Background and Aim:  Effective brucellosis treatment necessitates antibiotics that can penetrate macrophages. This study systematic review and meta-analysis aimed at assessing the antibiotic susceptibility profile of Brucella spp. isolated from humans, addressing this critical gap in understanding Brucella infections and their treatment. Materials and Methods:  Two authors conducted a systematic search across PubMed, Web of Science, and Scopus, with no time restrictions, encompassing English studies. Data extraction employed a standardized sheet, with two independent authors, and disagreements were resolved by a third. The data sheet included study characteristics and susceptibility/resistance information for various antibiotics. Statistical analysis involved random effects models, Mantel-Haenszel methods, I2 tests, z-tests, and funnel plots using R and RStudio. Results:  Based on the pooled susceptibility ratios, among the 630 samples of Brucella spp., 98% (95% CI: 85%-100%) were susceptible to trimethoprim. Among the 1255 samples of Brucella spp., 82% (95% CI: 54%-95%) were susceptible to rifampicin. Among the 1344 samples of Brucella spp., 100% (95% CI: 78%-100%) were susceptible to doxycycline. Among the 942 samples of Brucella spp., 100% (95% CI: 85%-100%) were susceptible to tetracycline. Among the 893 samples of Brucella spp., 100% (95% CI: 82%-100%) were susceptible to ciprofloxacin. Among the 906 samples of Brucella spp., 97% (95% CI: 96%-98%) were susceptible to gentamicin. Conclusion:  Based on our results, trimethoprim, doxycycline, tetracycline, ciprofloxacin, and gentamicin were effective, but rifampicin had lower susceptibility. This informs antibiotic selection for Brucella infections, underscoring its importance in managing the disease

2Background and Aim:  Staphylococcus haemolyticus is a prominent pathogen in hospital-related infections, exhibiting high antibiotic resistance. This study aimed to investigate antibiotic sensitivity, biofilm formation, and the presence of virulence-associated genes in S. haemolyticus isolated from pregnant women with urinary tract infections. Materials and Methods:  Clinical samples were collected from pregnant women with urinary tract infections between October 2021 and December 2022. S. haemolyticus isolates were identified using cultural, biochemical, and molecular methods. Antibiotic susceptibility was determined using the VITEK-2 system. Biofilm formation was assessed, and virulence-associated genes (hla, hlb, fnbA, and fnbB) were detected using PCR. Results: Among 260 clinical samples, 36 S. haemolyticus isolates were identified. The isolates exhibited high resistance to Benzylpencillin, Erythromycin, oxacillin, Trimethoprim/sulfamethoxazole, Levofloxacin, and Gentamicin. Resistance was lower to Tigecycline, linezolid, tobramycin, Rifampin, vancomycin, Moxifloxacin, Tetracycline, and Ticoplanin. Biofilm formation was negative in 69. 4% and weak in 30. 6% of isolates. The hla gene was present in all isolates, while hlb was detected in 77. 7%. Detection rates of fnbA and fnbB were 88. 8% and 38. 8%, respectively. Conclusion:  This study highlights the high antibiotic resistance, limited biofilm formation ability, and prevalence of virulence-associated genes in S. haemolyticus isolates from pregnant women with urinary tract infections. These findings underscore the clinical significance of this bacterium and the need for infection control measures

Background: Patients who use Permcath permanent catheter as the vascular access for hemodialysis are occasionally confronted with catheter-related infections. Permcath infections can lead to catheter removal in Haemodialysis patients. Successful use of a ‘locked-in’ antibiotic has decreased catheter infections. This study evaluates the impact of the intraluminal vancomycin in comparison with intravenous antibiotic administration.Material & Methods: This experimental nonrandomized controlled study included 67 end stage renal disease patients enrolled for HD from 2005 to 2007 at our hospitals. The patient was studied in to 2 groups. In the first group (intervention group), vancomycin was injected via each lumen of permcath, with IV Ceftriaxone for 7 days, and then oral antibiotics was administered according to the culture fore three weeks. If the culture was negative, Cefixime was administered. In the second group intravenous Vancomycin + intravenous Amikacin prescribed. In both groups, if the patients had it enough response after 72 hours, permcath was removed. Our endpoint is to assessment of catheter removal.Results: Patients characteristics didn’t differ between 2 groups. Of 28 patients in group 1, 1 catheter removal, and of 39 patients in group2, 22 catheter removals were done. There is a significant reduction of catheter removal in the first group (p<0.001).Conclusions: This study has shown that administration of Vancomycin via permcath is more effective than intravenous, and increase life time of catheter.

Background: Pseudomonas aeruginosa is one of the major pathogens causing burnt wound infection in hospitals. This study aimed to evaluate the prevalence of exoenzyme U (exoU) and exoenzyme S (exoS) genes and the antibiotic resistance pattern of Pseudomonas aeruginosa isolated from burn patients' samples in Kermanshah City, Iran.Methods: In this cross-sectional study, 194 samples were tested with conventional bacteriological methods. After evaluation of antibiotic sensitivity with disc diffusion method, specific primers were deployed to assess the frequency of exoU and exoS genes among isolates. The retrieved data were analyzed using SPSS software. Findings: From 91 isolates of Pseudomonas aeruginosa, 72 (79.1%) were multi-drug resistant (MDR) isolates. The most prevalent antibiotic resistances were against gentamicin (79.1%) and ceftazidime (74.7%); the most prevalent sensitivities were against colistin (100%) and polymixin B (92.3%). The frequency of exoU and exoS genes was 80.2% and 68.1%, respectively. There were significant relationships between the frequency of exoU gene and resistance to ceftazidime (P=0.041) and cefotaxime (P=0.050).Conclusion: Considering the role of Pseudomonas aeruginosa in burn wound infections and the role of cytotoxin and antibiotic resistance genes in colonization and survival of this bacteria, avoiding home remedies, accurate detection of virulence factors, and recognition of antibiotic resistance pattern among the isolates in order to choose the appropriate antibiotic regimen to prevent infection seem to be necessary.

Background: Efflux is the process in which bacteria transport compounds outside the cell which are potentially toxic, such as drug or chemicals or compounds. Materials and methods: For this review article by using key words: multidrug resistance, microorganims, efflux pumps, resistance mechanism we have assessed 12 articles in journals published during 1997-2002 Results: Multidrug efflux systems endow on bacterial cells the ability to limit the access of antimicrobial agents to their targets. By actively pumping out antibiotic molecules, these systems prevent the intra cellular accumulation necessary for antibiotics to exert their lethal actively. Drug efflux appears to be one of the most widespread antibiotic resistance mechanisms among microorganisms, since it has been demonstrated to occur in many Gram positive and Gram-negative bateria including medically important species like staphylococci, streptococci, enterobacteria and opportunistic pathogens like pseudomonas aeruginosa. Bacterial antimicrobial efflux transporters have generally been grouped into five superfamily. These include the major facilitator superfamily (MFS), the ATP- binding cassette family, the resistance- nodulation- division (RND) family, the small multidrug resistance (SMR) and multidrug and toxic compound extrusion (MATE) family. Conclusion: Efflux pumps can be specific for only one substrate or accommodate a more or less wide range of noxious products.