hasan shojaei | Isfahan University of Medical Sciences (original) (raw)

Papers by hasan shojaei

Isolation and molecular identification of biodegrading Mycobacteria

Journal of Medical Microbiology, 2019

Purpose. Community‐associated methicillin‐resistant Staphylococcus aureus (CA‐MRSA) has become a ... more Purpose. Community‐associated methicillin‐resistant Staphylococcus aureus (CA‐MRSA) has become a considerable public health concern in both developed and developing countries due to the rapid spread of this bacterium around the world, also the epidemiology of MRSA has changed, as the isolation of MRSA strains is not limited to health‐care settings or patients with predisposing risk factors. Therefore, the objective of this study is to determine the genetic diversity and antibiotic resistance profile of CA‐MRSA nasal carriage in Iranian children. Methodology. A cross‐sectional study was conducted from April 2013 to March 2014. A total of 25 CA‐MRSA were isolated from the anterior nares of 410 preschool children with no risk factors. All MRSA isolates were characterized by detection of the Panton‐Valentine leukocidin (pvl) and &ggr;‐hemolysin genes, staphylococcal cassette chromosome mec (SCCmec) typing and multi‐locus sequence typing (MLST). Results. In 25 CA‐MRSA isolates, Pvl and &ggr;‐hemolysin genes were detected in one (4%) and 18 (72%) isolates; respectively. Overall, 92% (23/25) of isolates belonged to SCCmec type IV and 8% (2/25) of them had SCCmec type V profile. Using MLST, the 25 isolates were grouped into six clonal complexes (CC) and eight sequence types (ST) (CC5/ST6, CC22/ST22 and ST217, CC30/ST30 and ST1107, CC78/ST859, CC398/ST291 and CC97/ST405). The ST859/SCCmec IV (11/25, 44%) was the predominant clone among the isolates. ST859‐MRSA‐IV‐pvl‐negative (resistant to tetracycline) have successfully adapted to the Iranian preschool children population. Conclusion. Our results suggest that the genomic diversity was observed among the CA‐MRSA. In addition, the current study demonstrates that pvl is not a reliable marker for CA‐MRSA in our region.

Medical mycology, 1998

The recent emergence of invasive infections due to Nocardia spp., including nosocomial outbreak, ... more The recent emergence of invasive infections due to Nocardia spp., including nosocomial outbreak, is now evident. Newer molecular diagnostic and typing methods are developed. Although sulfonamide-based therapy is generally effective, optimal treatment may be guided by antimicrobial susceptibility testing of isolates. The improved classification of nocardiae and other related genera such as actinomadurae, using the 16S ribosomal RNA sequencing, provide a sound basis for improved diagnostic methods for the identification of members of clinically significant species. The commonest cause of eumycetoma in Sudan is Madurella mycetomatis, and Streptomyces somaliensis and Actinomadura madurae for actinomycetoma. The humoral immunity response in actinomycetoma patients and in experimental mice was measured and significant titre of anti-P24 antibody was demonstrated.

Brazilian Journal of Infectious Diseases, 2011

JRSM Short Reports, 2011

This case represents the first report on the isolation of a difficult-to-identify clinical isolat... more This case represents the first report on the isolation of a difficult-to-identify clinical isolate of Mycobacterium elephantis from Asia.

Journal of Shahrekord University of Medical Sciences, 2002

از نظر تاریخی زخم های جراحی به زخم های تمیز، تمیز-آلوده و آلوده تقسیم بندی می شوند. عفونت زخم های... more از نظر تاریخی زخم های جراحی به زخم های تمیز، تمیز-آلوده و آلوده تقسیم بندی می شوند. عفونت زخم های جراحی دومین نوع عفونت های شایع اکتسابی بیمارستانی هستند که حداقل 17 این موارد را شامل می گردند. میزان عفونت در صورت تجویز آنتی بیوتیک پروفیلاکسی برای زخم های تمیز، تمیز-آلوده و آلوده بترتیب در حدود 0.8، 1.3 و 10.2 در هر یکصد بیمار گزارش گردیده است. برای ارزیابی وضعیت عفونت های بیمارستانی و نیز تخمین میزان عفونت زخم های جراحی توصیه شده است که زخم های تمیز مورد پایش قرار گیرند. لذا با در نظر گرفتن این حقیقت، بررسی حاضر با هدف تعیین میزان شیوع عفونت های زخم های تمیز، جداسازی و شناسایی گونه های شایع باکتریایی و بررسی الگوی حساسیت عوامل عفونت زا به آنتی بیوتیک ها انجام شد. همچنین رابطه عفونت با عواملی همچون سن، نوع عمل و طول مدت جراحی مورد بررسی قرار گرفت. 845 زخم جراحی تمیز یا کلاس I در طی 9 ماه از بهمن 1378 تا آبان ماه 1379 مورد برسی قرار گرفتند. میزان بروز عفونت برای زخم های جراحی تمیز 4.9 بدست آمد. از سوی دیگر، میزان عفونت در اعمال جراحی که بیش از نیم ساعت بطول انجامیده بود بیشتر از اعما...

Objective(s) Resistance to antimicrobial agents, particularly metronidazole and clarithromycin, i... more Objective(s) Resistance to antimicrobial agents, particularly metronidazole and clarithromycin, is frequently observed in Helicobacter pylori and may be associated with treatment failure. This resistance rate varies according to the population studied. The aim of this study was to assess the pattern of antimicrobial resistance of H. pylori isolates from dyspeptic patients in Isfahan. Materials and Methods Antral gastric biopsies from 230 dyspeptic patients were cultured. Susceptibility testing to commonly used antibiotics performed on pure cultures of 80 H. pylori-positive isolates by Modified Disk Diffusion Method (MDDM). Genomic DNA extracted and subjected for study of entire genomic pattern using Random Amplified Polymorphic DNA- Polymerase Chain Reaction (RAPD-PCR). Results The overall rates of primary resistance were 30.0%, 8.75%, 6.25%, 3.75%, 3.75%, and 2.50% for metronidazole, ciprofloxacin, clarithromycin, azithromycin, tetracycline, and amoxicillin, respectively. Multiple ...

Iranian Journal of Microbiology, 2014

Background and objectives Some microorganisms, mainly members of two genera including Pseudomonas... more Background and objectives Some microorganisms, mainly members of two genera including Pseudomonas and Mycobacterium, were found to be capable of transforming and degrading of polluting agents. We herein report the isolation of a few mycobacteria with the ability to biodegrade organic and inorganic compounds from water supplies of Iranian hospitals. Materials and methods The water samples were collected from hospital water supplies. Isolation processes were done according to standard methods. The colonies were subcultured on Löwenstein-Jensen medium to obtain a pure culture. The identification and characterization of the isolates were based on conventional and molecular methods including direct sequence analysis of almost full length of 16S rRNA gene. Results The almost complete 16S rRNA gene sequences of the studied strains revealed that the isolates WP16, AW18-1 and AW18-3 were identified as M. fredriksbergense, AW18-2 as M. austroafricanum, AW27-2 as M. obuenseand AW27-6 as M. pho...

Iranian Journal of Medical Microbiology, 2016

IJMM 2016; 10(2): 01-15 Tuberculosis is one of the most important infectious diseases during the ... more IJMM 2016; 10(2): 01-15 Tuberculosis is one of the most important infectious diseases during the history of humans’ life, various societies always have been trying to control and struggle against this disease. Tuberculosis could be controlled by Koch's discovery of the tubercle bacillus as etiologic agent and the discovery of Bacillus Calmette–Guérin (BCG) vaccine all around the world. In fact, it had been assumed Tuberculosis could ultimately be eradicated, however any possible global control of tuberculosis will be destroyed in the near future because of the existence of tolerant strains, the worldwide distribution of the disease, as well as the emergence of the AIDS epidemic. The fact that one-third of the world's population is infected with M. tuberculosis which can consider as a reservoir of infection. This issue has become even more complicated now since non-tuberculous Mycobacteria (NTM) is indistinguishable than tuberculous mycobacteria because they are environmental...

It is difficult to distinguish between clinically significant slowly -growing, non-pigmented myco... more It is difficult to distinguish between clinically significant slowly -growing, non-pigmented mycobacteria, notably to separate M. aviumand M. intracellulare from one another and from M. scrofulaceum strains. The purpose of this study was to evaluate the ext ent to which 16S rRNA sequencing could be used to highlight the taxonomic relationships of the mycobacterial strains, which are difficult to separate using conventional microbiologic methods. Almost the complete sequences of the 16S rRNA of several M. avium-intracellulare complex strains were determined following the isolation and direct sequencing of the amplified genes. The sequences were aligned with those of previously studied mycobacteria, and phylogenetic trees inferred by using the Fitch -Magoliash, neighbour-joining and maximum parsimony methods. It is evident from the result of the current study that the nucleotide signature regions of 16S rRNA provide valuable information for the differentiation of M.avium-intracellular...

Giriş: Çevresel insan enfeksiyonu kaynağı olarak son zamanlarda giderek artan düzeyde dikkat çeke... more Giriş: Çevresel insan enfeksiyonu kaynağı olarak son zamanlarda giderek artan düzeyde dikkat çeken ve toplamda 150'den fazla türü olan nontüberküloz mikobakterilere (NTM) verilen önem artmaktadır. Bu çalışmanın amacı, İran'ın kuzeydoğusunda çevresel NTM türlerini izole etmek ve tanımlamaktı. Gereç ve Yöntem: Razavi Horasan eyaletinin 73 şehrindeki içme suyu dağıtım ağları ve su kaynaklarından toplanan 344 su örneği kültür yoluyla incelendi. Nontüberküloz mikobakteriler tanımlaması ayrıca hsp65 geninin polimeraz zincir reaksiyonu amplifikasyonu, sekanslama ve veri analizi yoluyla da yapıldı. İstatistiksel analiz, SPSS 16.0 kullanılarak Pearson korelasyon katsayısı testi ve iki örnek t-testi ile yapıldı. istatistiksel anlamlılık seviyesi 0,05 olarak belirlendi. Bulgular: Nontüberküloz mikobakteriler, kültürde su örneklerinin %10,46'sında (36/244) tespit edilmiştir. En yaygın NTM türü Mycobacterium gordonae (13/36) olarak belirlenmiştir. Diğer saptanan türler M.

Background and Objective Over 165 million cases of shigellosis occur in the world each year, most... more Background and Objective Over 165 million cases of shigellosis occur in the world each year, mostly in developing countries. Outbreaks of shigellosis are associated with poor sanitation, natural calamities, contaminated food and crowded living conditions. In late summer 2006, during the final stage of an outbreak of shigellosis at a vast region of Isfahan province, Naein & Ardestan, our laboratory was assigned to investigate the outbreak in order to determine the causative agent. Materials and Methods A total of 146 rectal swabs which had been collected from the patients by local laboratories on separate days were screened using a battery of conventional and molecular tests. Results Thirteen specimens tested positive for Shigella spp. They were identified as S. sonnei (6, 46.1%), S. dysenteriae (4, 30.8%), S. flexneri (2, 15.4%) and Shigella spp (1, 7.7%) by conventional and molecular microbiological tests. According to ribotyping results the isolates were grouped into 3 distinct cl...

Iranian biomedical journal, 1999

Materials and Methods: The characteristics of isolates were determined using standard phenotypic ... more Materials and Methods: The characteristics of isolates were determined using standard phenotypic profiles including colony morphology, Gram staining, catalase, hyaluronidase, coagulase and Dnase tests as well as mannitol fermentation. The MRSA detection was carried out according to CLSI guidelines with oxacillin agar screen test. Methicillin resistance was further confirmed by detection of a 310 bp fragment of mecA gene of MRSA by PCR. Drug susceptibility testing to antibiotics other than methicillin was conducted by disk diffusion. The Beta-lactamase production and inducible clindamycin resistance were also determined by performing the double-disc diffusion and D-test.

JMM Case Reports

Introduction. Nocardia are Gram-positive partially acid-fast bacilli capable of inducing a wide r... more Introduction. Nocardia are Gram-positive partially acid-fast bacilli capable of inducing a wide range of infections in patients with immunodeficiency, AIDS, cancer, lupus erythematous and diabetes. Nocardia cyriacigeorgica was first isolated in 2001 from a patient with chronic bronchitis. Since then, there have been reports on the clinical significance of this organism in patients with bronchitis, brain abscess and lung diseases. We, herein, report a case of brain abscess in an elderly diabetic patient from Iran. Case presentation. The patient was a 73 year-old woman admitted to hospital due to severe headache and shortness of breath. The patient had lived with diabetes for 20 years and suffered from chronic foot ulcer. She was admitted to hospital with fever, weakness, drowsiness and vomiting. Clinical examination and the head CT scan of the left frontal lobe of the brain revealed a metastatic carcinoma involving skull bone in the tumor that resulted in two surgical operations in the following two years. The brain abscess biopsy revealed an infection with Nocardia cyriacigeorgica confirmed by phenotypic and molecular tests including a PCR-based amplification of a target genetic marker, a 596 bp fragment of 16S rRNA gene, followed by almost full 16S rRNA sequencing. Conclusion. The rare infections, such as brain abscess with Nocardia, are easily neglected or misdiagnosed due to the fastidious nature of the organism and inadequate microbiological experience of laboratories in the hospitals of developing countries. This case shows that hospitals should consider a better laboratory protocol to deal with the clinical cases in which fastidious organisms, and in particular Nocardia, are involved.

BMC Infectious Diseases

Background: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that is widely identif... more Background: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that is widely identified worldwide. This study aimed to investigate the phenotypic characterization and molecular typing of Clostridium difficile isolates among patients with UC at an inflammatory bowel disease clinic in Iran. Methods: In this cross-sectional study, conducted from April 2015 to December 2015, 85 UC patients were assessed for C.difficile infection (CDI). C. difficile isolates were characterized based on their toxin profile and antimicrobial resistance pattern. Multi-locus sequence typing analysis (MLST) and PCR ribotyping were performed to define the genetic relationships between different lineages of toxigenic strains. Results: The prevalence of C. difficile isolates was 31.8% (27/85) in patients, of those 15 patients (17.6%) had CDI. Three different sequence types (STs) identified based on MLST among the toxigenic isolates, that is ST54 (33.3%), ST2 (53.3%), and ST37 (13.6%). C. difficile strains were divided into four different PCR-ribotypes (012, 014, 017 and IR1). The most common ribotype was 014 accounting for 48.3% (7/15) of all strains. The strains isolated during the first episode and recurrence of CDI usually belonged to PCR ribotype 014 (ST2). A high rate of CDI recurrence (14.1%, 12/85) experienced in UC patients. Colonization of the gastrointestinal tract with non-toxigenic C. difficile strains was frequent among patients with mild disease. All C. difficile isolates were susceptible to metronidazole, and vancomycin, 86 and 67% of isolates were resistant to clindamycin and erythromycin respectively. There was no correlation between the toxin type and antibiotic resistance (p > 0.05). Conclusion: Overall CDI is rather prevalent in UC patients. All patients with CDI experienced moderate to severe disease and exposed to different antimicrobial and anti-inflammatory agents. Close monitoring and appropriate management including early detection and fast treatment of CDI will improve UC outcomes.

The Open Microbiology Journal

Background: Tuberculosis is one of the most important infectious diseases that has claimed its vi... more Background: Tuberculosis is one of the most important infectious diseases that has claimed its victims throughout much of known human history. With Koch's discovery of the tubercle bacillus as the etiologic agent of the disease, his sanitary and hygienic measures, which were based on his discovery and the development of a vaccine against tuberculosis by Albert Calmette and Camille Guérin in 1921, an attenuated Mycobacterium bovis strain, bacilli Calmette-Guérin (BCG), and the discovery of the first antibiotic against tuberculosis, streptomycin by Selman Waksman in 1943, soon led to the opinion that appropriate control measures had become available for tuberculosis and it had been assumed that the disease could ultimately be eradicated. The emergence of resistant strains of this bacteria and widespread distribution of the disease in the world, and the emergence of the AIDS epidemic destroyed any possibility of global control of tuberculosis in the foreseeable future. Objectives: ...

Antimicrobial Resistance & Infection Control

Background: Clostridium difficile infection (CDI) is known as one of the most important causes of... more Background: Clostridium difficile infection (CDI) is known as one of the most important causes of nosocomial infections. The main objective of this study was to evaluate the presence of Clostridium difficile in the stool of hospitalized patients with diarrhea as well as in their environments. Methods: C. difficile isolates were characterized according to the presence of toxin genes and antibiotic resistance. Multilocus Sequence Typing Analysis (MLST) was applied for finding the genetic polymorphism and relationship among strain lineages. Results: A total of 821 samples (574 stools and 247 swabs) were collected between April 2015 and May 2017. The prevalence of C. difficile isolates was 28.6% (164/574) in patients and 19% (47/247) in swabs taken from medical devices, hands of healthcare workers and skin patient sites. Finally, 11.5% (66/574) toxigenic C. difficile strains isolated from stool samples of inpatients and 4.4% (11/247) from hands of healthcare workers and skin patient sites. All the toxigenic isolates were inhibited by a low concentration of vancomycin (MIC < 0.5 μg/ml). About 43% (33/77) and 39% of isolates were resistant to Clindamycin and moxifloxacin respectively. All isolates were susceptible to metronidazole. Toxigenic C. difficile strains were analyzed by MLST and were divided into 4 different STs. The detected types were ST-54 (57.9%), followed by ST-2 (31.6. %), ST-15 (5.3%) and ST-37 (5.3%), while none of the isolates were identified as ST-1 or ST-11. Significant risk factors for CDI appear to be advanced age, undergoing chemotherapy, previous surgery, and residence in the nursing home. Conclusions: CDI is common in Iran and further studies are recommended to monitor its epidemiological variations. Moreover, greater attempts must be made to encourage antibiotic stewardship by healthcare workers and the public.

AMB Express

Anthropogenic origin pollutants including pesticides, heavy metals, pharmaceuticals and industry ... more Anthropogenic origin pollutants including pesticides, heavy metals, pharmaceuticals and industry chemicals impose many risks to human health and environment and bioremediation has been considered the strategy of choice to reduce the risk of hazardous chemicals. In the current study, we aimed to screen and characterize mycobacteria from the diverse range of Iranian aquatic and terrestrial ecosystems with harsh and unfavorable environmental conditions that can be utilized for biodegradation of target pollutants. Mycobacteria were isolated from a collection of 90 environmental samples and identified to the species level using conventional microbiological and molecular methods including the PCR amplification of hsp65 and sequence analysis of, 16S rRNA genetic markers. The growth rate of the isolates in presence of pollutants, chromatography, Gibbs and turbidometric methods were used to assess their biodegradation activity. A total of 39 mycobacterial isolates (43.3%) were recovered from 90 samples that belonged to 21 various species consisting of M. fortuitum; 6 isolates, M. flavescens and M. paragordonae; 4 isolates each, M. monacense, M. fredriksbergense and M. aurum; 2 isolates each, 7 single isolates of M. conceptionense, M. porcinum, M. simiae, M. celeriflavum, M. novocastrense, M. neoaurum, M. obuense and 12 isolates that belonged to 8 unknown potentially novel mycobacterial species. The isolates were categorized in three groups based on their bioremediation activity, i.e., 5 (12.8%) organisms without biodegradation activity, 20 (51.2%) organisms with previously reported biodegradation activity, and 14 (35.9%) organisms that showed biodegradation activity but not previously reported. Our results showed that the Iranian ecosystems harbor a good reservoir of diverse mycobacterial species with biodegrading potentiality for neutralizing environmental chemical pollutants.