Detection of antimicrobial susceptibility and integrons among extended-spectrum beta-lactamase producing uropathogenic escherichia coli isolates in southwestern Iran

Objectives: Urinary tract infections [UTIs] are one of the most prevalent infectious diseases and can lead to a high rate of morbidity and mortality. The emergence of multiple-drug resistant strains, particularly extended-spectrum beta-lactamases [ESBLs] producing strains, has become a global healthcare concern. Our study sought to investigate the antimicrobial resistance pattern and presence of integrons and fimH determinants among uropathogenic Escherichia coli [UPEC] isolates obtained from hospitalized Iranian patients

Methods: This cross-sectional study was performed on 121 E. coli isolates recovered from patients with clinical symptoms of UTIs, referred to Shiraz Nemazee Hospital, in 2016-17. The isolates were identified by standard microbiologic tests and confirmed by API 20E strip. Antimicrobial susceptibility testing was determined using the disk diffusion method. The presence of fimH and classes 1-3 integron encoding genes was determined using the polymerase chain reaction

Results: Ampicillin [9.1%] and nalidixic acid [19.0%] showed the lowest level of antibiotic susceptibility. The highest level of susceptibility was toward imipenem [77.7%]. The rate of ESBL-producing isolates was 42.1%. There was a significant association between production of ESBLs and higher antibiotic resistance in the tested isolates. Of the investigated virulence and resistance genes, fimH, intI1, and intI2 were positive in 98.3%, 59.5%, and 7.4% of isolates, respectively

Conclusions: The remarkable rate of ESBL-producing UPEC isolates accompanied with the presence of integrons suggest the necessity of restricted infection control policies to prevent further dissemination of resistant strains

High Incidence of Virulence Factors Among Clinical Enterococcus faecalis Isolates in Southwestern Iran

BACKGROUND: Over the past two decades, enterococci have emerged as an important agent responsible for hospital acquired infection. Several virulence factors contribute to the adherence, colonization, evasion of the host immune response, and pathogenicity and severity of the infection. Enterococcus faecalis is the most common and virulent species causing infections in hospitalized patients. The aim of the present study was to examine the prevalence of genes encoding virulence factors and antimicrobial resistance patterns of E. faecalis strains isolated from hospitalized patients in Shiraz, south west of Iran. MATERIALS AND METHODS: A total of 51 E. faecalis isolates from the urine, blood, pleural fluid, peritoneal fluid, eye discharge, endotracheal tube (ETT) and transjugular intrahepatic portosystemic shunt (TIPS) specimens of patients were identified by phenotypic and genotypic methods. Antimicrobial sensitivity tests and detection of virulence factors were performed using standard methods. RESULTS: The efa and asa1 were the most frequently detected gene (100%) among the isolates, followed by esp (94.1%), ace (90.2%), gelE (80.4%), cylA (64.7%), and hyl (51%). More than half of the isolates (52.9%) were high level gentamicin resistant (HLGR). Vancomycin resistance was observed among 23 (45.1%) isolates. The lowest antimicrobial activity was related to erythromycin (3.9%), tetracycline (5.9%) and ciprofloxacin (9.8%). No isolate was found resistant to fosfomycin and linezolid. CONCLUSION: Our data indicated a high incidence of virulence factors among E. faecalis strains isolated from clinical samples. Colonization of drug resistant virulent isolates in hospital environment may lead to life threatening infection in hospitalized patients. Therefore, infection control procedures should be performed.

Antimicrobial resistance pattern in Escherichia coli isolates obtained from a specialized women and children hospital in Shiraz, Iran: a prevalence study

Background: Escherichia coli, known as a clinically significant bacteria, can cause a wide range of infections, including urinary tract infections [UTIs], blood stream infections [BSIs], and can frequently be isolated from various clinical specimens. Evaluation of antimicrobial resistant pattern is a necessary action, especially about such bacteria which are frequent and life threatening. The aim of this study was to determine the frequency and antimicrobial resistance pattern of E. coli isolates obtained from various clinical specimens

Methods: This retrospective study was performed within a seven month period from January 2015 to August 2015 at a specialized women and children hospital in Shiraz, Iran. E. coli isolates were obtained from various clinical specimens and identified using standard microbiological procedure. Antimicrobial susceptibility patterns were determined using disk diffusion method in accordance with CLSI recommendation

Results: Of the total 130 positive cultures, the majority of E. coli isolates were obtained from urine [96=73.8%] and blood [11=8.5%] specimens. Overall, gentamicin [70.8%] was the effective antibiotic for the tested E. coli isolates. E. coli isolates obtained from urine specimens showed the highest resistance rates against ampicillin [84.4%] and nalidixic acid [61.5%]; while they showed the most sensitivity to gentamicin [79.2%], nitrofurantoin [70.8%] and ciprofloxacin [66.7%]. Moreover, the highest antibiotic resistance rates belonged to the isolates recovered from endotracheal tube [ETT]

Conclusion: The results showed that gentamicin was the most effective antibiotic against E. coli infections. However, in addition to the gentamicin, we can recommend nitrofurantoin and ciprofloxacin as the other effective agents for UTIs

Effects of Hydro-alcoholic Extract from Arctium lappa L. (Burdock) Root on Gonadotropins, Testosterone, and Sperm Count and Viability in Male Mice with Nicotinamide/ Streptozotocin-Induced Type 2 Diabetes

Background: Reproductive dysfunction is a complication of diabetes. Arctium lappa (burdock) root has hypoglycemic and antioxidative properties, which are traditionally used for treatment of impotence and sterility. Therefore, the aim of this study is to investigate the effects of its hydro alcoholic extract on gonadotropin, testosterone, and sperm parameters in nicotinamide/ streptozotocin-induced diabetic mice. Methods: In this experimental study, 56 adult male Naval Medical Research Institute (NMRI) mice (30–35 g) were randomly divided into seven groups: control, diabetes, diabetes + glibenclamide (0.25 mg/kg), diabetes + extract (200 or 300 mg/kg), and extract (200 or 300 mg/kg). Diabetes was induced with intraperitoneal injection of nicotinamide (NA) and streptozotocin (STZ). Twenty-four hours after the last extract and drug administration, serum samples, testes, and cauda epididymis were removed immediately for experimental assessment. Results: Body weight, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), and testosterone levels, and sperm count (P < 0.05) and viability (P < 0.01) decreased in diabetic mice. Administration of glibenclamide significantly improved these reductions in diabetic animals (P < 0.05). However, the hydro alcoholic extract (300 mg/kg) enhanced sperm viability only in diabetic mice (P < 0.01). In addition, this dose of extract increased sperm count, LH, FSH, and testosterone in nondiabetic animals compared with the control group (P < 0.05). Conclusion: The results indicate that applied burdock root extract has anti-infertility effects in nondiabetic mice. Hence, this part of the A. lappa plant has an effect on the health of the reproductive system in order to improve diabetic conditions.

Effects of Hydro-Alcoholic Extract of Rhus coriaria (Sumac) Seeds on Reproductive Complications of Nicotinamide-Streptozotocin Induced Type-2 Diabetes in Male Mice

PURPOSE: The purpose of this study was to investigate the effects of the hydro-alcoholic extract of Rhus coriaria seeds on the reproductive system of nicotinamide-streptozotocin-induced type-2 diabetic mice. MATERIALS AND METHODS: In this experimental study, 56 male Naval Medical Research Institute mice were randomly divided into seven groups (n=8): control; diabetic mice; diabetic mice administered glibenclamide (0.25 mg/kg); diabetic mice who received the hydro-alcoholic extract of R. coriaria seeds (200 and 400 mg/kg groups); and normal mice who received this extract (200 and 400 mg/kg groups). Diabetes was induced by intraperitoneal administration of streptozotocin (65 mg/kg) 15 minutes after an injection of nicotinamide (120 mg/kg). Then, glibenclamide and the above mentioned extract were administered orally for 28 consecutive days. Twenty-four hours after the last treatment, serum samples, the testes, and the cauda epididymis were removed immediately for hormonal, testis morphology, and sperm parameter assessments. RESULTS: Body and testicular weight, sperm count and viability, and serum luteinizing hormone, follicle-stimulating hormone and testosterone levels were significantly lower in the diabetic mice (p<0.05). The diabetic mice treated with 400 mg/kg of the hydro-alcoholic extract of R. coriaria seeds recovered from these reductions (p<0.05). Further, glibenclamide alleviated hormonal and sperm count depletion in diabetes-induced mice (p<0.05). CONCLUSIONS: The present results indicated that the hydro-alcoholic extract of R. coriaria seeds has anti-infertility effects in diabetic males.

Effects of Exendin-4 on Male Reproductive Parameters of D-Galactose Induced Aging Mouse Model

PURPOSE: The purpose of this study was to evaluate the role of exendin-4 on reproductive alteration in a D-galactose-induced aging mouse model. MATERIALS AND METHODS: In this experimental study, 72 male Naval Medical Research Institute mice (20~25 g) were randomly divided into six groups: control, exendin-4 (1 nmol/kg), exendin-4 (10 nmol/kg), D-galactose (500 mg/kg), D-galactose+exendin-4 (1 nmol/kg), and D-galactose+exendin-4 (10 nmol/kg). The aging model animals were gavaged with D-galactose for six weeks, and exendin-4 was injected intraperitoneally in the last 10 days. At the end of treatment serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone levels were evaluated and the cauda epididymis and testis were removed to analyze the sperm count and testis morphology. RESULTS: The testis weight and volume decreased in the D-galactose group (p<0.01 and p<0.05) respectively. Exendin-4 (1, 10 nmol/kg) increased these parameters in the normal and aging mouse models. Serum LH and FSH levels increased and the sperm count decreased in the D-galactose group (p<0.05). Further, exendin-4 (1 nmol/kg) decreased LH and FSH levels and increased the serum testosterone level and sperm count in both normal and aging animals. CONCLUSIONS: D-galactose can induce aging alternations in the male reproductive system such as decreased sperm count and increased serum LH and FSH levels through reactive oxygen species over production and reduced antioxidant enzyme activity. Further, co-administration of exendin-4 reduced reproductive complications of D-galactose in an aging mouse model.

Progesterone and Cilostazol Protect mice pancreatic islets from oxidative stress induced by hydrogen peroxide

Reactive oxygen species and oxidative stress impair beta-cell function and reduce insulin secretion. It has been shown that progesterone and cilostazol possess antioxidant properties. The present study was aimed to investigate in vitro pretreatment effect of progesterone and cilostazol on insulin secretion as well as their protective effects against hydrogen peroxide-induced oxidative stress in pancreatic isolated islets from mouse. Pancreatic islets were isolated from 84 male NMRI mice [25-30g] by collagenase digestion method and pretreated for 48h with cilostazol [10 microM], progesterone [0.5 microM] and glibenclamide [10 microM] in culture medium. Then islets were exposed to hydrogen peroxide [H2O2. 500 microM] for 2h. Next, culture mediums containing glucose concentration of 2.8 mM or 16.7 mM were added to them and incubated in this status for 1h. At the end, the rate of insulin output from islets, lipid peroxidation and antioxidant enzymes activities in islet tissues were assayed. Exposure of islets to H2O2, resulted in a significant decrease in insulin secretion, superoxide dismutase and catalase activities [P<0.001]. Also islets malondialdehyde levels were increased by H2O2, after addition of 2.8mM [P<0.05] and 16.7mM [P<0.001] glucose. 48h pretreatment of islets with cilostazol and progesterone, significantly reverted back this changes [P<0.05]. Results of present study showed that cilostazol and progesterone protect mice pancreatic islets against H2O2-induced oxidative stress. At the end, our results suggested that protective effects of progesterone and cilostazol are mediated by augmentation the antioxidant defence system of islets

Diagnostic performance of multislice CT coronary angiography in the assessment of significant coronary artery disease

The use of noninvasive assessment tools such as multi-slice CT coronary angiography [MSCT-CA-CA] is recently considered mainly because it offers safety, patient convenience, and faster performance. The aim of the present study was to determine the ability of MSCT-CA-CA for the detection of significant stenoses in the coronary arteries, in comparison to conventional invasive coronary angiography [ICA]. A total of 58 consecutive patients who were candidate for coronary angiography, with the diagnosis of acute coronary syndrome, from September 2006 to March 2006 were entered into the study. They underwent both coronary MSCT-CA-CA and ICA. The findings of each coronary segment were compared to MSCT-CA-CA in comparison with ICA. Based on artery analysis, sensitivity and specificity of MSCT-CA for the detection of involvement in RCA were 90.0% and 92.8%, in LAD were 71.8% and 92.9% and in LCX were 67.9% and 92.6%, respectively. On a per-segment basis, the sensitivity of MSCT-CA in the detection of injured segments ranged between 33.3% [for segment 11] and 100% [for segments 1, 2 and 12]. Also, specificity ranged from 63.6% [for segment 15] and 98.1% [for segment 6]. The presence of hypertension, hyperlipidemia, and smoking led to the reduction of the specificity and accuracy of MSCT-CA, whereas history of diabetes mellitus could increase the specificity and accuracy of this tool. MSCT-CA has high diagnostic performance in the assessment of significant coronary artery disease. Risk factors for coronary artery disease may influence this performance

[Anti-convulsant effect of alcoholic hyoscyamus niger L seed extract on PTZ model of kindling in male mice]

Regarding the prevalence of epilepsy in human society and with respect to inefficiency of the usual treatments, finding new strategies and methods for the medical treatment of epileptic patients are essential. Henbane seed has been used in Iranian traditional medicine as an anti-convulsion herb. With this regard the present study was carried out to consider the anti-convulsive effect of Henbane seed extract on the chemical kindling-induced convulsion. The present experimental study has been conducted at Medical Faculty of Shahed University in 2009. Sixty male mice have been chosen randomly and divided into 5 experimental groups including 12 mice in each group as follows: 1-control group receiving only Pentylene tetrazole [PTZ], 2[nd], 3[rd] and 4[th] experimental groups received alcoholic extract of henbane seed in doses of 50, 100 and 200 mg/kg intraperitoneally 30 minutes before PTZ injection and 5[th] group was positive control that received valproic acid 100 mg/kg 30 minutes before PTZ injection. Chemical kindling was performed in all of them by a total of 11 treatments with intraperitoneal injection of PTZ 35 mg/kg at every 48 hours. In the 12[th] injection all groups were tested for PTZ challenge dose [75 mg/kg]. Mice were observed 30 minutes after the last injection to detect convulsion. Data analysis was carried out by One way ANOVA and Tukey post-hoc tests. Data analysis shows that administration of henbane seed extract had an inhibitory effect on the steps, progression and duration of seizure, especially in the last steps of convulsion. However, therapy with henbane seed extract resulted in an efficient anticonvulsive effect from the 8[th] injection reaching the highest level of efficiency at the 12[th] step [p<0.001]. The results obtained from the present study showed that alcoholic Hyoscyamus niger seed extract could have markedly alleviated PTZ-induced seizure phases in male mice. Also, the extract at 100 mg/kg significantly increased and reduced the threshold and duration of 5th seizure phase