Background: Increased rates of multiDRUG-resistant tuberculosis (MDR-TB) have been reported from developing countries. We evaluated the incidence of DRUG RESISTANCE in children in order to determine the magnitude of the problem, in our region.Objective: To determine the RESISTANCE pattern of Mycobacterium tuberculosis to four anti-tuberculosis DRUGs in childhood pulmonary tuberculosis at National Research Institute of Tuberculosis and Lung Disease (NRITLD) which is a referral centre in Tehran. Treatment of the patients was based on the DOTS strategy according to the WHO protocols since 1989.Materials and Methods: Retrospective analysis of all cases of pulmonary tuberculosis with positive M. tuberculosis culture who had referred to paediatrics ward from January 1999 to August 2004. M. tuberculosis sensitivity testing was performed by the Lowenstein-Jensen medium for isoniazid (INH), rifampicin (RMP), streptomycin (SM), and ethambutol (EMB). Results: Among 350 children (0-15years) with confirmed tuberculosis, 7 children had RESISTANCE to at least one of the four anti-TB DRUGs. Out of the 7 patients, 6 were Afghan refugees and one patient was Iranian. Among those 85.7% had RESISTANCE to RMP, 71.4% to INH, 57.1% to SM, and 28.6% to EMB .In addition, 28.5% of patients had RESISTANCE to all four DRUGs (RMP, INH, SM, EMB), 14.2% to INH, RMP, SM, 28.5% to INH, RMP and 14.2% had RESISTANCE to each of SM and RMP.In this study 2% of children with TB had RESISTANCE out of which primary RESISTANCE was detected in 57.1%. Secondary RESISTANCE was found in 42.9% of cases who had previous history of anti-TB therapy.Conclusion: According to 2% prevalence of DRUG RESISTANCE in children and high RESISTANCE to RMP in our study, more aggressive interventions should be considered. Further management and supervision in DOTS implementation is highly recommended to prevent transmission of resistant tuberculosis.

Introduction: Prolonged required time for treatment, presence of primary resistant strains, changing or discontinuation of anti TB DRUGs before completion of therapy, presence of the underlying disease, changes in the life condition and the incidence of abnormal behavior such as alcoholism, homelessness, addiction, great migration, margination around big cities and AIDS, all have caused the incidence and dissemination of DRUG RESISTANCE strains as a serious danger Sistan and Baluchestan province regarding to its special cultural and economical condition and proximity to the countries with high prevalence of TB is at special risk for endemic situation of tuberculosis. So, this study was done for determination of DRUG resistancy of isolated strains to the first line of anti TB DRUGs (Isoniazid, Rifampin, Ethambutol and streptomycin) in mycobacterium tuberculosis strains isolated from patients referring to Bou-Ali hospital. Methods: All patients referring to Bou-Ali hospital in Zahedan during 2001-2002 which had a positive smear results with ZNCF staining methods. After primary culture and necessary subculturing on Lowenstein-Jensen medium and on the basis of growth rate, pigmentation and biochemical tests, Mycobacterium tuberculosis strains were identified and included in the study. DRUG sensitivity tests of isolated strains without attention to their history (newly diagnosed or previously treated) were done by standard proportional method. Results: Study on the 84 Mycobacterium tuberculosis isolated strains from patients referred to bou-Ali hospital during 2001-2002,demonstrated RESISTANCE rate for RIM, INH, STM& EMB as 55.9%, 39.2%, 33.3% & 27.3% respectively. MDR strain rate was 16.6% polyresistant pattern rate was 38.09%. Discussion: Prevalence rate and extent of DRUG resistancy investigated between mycobacterium tuberculosis isolates showed that if fast and accurate attention to the DRUG RESISTANCE of isolated strains was not paid, an unavoidable increase in the distribution and prevalence of multiple DRUG resistant strains will be observed.      

Background Tuberculosis is a common infectious disease these days; it has the highest mortality rate among all infectious causes only after HIV/AIDS. The emergence of tuberculous bacillus species resistant to multiple DRUGs has become a serious global threat to the human health. DRUG RESISTANCE is either acquired with the initial infection (from a host harboring resistant tubercle bacilli) or develops during treatment with antituberculous chemotherapeutic agents because of poor patients compliance or inadequate/ inappropriate treatment regimens. This study has been done to evaluate DRUG RESISTANCE and to determine the type of RESISTANCE in DRUG resistant tuberculosis patients.Material & Method The files of patients hospitalized during the past 2.5 years in Massih-Daneshvari clinical mycobacteriology ward due to suspected DRUG resistant tuberculosis were evaluated. Those who had a sputum antibiogram indicating RESISTANCE at least to one anti-TB DRUG were included in the study. Data, including demographic data, radiologic findings, sputum smear, sputum culture, and antibiogram were recorded in a specified questionnaire. Analysis was done for central indices using the SPSS software.Result Forty-three cases met the inclusion criteria. Twenty-seven (63%) were male and 16(37%) were female with the age range of 16-80 years (mean ±SD, 36.9±16.76). Twenty-five cases (58%) were Afghan and 13(30%) were Iranian (Other nationalities had not been recorded). Antibiograms of 38 patients (88%) showed RESISTANCE at least to isoniazid and rifampicin; these patients were considered as multiDRUG resistant (MDR) cases. In 24 cases (56%), the Mycobacterium tuberculosis was resistant to all four-DRUG isoniazid (INH), rifampicin (RIF), streptomycin (STM), and ethambutol (EMB). Thirty-six patients (85%) had RESISTANCE at least to STM, and 26 patients (60%) were resistant at least to EMB. Bacillus DRUG susceptibility to pirazinamide (PZA) was not specified.Conclusion Most DRUG-resistant cases of TB were seen among Afghan emigrants. Ninety-five percent of cases had a history of treatment at least once, and the RESISTANCE was secondary (acquired). Despite discontinuation of streptomycin usage as an anti-TB DRUG in Iran in the recent years, the most common type of RESISTANCE was related to this DRUG, occurring in 85% of cases. Confirming different studies in other countries, the lowest RESISTANCE to the first line anti-TB DRUGs was for EMB, detected in 56% of cases.

Objectives: RESISTANCE to multiple antibiotic classes is called multiDRUG RESISTANCE (MDR), extremely DRUG RESISTANCE (XDR), and panDRUG RESISTANCE (PDR). In addition, the genotyping survey of resistant bacteria is a prominent factor in epidemiological surveying. Therefore, the present study aimed to conduct an epidemiological survey in order to detect XDR, MDR, and PDR of Pseudomonas aeruginosa isolated from clinical specimens in Kurdistan province, Iran. Materials and Methods: During (December) 2015-(August) 2017, a total of 134 strains of P. aeruginosa were detected by the polymerase chain reaction and were tested for antibiotic RESISTANCE, MDR, XDR, and PDR. The related specimens of the patients with nosocomial infections were subjected to BOX-PCR analysis. Finally, the data were analyzed using Stata software with frequency determination, Fisher exact test, and Logistic regression (P ≤ 0. 05). BOX-PCR analysis was performed by GelJ version 1. 13 software. Results: Based on the results, the lowest and highest RESISTANCE and susceptibility rates in 134 isolates of P. aeruginosa were related to cefpodoxime (93. 28%), imipenem (27. 61%), colistin (69. 40%), and cefpodoxime (6. 71%), respectively. In addition, MDR and XDR isolates were observed in 97. 76% and 15. 67% of P. aeruginosa isolates, respectively. However, PDR was detected in none of the isolates while BOX-PCR demonstrated four main clusters with 56 unique patterns in nosocomial infection isolates. Further, a significant relationship was observed between MDR and XDR isolates and nosocomial infection (P ≤ 0. 05). Eventually, there was a significant association between ward, the type of specimens, and hospitals with nosocomial infection (P ≤ 0. 05). Conclusions: In general, a high frequency of antibiotic RESISTANCE was observed in this study whereas no genetic correlation was observed between P. aeruginosa strains. In sum, selecting the most effective antibiotics and devising an efficient way for controlling the antibiotic RESISTANCE should be taken into consideration.

Dear editor, Malaria is a major public health threat and is one of the leading causes of death worldwide, with a death toll of over 400, 000 annually (1). A great portion of these deaths comes from African countries, such as Burkina Faso, Niger, Mozambique, Tanzania, the Democratic Republic of Congo, and Nigeria, all accounting for about 51% of all malaria deaths worldwide (1). Over 90% of these malaria mortality cases is caused by Plasmodium falciparum, which is the most virulent form of the malaria parasite (1). In the past few decades, a major contributor to the increased severity and mortality rate of malaria is the nagging problem of DRUG RESISTANCE, mainly for P. falciparum, which has emerged against almost all used antimalarial DRUGs since the 1930s (2). This has greatlyimpededglobal efforts to control malaria. . . .

Bacteremia is an important infectious disease which may lead to death. Common bacteria and pattern of antibiotic RESISTANCE in different communities are different and understanding these differences is important. In the present study, relative frequency and pattern of DRUG RESISTANCE have been examined in bacteria isolated from blood cultures in Razi Hospital laboratory. The method of the study was descriptive. Data collection was carried out retrospectively. Total sample consisted of 311 positive blood cultures from 1999 to 2001. Variables under study were bacterial strains. antibiotics examined in antibiogram, microbial RESISTANCE, and patients age and sex. The most common isolated bacteria were salmonella typhi(22.2%) and the least common ones were citrobacter (1.6%). The highest antibiotic RESISTANCE was seen against amoxicillin (88.4%). The proportion of males to females was 1: 1/1 and the most common age group was 15-44 (47.3%). common bacteria and pattern of antibiotic RESISTANCE were different in some areas and this subject requires further studies in the future.

Background and Objectives: Non-fementer gram-negative bacilli (NFGB) are ubiquitous pathogen that has emerged as a major cause of health care associated infections. The aim of this study was to determine the prevalence and antimicrobial susceptibility of NFGB in an Iranian hospital.Materials and Methods: From July 2005 to November 2006 a total of 257 strains of NFGB including 109 (42.41%) strains of Pseudomonas aeruoginosa, 88 (34.24%) strains of Acinetobacter baumannii, 48 (18.67%) stains of Stenotrophomonas maltophilia and 12 (4.66%) strains of Burkholderia cepacia were isolated from clinical specimens taken from patients hospitalized in Milad Hospitsl, Tehran, Iran. Conventional bacteriological methods were used for identification and susceptibility testing of NFGB. Susceptibility testing was performed by method as recommended by Clinical Laboratory Standard Institute (CLSI). Data were analyzed using SPSS 11.5 for Windows (SPSS Inc., Chicago, IL).Results: A total of 257 non-duplicating of NFGB strains were isolated from 234 hospitalized patients. The most effective antibiotic against P. aeruginosa and A. baumannii was imipenem followed by tobramycin. Fluoroquinolones had moderate activity against P. aerugunosa. Most isolates of A.baumannii were multi-DRUG resistant. Susceptibility of S. maltophila to ticarcillinclavuanic, ofloxacin and ceftazidim was 96%, 94% and 81%, respectively. Thirty three percent of this bacterium isolates were resistant to co-trimoxazole.Conclusion: In our study, imipenem was the most effective antibiotic against P. aeruginosa and A. baummannii isolates. Previous history use of antibiotics, longer duration of hospital stay and mechanical ventilation were the major risk factors for RESISTANCE acquisition in NFGB especially in P. aeruginosa and A. baumannii.