نشریه بیماریهای عفونی و گرمسیری
پیاپی 53 (تابستان 1390)

There are many descriptive studies on Intestinal Parasitic Infections in Iran, mostly assessing the prevalence of the disease and its associations with various risk factors. In order to gain a better insight into the epidemiology of Intestinal Parasitic Infections in Iran and its heterogeneity around the country, we systematically reviewed all available studies and analyzed their findings using meta-analysis methods. All published papers in Iranian and international journals, final reports of research projects, papers presented in relevant congresses, and also all dissertations of medical students were reviewed using standard and Sensitive keywords. Studies published during 1991- 2009 which met the eligibility criteria, after Quality Assessment, Main Results Extracted and Combined with Random Effect Model, were entered into meta-analysis. on the basis of random effect model, the overall and final prevalence rate of intestinal parasitic infection calculated 38.29% with Q=59.63,t2=13.11,I2=22.85 and CI95%=24.4- 52.18.(P<0.0001) also variables of sample size, age mean and place of studies in the metaregression analysis were main factors for heterogeneity in study results. With Respect to that already prevalence of intestinal parasitic infections is high, it should increase hygiene level with science and research-based works and go to perspective health path and would be advanced.

Gastroesophageal reflux, by exposing the pharynx to Helicobacter pylori (H. pylori), is a potential risk factor for laryngohypopharyngeal carcinoma. Its possible association has been inconsistent. In this case–control study, we investigated the relationship between H. pylori seropositivity and laryngohypopharyngeal carcinoma in Iran.

We had 105 healthy controls (group A), 70 cases of laryngeal carcinoma (group B), and 28 cases of hypopharyngeal carcinoma group (group C). Age, sex, smoking habit alcohol use, and H. pylori serology were determined for all subjects.

Groups were matched in age and alcohol use. Smoking and H. pylori seropositivity were more common in groups B and C, and male sex was more common in group B (compared with group A). In multivariate regression, the effect of smoking (p <.01, odds ratio [OR] 5 2.92) and H. pylori seropositivity (p <.01, OR 5 11.49) remained highly significant.

H. pylori is an independent risk factor for laryngohypopharyngealcarcinoma. VVC 2008 Wiley Periodicals, Inc.Head Neck 30: 1624–1627, 2008

Antimicrobial drug resistance is increasing among Salmonella spp. and causes significant therapeutic problems in the treatment of diseases caused by this organisms. The main objective of this study was to investigate the frequency of class 2 integrons in Salmonella enterica strains isolated from Tehran during 2007-2008. Salmonella spp. strains have been isolated from several hospitals in Tehran during 2007-2008. The strains were identified by standard biochemical tests and serology. The susceptibility of the isolates was determined according to CLSI guidelines. Class 2 integrons were detected by PCR. In this research, 138 Salmonella spp. strains were isolated. Nine (6.5%) of the 138 isolates had a 2.16-kb class 2 integrons. This is the first study of the prevalence of integron class 2 in Salmonella isolates in Tehran. Our findings showed that integrons class 2 was less widely spread among Salmonella enterica isolates. In the present study, the widespread occurrence of resistance to several groups of antibiotics in Salmonella isolates was demonstrated. It may be due to inappropriate and incorrect administration of antimicrobial agents in empiric therapies.

Nosocomial infections caused by methicillin-resistant staphylococci (MRSA) poses a serious problem in many countries. This study aimed to determine the antibacterial susceptibility patterns of methicillin sensitive and resistant Staphylococcus aureus isolates from the hospitalized patients. Totally 356 isolates of Staphylococcus aureus (S. aureus) including 200, 137 and 19 corresponding to MRSA, MSSA and intermediates strains, respectively were isolated from the hospitalized patients. Antibacterial susceptibility patterns of the isolates to 14 antibiotics were examined using Kirby-Bauer method. MICs of 15 antibiotics to 156 MRSA isolates were determined by E test method. Cross-resistances of MRSA isolates to the other tested antibiotics were also determined. S.aureus with high frequencies were isolates from the blood, sputum and deep wound samples. All of 200 MSSA isolates were sensitive to oxacillin, vancomycin, tecoplanin, rifampin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid. A gradient of reduced susceptibility of MSSA to cephalexin, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin were noticed. MRSA isolates were sensitive to vancomycin, tecoplanin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid, while reduced susceptibility of them to rifampin, co-trimoxazole, clindamycin, cephalexin, tetracycline, ciprofloxacin, erythromycin and gentamicin were observed. MRSA isolates exhibited a high range of cross-resistance to the latter eight antibiotics. Overall, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin showed low activity against MSSA and MRSA isolates which may indicate they are not suitable to be used in clinics. To preserve effectiveness of antibiotics, rational prescription and concomitant application of preventive measures against the spread of MRSA are recommended.

Salmonellae infection is one of the most important foodborne diseases. Antimicrobial drug resistance is increasing among Salmonella species. The main objective of this study was to investigate the prevalence and molecular characterization of ESBL genes in Salmonella enterica isolates from Iran.

Salmonella species strains were isolated from several hospitals in Tehran. The isolates were identified by standard biochemical tests and agglutination using specific antisera. Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI). The presence and characterization of ESBL genes in Salmonella enterica isolates were investigated by PCR and sequencing.

In total, 4.3% of Salmonella enterica isolates showed an ESBL-positive phenotype. Three strains were attributed with serotype Enteritidis and three with serotype Infantis. blaCTX-M sequences were detected in all Salmonella strains, whereas blaTEM was observed in four isolates including two Enteritidis and two Infantis. The ISEcp1 insertion sequence that has been implicated in the expression and mobilization of the blaCTX-M genes has been also detected in all ESBL positive isolates.

Proper detection of -lactamases and corresponding treatment strategies are of paramount importance in curtailing this growing epidemic. Prevention and control strategies should be urgently implemented to stop further spreading of these strains.

Acute gastroenteritis has been established as the major public health problem in worldwide children. Rotavirus is the most important etiological agent of gastroenteritis among children, It is also major cause of children malnutrition. Rotavirus,which is a member of the reoviridae family, has a genome 11 dsRNA segment that are enclosed in a triple- layered capsid. Rotaviruses are classified into G-type and P- type. Therefore, determining the prevalent and types of rotaviruses within region is essential to prepare for introducing a vaccine. The genotype diversity of group A human Rotavirus and phylogenetic analysis of P-type detected by RT-PCR and DNASequencing. A total of 285 stool specimens were collected from children with diarrhea admitted to two pediatric hospitals in Tehran-Iran. Stool samples positive in RNA-PAGE were genotyped by Multiplex RT-PCR method. P-genotypes of rotavirus isolated were sequenced between 2008 and 2010. We found relatively high prevalence rate of rotavirus gastroenteritis in children. 29.1% stool specimens were positive. P [8] (81.92%) was the dominant of genotype, followed by P [4] (8.4%), P [6] (7.2%) and mix type (2.4%). The peak of incidence was in the winter. A few sequence of P-genotypes strains isolated showed high level of similarity to strains from other Asian countries. we reported the VP4 genotype of rotaviruses –associated childhood diarrhea with high prevalence of P [8] genotype. Rotavirus strain surveillance programs are important for future vaccine formulation in Iran.

Enterococci are normal microflora of the humans. They are identified as opportunistic pathogens and they are among the three major factors of hospital infections. Enterococci are able to form biofilms on the biotic and abiotic surfaces and this ability is one of the important factors to pathogenesis. The purpose of the present study was to evaluate biofilm formation and evaluation of antibiotic resistance among Enterococcus faecalis (E. f) isolates from clinical and environmental isolates in Tehran hospitals.

In total, 90 isolates of Enterococcus faecalis including 58 clinical and 32 environmental isolates of (E.F) were collected from 2 hospitals in Tehran. All enterococcal species isolates were identified by species-specific PCR. Antibiotic resistance pattern of 90 isolates of (E. f) isolates was determined by disk diffusion method according to the CLSI guidelines. Biofilm formation of (E. f) isolates was evaluated by microtiter plates method.

The highest resistant percents of clinical (E. f) isolates against tetracycline, erythromycin, co-trimoxazole, ciprofloxacin and gentamicin were 86%, 62%, 69%, 69% and 64%, respectively. Among environmental isolates the resistant percents were 75%, 44%, 25%, 22% and 25%, respectively. According to biofilm formation assay, 72% and 84.5% of clinical and environmental (E. f) isolates were positive, respectively. Samples that were able to form biofilms showed more antibiotic resistance than those that are not able to form biofilms.

The results of this study indicate high prevalence of antibiotic resistance and the ability of biofilm formation among Enterococcus faecalis. Considering the role of biofilms in increased antibiotic resistance and virulence, it is needed to carry out necessary measure to eliminate suitable conditions for biofilm formation which act as a shield against various conditions, including the host immune system and antibiotics.

Isoniazid, rifampine, Pyrazinamide and ethambutol Have many adverse effect including gasteronitestinal and hepatic side effects that may lead to withdrawing treatment; nonetheless there is no precise national statistics about these side effects. The goal of this study was to investigate of tuberculosis situation and drug adverse effect in patients with tuberculosis during six years. In this cross-sectional study all patients with tuberculosis who were diagnosed during 2004 to 2009 in Sanandaj district were assessed. The required data were gathered from TB registration record of district and from recorded documents of patients. In order to diagnose side effects of drugs, based on national guidelines, the examination results were recorded and were confirmed by TB coordinator physician of district. From 425 patients, 118 persons (27.8%) were affected by side effects of drugs; the most common recorded side effects were nausea and vomiting which were observed in 36 persons(8.5%). Hepatitis and increase in hepatic enzymes were observed in 35 persons (8.2%) d uring the study. There was no significant relationship between sex and type of TB. In addition, concerning TB diagnosis during past years, there was no difference between urban and rural areas. It seems that women are more vulnerable to TB in Sanandaj. The prevalence of hepatic drugs side effects in Sanandaj is higher than other area. It is necessary to train involved staff in TB program about side effects of drugs and treatment in order to record those side effects and to include a regular and accurate system of monitoring side effects in national TB program (instead of self-reporting).