نشریه بیماریهای عفونی و گرمسیری
پیاپی 54 (پاییز 1390)

Acute diarrheal infections are one of the most important health problems in developing countries. Despite of the decrease in mortality and morbidity during the last decade, prevalence, incidence, hospital costs, and sometimes mortality rates, are still high for developing countries. The aim of this clinical trial was to determine the effect of lactobacillusadded yogurt (probiotic yogurt) on the duration of acute diarrheal diseases and anorexia of children.Methods and This double blind randomized controlled trial was performed with two concurrent control groups and by the participation of mothers who had children aged 1-3 years old, during the summer of 2009. Patients were randomly allocated into three groups; group oneconsisted of probiotic yogurt users, group two were regular yogurt users, and group three were the controls (without any recommendation for yogurt consumption). To assess outcomes, duration of diarrhea and anorexia were compared in the three groups. After the intervention and assessing outcomes, the mean duration of diarrhea in probiotic, regular yogurt, and control groups were 1.5±1.9, 2.4±1.4, and 3.3±1.4, respectively, which means the duration of diarrhea in the probiotic group, was significantly less than the two other groups (P< 0.001). In other words, the consumption of probiotic yogurt reduced the duration of diarrhea by 55% in the control group and by 37% compared to regular yogurt. In addition, although the duration of anorexia in the probiotic group was less than the other two groups, but it was not statistically significant. The study shows that the use of probiotic yogurt can decrease the duration of

Environmental factors and host genetic are important factors indifferent outcomes of HBV infection. One of these genetic factors is polymorphisms of regulatory genes of cytokines. Single nucleotide polymorphisms (SNP) in the promoter region of the interleukin (IL)-10 gene has been reported to have a role in determining of hepatitis B virus (HBV) infection outcome. The present study was undertaken to evaluate the association between HBV infection and SNP in the promoter region of the IL-10 gene. A total of 127 cases including 30 subjects who had spontaneouslyrecovered from HBV infection, 34 healthy carriers, 32 patients with chronic hepatitis B and 31 healthy controls were enrolled in this study. The three biallelic (-819,-592,-1082) polymorphisms in the IL-10 gene promoter were analyzed by PCR and direct sequencing. No significant difference was found in frequencies of genotypes and haplotypes of IL-10 gene promoter region at position -1082, -819 and -592 among controls, individuals spontaneously recovering from HBV infection, carriers and patients with chronic hepatitis B infection. However, frequencies of A/A genotype at position -592 and T/T genotype at position -819 were higher in the HBV clearance group while frequency of G/G genotype at position-1082 was higher in persistence group. GCC/GCC and GCC/ACC haplotypes were significantly more frequent in anti-HBe positive patients. It seems that genetic polymorphisms of IL-10 promoter region are not associated with HBV infection outcome. However, patients with high and intermediate producer haplotypes of IL- 10 had more ability to produce anti-HBe than those with low producer haplotypes.

AIDS is a phenomenon with very wide social, cultural and economical aspects. In 1996, the United Nations mentioned AIDS as a health issue, and severe barrier for human development. Based on data reported by the World Health Organization, AIDS epidemic growth rate in Iran is rising and warnings. HIV/ AIDS has intensive effects on human’s health and efficacy, typically of young adults. It is also imposes great deal of direct and indirect costs to society. The indirect costs of AIDS were calculated seven times higher than direct costs mainly due to premature mortality and loss of productivity. This cross-sectional study conducted to patients referred to West Health Center and 12 Farvardin Clinics. The questionnaire developed for information with items related to costs of HIV/AIDS. Collected data analyzed by one-way Variance and Post Hoc. HIV/AIDS advanced patients with and without addiction had developed 18,583,449.93 (SD=403,233.63) and 18,535,164.90 (SD=323,515.82) Rial costs respectively. On the other hand HIV/AIDS non-advanced patients with and without addiction were characterized by 7,02,9,487.83 (SD=137,772.75) And 7,007,447.60 (SD=109,136.38) Rial costs respectively. These costs have been calculated on average. Anova analysis demonstrated statistically significant difference (p-value<0001). Differences between average direct (p-value=0.02) and indirect (p-value<0.001) costs also were found to be statistically significant. Length of stay for one episode of treatment was 24 months. Because of statistically significant relation between direct and indirect costs treatment between 4 groups on one hand and escalating of treatment costs parallel to the advancement of HIV/AIDS among contacted patients, attention to the economic study and analysis of HIV/AIDS services should be paid.

Shigellosis is one of the acute gastrointestinal diseases. In view of outbreaks and emergence of antibiotic resistant therefore construction a live attenuated vaccine strains owing to high-cost antibiotics therapy and preparation new antibiotic urgently required. The current study was aimed at producing a live attenuated
mxiA by using  Red recombinase system in isolated shigella in Iran.

In this study, a total of 48 isolates of S. dysenteriae have been isolated from children at Children Medial Center, Milad and Firozabadi hospitals During the four-year period from 2006 until 2010 which were collected. By use of biochemical, serological and PCR tests, the species of isolated shigella were confirmed. The pKD46 plasmid electrotransformed into shigella and mutant strain was generated by a chloramphenicol cassette replacement through recombination using FLP flanking recognition target site. Precision of process was confirmed by PCR and sequencing.

Biochemical, serological and PCR tests were demonstrate 3 strain all of them (6.25%), belong to dysenteriae's species and serotype's type 1. present of mxiA gene was confirmed by PCR reaction. Sequencing results and PCR test were verified 2061 bp of mxiA gene was deleted.

use of  Red recombinase system facilitates mutant construction in more cost-effective method in comparison with the other techniques such as suicide vector.

Shigella spp are the most important intestinal pathogens in human. This species cause bloody diarrhea as called dysentery. The infectious dose of bacteria to cause the disease is very low, hence, rapid detection of bacterium especially in children, is of great concern. The aim of study was molecular detection of Shigella spp by PCR.

In this study, a pair of primers was used to replicate a chromosomalsequence (Putative integrase). For evaluation of method, we studied 30 Shigella spp that had been isolated from clinical cases, confirmed serologically, and biochemically. Boiling method was used for DNA extraction. PCR was performed by different thermal gradient. Amplified product was electrophoresed, stained by ethidium bromide and visualized by gel documentation. For evaluation of specificity of method, some related bacterial strains were used.

The result of PCR showed expected amplified DNA band in all four Shigella. In the evaluation of optimum thermal gradient for polymerase chain reaction, best temperature was 62°C. Any non-specific reaction with other bacterial strains such as Escherichia and Salmonella was not seen and designed method was able to detect all 30 Shigella species.

The results showed that genes located on chromosomal conservative regions are appropriate targets for rapid detection of Shigella spp. Designed method with new primers is sensitive, easy, rapid, reliable and is recommended for detection of Shigella spp.

Enterotoxigenic Escherichia coli (ETEC) is the most commonly cause of bacterial diarrhea in the world wide. CFA/I fimbriae is one of the important virulence factor that have critical role in bacterial pathogenesis. Therefore, tip protein of these fimbriae (CFaE) could be considered as a vaccine candidate. The aim of this study is investigation of efficiency of produced antibody against CFaE for attachment inhibition of ETEC to receptors which located on the surface of human erythrocyte as a model. after codon optimization, cfaE gene synthesized and then cloned into pET28a as an expression vector. When gene construct induced by IPTG, desirable protein was expressed and purified with using by affinity chromatography. Recombinant protein as an antigen injected to mice and serum titers was measured with ELISA. Finally, ability of bacterial attachments to human erythrocyte group A was studied, in present and absent of anti-CFaE. bacterial which treated with serum of immune mice unlike those that treated with serum of control mice couldn`t caused hemagglutination of erythrocytes. the results were indicated that rCFaE is a good immunogenic protein, so it could stimulate immune system of mice. Also, raised antibody with binding to fimberial proteins of bacteria inhibited attachment of ETEC to its target receptor.

ventilator-associated pneumonia, is the most common nosocomial infection in intensive care unit (ICU) thatcuases increase in mortality and hospital costs. The purpose of this study was to determine the frequency of early ventilator-associated pneumonia in intensive care unit (ICU).

In a six-month cross-sectional study, all eligible patients admitted in ICU for 4 days after intubation in two selected hospitals were studied. The prevalence of early VAP based on Mini-BAL procedure and the clinical pneumonia infection scoring system wasdetermined.

The average age of 32/68 years and people with non-infected individuals was 44/524 (P <0.05). Incidence of early ventilator-associated pneumonia based on Mini- BAL method was 40/8% and CPIS method 42/3%. Frequency of early ventilator- associated pneumonia was 22/88 per 1000 ventilator days.

This study suggests the high incidence of early ventilator- associated pneumonia. Compare the results of two diagnostic methods were similar MINI-BAL and CPIS Therefore, noninvasive diagnostic methods such as CPIS recommended.