فهرست مطالب

Archives of Clinical Infectious Diseases
Volume:9 Issue: 2, Apr 2014

  • تاریخ انتشار: 1393/06/15
  • تعداد عناوین: 8
|
  • Tabassom Mirzaei, Masoud Alebouyeh *, Leila Shokrzadeh, Hamid Asadzadeh Aghdaei, Nasataran Farzi, Homayoun Zojaji, Mohammad Reza Zali Page 1
    Background
    Helicobacter pylori diagnostic tests can be affected by different interventional factors. We studied the effects of smoking, proton pump inhibitors (PPIs) and antibiotic administration on results of the bacterial culture, and its diagnosis tests due to polymerase chain reaction (PCR) and rapid urease test (RUT) methods..
    Objectives
    This study was aimed to investigate the undesirable effects of PPI and antibiotics on the results of H. pylori screening tests in patients with gastritis..Patients and
    Methods
    A total of 100 patients with gastritis and indication for upper gastrointestinal (GI) endoscopy were enrolled in this study. Three biopsy samples from each patient were immediately processed for detection of H. pylori based on culture, RUT, and PCR methods. The sensitivity of these three detection methods was measured in the three infected patients groups that were subjected to conventional therapy, proton pump inhibitors (PPIs) therapy, and no medication as control group. The possible effects of PPIs and antibiotics on H. pylori detection were analyzed in vitro..
    Results
    The prevalence of H. pylori infection was higher among the non users and PPI users (40% and 57.9%, respectively), while the number of isolated bacteria from the patients with a history of recent antibiotic prescription was significantly lower (18.75%) (P <0.05). An inverse association was found between H. pylori infection and smoking. Among the studied methods, PCR showed the highest sensitivity in all groups. The results of RUT illustrated a significant difference between the PPI users and patients with a history of recent antibiotic administration that was consistent with the results of in vitro study (P = 0.01)..
    Conclusions
    This study revealed a lower sensitivity of common H. pylori screening tests during the antibiotic or PPI administration. PCR was determined as the most accurate test used for diagnosis of H. pylori infections..
    Keywords: Helicobacter pylori, Smoking, Proton Pump Inhibitors, Antibacterial Agents
  • Zahra Abdi, Fereshte Ghiasvand *, Seyed Ali Dehghan Manshadi Page 2
    Introduction
    Tuberculosis of the foot is an unusual type of skeletal tuberculosis..
    Case Presentation
    We report on an eighty-six-year-old woman, who presented pain and purulent discharge from the right foot for 10 months. The final diagnosis was confirmed with a culture of Mycobacterium tuberculosis..
    Discussion
    Diagnosis of this form of tuberculosis is established with some delay due to the uncommon site of involvement, lack of awareness about the condition and its ability to mimic other disorders. Diagnosis and appropriate treatment can often be delayed, which may lead to significant consequences for the patient. Our case was treated with anti-tuberculin medications for nine months and conservative management of the bony lesions resulting complete resolution of symptoms..
    Keywords: Tuberculosis, Osteomyelitis, Foot
  • Ebrahim Badparva, Hassan Nayebzadeh *, Malek Hossein Barkhordari, Behrouz Ezatpour Page 3
    Background
    Strongyloides stercoralis causes strongyloidiasis, one of the major parasitic infections in human worldwide..
    Objectives
    This study was carried out to examine the prevalence of S. stercoralis in the state of Lorestan, west of Iran, using a comparative diagnostic approach..
    Materials And Methods
    Stool specimens from a random population sample were examined with light microscope, using direct fecal smear, formalin-ether concentration, and nutrient agar plate culture..
    Results
    The prevalence of S. stercoralis in this study was 0.07%. The statistical random sample in this study was 2839 people whose stool specimens were collected and examined using nutrient agar plate culture. The results showed only two infected persons. The same procedure was administered using direct fecal smear and formalin-ether concentration, which showed no result..
    Conclusions
    As a precautionary measure, a stool test based on nutrient agar plate culture is recommended for detection of S. stercoralis..
    Keywords: Strongyloides stercoralis, Prevalence, Feces
  • Abdolmajid Ghasemian, Shahin Najar Peerayeh *, Bita Bakhshi, Mohsen Mirzaee Page 4
    Background
    Staphylococcus aureus is one of the most important agents causing nosocomial infections. Inducible clindamycin resistance is an important concern, because, common laboratory tests could not detect it..
    Objectives
    The aim of this study was to detect the inducible clindamycin resistance by D-test method..
    Materials And Methods
    A total of 209 clinical S. aureus isolates were collected and identified by conventional phenotypic tests. Antibiotic susceptibility pattern was detected by disc diffusion method. D-test was done using clindamycin (2 μg) and erythromycin (15 μg) discs according to the protocols of Clinical and Laboratory Standards Institute (CLSI). To detect methicillin resistant Staphylococcus aureus (MRSA), oxacillin disc was used and the results were confirmed by detection of mecA gene..
    Results
    Of all 209 clinical S. aureus isolates, 207 (99%) were resistant to amoxicillin. All isolates were susceptible to vancomycin and linezolid. The rate of clindamycin inducible resistance was 4% (n = 8). This phenotype was not observed in MRSA strains. There was no significant difference between methicillin resistant and susceptible strains. Resistance to clindamycin and erythromycin was higher in MRSA strains. D+ phenotype was detected in 1 (1%) of all isolates. Methicillin resistance was detected in 66 (32%) isolates by oxacillin disc and mecA gene was detected by PCR..
    Conclusions
    In our study, inducible clindamycin resistance rate was 4%; so it is necessary to conduct D-test regularly by disc diffusion for this bacterium. Resistance to erythromycin, clindamycin, ciprofloxacin and gentamicin was significantly higher in MRSA isolates than methicillin susceptible Staphylococcus aureus (MSSA), although the methicillin resistance prevalence was low..
    Keywords: Staphylococcus aureus, Methicillin, Resistant Staphylococcus aureus, D, test, Inducible Clindamycin Resistance
  • Mohammad Yasin *, Nina Gozali Asl, Amirhossein Moghhtader Mojdehi, Masoud Mardani, Kamran Akbarzadeh Page 5
    Introduction
    Wound myiasis is one of the common types of myiasis that demonstrates obligatory parasitic behavior..
    Case Presentation
    A 62-year-old homeless man presented with an abnormally growing and ruptured neck mass containing worms. He had wound myiasis caused by the larva of Lucilia sericata in his previously punctured neck..
    Discussion
    Lucilia sericata can cause both facultative and obligatory myiasis. Immunocompromised patients with diabetes, malignancies, and patients without any kind of nursery are at risk of wound myiasis. In addition, aggressive treatment is needed to prevent the secondary infections in case of obligatory infestation..
    Keywords: Myiasis, Ectoparasitic Infestations, Wound, Lucilia sericata
  • Mohammad Jobayer *, Sm Shamsuzzaman, Kazi Zulfiquer Mamun Page 7
    Background
    Tuberculosis (TB) is a curable infectious disease yet the leading cause of death worldwide and in Bangladesh it is responsible for 7% of total deaths every year..
    Objectives
    This cross sectional study was conducted to isolate and identify Mycobacterium tuberculosis from sputum and to evaluate the efficacy of polymerase chain reaction (PCR) for the early diagnosis of pulmonary tuberculosis..Patients and
    Methods
    A total of 150 clinically suspected pulmonary TB patients (male/female: 97/53; age: 31.9 ±9.8 years) were enrolled in this study. Freshly passed single morning sputum was collected from each patient and diagnostic efficacy of PCR was compared with staining and culture methods..
    Results
    Among 150 sputum samples, 25 (16.7%) were positive by Ziehl-Neelsen (ZN) stain, 37 (24.7%) yielded growth in Lowenstein-Jensen (LJ) media and 45 (30%) were positive by PCR. Of the 37 isolated Mycobacteria in culture, 36 were M. tuberculosis and one was identified as non-tuberculous Mycobacterium by PCR and biochemical tests. The mean detection time was 26.9 days for the culture and 12 hours for the PCR method. Considering the culture method as the gold standard, the sensitivity of PCR was 97.3% and specificity was 92% with accuracy of 93.3%. Twenty-one (16.8%) smear negative cases and nine (7.9%) culture negative samples were positive by the PCR method..
    Conclusions
    PCR was the most sensitive, accurate and rapid method for diagnosis of TB. It was concluded that, for the diagnosis of pulmonary tuberculosis, PCR directly from sputum may be recommended in Bangladesh, especially in suspected tuberculosis patients who remain negative by conventional methods..
    Keywords: Bangladesh, Mycobacterium tuberculosis, Polymerase Chain Reaction, Tuberculosis, Pulmonary
  • Gita Eslami, Soudabeh Taheri *, Hosein Goudarzi, Somayeh Alavi, Bita Pourkaveh Page 8
    Background
    In spite of many advantages of modern medicine in comparison with traditional treatments, chemical therapeutic agents have side effects. Pistachio skin extract has antibacterial effects, but side effect has not been reported.
    Objectives
    The aim of this study was to compare the effects of pistachio skin extract with that of antibiotics such as amoxicillin, tetracycline, cefixime and ciprofloxacin, on enteric bacteria collected from patients with gastroenteritis..Patients and
    Methods
    Experimental method was used for this study. One hundred samples were taken from patients with gastroenteritis; then, the samples were characterized and the diagnosis was made. The pistachios internal soft skin extracts were obtained, using the decoction method and water as the solvent. Afterwards, the solution was crystallized and placed on 37ºC and its water has been evaporated. The solution required two days for the entire water loss process. Antibacterial effect of the extract was analyzed with the disc diffusion method using Mueller-Hinton agar medium. After steeping the blank disc in the extract, bacteria reached 0.5 McFarland density, were cultured on plates with four antibiotic discs including amoxicillin, tetracycline, cefixime and ciprofloxacin. Next, depending on the type of bacteria, the inhibition zones were compared to determine the antibiotic inhibitory effects. Statistical analysis for comparing the antibiotics and pistachio skin extract effects was performed using chi-square tests..
    Results
    Shigella with 19% sensitivity and 1% resistance had the highest sensitivity and the lowest resistance to each of the antibiotics, including tetracycline, amoxicillin and ciprofloxacin; this difference was statistically significant (P < 0.05). The results showed that Escherichia coli with 13.6 mL sensitivity and 6.4 mL resistancy was the bacteria, for which antibiotics were least effective (amoxicillin: P = 0.000, tetracycline: P = 0.049, cefixime: P = 0.000); this finding was statistically significant (P < 0.05)..
    Conclusions
    Regarding the natural therapeutic effects of pistachio skin extract and obligations of the routine antibiotics such as resistancy, using pistachio extract as a co-therapeutical agent with ordinary antibiotics can enhance the success rate of the treatment..
    Keywords: Enteric Bacteria, Pistachio Skin Extract, Antibiotics