Gh Pourmand , M.r Pourmand , S Salem , M Taheri Mahmoudi , A.r Mehrsai , R Ebrahimi , M.r Nikoobakht , K Nouri Jelyahi ,
Volume 4, Issue 2 (3 2006)
Abstract
Background and Aim: Infectious complications after renal transplantation are associated with significant morbidity and mortality. We evaluated post-transplant complications due to infections and their relationship with graft function, immunosuppressive drugs and mortality.
Materials and Methods: Over a 2-year period (2002-2004), 179 renal transplantations were performed in our center. Of these, 142 cases were followed for a period of one year. The immunosuppressive regimen included cyclosporin A, mycophenolate mofetil and prednisolone. Each patient was assessed through regular visits and according to the ward protocol. Results of the investigations (infections and their relationship with age, sex, donor type, creatinine level, acute rejection, immunosuppressive drugs, graft and patient survival) were recorded and analyzed.
Results: The overall incidence of infection was 54%. The most common sites were lower urinary tract (42%) and respiratory tract (6%). The most frequent causes were Klebsiella (24%) and Cytomegalovirus (18%). Wound infection occurred in 5% of the patients. The overall mortality was 7.7%, and almost half of the death cases (3.5%) involved sepsis development. Graft loss occurred in 16 (11%) of the cases: 2 developed Cytomegalovirus infection, 2 experienced urinary tract infection (UTI) and 5 developed sepsis (and expired). Mycobacterial and hepatitis C infections were noticeably low compared to other studies. The hazard rate in occurrence of UTI, CMV, acute rejection and mortality were higher in cadaveric transplant recipients than in others.
Conclusion: This study identifies infections as a major cause of morbidity and mortality in the post-transplant period. Patients having higher creatinine levels and those receiving high doses of drugs at discharge are considered to be at high risk and should be evaluated thoroughly.
S Bagherzadeh Yazdchi, M.h Pourmand , M Hajiabdolbaghi, M Hoseini , N Mardani ,
Volume 6, Issue 2 (27 2008)
Abstract
Background and Aim: Staphylococcus aureus is one of the most important human pathogens. A major clinical concern is the high rate of antibiotic resistance among Staphylococcus aureus strains. Methicillin-resistant S. aureus (MRSA) strains are a major cause of community- and hospital-acquired infections. Therefore, genetic investigation of S. aureus strains isolated from patients with staphylococcal infection is crucial not only for tracking of infections but also for nosocomial infection control.
Materials and Methods: In this study, 103 Staphylococcus aureus isolates were collected from Tehran University of Medical Sciences hospitals. Antibiotic susceptibility patterns of the isolates were determined using a panel of 13 antibiotics by the disk-diffusion method. The isolates were investigated for hvr by the PCR method.
Results: According to the antibiotic susceptibility testing, 21 antibiotype profiles were detected. Sixty-four out of the 103 isolates were resistant to methicillin. PCR results showed 10 different patterns of hvr.
Conclusion: The results of this study showed high rates of antibiotic resistance and variations of hvr among the Staphylococcus aureus isolates. The high degree of hvr variation can be a good tool to use for molecular typing of this bacterial strain. Further investigation of antibiotic susceptibility patterns and genetic features of this bacterium is highly recommended for controlling community- and hospital- acquired infections.
