Journal of

Background: With due attention to the prevalence of thalassemia in Iran and patients' importunate needs for blood intake, this study aimed to inspect contaminations due to repeated blood transfusion which does not sift in blood donation. One such contamination is cytomegalovirus infection, which is an important pathogen in immunosuppressive patients or receivers of transplanted organs.

Methods: This cross sectional study was conducted on 311 thalassemia patients under age of 15 yr who was receiving blood from Hospitals in Tehran and Noorabad Mamasani repeatedly. To determine active infection (presence of IgM antibodies) of cytomegalovirus, ELISA method was used. In addi­tion, 225 healthy people under age of 15 yr were studied as testified group and finally all data were analyzed using SPSS ver. 11.5.

Results: 12.9 % of patients were positive from the view point of active infection. Regional separation of patients showed that the patients resided in Tehran are more contaminated to this virus than patients of other cities.

Conclusion: The range of cytomegalovirus active infection in thalassemia patients is high. One reason might be the infected blood intake or immunosuppressant (weakness of immune system) in patients, there­fore immunity care of these patients and negative serologic blood intake with respect to and also he­matic parents (parents with the same blood) are important.

Background and Aim: Evaluation for STIs requires speculum examination. It is sometimes uncomfortable and rejected by many patients. Speculum examination often is impractical or not available in remote areas. Recently, it is possible to omit the speculum examination and noninvasively diagnose for Chlamydia and gonorrheal infections from urine sample. This comparison study was conducted by collected vaginal specimens directly without performing a speculum examination for the diagnosis of trichomonas infections.The aim of this study was comparison of two methods of vaginal discharge collection with and without speculum examination for diagnosis of the trichomonas infection.

Materials and Methods: We examined 100 patients with vaginal discharge to the gynecology clinic of the Taleghani hospital. Two vaginal swab were collected from vaginal discharge of patients before and during speculum examination for diagnosis of trichomoniasis. Both of vaginal specimens were tested with blinded microscopic. Compared collection methods sensitivities, specificity, positive predictive value, negative predictive value and accuracy of both methods was compared.

Results: Sensitivities, specificity, positive predictive value, negative predictive value and accuracy of speculum collection methods were 69%, 99%, 92% ,94% and 93% for trichomoniasis respectively. Sensitivities, specificity, positive predictive value, negative predictive value and accuracy of nonspeculum collection methods were 62.5%, 99%, 91%, 93% and 92% for trichomoniasis respectively. The differences between methods was not statistically significant (P= NS). There was a very good agreement between both methods for diagnosis of trichomoniasis (KAPPA= o.85).

Conclusions: We have demonstrated the benefit of  nonspeculum vaginal specimens for the diagnosis of trichomoniasis. This technique has applicability for studies involving the epidemiology of vaginal infection as well as for home diagnostic testing ,elder and pregnant women respectively.

Background and Aim: Procalcitonin is prohormone of calcitonin and is made 116 amino acids. The normal value of procalcitonin is less than 0.5 ng/ml, that if this amount exceeds, infection is indicated. This poly-peptide is a marker for the diagnosis of primary infection. Increased amounts of procalcitonin is associated with infection especially bacterial infections.

Materials and Methods: 32 patients with liver cirrhosis and 16 healthy controls enrolled in this study were. Serum PCT levels in these subjects was measured. PCT level was measured by semi-quantitative method.

Results: Patient group included 23 males and nine females with mean age of 45 years and SD= 17.44 years, the control group included 11 males and 5 females with mean age of 46 years and SD=15.5 years.
The statistical analysis showed that there was significant difference between PCT levels in patients and controls (P<0.05).Furthermore PCT levels was significantly hgher in cirrhotic patients with hepatitisec background.

Conclusion: Since these patients had no symptoms of infection and were hospitalized for endoscopy test and the PCT test was positive in 78.1% of cirrhotic patients ,whereas this ratio was 25% in the control group, the patients probably were infected and should be under proper treatment.

Background and Aim: Group B streptococcus(GBS)(Streptococcus agalactiae) is the leading cause of morbidity and mortality of the newborn infant and accounted as a factor leading septicemia after birth in mothers. Infections in infants are usually acquired by contact with the genital tract of the mother during labor and delivery. So a rapid screening test for group B streptococcus that could accurately identify pregnant women who are carrying the bacteria at the time of delivery would obviate the need for prenatal screening.The goal of this study was molecular epidemiology of group B beta Hemolytic Streptococcal(GBS) colonization in the vaginal flora of pregnant women.

Materials and Methods: Samples were taken from mucus of anal and vaginal of 250 pregnant women during 35-37 week's ingestion by swap. Samples were tested by standard culture using Todd Hewitt Broth and Blood Agar and also by PCR using cfb gene.

Results: Culture identified 21(8.4%) women as carriage of GBS from 250 women but PCR assay could identify 24(9/6%) women. In comparison to culture results, sensitivity, NPV Specificity PPV of PCR Were(100%, 100% and 97%, 82%) respectively. The times that used for PCR assay and culture were 2h and 36h respectively.

Conclusion: In conclusion, we found that group B streptococci can be detected rapidly and reliably by a PCR assay of combined vaginal and anal secretions from pregnant women at the time of delivery. Also this study shows that incidence of GBS is at high rate in Iranian pregnant woman, so we recommend screening of pregnant woman for detecting of GBS emphatically.

Background and Aim: The aim of this study was to evaluate bacterial contamination of keyboards of computers located in various wards of Vali-e Asr Teaching Hospital, Birjand, Iran.

Materials and Methods: In this study, all computer keyboards in various wards of Vali-e Asr Hospital were sampled (n=24). Then, the samples were sent to Microbiology Research Laboratory at Birjand University of Medical Sciences and were cultured on Blood ager, Manitol Salt ager and Eosin Methylene Blue media. The isolated bacteria were identified based on their colonial morphology and biochemical characteristics.

Results: A total of 26 samples from 24 different computer keyboards of 16 different wards were obtained. Two keyboards of Infectious Diseases and Neurology wards were routinely disinfected at the end of every shift. All samples(100%) showed contamination to different bacteria. The keyboard of the computer located in Internal Medicine ward(women's division) was the most contaminated one. In total, 13 different bacterial spp. were isolated from keyboards of different computers. The species belonging to Enterobacteriaceae family(61.5%) were the most common contaminating bacteria followed by Bacillus spp(30.7%).

Conclusion: Based on the results, all the sampled keyboards were contaminated by at least one bacterial spp. Therefore, it is necessary to pay more attention to the fact that computer keyboards in hospitals should regularly be disinfected.

Background and Aim: A vast majority of clinical specimens are contaminated with Klebsiella species. The drug resistance among Klebsiella species is increasing day by day therefore, antibiotic senility test is necessary before prescribing antibiotics. The aim of this research was to determine the antibiotics resistance patterns of Klebsiella species isolated from clinical specimens of patients using the standard Kirby-Bauer method.

Materials and Methods: The present research was performed on 300 specimens of Klebsiella collected from Imam Khomeini hospital. After identification, drug resistance was investigated through the standard CLSI procedure. The drug sensitivity test was determined for all of the 12 antibiotics using standards of disk diffusion in agar Kirby-Bauer.

Results: The frequency rates of the isolated Klebsiella species were: pneumonia(94%), oxytoca(4%), ozaenae(1%), and rhinoscleromatis(1%). Moreover, in terms of source of infection, the collected samples in order of frequency were: urine, sputum, vagina, scar, stool, and blood, respectively. Altogether, the percentage rates of resistance were as follows: Ampicillin(97%), Amoxycillin(97%), Cefalotin(39%), Gentamicin(30%), Colistin(55%), Nalidixic acid(2%), Chloramphenicol(26%), Kanamycin(17%), Tetracycline(28%), Nitrofuration(44%), Ceftazidime(2%), and Amikacin(0%).

Conclusion: The results showed that the lowest resistance rate obtained was related to Amikacin in all tested Klebsiella therefore, it can be recommended as the most effective antibiotic.

Background and Aim: Effective educational programs, is one of the most basic methods in prevention of Nosocomial infection. This study aimed to compare the effects of E-learning versus lecture-based education in prevention of Nosocomial infections among hospital staffs.

Materials and Methods: A randomized pre and posttest control group design was conducted on 98 hospital staffs in 2013 after allocating into two groups of "lecture-based education" and "E-learning”. Data were collected by a researcher-made questionnaire which its validity and reliability was confirmed by a pilot study. Wilcoxon, Paired and Independent sample T-test was conducted using SPSS, version18.

Results: There was a significant difference for outcomes before and after education based on two approach of lecture-based (p=0.01) and E-learning (p=0.01).The mean and standard deviation of knowledge in lecture-based education and E-learning group were 12.73± 2.76, 11.50 ± 2.64 respectively. The level of knowledge in the lecture group was significantly higher than that of participants in the E-learning group (p=0.02).

Conclusion: Despite the effectiveness of E-learning in learning and raising awareness of the learners, using of this method among health-related organizations need to empower employees, remove the barriers and suitable infrastructure.