Archives of Clinical Infectious Diseases
Volume:10 Issue: 1, Jan 2015

Sepsis is one of the most important causes of morbidity and mortality in the intensive care units (ICUs). It is difficult to accurately differentiate sepsis from similar diseases rapidly. Therefore, it becomes critical to identify any biomarker with the ability of differentiation between sepsis and nonsepsis conditions. The urokinase plasminogen activator receptor has been implicated as an important factor in regulation of leukocyte adhesion and migration. In this study, we evaluated the value of soluble urokinase plasminogen activator receptor (suPAR), erythrocyte sedimentation (ESR), and C-reactive protein (CRP) serum levels in terms of their value for sepsis diagnosis in ICU patients.Patients and We enrolled 107 ICU patients; 40 with sepsis, 43 with systemic inflammatory response syndrome, and 24 as control group. Serum soluble urokinase plasminogen activator receptor, ESR, white blood cell (WBC), and CRP levels were measured on the day of admission. The group with sepsis had higher suPAR, ESR, and CRP levels compared with the group with noninfectious systemic inflammatory response syndrome (SIRS) (P = 0.01, 0.00 and 0.00, respectively). CRP concentrations and ESR were higher in the sepsis group than in the non-SIRS group (P = 0.00 and 0.00, respectively). In a receiver-operating characteristic curve analysis, ESR, CRP and suPAR had an area under the curve larger than 0.65 (P = 0.00) in distinguishing between septic and noninfectious SIRS patients. CRP, ESR and suPAR had a sensitivity of 87%, 71% and 66% and a specificity of 59%, 76% and 74% respectively in diagnosing infection in SIRS. The diagnostic values of CRP and ESR were better than suPAR and WBC count in patients with sepsis.

Brucellosis is still one of the most challenging issues for health and the economy in many developing countries such as Iran. This study investigated the epidemiological features of brucellosis in Shahin Dezh, Western Azarbaijan province, North West of Iran.Patients and This study had across-sectional design and data was collected from private and public sectors over a five-year period (2008-2012). All cases were studied between years 2008 and 2012 in Shahin Dezh. In total, 492 cases of brucellosis were reported. The prevalence of brucellosis decreased from 152 cases/100000 inhabitants in 2008 to 97 cases/100000 inhabitants at the beginning of 2012. About 52.3% of subjects were male, and most cases of brucellosis were aged 25-30 years. Eighty-one percent of subjects lived in rural areas. There was a statistically significant difference regarding contact with livestock between rural and urban areas (91.7% vs. 68.8%) (P value <0.001). Raw milk was the most commonly consumed dairy product; consumed by 37% of cases. Finally, during winter and spring a high prevalence rate of brucellosis was reported. Comprehensive health-related interventions need to empower communities at risk, especially young men and young and adult women in the Shahin Dezh County. Health education is needed to raise awareness of people in the studied area.

Hepatitis B infection remains a major health problem worldwide and is an important cause of morbidity and mortality. Since it is transmitted parenterally, investigation of new cases of Hepatitis B infections for potential routes of transmission plays a crucial role in controlling hepatitis B infection in the community. In this study, we reported a new case of hepatitis B infection. Although the case had been exposed to different routes of transmission, only transmission via blood transfusion was evaluated. To improve infection control in the community, strategies should be performed to investigate more frequent routes of transmission and not only transfusion.

Immunization is an essential issue in primary health care, which has a tremendous impact on infection prevention. This study aimed to determine the immunization status of health care personnel (HCP) and adult patients admitted at teaching hospitals.Patients and A total of 1506 HCP and patients were enrolled according to 13 target groups. The immunization profile was evaluated based on adjusted recommendations of Advisory Committee on Immunization Practices (ACIP) according to the available vaccines in Iran. The rate of immunization was more than 50% only in hepatitis B vaccination among HCP (64.5%) and tetanus-diphtheria (Td) booster dose among HCP and pregnant women (54.6% and 72.9%, respectively). The other vaccines according to the target groups had no acceptable rate, especially with respect to influenza and pneumococcal vaccinations among patients with underlying chronic diseases. The low rate of immunization warrants implementation of novel protocols in adults as well as implying on educational programs in Iran.

The first report of Pseudomonas aeruginosa (P. aeruginosa) carbapenem resistant strains, and especially the Metallo-Beta-Lactam (MBL) producers was from Japan, however, further reports were global. The current study aimed to determine the frequency of vim and imp genes among P. aeruginosa MBL producer isolated from Children Medicinal Center during from 2011 to 2012. In the current descriptive study, 90 P. aeruginosa strains were collected from different clinical samples of children referring to Children’s Medical Center of Tehran, Iran. All the isolates were identified and confirmed by the standard tests. Their resistance against common antibiotics was determined by disk diffusion method based on Clinical and Laboratory Standards Institute (CLSI) 2010 protocol. The MBL producers were screened by Combined Disk Diffusion test (CDDT) and using imp-imp/Ethylen Ediamine Tetra Acetic Acid (EDTA), and increasing of 7 mm≤ the diameter of inhibiting zone. The frequency of vim and imp genes was determined by Polymerase Chain Reaction (PCR). Based on standard tests including Triple Sugar Iron Agar and Oxidation- Fermentation (OF) media and disability of the bacteria for glucose fermentation, 90 P. aeruginosa strains were confirmed. Their resistance against the following antibiotics was evaluated by disk diffusion 36.6% to cefotaxim, cefpodoxim and ticarcillin 33.3%, meropenem and aztreonam 32.2%, amikacin 28.8%, ciprofloxacin and ceftriaxon 27.7%, ceftazidime 22.3% and imipenem 15.5%. By PCR the frequency of imp gene with its 328 base pair band was (3.3%). The vim gene was not detected among the tested strains. Despite of high resistance of P. aeruginosa, the resistance rate of P. aeruginosa strains isolated from children in the current study was not high. Then accurate prescription of antibiotics can decrease the speed of resistance creation.

Rodents play a major role in economic losses and public health problems. These animals are considered as natural reservoir hosts of Zoonotic Cutaneous Leishmaniasis (ZCL), one of the major health concerns in Iran. This research was aimed to study rodents’ diversity and faunistic of Chabahar County, Sistan-Baluchistan Province, Southeastern Iran, as an old ZCL focus. Trappings were randomly performed with 20 Sherman live-traps at four localities from Chabahar County, continuously during 5 months. In the laboratory, the animal skin was entirely removed and taxidermy was performed. Four standard external characters and seven cranial variables were measured using a ruler and vernier calipers, respectively. The collected specimens were identified with respect to their morphological, external, cranial and dental characteristics. A relevant key was used for identification. Sampling was performed in different places from vegetation covering around rodent burrows. Seven species belonging to two families, Muridae and Sciuridae, were collected and determined. A total of seventy individuals of rodents, Meriones hurrianae (M. hurrianae) Jordon 1867, Tatera indica (T. indica) Hardwicke 1807, Mus musculus (M. musculus) Linnaeus 1758, Rattus norvegicus (R. norvegicus) Berkenhout 1769, Rattus rattus (R. rattus) Linnaeus 1758, Nesokia indica (N. indica) Gray 1830 and Funambulus pennantii (F. pennantii) Wroughton 1905, were trapped. The majority (78.6%) of the study specimens comprised of M. hurrianae and T. indica. These two species were found in all study areas, with high abundance. They live socially in large parts of area lands, with a very large number of rodent burrows. Standard external morphologic and morphometric characters of M. hurrianae and T. indica, including cranial and dental, are given. The spatial and temporal monitoring of wild rodents will help to predict the potential zoonotic rodent-borne diseases.

Cephalic tetanus is a rare form of tetanus, defined as trismus and cranial nerve palsy. It has a mortality rate of 15 - 30%. The purpose of this case report was to present a case of cephalic tetanus with trismus, a rare form of tetanus, in an intravenous drug abuser. Timely diagnosis and management prevented progression into the generalized form and made the patient needless of invasive procedures. Two main risk factors for getting tetanus include not being immunized against it and decrement in immunity in the elderly. Catch up vaccination programs should be carried out to cover the previously unimmunized individuals, especially in high-risk groups such as intravenous drug abusers. Booster doses of tetanus and diphtheria toxoids vaccine (Td) for the elderly should be considered.

Monilial Vaginitis is one of the most common gynecological problems among women all over the world causing 10 million consultations annually. Although the global prevalence of vaginitis is not clear, it has been reported that this infection becomes about twice more. The first cause of vaginitis in the Europe and the second cause in the United States are infections related to Candida albicans. Generally, the important cause of vaginitis is Candida albicans. Popular drugs regarding Candida albicans Vaginitis are topical ones such as Azoles. These drugs are known to cause severe adverse effects and high rate of relapse, in contrast some antifungal effects of Nigella Sativa L. without causing any adverse effect have been reported. The aim of this study was to determine the effect of Nigella Sativa Linn capsule in the treatment of Candida albicans vaginitis.Patients and This study was a randomized clinical trial, triple-blind, placebo controlled study performed on 100 women in Iran. Gynecological and microbiological evaluations were performed before and after the treatment. There were not statistically significant difference in signs and symptoms of monilial vaginitis before the treatment (P 0.05). Nigella Sativa Linn capsule and clotrimazole vaginal cream for the study group and placebo capsule and clotrimazole vaginal cream for the control group were prescribed for seven days. Data was obtained by interview and observation and analyzed with Chi-square, t-test, Mann-Whitney, Fisher-exact-test and McNemar tests. There was a statistically significant difference in vaginal itching, discharge, irritation, vulvovaginal redness and inflammation after the treatment between the two groups and much more in the study group (P 0.001). However, the culture and wet mount (with KOH) results showed much improvement in the study group after treatment. The use of Nigella sativa L. capsule with clotrimazole vaginal cream was found more effective than clotrimazole vaginal cream alone, in most common symptoms and signs of this vaginitis. Therefore, Nigella Sativa L. capsule is suggested for the treatment of Candida albicans Vaginitis.