Background: Pseudomonas aeruginosa is a nosocomial pathogen which especially causes infections among burn patients. Carbapenems are extensively used for the treatment of infections caused by multidrug-resistant P. aeruginosa isolates. The emergence of carbapenemases producing isolates is an outcome of increased utilization of carbapenems. The aim of this study was to determine the bla-IMP-1 and bla-IMP-2 genes in metallo-b-lactamase (MBL) -producing Pseudomonas aeruginosa isolated from burn patients in Isfahan.Material and Methods: A total of 150 P. aeruginosa were isolated from burn patients hospitalized in Imam-Mousakazem hospital in Isfahan. Antimicrobial susceptibility was determined using disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Double Disk Synergy Test (DDST) was carried out for screening of MBL production in imipenem-resistant strains. PCR assays were used for detection of bla-IMP-1 and bla-IMP-2 genes among metallo- b -lactamase-producing Pseudomonas aeruginosa isolates. The purified PCR products were sequenced.Results: Of 150 Pseudomonas aeruginosa isolates, %100 identified as multi-drug resistant strains. The most resistance rates were seen against ciprofloxacin, tobromycin, meropenem and imipenem. All of 144 imipenem-resistant Pseudomonas aeruginosa isolates were MBL producing by DDST test. Twenty-nine (19.3%) and 8(5.3%) MBL producing Pseudomonas aeruginosa isolates harbored bla-IMP-1 and bla-IMP-2 genes respectively.Conclusions: According to results of this study high level resistance to imipenem and MBl genes carriage was seen among Pseudomonas aeruginosa isolated from burn patient infections in our region.

Objective(s): We developed a simple non-invasive I-123-N-isopropyl-p-iodoamphetamine (123I-IMP) quantification method by analyzing chest RI-angiography and single photon emission computed tomography (SPECT) images based on the microsphere model (SIMS method). Theoretically, the SIMS method could be changed to the simple non-invasive ARG (SIARG) method by modifying the integrated washout ratio (WR) to one-point WR. If the regional cerebral blood flow (rCBF) values derived from the SIARG and ARG methods correlate well, the facilities employing the ARG method can easily switch to the SIARG method. The purpose of this study was to develop the SIARG method by modifying the SIMS method, and to confirm the feasibility of this method.Methods: The correlation between the input counts of the SIARG method and the blood counts was determined by linear regression analysis. The rCBF values determined by the SIARG method were compared with the values obtained with the ARG and SIMS methods.Results: There was a good linear correlation between the SIARG counts and the arterial blood counts obtained by the ARG method (r=0.85, P<0.001, n=29). The rCBF values obtained by the ARG and SIARG methods (n=29, 696 ROIs) correlated well (y=1.01x – 3.6, r=0.85, P<0.001). Similarly, the rCBF values obtained by the SIARG and SIMS methods (n=29, 696 ROIs) correlated well (y=0.98x – 15.2, r=0.90, P<0.001). rCBF values obtained by the SIARG method were almost the same as the values obtained by the ARG method, and values of the SIMS method were 15 ml/100g/min higher that of those obtained by the SIARG method.Conclusion: The rCBF values obtained by the ARG, SIARG, and SIMS methods correlated very well. Therefore, the SIARG method is potentially useful for examinations in routine clinical practice.

Background: Alterations in carbohydrate metabolism are frequently observed in cirrhosis. We conducted this study to define the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in patients with chronic liver disease (CLD), and explore the factors that may be potentially associated with the development of DM in these patients. Methods: From October 2002 to March 2003, 185 consecutive patients with CLD, who referred to "Tehran Hepatitis Center", were enrolled into the study. Fasting plasma glucose and two-hour plasma glucose were measured in patients' sera. DM and IGT were diagnosed according to latest American Diabetes Association criteria. Results: The subjects included 42 inactive HBV carriers, 102 patients with HBV or HCY chronic hepatitis, and 41 cirrhotic patients. Mean age was 43.8±12.0 years ranging between 22 to 84 years. DM and IGT were diagnosed in 40 (21.6%) and 21 (11.4%) patients, respectively. Univariate analysis, showed that age (P=0.000) CLD status (P=0.000) history of hypertension (P=0.007), family history of DM (P=0.000), and body mass index (BMI) (P=0.009) were associated with DM. Using Multivariate analysis, age (P=0.01), family history of DM (P=0.0001), chronic hepatitis (0.0004), and cirrhosis (P=0.0004) remained as the factors independently associated with DM. When patients with cirrhosis and chronic hepatitis were analyzed separately, higher Child-Pugh's score in cirrhosis (P=0.04) and older age (P=0.04), higher fibrosis score (P=0.04), and higher BMI (P=0.003) in patients with chronic hepatitis were found to be associated with higher prevalence of DM. Conclusion: Our findings indicated that patients with cirrhosis and chronic hepatitis are at risk of developing DM. Older age, sever liver disease, and obesity were associated with development of DM.        

Background: Pseudomonas aeruginosa is an opportunistic pathogen associated with nosocomial infections. The emergence and dissemination of metallo-b-lactamases (MBLs) and extended-spectrum- b -lactamases (ESBLs) have contributed to the high rate of resistance among the p. aeruginosa isolates. This study investigated the prevalence of IMP, SHV and PER genes in p. aeruginosa isolates.Methods: Antibiotic susceptibility testing was performed using the minimal inhibitory concentrations (MIC). Then the polymerase chain reaction (PCR) was used for the detection of 3 genes encoding IMP, SHV and PER.Results: Of the 60 isolates tested, 38 (63.3%) were resistant to piperacilin, 42 (70%) to ceftazidime, 44 (73.3%) to imipenem and 45 (75%) to cefepime. Five (8.3%) and 8 (13.3%) of the isolates had PER and SHV genes by PCR results. In this study IMP gene was not found.Conclusion: According to this study, P. aeruginosa isolates were highly resistant to antibiotics. Therefore the susceptibility of isolates should be tested before treatment. Among the three b -lactamases genes studied the highest prevalence was related to SHV gene. Given the clinical significance of MBLs and ESBLs producing isolates, identification of these organisms is essential in the hospitals in order to get a better therapeutic response and control of bacterial dissemination.