فهرست مطالب

  • Volume:6 Issue:1, 2012
  • تاریخ انتشار: 1390/10/11
  • تعداد عناوین: 10
|
  • Masoud Mardani, Monireh Kamali Page 1
  • Seyed-Moayed Alavian, Seyed Mohammad Miri, Mohammad Javad Behzadnia Page 5
    Background
    To evaluate the strength of association and to determine the best prediction of response in terms of sensitivity and specificity among quantitative baseline HBV-DNA levels in blood serum in patients with chronic hepatitis B (CHB) infection who treated with interferon-alpha-2b.Patients and
    Methods
    Totally, 78 CHB patients with serum HBV-DNA>105 copies/mL were treated with interferon-alpha-2b (PDferon: Pooyesh Darou, Tehran, Iran) for 52 weeks as 5 MU Sc. for 24 weeks in HBeAg(+) and 48 weeks for HBeAg(-) at baseline of study in Tehran, Iran. Serum HBV-DNA level using Cobas Amplicor HBV Monitor test and HBeAg status were assessed at baseline and end of 6-months follow-up. Sustained response (SR) (n=42, 56%) was defined by HBeAg seroconversion (n=12), or with a decrease in HBV-DNA >105 copies/mL to undetectable value (n=33), or chemical response (n=20).
    Results
    Higher pretreatment HBV-DNA levels have a significant relationship with better response to treatment in HBeAg (+) (R=0.7, p=0.04). Positivity of HBeAg in SR was a better predictor of chemical response in our patients, when compared to HBeAg negative (SR: 85% vs. 15%, respectively). At end of follow up, HBeAg (-) patients revealed more decrease in HBV-DNA levels than HBeAg (+) (412 vs. 290 ×105 copies/ml,
  • Rezvan Moniri, Zahra Tavajjohi Page 18
    Background
    Pseudomonas aeruginosa is characterized as an important nosocomial pathogen with increasing antimicrobial resistance. The multidrug-resistant (MDR) phenotype in P. aeruginosa is increasing worldwide. The purpose of this study was to evaluate the prevalence of antibiotic susceptibility, ESBLs (Extended spectrum beta lactamases) producing and multidrug resistant (MDR) P. aeruginosa, isolated from clinical specimens of patients and environment of hospital. Patients and
    Methods
    This descriptive study was carried out on 76 isolates of P. aeruginosa from a 500-bed tertiary-care general teaching hospital in Kashan, Iran in 2010. Susceptibility testing according to the CLSI (Clinical Laboratory Standards Institute) recommended to eight antipseudomonal agents was performed. ESBLs producing strains were confirmed by double disk diffusion method. Multidrug-resistant isolates were defined as those resistant to three or more classes of antipseudomonal agents.
    Results
    The highest resistance rates from the isolated P. aeruginosa were shown against piperacillin, imipenem, cefotaxime, ceftriaxone, gentamicin, ceftazidime, aztreonam, and ciprofloxacin, respectively. Seven isolates (9.2%) were ESBL producers. More than 30% of the isolates were resistant to at least three classes of antibiotics, and 13% of MDR strains were resistant to all eight tested classes of antimicrobials. Among the total isolates, 6.6% were susceptible to all studied agents, and 9.2% were resistant to a single agent. The isolated bacteria from the tracheal samples showed the highest MDR rate.
    Conclusion
    Prevalence of P. aeruginosa producing ESBL and MDR strains from our clinical samples and environment is still low.
  • Onyango David Miruka, Kakai Rose, Waindi Eliud Nyandago Page 24
    Background
    Tetracyclines (TCs) are a type of broad-spectrum bacteriostatic antibiotics used for treatment of a wide variety of infections. These antibiotics eventually reach terrestrial and aquatic environments via application of manure or slurry to areas used agriculturally, or by other methods. Bacteria resistance to tetracycline is due to efflux pump among others. This study discerned the existence of tetracycline efflux pump in Salmonella enterica belonging to different serovars isolated from diarrhea patients in two rural health centers in Western Kenya.Patients and
    Method
    Forty-five unrelated tetracycline-resistant Salmonella isolates from diarrheal patients were cultured and phenotypically identified using conventional methods. Phenotypic tetracycline resistance profile was determined by using Agar Disc Dilution. Tetracycline growth curve for resistant isolates were determined by incubating 106 cfu in 10 ml nutrient broth having 30μg/ml tetracycline and incubated at 37°C in a rotary incubator. Generation rate was spectrophotometrically assayed at 600nm. Tetracycline resistant isolates DNA were extracted using QIAMP Qiagen protocol and amplified using specific tetracycline primers.
    Results
    Tetracycline resistance genes were isolated in 62.2% (n=28/45) Salmonella isolates. Out of these, 64.3% (n =18/28) were S. typhi, 17.8% (n =5/28) S. typhimurium, and 14.3% (n=4/28) S. enteritidis. S. typhi expressed resistance to tetA 3.6% (n=1/28), tetB 10.7% (n=3/28), tetD 10.7% (n=3/28), tetG 10.7% (n=3/28), tetE, H, J, 10.7% (n=3/28) and tet AC 17.8% (n=5/28) in isolation or in combination. All the 5 S. typhimurium expressed tetA resistance. Totally, S. enteritidis displayed tetA, tetB and tetC resistance in 7.1%, 3.6%, and 3.6%, respectively.
    Conclusion
    These data show that the identified gene encoded tet resistance gene as MFS–type multi-substrate efflux transporter, which contributes to intrinsic resistance on range of structurally unrelated compounds in Salmonella species.
  • Gita Eslami, Mahrokhsar Fotouhi, Habibolah Peirovi, Mohammad Hashemibahramani, Masoumeh Douraghi, Elahe Ahmadzadeh, Shams Jahan Fotouhi Page 31
    Background
    Prior investigators demonstrated Helicobacter pylori as a risk factor of liver diseases. In this study association between H. pylori and hepatocellular carcinoma was investigated.Patients and
    Methods
    Totally, 59 specimens of liver were collected from two health care centers affiliated to Shahid Beheshti University of Medical Sciences, including 22 specimens of hepatocellular carcinoma, 18 specimens of cirrhosis and 19 normal specimens of liver. Polymerase chain reaction was used to determine the presence of H. pylori in liver samples using H. pylori gene-specific primers.
    Results
    16srRNA of Helicobacter genus were found in 31.8% of hepatocellular carcinoma and 16.7% of cirrhotic specimens, however, we could not find this gene in normal samples. Meanwhile, the presence of ureC and cagA genes specific for H. pylori were investigated in positive specimens to confirm the H. pylori infection, however, these genes were not detected.
    Conclusion
    Helicobacter infection exists in liver of patients with hepatocellular carcinoma. However, further studies are necessary to confirm this association.
  • Hourieh Shamshiri Milani, Eznollah Azarghashb* Page 35
    Background
    Sexual and reproductive ill health causes over one third of the global burden of diseases among women of childbearing age. This survey was performed to study female student's knowledge and attitudes towards STDs and sexual relations.Patients and
    Methods
    A KAP study was achieved. Knowledge, attitudes and practice were asked by questionnaire. One hundred and four female students of three dormitories were selected by convenient sampling method. The levels of knowledge and attitudes were measured and analyzed by SPSS software.
    Results
    AIDS and hepatitis were recalled by 85.6% and 44.9% of students, respectively. Only, 1% of students had acceptable knowledge and the remaining had low and very low level of knowledge. Students guessed their intimate friends have sex relationship with their boyfriends (28.3%). Female students pointed to "sexual need and instinct" as the most prevalent reasons for before marriage sex (40.1% for females and 72.6% for males, p
  • Faramarz Mehrnejad, Fatemeh Karimi, Fahimeh Asadi Amoli, Zohreh Abedinyfar, Farahnoosh Doustdar, Hossein Goudarzi Page 41
    Background
    As Pseudomonas aeruginosa is known the most common etiologic agent in microbial keratitis associated with contact lens use, this study was designed to study the distribution and patterns of resistance to antimicrobial agents of keratitis isolates in Iran. In this study, also the suitability of enterobacterial repetitive intergenic consensus (ERIC)-PCR to rapidly type P. aeruginosa strains isolated from patients with keratitis was examined.Patients and
    Methods
    For this purpose, 57 clinically isolates of P. aeruginosa from keratitis patients referred to Farabi hospital were analyzed by antimicrobial susceptibility test using the disc diffusion method. Polymerase chain reaction with enterobacterial repetitive intergenic consensus primers (ERIC-PCR) was used to establish clonal relationship between the different isolates.
    Results
    All the strains showed resistance to at least 4 antibiotics, but all were susceptible to fluoroquinolones. Multidrug resistance was found in two isolates (3.5%) which were resistant to more than one category of antibiotics including aminoglycoside (gentamicin) and β-lactam (cefazoline). ERIC-PCR produced 53 different ERIC fingerprints, 49 of which contained only 1 strain. Eight of the isolates had 100% similarity, forming four real clones but considering 85% similarity cut off between isolates, 8 clones containing 25 isolates (43.8%) could be considered.
    Conclusion
    Fluoroquinolones appeared to be the most effective agent against ocular P. aeruginosa isolates. Comparison of ERIC-PCR profiles revealed a low level of similarity among the strains analyzed. ERIC-PCR seems to be an inexpensive, fast, reproducible, and discriminatory DNA typing tool for effective epidemiologic surveillance of P. aeruginosa isolates potentially transmissible between patients with ocular infections.
  • Morteza Pourahmad, Rahim Raoofi, Sadegh Chinikar, Seyed Mojtaba Ghiasi, Arash Ghalyanchilangeroudi Page 47
    ackground: Crimean-Congo hemorrhagic fever (CCHF) virus causes a severe hemorrhagic syndrome in humans with fatality rate up to 50%. Its transmission to humans is through the bite of Ixodid ticks or by contact with blood or tissues from infected livestock.Patient: By a nosocomial transmission of Crimean-Congo hemorrhagic fever (CCHF), a health care worker was infected in December 2008 due to a re-emerging outbreak of CCHF in Fars province, Iran. After admission of probable CCHF cases in a local hospital, one of the nurses contributed in taking care of the patients was infected with CCHF, though it seems that she had not had direct contact with blood and secretions of CCHF patients. The laboratory detected anti-CCHF virus IgM antibody through specific ELISA and also the CCHF virus genome in her serum by real-time and gel-based RT-PCR. She was improved by an alert and on time clinical diagnosis and treatment.
    Conclusion
    We recommend that in outbreaks of CCHF, care to prevent airborne transmission should be kept in mind
  • Roya Ghasemian, Narges Najafi, Tahereh Shokohi Page 51
    Background
    Cryptococcal meningitis is a common opportunistic infection in patients with underlying immunosuppressive state specially AIDS patients. However, it could be seen in immunocompetent patients mostly in tropical areas. There are scanty reports of such infection in healthy patients of non-tropical areas.Patient: We report an immunocompetent 43 years old Iranian man who was in excellent health status until 3 weeks before hospitalization when he developed headache. He experienced a 5-week delay in diagnosis of cryptococcal meningitis which led to his blindness of right eye despite treatment.
    Conclusion
    We believed that the nonspecific clinical and laboratory finding of the present case and also the rarity of disease in our area especially in immunocompetent patients made his diagnosis confounding.
  • Nasser Ebrahimi Daryani, Mohammad Taher, Samira Shirzad Page 56