International Journal of Infection
Year:2020 | Volume:7 | Issue:4|Papers Count:8

Dear Editor, When Coronavirus disease (COVID-19) spread throughout the planet, the vast majority of countries decided to take extraordinary actions to decelerate the spread of infection and decrease the fatality rate (1, 2). Most countries decided to go into lockdown status and reduce the financial problems associated with such an issue. Many governments are implementing a complementary socioeconomic program to support those who face financial challenges. Few countries such as Sweden decided to go to a self-responsible response, which included softer guidelines to protect the population (3), urging the senior citizens to stay home and avoid contact with others, the prohibition of the gathering of over 50 people, avoiding overcrowding in pubs and restaurants (3)...

Background: Peritonitis remains a significant complication of peritoneal dialysis (PD) in children. Objectives: The current study aimed to evaluate the causative agents of PD-related peritonitis in pediatric patients treated by continuous ambulatory peritoneal dialysis (CAPD) in order to provide evidence for improving the empirical treatment of PD-related peritonitis and avoid antimicrobial resistance. Methods: The medical records of children diagnosed with PD-related peritonitis hospitalized at Mofid and Ali-Asghar Children’ s Hospitals from January 2018 to December 2019 were retrospectively reviewed. Cases of relapsing peritonitis and fungal peritonitis were excluded. Data on demographics, clinical manifestations, para-clinical evaluations, peritoneal fluid culture and antibiogram, and antibiotic regimen were analyzed. Results: A total of 23 CAPD children aged 1-17 years were hospitalized with a confirmed diagnosis of PD-related peritonitis, accounting for a total of 27 peritonitis cases. The most frequent manifestation of peritonitis was cloudy dialysate (85. 2%), followed by abdominal pain (59. 3%). Gram-negative organisms were isolated in 48. 1% of cases, and 4 cases had negative cultures. The frequency of antibiotic prescription within 14 days of admission was significantly higher in culture-negative cases (P = 0. 002), and abdominal pain was more prevalent in Gram-negative peritonitis (P = 0. 004). All Gram-negative organisms were sensitive to ceftazidime and imipenem; while 61. 6% of them were sensitive to gentamycin. All Gram-positive organisms were sensitive to cefazolin, and vancomycin was effective against all Staphylococcus strains. Oxacillin resistance was reported in 50% of Staphylococcus strains. Conclusions: PD-related peritonitis should be suspected even in cases with clear dialysis effluent who present with other manifestations of peritonitis such as fever or abdominal pain. Moreover, intraperitoneal administration of a first-generation cephalosporin (cefazolin) combined with ceftazidime was an appropriate therapeutic option for empiric therapy.

Background: Considering the fundamental role of nursing staff and students in patient care and nosocomial infection control. Objectives: This study aimed to evaluate and compare the performance of students and nursing staff in nosocomial infection control in Behbahan city in 2019. Methods: This is a descriptive-analytical study. The participants were 217 nursing staff and students of three hospitals in Behbahan who were selected by random sampling. The data gathering tool was a questionnaire that consisted of demographic information and five common nursing procedures. The performance measurement criterion was based on fulfilling or not fulfilling standards. After gathering the data, they were analyzed by statistical tests, including ANOVA and Pearson correlation in SPSS 16 software. Results: The participants were 157 nursing staff and 60 nursing students. In line with the main objective of the study, the results showed that the average performance scores of students (152. 9 12. 5) and nursing staff (15. 5 13. 2) were at a good level, and there was no statistically significant difference between the performance of students and nursing staff (P = 0. 08). Also, there was no statistically significant difference between the nursing staff of three hospitals (P = 0. 76). However, there was a statistically significant difference between the performance scores of staff in different wards (P < 0. 001). The CCU and NICU personnel outperformed other wards’ personnel. Conclusions: Based on these findings, it can be concluded that nurses at different levels of education, with different demographic characteristics, and different work environments have a good performance in controlling infections. This is a strong point in the nursing profession.

Background: Since December 2019, many patients with novel coronavirus pneumonia (NCP) have appeared in Wuhan, Hubei Province, China. The pneumonia was caused by a novel coronavirus named “ coronavirus disease 2019, COVID-19” by the WHO on February 11, 2020. The COVID-19 outbreak has created a global public health crisis, and the challenge of combatting this pandemic and its impact is daunting. At present, vaccines and prophylactic therapies for COVID-19 are not available. What we can do now is to aggressively implement infection control measures to prevent the spread of COVID-19 via human-to-human transmission. Objectives: The study aimed to summarize the effect of classification and division management methods on the prevention and control of COVID-19 in the Pediatric Immunology and Rheumatology Department. Methods: Corresponding and targeted medical countermeasures for the prevention and control of COVID-19 from the aspects of personnel, ward, and process management were retrospectively analyzed. Results: From January 16, 2020, to July 31, 2020, there were 11, 000 outpatients with rheumatic disease visiting our hospital and 565 children with rheumatic diseases hospitalized in our department. All the patients received timely and reasonable treatment. None of the patients, their caregivers, or medical staff acquired COVID-19 infection in our department, and no suspected COVID-19 case was confirmed in our ward. Conclusions: The model of classification and division management ensured the orderly and safe treatment of children with rheumatic disease during the epidemic prevention and control period, and protected the medical staff from occupational injuries at work, and brought the pandemic under control.

Dear Editor,

Background: The emergence and spread of drug resistance among Klebsiella pneumoniae clinical isolates have limited the treatment options for these bacteria. Efflux pumps are considered as one of the key mechanisms of antibiotic resistance in K. pneumoniae isolates. Objectives: The present study aimed to detect oqxA, oqxB, and qepA efflux genes in K. pneumoniae isolated from urinary tract infection (UTI) and survey their association with antibiotic resistance. Methods: In total, 100 K. pneumoniae isolates were obtained from urine samples, and an antimicrobial susceptibility test was conducted using the disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) instructions. Polymerase chain reaction (PCR) was done for the detection of efflux pump genes including, oqxA, oqxB, and qepA, and their association was statistically analyzed with resistance to antibiotics. Results: The highest rate of resistance was obtained against trimethoprim-sulfamethoxazole (72%), amikacin (70%), levofloxacin (68%), gentamicin (56%), ceftazidime (56%), and ceftriaxone (51%), and the lowest resistance was against imipenem (10%). Thirty one percent of isolates were multidrug resistant (MDR). Molecular distribution test showed that 57% and 56% of isolates carried the oqxA and oqxB genes, respectively. Also, the frequency of qepA genes was 21%. The presence of oqxA/oqxB and qepA efflux genes were significantly associated with fluoroquinolone and beta-lactam resistance phenotypes (P < 0. 05). Conclusions: The high frequency of efflux genes showed that this resistance mechanism is the main way, along with other resistance mechanisms in K. pneumoniae isolates. It is necessary to adopt appropriate treatment to reduce the incidence of resistance.

Dear Editor, Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), a new beta coronavirus, was officially declared a global pandemic by theWorld Health Organization (WHO) on March 11, 2020, after coming under the spotlight through a pneumonia outbreak in Wuhan, China, first reported on December 30, 2019. As of June 2, 2020, 6, 194, 533 confirmed COVID-19 cases, and 376, 320 associated deaths were reported worldwide (1)...

The novel Coronavirus Disease 2019 (COVID-19) appeared as an emerging respiratory disease in December 2019 in Wuhan, Hubei province, China, and then spread rapidly worldwide, being declared a pandemic on March 11, 2020. Researchers are attempting to discover specifically designed antiviral treatments for COVID-19. Several therapeutic agents such as Interferon- , Lopinavir/Ritonavir, Ribavirin, Chloroquine, Chloroquine phosphate, Hydroxychloroquine, Arbidol, Favipiravir, Remdesivir, Darunavir, Imatinib, Teicoplanin, Azithromycin, COVID-19 convalescent plasma, other potential antiviral drugs, and Chinese herbal agents are now being clinically studied to examine both pharmaceutical efficacy and safety for COVID-19 treatment in several countries. Some favorable results from these studies have been obtained to date. This review article summarizes and reiterates drugs that are potentially efficient against COVID-19.