فهرست مطالب

  • Volume:2 Issue:1, 2007
  • تاریخ انتشار: 1386/02/11
  • تعداد عناوین: 10
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  • Hossein Goudarzi, Hamid, Reza Jamaati, Gita Eslami, Fatemeh Fallah, Roxana Khanipourroshan Page 5
    Background
    Community acquired pneumonia (CAP) is a common health concern and the main mortality factor worldwide. Nowadays, legionella pneumophila is one of the most common microorganisms responsible for CAP. We designed this study to investigate the antigen test as a useful, simple and rapid test for early diagnosis of legionella pneumophila.
    Materials And Methods
    We enrolled 118 patients (32 females and 86 males) with CAP, COPD and asthma in Masih Daneshvari medical center during 2004 –5. Clinical and microbiological evaluations were performed. Sputum culture and legionella urinary antigen tests were carried out.
    Results
    Different types of bacteria were isolated from 118 patients. The most frequently isolated respiratory microorganisms were: streptococcus pneumonia (88%), candida spp. (76.2%), beta-hemolytic streptococcus (61.8%), neiseria spp (44.4%), staphylococcus (40.6%), klebsiella spp (27.1%), fungi (16.1%), E.coli (8.4%), and pseudomonas spp (5.1%). No legionella was detected from sputum specimens. Legionella urinary antigen testing was revealed to be positive in 3 males.
    Conclusion
    Urinary antigen test is a particularly useful, simple and rapid test since it is often easier to obtain urine in ill patients. The results can be available within hours and it is also reliable enough to commence treatment.
  • Alireza Ekrami, Enayat Kalantar Page 9
    Background
    The major challenge for a burn team is nosocomial infection, which is known to be responsible for over 50% of burn-related deaths. Most studies on infection in burn patients focus on burn wound infection, whereas other nosocomial infections among these patients have not been addressed well. This study attempts to determine three types of nosocomial infections: burn wound, urinary tract, and blood stream infections on the basis of National Nosocomial Infection Surveillance System (NNIS) definition.
    Materials And Methods
    During an academic year (May 2003 to April 2004), 182 patients were included. Blood, urine and wound biopsy samples were taken 7 and 14 days following the admission. Isolation and identification of microorganisms were performed according to the reference procedures. Susceptibility testing was carried out using disk diffusion procedure as recommended by Clinical and Laboratory Standard Institute.
    Results
    Of 182 patients, 140 (76.9%) acquired at least one type of infection. A total of 116 patients (82.8%) were culture positive on day 7th while 24 (17.2%) were positive on day 14th. Primary wound infection was the most common infection (72.5%), followed by blood stream (18.6%) and urinary tract infections (8.9%). The most frequent microorganisms were pseudomonas aeruginosa (37.5%), staphylococcus aureus (20.2%), and acinetobacter baumanni (10.4 %). Among these isolates, P. aeruginosa was found to be 100% resistant to amikacin, gentamicin, carbenicillin and ciprofloxacin. It is worth to note that 58% of S. aureus and 60% of coagulase-negative staphylococcus isolates were methicillin resistant (MRSA).
    Conclusion
    High prevalence of nosocomial infections, presence of multi-drug resistant bacteria, and MRSA are serious health concerns in burn patients at Taleghani hospital. We, therefore, concluded that continuous surveillance of burn infections is warranted in this high-risk group of patients in order to develop strategies for antimicrobial resistance control and treatment of infectious complications.
  • Masoud Mardani, Latif Gachkar, Shahin Najar Peerayeh, Ali Asgari, Bahareh Hajikhani, Ramezanali Amiri Page 13
    Background
    Bottled mineral water is generally considered more pure than tap water in developing countries. Immunocompromised patients and those with co morbid conditions are often offered bottled mineral water since they are believed to be safer. The present study was designed to determine the risk of common bacterial contamination of commercially available bottled mineral water in Iran.
    Materials And Methods
    For this descriptive study, 68 samples (35 brand named companies) of bottled mineral water were collected from different provinces of Iran. Initially 200 ml of bottled water was filtered with 0.45 micrometer pore (Sartorius label). The filter was divided by sterile pence and scissor to multiple pieces, suspension in nutrient broth and centrifuged. The culture was made by selective media: nutrient agar and broth, dextrose sodium azide agar, yersinia agar, and Clostridium selective agar. The bacterial contaminations were detected after incubation at 42ºC, 35ºC and 25ºC for 24h, 48h and 7 days.
    Results
    Of 68 samples, 41 (60%) showed evidences of contamination with common bacterial, including 15 samples (36%) with Gram-positive spore-forming bacilli, 20 samples (49%) with Gram-positive non-spore-forming bacilli (diphteroids) and 6 samples (15%) with Gram-positive cocci. The marker organisms, i.e. the classic fecal contamination indicators, were not detected in any of the samples.
    Conclusion
    Our results revealed that the use of bottled mineral water in immunocompotent individuals is safe, however, the use of this bottled mineral water in immunocompromised patients should be observed with meticulous precaution. Some of bacteria known as human commensals, contaminate water prior to bottling. It is recommended that bottling, packaging and distribution of mineral water to be carried out under safer processes.
  • Zahra Fardyazar, Shahram Habibzadeh, Sedigheh Abdollahi, Fard, Mahshid Tello Page 17
    Background
    Vulvovaginal candidiasis (VVC) is a fungal infection of the vagina and vulva. It is usually caused by Candida albicans, however, occasionally other candida species are responsible. The optimal treatment of VVC has not yet been defined. The present study was designed to compare the efficacy and safety of a single oral dose of fluconazole with clotrimazole vaginal cream as the treatment of choice for recurrent VVC.
    Materials And Methods
    We conducted a clinical trial study on 124 women with RVVC. Sampling of vaginal discharge was achieved for clinically suspected patients, then, observed with KOH for vaginal candidiasis. Sample culture was performed for cases in whom the result of direct examination was negative but there was high clinical suspicion of the disease. For laboratory examination, swab specimens were placed on sabourauds agar plus chloramphenicol and cyclohexamide with natural PH. For treatment, patients were randomized systematically in 2 equal groups, one receiving clotrimazole vaginal cream 5g/day for 7 days for acute episode and 5g twice a week for 6 months as a prophylaxis. The second group was prescribed single oral dose of fluconazole capsule 150 mg for acute episode followed by prophylactic regimen of 150 mg weekly for 6 months.
    Results
    A total of 124 women with RVVC were enrolled and assigned in 2 groups of fluconazole and clotrimazole with the mean age of 32±5 years (a range, 18-50 years) and 32±2 years (a range, 19-49 years), respectively. Of 117 cases, the recurrence rate was 8.6% in fluconazole and 8.5% in clotrimazole group. Recurrence rate in follow up period (second 6 months) was 38.3% and 40%, respectively (NS).
    Conclusion
    Response to treatment and reduction in recurrence rate of VVC were similar among fluconazole and long-term users of azole vaginal creams.
  • Mohammad Hossein Somi, Mohammad Reza Ardalan, Homayoun Sokhanvar, Sara Farhang, Ali Pouri Page 23
    Background
    Hepatitis C virus (HCV) is a major cause of chronic liver diseases among chronic renal failure (CRF) patients undergoing maintenance hemodialysis. The aim of this study was to identify the hepatitis C virus infection in patients under dialysis therapy from Tabriz, northwest Iran and estimate the risk factors.
    Materials And Methods
    Sera of 462 chronic renal failure patients from five dialysis units were screened for hepatitis C antibody and HCV RNA. The mean age of patients was 52.7±16.5 years and 55% were male.
    Results
    Totally, 69 patients (14.9%) were found to be HCV seropositive by ELISA 3 assay and 64 were HCV RNA positive giving an overall prevalence of 10.2%. History of blood transfusion seems to be a significant risk factor. Drug abusers (6.5%), patients with a history of surgical interventions (78.3%) or renal transplantation (32.6%) had a higher risk for infection with HCV while patients who had received peritoneal dialysis (14.4%) had a low infection rate.
    Conclusion
    This study gives added evidence of increased risk for HCV infection of CRF patients under dialysis with the duration and frequency of hemodialysis, which may be reduced by early transplantation. Considering the immune insufficiency in such patients who receive several interventions, serious education about sanitation to patients and medical staff will be of assistance.
  • Reza Imani, Ezzat Shamsipoor, Reza Khadivi Page 29
    Background
    Brucellosis is a zoonotic disease involving several organs with different presentations. It is primarily a disease of animals. Human infection is usually acquired by close contact with infected animals or consumption of unpasteurized dairy products. The major reservoirs include goat, sheep, swine and cattle. Human to human transmission of brucellosis is a rare entity, especially perinatal transmission. This report is introducing congenital transmission of brucellosis. Patient: A pregnant woman with brucellosis referred when she was on 32nd week of gestation. She transferred brucellosis to her off-spring due to inappropriate therapy. After definite diagnosis, a standard treatment was commenced and they were doing well while relapse was not seen.
    Conclusion
    Brucellosis can be transmitted perinatally, although it is a rare entity. A combination of rifampin and trimethoprime-sulfamethoxazole can be safely prescribed for brucellosis during pregnancy, except for the first trimester and the last 2-4 weeks of pregnancy.
  • Gholamali Ghorbani, Seyed, Javad Hosseini, Vahid Pourfarziani, Javad Ameli, Mohammad, Hossein Akbari Page 33
    Background
    Cutaneous leishmaniasis is an endemic infectious disease in Iran caused by flagellated protozoa. The most common cause of cutaneous leishmaniasis is L. major. We report a case of disseminated cutaneous leishmaniasis after renal transplantation.Patient: A 50-year old man received renal transplantation three months ago for diabetes mellitus-associated renal failure. Before renal transplantation, he gave the history of insect bite and a single nodule that was clinically diagnosed as local cutaneous leishmaniasis, however, he had not received therapy. Three months after transplantation while he was on immunosuppressive therapy, he was admitted for disseminated cutaneous nodule. Direct smear and pathology detected lieshman body and amastigote in the lesion compatible with the diagnosis of disseminated cutaneous lishmaniasis. Despite difficult therapeutic approach, he cured after combination therapy with glucontim and amphotricin B for one month.
    Conclusion
    In countries like Iran where leishmaniasis is endemic, each nodule or chronic skin lesion should be evaluated for cutaneous leishmaniasis. Transplant clinicians should have a high index of suspicion of leishmania infections as an important cause of post transplant morbidity.
  • Hossein Poustchi, Mehdi Mohamadnejad, Reza Malekzadeh Page 37
  • Mohammad Rahmati Roodsari, Farhad Malekzad, Ameneh Alaeen Page 53