Objective: Acinetobacter baumannii is among the most common bacterial agents causing nosocomial infections in the world. In recent years, the antibiotic resistance of A. baumannii strains has shown an increasing trend, which may be resulted from the activity of efflux pumps. This study was carried out to determine the efflux pump genes associated with MDR in clinical isolates of A. baumannii in Tehran province.Methods: In this study, 200 clinical samples were collected, and were identified through standard biochemical tests. Then, for the selected antibiotics, the antibacterial susceptibility patterns were determined using disk diffusion method with and without inhibitors of efflux pumps of adeJ, adeH, adeB, adeG, adeF, and adeS that were determined by employing PCR according to the Clinical & Laboratory Standards Institute (CLSI 2020) guideline.Results: A total of 60 clinical isolates of A. baumannii were identified and later confirmed by the detection of blaOXA-51-like and 16S rRNA genes. The findings of this study show that 98.37% of A. baumannii isolates were 100% resistant against piperacillin, meropenem, cefotaxime, ceftriaxone, ceftazidime, ceftazidime, and ciprofloxacin. In addition, 100% of all A. baumannii isolates possessed AdeFBJ, 95% adeH, 80% adeS, and 76.7% adeG efflux pumps. Conclusion:The majority of A. baumannii isolates had antibiotic efflux pumps, and more than 73% of A. baumannii isolates were indicated to be resistant to the target antibiotics, indicating the significant role of efflux pumps in the development of resistance against these antibiotics.

Background: Blastocystis sp., located in the large intestine, is one of the most common zoonotic parasites. Risk factors affect its prevalence and pathogenicity, and it causes gastrointestinal disorders. Thus, this study aimed to investigate the Blastocystis sp. prevalence and its relationship with gastrointestinal disorders, in patients referred to laboratories, and provide some prevention strategies. Methods: In this descriptive-analytical study, 1,000 stool specimens were collected from patients referred to Ilam, Iran laboratories from 2018-2019. Wet mount method was conducted on samples, and suspected specimens were confirmed using trichrome staining. The demographic and clinical information was recorded in a questionnaire. Finally, the results were analyzed using the SPSS. Results: Blastocystis infection was detected in 81 out of 1,000 patients (8.1%) including 61 (75.3%) males and 20 (24.7%) females. and illiterate people were more at risk. The prevalence in rural was more than urban areas, and it was more in the age group of 31-50 year. Conclusion: There was a significant relationship between Blastocystis sp. and risk factors (age, sex, level of education, and residence) and clinical symptoms (stomach ache and nausea) (P<0.05), but interestingly there was no significant relationship between bloating and diarrhea.

Giardia lamblia has proved to be the most common intestinal protozoan parasite in humans that causes giardiasis. Given the high mutations in the genome of this parasite, the present study was conducted to determine the prevalence of Giardia lamblia subtypes and their relationship with clinical symptoms in patients who appear to have giardiasis. In 69 stool specimens with an appropriate number of giardia cysts, the DNA was first purified, and the genotype was then determined based on the glutamate dehydrogenase (gdh) gene sequence using PCR-RFLP. Data were collected on the clinical symptoms of the patients through a questionnaire, and their relationship with molecular results was studied. Four samples (5.8%) were found to be of subtype AI, 51 (73.9%) of subtype AII and 14 (20.3 %) of subtype BIII. No BIV subtype was found in the present study. A correlation was observed between Giardia lamblia genotypes (AI, AII and BIII) and abdominal pain. All of the people (100%) who had the AI genotype (i.e. the zoonosis subtype) had been losing weight. There was a significant correlation between weight loss and the AI subtype. All of the people (100%) infected with the BIII genotype experienced diarrhea, and this genotype was found to be associated with diarrhea. The present study found abdominal pain to be the most common symptom of giardiasis in Ilam province. Moreover, humans were found to be the main reservoir for giardia lamblia, although zoonosis subtypes such as AI and BIII still exist in the region and pose a risk for a giardiasis epidemic.

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