IRANIAN JOURNAL OF CLINICAL INFECTIOUS DISEASES
Year:2008 | Volume:3 | Issue:2|Papers Count:11

Human infections with highly pathogenic avian influenza A (H5N1) viruses present a serious and highly complex public health challenge. In May 1997, the first human case of H5N1 virus infection was identified and by the end of the same year a total of 18 cases had been confirmed. In 2003 and 2004, H5N1 viruses re-emerged and spread rapidly among poultry in several Asian countries with associated human infections. Since February 2003, millions of birds have been infected and more than 360 human cases recorded, with more than 230 deaths in 12 countries in Africa, Asia and Europe.

Background: We investigated frequency of trichomoniasis among non-pregnant women in health centers of Tabriz, Iran.Patients and methods: 1000 non-pregnant women aged 15-49 in health centers of Tabriz, Iran were examined by wet smears and Diamond culture methods for Trichomonas vaginalis, during the period of March to September 2005.Results: Among 1000 specimens 92 cases were revealed to be positive for Trichomonas vaginalis by culture method and 31 cases by wet smear method. There was no significant difference in the isolation rate of trichomoniasis in women according to age, occupation, husband education level, abortion, parity, menstrual status and contraception use. The difference in the isolation rate of trichomoniasis in women with marriage age of more than 18 years (10.9%) and in women with marriage age of less than 18 years (8%) was statistically significant. Infection rates in different education levels did not show statistically significant difference.Conclusion: Trichomonas vaginalis is one of the important diseases with a high prevalence in women in Tabriz.Eradication of this disease is possible with extensive public health education and administration of specific therapeutic agents to the infected patients.

Background: Vancomycin resistant isolates of Enterococcous faecium (VRE) have previously been reported from Tehran Hospitals. However, little data were available on the genetic heterogeneity of VRE isolates among the Iranian population. Therefore the emergence of infections with the new clones of VRE needs to be investigated. The drug resistance surveillance program at Labbafinejad hospital has to be continued.Patients and methods: Overall, 103 non-replicative isolates of enterococci grown from urine samples in the first quarter of 2005 were screened for their susceptibilities to different antibiotics. Ribotyping was then used to genetically characterize the isolates of VRE.Results: Using disk diffusion method, all isolates were found susceptible to linezolid. Resistance to high level concentration of gentamicin was detected in 65.7% of isolates. All isolates of E. faecalis (n=86) were susceptible to vancomycin. Conversely, over 70% of E. faecium isolates (n=12) showed resistance to this glycopeptide. The VRE isolates recovered from patients in 2005 were heterogeneous comparing with those of 2000.Conclusion: Conventional bacteriology confirmed the increase in the rate of VRE. It appears that a variety of new VRE clones have arisen recently at different wards of this hospital as determined by ribotyping.

Background: It is obvious that because of the lack of resources, we should devote our limited resources to priorities in order to reach an acceptable level of health. The objective of this study was research priority setting of infectious diseases using COHRED (Council on Health Research for Development) model.Materials and methods: First of all, the stakeholders were identified and the situation of the field of infectious diseases was analyzed. Then, research areas and titles were specified using announcement, infectious diseases sources, (International Classification of Diseases 10) ICD10 and consensual qualitative techniques including brainstorming sessions, focal group discussion and Delphi. Finally, research priorities were specified by giving scores according to the criteria.Results: Twenty-five research areas were obtained as priorities of infectious diseases and tropical medicine. These areas are HIV/AIDS, tuberculosis, drugs, infections in special hosts, avian flu, nosocomial infections, infections due to needle stick injury, malaria, viral hepatitis, viral hemorrhagic fevers, surgical- and burn- related infections, fever, central nervous system infections, effectiveness of vaccination, bloodstream infections, influenza, lower respiratory tract infections, gastrointestinal infections due to Entamoeba histolytica, bone and joint infections due to brucella, bioterrorism, brucellosis, hydatidosis, anthrax, botulism, and the role of migrants in the distribution of infectious diseases in Iran.Conclusion: Three subheadings including treatment, prevention and control and diagnosis methods got the most priorities, respectively. Although about half of the priorities are related to two subheadings including treatment and diagnosis methods, research priorities of prevention and control methods (22% of all priorities) indicate the importance of prevention for clinicians who gave scores to the titles.

Background: In vitro evidence shows that immune function is compromised in people with diabetes. Therefore, infections are more common and infection-related mortality is higher in this group. Accurate information about the prevalence of infectious diseases in diabetic patients can help in health care policy and support planning. We do not know the spectrum of clinical infectious diseases in our patients .This study was conducted to determine the most common infectious diseases in diabetic patients.Patients and methods: In this cross-sectional study all diabetic patients who were admitted to our hospital in Zahedan (Southeastern Iran) between 2001 and 2006, were evaluated. At first, we selected all of the patients with diabetes. Then all patients files were reviewed retrospectively for demographic factors and duration of diabetes, type of diabetes, cause of admission, prevalence of infectious diseases, duration of hospitalization and mortality rate.Results: A total of 112 patients with diabetes (45 males and 67 females with an age range of 10 to 80) were evaluated.Pneumonia, diabetic foot and tuberculosis were the most common infections. Seventy percent of cases had type 2 diabetes. Duration of hospitalization was between 1 to 20 days.Conclusion: Upon the results emerged from this study, infection is the most frequent cause of hospitalization and death in the diabetic patients. Control of the disease, good health care system and vaccination can decrease the rate of infectious diseases.

Background: Considering the increasing spread of Human Immunodeficiency Virus (HIV) in the Middle East, informing about how it can be transmitted and prevented is the primary weapon against its spread. Determining the public information regarding HIV/AIDS and their attitude toward people with AIDS/HIV can provide basis for appropriate educational program in each community. So, we investigated knowledge and attitude toward AIDS/HIV among senior school students in Isfahan, Iran.Patients and methods: A cross sectional survey among randomly selected high school students in Isfahan city was conducted. The students responded to an anonymous self administered questionnaire after orally consenting to participate in the study. Knowledge and attitude were scored. Descriptive and inferential statistics were used to analyze data by SPSS package.Results: The total knowledge level of 60.2% of students was good, of 34.1% of them was moderate and 5.7% of subjects had poor knowledge levels, and total knowledge level was not significantly different among girls and boys. In the present study there were negative attitudes towards AIDS and HIV positive persons. In 68.6% of students the attitude was moderate, in 23.3% the attitude was good and in 8.1% of students the attitude was poor.Journal and books were the main information sources in girls and in boys the main information source was TV.Conclusion: Most respondents knew the main mode of transmission of HIV infection. Thus, while mass media approaches could be the most likely strategy for future educational efforts, education intervention in schools programs involving teachers and school consultants can be tailored appropriately to the special needs of students, so as to maximize their effectiveness.

Background: The aim of this study was to compare the diagnostic value of fluorochrome microscopy (FM) with Ziehl-Neelsen (ZN) staining in the diagnosis of tuberculosis (TB).Patients and methods: In this study, 920 consecutive patients suspected of having pulmonary TB, referred to TB laboratory, provincial office of health care, Birjand University of Medical Sciences, recruited and a total of 2760 sputum specimens were collected from them. All samples were smeared and stained using both Ziehl Neelsen and auraminphenol methods as recommended by WHO. All positive smears by fluorescent microscopy were over-stained by ZN technique for confirmation. The sensitivity of ZN staining was also evaluated in different contamination conditions.Results: A total of 102 out of 920 study subjects had pulmonary TB, of them 68 (66.66%) patients were smear positive by either staining method while others were smear negative. The proportion of positive smears detected was 51% and 57% for the ZN and auramine phenol staining methods, respectively. The sensitivity, specificity, positive predictive value and negative predictive value were 51%, 100%, 100%, 94% and 57%, 100%, 100, 95% for the ZN and auramine phenol staining methods, respectively.Conclusion: FM is more sensitive than ZN for diagnosis of TB. However, since FM is more sensitive and rapid, using this method in clinical laboratories with large specimen numbers is recommended.

A male patient referred with rash, fever, malaise, weakness during the past 12 days prior to admission. He has been an intravenous drug user since 4 years ago. The rashes were first noted in his face and then spread to the trunk and extremities. He also complained of melena.

Background: Brucellosis is a common zoonosis disease which affects both humans and animals. Common symptoms of brucellosis are: fever, sweating, weakness, lethargy, loss of appetite and arthritis.Patient: The patient was a 3.5 month infant with irritability, loss of appetite and immobility of left hip joint since 10 days ago. There was no medical problem during fetal and neonatal period of his life. The infant nutrition was provided by breast feeding. About one month ago his mother has been treated as a brucellosis patient but because of disappearance of her symptoms (pain, knee edema) she stopped her treatment ahead of schedule. In physical exam of the infant his growth and developing indices were normal but there was hypersensitivity in his left hip joint. The important laboratory results were as follows: leukocytosis, Wright=1.640, Coomb’s Wright=1.1280 and 2ME=1.160. His disease diagnosed as brucellosis transmitted by lactation and he was treated with co-trimoxazole and rifampin. Breast feeding was discontinued and he was fed with formula thereafter. After a few days all symptoms disappeared and he discharged in a good condition.Conclusion: Applying serologic tests for infant whose mother is suspected of brucellosis seems logical.

Introduction: After World War II it was widely believed that human-kind was winning the battle with the microbial world due to the advent of safe and antimicrobial compounds against diseases, such as tuberculosis and typhoid; vaccines against polio, diphtheria and pertusis; vast improvements in public sanitation and water/food quality; and effective chemical pesticides to control insect vectors of disease. In 1969, an American surgeon (William H. Stewart) even declared to the congress that: "it is time to close the book on infectious diseases, declare the war against pestilence won.

BA is a disorder of neovascular proliferation originally described involving skin and regional lymph nodes of HIV infected person (1,2). It has been demonstrated to involve a variety of internal organs, including liver, spleen, bone, brain, lung, bowel and uterine cervix (3-5) and to occur in other immunocompromised patients as well as immunocompetent hosts (6,7). Bartonella quintuna and B. henselae have been shown to be a cause of BA, both by direct culture (8).