Background: Pseudomonas aeruginosais an opportunistic pathogen which causes severe, acute and chronic nosocomial infections. These infections are difficult to eradicate since the organisms are usually multidrug-resistant. Carbapenems are considered as the most effective drugs against these isolates. However, recent emergence of carbapenem-resistant P. aeruginosa has become a major healthcare problem. Objectives: The present study was conducted to determine the antibiotic susceptibility of P. aeruginosa burn isolates to 13 antibiotics including imipemen and meropenem. Materials and Methods: One hundred and thirty three P. aeruginosa burn isolates were collected from Shahid Motahari Burn Hospital between July and December 2011. The majority of the isolates were from wounds (88.7%), followed by 5.26% from blood, 4.15% from subclavian catheters and 1.5% from urine. The antibiotic susceptibility profiles were studied by the agar disc diffusion. Results: The results showed 99.2% resistance to carbenicillin, 98.4% to ticarcillin, 96.2% to ciprofloxacin, 95.4% to co-trimoxazole, 94.7% to imipenem and meropenem, 93.9% to piperacillin, 93.2% to azetronam, 92.4% to tobramycin, 91.7% to cefepime, 89.4% to amikacin and ceftazidime, and finally 87.2% to piperacillin-tazobactam. Overall, 100% of the isolates showed multidrug-resistance (resistance to ≥ 3 classes of antibiotics) including theimipenem-resistant isolates. Conclusions: The high rate of multidrug-resistance is alarming and it is crucial to screen for carbapenem resistance prior to-antibiotic therapy.

Background/aim: Pseudomonas aeruginosa is the cause of 10% of hospital-acquired infections. The organisms are often multidrugresistant, mediated mostly by antibiotic-resistant integrons. The aim of this research was to study integron carriage and its association with multidrug resistance in burn and nonburn clinical isolates of P. aeruginosa.Materials and methods: A total of 112 P. aeruginosa clinical isolates were collected from the Motahari and Shohadaye Tajrish hospitals in Tehran between July and December 2011. Antibiotic susceptibility to 13 antibiotics was determined by disk diffusion. Detection of integron classes 1 and 2 and amplifications of internal variable regions (IVRs) of class 1 integrons were carried out by PCR and specific primers.Results: Among the 112 isolates, 77 were from burn patients and 35 were nonburn isolates. Multidrug resistance and class 1 integron carriage were both significantly higher in the burn isolates compared to the nonburn strains (97.4% vs. 22.8% and 82.3% vs. 17.7%, respectively). Class 2 integron (2.7%) was only present in the burn isolates. Amplification of IVRs of class 1 integrons revealed 3 different fragment arrays. Conclusion:The significant association between multidrug resistance and integron carriage among P. aeruginosa burn isolates suggests a dissemination of resistance determinants by horizontal gene transfer.

Background: Cystic fibrosis (CF) is an autosomal recessive disease characterized by respiratory, gastrointestinal, and reproductive tract problems. Patients with CF often suffer from chronic pulmonary infections due to the Pseudomonas aeruginosa, which frequently ends in pulmonary exacerbations. With their anti-inflammatory, anti-virulence, and anti-biofilm properties, macrolides such as azithromycin (AZM) play a beneficial role in the treatment of CF. Objectives: We evaluated the ability of biofilm formation among P. aeruginosa isolates from CF patients and compared the anti-bacterial and anti-biofilm effect of the AZM on them. Methods: Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of AZM against 21 P. aeruginosa isolates from Iranian CF patients were determined. Then, we investigated the ability of biofilm formation by P. aeruginosa and also anti-biofilm effect of AZM on biofilm producing P. aeruginosa isolates. Results: The results showed a high level of AZM MIC (≤ 512 µg/mL) and MBC (≤ 2048 µg/mL) against P. aeruginosa isolates. Most isolates (70%) were biofilm producers, 20% being strong producers. The AZM anti-biofilm effect showed that sub-MIC concentration (≤ 64 µg/mL) could inhibit biofilm production. Conclusions: P. aeruginosa isolated from CF patients showed a high level of MIC and MBC for AZM that indicated a weak anti-bacterial effect of AZM. However, AZM inhibited biofilm formation in low doses; this might lead to dangerous chronic pulmonary infection by P. aeruginosa.

Objectives: Aim of this study was determining the relationship between burden of care and fear of disease progression in mothers of children with cystic fibrosis. Methodology: 142 mothers of children with cystic fibrosis (CF) participated in this correlational study. Data were collected with sequential method. The researchers employed the self-report Zarit burden of care and fear of disease progression questionnaire in parents of children with CF. Mothers answered the questioners separately.  Data were analyzed with statistical analysis of variance and independent t-test. Results: According to the results, the mean maternal burden of care was 34.12 ± 69.77, and the mean fear of disease progression was 32.12 ± 92.11. The burden of care had the highest regression effect on fear of disease progression in mothers of children with CF (β = 0.896). With an increase of one unit of standard deviation in the burden of care, an increase of 0.896 units occurred in fear of disease progression in parents of children with CF. Conclusion: Mothers of children with CF experience a moderate burden of care and fear of disease progression. An increase in the burden of care and psychological stress increases the fear of disease progression in these mothers.