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Introduction Hospital wastewater contains highly resistant and virulent bacteria that can spread into the environment. This study was conducted to investigate the antimicrobial resistance of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) in raw and treated hospital wastewater. Methods During a three-month period, 40 sewage samples were collected from the hospital sewage (Kermanshah, Iran), and S. aureus were identified using culture and biochemical tests. MRSA was detected by resistance to cefoxitin. Antibiotic resistance (AR) was determined using disk diffusion according to the Clinical and Laboratory Standards Institute (CLSI) in 20 MSSA (10 raw and 10 treated sewage) and 40 MRSA isolates (20 raw and 20 treated sewage). The antimicrobial resistance genes (ARGs) were determined by PCR. Results Eleven and eight percent of the isolates were MRSA in raw and treated sewage samples, respectively. Out of 60 isolates, 59 (98%) were multidrug resistant (MDR). The most common ARGs were mecA (raw=100%, treated=100%), aacA-D (raw=100%, treated=85%) and tetK (raw =95%, treated =45%) in MRSA, while the tetM gene was the most abundant gene (raw=50%, treated=80%) in MSSA. None of isolates (n=60) was positive for the vanB gene. MSSR (n=20) had the highest level of resistance against penicillin (100%), clindamycin (raw=90%, treated=90%), azithromycin (raw=80%, treated=90%). All MRSA isolates (n=40,100%) in both raw and treated sewage samples were non-susceptible to penicillin, oxacillin and azithromycin. There was no significant difference in the frequency AR and ARGs between raw and treated sewage samples (p>0.05). Conclusion The results indicated a high frequency of MDR and ARGs in both raw and treated sewage isolates which could be released into the environment through sewage system and pose a serious threat to public health. Hospital wastewater treatment processes should be improved in order to prevent the dissemination of the most resistant strains of S. aureus .

The urinary tract infections (UTIs) are some of the most important diseases among children. The common UTI pathogens among children are the bacteria in the Enterobacteriaceae family, such as Escherichia coli and Klebsiella pneumonia (1). Despite the fact that beta-lactam antibiotics, cotrimoxazole and ampicillin are the first line of medicine for the experimental treatment of patients with UTI, there are reports of high resistance to these antibiotics

Introduction:Klebsiella pneumoniae (K. pneumoniae) is an important opportunistic pathogen causes serious community and hospital-acquired infections, which is highly resistant to antibiotics. We aimed to determine the frequency of multidrug resistant (MDR) and molecular typing of clinical isolates of K. pneumoniae.Methodology:One hundred isolates of K. pneumoniae were collected from clinical samples in three general hospitals in Kermanshah. The antimicrobial susceptibility and extended-spectrum beta-lactamases (ESBL) production of isolates were determined using disk diffusion and combined disk methods, respectively. The blaCTX-M gene, class I and II integrons were detected using polymerase chain reaction. The blaCTX-M positive isolates were selected for genotyping using pulsed-field gel electrophoresis (PFGE).Results:MDR phenotype was observed in 56% of isolates. The 40% of isolates were ESBL positive and 35 isolates contained blaCTX-M. Class I and II of integrons were detected in 50 (89.2%) and 39 (69.6%) of MDR isolates, respectively. PFGE patterns of K. pneumoniae blaCTX-M positive isolates indicated 19 clusters (X1-19) with different genotype patterns.Conclusions:The study findings highlight the concern of circulating MDR strains of K. pneumoniae with blaCTX-M and class I and II integrons in Kermanshah hospitals. The presence of integrons among isolates may facilitate the spread of new resistance genes in this bacterium. Therefore, surveillance for the spread of MDR strains of this bacterium is recommended in hospitals.

Background and Objectives: Acquisition of AmpC β-lactamase enzymes is one of the important factors in the resistance of Klebsiella pneumoniae to β-lactam antibiotics. The purpose of this study was to determine the antibiotic resistance, phenotypic frequency of AmpC, and detection of MOX, CIT, DHA, ACC, EBC, and FOX genes in K. pneumoniae strains isolated from medical centers in Kermanshah.Methods: In this descriptive cross-sectional study, 100 suspected cases of K. pneumoniae, were collected from 2013 to 2015 from patients referring to three hospitals and one laboratory in Kermanshah city. antimicrobial susceptibility disk diffusion test and AmpC phenotypic screening test, were performed using boronic acid combination method, and after extraction of bacterial genome, AmpC genes were identified by multiplex PCR method.Results: Resistance to third generation cephalosporins, was 70%, and resistance to aztreonam was reported 65%. The highest and the lowest resistance was to ampicillin (98.5%) and carbapenems (less than 10%), respectively; 27.1% of the isolates phenotypically produced AmpC and a high percentage of isolates from the infectious ward and intensive care unit (ICU) was AmpC producer. The frequency of MOX, CIT, FOX, and DHA genes was obtained to be 11.4%, 10%, 2.8%, and 1.4%, respectively. However, EBC and ACC genes, were not found in any of the isolates. Conclusion:The results of this study showed that phenotypic tests alone are not sufficiently accurate in the evaluation of AmpC enzymes. Therefore, simultaneous use of genotypic methods is necessary. In this study, the high prevalence of AmpC genes, especially MOX and CIT in K. pneumoniae isolated from infectious and ICU wards in Kermanshah hospitals is indicative of importance of dissemination of this group of β-lactamase enzymes.