Evaluation of mechanisms of colistin resistance in Klebsiella pneumoniae strains isolated from patients with urinary tract infection in ICU.

Background and Objectives: One of the major causes of urinary tract infections is Klebsiella pneumoniae. Currently, few studies investigated the mechanisms of resistance to colistin in Iran. The current study aimed to determine the prevalence of plasmid and chromosome-mediated resistance to colistin in K. pneumoniae isolates. Materials and Methods: 177 urine samples were collected from patients with urinary tract infections hospitalized in the intensive care unit (ICU) of hospitals in the city of Qazvin. K. pneumoniae isolates were identified by standard biochemical methods, resistance to colistin among K. pneumoniae isolates were tested by disk diffusion and microbroth dilution methods. The chromosomal mutation and presence of the mcr genes in colistin-resistant K. pneumoniae were evaluated by PCR. Results: Out of 177 samples, 65 K. pneumoniae were obtained from patients in the ICU. Six colistin-resistant isolates were isolated with MIC values ≥4 µg/mL, none of them was positive for mcr1-5. In 4 isolates, missense mutation in mgrB gene resulted in amino acid substitutions and in one isolate of mgrB gene was found intact mgrB gene. Conclusion: The results suggest that mgrB mutation was the main mutation among colistin-resistant isolates and plasmid-borne colistin resistance was not expanded among strains.

Frequency of Multi-Drug Resistance and Molecular Characteristics of Resistance to Colistin in Acinetobacter baumannii Collected from Patients in Intensive Care Units with Ventilator-Associated Pneumonia.

Background: Acinetobacter baumannii is one of the most common causes of ventilator-associated pneumonia (VAP) in patients hospitalized in ICU. Multiple resistance has resulted in excessive use of Colistin antibiotic, which is the latest treatment option for this bacterium. Therefore, the purpose of this study was to determine the abundance of multi-resistance and molecular characteristics of resistance to colistin among A. baumannii isolated from patients that are infected with VAP and hospitalized in ICU of "Qazvin" and "Masih Daneshvari" hospitals. Materials and Methods: In this study, 200 A. baumannii isolates related to VAP were collected from ICU of "Masih Daneshvari" (2012-2018) and "Qazvin" (2017-2018) hospitals, from bronchoalveolar lavage & tracheal aspirate specimens. Isolates were detected as A. baumannii by PCR with specific primers of the blaOXA-51-like gene. Antibacterial susceptibility of isolates to colistin was determined by the MIC method, and other antibiotics were examined by the disk diffusion method, according to the CLSI criteria. Multi-drug resistance (MDR) and extended-drug resistance (XDR) isolates were determined according to standard definitions of the CLSI. Results: All the isolates were susceptible to colistin. Moreover, they were resistant to piperacillin, piperacillin-tazobactam, ceftazidime, cefotaxime, ceftriaxone, amikacin, gentamycin, levofloxacin, co-trimoxazole, and ciprofloxacin. Antimicrobial resistance rates for tetracycline and ampicillinsulbactam were 8.5% and 20%, respectively. All isolates were MDR and XDR. All isolates were susceptible to colistin (MIC50=1 and MIC90=2 µg/ml). The sequencing results did not show any point mutation in pmr CAB genes, and mcr-1 gene was not detected in any isolates. Conclusion: In this study, all A. baumannii isolates collected from VAP patients were MDR and XDR. Although all isolates were susceptible to colistin, and this agent seems the most appropriate antibiotic for treatment of VAP, colistin resistance can become endemic in the world rapidly due to plasmid-mediated mobile colistin resistance mcr genes.

Metacognition and Body Image in Predicting Alexithymia in Substance Abusers.

BACKGROUND: Substance dependency is one of the biggest problems and worries of the world. It stunts the growth of society and causes various problems such as reduction in public health, increase in mortality, rise in social and domestic traumas, loss of educational and occupational opportunities, involvement with the judicial system, and development of the substance-abuse cycle. OBJECTIVES: The aim of this study was to determine the role of metacognition and body image in predicting alexithymia in substance abusers. PATIENTS AND METHODS: The research sample included addicts (males and females aged 10 to 70 years) who referred to the addiction treatment and counseling centers of three Iranian cities of Zahedan, Sari, and Neyriz. Participants were selected by random sampling. The metacognitive strategy questionnaire (MCQ-30), physical self-description questionnaire (PSDQ), and Toronto alexithymia scale (TAS-20) were used for data collection. The hypotheses were tested using the Pearson's correlation method and regression analysis. RESULTS: According to the results of the current study, the highest correlation was between alexithymia and the cognitive awareness subscale (r = 0.305; P < 0.01).There was no significant correlation between alexithymia and body image. Based on the multiple regression analysis, the three predictors explained 11% of the variance (R(2) = 0. 11, F = 3.981; P < 0.01). Cognitive awareness significantly predicted 9% of the variance (ß = 0.305; P < 0.01), and the other subscales predicted about 2%. CONCLUSIONS: These findings demonstrated that metacognition had an important role in predicting alexithymia in the substance abusers, which underscores the necessity of precautionary measures.

Metacognition Beliefs and General Health in Predicting Alexithymia in Students.

OBJECTIVES: The present study was conducted to investigate the role of metacognition beliefs and general health in alexithymia in Iranian students. METHODS: This descriptive and correlational study included 200 participants of high schools students, selected randomly from students of two cities (Sari and Dargaz), Iran. Metacognitive Strategies Questionnaire (MCQ-30); the General Health Questionnaire (GHQ) and Farsi Version of the Toronto Alexithymia Scale (TAS-20) were used for gathering the data. Using the Pearson's correlation method and regression, the data were analyzed. RESULTS: The findings indicated significant positive relationships between alexithymia and all subscales of general health. The highest correlation was between alexithymia and anxiety subscale (r=0.36, P<0.01). Also, there was a significant negative relationship between alexithymia and some metacognitive strategies. The highest significant negative relationship was seen between alexithymia and the sub-scale of risk uncontrollability (r=-0.359, P < 0.01). Based on the results of multiple regressions, three predictors explained 21% of the variance (R2=0. 21, F=7.238, P<0.01). It was found that anxiety subscale of General Health significantly predicted 13% of the variance of alexithymia (ß=0.36, P<0.01) and risk uncontrollability subscale of Metacognition beliefs predicted about 8% of the variance of alexithymia (ß=-0.028, P<0.01). CONCLUSIONS: The findings demonstrated that metacognition beliefs and general health had important role in predicting of alexithymia in students.

Frequency of structural brain abnormalities among adult diagnosed with Attention - Deficit/Hyperactivity Disorder.

Although ADHD is known as a childhood disorder, it is prevalent among adults as well. Several studies have been conducted on the etiology of this disorder and its neurobiological and neuroanatomical manifestations in children, but the knowledge of adult ADHD is not enough. The present research was aimed at studying the structural brain abnormalities in adult ADHD cases. Fifteen adult patients diagnosed with ADHD, developed during their childhood, were selected for this study. In addition to clinical interview and Magnetic Resonance Imaging (MRI), all the participants were asked to fill the (ASRS-VI.I). The results indicated that about 40 % of adults with ADHD suffer from structural brain abnormalities. The results of MRI showed that 100% of the individuals with inattentive and combined types of ADHD were structurally damaged but MRI results did not reveal any structural brain abnormalities in hyperactive participants. The results of the present study are somewhat consistent with the results of previous studies. In general, any brain injury in the region related to cognitive processes (such as attention, memorization, and prevention) and brain circuits related to motor functions and motivation can contribute a role to the induction of ADHD symptoms. It is recommended to conduct more researches in the future with larger samples using other methods that are capable of assessing brain performance and the level and mechanism of the functions of neurotransmitters and neuronal modulators.