فهرست مطالب
Archives of Clinical Infectious Diseases
Volume:10 Issue: 2, Apr 2015
- تاریخ انتشار: 1394/02/26
- تعداد عناوین: 8
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Page 1BackgroundExtended spectrum β-lactamases (ESBLs) have emerged as a major threat worldwide, with limited treatment options available..ObjectivesThe present study aimed to estimate the prevalence, possible types of ESBL genes and antibiotic resistant patterns of ESBL-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae)..Materials And MethodsA total of 199 clinical isolates of E. coli and K. pneumoniae, collected between October 2010 to March 2012, at three University Hospitals in Aleppo city center, in north Syria, were examined phenotypically and genotypically for ESBL production..ResultsThe ESBLs were found in (62.89%) of E. coli and (67.5%) of K. pneumoniae isolates. The majority of the typeable isolates harbored two or more ESBL genes (73%). Overall, blaCTX-M-1 was the commonest genotype (81.74%). Resistances of ESBL isolates to other antibiotics were measured: tremithoprim/sulfamethoxazole (72%), nalidixic acid (72%), tetracycline (66%), gentamicin (54%) and ciprofloxacin (53%)..ConclusionsOur study showed high ESBL incidence, with CTX-M genotype as the emerging strain in our hospitals. High co-resistance to other non-β-lactam antibiotics is a major challenge for the management of ESBL infections..Keywords: Escherichia coli, Klebsiella, beta, Lactamase, Antibiotic Resistance, Bacterial
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Page 2BackgroundBrucellosis still remains a major health problem with different symptoms and various diagnostic methods. Diagnostic methods of brucellosis are usually based on detecting specific antibodies in the patient’s serum. Nowadays, many serological tests are applied for the diagnosis of human brucellosis. Most routine tests are serum agglutination tests based on Wright and 2-Mercaptoethanol (2-ME)..ObjectivesThe aim of this study (cross sectional study) was to evaluate the prevalence of brucellosis and assess the degree of agreement among serum samples of suspected brucellosis serological tests routinely performed in Mashhad, Iran..Patients andMethodsThis study was conducted in Mashhad from August 2011 to September 2012. Sera (2 - 3 mL) were collected from 83 cases suspected of brucellosis among 594 patients. Ten serum samples were collected from healthy subjects as control sera. Rose Bengal test for initial screening and Wright and 2 ME as standard tests were conducted to determine antibody titers. Thereafter, IgG and IgM levels were determined by the Enzyme Linked Immunosorbent Assay (ELISA) method..ResultsAmong 83 serum samples, Rose Bengal test was able to identify 20 (12%) positive specimens; the standard tube agglutination test was able to detect 30 (18%) positive samples, and the ELISA IgG and ELISA IgM were able to trace 42 (21%) and 13 (6.5%) positive samples, respectively. Ten control samples had negative results for the ELISA method. The results were calculated by the Kappa formula. The highest level of agreement was among 1 = KRB-SAT tests and the lowest level of agreement was among tests K ELISA IgM-IgG = 0.30..ConclusionsAccording to the results, brucellosis has remained endemic in this region. Most cases were detected by ELISA IgG. The highest kappa agreements were between tests KRB-SAT, KRB-IgG and KSAT-IgG, while the lowest levels of agreement were between tests SAT-IgM and ELISA IgM-IgG. Considering that ELISA IgM results are covered by SAT and ELISA IgG test results, applications of this test do not seem necessary..Keywords: 2, Mercaptoethanol, Enzyme, Linked Immunosorbent Assay, Agglutination, Brucella
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Page 3Introductio: Dengue fever is the world’s most important hemorrhagic fever, especially in America, Pacific islands, and Asia. In countries like ours where viral hepatitis, malaria, enteric fever are common; it represents a challenge to identify the etiology of acute fever complicated by hepatitis..Case PresentationWe report a case of acute hepatitis in a 7-year-old male with dengue hemorrhagic fever. The child responded to IV fluids and symptomatic treatment..ConclusionsDengue fever should be considered, when liver functions are deranged, because they are potential candidates for acute fulminant hepatic failure apart from routine hepatotropic viruses. We would like to emphasize the importance of considering dengue infection in the differential diagnosis of acute hepatitis in children in developing countries like India..Keywords: Dengue, Hepatitis, Jaundice
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Page 4BackgroundPolycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in 4% - 6% of women in the reproductive age and is a common cause of infertility. Even though the number of investigations is scarce, studies show that Helicobacter pylori infection may influence reproduction..ObjectivesThe purpose of this study was to determine and compare the levels of H. pylori specific antibodies IgA, IgG and anti-CagA at both PCOS and non-PCOS women with their spouses using the serological test..Patients andMethodsIn this cross-sectional study, 127 women with their spouses (age range, 30 - 60 years) were selected. These patient were referred to infertility center of Shariati Hospital in Tehran, Iran, with a diagnostic criteria of PCOS based on Androgen Excess Society (AES). The specific antibodies of IgA, IgG and anti-CagA were measured using the commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit..ResultsThe positive titers of H. pylori antibodies IgA, IgG and anti-CagA in the PCOS group were 45 (35%), 79 (62%) and 77 (60.5%), respectively, while in non-PCOS group were 38 (30%), 76 (60%) and 50 (39.5%), respectively. The sera positive for IgA, IgG and anti-CagA antibodies in spouses of the non-PCOS group were 38 (30%), 84 (66%) and 79 (62%) respectively, but in spouses of the PCOS group were 51 (40%), 83 (66%) and 48 (38%), respectively. The results showed that H. pylori infection probably did not affect infertility or reproduction..ConclusionsFindings of this study demonstrate no significant difference between levels of H. pylori specific antibodies of IgA, IgG, anti-CagA and the presence of PCOS disorders, and also indicate that serologic testing is a sensitive method for the detection of H. pylori antibodies. The high prevalence of H. pylori positive antibody levels in both PCOS and non-PCOS patients can be probably associated with the high frequency of H. pylori infection..Keywords: Helicobacter pylori, Serological Tests, Polycystic Ovary Syndrome
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Page 6BackgroundThe use of mobile phone by clinical staffs enhances transmission of pathogens and therefore, might intensify the hardship of interrupting infection spread..ObjectivesThe aim of this study was to determine bacterial colonization on the mobile phones used by clinical staffs in hospitals..Patients andMethodsWe randomly selected and examined 250 mobile phones from their users. The phones were obtained from the following study groups: Group A, 125 clinical staffs including physicians, nurses, residents, and interns; and group B, 125 university headquarters staffs. Isolated microorganisms were identified using biochemical tests such as Gram stain, morphology, catalase, and oxidase reaction, and all isolates were allocated to appropriate genera. Antibiotic sensitivity test was done using the Kirby-Bauer disc diffusion method..ResultsIn total, 99.2% of mobile phones in clinical staffs group demonstrated growth of bacterial species. The most common isolate were consecutively coagulase-negative staphylococci (82.4%), Staphylococcus aureus (20.0%), and Pseudomonas aeruginosa (12.0%). Among controls, 93.6% of mobile phones demonstrated growth of bacterial species. For eradication of coagulase-negative staphylococci, the highest resistance rate was detected to oxacillin. For inhibition of S. aureus, the highest resistance was detected to Oxacillin. For eradicating P. aeruginosa, considerable resistance rate to ampicillin was detected in both study groups..ConclusionsMobiles contamination with different pathogens is extremely common among our health care staffs compared with other societies, and resistance of these isolates to various antibiotics is also detectable. Thus, quick assessment of this issue to prevent the spread of these infectious agents is critical for the authorities in our health care systems..Keywords: Mobile Phone, Bacterial Infection, Healthcare, Iran
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Page 7BackgroundMeningitis is a serious inflammation of the meninges, mainly caused by bacteria. Treatment of this life threatening disease should not be delayed; therefore, rapid empirical antibiotic therapy should be immediately started. Antimicrobial therapy based on early Cerebrospinal Fluid (CSF) examination has an important role in limitation of bacterial meningitis..ObjectivesThe current study aimed to identify the prevalence of etiological agents of bacterial meningitis and their susceptibility patterns against commonly used antibiotics..Patients andMethodsThis cross-sectional study was performed within a two-year period 2011-2013 on all patients with suspected meningitis referring to Nemazee Hospital, Shiraz, Iran. Cerebrospinal fluid specimens were collected aseptically, and conventional methods were employed to isolate and identify the bacteria. Antimicrobial susceptibility tests were performed using disk diffusion method according clinical and laboratory standards institute (CLSI) recommendation..ResultsOut of 2229 suspected meningitis cases, 255 (11.4%) were detected as positive culture. Most of the isolates were Gram-positive cocci, which 116 (45.5%) were Staphylococcus epidermidis, and 20 (7.8%) identified as Streptococcus spp. Among Gram-negative isolates, Escherichia coli and Acinetobacter spp., each with 19 isolates (5.9%), were predominant. Overall, the most effective antibiotics against Gram-positive cocci were vancomycin (91.5%), chloramphenicol (75.2%), and gentamicin (59.3%), respectively. Gram-negative isolates were mostly susceptible to gentamicin (65.1%), chloramphenicol (42.9%), and ciprofloxacin (39.7%), respectively..ConclusionsGram-positive cocci, such as (Coagulase-Negative Staphylococci) CoNS and aerobic Gram-negative bacilli, were identified as the common etiologic agents of bacterial meningitis. Since the majority of these isolates was part of the normal flora and considered as opportunistic nosocomial infections, it is required to consider the importance of infection control programs in the healthcare centers..Keywords: Bacterial Meningitis, Cerebrospinal Fluid, Nosocomial Infections
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Page 8BackgroundOne of the important causes of mortality and morbidity in burn wards is infection. There are several reasons which make burn patients disposed to infection..ObjectivesThe current study aimed to investigate the role of different factors that affect bacteremia occurrence in burn patients and factors relevant with mortality in these patients..Patients andMethodsThis cross-sectional study was performed in one year on 81 burn patients. We collected patient data regarding age, body weight and height, cause of burn, lesion color and place and percentage of burn. Then we documented all interventions, blood tests and cultures and recorded colonies criteria..ResultsThirty-nine males (48.1%) and 42 females (51.9%) included with a mean age of 32.06 ± 17.46 years. In patients without bacteremia, 57 patients did not need catheterization (89.1%), however in patients with bacteremia, nine needed a catheter (52.9%).. In this survey, in patients with bacteremia, 12 survived (70.9%), however in those without bacteremia, 56 patients survived (92.2%). Then, the relativity between the type of burn and wound infection bacteria species was investigated, but analysis found a P value of 0.65, which was not significant..ConclusionsInvasive interventions increased bacteremia susceptibility in burn wards. Mortality rate had a direct association with bacteremia prevalence and increased by larger burn area..Keywords: Bacteremia, Burn, Patients, Bacteriologic Technics