Background:Klebsiella pneumoniae is among the most frequently recovered etiologic agents from nosocomial infections. This opportunistic pathogen can generate a thick layer of biofilm as one of its important virulence factors, enabling the bacteria to attach to living or abiotic surfaces, which contributes to drug resistance.Objectives:The resistance of biofilm-mediated infections to effective chemotherapy has adverse effects on patient outcomes and survival. Therefore, the aim of the present study was to evaluate the biofilm-formation capacity of clinical K. pneumoniae isolates and to perform a molecular characterization using enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) to determine the dominant biofilm-producing genotype.Patients and Methods:In the present study, 94 K. pneumoniae isolates were obtained from two hospitals in Tehran, Iran. Biofilm formation was assayed by a modified procedure, then ERIC-PCR was carried out.Results:The distributions of the clinical specimens used in this study were 61.7% from urine, 18.1% from wounds, 11.7% from sputum, and 8.5% from blood. Among these isolates, 33% formed fully established biofilms, 52.1% were categorized as moderately biofilm-producing, 8.5% formed weak biofilms, and 6.4% were non-biofilm-producers. Genotyping of K. pneumoniae revealed 31 different ERIC types. Biofilm-formation ability in a special ERIC type was not observed.Conclusions:Our results indicated that an enormous proportion of K. pneumoniae isolated from sputum and surgical-wound swabs produced fully established biofilms. It is reasonable to assume the existence of a relationship between the site of infection and the formation of biofilm. A high level of genetic diversity among the K. pneumoniae strains was observed.

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Background:Probiotics are thought to interfere with the mechanisms involving in the pathogenesis of necrotizing enterocolitis in neonates. Objectives: This study was planned to assess the effect of prophylactic probiotics for the prevention of necrotizing enterocolitis in low birth weight neonates. Patients and Methods:This prospective triple-blinded, interventional, randomized clinical trial enrolled 136 low birth weight newborn infants with a minimum birth weight of 700 g, from September 2010 to September 2011. The study and control groups were compared regarding; 1-occurrence of NEC, 2-time to reach full feeding, defined as days required to reach full enteral feeding, 3-duration of hospital course, and 4-incidence of sepsis and death. The study group was fed with milk and Protexin (restore) and the control group was fed with milk and a placebo that was physically indistinguishable from the probiotic powder. SPSS version 16 was used, and P-value less than 0.05 was considered significant. Results: One hundred thirty six neonates were enrolled in the study. Seventy six (54.4%) were male. The mean of gestational age and birth weight were 31 weeks and 1407 grams, respectively. The mean age to start feeding was 4.36 days. There was not any significant difference in the NEC cases between the two groups. Conclusions: This study did not show any benefit from prophylactic probiotics in the prevention of necrotizing enterocolitis in low birth weight neonates which could be probably due to low dose probiotics used.

Background: The administration of Haemophilus influenzae type b (Hib) conjugate vaccine led to a decrease of over 90% in the prevalence of severe Hib diseases in the countries with universal coverage vaccine. After addition of Hib vaccine to the national vaccination program and since no study has yet investigated this subject. Objectives: The current study aimed at investigating the serologic response and assessing oropharyngeal colonization with Hib after the last dose of vaccine. Methods: A total of 500 blood and oropharyngeal samples were collected from one-year-old children referred to Karaj health care centers, Iran. Demographic information and risk factors of the children were collected. Oropharyngeal and blood samples were transferred to the laboratory to determine antibody titer by the enzyme-linked immunosorbent assay (ELISA) technique, culture testing, and polymerase chain reaction (PCR). Results: In the current study, 11.8% of children (95% confidence interval (CI): 8.97-14.63) had an anti-Hib IgG titer of ≥ 5 µg/mL. Geometric mean titer (GMT) of vaccine antibody was 6.92 µg/mL (95% CI: 6.76-7.08); 9% of oropharyngeal culture results were positive for H. influaenzae (non-type b) and 8.2% were confirmed by PCR. Prevalence of oropheryngeal Hib colonization was 0.02%. There was no significant correlation between the titer of H. influaenzae antibody and positive culture of H. influaenzae and the other studied variables (P > 0.05). Conclusions: In Iran, similar to most countries, pentavalent vaccine in national vaccination program decreased the prevalence of Hib colonization. Prevalence of Hib colonization is an important factor in invasive diseases incidence. It is suggested that further studies asses the prevalence of invasive Hib diseases after national vaccination.