Background: The Methicillin-resistant Staphylococcus aureus (MRSA) strains cause wide spectrum INFECTIONS in hospitals and are responsible for the majority of the communityacquired INFECTIONS. The emergence of COMMUNITY-ACQUIRED MRSA in patients without risk factors represents a high risk for public health. Objectives: In this study, we aimed to molecular typing the nasal carriage MRSA strains harbored mecA gene isolated from healthy children living in the North of Iran and also to determine the pattern of vancomycin susceptibility in these isolates. Methods: The MRSA strains were identified using standard microbiological and molecular procedures. The antibiotic susceptibility test was performed according to the clinical and laboratory standards institute. The MRSA strains were characterized by spa typing. Results: In total, 14 different patterns of spa genes were obtained from MRSA isolates in this study, which included t790 (23. 07%), t2962 (15. 38%), t267 (15. 38%), t159 (7. 69%) and t701, t094, t1816, t11332, t937, t2135, t180, t160 [1 (3. 84%) isolate per each type]. The rate of resistant isolates to cefoxitin, , cefalotin, clindamycin, cefazolin, co-amoxiclav, co-trimoxazole, and cephalexin antibiotics were 69. 23%, 100%, 46. 15%, 96. 15%, 100%, 3. 48%, and 100%, respectively. In total, six (23. 07%) revealed vancomycin-intermediate resistant phenotype and five (19. 23%) isolates revealed vancomycin-resistant S. aureus phenotype. Conclusions: This study showed the different variants of MRSA strains based on molecular typing, among healthy children. Continuous surveillance studies to monitor MRSA should be encouraged to gain a better understanding of the circulating MRSA strains and prevent community spread of this pathogen.

Background: We aimed to evaluate the characteristics of a stress injury in COMMUNITY-ACQUIRED pneumonia (CAP) patients in the respiratory intensive care unit (RICU) and analyze the risk factors, to provide evidence for clinical prevention and treatment. Methods: This retrospective study was conducted in RICU at Qilu Hospital of Shandong University, China. We selected 85 patients with traumatic CAP who were brought in from January 2019 to December 2020 as the case group and 167 patients without traumatic CAP hospitalized in the same period as the control group. Multivariate binary Logistic regression analysis was used to explore the influencing factors. Results: The incidence rate of a stress injury in 252 patients was 33. 73%. The most affected region found in these patients was the sacrococcygeal region (24. 26%). Most of the patients were presented in stage one (49. 50%). Factors associated with a stress-induced injury in RICU, CAP patients were CURB-65 combined with cerebrovascular disease, fever combined with heart disease and albumin was found as an independent risk factor. Conclusion: Attempts to improve stress injury in CAP patients through setting measurable process of care standards are to be encouraged. An approach including the patient’, s clothes and bedding should be changed frequently, nutrition should be managed and the skin of the patient should be kept clean and dry. The occurrence of stress can further be reduced by the use of protective tools and the timely participation of the family members in patient management.

Backgrounds: Enterococci are Gram-positive bacteria that colonize the intestine of warmblooded animals and humans as normal flora. Enterococci cause a variety of communityacquired and nosocomial INFECTIONS. The emergence of vancomycin and gentamicin resistant enterococci has made a major challenge in the treatment of enterococcal INFECTIONS worldwide. Therefore, the present study was conducted to evaluate the prevalence of vancomycin and gentamycin resistance among Enterococcus spp in Iran during 2007-2019. Materials & Methods: In this study, 26 studies were reviewed to collect data on the frequency of vancomycin and gentamicin resistant enterococci in Iran. To find studies published during January 2007 to January 2019, a search strategy was performed by searching different Iranian and international databases, including SID, Google Scholar, Scopus, Medline, Pub Med, and Web of Science. Findings: The prevalence of vancomycin-and gentamicin-resistant enterococci was very high in Iran (41 and 44%, respectively). Accordingly, Enterococcus faecalis was more prevalent in clinical samples compared to E. faecium (75. 49% vs. 24. 05%). However, resistance to vancomycin was higher in E. faecium strains compared to E. faecalis. Conclusion: Due to the increasing vancomycin and gentamicin resistance among Enterococcus species in Iran, it is necessary to design strategies that lead to the rational prescription of antibiotics and limit the spread of resistant enterococci.