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Background & Objective: Urinary tract infections (UTI) are regarded as one of the most common infectious diseases. A remarkable percent of urinary tract infections are asymptomatic. In some cases of urinary tract infections, significant bacteriuria is not present. One the etiologic agents of culture negative genitourinary tract infections, which can be transmitted through intercourse, is Chlamydia Trachomatis. On the basis of high incidence of negative results of urine culture (Up to 60%) in patients suffering from UTI referring to Bou-Ali infectious hospital and taking into consideration the importance of genitourinary Chlamydial infections, we decided to study prevalence of Chlamydia Trachomatis in urine sample of patients with UTI referring to this hospital. Materials & Methods: This research was a descriptive study on the 320 patients referring to Bou-Ali infectious hospital in Zahedan, which were chosen by non-randomized sampling. One early morning urine sample was taken from these patients. After centrifugation, sediment of samples was used as antigen for Chlamy-check-I ELISA kits. Results: Out of 320 urinary specimens, 95 specimens (29.69%) were positive and 225 specimen (70.31%) were negative for Chlamydia Trachomatis. From 95 positive samples, 43 person (45.2%) were male and 52 person (54.73) were female. In both sexes the highest percent was related to 20-29 years old group. Conclusion: In accordance with above reported prevalence rate and bearing in mind the consequences of inappropriate treatment of Chlamydial infections (PID, infertility, extra uterus pregnancy, epididiomitis) the importance of precise treatment of Chlamydial infection and necessity of providing laboratory facilities for accurate and rapid diagnosis of Chlamydial infections in the area with high incidence of culture negative urine specimens is recommended.

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Background and Objective: Hematuria is one of the common causes of pediatric nephrology and urology diseases and is reported in 0.5-2% of children. This study was performed to determine the causes of hematuria in infants and children. Methods: This descriptive study was done on 200 infants, children and adolescents in one month to 18 year old ages with chief complaint of hematuria in Hamadan, Iran. Patients were evaluated by urinalysis, urine culture, measurement of calcium, creatinine and uric acid in random urine sample and abdominal sonography. Results: Microscopic and gross hematuria was detected in 79.5% and 20.5% of patients, respectively. Hematuria was idiopathic in 74 (37%) of patients. Urinary tract stones (18%), urinary tract infections (15.5%), hypercalciuria (13%), hyperuricosuria (10%), urinary tract anomalies (5.5%) and glomerulonephritis (1%) were diagnosed as causes of hematuria. Conclusion: In 56% of patients, hematuria was caused by three common etiologies of stone, urinary tract infections and crystalluria.

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Background and Objective: Urinary tract infection is the second common bacterial infection in children. Constipation as a risk factor in urinary tract infection was reported by several studies. This study was carried out to evaluate the relationship between rectal diameter and constipation with urinary tract infections in children. Methods: This case – control study was performed on 40, 2-12 years old hospitalized children with urinary tract infections as cases and 40 healthy children with the same age as controls in Boali Hospital in Sari, Iran. Rectal diameter was measured by ultrasonography. Demographic characteristics, rectal diameter, during of infectious and disease clinical signs were recorded for each subject. Results: Constipation was observed in 62.5% and 17.5% of cases and controls, respectively (P<0.05). Rectal diameter was 47.64 mm and 26.48 mm in case and control groups, respectively (P<0.05). Conclusion: Regarding to increasing of rectal diameter in patients with urinary tract infections in comparison with healthy subjects, ultrasonography can be a reliable method either to confirm or reject the presence of constipation in urinary tract infections.

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Background and Objective: Imperforate anus is a common anorectal malformation, which is associated with other anomalies. This study was done to determine the associated malformations in newborns with imperforate anus in northern Iran. Methods: This descriptive study was carried out on 40 hospitalized newborns (24 boys and 16 girls) with imperforate anus in Taleghani teaching hospital in Gorgan, northern Iran during 2006-10. Results: From 40 newborns with imperforate anus, 23 newborns (57.5%) had associated anomalies. The commonest associated anomalies was genitourinary (65.2%) followed by heart (47.8%), gastrointestinal (13%) and musculoskeletal anomalies (8.7%). Conclusion: Associated anomalies in newborns with imperforate anus in northern Iran have a high prevalence in comparison with other reports.

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Background and Objective: Uropathogenic strains of Escherichia coli (UPEC) are the most common cause of urinary tract infections. UPEC strains possess an arsenal of virulence factors including fimH, iucD, iroN and hlyA which increase their ability to cause urinary tract infections. This study was done to determine the relationship between phylogenetic group and distribution of virulence genes of Escherichia coli isolated from patients with urinary tract infection. Methods: This descriptive - analytic study was performed on 100 isolates Escherichia coli which collected from patients with UTIs. DNA was extracted from all isolates by the boiling method and subsequently DNA was used to determine the presence of genes encoding virulence factors by Multiplex-PCR. In addition, determination of phylogenetic group, A, B1, B2 and D, was performed by determination of present or absent of of yjaA and chuA genes and DNA fragment TSPE4.C2 using Triple-PCR. Results: The frequency of virulence factors, fimH, iucD, iroN and hlyA were 95%, 69%, 29% and 32%, respectively. In all isolates, the frequency of phylogeny of groups A, B1, B2 and D were 17%, 6%, 55% and 22%, respectively. A significant correlation was found between the presence of virulence encoding genes and the B2 phylogenetic group (P<0.05). Conclusion: Virulence genes were common in phylogenetic group B2 isolates among all phylogenetic groups.

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Background and Objective: Beta-lactamase enzymes are the most important resistance factors among Gram-negative bacteria to the beta-lactam group of antibiotics. This study was conducted to determine the prevalence of extended-spectrum beta-lactamases (ESBL) in Escherichia coli isolates using PCR method.

Methods: This descriptive – analytic study was conducted on 120 Escherichia coli samples isolated in hospitals in Sari in northern Iran during 2013. Antibiogram was conducted using combined disk method to determine the sample resistance. The presence of β- lactamase gene of CTX-M-15 in ESBL was assessed using PCR method.

Results: Out of 120 Escherichia coli, 98 (81.6%), 15 (12.5%) and 7 (5.8%) bacteria isolated from urinary tract, blood and wound, respectively. Multiple drug resistance were seen in 98% of urine samples, 12.7% of blood samples and 3.6% of wound samples (P<0.05). 18.3% of multiple drug resistance samples were positive for CTX-M-15 β -lactamases resistance gene. The probable presence of CTX-M-15 were detected in blood sample (20%), urine sample and wounds (14.3%) (P<0.05).

Conclusion: Beta-lactamase enzymes were detected in high percent of Escherichia coli isolated from urine samples.

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Background and Objective: Production of beta-lactamase enzymes is the most common mechanism of bacterial resistance against beta-lactam antibiotics. The aim of this study was to determine the antibiotic resistance pattern and the frequency of AmpC genes in Escherichia coli (E.coli) isolated in outpatients.
Methods: In this descriptive-analytical study, 67 isolates of E.coli were investigated from urinary tract infection of outpatients of the largest medical center in Kermanshah, west of Iran. Their susceptibility to ceftriaxone, cefotaxime, ceftazidime, cefoxitin and imipenem antibiotics was determined using disk diffusion. AmpC phenotypic screening was performed using combination disk method (cefoxitin with and without boronic acid). After extraction the bacterial genome, the presence of MOX, CIT, DHA, ACC, EBC and FOX genes were tested by multiplex PCR.
Results: The resistance of 67 E.coli isolated to ceftriaxone, cefotaxime, ceftazidime and cefoxitin was 49.2%, 49.2%, 37.3% and 25.3%, respectively. The 100% of the isolates were sensitive to imipenem. Seventeen (25.3%) and 9 isolates (13.4%) were phenotypically and genotypically positive for AmpC, respectively. The prevalence of CIT, MOX, FOX, DHA and EBC genes was 7.4%, 5.9%, 4.4%, 4.4% and 2.9%, respectively. However, the ACC gene was not found in isolates. Except for significant correlation between AmpC phenotype and MOX gene (P<0.05), no significant statistical relationship was found between phenotype and AmpC genotype. There was a significant correlation between AmpC phenotype and ceftazidime antibiotic (P<0.05). There was a significant correlation between CIT gene and EBC and FOX (P<0.05).
Conclusion: AmpC-producing E.coli isolates cause significant resistance to cephalosporins. One of the current therapeutic options is using of carbapenems. However, the relatively high prevalence and synergistic genes of AmpC in outpatients are a big concern and unfortunately it reflects the fact that these isolates are prevalent in the society.