Carbapenem-hydrolyzing β-lactamases are increasingly reported worldwide, leading to therapeutic failure. In an era where the drug development pipeline is stagnant, it is crucial to preserve current classes of antibiotics to help fight against infection caused by multidrug-resistant organisms (MDROs), by practicing a rational approach for the use of antibiotics. Identifying the mechanisms of resistance gives us much needed insights in this field. A total of 113 consecutive, non-duplicate carbapenem-resistant clinical isolates were collected from July to December 2012. These isolates were subjected to the modified Hodge test (MHT) for phenotypic detection of carbapenemases, an inhibitor-based test employing EDTA for the detection of metallo-β-lactamase (MBL), and phenylboronic acid for the detection of Klebsiella pneumoniae carbapenemase (KPC). A multiplex polymerase chain reaction (PCR) assay that characterized the five most predominant carbapenemases (bla NDM, bla OXA, bla VIM, bla IMP, bla KPC) was designed. The 113 isolates consisted of Klebsiella spp. (46), Enterobacter spp. (32), Escherichia coli (31), Citrobacter spp. (2), Proteus spp. (1), and Morganella spp. (1). bla NDM-1 was the most prevalent carbapenemase and accounted for 75.22 % (85/113) of the isolates. This was followed by bla OXA [4.42 % (n = 5)]. 18.5 % (21/113) of the isolates possessed dual carbapenemase genes. 98.9 % concordance was observed between the phenotypic tests and the molecular tests for the detection of MBL. In conclusion, patients infected with resistant bacteria require early appropriate antimicrobial treatment for good clinical outcome. Thus, identifying the resistant mechanisms of suspected pathogens becomes crucial. Also, the high incidence of plasmid-mediated bla NDM-1 calls for the implementation of strict infection control and contact isolation precautions in order to prevent the spread of these organisms.

Background: Mendelian susceptibility to mycobacterial diseases (MSMD) is a rare inheritance syndrome, characterized by a disseminated infection in children following BCG vaccination performed at their birth time. In the infected children with MSMD, there is a susceptibility to systemic infection with mycobacterium tuberculosis and nontuberculous including Bacillus Calmette-Guerin (BCG) vaccine Aime:We aimed to diagnosis MSMD patients over a period of 2 years at the main referral center for immunological disorders in Iran.Methods & Materials: In this study, suspected patients with MSMD referred to "Immunology, Asthma and Allergy Research Institute" are studied genetically. The patients were affected with localized disseminated and recurrent lymphadenopthy after BCG vaccination at the birth time, and have normal immune system result testsTheir LTT function is normal in the exposure with PHA, is defective in the exposure to BCG In this study, we measured Il12, IFN gama levels to help identify patie Results: In this study, we have 4 controls and 8 patients that had impaired response to IL-12. Although there was no significant relationship between LTT with PHA .it becomes signification when we added BCG aliveIn addition the arrays of IL l12(0.003), IFN gama(0.015) between controls and patient groups was signification Conclusion: Evaluating IFN-g and IL-12 assay can help for quick and short time diagnosis of MSMD disease (defect in IL12r1, recep-tor1, and defect in IL12 and IFN-g receptor). However genetic investigation in this disease is more complete and definitive for the diagnosis in these patients.

No abstract