نشریه بیماریهای عفونی و گرمسیری
پیاپی 55 (زمستان 1390)

Patients with HIV / AIDS) PLWA(were discriminated due to infection through unprotected sexual behaviors and shared injections. Nurses should respect the rights of these patients and they provide medical care to them. This study conducted to determine the status of stigma and and discriminatory practices of nurses deal PLWA in hospitals of Shiraz. In this cross-sectional study, we selected 356 nurses and 114 by random sampling from namazi hospital and shahid faghihi hospital. Data was gathered by a questionnaire. We used software of SPSS (14) and data analyzed by descriptive tests. 67. 2 percent of respondents believed that wife/husband of PLWA should be notified of the patient's status even without her/his consent. 73. 8 percent of respondents agreed that PLWA should be hospitalized in a separate ward. 30. 5 percent believed that they can refuse care for PLWA so they can protect themselves and their families. 78.5 believed that fear of becoming contaminated are most concerns about treating PLWA. 21.9 reported that have refused to care for a patient with HIV/AIDS. bad status of stigma and discrimination nurses to patients with HIV / AIDS could be due to fear of infection and lack of equipments. It is recommended to providing of appropriate training, financial incentives and new for improving this status.

Infectious diarrhea is one of world leading causes of morbidity and mortality, resulting in about two million deaths per year. Enteropathogenic Escherichia coli (EPEC) are one of the pathotypes causes diarrhea. In the present study the EPEC isolates will be investigated by PCR among diarrheal children with diarrhea. The 363 stool samples directly were cultured on TSB (Tryptic soy Broth) and after cultured on Mac conkey plates, and finally were confirmed as E.coli by IMVIC(Indol,MR,VP,Citrat)test. The DNA was extracted from the E.coli isolates and were subjected to PCR for molecular detection of EPEC. In total, 194 of 363 strains (53.15%)were identified as E.coli. The PCR was performed during 2 stages: first stage with escv primers, those were positive with this gene were subjected to second round of PCR with bfpB primers. On the basis of PCR analysis EPECs were classified as typical (escv+ bfpB+) or atypical (escv+ bfpB-). In this study, atypical EPEC was diagnosed in 28(14.5%) isolates and typical EPEC strains were isolated from 2(1%) isolates. while typical EPEC have been regarded as one of the leading cause of infantile diarrhea in developing countries, atypical EPEC is the causative agent in industrialized countries. Resent data suggests that atypical EPEC are prevalent among diarrheal patient and more epidemiological studies in this regard are required to be performed in other regions.

Salmonella spp are the most important cause of food poisoning and diarrhea. Routine diagnostic methods for identification of Salmonella such as culture are time consuming. The aim of this study was to evaluate a Uniplex PCR for rapid molecular detection of Salmonella spp. In this study, a pair of primers was designed and used to replicate a chromosomal sequence (invA gene) of Salmonella spp. We evaluated the method on Salmonella spp isolated from clinical cases that had been 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 the method, some related bacterial strains were used. The result of PCR showed expected amplified DNA band in Salmonella spp. Any non-specific reaction with other bacterial strains such as Escherichia and gram positive cocci was not seen and designed method was able to detect all tested Salmonella spp. The results showed that invA gene is an appropriate target for rapid detection of Salmonell spp. Designed method with new primers is sensitive, easy, rapid, reliable and is recommended for detection of Salmonella spp.

Human immunodeficiency virus (HIV) is the etiological agent of AIDS in humans. The infection is usually accompanied by changes in the synthesis and secretion of several cytokines, and dysregulation of these cytokines has an important role in HIV infected individuals. A switch from a T helper 1 (Th1) to a Th2 cytokine has been proposed as an important factor in progression of HIV infection to AIDS. The aim of the present study was to assess the levels of Th1 and Th2 cytokines in HIV infected individuals in order to identify the switch from Th1 to Th2 cytokines.

This study was carried out in 140 HIV infected patients and 35 matched healthy controls. The serum samples were checked with ELISA for interleukin (IL)-2, IL-4, IL-10 and interferon (IFN)-gamma.

IL-2 level was relatively higher and IL-10, IL-4 and IFN-gamma levels were relatively lower in the treatment naïve group than the under treatment group. Except for IL-2, all of the other cytokines exhibited a negative correlation with the CD4 cell counts and IFN-gamma levels showed the strongest negative correlation.

Our observations did not demonstrate switching of the type 1 to type 2 T helper cells cytokine profile in HIV infected patients and suggested more complex changes in Th1 to Th2 cytokine patterns in HIV infection.

Globally, millions die each year from infections caused by Streptococcus pneumoniae. The effective treatment of pneumococcal infections has been compromised by the emergence of strains resistant to currently available antibiotics. In resistant strains there is a reduction in the capacity to bind to antibiotics in penicillin binding proteins. The purpose of this study was to determine the rates of antibiotics resistance in clinical strains of Streptococcus pneumoniae and analyse occurred mutations in pbp2x. 58 pneumococcal isolates were collected from patients with pneumococcal infections. The drug susceptibility patterns of the strains were tested by the disc diffusion method for penicillin G, cefotaxime, erythromycin, tetracycline, and trimethoprim-sulfamethoxazole. MICs of penicillin and cefotaxime determined by broth microdilution. lytA and pbp2x genes were amplified by PCR. The nucleotide sequences were determined by direct sequencing. From all 58 Streptococcus pneumoniae strains, 24 (41.3%) were penicillin intermediate and 14 isolates (24.1%) were penicillin resistant (MIC≥2 μg/ml). 28 (48.2%) were trimethoprim-sulfamethoxazole resistant, 9 (15.5%) were erythromycin resistant and 10 (17.2%) were tetracycline resistant. 8 isolates (13.8%) were cefotaxime resistant. Most of the strains resistant to penicillin and cefotaxime showed additional resistance to one or several other drugs. All of the cefotaxime resistant isolates had alterations in PBP2x. Prevalence of beta-lactam resistant strains revealed a crisis in treatment of pneumococcal infections. We showed that alterations in the conserved motifs in PBP2x are associated with cefotaxime resistant in Streptococcus pneumoniae.

Scorpion envenomation is a public health problem in Iran. Scorpions are the second accident after snake envenomation in causing human fatalities. Hemiscorpius lepturus is the most medically important scorpion in Iran with 95% mortality. The venom from H. lepturus is primarily a cytotoxic agent and has hemolytic dermonecrotic, nephrotoxic, and to some extent, hepatotoxic activities. H. lepturus venom collected from Khuzestan province. Reverse phase HPLC (RP-HPLC) was performed to analyze proteins and peptides in crude venom. The collected fractions were dried and re-solubilized in dH2O. The haemolytic test done on obtained RP-HPLC fractions and their molecular weights were determined. The positive fractions in haemolytic test were subjected to dermonecrotic test in Rabbit. The number of 103 fractions collected from C18 RP-HPLC column in the crude venom of H. lepturus. Four fractions with severe hemolytic activities were selected. The SDS-PAGE showed 32-32kDa proteins. The amount of 5 and 20 μg of hemolytic positive fractions were subjected to the dermonecrotic test on rabbit skin and the severity of lesions were studied. These fractions showed a different necrosis level in the skin that the highest activity belonged to the fraction in 157.55 min elution time. The analysis of the protein contents of the venom of Hemiscorpius lepturus showed that the major toxins are related to the proteins with haemolytic/dermonecrotic activities. The severity of four identified proteins is due to the different isoforms of a major protein.

Back ground and In recent years, antimicrobial drug resistance among Salmonella species has been increasing. According to the importance of antimicrobial resistance among Salmonella spp. the aim of this study was to determine the antibiotic resistance pattern of Salmonella spp. isolated from hospitals in Tehran.41 Salmonella spp. strains isolated from different clinical specimens at different hospitals of Tehran during 2009-2010. These strains were identified by standard biochemical tests. Antibiotic susceptibilities were determined by disk- diffusion method according to CLSI guidelines. Among 41 Salmonella strains isolated in this study, 17/1℅ were resistant to Nalidixic acid, 17/1℅ were resistant to Co-trimocsazol, 14/6℅ were Chloramfnicol, 12℅ were resistant to Ampicilin, 4/9℅ were resistant to Ceftazidim, 4/9℅ were resistant to Cefotaxim, 4/9℅ were resistant to Aztronam, 2/4℅ were resistant to Gentamicin. Ciprofloxacin and Amikacin resistant strains were not observed in our investigation. All studied Salmonella isolates were sensitive to Ciprofloxacin. These findings suggested that Ciprofloxacin may still be useful against Salmonella infections. The most resistance of isolates was seen to Nalidixic acid, Cotrimocsazol, Cloramfenicol and Ampicillin. The isolates showed low rate of resistance to studied cephalospotins and aminoglicosides. Considering of antimicrobial resistance rate, surveillance of antibiotics therapy is necessary.

Shigella is a gram-negative bacterium which causes the most communicable of bacillary infection in the world (shigellosis). The emergence antibiotic-resistant strains to multiple antibiotics, as well as, owing to increasing cases caused by shigella infection in the areas of the world, particularly in developing countries revealed surveillance necessity studies in order to assess the incidence shigella infection, identifying prevalent serogroup of shigella's species and also studying the pattern of antibiotic resistance of Shigella spp.

In current research, during 2008 to 2010, a total of 134 hospital's samples had been isolated from enteritis cases at Milad and Children Medical Center (located in Tehran) was collected. The biochemical and serological test were done for determination of shigella Spp. Antibiotics susceptibility assay test was evaluated to 13 commonly-used antibiotics through disk diffusion method in Muller agar.

According to biochemical and serological tests, existences of the shigella's genus in the all of the hospital's samples (100%) were confirmed. Classification was performed based on serological analysis which showed: 78 were Shigella sonnei (58.20%), 35 Shigella flexneri (26.12%), 12 Shigella boydii (8.96%) and 9 Shigella dysenteriae (6.72%). In an antibiogram test, co-trimoxazole, ampicilin and tetracycline were showed high degrees of resistant including 73.13%, 37.31% and 26.11%, respectively. In addition, the highest incidence of shigellosis was found in summer (54.23%) which belonging to children between 2 -12 of age. Furthermore, all of the stains were completely susceptible to three antibiotics including ciprofloxacin, ceftazidime and ceftriaxone, respectively.

This epidemiologic study systematically monitored rate of occurrence shigella infection at tow hospital in Tehran, during 2008 to 2010. Among other species, Shigella sonnei was distinguished as the prevalent strain. The antimicrobial resistance pattern indicated the prescription of three antibiotics including co-trimoxazole, ampicilin and tetracycline not recommended empirically. Utilization of the third generation of cephalosporin and new quinolone as the first line of treatment and the best antibiotics therapy was suggested.