<?xml version="1.0" encoding="utf-8"?>
<journal>
<title>Tehran University Medical Journal</title>
<title_fa>مجله دانشکده پزشکی، دانشگاه علوم پزشکی تهران</title_fa>
<short_title>Tehran Univ Med J</short_title>
<subject>Medical Sciences</subject>
<web_url>http://tumj.tums.ac.ir</web_url>
<journal_hbi_system_id>1</journal_hbi_system_id>
<journal_hbi_system_user>admin</journal_hbi_system_user>
<journal_id_issn>1683-1764</journal_id_issn>
<journal_id_issn_online>1735-7322</journal_id_issn_online>
<journal_id_pii></journal_id_pii>
<journal_id_doi>10.18869/acadpub.tumj</journal_id_doi>
<journal_id_iranmedex></journal_id_iranmedex>
<journal_id_magiran></journal_id_magiran>
<journal_id_sid>000</journal_id_sid>
<journal_id_nlai>000</journal_id_nlai>
<journal_id_science>000</journal_id_science>
<language>fa</language>
<pubdate>
	<type>jalali</type>
	<year>1391</year>
	<month>3</month>
	<day>1</day>
</pubdate>
<pubdate>
	<type>gregorian</type>
	<year>2012</year>
	<month>6</month>
	<day>1</day>
</pubdate>
<volume>70</volume>
<number>3</number>
<publish_type>online</publish_type>
<publish_edition>1</publish_edition>
<article_type>fulltext</article_type>
<articleset>
	<article>


	<language>fa</language>
	<article_id_doi></article_id_doi>
	<title_fa>بررسی شیوع عفونت‌های بیمارستانی ناشی از انتروباکترکلوآکه و تعیین الگوی مقاومت آنتی‌بیوتیکی در نمونه‌های جدا شده از مراجعین به دو بیمارستان تهران</title_fa>
	<title>The prevalence of nosocomial infections caused by Enterobacter cloacae and antibiotic resistant patterns in samples isolated from patients in two hospitals in Tehran</title>
	<subject_fa></subject_fa>
	<subject></subject>
	<content_type_fa></content_type_fa>
	<content_type></content_type>
	<abstract_fa>&lt;p dir=&quot;rtl&quot; style=&quot;text-align: justify&quot;&gt;&lt;o:officedocumentsettings&gt; &lt;o:targetscreensize&gt;800x600&lt;/o:targetscreensize&gt; &lt;/o:officedocumentsettings&gt;   &lt;w:view&gt;Normal&lt;/w:view&gt; &lt;w:zoom&gt;0&lt;/w:zoom&gt; &lt;w:trackmoves&gt; &lt;w:trackformatting&gt; &lt;w:punctuationkerning&gt; &lt;w:validateagainstschemas&gt; &lt;w:saveifxmlinvalid&gt;false&lt;/w:saveifxmlinvalid&gt; &lt;w:ignoremixedcontent&gt;false&lt;/w:ignoremixedcontent&gt; &lt;w:alwaysshowplaceholdertext&gt;false&lt;/w:alwaysshowplaceholdertext&gt; &lt;w:donotpromoteqf&gt; &lt;w:lidthemeother&gt;EN-US&lt;/w:lidthemeother&gt; &lt;w:lidthemeasian&gt;X-NONE&lt;/w:lidthemeasian&gt; &lt;w:lidthemecomplexscript&gt;AR-SA&lt;/w:lidthemecomplexscript&gt; &lt;w:compatibility&gt; &lt;w:breakwrappedtables&gt; &lt;w:snaptogridincell&gt; &lt;w:wraptextwithpunct&gt; &lt;w:useasianbreakrules&gt; &lt;w:dontgrowautofit&gt; &lt;w:splitpgbreakandparamark&gt; &lt;w:enableopentypekerning&gt; &lt;w:dontflipmirrorindents&gt; &lt;w:overridetablestylehps&gt; &lt;/w:overridetablestylehps&gt;&lt;/w:dontflipmirrorindents&gt;&lt;/w:enableopentypekerning&gt;&lt;/w:splitpgbreakandparamark&gt;&lt;/w:dontgrowautofit&gt;&lt;/w:useasianbreakrules&gt;&lt;/w:wraptextwithpunct&gt;&lt;/w:snaptogridincell&gt;&lt;/w:breakwrappedtables&gt;&lt;/w:compatibility&gt; &lt;w:browserlevel&gt;MicrosoftInternetExplorer4&lt;/w:browserlevel&gt; &lt;m:mathpr&gt; &lt;m:mathfont m:val=&quot;Cambria Math&quot;&gt; &lt;m:brkbin m:val=&quot;before&quot;&gt; &lt;m:brkbinsub m:val=&quot;--&quot;&gt; &lt;m:smallfrac m:val=&quot;off&quot;&gt; &lt;m:dispdef&gt; &lt;m:lmargin m:val=&quot;0&quot;&gt; &lt;m:rmargin m:val=&quot;0&quot;&gt; &lt;m:defjc m:val=&quot;centerGroup&quot;&gt; &lt;m:wrapindent m:val=&quot;1440&quot;&gt; &lt;m:intlim m:val=&quot;subSup&quot;&gt; &lt;m:narylim m:val=&quot;undOvr&quot;&gt; &lt;/m:narylim&gt;&lt;/m:intlim&gt;&lt;/m:wrapindent&gt;&lt;/m:defjc&gt;&lt;/m:rmargin&gt;&lt;/m:lmargin&gt;&lt;/m:dispdef&gt;&lt;/m:smallfrac&gt;&lt;/m:brkbinsub&gt;&lt;/m:brkbin&gt;&lt;/m:mathfont&gt;&lt;/m:mathpr&gt; 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semihidden=&quot;false&quot; unhidewhenused=&quot;false&quot;&gt; &lt;w:lsdexception locked=&quot;false&quot; name=&quot;Medium Grid 1 Accent 4&quot; priority=&quot;67&quot; semihidden=&quot;false&quot; unhidewhenused=&quot;false&quot;&gt; &lt;w:lsdexception locked=&quot;false&quot; name=&quot;Medium Grid 2 Accent 4&quot; priority=&quot;68&quot; semihidden=&quot;false&quot; unhidewhenused=&quot;false&quot;&gt; &lt;w:lsdexception locked=&quot;false&quot; name=&quot;Medium Grid 3 Accent 4&quot; priority=&quot;69&quot; semihidden=&quot;false&quot; unhidewhenused=&quot;false&quot;&gt; &lt;w:lsdexception locked=&quot;false&quot; name=&quot;Dark List Accent 4&quot; priority=&quot;70&quot; semihidden=&quot;false&quot; unhidewhenused=&quot;false&quot;&gt; &lt;w:lsdexception locked=&quot;false&quot; name=&quot;Colorful Shading Accent 4&quot; priority=&quot;71&quot; semihidden=&quot;false&quot; unhidewhenused=&quot;false&quot;&gt; &lt;w:lsdexception locked=&quot;false&quot; name=&quot;Colorful List Accent 4&quot; 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&lt;strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;زمینه و هدف&lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;:&lt;/span&gt;&lt;/strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;&amp;nbsp;&lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;مصرف روزافزون آنتی&#8204;بیوتیک&#8204;های بتالاکتام در بالین از ابتدای دهه 1980 در درمان عفونت&#8204;های مختلف باکتریایی منجر به افزایش ظهور مقاومت به این آنتی&#8204;بیوتیک&#8204;ها در بین انواع باکتری&#8204;های جدا شده از بیماران گردیده است. به&#8204;طوری که امروزه یکی از معضلات درمان عفونت&#8204;های بیمارستانی ناشی از باکتری&#8204;های مقاوم بالاخص &lt;em&gt;انتروباکترکلوآکه&lt;/em&gt; به&#8204;لحاظ وجود مقاومت متقاطع در این میکروارگانیسم&#8204;ها و به&#8204;دلیل تولید آنزیم&#8204;های بتالاکتاماز وسیع&#8204;الطیف می&#8204;باشد. هدف از این مطالعه بررسی فراوانی &lt;em&gt;انتروباکترکلوآکه&lt;/em&gt;&#8204;های تولید&#8204;کننده آنزیم بتالاکتاماز وسیع&#8204;الطیف جدا شده از نمونه&#8204;های مختلف عفونی ارسالی از دو بیمارستان میلاد و شهید مطهری تهران می&#8204;باشد.&lt;/span&gt;&lt;span style=&quot;font-size: 9pt&quot;&gt; &lt;/span&gt;&lt;/w:donotpromoteqf&gt;&lt;/w:validateagainstschemas&gt;&lt;/w:punctuationkerning&gt;&lt;/w:trackformatting&gt;&lt;/w:trackmoves&gt;&lt;/p&gt;

&lt;p dir=&quot;rtl&quot; style=&quot;text-align: justify&quot;&gt;&lt;span style=&quot;font-size: 9pt&quot;&gt;&lt;/span&gt;&lt;strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;روش بررسی:&lt;/span&gt;&lt;em&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;&amp;nbsp;&lt;/span&gt;&lt;/em&gt;&lt;/strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;در مطالعه حاضر 101 &lt;em&gt;انتروباکترکلوآکه&lt;/em&gt; از بهمن 1389 تا شهریور 1390 از بیمارستان&#8204;های میلاد و شهید مطهری تهران جمع&#8204;آوری گردید. پس از تایید گونه توسط آزمایش&#8204;های &lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;استاندارد و &lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;اختصاصی میکروبیولوژی، تست حساسیت آنتی&#8204;بیوتیکی طبق روش استاندارد &lt;/span&gt;&lt;span style=&quot;font-size: 7pt&quot;&gt;CLSI&lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt; &lt;span lang=&quot;AR-SA&quot;&gt;و با استفاده از 13 آنتی&#8204;بیوتیک انتخابی &lt;/span&gt;&lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;مصرفی در مطالعه حاضر &lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;انجام گرفت. هم&#8204;چنین گونه&#8204;های تولیدکننده آنزیم بتالاکتاماز وسیع&#8204;الطیف با استفاده از روش دیسک ترکیبی &lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;به&#8204;عنوان یک روش استاندارد تشخیص فنوتیپی&lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt; جداسازی شدند.&lt;/span&gt;&lt;strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;&amp;nbsp;&lt;/span&gt;&lt;/strong&gt;&lt;/p&gt;

&lt;p dir=&quot;rtl&quot; style=&quot;text-align: justify&quot;&gt;&lt;strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;یافته&#8204;ها:&lt;/span&gt;&lt;/strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt; نتایج حاصل از روش فنوتیپی نشان داد که 33 (33%) از گونه&#8204;های &lt;em&gt;انتروباکترکلوآکه&lt;/em&gt; جداسازی شده توانایی تولید آنزیم بتالاکتاماز وسیع&#8204;الطیف را دارا بودند.&lt;span&gt;&amp;nbsp;&lt;/span&gt;&lt;span&gt;&amp;nbsp;&lt;/span&gt;5% گونه&#8204;های جدا شده به ایمی&#8204;پنم نیز مقاوم بودند. &lt;/span&gt;&lt;/p&gt;

&lt;p dir=&quot;rtl&quot; style=&quot;text-align: justify&quot;&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;&lt;/span&gt;&lt;strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;نتیجه&#8204;گیری:&lt;/span&gt;&lt;em&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;&amp;nbsp;&lt;/span&gt;&lt;/em&gt;&lt;/strong&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;مطالعه حاضر نشان از &lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;مقاومت بالا به بتالاکتام&#8204;های وسیع&#8204;الطیف و هم&#8204;چنین &lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt;وجود پنج درصدی سوش&#8204;های با مقاومت چندگانه &lt;/span&gt;&lt;span style=&quot;font-size: 7pt&quot;&gt;(MDR)&lt;/span&gt;&lt;span style=&quot;font-size: 10pt&quot;&gt; در بین &lt;em&gt;انتروباکترکلوآکه&lt;/em&gt;&#8204;های ایزوله&#8204;شده دارد. این سویه&#8204;ها تنها به کلستین حساس بودند. این نتایج می&#8204;تواند زنگ خطری برای پزشکان جهت درمان عفونت&#8204;های ناشی از &lt;em&gt;انتروباکترکلوآکه&lt;/em&gt;&#8204;های مقاوم به آنتی&#8204;بیوتیک&#8204;ها بالاخص گونه&#8204;های تولیدکننده آنزیم بتالاکتاماز وسیع&#8204;الطیف باشد.&lt;/span&gt;&lt;/p&gt;
</abstract_fa>
	<abstract>&lt;p style=&quot;text-align: justify&quot;&gt;&lt;strong&gt;Background&lt;/strong&gt;: The increasing use of &amp;beta;-lactam antibiotics in clinics for the treatment of different bacterial infections since early 1980s has led to increased rates of resistant bacteria isolated from patients. One of the problems in the treatment of nosocomial infections is related to resistant bacteria such as Enterobacter cloacae due to cross resistance through extended-spectrum beta-lactamase production. The aim of this study was to determine the prevalence of extended-spectrum beta-lactamase producing E. cloacae from different clinical specimens collected from hospitalized patients.&lt;/p&gt;

&lt;p style=&quot;text-align: justify&quot;&gt;&lt;strong&gt;Methods&lt;/strong&gt;: In the present study, 101 E. cloacae confirmed by standard specific microbiologic tests were collected from different specimens in Milad and Motahri hospitals in Tehran, Iran during February 2010 and September 2011. Antibiotic susceptibility tests were conducted according to the process recommended by the Clinical and Laboratory Standards Institute for 13 antibiotics of choice. Extended-spectrum beta-lactamase producing strains were screened for by combined disk method as a phenotypic diagnostic test.&lt;/p&gt;

&lt;p style=&quot;text-align: justify&quot;&gt;&lt;strong&gt;Results&lt;/strong&gt;: From a total of 101 E. cloacae, 33 (33%) were shown to produce extended-spectrum beta-lactamase by phenotypic tests 5% of the bacteria were resistant to imipenem too.&lt;/p&gt;

&lt;p style=&quot;text-align: justify&quot;&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: This study clearly showed the high prevalence of resistance to broad-spectrum beta-lactam antibiotics in the isolated E. cloacae among which 5% were multi drug resistant. All the isolated E. cloacae were susceptible to Colistin. These results can be alarming for physicians treating resistant E. cloacae infections, especially extended-spectrum beta-lactamase producing species.&lt;/p&gt;
</abstract>
	<keyword_fa>انتروباکترکلوآکه,بتالاکتاماز وسیع‌الطیف,مقاومت آنتی‌بیوتیکی</keyword_fa>
	<keyword>Antibiotic resistance,Enterobacter cloacae,extended-spectrum beta-lactamase</keyword>
	<start_page>183</start_page>
	<end_page>187</end_page>
	<web_url>http://tumj.tums.ac.ir/browse.php?a_code=A-10-574-2&amp;slc_lang=fa&amp;sid=1</web_url>


<author_list>
	<author>
	<first_name>Rahbar</first_name>
	<middle_name></middle_name>
	<last_name>Mohammad</last_name>
	<suffix></suffix>
	<first_name_fa>محمد</first_name_fa>
	<middle_name_fa></middle_name_fa>
	<last_name_fa>رهبر</last_name_fa>
	<suffix_fa></suffix_fa>
	<email></email>
	<code></code>
	<orcid></orcid>
	<coreauthor>No</coreauthor>
	<affiliation>Antimicrobial Resistance Research Center, Tehran University of Medical Sciences, Tehran, Iran. Department of Microbiology, Iranian Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran.</affiliation>
	<affiliation_fa>مرکز تحقیقات مقاومتهای میکروبی، دانشگاه علوم پزشکی تهران.آزمایشگاه مرجع وزارت بهداشت، درمان و آموزش پزشکی و آزمایشگاه بیمارستان میلاد</affiliation_fa>
	 </author>


	<author>
	<first_name>Azimi</first_name>
	<middle_name></middle_name>
	<last_name>Leila</last_name>
	<suffix></suffix>
	<first_name_fa>لیلا</first_name_fa>
	<middle_name_fa></middle_name_fa>
	<last_name_fa>عظیمی</last_name_fa>
	<suffix_fa></suffix_fa>
	<email></email>
	<code></code>
	<orcid></orcid>
	<coreauthor>No</coreauthor>
	<affiliation>Antimicrobial Resistance Research Center, Tehran University of Medical Sciences, Tehran, Iran</affiliation>
	<affiliation_fa>مرکز تحقیقات مقاومتهای میکروبی، دانشگاه علوم پزشکی تهران</affiliation_fa>
	 </author>


	<author>
	<first_name>Mohammad-Zadeh</first_name>
	<middle_name></middle_name>
	<last_name>Monaaranak</last_name>
	<suffix></suffix>
	<first_name_fa>مونا</first_name_fa>
	<middle_name_fa></middle_name_fa>
	<last_name_fa>محمد‌زاده</last_name_fa>
	<suffix_fa></suffix_fa>
	<email></email>
	<code></code>
	<orcid></orcid>
	<coreauthor>No</coreauthor>
	<affiliation>Department of Microbiology, Iranian Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran.</affiliation>
	<affiliation_fa>آزمایشگاه مرجع وزارت بهداشت، درمان و آموزش پزشکی و آزمایشگاه بیمارستان میلاد</affiliation_fa>
	 </author>


	<author>
	<first_name>Alinejad</first_name>
	<middle_name></middle_name>
	<last_name>Faranak</last_name>
	<suffix></suffix>
	<first_name_fa>فرانک</first_name_fa>
	<middle_name_fa></middle_name_fa>
	<last_name_fa>عالی‌نژاد</last_name_fa>
	<suffix_fa></suffix_fa>
	<email></email>
	<code></code>
	<orcid></orcid>
	<coreauthor>No</coreauthor>
	<affiliation>Microbiology Laboratory, Motahhari Hospital, Tehran University of Medical Sciences, Tehran, Iran</affiliation>
	<affiliation_fa>آزمایشگاه میکرو بشناسی بیمارستان شهید مطهری</affiliation_fa>
	 </author>


	<author>
	<first_name>Soleymanzadeh</first_name>
	<middle_name></middle_name>
	<last_name>Somayeh</last_name>
	<suffix></suffix>
	<first_name_fa>سمیه</first_name_fa>
	<middle_name_fa></middle_name_fa>
	<last_name_fa>سلیمان‌زاده مقدم</last_name_fa>
	<suffix_fa></suffix_fa>
	<email></email>
	<code></code>
	<orcid></orcid>
	<coreauthor>No</coreauthor>
	<affiliation></affiliation>
	<affiliation_fa>مرکز تحقیقات مقاومت های میکروبی، دانشگاه علوم پزشکی تهران</affiliation_fa>
	 </author>


	<author>
	<first_name>Sattarzadeh</first_name>
	<middle_name></middle_name>
	<last_name>Mahboobeh</last_name>
	<suffix></suffix>
	<first_name_fa>محبوبه</first_name_fa>
	<middle_name_fa></middle_name_fa>
	<last_name_fa>ستارزاده</last_name_fa>
	<suffix_fa></suffix_fa>
	<email></email>
	<code></code>
	<orcid></orcid>
	<coreauthor>No</coreauthor>
	<affiliation>Microbiology Laboratory, Motahhari Hospital, Tehran University of Medical Sciences, Tehran, Iran</affiliation>
	<affiliation_fa>آزمایشگاه میکرو بشناسی بیمارستان شهید مطهری</affiliation_fa>
	 </author>


	<author>
	<first_name>Rastegar Lari</first_name>
	<middle_name></middle_name>
	<last_name>Abdolaziz</last_name>
	<suffix></suffix>
	<first_name_fa>عبدالعزیز</first_name_fa>
	<middle_name_fa></middle_name_fa>
	<last_name_fa>رستگار لاری</last_name_fa>
	<suffix_fa></suffix_fa>
	<email>lari@tums.ac.ir</email>
	<code></code>
	<orcid></orcid>
	<coreauthor>Yes
</coreauthor>
	<affiliation>Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Department of Microbiology, Iranian Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran.</affiliation>
	<affiliation_fa>گروه میکرو بشناسی، دانشکده پزشکی، دانشگاه علوم پزشکی تهران آزمایشگاه مرجع وزارت بهداشت، درمان و آموزش پزشکی و آزمایشگاه بیمارستان میلاد</affiliation_fa>
	 </author>


</author_list>


	</article>
</articleset>
</journal>
