Contribution to the knowledge of Carabidae in Iran with the descriptions of five new taxa, proposing of four synonyms and providing of nine new records (Insecta: Coleoptera).

A contribution to the knowledge of the ground beetles in Iran is given. The ground beetle diversity in Iran is rich, with 1135 known species and subspecies in total so far, and 20% percent of them are endemic. However, the Iranian fauna is still not well known. In this paper, five new taxa of ground beetles are described: Leistus (Pogonophorus) spinibarbis zagrosensis ssp. n., Trechus kouroshi sp. n., Atranus dariushi sp. n. from Zagros, and Philorhizus flavocorpus sp. n. and Philorhizus kermanus sp. n. from Kerman; four new synonyms are established: Poecilus (Ancholeus) aeneolus (Chaudoir, 1868) syn. n. and Poecilus (Ancholeus) hafezi (Morvan, 1975) syn. n. = Poecilus (Ancholeus) puncticollis (Dejean, 1828); Poecilus (Ancholeus) iranicus (Morvan, 1974) syn. n. = Poecilus (Derus) advena (Quensel, 1806), and Olegius turkmenicus Komarov, 1996 syn. n. = Pogonopsis pallida Bedel, 1898; and the first records of nine species for Iran are provided: Porotachys ottomanus ssp. ottomanus Schweiger, 1968, Tachyura (Tachyura) shahinei (Schatzmayr Koch, 1934), Tachyura (Tachyura) conspicua (Schaum, 1863), Polyderis algiricus (Lucas, 1846), Polyderis impressipennis (Motschulsky, 1860), Pogonopsis pallida Bedel, 1898, Chlaenius (Trichochlaenius) albissoni Reitter, 1908, Philorhizus crucifer ssp. crucifer (Lucas, 1846), and Demetrias monostigma Samouelle, 1819.

A remarkable new lebiine genus with two new species from Pakistan, Afghanistan and Iran (Coleoptera: Carabidae: Lebiini).

The peculiar lebiine genus Disciferella gen. n. is described as a representative of the subtribe Dromiusina Bonelli, 1810. The genus is very distinct habitually and could be easily recognized among other lebiines already by its appearance. In combination of its distinctive features, it is most similar to the enigmatic monotypic genus Brachynopterus, but distinguished from it by several sufficient characters, including the shape of the gonocoxite which is very characteristic (elongate and slightly arcuate) in the latter genus and typical for Dromiusina (short and wide) in Disciferella gen. n. The new genus includes two newly described species: D. kabakovi sp. n. (type species) from Afghanistan and Pakistan, and D. psammophila sp. n. from south-eastern Iran. The very characteristic habitus of the two new species with their wide discoidal elytra is similar to that of some species of the genera Discoptera Semenov, 1889 and Graphipterus Latreille, 1802 living in sandy habitats. This resemblance suggests a similar specialized mode of life, most likely in sandy deserts and dunes. The systematic position of the new genus is discussed.

Study of Laemostenus species across Zagros and Central zone of Iran, with the description of seven new cavernicolous species and notes on subgenus Iranosphodrus (Coleoptera: Carabidae: Sphodrini).

The species belonging to the Sphodrine genus Laemostenus Bonelli, 1810 from central and southern Zagros Mts. and central zones of Iran were studied. Two new species-groups of the subgenus Antisphodrus Schaufuss, 1865 are proposed, and seven new species belonging to subgenera Antisphodrus Schaufuss, 1865 and Iranosphodrus Lohaj & Casale, 2011 are described. Morphological characters of the habitus and shape of male genitalia were used to delimit the species. New species of subgenus Antisphodrus are: L. (A.) zagrosensis sp. nov. and L. (A.) speleophilus sp. nov. from Chaharmahal and Bakhtiari province, and L. (A.) farsicus sp. nov. from Fars province (zagrosensis species-group); Laemostenus (A) zakariyiensis sp. nov. from Fars province (aequalis species-group), and L. (A.) shirazensis sp. nov. from Fars province (glasunowi species-group).  Based on the newly collected material, the subgenus Iranosphodrus is redefined and two new species from Yazd province are described: L.(I.) yazdensis sp. nov. and L.(I.) troglophilus sp. nov. An identification key for the Laemostenus species of the studied area is provided, and a check list for Iranian representatives of subgenera Antisphodrus and Iranosphodrus are given.

Recommendations for the empirical treatment of complicated urinary tract infections using surveillance data on antimicrobial resistance in the Netherlands.

BACKGROUND: Complicated urinary tract infections (c-UTIs) are among the most common nosocomial infections and a substantial part of the antimicrobial agents used in hospitals is for the treatment of c-UTIs. Data from surveillance can be used to guide the empirical treatment choices of clinicians when treating c-UTIs. We therefore used nation-wide surveillance data to evaluate antimicrobial coverage of agents for the treatment of c-UTI in the Netherlands. METHODS: We included the first isolate per patient of urine samples of hospitalised patients collected by the Infectious Disease Surveillance Information System for Antibiotic Resistance (ISIS-AR) in 2012, and determined the probability of inadequate coverage for antimicrobial agents based on species distribution and susceptibility. Analyses were repeated for various patient groups and hospital settings. RESULTS: The most prevalent bacteria in 27,922 isolates of 23,357 patients were Escherichia coli (47%), Enterococcus spp. (14%), Proteus mirabilis (8%), and Klebsiella pneumoniae (7%). For all species combined, the probability of inadequate coverage was <5% for amoxicillin or amoxicillin-clavulanic acid combined with gentamicin and the carbapenems. When including gram-negative bacteria only, the probability of inadequate coverage was 4.0%, 2.7%, 2.3% and 1.7%, respectively, for amoxicillin, amoxicillin-clavulanic acid, a second or a third generation cephalosporin in combination with gentamicin, and the carbapenems (0.4%). There were only small variations in results among different patient groups and hospital settings. CONCLUSIONS: When excluding Enterococcus spp., considered as less virulent, and the carbapenems, considered as last-resort drugs, empirical treatment for c-UTI with the best chance of adequate coverage are one of the studied beta-lactam-gentamicin combinations. This study demonstrates the applicability of routine surveillance data for up-to-date clinical practice guidelines on empirical antimicrobial therapy, essential in patient care given the evolving bacterial susceptibility.

Consequences of switching from a fixed 2 : 1 ratio of amoxicillin/clavulanate (CLSI) to a fixed concentration of clavulanate (EUCAST) for susceptibility testing of Escherichia coli.

OBJECTIVES: The CLSI recommends a fixed 2 : 1 ratio of co-amoxiclav for broth microdilution susceptibility testing of Enterobacteriaceae, while EUCAST recommends a fixed 2 mg/L clavulanate concentration. The aims of this study were: (i) to determine the influence of a switch from CLSI to EUCAST methodology on Escherichia coli susceptibility rates; (ii) to compare susceptibility results obtained using EUCAST-compliant microdilution with those from disc diffusion and the Etest; and (iii) to evaluate the clinical outcome of patients with E. coli sepsis treated with co-amoxiclav in relation to the susceptibility results obtained using either method. METHODS: Resistance rates were determined in three laboratories that switched from CLSI to EUCAST cards with the Phoenix system (Becton Dickinson) as well as in 17 laboratories that continued to use CLSI cards with the VITEK 2 system (bioMérieux). In one laboratory, isolates were simultaneously tested by both the Phoenix system and either disc diffusion (n = 471) or the Etest (n = 113). Medical and laboratory records were reviewed for E. coli sepsis patients treated with co-amoxiclav monotherapy. RESULTS: Only laboratories that switched methodology showed an increase in resistance rates - from 19% in 2010 to 31% in 2011 (P < 0.0001). All isolates that tested susceptible by microdilution were also susceptible by disc diffusion or the Etest, but of 326 isolates that tested resistant by microdilution, 43% and 59% tested susceptible by disc diffusion and the Etest, respectively. Among the 89 patients included there was a better correlation between clinical response and measured MICs using the Phoenix system than the Etest. CONCLUSIONS: EUCAST methodology resulted in higher co-amoxiclav E. coli resistance rates than CLSI methodology, but correlated better with clinical outcome. EUCAST-compliant microdilution and disc diffusion provided discrepant results.

Trends in the incidence of surgical site infection in the Netherlands.

OBJECTIVE: To evaluate the time trend in the surgical site infection (SSI) rate in relation to the duration of surveillance in The Netherlands. SETTING: Forty-two hospitals that participated in the the Dutch national nosocomial surveillance network, which is known as PREZIES (Preventie van Ziekenhuisinfecties door Surveillance), and that registered at least 1 of the following 5 frequently performed surgical procedures for at least 3 years during the period from 1996 through 2006: mastectomy, colectomy, replacement of the head of the femur, total hip arthroplasty, or knee arthroplasty. METHODS: Analyses were performed for each surgical procedure. The surveillance time to operation was stratified in consecutive 1-year periods, with the first year as reference. Multivariate logistic regression analysis was performed using a random coefficient model to adjust for random variation among hospitals. All models were adjusted for method of postdischarge surveillance. RESULTS: The number of procedures varied from 3,031 for colectomy to 31,407 for total hip arthroplasty, and the SSI rate varied from 1.6% for knee arthroplasty to 12.2% for colectomy. For total hip arthroplasty, the SSI rate decreased significantly by 6% per year of surveillance (odds ratio [OR], 0.94 [95% confidence interval {CI}, 0.90-0.98]), indicating a 60% decrease after 10 years. Nonsignificant but substantial decreasing trends in the rate of SSI were found for replacement of the head of the femur (OR, 0.94 [95% CI, 0.88-1.00]) and for colectomy (OR, 0.92 [95% CI, 0.83-1.02]). CONCLUSIONS: Even though most decreasing trends in the SSI rate were not statistically significant, they were encouraging. To use limited resources as efficiently as possible, we would suggest switching the surveillance to another surgical procedure when the SSI rate for that particular procedure has decreased below the target rate.

Associations between surgical site infection risk and hospital operation volume and surgeon operation volume among hospitals in the Dutch nosocomial infection surveillance network.

OBJECTIVE: To examine the association between hospital operation volume and surgeon operation volume and the risk of surgical site infection (SSI). DESIGN: Prospective, multicenter cohort study based on surveillance data. METHODS: Data were obtained from the Dutch surveillance network for nosocomial infections (Preventie Ziekenhuisinfecties door Surveillance [PREZIES]) on 9 different types of orthopedic surgery, general surgery, and gynecology procedures performed during 1996-2003. Multilevel logistic regression analysis was performed to assess the independent effect of hospital volume and surgeon volume on SSI risk. RESULTS: Hospital volume was not significantly associated with SSI risk for any of the selected procedures. Low surgeon volume was associated with an increased risk for an infection for 7 of 9 types of procedures, although this effect was statistically significant only for knee arthroplasty. For 4 procedures, the odds of exceeding the 75th percentile for duration of surgery were greater when the surgeon volume was low than when the surgeon volume was moderate or high. CONCLUSIONS: Patients operated on by surgeons with a low operation volume seem to have a higher risk of developing an SSI with some procedures, particularly knee arthroplasty. The higher SSI risk for surgeons with a low operation volume is possibly partly mediated by the longer duration of surgery, a well-known risk factor for development of SSI.