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pISSN: 2251-6085
eISSN: 2251-6093
Chairman & Editor-in-Chief:
Dariush D. Farhud, MD, Ph.D., MG.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE). 
Vol 36 No Supple 2 (2007)
Articles
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Background: Helicobacter pylori is gram negative bacteria and is the etiologic agent of some gastrointestinal disease are such as chronic gastritis, gastric ulcers, lymphoma and aden carcinoma. Multiple invasive and noninvasive methods for detection of this infection are available, and among non invasive methods diagnostic value of specific IgM, IgG and IgA by ELISAis one of the best methods. The aim of this study to detect H. pylori antibodies for IgM, IgG and IgA by ELISA method. Methods: Blood samples From 131 referred patients (78 female and 53 male) for detection of H.pylori was taken and serum separated for detection of IgM, IgG and IgA antibodies. IgG assessed by EIU units (<34 was Negative and >42 was Positive) .Also for IgM and IgA antibodies reported by U/ml unit (<8 was Negative and >12 was Positive). Results: 131 Samples were tested for H. pylori IgM, IgG and IgA antibodies and showed 27.47%, 42% and 25.19% positive for IgM, IgG and IgA antibodies respectively. Age group 20-40 years old for IgM, IgG and IgA antibodies 23.3% and 28.3% and 16.7% positive respectively and for 41-80 years old IgM, IgG and IgA antibodies were 31%, 53.5% and 32%, respectively. The above data showing infection is higher at 41- 80 years old patients. Conclusion: The simple method for detection of H. pylori antibodies are available commercially and have sensitivity and specificity for H. pylori diseases. IgG, IgM and IgA have diagnostic importance, therefore regarding acceptable sensitivity and specificity, ease of work with ELISA, being economical and non invasive, it can be employed in diagnosis of H. pylori infections.
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The Study of Blood Culture for Prevalent Bacteria and Antibiotic Resistance on Hospitalized PatientsBackground: Bacteremia means invasion of bacteria to coronary- arthery system. One third of these cases lead to septicemia and in 40-50% cases, it causes patient’s death. Therefore information about resistance and prevalent of bacteria isolated from blood culture is important for deciding about suitable therapeutic management. Methods: This retrospective study was done on all positive blood cultures for typing and detecting of antibiotic resistance during 2001- 2005. Data was analyzed by statistical procedure. Results: In 252 (4.35%) of studied blood cultures, the most prevalent bacteries were Staph. epidermidis (35.2%) and E. Coli (18.5%). The greatest and the least resistance antibiotics were βLactam (75.2%) and glycopeptide (7.8%) groups, respectively. Conclusion: With regard to antibiotic resistance increased during these years, awaring of the last changes about it in every therapeutic center is necessary.
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Background: Bacterial diarrhea is very common in particular in devoloping countries and is still one of the most causes of mortalities in children.The aim of present study was to identify the most common of bacterial agents causing acute bacterial diarrhea in children under 12 years old and detection of their resistance to antibiotics in patients who referred to pediatrics department of university hospitals of Hamadan. Methods: During two years) 2003-2005(, 610 samples obtained from children under 12 years old with gastroentrotitis were investigated for bacterial cultures, frequency of age, serotyping of isolates and antibiogram patterns. Polyvalent (I, II, III, IV) and monovalant antisera (055, 0111, 011, 086, 026, 0125, 0119, 0146, 0128, 0142, 0157) were used for serotyping of E. coli (EPEC). Antibiogram tests were also performed by gel-diffusion method of Kirby-Bauer. The data were gathered through a questionnaire and analysed using spss software. Results: Out of 610 tested samples, 155 cases (25.4%) had positve culture for intestinal pathogenic bacilli. The most common isolate was; Escherichia coli (EPEC) with 105 cases (67.8%) and the lowest isolate was Shigella with 18 cases (11.6%). The most common serotype of E. coli was 0128 (26.6%) and the lowest serotype was 0119 (5.7%). The most common serotypes of Salmonella were S.typhi (34.4%) and S.typhimurium and the lowest serotype was S. para A (3.1%). The most common serotype of Shigella was S.sonnei (55.6%) and the lowest serotype was S. boydii (5.6%). The most effective antibiotics against bacteria were ceftriaoxne, nitrofurantoin, imipenem, amikacin and gentamycin, but they showed high resisitance to ampicillin, cephalexin, trimethoprim and chloramphenicol. Conclusion: The present study showed that gram negative bacilli in particular, Escherichia coli (EPEC) and Salmonella species are predominant causes of bacterial diarrhea in children under 12 years old in this region. In many other countries, the most common serotypes of E. coli are 0157 and 055, but in our study the serotype of 0128 was common. Most species showed high resisitance to routine antibiotics such as ampicillin, trimethoprim and chloramphenicol.
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Background: Septicemia is one of the most important neonatal diseases which occurrs as a result of bacterial infection. The major criterion for its diagnosis is based on body fluid cultures specially blood culture. The aim of this study is to determine the prevalence of septicemia and also detection of isolated bacterial sensitivity to selected antibiotics in neonatal ward of Besat Hospital. Methods: This study is descriptive. Blood cultures were ordered for all hospitalized neonates. A questionnaire including clinical manifestations of septicemia such as fever, hyporeflexia, hypothermia, cyanosis, abdominal distention, loss of appetite and jaundice was filled out for every neonate clinically suspected of having septicemia. At last the collected data were analyzed by means of SPSS software and descriptive statistics. Results: This study included 700 specimen of blood cultures, 17.6% of the cases were suspected of having septicemia but %30 of them had positive blood cultures. The most common species isolated was coagulase negative staphylococci. As to sign and symptoms hyporeflexia, juandice, and anorexia were detected most frequently. Sensitivity of gram negative bacteria to ciprofloxacin was 100% & to cefotaxime 66.7%. Sensitivity of gram positive bacteria to cephalotin was 43%, while gram negative bacteria had highest resistance rate to ampicilin & cephalotine in 100% and gram positive bacteria to oxacilin in 68.6% & cotrimoxasol in 62.9% of the cases. In this study prevalence of septicemia in those having positive blood cultures was 30% with a mortality rate of 4.9%. Conclusion: This research shows that clinical manifestation is not enough for the diagnosis of septicemia and blood cultures should be considered necessary in suspected cases. Considering high resistance rate of isolated bacteria to ampicilin & cephalotin, culture and antibiogram can be of great value to select suitable antibiotic. Ciprofloxacin can be regarded as the drug of choice for gram negative bacteria. To reduce prevalence and mortality rates of septicemia, proper planning to confront microorganisms & nosocomial infections is necessary. Also appropriate and timely prescription of antibiotics by pediatricians can prevent bacterial resistance to antibiotics.
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Background: Nowadays, it has been known that Helicobacter pylori (H. pylori) is causative agent of the most common GI infection in world; at least half of the populations of many communities are affected by this bacterium. H. pylori infection plays an important role in progression of gastritis and especially in the peptic ulcers of duodenum. Eradication of H. pylori has lead to a significant decrease in the prevalence of PUD world-wide. At present, due to various reasons, such as to overcome bacterial resistances, it seems that the investigation for production of new antibacterial products is a necessity. So, this study was designed to evaluate the "in vitro" inhibitory effects of ether and water extracts of turmeric and cinnamon on the growth of H. pylori. Methods: Ether and water extracts of Turmeric and cinnamon was investigated by agar dilution and disc diffusion methods on five strains of H. pylori. Results: Ether and water extracts obtained from the studied plants have antibacterial effects and water extract of turmeric represented the most potent antibacterial effect. Conclusion: The results showed that the investigated plants have antibacterial capacity; in this case, cinnamon water extracts have a considerable antibacterial effect on H. pylori. Therefore, more investigation on this plant is recommended, by extraction of its effective materials. Abbreviations: H. pylori, Helicobacter pylori; ASR, age standardized rate; MIC, minimum inhibitory concentration; GI, gastrointestinal; PUD, peptic ulcer disease; DNA, deoxyribonucleic acid
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Background: Increase of bacterial resistance against antibiotics makes some difficulties in patient’s treatment and it is essential to study of antibiotics situation and bacterial sensitivity pattern against antibiotics. Physicians often get soon start to treatment patients based on bacterial quantities and bacterial sensitivity against antibiotics that seem always is not an effective treatment and make to spread some resistant species against antibiotics and increase their quantities in populations. So determination of antibiotic sensitivity in bacterium get from patients is important to an effective treatment. Methods: various body fluids include of cerebrospinal fluid synovial fluid pleural and ascite fluid get from patients were studied during one year. All samples were cultured to probably growth of bacterium by standard method in Qazvin Avicenna hospital. gram positive and gram negative bactries were separated. Bacterial sensitivity test were done by NCCLS standard method and get some importable results that show us we couldn’t guess bacterial resistance pattern against antibiotics. Results: Information gets from this study show us that we couldn’t guess bacterial sensitivity against antibiotics. Conclusion: Treatment must be done based on antibiogram results. It is better to find some other useful techniques that results soon be received by physicians.
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Background: Urinary tract Infections is the most frequently diagnosed kidney and urologic diseases and Escherichia coli is the most common pathogen found in urinary tract infections. The most frequent serogroups determined in the P- fimbriated strains belonged to one of the six serogroups O1, O2, O4, O6, O7, O18. In E. coli strains, the P fimbriae are considered an essential virulence factor causing pyelonephritis the pap operon encodes for the p fimbriae adhesion. Methods: 130 E. coli strains were isolated from 130 patients with UTI, symptoms and bacteriuria >105 CFU/ml. All of the isolated E. coli were serotyped using 13 different O-antisera. The DNA was released from whole organisms by boiling. Pap gene was detected in all isolated strains using PCR. Pap1 and pap2 25-mer primers were used for PCR and DNA target segment were 328 bp. Results: Serogroups O6(23.84%), O18(12.30%) and O15(6.93%) were the predominant serogroups, respectively. The 44 strains (33.86%) were non-typeable and 61% strains in this study were positive for the pap operon. Conclusion: The pap operon investigated in this study was particularly present in strains belonging to 4 sero-groups most frequently detected in uropathogenic E. coli. Urinary tract infection are caused by a limited number of uropathogenic E.coli strains that predominant possess the pap adhesion-encoding operons.
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Background: The salvia plant is one of the Lamiacea family members, that is being cultiurated all over the world. In Iran almost all spices of this plant could found, that are used for medical, food industry and parfumers production. Salvia sahendica genus is the member of this family, that its antibacterial effects on Klebsiella pneumonia, Staphylococcus aureus and Pseudomonas aeruginosa have been investigated. Methods: In this study are used standard strains of Pseudomonas aeruginosa (ATCC 27852) Staphylococcus aureus, (ATCC 25923) and, Klebsiella pneumonia (ATCC 3583). Salvia was provided from Tabriz mall and was powdered. Then this powder was suspended with ratio 1:10 with Metanol, Aceton, Chloroform, Hexan, Ethyl acetate and water. After 24h extractions isolated and concentrated with distillated in vacuum system. Which of bacteria were cultured to over night in Mohler Hinton agar medium, then compared with 0.5 macfarland. In continue extraction were tested by used of well assay method and then the diameter of zone measured. Experiments repeated tree times and the average of data obtained. In each of tests we had a control from special solvent. Results: Regarding to the results, all of salvia sahendica extractions showed antibacterial activity on Staphylococcus aureus, Pseudomonas aeruginosa and. That regarding Klebsiella pneumonia, Ethanol, Chloroform, Ethyl acetate, Hexan, and regarding Staphylococcus aureus Metanol, Aceton, Chloroform, Hexan, Ethyl acetate and Pseudomonas aeruginosa only Chloroform this plant has antibacterial effects. Chloroform extraction of salvia shows the most antibacterial activity (with the biggest diameter of antibacterial zone). Conclusion: Regarding the carried out study it could be noted that for inhibition and destroying Staphylococcus aureus and Klebsiella pneumonia, plants effects extraction could be used.
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Background: Clostridium difficult is an identified cause of antibiotic-associated diarrhea, antibiotic-associated colitis, pseudomembranous colitis and nosocomial diarrhea. The purpose of this study was to investigate the prevalence of nosocomial C. difficile-associated diarrhea in Tehran University of Medical Science Hospitals. Methods: In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA) and incubated in anaerobic conditions, at 37 °C for 5 days. Isolated C. difficile by conventional biochemical tests, bacterial cytotoxicity by Vero tissue culture and antimicrobial sensitivity to antibiotics by Kirby Bauer method (disk diffusion) were investigated. Results: Of the total patients, 57 Toxigenic C. difficile (6.1%) were isolated. Results of statistical analysis show significant differences between the rate of isolated Toxigenic C. difficile and age group of patients (P< 0.05). Among the units of selected hospitals, Toxigenic C. difficile was isolated most frequently in gastroenterology of Children clinical center. Meanwhile, the isolated Toxigenic C. difficile were sensitive to vancomycin, Chloramphenicol and ceftriaxone. Conclusion: Our findings show that, Toxigenic C. difficile was found in 6.1% hospitalized patients. Therefore, further studies to evaluate the role of Toxigenic C. difficile in nosocomial diarrhea processes, ecological and pathogenic terms by culture, Tissue culture and molecular methodes are suggested.
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Background: Escherichia coli strains that cause nonbloody diarrhea in infants are known to present four distinct patterns of adherence to epithelial cells, namely, Localized (LA), Localized Adherence Like (LAL), Diffuse (DA) and Aggregative (AA) adherence. Strains with LA and AA are well recognized as a cause of diarrhea, but the role of strains with DA is controversial and strains with LAL have been more frequently isolated in diarrheal than asymptomatic cases. Methods: To determine the distribution of the different types of enteropathogenic E. coli (EPEC) adherence patterns in diarrhea, we studied 191 EPEC strains isolated from infants less than 5 years of age with and without diarrhea in Iran. Results: Totally 131 (68.5%) strains adhered to HeLa cells and 60 (31.5%) isolates did not. The results revealed that Localized Adherence (LA) was manifested by 30 of 111 (86%) strains isolated from diarrheal cases of which the most belonged to serogroups O86 and O55. Localized Adherence like (LAL) was exhibited by 16 and Aggregative Adherence (AA) by 9 strains isolated from patients. However, Diffuse Adherence (DA) was exhibited by 8 strains equally distributed between both diarrheal and healthy persons. Undefined Pattern (UDP) was observed in 24 strains. Conclusion: Overall, the results showed that LA, LAL and AA adherence significantly associated with diarrhea (P< 0.05).
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Background: The CLSI screening and confirmatory methods are recommended by CLSI for detection of extended- spectrum β- lactamases in Escherichia coli (ECOL), Klebsiella pneumoniae (KPNE) and Klebsiella oxytoca. It is recommended that screening be performed routinely in these species, and if the screening test is positive, that a confirmatory test be undertaken. The CLSI standards do not currently provide advice on what to do with screen positive, confirmatory test-negative strains. Methods: All isolates of ECOL and KPNE collected as part of the SENTRY APAC region surveillance, 1998 to 2003, that had MICs by the CLSI broth microdilution method to ceftriaxone, ceftazidim and aztreonam with a MIC above 1 mg/L to any of these three were subjected to confirmatory testing as per CLSI method, except that ceftriaxon replaced cefotazime. Selected isolates were subjected to PCR for detection of β- lactamase genes belonging to TEM, SHV, and family specific group CTX-M and plasmid-mediated AmpC β-lactamase. Results: Overal 8.9% of 4,515 ECOL and 20.3% of 2,081 KPNE collected over 6- year period were screen positive (P+). The presence of an ESBL was not confirmed (P+C -) in over 30% and 15% of the screen positive ECOL and KPNE respectively. Over 60% of P+C- ECOL had a plasmid-mediated AmpC β-lactamase (65% of which belonged to the CIT group), while in KPNE, 74% of the P+C- strains contained AmpC (89% DHA group) either alone or in combination with TEM or SHV genes. AmpC was strongly associated with ceftazidime rather than ceftriaxone non-susceptibility with (MIC> 8 mg/L) in both species. Conclusion: There is a high prevalence of non-ESBL β-lactameses, especially AmpC, in ECOL and KPNE with elevated MICs (2-8 mg/L) in the Asia-Pacific region.
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Background: There is ample evidence that the basis for latent tuberculosis infection in humans is persistence of tubercle bacilli for long periods of time even though lifetime. This status is currently defined as non-replicating persistence (NRP). Documented evidence from both macrophage physiology & the nature of TB granuloumas in human lungs suggests that gradually depletion of oxygen, hypoxia and micro aerobic condition is a major factor in inducing NRP state of tubercle bacilli. Methods: 100 clinically isolated tubercle bacilli were examined by the slowly stirred head space ratio method (0.5 HSR), which involve a slow depletion of oxygen within a sealed, slow stirred culture tube. The in-vitro induced hypoxically different stages of NRP was setting up, and the expression of the alpha-crystalline chaperone protein that are expressed when MTB undergoes to NRP srate was detected. Indeed the activity of rifampin, isoniazide, pyrazynamide, ciprofloxacin and meteronidazole were evaluated against two NRP stages of MTB. Results: During oxygen shift-down bacterial physiology changes from active growth to a NRP state. Two characteristic stages of NRP are seen; NRP-1 occurs when the oxygen concentration gradually dropped to microaerophilic condition. The 16 KD α- crystalline protein was expressed at just beginning of NRP-1 stage. The NRP-2 stages occur when the oxygen concentration dropped to anaerobic condition. When the NRP-2 state transferred to an oxygen – reach fresh medium the bacteria consume oxygen and resume growth in a synchronized replication manner from NRP-2 state. Conclusion: slow depletion of O2 appears to permit the occurrence of adaptations that favor long-term non replicating persistence of tubercle bacilli under microaerophilic conditions and also enhance the ability of the bacilli to survive in anaerobic conditions. This versatility could account for long-term latency of tuberculosis in the human host. The model presented here should be useful for identifying the molecular events include; mRNA expression and native products such as α-crystalline protein and others that are responsible for the versatility of MTB in surviving under that range of conditions, as well as those associated with reactivation of these bacilli.
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Background: Latent tuberculosis infection (LTBI) is caused by mycobacterium tuberculosis in a state of non-replicating persistence (NRP). Recent evidence suggests that some very specific adaptations to oxygen depletion occur that MTB undergoes to hypoxic RNP state. In this study the modified slowly stirred, limited Head Space Ratio (0.5HSR) method was used to investigate the physiological response of MTB to different oxygen tension levels. Methods: For setting up the various NRP stages 100 susceptible & drugs resistant clinically isolated strains of MTB were cultivated in Dubos Albomin Tween medium via hypoxically, slow stirring 0.5 HSR method and the effects of isoniazid ,rifampin, pyrazinamide .ciprofloxacin & metronidazole against MTB were examined during NRP-1 and NRP-2 stages . The α-crystalline protein was detected during NRP-1 stage of the MTB cultures via performance of the suitable procedures for pellet preparation, washing and cell disruption and SDS-PAGE technique. Results: NRP-1, NRP-2 stages of MTB subjected to be test documentary were seen. The first three of the four drugs mentioned above affected the MTB at actively replicating period and the rifampin effect was continued slightly during NRP-1 stage. Meteronidazole was affected the MTB at anaerobic NRP-2 stage. α- crystalline protein was detected at NRP -1 stage but do not detect at aerated cultures. Conclusion: Induction of the α-crystalline protein during hypoxic shift-down of MTB metabolism, its function as a chaperone, suggests a critical role for this protein in the ability of MTB to persist without replicating in the hostile regions of the host's tissues. Therefore, understanding of the mechanisms of induction of factors associated with the hypoxic condition of tubercle bacilli that should be contribute to the development of strategies for identification of the new drugs targets and preventing the persistence states in human lesions must be critical for affective TB control programs.
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Introduction: Uropathogenic Escherichia coli (UPEC), the commonest cause of urinary tract infections, bind to target cells and phagocytes via several distinct pairs of adhesins and receptors. In some cases bacterial binding to phagocytes ends to bacterial elimination. The survival and spread of bacteria in infected tissues are determined by the resistance of bacteria to elimination by phagocytic cells like neutrophils. The aim of this study was to determine the role of type 1 pili in interaction of UPEC with human neutrophils and its effect on bacterial killing. Methods: We used 3 clinical and 1 standard strains of type 1 piliated and 1 unpiliated standard strain of UPEC. Type 1 piliated and unpiliated strains (obtained by growth at a pilus-restrictive temperature) of UPEC were used for determining the effect of this pili on migration of neutrophils towards bacteria in Boyden chamber. Also intracellular killing of bacteria by human neutrophils was estimated by counting of the number of viable bacteria in 45 minutes after incubation of piliated and unpiliated strains with purified neutrophils.The results were analyzed with t-test. Results: In chemotaxis assay, PMN migration towards piliated strains was 46-73% of that observed with FMLP, but it was 34-41% in unpiliated strains.The results obtained showed that type 1 piliated UPEC stimulated significantly greater chemotaxis than did unpiliated ones(P<0.05).In phagocytic killing assay, 40-70% of piliated strains were killed in 30 min after incubation with PMN, but the number of viable unpiliated strains was increased in this period of time .There was a significant difference between the intracellular killing of piliated and unpiliated strains with neutrophils (P<0.05). Discusion: Human granulocytes recognize type 1 piliated UPEC via α-mannose-containing structures. So the existence of this adhesin on UPEC strains can leads to increase of neutrophil chemotaxis towards bacteria, phagocytosis and bacterial killing.
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Backgrounds: Helicobacter Pylori is the major cause of acute and chronic gastritis, gastric and duodenal ulcer and increased incidence of gastric adenocarcinoma and elevated gastric mucosa lymphoproliferation. Reactive oxygen species have been suggested as one of the main causes of cell injury in H. Pylori associated gastritis. Methods: In this study to evaluate oxidative stress in H. Pylori infection the activities of Superoxide Dismutase (SOD) and Glutathione Peroxidase (GPX) were measured in gastric juice of sex and age matched H. Pylori positive (n= 43) and negative (n= 43) individuals. This was determined through endoscopic and urease rapid test examinations. Results: The mean activities of SOD and GPX in the gastric juice of the patients (H. Pylori positive) were significantly higher than those of control group (H. Pylori negative) (P= 0.0001 in both cases). Correlation test between the mean activities of the both enzyme in gastric juice of control group revealed a direct and significant relationship was noticed (r= 0.702, P= 0.0001) while in the patient group a reverse but non-significant correlation was found (r= -0.028, P= 0.859). Conclusion: Since the activity of GPX is considered as being complementary to the activity of SOD, direct correlation between the activities of the two enzymes in gastric juice in uninfected group, and indirect correlation between these in that of infected group may suggest the presence of oxidative stress in H. Pylori infection.
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Early determination of antibacterial susceptibility increases the success of therapy, decreases unnecessary use of antibacterial agents and side-effects, and lowers the overall healthcare cost. We have evaluated a rapid antibacterial susceptibility test, Qui-Sensitest (Salubris Inc., Istanbul, Turkey), which is based on a rapid culture medium that indicates growth by changing its color. Qui-Sensitest proved to be a reliable rapid test for determining antibacterial susceptibility having an overall agreement of 97.6% with Kirby Bauer disk diffusion test results for enteric bacteria with 0.4% of major discrepancies and 2.0% of minor discrepancy. Since the test makes the results available in 3.5-6 hours, it can provide the means for choosing the right treatment regimen the same day the infectious agent is isolated.
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Background: Recent increase in resistance among gram-negative bacteria, particularly in referral centers led to difficulties in medical management of severely ill patients all around the world. Given the economic issues, different epidemiologic status and absence of routine system for susceptibility testing in our setting for new antibiotics including 4th generation cephalosporines, it is an urgent need to evaluate their role in our country. Methods: Various multi-drug resistant (resistant to at least two different representatives from the main groups of commonly used antibiotics including third generation cephalosporines, aminoglycosides and new quinolones) gram-negative bacteria were subcultured again on Muller-Hinton agar. Susceptibility testing was done using disk diffusion method with NCCLS criteria and reported according to the predetermined patterns of resistance, types of organs and site of isolation separately. Results: among 96 samples of MDR gram-negative bacteria, Klebsiella spp, Ecoli, Acinetobacter and pseudomonas spp were dominant. Generalized resistance to all groups was the most common pattern of resistance in our samples, in one third of which, there was sensitivity to forth generation cephalosporines. The best observed response was seen among those bacteria with generalized resistance to third generation cephalosporines and partial resistance to new quinolones. Overall, 36% of isolates were sensitive to Cefepime. Urine culture was the most common site of sampling, still the best sensivety results were observed among those isolates from respiratory site. Conclusion: according to our preliminary study, Cefepime might be used in severe infections of gram-negative origin that show generalized resistance to third generation cephalosporines and partial resistance to new quinolones.
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Background: Acinetobacter spp are associated with various nosocomial infections like as septicemia and are isolated form blood cultures in hospitalized patients. Methods: In this study, 45 Acinetobacter strains were isolated from blood samples in Yazd shahid sadoughi hospital from 21 March 2005 to 20 September 2006 and were identified by biochemical tests. Antibiotic susceptibility of the strains was tested by standard disk diffusion method. Results: In this research, 45 isolates identified as Acinetobacter and of isolated strains, 88.8% of them found sensitive to imipenem and 80% to ciprofloxacin. Also 51.5% to nalidixic Acid 24.5% to trimethoprim/sulphametoxazole, 11.1% to ceftazidim and ceftriaxone, 8.8% to cefotaxime and cefexime and also 6.6% to ceftizoxime. Conclusion: Because of increasing of drug resistance in Acinetobacter spp. Isolated from blood samples, it is necessary to perform susceptibility testing, also imipenem and ciprofloxacin recommended for drug therapy.
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Background: Urinary tract infections are the most prevalent bacterial infections in the world and using empiric antibiotic therapy may increase the drug resistance. This cross- sectional study accomplished to determine the prevalence of UTI and related antibiotic resistance pattern. Methods: UTI suspected patients referred to Yazd central laboratory studied. The urine samples cultured colonies with colony count of > 105 cfu/ml identified, and antibiotic resistance patterns determined by the standard disk diffusion method (Kirby-Bauer). Results: Out of 17353 samples 1623 (9.35%) were positive culture. The most prevalent microorganisms were as follows: E.coli (47.07%). Enterobacter (12.07%). S. aureus (10.96%), Klebsiella pneumoniae (9.85%), CNS (8.37%), group B streptococci (4.86%). Enterococci (2.09%). Pseudomonas aeruginosa (1.54%). Proteus (1.17%). Nonhemolytic streptococci (0.86%), Citrobacter and α hemolytic Streptococci (0.55%). The antibiogram results showed that isolated strains had the most drug resistance as follows: to ampicillin (80%), SXT (53.66%), tetracycline (50.33%), cephalexin (22.92%), nalidixic acid (19.4%), nitrofruntain (17.12%), ceftizoxime (8.5%) and ciprofloxacin (8%). Gram (+) cocci strains were 100% sensitive to vancomycin. Conclusion: selection of proper antibiotic against isolated species though susceptibility testing decreases the dissemination of resistant strains.
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Background: The peripheral blood cells' capacity to produce pro-inflammatory (TNF-alpha, IL-12, IFN-gamma) and anti-inflammatory (IL-10) cytokines in response to intracellular bacteria, like Mycobacterium Tuberculosis, play key role in protection from and pathogenesis of mycobacterial infection, and their balance and dynamic changes may control or predict clinical outcome of disease. Method: IFN-gamma and IL-10 serum levels were evaluated, by ELISAmethod, in some complicated cases of tuberculosis (TB) patients who were resistant to therapy. Results: IFN-gamma serum level was decreased and production of IL-10 was increased during active TB in patiens who were resistant to therapy compared to controls. IFN-gamma/IL-10 ratio's has significant correlation with TB-cure in these patients. Conclusion: Decline of IFN-gamma, as a pro-inflammatory cytokine and increasing IL-10, as an anti-inflammatoy cytokine could be appropriate indexes of clinical outcome of TB.
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Background: The geographic conditions is such that animal husbandry is in separable part of villagers and farmers life and they are at risk of infection due to contact with cattle and on the other hand, the whole peopele urban or rural are using unpaseurized dairy products expose at the risk all of society. Brucellosis diagnosis can have special significance based on serologic tests. The tube Standard test has the most usage in brucellosis diagnosis. Antibodies such as IgM and IgG induce agglotination and in some cases become negative due to to existance of blocking and incomplete antibodies that if so, the above antibodies are detectable through coombs wright test. Methods: In this research, 150 cattle owners and 300 cattle were investigated random during year of 83-84. After blood sampling in view of Rosbangal, tube wright test, 2 ME and Coombs wright test were investigated. Results: Between 150 serum Sample of studing cattle owners, 80 and 70 people were men and women respectively. The relative average of these people was 38.86. The most percent of negative cases dedicated to Rosbangal test is 66.7%. The significant difference wasn’t observed with Rosbangal method according to Sex in cattle owners (P value= 0/863). According to the obtained results, the serum titre of tube wright test in the studied people was different from 1/20 to 1/2560 and in (3.3%), (2%) and (0.7%) was 1/640, 1/1280 and 1/2560 respectively. The serum titre 2 ME in (2.7%), (2.7%) and (2%) was 1/160, 1/320 and 1/640 respectively. The serum titre of coombs wright in (8.7%) and (5.3%) was 1/320 and 1/640 respectively. With the above studied, in 300 cattle there was positive 9% with Rosbangal test and serum titre of tube wright (0.7%) 1/160, (0.7%) 1/320, (0.7%) 1/640, (1.3%) 1/1280 and 2 ME serum titre (0.7%) 1/160, (0.3%) 1/320, (1.7%) The major findings of this investigation, the significant agreement statistically between Rosebangal results and the other methods including tube wright, 2 ME and brucella and coombs wright have been observeol in the anti brucella antibody in cattle owners serum (r= 0.667). Conclusion: The fining of this research indicated that Brucellosis is still part of common diseases in the studied region. The Training necessity of transmission routes, effects, preventation methods and environment health control and Veterinary is necessary to reduce this disease.
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Background: The purpose of the present study was to test the bactericidal effect of virkon on native species of bacteria seen in Iran by selecting a suitable concentration of virkon which would effectively reduce the level of environmental bacterial contamination including contamination of platelets components while following the exact instruction of the use of the disinfectant. Methods: This was an interferal -applied study. 160 samples were taken from laboratory benches, instruments and outer surface of blood component bags. The growing organisms were identified by using the McFarland constant standard protocols and the CFU/ml of bacteria was determined. Later all the laboratory benches and instruments involved in the preparation of platelet components were disinfected using (1%) virkon solution. 101 samples were taken from disinfected areas and swabs were plated on to standard bacteriological media and plates were read. In addition, 1100 segments from platelet bags were separated and the platelet contents were plated and any bacterial growths were assessed using quality control department guidelines. Results: Out of 169 samples which were plated before disinfection by virkon following organisms were separated 56/8% gram positive b. (spore forming and without spores) 96 samples, 59/8% gram positive cocci (staph. &strept.) 101samples, 94/8% gram negative b. 159 samples, 82/2% gram negative cocci 139 samples. Post disinfection by virkon solution, out of 101 samples following organisms was separated: 24/8% gram positive b. 25 samples, 16/8% gram positive cocci 17 samples, 0% gram negative b. 5/9% gram negativ 6 samples, out of 1100 segment separated from platelets bags 4 samples (segments) had bacterial growth (0036%) 2 samples had gram positive b. growth and 2 samples had staph. Conclusion: By using correct concentration of virkon solution and following the exact manufactures instruction for use we were able to observe log reduction in bacterial contamination of the areas that blood components were made hence strong bactericidal action of specific concentration of virkon solution (1%) was present.
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Background: Pyrazinamide (PZA) is an important front-line antituberculosis agent. This drug plays a unique role in shortening the therapy, besides of metabolically active and replicating bacilli; it kills a population of semi-dormant organisms that are not killed by other first-line antituberculosis drugs. The activity of PZA correlates with the acidity of the medium, being most active at PH 5.5 less active at PH 6 and inactive at neutral PH. The problem is that such an acidic environment is quite unfavorable for Mycobacterium tuberculosis growth. Therefore the PZA susceptibility testing is difficult and often unreliable because of the acid PH requirement for drug activity. For this reason, many clinical microbiology laboratories do not perform PZA susceptibility testing and most drug-resistance surveys do not have PZA resistance data. For this reason a special condition which could be to support the optimal growth of organisms & allow to performing PZA susceptibility testing at favorable PH has been developed. Methods: The continuously buffered Middlebrook 7H10 agar base with an acidic PH of 6.0 used, to provide optimal conditions for PZA acidity, it also differs from conventional 7H10 medium in that supplemented with animal serum instead of oleic acid to support optimal growth of organism at low PH of 6.0. Individual critical concentrations of PZA were used according to the Hassle- Bausch´s enzyme- substrate activity correlation in this medium made it possible to differentiate between PZA-susceptible and PZA-resistant clinical isolates. Results: During two years survey following results was obtained; approximately 2.6٪ of isolated were identified as PZA-resistance together other drugs resistance, with about 1٪ only PZA-resistance. PZA positive & PZA negative standard strains as control shown the method was used in this study obtains reliable results. Conclusion: Compared to a liquid medium this agar medium also has the following advantages: it allows determination of the actual proportion of PZA-resistant bacteria in the isolate and it is simple and inexpensive. In addition, it has the potential of being used for a direct susceptibility test with PZA
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Background: Nosocomial infection is one of the most important and problematic difficult in the educational hospital. There are different points of view about applying of disinfectant material in surgical rooms. According to the both side effect and health care financial, selecting the best material to disinfections is important. Therefore this study has been done to determine of effects of two material including Cidex (glutaraldehyd) and Deconex 50 AF (ammonium quaternary compounds). Methods: In this study 460 samples were collected randomizing from surgical rooms of Mobasher Kashany and Imam Khomeini hospitals of Hamadan. The samples were taken from surfaces and surgical instrument. The first group was the samples that were taken before and after applying Glutaraldehyd. In this group there were 110 samples befor and 110 after doing disinfections. The second group was the samples that were taken before and after applying Deconex 50 AF. The numbers of samples were 120 before and 120 after doing disinfections. There were five days interval between each stage of sampling in this period, the surgical room was active after selecting and the samples were cultured on the specific media and transferred to lab. Then the data were analyzed and compared by SPSS program by computer. Results: The most important bacteria isolated were as follow: Bacillus subtilis, Staphylococcus epidermidis, Enterobacter aeroginosa, Corynebacterium diphteroides and E. coli. This study also indicated that the efficacy of the two solution were significantly different (P= 0.04) before and after disinfections. The disinfections effect of Deconex 50 AF was 73% and Glutaraldehyde was 59%. Acording to the ranking of efficacy, the first is Deconex 50 AF and the second is Glutaraldehyde. Conclusion: Our results showed that Deconex 50 AF was relatively more effective than Glutaradlehyde and also it has less side effect rather than Glutaradlehyde.
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Background: Cutaneous leishmainasis (CL) is highly prevalent in several provinces of Iran, having been increased during the recent decade. The diagnosis of CL in most of clinical laboratories is usually performed using routine microscopy. However, this method is not sensitive enough, and the assessment and utilization of other methods, including a variety of PCR techniques, have been taken to consideration. Methods: In the present study, a direct PCR, based on kDNA primers, in comparison with the microscopic examination and in vitro NNN culture was evaluated for the detection of CL. The scrapings were taken from 73 patients from Mirjaveh, Sistan va Baluchestan province, and subjected to the comparative diagnoses. Results: The results showed that 38.4%, 55.5% and 60% of the specimens were positive by microscopy, PCR and NNN culture, respectively. Separate comparisons of both microscopy and PCR methods with NNN culture, showed that the sensitivity of the PCR (76%) is higher than that of microscopy (61%). The calculated specificity, however, was 100% for microscopy and 73% for PCR. The parasite species were also characterized by PCR. Conclusion: In addition to the higher sensitivity, this particular PCR, which uses species-specific primers, has a major advantage of identification of Leishmania species at the same time. It is, therefore, concluded that this PCR technique can be a suitable complement to the routine microscopic examination for diagnosis and identification of the parasite species from suspected leishmaniasis.
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Background: Major endemic foci of cutaneous leishmaniasis are present in different areas of Iran, including the city of Yazd, and it is one of the important parasitic diseases in tropical and subtropical regions. The first step in reduction of the disease cases is acknowledging its epidemiologic status. Methods: The present descriptive cross-sectional study was performed during 6 years, from autumn of 2000 to autumn of 2006 on the 1020 cases referred for diagnosis to the Yazd Central (reference) Medical Laboratory. The scraping method was used for preparation of direct smears, which were stained with Giemsa. Results: From the 1020 cases suspected of cutaneous leishmaniasis (450 males and 570 females, comprising 44.1% and 55.9% of them, respectively), in 615 patients (60.3%) the amastigote form of parasites were found, of them 290 patients (47.2%) were males and 325 patients (52.8%) were females, showing no significant difference (P value=0.22). The most common location of the lesion was hand (In 148 patients or 24% of cases), followed by face, forearm, foot, arm, and trunk. In 394 patients (64%) there was a single ulcer, and 221 cases (36%) had more than one lesion, including a patient with 16 lesions. The most commonly affected age groups were 10-19 years (23.5%) and 20-29 years (21.5%). Also it was shown that the most common areas of residence in patients ( in 155 cases, or 25.2%) was in the Imam Khomeini street ( Hazira and Ghale Asadan areas) of Yazd city, where there are many ancient houses located on destroyed water channels and the resident people are in a low socioeconomic status. Conclusion: Considering the high (60.3%) positivity rate of leishmaniasis in referred cases from the physicians, it seems necessary to raise the clinical index of suspicion in cutaneous ulcers. It can also be suggested that health system officials pay more attention to detection of vectors and reservoirs of leishmania, in addition to educating the people at risk, for recognition of cutaneous leishmaniasis and its ways of control.
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Background: Diagnosis and treatment of parasitic infections are very important because of pathologic changes and clinical symptoms produced in the host, and for taking measures against them. These diseases have more adverse effects and more importance in children. This study was aimed at determining the prevalence of intestinal parasites and their clinical manifestations in children 0-14 years old referred to Yazd Central Laboratory. Methods: The present cross- sectional descriptive study was performed during the April 2005 to September 2006, with data obtained from the stool samples of 1500 children, using both wet mount smear (physiologic saline and Lugol΄s solutions) and formalin-ethyl acetate concentration method for detection of the intestinal parasites and also with the tape test for eggs of Enterobius vermicularis and Taenia. Results: From 1500 examined stool samples, 128(8.5%) cases were positive for one of the intestinal parasites, including 67(52.3%) females and 61(47.7%) males. Ninety five percent of positive cases were infected with protozoa and 5% with helminths. The most frequent protozoans were Blastocystis hominis 41.3%, Giardia lamblia 33.6%, and Entamoeba coli 14.7%. Enterobius vermicularis (4.3%) and Hymenolepis nana (0.7%) were the helminth species. The most abundant infection rate was shown in the 5-9 years old group, with a significant difference compared with other age groups (P< 0.05). About 87% of children infested with Blastocystis hominis showed more than 5 Blastocystis per 400x microscope fields, and 100% of children infested with Giardia lamblia and Chilomastix mesnili had clinical symptoms. Conclusion: In this study, lower contamination rates in comparison with the similar studies conducted in other regions of the country was seen, which may be as a result of the hot and dry climate and improved personal hygiene and public health services. There is a need for further studies about the prevalence and clinical symptoms of some parasites such as Blastocystis hominis and Chilomastix mesnili.
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Background: Infection with Strongyloides stercoralis, an intestinal nematode of humans and some animals, is rare in dry climates such as Yazd. This article presents a patient with this infection who was mistakenly under treatment for ulcerative colitis, which recovered after proper diagnosis and anti-helminthic therapy. Case presentation: A 32 years-old man from Qeshm referred to Yazd Central Laboratory in August 2005, when many rhabditiform larvae of S. stercoralis were found in stool exam. Until then, he was under treatment with sulfasalazine and other drugs for ulcerative colitis. Treatment with tiabendazole was completely effective at relieving intestinal symptoms, without recurrence in 15 months of follow-up. All lab reports and documents are available. Conclusion: Careful attention is necessary because delayed diagnosis of S. stercoralis may lead to severe and fatal strongyloidiasis, and this parasite can manifest itself with symptoms similar to other intestinal diseases, such as ulcerative colitis.
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Background: A fundamental feature of most parasitic infections is their chronicity. Although renal disease is not one of the common presenting features, many parasitic infections are associated with glomerular lesions. Glomerular lesions are observed with visceral leishmaniasis (kala-azar) caused by Leishmania donovani. Leishmanial parasites affect children under 2 yaer in more than 88 countries. Thus study of glomerulopathy Associated with Visceral leishmaniasis is very important. Methods: In this retrospective study we review the glomerulopathies observed in visceral leishmaniasis and the pathogenic mechanisms thought to be involved in the individual infections, and discuss the general mechanisms that can be extracted from these observations. Results: Prospective studies have shown that 60% of patients with kala-azar have mild proteinuria with benign changes in the urinary sediment (microscopic hematuria and leukocyturia). The pathological picture is a glomerulonephritis ranging from purely mesangioproliferative to membraneoproliferative. Amyloidosis can be a complication of kala-azar. Using immunofluorescence, IgG, IgM, IgA, and C3 are seen in the mesangium with some extensions along the capillary loop. Conclusion: Kala-azar is usually associated with hyperimmunoglobulinemia with high IgG levels, circulating immune complexes, and high titers of rheumatoid factor and cryoglobulin. Together with the presence of immunoglobulins in the glomeruli, this suggests the pivotal role of polyclonal B-cell activation and “classical” B-cell activation in the pathogenesis of leishmanial nephritis.
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Background: Hydatidosis is one of the most important helminthiasis, and is a public health problem in many regions of the world. Methods: With the aim of production of recombinant subunits of antigen B, two different sequences of Echinococcus granulosus Antigen B, acquired from Gene Bank and amplified with specific primers via RT-PCR reaction. The amplified fragments (HI, HII) cloned into pTZ57R T.vector, and then subcloned into pGEMEX-1 expression vector. Resaults: The SDS-PAGE performed after induction of cloned genes, and production of about 35 K.Da recombinant fusion proteins were confirmed for either two cloned genes. The immunogenicity of the recombinant fusion proteins were tested using double diffusion and immunoblotting. Both recombinant fusion proteins derived from lysate of transformed bacteria, were reactive for antibodies in serum of cystic hydatid patient. Conclusion: The produced recombinant antigen B subunits can be use in seroldiagnostic tests of hydatidosis, after purification.
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Introdution: Toxoplasosis is a parasitic infection that created by protozoan named Toxoplasma gondii. A definitive host is cat and intermediate hosts are mammalian and birds (tissue cyst in organs). Human be infected via ingestion oocyst and row or undercooked contaminated meat. The causative agent transforms to tissue cyst in the divers organs especially in eye and bring about O.T .The majorities of cases are asymptomatic but the protozoan can locate in the eye and create acute corioritinite .The most prevalent causative agent of corioritinite is toxoplasmosis and it is estimated that 35% of corioritinite cases in children and adult, attributed to toxoplasma gongii Methods: Many articles about pathologic effects, prevalence, life cycle of toxoplasma gongii affected groups and ontrol of the infection have been studied. Resultss: Ocular toxoplasmosis in the human manifests most commonly following congenital infection. Experimentally it is showed that 5.3% of the mice offspring going on to develop bilateral or unilateral cataracts. Lymphocytes and macrophages were seen to enter the eye and the presence of degraded photoreceptor segments within macrophage phagolysosomes was shown. Retinal pigment epithelial cells (RPE), were also found to migrate, enter the eye and participate in phagocytosis. Conclusion: Because to high prevalence of toxoplasmosis (70% in some regions) it is deserved that toxoplasmosis be considered as a main causative agnate of corioritinite and ophtalmogists insert toxoplasma gongii as a causative agent in the clinical table.
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Background: Broad spectrum anthelmintics had been used for about 50 years to control internal parasites of human and animals. Methods: In this survey, resistance in gastrointestinal nematode of sheep to levamisole and albendazole were investigated in 15 sheep flocks. On each flock, faecal samples were taken from 20 randomly selected sheep. Nematode eggs were separated from the samples and placed in microplate for 24 hours at 25 °C to hatch and then Nutritive media, Escherichia coli and different concentrations of levamisole or albendazole were added to first stage larvae and incubated at 25 °C for 6 more days. LD50 of these drugs in each flock were calculated according to precent of larval development parameter in different concentration of levamisole or albendazole (Hubert and Kerboeuf, 1992). Results: LD50 of levamisole were varied between 0.021 to 0.27 μg /ml and LD50 of albendazole between 0.021 to 0.13 μg/ml. In negative control samples with no anthelmintic average larval development was 65% and third stage larvae were mostly composed of Ostertagia (59%), Trichostrongylus (20%) and Haemonchus (21%) but in positive contol samples with the highest concentration of levamisole Ostertagia spp and Trichostrongylus spp and albendazole Ostertagia spp were detected. Conclusion: Therefore we can conclude that resistance have been developed in some isolates of Ostertagia spp and Trichostrongylus spp to levamisole and to in some isolates of Ostertagia spp to benzimidazoles that can be alarming for treatment of trichotrongylus in people.
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Intestinal Coccidia are a subclass of Apicomplexa phylum. Eucoccidida are facultative heteroxenous, but some of them are monoxenous. They have sexual and asexual life cycle. Some coccidia are human pathogens, for example: Cryptosporidium: Cryptosporidiums has many species that are mammalian intestinal parasites.C. Parvum specie is a human pathogenic protozoa. Cryptosporidum has circle or ellipse shapes and nearly 4-6 mm. It is transmitted in warm seasons. Oocyst is obtained insexual life cycle that has 20% thin layer and 80% thick layer. Oocyst with thick layer is able to live a long time in nature. They are the third or forth of gastroentritis disease that have digestive disorder like anorexia, nausea, persistent diarrhoea, malabsorption and leanness. The disease forms choronic and acute stages and it is able to kill the immunodeficiency cases. Sometimes it has HIV symptoms similar to pneumonia and respiratory track infection. Laboratory diagnosis is based on Oocyst finding in stool exam and that shitter floatation and Cr (KOH)2 are the best methods. Modified zyh-lnelson and fleocroum are the best staining methods too. This parasite is transmitted by zoonotic and Antroponotic origin. Molecular studies have shown two Genotypes (I&II). Genotype I is aquatic and II is zoonotic. The prevalence rate is 3% in infants and 10% in calves. Cyclospora: This parasite is novel and is bigger than cryptosporidium.It isn't known a clear life cycle but is transmitted by water, vegetables and fruits as raspberries. and mulberries. Human is a specific host. When a parasite is in the intestine it causes inflammatory reaction in Entrocyte.The patient shows watery diarrhoea with nausea, vomitting, pain, Stomach cramp, anorexia, malabsorption and cachexia. The disease period is 3 monthes in immunodeficiency cases but it is selflimited in normal cases. Autofluorescence characteristic is differential diagnosis, prevalence rate of disease is unknown. Isospora: This intestinal parasite is in most parts of the world. Sometimes it is noun traveller diarrhea Syndrom. The egg shapes of Oocyst are disporic tetrazoic. It is transmitted by vegetables and fruits. Trophozoite pass through schizogony step and repeats it several times. In the end of the cycle gametogony is done and the sexual forms will be repelled the human intestine. Symptoms are persistent diarrhoea, epigastric pain, headache, fever, vomitting and leanness, especially when physiologic disorder condition is seen in patient or they are in traveling. Misdiagnosis is a problem in laboratories but floatation method with zinc sulfate or sugar syrup is recommended. Sarcocystis: Sporocyst of S.hominis and S. suihominis is in the human feces, and the cyst form is in pig and cow muscles. It founds in tha tongue, pharynx and oesophagus muscles of habitant buffalo in Iran. Because of the large size of the cyst (1cm), it is seen with naked eyes and the risk of human infection is rare. If human eats raw or uncooked cow and pig meat, he will be infected with it. Sexual cycle is in the human body and sporocyst is repelled by the intestine. The disease may or may not have any symptoms. The symptoms are diarrhoea, stomach cramp, jejenuom and ileum necrosis. Diagnosis is based on concentrated floatation. The prevalence rate is too much in domestic animals.
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Background: The growth of different microorganisms including bacteria, fungi and viruses has been inhibited by garlic extracts in many studies. The antifungal activity of aqueous garlic extract was investigated in an in vitro system using broth microdilution method against six commonly clinical isolates of Candida species. The synergic antifungal effect of garlic and amphotericin B was also determined in this study. The aim of this study was to evaluate the in vitro antifungal activity of an aqueous extract of garlic against six commonly clinical Candida species isolated from patients with systemic candidiasis Methods: The yeast strains examined were clinically isolated of C. albicans, C. tropicalis, C. glabrata, C. parapsilosis, C. guillermondi and C. krusei. The minimum inhibition concentration, MIC endpoints and checkerboard titrations of garlic extracts and amphotericin B were determined using broth microdi-lution test according to National Committee for Clinical Laboratory Standards (NCCLS) document. Results: The strongest activity of garlic extracts was seen against Candida tropicalis, followed by C. glabrata, and C. albicans. The minimum inhibition concentration (MIC) of garlic extract was 0.78, 1.56, and 3.125 mg/ ml for Candida tropicalis, C. glabrata, and C. albicans respectively. C. krusei was the most resistant species against garlic extract in this study with MIC 6.25 mg/ml. The amphotericin B minimum inhibition concentration was reduced six folds against C. tropicalis, 4 folds against C. glabrata, and C. albicans, and 2 folds for other Candida strains. Conclusion: Candida tropicalis was the most sensitive tested Candida species to garlic extracts followed by C. glabrata and C. albicans. However the mechanisms of action weren't clear and more in vitro studies is necessary for determination of its growth inhibitory activity mechanisms.
