We reviewed the medical charts of 1, 700 patients diagnosed with HIV who referred to a central HIV clinic in Tehran between 2004 and 2017. Participants who had a viral load of > 200 copies/mL after six months or more on antiretroviral therapy (ART) were grouped as virologic failure (VF). We assessed the demographic characteristics, diagnosis date, fi rst ART regimen, and RESISTANCE to various ART DRUGs. Out of 1, 700 patients, 72 (4. 2%) had a treatment failure. Among those with treatment failure, 51. 3% were on zidovudine + lamivudine + efavirenz, 18. 1% were on tenofovir + lamivudine + lopinavir/ritonavir, and 12. 5% were on tenofovir + emtricitabine + efavirenz. In patients with treatment failure, the highest RESISTANCE was to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) combination (44. 4%). In these patients, RESISTANCE to tenofovir (one of the NRTIs) was 29. 1%. The highest treatment failure was observed among patients treated with nevirapine (NVP) and efavirenz (EFV)-based regimen. Our fi ndings suggest that protease inhibitors should be considered as fi rst-line DRUGs in ART regimens in VF patients in Iran.

Background: Pseudomonades are gram-negative, aerobic bacillus bacteria that are mobile and can be found in small numbers in the normal flora of intestine and on the skin of humans. These bacteria can enter the sites with the impaired normal defense to cause diseases.P. aeruginosa in immunocompromised patients, cutaneous membranes injuries, intravenous or urinary catheters, and neutropenia or cystic fibrosis can lead to infections. Pseudomonas is resistant to many antibacterial DRUGs and their RESISTANCE has increased in the last years.Objectives: The aim of this study was to examine the DRUG RESISTANCE of Pseudomonas aeruginosa in Yazd, Iran, during 2015 - 2016.Methods: This study was done on 191 positive cultures for P. aeruginosa from May 2015 until May 2016 in Shahid Sadoughi and central laboratories. The questionnaires were filled out through checklists and data were analyzed in SPSS16 using Chi-Square test. In this study, the sensitivity was evaluated according to the type of antibiotics, location of sampling, and the type of the specimens.Results: The bacteria had most sensitivity to imipenem (55%) and then to amikacin (45%). In addition, the highest RESISTANCE was to ceftriaxone (100%). The bacterial RESISTANCE to other types of antibiotics was as follows: Meropenem (100%), ciprofloxacin (100%), ceftazidime (95%), and cefotaxime (10%). There were no significant differences between antibiotic sensitivities according to the type of specimens while there was a significant difference between antibiotic sensitivities based on the location of the clinic.Conclusions: According to the results of this study and RESISTANCE changes through the years, it is suggested that DRUG RESISTANCE of these bacteria is investigated periodically.

Background and Objectives: Urinary tract infections are one of the most commonly associated human infectious diseases caused by the bacteria Escherichia coli. Escherichia coli is described as having a large number of virulence genes that enable DRUG RESISTANCE, which is a cause for great concern. Monitoring of antimicrobial susceptibility is critical to determining the scope of the problem and selecting appropriate antimicrobial DRUGs. The current study aimed to identify the distribution of uropathogenic E. coli (UPEC) based on genetic profiles and to determine RESISTANCE patterns among isolates. Materials and Methods: This study employed biological correlations to study the patterns of antibiotic RESISTANCE and the distribution of phylogenetic groups of 118 isolates of E. coli and the relationship between them, which were isolated from three hospitals in Baghdad, Iraq. Results: The results of phylogenetic analysis showed that phylogroup F was the most common group among E. coli isolates (37. 3%), followed by phylogroups C (20. 3%), B2 (15. 3%), E (14. 4%), UP (4. 2%), A and D (3. 4%), and B1 (1. 7%). The majority of antibiotic RESISTANCE patterns were related to penicillin groups (80. 5%) and the least to the sulfonamide groups (67. 0%). 51. 7%, 42. 4%, and 1. 7% of isolates were Extensive DRUG RESISTANCE (XDR), Multi-DRUG RESISTANCE (MDR), and Pan DRUG RESISTANCE (PDR), respectively. Antibiotic RESISTANCE was most commonly detected in group F (35. 6%). Conclusion: Our observations revealed that the dominant phylogroup F had the highest prevalence of multi-DRUG RESISTANCE and extensive DRUG RESISTANCE among E. coli isolates. The newly identified phylogroups C, E, and F account for about 72. 0% of the E. coli isolates. Such investigations should be conducted in other localities as well, in order to gain a better understanding of the pattern of antibiotic RESISTANCE patterns and the frequency of distinct phylogenetic groups.

BACKGROUND AND OBJECTIVE: Fungal peritonitis is a relatively rare disease with serious complications in peritoneal dialysis patients and is associated with significant morbidity and mortality. Candida species are the most common cause of fungal peritonitis. The objective of this study was to isolate the Candida species in the patients with peritoneal dialysis by molecular methods, and thus to determine their DRUG RESISTANCE.METHODS: In this cross-sectional study, sampling (peritoneal samples) was carried out on 210 suspicious patients with peritonitis after peritoneal dialysis in Tehran, Iran in 2010. Species identification was done by direct microscopic tests, culture on Chromagar and Corn meal agar, Germ tube test in bovine serum, Urease test, and biochemical identification with the API 20 kit. Identification of isolated yeasts was confirmed by PCR-RELF method. Antifungal susceptibility testing of isolated Candida species was conducted by the broth dilution method in accordance with the National Committee on Clinical Laboratory Standards guidelines [NCCLS-M27].FINDINGS: Totally 210 samples were surveyed that 40 cases (19.05%) with microbial peritonitis were identified based on experiments, which only 9 cases (22.5%) had Candida peritonitis which determined as specific species in accordance with PCR-RFLP molecular technique for confirming phenotyping methods. Among these 9 cases of isolated candida species, 5 cases of them (55%) were C. albicans, 1 case (11%) was C. Kefyr and 2 cases (22%) were C. guilliermondii and also 1 case (11%) was C. parapsilosis. The MIC determined by antifungal susceptibility testing were: C. albicans (Amphotericin B=0.125 mg/ml, Fluconazole=2 mg/ml, 5- Flucytosine=2 mg/ml), C. guilliermondii (Amph B=1 mg/ml; Flu=2 mg/ml, 5- Fluc=4 mg/ml), C. Kefyr (Amph B=0.5-1 mg/ml, Flu=0.5-1 mg/ml, 5- Fluc=2-4 mg/ml) and C. parapsilosis (Amph B=0.5 mg/ml, Flu=1 mg/ml, 5- Fluc=0.5g/ml).CONCLUSION: Accurate identification of Candida albicans and non-Candida albicans species cases of Candida peritonitis in patients with peritoneal dialysis is necessary.

Background: There are limited data on the Mycobacterium tuberculosis (MTB) DRUG RESISTANCE in regions located at the proximity of the Caspian Sea. We aimed to assess the DRUG RESISTANCE patterns of the MTB isolates to anti-tuberculosis DRUGs in patients from four northern provinces of Iran between April 2013 and March 2019. Methods: DRUG susceptibility testing (DST) was performed by culturing MTB isolates on the Lowenstein-Jensen medium using the proportion method. Results: Out of 963 MTB isolates, 927 (96. 3%) were recovered from Iranian cases and 36 (3. 7%) were from Afghan immigrants. Based on DST, 59 (6. 1%) showed any DRUG RESISTANCE pattern, while 18 patients (1. 9%) were multiDRUG-resistant (MDR) or rifampicin-resistant (RR). RESISTANCE to streptomycin (STR), isoniazid (INZ), rifampicin (RIN), and ethambutol (ETL) was reported in 33 (3. 4%), 28 (2. 9%), 18 (1. 9%), and 12 isolates (1. 2%), respectively. Conclusion: The rate of MDR/RR in four northern provinces of Iran was in line with previous reports from the World Health Organization. Due to proximity to the former Soviet Union, which had a high rate of MDR/RR isolates, the establishment of cross-border tuberculosis (TB) control strategies is recommended to reduce the possibility of MDR-TB transmission. Moreover, DST for all TB cases is recommended as an effective diagnostic tool for optimal monitoring and control of DRUG RESISTANCE in these areas. Future studies with a molecular epidemiology approach will be needed to evaluate the transmission dynamics of MTB in these regions.

Determination of sensitivity of isolated bacteria to consuming antibiotics could help clinician use appropriate antibiotics because due to unavailability of appropriate alternative antibiotics for hospitalized patients, it may be life-threatening in some cases. This study was performed to determine the most common bacteria isolates from hospitalized patients in Qom, Central Iran and to evaluate their antibiotic susceptibility patterns.