Iranian Journal of Infectious Diseases and Tropical Medicine
Year:2004 | Volume:9 | Issue:24|Papers Count:20

Introduction: Since bum patients lose their skin which is barrier to prevent of microorganisms to entry, are very susceptible to infections. The aim of this study was to compare isolated bacteria in 3 different times in Motahari bum center. Methods: In 3 studies for isolating bacterial infections in Motaharibum center in 1993, 2000, 2001, total of 863 samples were collected from bum patients with less than 50% and also from environment of patients such as facilities in the patient room, walls of dressing of the wound room, bath room and different place of hospital. Then, bacteria were identified by standard bacteriological methods. Results: Isolated bacteria from patients were similar to environment. In 1993, the isolated bacteria were Pseudomonas aeruginosa, Enterobacter, Bacillus, Klebsiells, Staphylococci, Micrococci, E. coli and Clostridiun: In 2000, Pseudomonas aeruginosa, Acinetobacter, E. coli, Staphylococci, Enterobacter, Klebsiella, Proteus, and in 2001, Pseudomonas aeruginosa, Acinetobacter. Staphylococci, E. coli, Enterobacter, and Klebsiella was found. Pseudomonas aeruginosa was the highest percent of infection in this 3 research. Discussion: Acinetobacter was not detected in 1993, but was isolated in 2000 (15.5%), and in 2001 (20.5%). This indicated the increased risk of infections by this bacteria in future. So, it needs to clean more environment from contamination and also, clean bum intensive unit.

Gram-positive bacteria in recent decade became relatively more common than Gram-negative bacteria in most centers. Awareness about common pathogens in each center and identification of Empirical antibiotic therapy seems essential. In this survey 47 cases of fever and neutropenia was studied in 41 patients. In 10 cases (21.4%) bacteremia, in 11 cases (23.4%) documented infection without bacteremia, in 13 cases (27.6%) clinically documented infection and in 13 case (27.6%) unexplained fever were found. The most common isolated bactereia were Escherichia coli in 10 cases (3 cases bacteremia), Pseudomonas aeruginosa in 5 cases (2 cases bacteremia) and staphylococcus aureus in 5 cases (1 case bacteremia) overall, 13 cases (62%) Gram-positive and 9 cases (38%) Gram- negative bacteria were isolated. The most common sites of bacterial isolation were blood stream (29.4%) and urinary tract (20.5%), but clinically lungs and esophagus were the most involved areas. Using reliable cultures of blood, urine and other suspicious sites to infection, empirical use of anti-pseudomonas antibiotics, use of vancomycin only in limited defined conditions, changing of antibiotics according to culture results and specific attention to blood stream, urine, ear, sinuses and lungs as important sites of infection in febrile neutropenic patients are recommended.

Domestic poultry constitutes the largest single reservoir of salmonella organisms existing in nature. Among all species salmonella are most frequently reported from poultry and poultry products, because of the large population at risk and the active nation wide programmes for their isolation and identification. The present work conducted to study the prevalence of salmonella spp infection in broiler chicks up to 14 days of age. One hundred fifty five broiler chicks up to 14-days of age were collected from 31 poultry farms around the Ahvaz city. The chicks were killed by dislocation of cervical vertebrae. Individual tissue from liver, lungs, cecum, yolk sac, air sacs and heart blood were cultured on brilliant green agar according to Mallinson and Snoeynbos method. The results showed that from 18 (%58.06) poultry farm out of 31 were infected with salmonella. Salmonella were isolated from 44 (%28.38) of chicks out 155 chicks. The highest percentage of isolations was made from cecum with 21 (%13.54) positive samples, followed by liver 19 (%12.25), heart blood 16(%10.32), yolk sac 11(%7.09) and lungs 4 (%2.58) positive samples. The salmonella could not isolated from air sacs. The age of 130 out of 155 chicks were less than one week and from 29 percent of these chicks salmonella were isolated. The highest percentage of isolation from chicks under one week of age was made from cecum with 17 (%13.07), followed by liver and heart blood with 16(%12.3), yolk sac with 11(%8.46) and lungs with 4 (%3.07) positive samples. Salmonella were isolated from 6(%24) out of 25 chicks 7 to 14 days of age. The highest percentage of isolation from chicks 7 to 14 days of age was made from cecum with 4(%16) followed with liver with 3 (%12) positive samples. Salmonella could not isolated from heart blood, lungs, youlk sac and air sacs.

The differentiation Between Exudates and transudates is the initial step in the Analysis of Pleural Effusion as it often gives an indication of the underlying patophysiologic process. The differential diagnosis and the need to further investigation. For differentiation between Exudates and transudates Light's criteria, Effusion cholestrol concentration, Pleural/serum cholestrol concentration and pleural/Serum Bilirubin concentration have Been recommended. Aim of study: to determine diagnostic valuability- of pleural cholestrol concentration, P/S cholestrol And P/S bilirubin concentration in differentiation between Exudates and transudates. Patient and method: A study was carried out from october 2002 to January 2003 at infectious wards of Labbafi nejad hospital, Booali hospital and Loghman hospital. Sixty two pleural effusions and s erum specimens were Analyzed. After discharge the hospital record of all patients reviewed for a diagnosis. Conclusion: The criteria of light et al remain the best method for distinguishing Exudates from transudates. Pleural cholestrol (>43mg/dl) and P/S cholestrol ≥0.3) are useful in distinguishing Exudates from transudates but cholestrol concentration of pleural fluid (>60 mg/dl) has a low sensitivity and isn't useful. P/S bilirubin has a high sensitivity however a lower specify has.

A study on the prevalence of genital mycoplasma in 67 patients with spontaneous obortion was conducted to a clinic in Tehran (1381). 46 women (68.6%) were positive for M.H and u.u.M.H and u.u separately isolated from infected women yielded frequencies of 6.5% and 60.8% respectively. The remainder were infected with both species. Material and Methods: 67 women attending to a clinic in Tehran for abortion were survived. One vaginal swap was taken into a transport medium and delivered to a liquid medium for identification of u.u and M.H. They were incubated at 37° and observed for color change after 24 and 48 hours. Development of color identifies the presences of M.H and u.u. subsequently after this color change some inoculation from transport medium to mycoplasma agar was done and then incubated at 37°. Results Were interpreted after 24 and 48 hours. Colonies presenting with a friedegg appearance suggest the presence of M.H, while colonies t hat are brown and tiny indicate presence of u .u. Discussion: The prevalence of genital mycoplasma found in the population studies with similar to that reported by others. u.u has been shown to be more frequently isolated in women than M.H. u.u. is also the most important causing infections during pregnancy and in neonates from infected mothers. In our study u.u. was more frequently than M.H. Since genital mycoplasma have been found to be more frequent in women under 30 years of age it's not suprising that in our study young women were the most effected. Infection in pregnancy with have been a wide range of adverse outcome such as early abortion, prematurity, neonatal mortality rate and morbidity. It's quiet clear that additional studies are required for antibiotic resistancy.

Background and Objectives: Regarding the importance of imaging studying in the common problem of urinary tract infection, this study was done to determine the imaging finding in children with UTI, referring to Beheshti hospital and private clinics in 1377. Methods: In this descriptive study all of the children with urinary tract infection referring to the noted centers were studied. For these patients sonography was done in acute phase of disease. One month after treatment in some of these patients vesicourethrography (VCUG) was done, all of the data including the sex and age of patients were written in a table and statistical analysis was done. Result: In this study 160 children had urinary tract infection and for all of them sonography was done. 24% of them had abnormal findings. Stasis was 20% which was more prevalent, VCUG was done for 53 patients and 58% of them were abnormal and the most revalent was vesicouretral reflux (50.9%). Conclusion: Considering the abnormal findings in sonography and VCUG it is concluded that radiologic studies (at least sonography and VCUG) in every patient with urinary tract infection is necessary.

AIMS AND OBJECTIVE: Tuberculosis (TB) is considered as one of the main causes of mortality and morbidity in developing countries. At present, extensive contact investigation among households is not a routine part of TB control efforts in most countries. The investigation of contacts in TB cases is an essential part of TB control program. In this study we have evaluated the active contact tracing among close contacts of smear positive TB patients. The main aim of this research was to demonstrate the prevalence of TB and to fully screen the close contact of TB patients to detect the active and infected TB cases. METHODS AND MATERIALS: Close contacts of newly diagnosed patients with smear positive pulmonary TB were identified. The information and data of the contacts including history, clinical examination, history of BCG vaccination, results of tuberculin test (TST), and bacteriological and radiological manifestations were collected on special questionnaires. RESULTS: Out of the total 147 close contacts of34 index cases, 81 (55.1%) were female and 66 (44.9%) were male. Based on the nationality, there were 38 (25.9%) Afghan refugees and 109 (74.1%) Iranian. The duration of contact were as follows: in 30 cases the contact time period was less than 1 yr., in 75 individuals it was more than 1 yr., while 42 individuals had a persistent contact. In 61.8% of the cases the induration of TST was 1ess than 14 mm, while in 38.2% it was more than 15 mm. Abnormal radiological manifestations were detected in 56.3% of close contacts: calcification (25.17%), parenchymal infiltration (4.08%), cavity (2.04%) and nodular lesions (2.04%). According to the diagnostic findings, out of 147 contacts, 7 (4.8%) cases of pulmonary TB were detected. CONCLUSION: In our study no significant statistical difference was found between the prevalence of TB among the Iranian and Afghan close contacts. Also there was no significant statistical difference in the duration of contact time of the TB cases. Furthermore, positive radiological findings were detected in 56.3% of the close contacts. In 25.7% of the cases, the pattern was calcification indicating primary TB infection. According to the results of this research the rate of TB in contacts is 400 times higher than society (4800/100,000 versus 12/100,000). This study points out the importance of systematic investigation of contacts to discover new cases of TB. It also demonstrates the significant role of radiology as a major tool in diagnosing both infection and disease of tuberculosis.

Suppuration parotitis is uncommon in children and very rare in newborns. The clinical syndrome is characterized by swelling of the gland, fever, anorexia, irritability, and failure to gain weight. Staphylococcus aureus is the most common pathogen. Prognosis in the infant with appropriate antibiotic therapy without other pathology is good. Here is reporting one case of acute infection of the salivary gland occurring in the neonatal period due to staphylococcus aureus infection. The patient had good response to antibiotic therapy without any problem in the follow up. Although neonatal suppurative parotitis is now uncommon in the newborn, it should be considered in differential diagnosis of other neopatal infectious diseases to prevent the complications.

Report of 20 patients of neurobrucellosis referred to Sina hospital of Hamadan (1993- 2000) Introduction: Brucellosis is endemic in Iran. The most common agent of neurologic complication of brucellosis is Brucella Mellitensis. Direct involvement of the CNS occurs in ~5% of patients and it includes meningitis, meningoencephalitis, meningovascular complications, parenchymatous dysfunction, psychosis and peripheral neuropathy/ radiculopathy. Methods: The records of 1375 patients of Brucellosis who were admitted to-the Sina hospital of Hamadan from 1993to 2000, were reviewed and 20 patients were diagnosed neuroBrucellosis (NB). We gathered their information and analyzed it. Results: The –prevalence of NB was 1.4% that all of them out of one, had meningoencephalitis. One of the patients had peripheral neuropathy. The most common clinical manifestations were headache (75%), fever and vomiting (50%) and impaired consciousness (35%). Conclusion: The prevalence of NB was less than result of other studies but epidemiological characteristics of NB were adjusted with other studies.