Zahedan Journal of Research in Medical Sciences
Year:2014 | Volume:16 | Issue:4|Papers Count:18

Background: Extended spectrum beta lactamases (ESBLs) have been observed in nearly all the species of family Enterobacteriaceae. The enzymes are plasmid mediated and are derived from broad-spectrum beta lactamase TEM and CTX- M by a limited number of mutations. This study was undertaken to characterize ESBL producers among Klebsiella pneumoniae and Pseudomonas aeruginosa by PCR, which were initially screened by phenotypic method.Materials and Methods: A cross-sectional study was performed to evaluate 180 strains (30 K. pneumoniae and 150 P. aeruginosa) isolated from urine culture of hospitalized patients (Amir Al-Momenin Hospital, Zabol, south-eastern Iran) suffered from urinary tract infections during a period of six months. The prevalence of ESBL producing K. pneumoniae and P. aeruginosa was evaluated by disk diffusion test and polymerase chain reaction (PCR) by detecting TEM and CTX-M gene.Results: The results of the study revealed that the prevalence of ESBL producing P. aeruginosa and K. pneumoniae by disk diffusion test was 13.3% for P. aeruginosa and 66.6% for K. pneumoniae. Seventy five percent and 65% of K. pneumoniae harboured the gene TEM and CTX-M, respectively. Forty five percent of P. aeruginosa isolates harboured the gene TEM but none of them demonstrated the gene CTX-M using PCR method.Conclusion: ESBL producing P. aeruginosa and K. pneumoniae isolates showed a high prevalence in this study. Therefore it seems that continuous surveillance is essential to monitor the ESBLs producing microorganisms in hospitals and community.

Background: AmpC beta-lactamases are capable to hydrolyse all beta-lactam antibiotics except cefepime and carbapenems. Herbal medicines have been important sources of products for the developing countries in treating common infectious diseases and overcome the problems of resistance and side effects of the currently available antimicrobial agents.Materials and Methods: Total 410 non repetitive clinical E. coli strains recovered during 7 month, were screened for AmpC production by disc diffusion test using cefoxitin (30 mg) discs and confirmed by combined disc diffusion test using phenyl boronic acid and the MIC and MBC of Allim sativum (A. sativum) alcoholic extract against AmpC positive E. coli isolates were determined.Results: A total of 107 of 410 isolates (26%) were cefoxitin resistant and 13 (3.1%) isolates harboured AmpC enzymes. A. sativum alcoholic extract were effective against AmpC producing E. coli isolates.Conclusion: There is need for a correct and reliable phenotypic test to identify AmpC beta lactamases and to discriminate between AmpC and ESBL producers and also these bioactive plants may help alleviate the problem of drug resistance.

Background: Neurofilaments (NFs) are the main constitutes of intermediate filaments in neurons. They are composed of three subunits with heavey, medium and low molecular weight. Anti-neurofilament antibodies exist in serum of patients with some neurodegenerative diseases.Materials and Methods: A fluoroimmunoassay has been developed for determining of antibodies against neurofilaments, using an anti-fluorescein serum and fluorescein-labeled NFs. Antibodies raised against bovine spinal cord NFs in rabbit and the labeled NFs are incubated with anti-fluorescein serum at room temperature.Results: At high levels, binding of anti-neurofilaments (anti-NFs) to labeled NFs prevented subsequent binding of the anti-fluorescein to fluorescein groups, resulting in little change in the signals of the label. Conversely, at low level of anti-NFs the free fraction of the labeled NFs is available to be bound by anti-fluorescein, which markedly reduced fluorescence intensity of label. Thus, the fluorescence intensity of assay mixture directly reflects the amount of anti-NFs antibodies in the serum.Conclusion: It is concluded that the availability of fluorescein-labeled NFs and antibody directed against fluorescein group permit measurement of anti-NFs antibodies in serum of neurodegenerative patients.

Background: Malaria is one of the most important infectious diseases worldwide and also in Iran. Reports announced by Controlling Diseases Center (CDC) prove the presence of two species including Plasmodium vivax and Plasmodium falciparum in this province. P. falciparum cases diagnosis in purpose of true treatment and following up patients is necessary. This study is intending to extract DNA from negative microscopic smears using the newly invented method by research group and afterwards to evaluate negative malaria Giemsa-stained smears using nested polymerase chain reaction.Materials and Methods: Aiming to diagnose malaria, nested PCR amplification was accomplished using DNA extracted from fixed negatively diagnosed microscopic smears and Giemsa-stained. The extracted DNA was used as a pattern to amplify the specific sequence of P. falciparum and P. vivax using the small subunit of ribosomal RNA [18ssrRNA]. This retrospective study was implemented on 500 malaria negative microscopic smears storing from 6 months to 1 year.Results: By accomplishing PCR amplification on 500 microscopic smears, 54 (10.8%) malaria positive samples were diagnosed which were incorrectly diagnosed to be negative previously. Of all specimens revealed to be positive, 34 (6.8%) cases were P. vivax while 20 (4%) cases were P. falciparum.Conclusion: This study reveals the priority of nested-PCR method to microscopic examination method and the possibility of using old microscopic smears in epidemiologic and retrospective studies clearly.

Background: Pleural tuberculosis occurs in 4% of newly diagnosed cases of tuberculosis. T-cells have an important role on the immunity against mycobacterial infections and as a result, the level of soluble interleukin 2 receptors (SIL-2R) as a marker of T-cell activation is elevated in patients with tuberculous pleural effusion.Materials and Methods: In this cross sectional study, the diagnostic accuracy of SIL-2R level was assessed in separating tuberculous from non- tuberculous effusions in Zahedan, Iran. From 112 patients fulfilled entrance criteria for exudative pleural effusion, 88 patients were included and underwent diagnostic procedures to identify the origin of pleural effusion. The SIL-2R was evaluated at various cut-off levels by nonparametric receiver operating characteristic (ROC) curve, and values affording greatest diagnostic accuracy were selected.Results: SIL-2R level in TB group was 9147±3573 while this level in non-TB group was 2724±1326 and the difference was statistically significant (p=0.001). The cut-off point in our study was 4200 U/ml and the area under curve was 0.930 with 95% CI: 0.881–0.979 (p=0.001). The sensitivity and specificity for this level is 86 and 89%.Conclusion: Several factors lead to the variation in the level and cut-off point of SIL-2R in different regions. Our cut-off point was lower than other studies. The level of SIL-2R in patients with tuberculosis is significantly higher than parapneumonic effusions. We suggest that measuring the SIL-2R level in pleural fluid of tuberculous patients is a useful diagnostic tool in diagnosing tuberculous pleural effusion.

Background: Human brucellosis is an endemic disease in many countries including Iran. Exact diagnosis of brucellosis is not just based on clinical symptoms, because it will be considered in differential diagnosis of other diseases. Therefore, defining organism in culture or identification of organism by serological and molecular methods for confirming clinical diagnosis is necessary. Our aim was to develop a diagnostic PCR assay and define the optimal clinical specimen for this test.Materials and Methods: This cross-sectional and descriptive study was from February 2011 to November 2012. Results of standard agglutination test (SAT) and specific immunoglobulin IgG and IgM by enzyme-linked immunosorbent assay (ELISA) were compared with multiplex PCR in 116 patients with suspected brucellosis referred to the Ali Ebn-e-Abitaleb hospital, Rafsanjan, Iran. Their sera were collected and tested by SAT, ELISA and multiplex PCR. DNA was extracted from serum samples and examined by multiplex PCR involving specific primers for Brucella melitensis and Brucella abortus based on IS711 in the brucella chromosome.Results: Brucellosis was confirmed in 116 patients (75% male and 25% female) based on applied diagnostic methods and clinical features. Results of ELISA, the SAT, and PCR were positive in 116, respectively. B. abortus and B. melitensis were detected in 101 and 15 patients.Conclusion: The results of present study showed that multiplex PCR assay is a rapid and sensitive technique for diagnosis of brucellosis compared to SAT. However it is more accurate when coupled with conventional methods.

Background: Enterotoxins of Staphylococcus aureus are the main factors which cause food poisoning.Materials and Methods: Thirty five samples of Schizothorax zarudnyi were cultured by bacteriological methods and S. aureuses were identified. The isolated bacteria were evaluated by PCR for diagnosis of the gene encoding of SEA and SEB. Data were analyzed using Stata software.Results: PCR is a rapid, sensitive, specific and inexpensive method for detecting Staphylococcal enterotoxins in food.Conclusion: 37.2% of fishes were contaminated by S. aureus. The PCR results showed that 14.3% of S. aureus isolates possessed the SEA gene, 8.5% had the SEB gene and 5.7% possessed both genes.

Background: Crimean–Congo hemorrhagic fever (CCHF) is a viral disease and causing approximately 30% fatality rate. Recent studies have been reported that hepatitis in CCHF patients is with high mortality. The aim of this study was to determine the prevalence of hepatitis in the CCHF cases and also detect the mortality rate among patients with hepatitis.Materials and Methods: The present study was conducted in patients with CCHF who were hospitalized in Boo-Ali hospital in Zahedan between Oct 2009 to Feb 2012. Liver function tests including aminotransferase enzymes and prothrombin time and mortality rate were evaluated.Results: Among 53 patients with CCHF, hepatitis was seen in 19 patients (45%). Nine patients died (21%). All dead patients had a serum aminotransaminase level≥10 times the upper normal limit.Conclusion: Our study showed that hepatitis is prevalent in CCHF patients and a serum aminotransaminase level≥5 times the upper normal limit (UNL) is a risk factor for severe disease and high mortality.

Background: According to unpublished reports that there have been cases of relapsing fever in the years ago. We decided to determine prevalence of ticks-born relapsing fever in Chabahar.Materials and Methods: This study conducted from March 2011 to February 2012, on all individuals suspected of malaria in Chabahar. The peripheral blood smears examined using a dark field microscope.Results: A total of 12, 203 smears evaluated, of which, 5.7% of the patients confirmed to have malaria, but spirochetemia were not seen in any of the samples.Conclusion: Our study showed that TBRF is not common in Chabahar city.

Background: House dust mite allergens especially pyroglyphid species are among the most important indoor allergens and have an important role in development of asthma and allergies.Materials and Methods: In current study, the level of two main allergens from mites including Der-p1 and Der-f 1 in dust of 28 homes in Birjand city was measured by ELISA method.Results: All samples were negative for Der-p1. Low leverl of Der-f 1 was detected in one sample. Prevalence of asthma, rhinitis and rhinoconjunctivitis was 2%, 28% and 15% respectively.Conclusion: The results of this study suggest that House dust mites could not grow in Birjand climate.

Background: Sistan and Balouchestan province is one of areas in Iran that have the highest malaria incidence. We have tried to investigate the epidemiology of malaria in this province.Materials and Methods: In this study, we evaluated epidemiological data of all malaria cases from April 2008 to March 2011 in this province.Results: In our study Plasmodium vivax was the most type of malaria. Malaria incidence was more in men and rural than female and urban.22.7% of all cases were foreigners. Malaria incidence has had two picks.Conclusion: Malaria control interventions should be focused on high risk group and based on incidence peak.

perforation of hydatid cyst to pleural space or bronchi is an infrequent complication of hydatid cyst. The allergic reaction may occur after perforation cyst, but anaphylactic shock is rare. We report a 45-year-old man with a paroxysmal dyspnea, productive cough, fever and fatigue, respiratory rate 25 b/min and temperature 39oC. Chest radiograph showed a cavitary lesion in its inferior lobe (Fig.1A). Hydatid cyst serology was positive. Three days after hospitalization, hypoxia and hypotension occurred. Due to ARDS, endotracheal intubation was performed and mechanical supportive ventilation initiated. The lung CT-scan showed a 6×7 cm cavitary lesion with a slim wall and some internal membranes and a consolidation around it (Fig.1B). Treatment initiated with antihistamine, intravenous corticosteroid, albendazol and norepinephrine. The patient was extubated successfully after 13 days. Thoracotomy and hydatid cyst excision were performed a week later. Finally, he discharged after 2.5 months of hospitalization. Albendazol discontinued after 4 months.

health is one of the rights of all humans. Everyone should have health. The health risk factors should be reduced for all, and all patients should be able to benefit from health services tailored to the type and severity of disease. Currently, malaria is still one of the most important health problems in the world [1]. Third millennium declaration", which was the summit of 189 countries in September 2000, includes the following objectives: eradicate extreme poverty and hunger, universal education, gender equity, child health, maternal health, combat HIV/AIDS and other diseases, environmental sustainability, global partnership up to 2015 [2].

chinococcosis is one of the major zoonotic parasitic diseases that occurs throughout the world and causes considerable economic losses and public health problems in many countries. Given that sheep act as intermediate and dogs as definitive hosts of Echinococcus granulosus, hydatidosis poses both a human health risk and an economic loss to the country. Hydatid cysts can grow in any site of the human's body, but the most common locations are the liver (65%) and the lungs (25%) [1]. Human contamination take accidentally place through close contact with an infected dog and human is usually a "dead-end" for the parasite. Hydatid cysts are maintained in three distinct cycles in Iran, a livestock/dog domestic cycle (sheep, cattle, goats and equines), a desert cycle between dogs and camels, and a wild cycle between wild carnivores and wild ruminants [2].

prophylactic antibiotics add some cost to the routine care of surgical patients. Prolonged use of prophylactic antimicrobials is associated with emergence of resistant bacterial strains. The aim of this study was to assess the adherence of surgeons to major aspects of surgical prophylaxis and to measure costs and appropriate use of antibiotics in surgical wards of five training hospitals in central province of Iran. The appropriateness of antibiotic determined by American Society of health-system pharmacists guidelines [1].

echinococcosis is a zoonotic disease caused by echinococcus spp. tapeworms. The growth of the larvae, which form cysts in vital organs such as the liver and lungs, can lead to illness and death in intermediate hosts including human. Echinococcosis is a major public health problem in some countries. Approximately 2-3 million human cases are thought to occur worldwide [1].

tuberculosis is an important infectious disease in Iran and the word so that the World Health Organization has declared it as a public health emergency disease. Each year approximately 3 to 4 million TB positive sputum smear occurs and the same number for negative and extra-pulmonary tuberculosis has been occurring and approximately 2 to 3 million people disease due to tuberculosis [1]. Knowing the number, age distribution and the incidence of new case sineachregion will show the real image of the disease. According to the statistics on the high incidence and prevalence rate of tuberculosis in the region, it would be needed careful and thorough review of the actual incidence of the disease in order to be used by researchers and authorities.

how to use standard precautions by health care workers is important. This study has been conducted to assess the use of standard precautions to prevent HBV infection before, during and after exposure to risky job.