Purpose: urinary tract infection (UTI) is the most common nosocomial infection among hospitalized patients. Meanwhile, most frequent infections involving enterococci affect the urinary tract. The aims of this study were to investigate the susceptibility pattern of isolated enterococci from UTI and the prevalence of virulence genes.Methods: The study used enterococci isolated from urinary tract infections obtained from 3 university teaching hospitals in Northwest Iran. The antimicrobial susceptibility of the strains was determined using the disc diffusion method. Multiplex PCR was performed for the detection of genus- species specific targets, and potential virulence genes.Results: Of 188 enterococcal isolates, 138 (73.4%) and 50 (26.6%) were Enterococcus faecalis and E. faecium, respectively. Antibiotic susceptibility testing showed high resistance to amikacin (86.2%), rifampicin (86.2%) and erythromycin (73.9%), irrespective of species. In total, 68.1% were positive for gelE, and 57.4%, 53.2%, 56.4%, and 52.1% of isolates were positive for cpd, asa1, ace, and esp, respectively.Conclusion: The study revealed that most of UTI isolates were multidrug resistance against the antibiotics tested and antibiotic resistance was more common among E. faecium isolates than E. faecalis. A significant correlation was found between UTI and the presence of gelE among E. faecalis strains (p<0.001).

Background: Uropathogenic E. coli (UPEC) is the primary cause of humanurinary tract infections (UTIs) worldwide. Moreover, there has been renewed and growing interest in using older antibiotics for treatment, such as aminoglycosides.Objectives: The goal of this study was to determine the plasmid profile patterns of UPEC isolates harboring the aminoglycoside resistance geneaac (3) -IIa.PatientsandMethods: Atotal of 276 uropathogenic E. coli (UPEC) samples were isolated from UTI patients at the Tehran heart center in Tehran, Iran. Antimicrobial susceptibility testing against five aminoglycosides was performed by the disk diffusion method, and theaac (3) -IIa gene was detected via PCR. Moreover, plasmid profiling was carried out on those UPEC isolates harboring the aac (3) -IIa gene. Finally, the similarities among these isolates were determined on the basis of their plasmid profiles.Results: The highest level of resistance was seen for tobramycin (24.6%), and the aac (3) -IIa gene was found in 51 isolates. Twentyseven different plasmid profiles were identified among the isolates harboring theaac (3) -IIa gene, with the 15 kb plasmid being the most common. Moreover, no significant correlation was found between the resistance patterns and the number of plasmids. The cluster analysis based on the plasmid profiles grouped the isolates into five different clusters, of which cluster one was the largest (containing 14 of 51 isolates).Conclusions: Ourdata suggest the monitoring of aminoglycoside resistance, andits consideration in the empirical therapy of UPEC infections.

Background and Purpose: Candida species are reportedly the most common human fungal pathogens. The incidence of urinary tract infections (UTIs) caused by Candida pathogens has increased in recent decades. However, such infections rarely occur in the absence of any predisposing factors. Regarding this, the aim of the present study was to identify the Candida species causing UTIs and determine the predisposing factors for candiduria. Materials and Methods: The current study was conducted on 1, 450 urine samples obtained from patients suspected of UTI. Out of this number, 19 cases were candidiasis, and 2 cases were mixed infections caused by bacteria and fungi. Candida species were diagnosed differentially using the germ tube test, colony staining on CHROMagar medium, intracellular beta-glucosidase enzyme activity, and glucose absorption pattern. Then, the colonies with the same morphology were confirmed by the DNA sequencing of internal transcribed spacer regions. Results: According to the results, 38%, 28. 6%, 14. 3%, and 9. 5% of the isolates were identified as C. albicans, C. glabrata, C. tropicalis, and C. kefir/C. krusei, respectively. The presence of one or more predisposing factors was proved in all patients in whom diabetes was the most prevalent predisposing factor (21. 1%). Conclusion: Based on the obtained results, C. albicans species was the most prevalent fungal species. In addition, urinary fungal infections were less prevalent than bacterial urinary infections.

Background: During the last decade, enterococci have become important nosocomial pathogens, representing the second leading cause of urinary tract infections. This increasing prevalence has been paralleled by the occurrence of multi-drug resistant (MDR) and high-level gentamicin resistant (HLGR) strains. Methods: From September 2005 to 2006, a total of 638 enterococcal isolates were collected from urine samples among 9 medical centers in Tehran (Iran). Confirmation of species and detection of gentamicin resistance genes were done by PCR method. Anti-microbial susceptibility test was determined with disk diffusion and minimal inhibitory concentration of gentamicin among HLGR isolates assayed by microdilution methods. Results: The isolates were found to consist of Enterococcus faecalis (77.8%) and Enterococcus faecium (22.2%). The results obtained from PCR showed a high rate of agreement with phenotypic assays for both species. MDR to most prevalent anti-microbials was present in 29% and 72% of the E. faecalis and E. faecium isolates, respectively. HLGR phenotype was detected in 64% of E. faecalis and 92% of E. faecium isolates. The aac(6')-Ie-aph(2")-Ia gene were identified in 83% of E. faecalis and 100% of E. faecium HLGR isolates. E. faecalis and E. faecium isolates differed in their susceptibilities to different antibiotics. Conclusion: Emergence of multi-resistant enterococci and high level resistance to gentamicin shown by enterococcal strains is of concern because of the decrease in the therapeutic options for treatment of infections caused by enterococci.