a three - month period from April to June 2014. Midstream specimens of urine were collected from outpatients suspected of having a bacterial urinary tract infection, which had not received any antibiotics. Group B Streptococci isolates were confirmed by typical colony morphology and identified by differential tests. Antibiotic susceptibility testing was carried out by disk diffusion method on Mueller Hinton agar (Merck, Germany) based on (CLSI) Guidelines 2012.
Results: GBS strains were isolated from 264 (21.1%) cases (out of 1249 positive bacterial urine cultures). The higher prevalence was recorded in the 15-44 and 45-64 age groups. Antibiotic susceptibility tests revealed that vancomycin, penicillin, and linezolid had the lowest, and tetracycline had the highest resistance rate.
Conclusion: In conclusion, the results of the present study confirm the universal susceptibility of GBS strains to the penicillin family and assert the use of penicillin or ampicillin as the first drug of choice for treatment and prophylaxis against GBS infections. However, it is important to perform antibiotic susceptibility testing whenever penicillin could not be prescribed.

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Backgrounds: Sepsis is a systemic inflammatory response syndrome triggered by an infectious agent and an important cause of admission to intensive care units (ICU), especially in immunodeficient patients. The aim of this study was to determine the spectrum of bacterial etiology and antibacterial susceptibility pattern of sepsis and urinary tract infections (UTIs) in Iranian HIV-infected patients.
Materials & Methods: This retrospective cross-sectional study was conducted on HIV/AIDS patients for a period of ten years from January 2005 to January 2015 at two major hospitals in southwestern Iran. Standard microbiological methods were used for the isolation and identification of bacteria from samples. Antimicrobial susceptibility tests were done using disk diffusion method.
Findings: Out of 228 samples collected, the frequency of culture-positive blood and urine samples was 23.2% (n = 53) and 9.6% (n=22), respectively. Among culture-positive blood samples, Staphylococcus aureus (N = 17, 32.1%) and Pseudomonas (N = 5, 9.4%) were the main etiologic agents. While among 22 culture-positive urine samples, the predominant bacteria were Enterococci (N = 7, 31.8%) and Escherichia coli (N = 5, 22.7%). Antibacterial susceptibility testing results showed that Gram-positive bacteria were mostly susceptible to vancomycin, rifampin, and co-trimoxazole; meanwhile, Gram-negative bacteria were mostly susceptible against tobramycin, amoxicillin/clavulanate, and aztreonam.
Conclusions: In summary, this study findings highlighted the emergence and spread of opportunistic infections and a high level of antibiotic resistance among HIV-infected patients; therefore, restricted infection control strategies must be pursued in these hospitals.

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Aims: Numerous microbial agents have been identified as the causative agents of UTIs, such as Escherichia coli. The spread of antibiotic resistance is increasing among strains causing UTIs. The present study aimed to investigate the prevalence of etiological agents of UTIs and their antibiotic resistance patterns and to determine related risk factors and treatment outcomes of antibiotic resistance in Razi teaching hospital, Guilan, North of Iran.
Material & Methods: This retrospective cross-sectional study was performed from April 2017 to September 2018. All patients with clinical symptoms of UTI were included. The patients’ complete medical records were assessed. Moreover, bacterial isolation and identification were performed by conventional bacteriological and standard biochemical tests. Antibiotic susceptibility testing was performed using the disk diffusion method based on the CLSI recommendation.
Findings: Gram-negative bacilli were identified as the most common causative agents of UTIs in all cases (140, 100%), of which E. coli had the highest isolation rate with 76 cases (54.3%), followed by Klebsiella spp. with 23 cases (16.4%).  Antibacterial susceptibility tests revealed that 64.3% of the isolates were resistant to three antibiotics of different classes (MDR phenotype).
Conclusion: In conclusion, Gram-negative bacilli were the most common causative agents of UTIs, and E. coli had the highest isolation rate (54.3%). Regarding the high prevalence of antibiotic resistance and MDR phenotype, paying attention to drug resistance patterns of pathogens and proper and correct administration of antibiotics as well as proper and timely monitoring of treatment, could help physicians decrease the patients’ mortality rate.

 

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Background: Urinary tract infections are considered as a major health concern. Escherichia coli is the most common cause of urinary tract infections. The presence of qnr plasmid genes in bacteria is the main cause of resistance to quinolones. The aim of this study was to investigate the antibiotic resistance pattern and prevalence of qnrB gene in E. coli strains isolated from patients with urinary tract infections.
Materials & Methods: In this cross-sectional study, samples were taken from patients with urinary tract infections, referred to Kermanshah hospitals during the spring of 2017. E. coli strains were identified by biochemical tests. Then antibiotic susceptibility testing was performed for the isolates by the disc diffusion method. Following that, qnrB resistance gene was detected by PCR; finally, data were analyzed by SPSS software Ver. 23.
Findings: In this study, 105 E. coli strains were isolated from urine specimens. The strains resistance rate to nalidixic acid, ciprofloxacin, and ofloxacin antibiotics was 62.85, 38.09, and 33.33%, respectively. PCR results showed that 67 strains (63.8%) had qnrB gene, and 38 strains (36.19%) lacked this gene. Logistic regression analysis showed that there was a significant relationship between the presence of qnrB gene and nalidixic resistance.
Conclusion: The results of this study show that the frequency of qnrB gene among the E. coli strains isolated from urinary tract infections is fairly high in Kermanshah. Therefore, it is necessary to do further investigates using molecular techniques and to take serious preventive measures.

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Background: Malnutrition is a major cause of morbidity and mortality in children under five years. This study aimed to evaluate malaria and urinary tract infections among children under five years of age with malnutrition.
Materials & Methods: This cross-sectional study was carried out on 189 children under five years with malnutrition. Their weight and height were measured using standard scales. Weight to height/length (wasting), weight to age (underweight), and height/length to age (stunting) ratios were computed using WHO growth charts. Clinical features were assessed. Blood smear, rapid diagnostic test for malaria, as well as urine dipstick test were done to detect those with malaria and urinary tract infections.
Findings: About 80.95% of participants had marasmus, and 11.64% had marasmic kwashiorkor, while 7.41% had kwashiorkor. Also, 23.70 and 62.42% of participants had moderate and severe malnutrition, respectively; in addition, 21.69 and 2.12% were moderately and severely stunted, respectively. Regarding underweight (weight to age), 50.26 and 4.76% were moderately and severely underweight, respectively. Also, 15.87% of participants had a positive blood smear for malaria, and 19.58% had a positive rapid diagnostic test for malaria, while 20.11 and 20.63% had positive results for nitrite and leukocyte esterase activity in urine dipstick test, respectively.
Conclusion: Malaria and urinary tract infections are common among children with malnutrition and could be diagnosed using simple laboratory tests such as rapid diagnostic tests and urine dipstick tests in health facilities without laboratory support in resource-limited countries.

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Introduction and aim: Diagnosis and treatment of urinary tract infection in children must be done before renal damage. So, in many countries the screening programs are done in the schools. There are a few reports on the prevalence of this disease among children in different parts of Iran. This study aims to investigate the prevalence of this infection in the seven years old children of Birjand city and determine the worth of recommending a screening program for the UTI before attendance to school ,this study was performed . Methods: 278 Students (148 boys and 130 girls) Were selected by multi stage cluster sampling. After filling the questionnaire ,urine culture was done. In those who had colony count above or equal 104 per ml and below 105, U/C was repeated. children with 105 colony count per ml had documented as UTI. Results: The prevalence of UTI was 1.1% in all students. The prevalence of UTI was 1.4% in boys and 0.8% in girls. There was not any significant difference in the prevalance of UTI between two sexex (P.Value =1). 68.9 % of the boys (102 persons) were circumcised. The prevalance of UTI was 1% in circumcised boys and 2.2% in uncircumcised ones. There was not any significant difference in UTI between these two groups (Pvalue = 0.53). the most common age of doing circumcision was six years old. We had only Ecoli in the results of all documented UTI. Conclusion: Regavding to a few information about the prevalance of UTI among children in different parts of Iran, it is better to conduct more studies to determine the worth of recommending a screening programs for UTI in pre-school age .We recommend giving more information and education to people about the best age for circum cision.

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Antibiotics are widely used as bacteriostatic and bactericidal drugs in bacterial infections. Besides the respective interactions between the antibiotics and bacteria and between the immune system and bacteria, antibiotics also interact directly with the immune system and have various immunomodulatory effects on phagocytosis, chemotaxis, cytokine production and endotoxine release. In this study, monocytes and neutrophils were separated from the blood samples of the patients with urinary tract infection before and after the therapy with 500 mg ciprofloxacin tablets. The cells were cultured in the presence of ciprofloxacin and activators including IFN-γ and LPS or PMA (for in vitro evaluation) or only the activators (for ex vivo evaluation) . Supernatants of the cells were collected and then production of NO and H2O2 was measured. The effect of ciprofloxacin on NO and H2O2 production by monocytes and neutrophils in the patients with urinary tract infection caused by E. coli (E.Coli) was evaluated.The results were compared to an age- and sex-matched normal population. Peripheral blood samples from 45 patients with uUTI were collected at the time of diagnosis and at the end of the treatment. The results showed that NO and H2O2 production was significantly increased in the patients comparison to the control group, before and after the treatment (P<0.05). NO level in the post treatment group was also significantly raised compared to the pre-treatment group (P<0.05), but H2O2 level was not significantly altered (P>0.05). The results showed that the results of in vitro study was different from ex vivo. and alteration was not different between pre-treatment and post treatment groups significantly (P>0.05) .

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Aims: Bacterial urinary tract infections are observed in all age groups due to the development of antibiotic-resistant species. This study aimed to investigate resistance genes gyrase subunit A (gyrA), topoisomerase IV (parC) subunit gene, beta lactamase (blaZ), erythromycin ribosome methylase (ermC), ermB, and ermA in Staphylococcus saporophyticus isolated from patients with urinary tract infections (UTIs) in Mazandaran Province, Iran.
Materials & Methods: In this cross-sectional descriptive study, 3280 clinical samples were collected from patients with UTIs in Mazandaran Province from April to December 2022. Isolates were identified by biochemical tests. Microbial sensitivity tests were performed by disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Polymerase chain reaction (PCR) was used to check the presence of resistance genes.
Findings: Out of a total of 3280 clinical samples collected, 2088 samples were detected by biochemical tests at the genus level. Escherichia coli (55.22%) and staphylococci (21.59%) were the most frequent bacterial isolates. S. saprophyticus was identified in 52 (2.49%) samples. The frequency of gyrA and parC genes in S. saprophyticus isolates was 23 and 1.92%, respectively. The blaZ gene was observed in none of the samples. The prevalence of ermA, ermB, and ermC genes was 21, 1.92, and 26%, respectively.
 The antibiogram test showed that the highest frequency of resistance to erythromycin, azithromycin, and clarithromycin was 70, 36, and 20%, respectively.
Conclusion: According to the present study findings, rapid detection of these strains in hospitals leads to more effective control of the spread of these strains.
 

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Background: This study aimed to evaluate the frequency of extensively drug-resistant (XDR) uropathogenic Escherichia coli (UPEC) isolates and to detect their metallo-beta-lactamase (MBL) genes.
Materials & Methods: Three hundred urine samples collected from patients with suspected urinary tract infection (UTI) were evaluated for the presence of UPEC isolates. These isolates were subjected to antibiotic susceptibility testing to determine multidrug-resistance (MDR) and XDR profiles. Imipenem or meropenem-resistant isolates were evaluated for MBL production using modified carbapenem inactivation (mCIM) and EDTA-CIM (eCIM) methods. PCR was carried out to identify the presence of MBL genes, including bla_GIM, bla_SIM, bla_VIM-1, bla_VIM-2, bla_SPM-1, bla_IMP-1, bla_IMP-2, bla_NDM, and bla_KPC.
Findings: Out of 300 urine samples, 200 (66.66%) were positive for UTI. Among these, 150 were caused by UPEC. The highest antimicrobial resistance was against cefepime (88%) and ampicillin (85.3%), while the highest susceptibility was against imipenem (91.7%) and fosfomycin (84%). MDR and XDR profiles were detected in 145 (96.66%) and 5 (3.33%) isolates, respectively.  Overall, five UPEC isolates were XDR and resistant to imipenem and meropenem. All these isolates were positive for mCIM, while four were positive for eCIM. The bla_NDM gene was found in all five isolates, while the other MBL genes were not found.
Conclusion: The existence of MDR and XDR bacteria poses a significant risk to public health. bla_NDM is circulating in UPEC strains at least in Nasiriya province, Iraq. This could lead to increased resistance to carbapenems among Enterobacteriaceae, a serious threat to public health.

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Abstract
Urinary tract infection is one of the most common and common bacterial infections, accounting for a significant proportion of hospital admissions (about 30-40%). Silver nanoparticles work by releasing silver ions against various bacteria. The fact that bacteria are not resistant to nanoparticles is very important and therefore will affect a wide range of bacteria.
Materials and Methods
In this study, 50 specimens of positive cultures with urinary tract infection referred to Imam Reza Hospital Laboratory in Bojnourd were studied. Resistance and susceptibility of the isolates were determined by disk diffusion method. In this study, antibacterial effects of silver nanoparticles were investigated by microdilution method using aqueous extract of Ganoderma leucidum. Vegetative electron microscopy was used to measure the size and shape of silver nanoparticles. In addition, infrared spectroscopy analysis was performed to investigate possible organic compounds involved in the synthesis of nanoparticles.
Results: The highest antibiotic resistance was related to ampicillin (84%). The resulting nanoparticles were 20 to 45 nm in size.
Conclusion:
The produced nanoparticles have antimicrobial activity and can be a good alternative in the treatment of antibiotic resistant infectious diseases.
 

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Objective: Aminoglycosides are highly potent, broad-spectrum antibiotics with many desirable properties for the treatment of life-threatening infections. Escherichia coli (E. coli) is the most common cause of urinary tract infection (UTI). Antibiotic resistance has recently become prevalent. Enzymatic inactivation of aminoglycosides by aminoglycoside-modifying enzymes is the main mechanism of resistance to these antibiotics in E. coli. The main purpose of this research is to evaluate the presence of the 2'-aminoglycoside nucleotidyltransferase)ant(2′′)-Ia( gene in E. coli isolates sensitive to mannose and hemolysin production. Methods: After collecting 276 E. coli isolates from patients that referred to Tehran Heart Center, we used the disk diffusion method to determine the resistance patterns of isolates toward Gentamicin, Tobramycin, Kanamycin, Amikacin and Netilmicin antibiotics according to the CLSI principles. We evaluated hemolysin production by assessing the ability of the isolates to grow on sheep and human blood agar media. Chromosomal DNA of the isolates was extracted using DNA extraction kits and PCR method used for the detection of the ant(2′′)-Ia gene.In order to study mannose sensitivity we used human RBCs. Results: Results obtained from antibiotic resistance determination tests showed that the highest rate of resistance was observed against tobramycin (24/63%). Of those resistant, 6% could produce hemolysin in both sheep and human blood agar media. Mannose sensitivity was observed in 14% of isolates during agglutination. There were 24.63% of E. coli isolates resistant to Tobramycin, 23.18% resistant to kanamycin, 21.01% resistant to gentamicin, 6.15% resistant to netilmicin and 3.62% resistant to amikacin. ant(2′′)-Ia gene was detected in 47.88% of E. coli isolated from urine. Conclusion: Due to the high prevalence of urinary tract infections caused by uropathogenic E. coli (UPEC) strains and the increasing rate of antibiotic resistance, periodic evaluations should be conducted for outbreaks of resistance in order to select the most suitable treatment to prevent routinely increasing antibiotic resistance.