Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are known as chronic gastrointestinal inflammatory disorders. The present systematic review and meta analysis was conducted to estimate the prevalence of adherent-invasive Escherichia coli (AIEC) isolates and their phylogenetic grouping among IBD patients compared with the controls. A systematic literature search was conducted among published papers by international authors until April 30, 2020 in Web of Science, Scopus, EMBASE, and PubMed databases. The pooled prevalence of AIEC isolates and their phylogenetic grouping among IBD patients as well as in controls was estimated using fixed or random effects models. Furthermore, for estimating the association of colonization by AIEC with IBD, odds ratio along with 95% confidence interval was reported. A total of 205 articles retrieved by the initial search of databases, 13 case–control studies met the eligibility criteria for inclusion in the meta analysis. There were 465 IBD cases (348 CD and 117 UC) and 307 controls. The pooled prevalence of AIEC isolates were 28% (95% CI: 18–39%), 29% (95% CI: 20–40%), 13% (95% CI: 1–30%), and 9% (95% CI: 3–19%), respectively among IBD, CD, UC, and control group, respectively. Our results revealed that the most frequent AIEC phylogroup in the IBD, CD, and control groups was B2. Fixed-effects meta analysis showed that colonization of AIEC is significantly associated with IBD (OR: 2.93; 95% CI: 1.90–4.52; P < 0.001) and CD (OR: 3.07; 95% CI: 1.99–4.74; P < 0.001), but not with UC (OR: 2.29; 95% CI: 0.81–6.51; P = 0.11). In summary, this meta analysis revealed that colonization by AIEC is more frequent in IBD and is associated with IBD (CD and UC). Our results suggested that the affects of IBD in patients colonized with the AIEC pathovar is not random, it is in fact a specific disease-related pathovar.

Background: Uropathogenic Klebsiella pneumoniae is one of the well-kown uropathogens that have the main rule in biofilm formation. Increased prevalence of ESBL enzyme is one of the therapeutic problems. However, the aims of this study were to characterize the ability of biofilm formation and ESBL-producing isolates produced by urinary tract infection’s K. pneumoniae to identify the prevalence of this type of infection in the studied area. Methods: Between the 500 nonrepetitive clinical isolates, 128 isolates were detected as K. pneumoniae . Biofilm production of these isolates was showed by Merrit and Christensen method. The standard Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing. The phenotype ESBL was confirmed by double disc synergy test (DDST). Genotypic identification of ESBLs did by molecular detection. The statistical analysis was done using software IBM SPSS Statistics (SPSS Inc) and chi-square and Fisher exact tests. Results: The result of microtiter plate was observed and it was found that 86 (67.2%) isolates had weak biofilm, 24 (18.8%) moderate biofilm, and 18 (14.1%) strong biofilm. Also, 57 (44.5%) out of 128 isolates were diagnosed as MDR. The highest frequency of resistance was identified for cefotaxime 60 (46.9%) and tetracycline 60 (46.9%), and the lowest rate was for amikacin 16 (12.5%). The results of DDST showed 55 of 128 (43%) produced ESBL enzymes. PCR detection in ESBL-producing isolates showed contained bla TEM 33 of 55(63.1%), and bla VEB 13 of 55 (23% ). Also, 1 of 55 (2%) had both bla TEM and bla VEB . Also, 5 of 13 (38.4%) isolates that had the bla VEB gene were also MDR and had weak biofilm (8/13; 61.5%), intermediate biofilm (3/13; 23%), and strong biofilm (2/13; 15.4%). Conclusion: To decrease treatment complications and mortality rate of drug-resistant bacterial infections, rapid detection of β-lactamases genes and evaluation of these properties and infection management programs can help to prevent the transmission of drug resistant-strains.

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Background: Klebsiella pneumoniais producer of carbapenemase (KPC) an emerging pathogen with propensity to malady in weak patients, increasing their morality rates.Carbapenemaseis an enzyme that destroys all beta-lactam antibiotics and is the therapeutic choice for infections with extended-spectrum beta-lactamase (ESBL)-producing organisms.ESBLESBLs are penicillin, narrow spectrum also third-generation cephalosporin, and monobactams hydrolyser and checkrein by clavulanic acid. Objectives: The present study was performed to separate and identify the carbapenemase resistance pattern of multidrug-resistant (MDR) and ESBL-positive K.pneumoniaas well as its prevalence among different wards and various clinical specimens in Isfahan. Patients and Methods: Over 500 different clinical samples were collected from different sections of great teaching hospitals in Isfahan, in which K. pneumonia isolates were identified by IMVIC and urease standard biochemical tests and also were confirmed by determination of the ureD Gene. Antimicrobial susceptibility tests were performed as standard disk-diffusion on Mueller-Hinton agar (Merck, Germany) based on the instructions of Clinical Laboratory Standards Institute (CLSI, 2013). Sieving and phenotype conformation of ESBL isolates were performed by double disc synergy test (DDST), and then, the strains identified as ESBL were test by carbapenem, ertapenem, imipenem andmeropenem. Finally, the statistical analyses were performed using the WHONET software version 5.6. Results: Of clinical isolates of K.pneumonia, 142 were confirmed using biochemical methods and then the molecular confirmation was performed by PCR of the ureD gene. Of the total isolates, 57% were from males and 43% from females; 120(84%) of isolates were recognized as MDR. The highest rates of resistance were related to piperacillin (80%), ceftazidime (76%), and cefotaxime (73%). Among these MDR isolates, 101 (71%) were detected as ESBL, using DDST. The ward and the clinical specimen with the most prevalence were ICU with 55 (38.7%) and urine with 61(42.9%) samples, respectively. The lowest prevalence was related to the neurosurgery ward with 8 (5.6%) samples and the clinical specimen with the lowest prevalence was cerebrospinal fluid (CSF) with 2 (1.4%) samples. The susceptibility patterns to carbapenem agents were as follows: ertapenem50.7%, meropenem 44.8% and imipenem35.8%. Conclusions: In this study, the prevalence of carbapenem-resistant K.pneumoniae was high in positive ESBL isolates, which can create significant therapeutic problems. According to the resistance pattern of ESBL-positive isolates for carbapenems in this research, ertapenem can probably serve as a suitable therapeutic option for uncomplicated infections by ESBL-producing K.pneumoniae instead of imipenem and meropenem.

10.30699/jambs.28.128.144 Background & Objective: Infections due to burn wounds are serious because of their effects on the course of the disease and its consequences. The rate of burn wound infection is very high in developing countries. The purpose of this study was to identify common bacterial agents causing burn wound infection and determine antimicrobial susceptibility patterns in a burn Hospital, Isfahan, Iran. Materials & Methods: This cross-sectional study was conducted from 2017 to 2018 on all patients with burn wound infection. Burn wounds suspected of infection were collected aseptically and traditional bacteriological methods were used to identify the causes of infection. Antimicrobial resistance test was done by the disk diffusion method in accordance with CLSI recommendations. Results: From the total of 1500 wound culture, 957(63.8%) samples were detected as positive. The highest rate of infection was in the ICU ward and the lowest was in the restoration ward. The most common gram-negative bacteria were Acinetobacter baumannii (34.9%) with the highest and the lowest antibiotic resistance to Ceftazidime and Tobramycin, respectively. Among recovered Gram-positive isolates, Staphylococcus aureus (10.2%) were the predominant isolates with the highest and the lowest antibiotic resistance to Penicillin and Vancomycin, respectively. Conclusion: Due to the variable nature of antibiotic susceptibility patterns and pathogens causing burn wound infection, continuous evaluation, detection of dominant bacterial infections and sensitivity patterns to locally available antibiotics in burn wound patients in order to modify the drug regimen for proper antibiotic treatment is important and seems reasonable.