The aim of the present study was to investigate the incidence of fungal and bacterial contaminations of in-use eye drop products in the teaching department of ophthalmology, Imam Khomeini Hospital, Ahvaz. Two hundred and eighty seven eye drop bottles were randomly collected at the end of day 1, day 2, day 3, day 4 and day 7 of use. The eye drop residues, swabs from internal caps and droppers were inoculated onto MacConkey agar, blood agar and Sabouraud's dextrose agar. The identification of the recovered organisms was accomplished using standard microbial identification techniques. The incidence of microbial contamination of in-use eye drop products was 17.8%, with the highest rate (24.6%) and the lowest rate (9.0%) noted with day 1 and day 3 samples, respectively. The most contaminated part of the eye drop products was the caps (45.9%) followed by droppers (41.0%) and residual contents (13.1%). Considering mendicants contents, those with pilocarpine (41.7%) had the highest rate of contamination followed by atropine (31.8%), tropicamide (28.6%) and betamethasone (23.3%). Our study revealed the potential risk of contamination of in-use eye drop products in hospitals, but we did not find a direct relationship between usage duration and contamination rate.

Background: Streptococcus mutans, an organism colonizing the oral cavity, is considered to be the main cause of dental caries. In addition to dental caries and related pyogenic dental infections, S. mutans is also a very important endocarditis agent. The participation of this microorganism in both oral and non-oral diseases has prompted interest in the knowledge of this susceptibility to antimicrobial agents. The aim of this study was to determine the antimicrobial susceptibility of S. mutans biotypes isolated from children dental caries free. Methods: Unstimulated saliva samples were collected from 60 children, diluted and cultured onto mitis salivarius bacitracin (MSB) agar plates for the selective isolation and enumeration of S. mutans. The MSB agar plates were incubated anaerobically (H 2 :CO 2 : N 2 10:10:80) for two days a 37 • C. The biotyping of S. mutans was realized using the api Zym system (bioMérieus; Marcy-lÉtoile, France). The minimal inhibitory concentrations were evaluated against penicillin, amoxycillin, cefazolin, erythromycin, clindamycin, imipenem and vancomycin by using an agar dilution method with concentrations between 0.003 and 32 ug/ml. Results: Twenty biotypes were detected in the 74 strains of S. mutans isolated. The most frequent byotipes were the 2,3,10 and 13 (n = 6). Nineteen out of the 23 children in whom 2 strains of S. mutans were isolated, and 7 children in whom 3 strains of S. mutans were isolated presented different biotypes of S. mutans. All biotypes were highly sensitive to penicillin, amoxicillin, cefazolin, erythromycin, clindamycin, imipenem and vancomycin; 50 and 90% of S. mutans strains were inhibited by using concentrations of less than 0.12 and 0.5 ug/ml, respectively, for all antibiotics studied. Conclusion: S. mutans biotypes were highly sensitive to he antibiotics tested.

Background:Infections caused by Gram negative bacteria, producing extended-spectrum β-lactamase (ESBL), including Klebsiella pneumoniae are increasing all over the world with high morbidity and mortality. Objectives: The aim of this study was to determine the prevalence of K. pneumoniae encoding the CTX-M, TEM-1 and SHV-1 ESBL enzymes genes, isolated from clinical specimens. Materials and Methods: A total of 500 Entrobacteriaceae isolates were collected and identified using traditional culturing and biochemical tests. Antibiotic susceptibility testing was performed by disc-diffusion method according to the CLSI guideline. Screening of ESBLs was undertaken using Combination Disc Method. PCR technique was used to detect SHV-1, TEM-1 and CTX-M-1 genes according to the standard protocol. Results: Fifty five (11%) out of 500 tested Entrobacteriaceae isolates were identified as K. pneumoniae possessing 26 (47.27%) ESBL positives amongst them. ESBLs positives showed the highest resistance to amoxicillin-clavulanic acid (100%), followed by amoxicillin (97.89%) and ampicillin (96.36%). Imipenem and meropenem showed the highest antibacterial activity against ESBL producing K. pneumoniae. Based on the results of PCR, the prevalence of SHV-1, TEM-1 and CTX-M-1 genes among ESBLs-positive isolates was 12 (46.15%), 9 (34.61%), and 7 (26.92%) respectively. TEM-1 and SHV-1 were seen in four isolates (15.38%) simultaneously. Conclusions: In conclusion, the rate of ESBL-producing K. pneumoniae was 47.27% in the present study, representing their commonness in our institute resistance to many classes of antibiotic, resulting in limited treatment options. Since the management of infections caused by these organisms is difficult, it is important to control such strains closely in order to prevent and reduce their spread.

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The aim of this study was to determine the presence and nature of bacterial flora on hearing aids earmoulds in a children's population. The study population consisted of 119 children referred to Imam Ali and Rudaky Schools in Ahvaz, Iran. Three samples were taken from surface of hearing aids earmoulds; canal in hearing aid wearers and ear without hearing aids earmoulds. The samples were cultured directly onto blood agar and MacConkey agar plates. According to preliminary examination, necessary standard biochemical tests were performed on grown bacteria and the organisms were identified as per standard identification criteria. Totally, 66 samples (61.1%) from hearing aids earmoulds and 124 samples (52.1%) from both ear canal without hearing aids earmoulds were culture positive, which 73 (58.9%) and 51 (41.1%) were from right and left ears, respectively. The majority of isolated bacteria from earmoulds were Coagulase-Negative Staphylococci (CNS) 40 (60.6%) and Polybacterial flora 14 (21.2%) and the least isolated bacteria were Pseudomonas aeruginosa and Staphylococcus aureus. In conclusion, although the majority of isolated bacteria were common normal flora of the ear, however a few pathogens were isolated as well. So, it is very important to educate the people with hearing aids earmoulds about proper cleaning and disinfection procedure to prevent any serious ear canal infection.