Osong Public Health and Research Perspectives

Original Articles

Antibiotic Resistance of Acinetobacter baumannii in Iran: A Systemic Review of the Published Literature: Jale Moradi, Farhad B. Hashemi, Abbas Bahador; Osong Public Health Res Perspect. 2015;6(2):79-86. Published online April 30, 2015; DOI: https://doi.org/10.1016/j.phrp.2014.12.006

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Objectives
Acinetobacter baumannii is a bacterium responsible for health care-associated infections, and it frequently develops multiple drug resistance (MDR). The prevalence of antibiotic-resistant A. baumannii in Iran has increased, and this may cause significant clinical problems. Therefore, in order to elucidate the development of antibiotic resistance, we performed a systematic review of the literature published on antibiotic-resistant A. baumannii reported in Iran.
Methods
Thirty-six publications that met the criteria for inclusion were reviewed from an initial 87 papers. Selected papers published between 2008 and September 2014, were categorized on the basis of the sample collecting year been between 2001 and 2013.
Results
Analysis of data revealed that, in general, there was an increase in antimicrobial resistance. During the initial time point of these studies (2001–2007) there was a high rate of resistance to all antibiotics, with the exception of carbapenems, lipopeptides, and aminoglycosides that had a low resistance rate in comparison with the others. Also, the resistance rate was increased in one group of these three antimicrobial groups from 2010 to 2013. In particular, there was an increase in resistance to carbapenems (imipenem and meropenem) from 2010–2011 and 2012–2013, whereas no significant change in the resistance rate of the other two antimicrobial groups (lipopeptides and aminoglycosides) during the study time was observed, although we did observe certain trends in amikacin (aminoglycoside group antibiotic) between 2011–2012 and 2012–2013.
Conclusion
These findings indicate that antimicrobial resistance of A. baumannii in Iran has increased, which may very well affect the antimicrobial resistance of this organism worldwide. Based on these results, novel prevention and treatment strategies against A. baumannii infections are warranted. Furthermore, these data may assist in revising treatment guidelines and regional policies in care units to slow the emergence of antimicrobial resistance.

Citations

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Frequencies of CD4+ T Regulatory Cells and their CD25^high and FoxP3^high Subsets Augment in Peripheral Blood of Patients with Acute and Chronic Brucellosis: Abbas Bahador, Jamshid Hadjati, Niloofar Hassannejad, Hadi Ghazanfari, Mohammadreza Maracy, Sirous Jafari, Maryam Nourizadeh, Amirhooshang Nejadeh; Osong Public Health Res Perspect. 2014;5(3):161-168. Published online June 30, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.04.008

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Abstract PDF

Objectives
Brucellosis remains one of the most common zoonotic diseases worldwide. In humans, brucellosis can be a serious, debilitating, and sometimes chronic disease. Different mechanisms can be postulated as to the basis for the induction of the chronic status of infectious diseases that T regulatory cells are one of the most important related mechanisms. The current study was designed to determine whether percentage of CD4+Treg cells and their CD25^high and FoxP3^high subpopulations in peripheral blood are changed in human brucellosis samples in comparison to a control group.
Methods
In total, 68 brucellosis patients (acute form: n = 43, chronic form: n = 25) and 36 healthy volunteers entered our study. After isolating of peripheral blood mononuclear cells, heparinized venous blood samples were obtained from both patients and healthy donors, CD4, CD25, and FoxP3 molecules were evaluated by two- and three-color flow cytometric methods.
Results
The results revealed a new finding in relation to Treg cells and human brucellosis. The numbers of CD4⁺Treg cells and their CD25^high and FoxP3^high subsets increase significantly in the peripheral blood of acute and chronic forms of brucellosis samples compared with healthy groups, with this increase being greater in the chronic group.
Conclusion
There seems to be a correlation between increase of CD4+Treg cells and their subsets and the disease progress from healthy state to acute and chronic brucellosis.

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Virulence Factors of Staphylococcus aureus Isolates in an Iranian Referral Children's Hospital: Farah Sabouni, Shima Mahmoudi, Abbas Bahador, Babak Pourakbari, Reihaneh Hosseinpour Sadeghi, Mohammad Taghi Haghi Ashtiani, Bahram Nikmanesh, Setareh Mamishi; Osong Public Health Res Perspect. 2014;5(2):96-100. Published online April 30, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.03.002

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Abstract PDF

Objectives
The clinical importance of Staphylococcus aureus (S. aureus) is attributed to notable virulence factors, surface proteins, toxins, and enzymes as well as the rapid development of drug resistance. The aim of this study was to compare the occurrence of virulence factors produced by S. aureus strains isolated from children in an Iranian referral children's hospital.
Methods
The presence of genes encoding for the enterotoxins A (sea), B (seb), C (sec), D (sed), TSST-1 (tsst), exfoliative toxin A (eta), and exfoliative toxin B (etb) were detected by Multiplex polymerase chain reaction (PCR) using specific primers. In addition, the standardized Kirby-Bauer disc-diffusion method was performed on Mueller-Hinton agar.
Results
In total, 133 S. aureus isolates were obtained from different patients. Of these S. aureus isolates, 64 (48%) were methicillin-resistant S. aureus (MRSA), and all of these tested positive for the mecA gene. Regarding the classical enterotoxin genes, sea gene (40.6%) was the most prevalent followed by seb (19.6%), tsst (12.8%), eta (11.3%), etb (9%), sed (4.5%), and sec (3%). Among methicillin-susceptible S. aureus (MSSA) isolates, seb and tsst were the more prevalent toxins in comparison with MRSA isolates (p < 0.05), while the frequency of sea, sed, eta, and etb genes were higher among MRSA isolates (p > 0.05).
Conclusion
In our study enterotoxin A was produced by 40.6% of the isolates (48% from MRSA and 33% from MSSA isolates) which was higher than in previous reports. According to our results, strict hygiene and preventative measures during food processing are highly recommended.

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