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Mohammad Motamedifar , Davood Mansury , Hadi Sedigh Ebrahim-Saraie, Jamal Sarvari ,
Volume 73, Issue 4 (July 2015)
Abstract

Background: Antimicrobial resistance is a growing problem in many bacterial pathogens and is of particular concern for hospital-acquired nosocomial infections. Klebsiella pneumonia is an important cause of nosocomial infections has rapidly become the most common extended spectrum beta-lactamases (ESBLs) producing organism. ESBL are defined as the enzymes capable of hydrolyzing oxyimino-cephalosporins. The aim of this study was to compare phenotypic detection of ESBL using two phenotypically method among the clinical isolates of Klebsiella pneumoniae. Methods: In this cross-sectional study a total of 144 isolates from clinical samples Urine, sputum, wound, blood, throat and body fluids isolated and identified as K. pneumoniae in a teaching hospitals in Shiraz within a six months period from December 2012 to May 2013. Antibacterial susceptibility test performed to 14 antibiotics by the disk diffusion method according to CLSI guideline and then isolates that were resistant to at least one of the beta-lactam antibiotics evaluated for the production of beta-lactamase enzymes by using E-test ESBL and combined disk method. Results: Totally 38 (26.3%) isolates produced ESBLs. All ESBL producing isolates were susceptible to imipenem and meropenem and resistant to aztreonam. The highest antibiotic resistance was observed for amoxicilin (100%) and the lowest antibiotic resistance was observed for meropenem (9.7%). The number of 38 (100%) isolates were identified as ESBL producer by using E-test ESBL ceftazidime. It was while using the combined disks ceftazidime/clavulanic acid, cefotaxime/clavulanic acid and cefpodoxime/clavulanic acid, respectively 35 (92.1%), 34 (89.4%) and 31 (81.5%) of isolates identified as beta-lactamase producing isolates. Conclusion: Considering the high prevalence of bacteria producing ESBL, screening for infections caused by ESBL-producing isolates may be lead to the most effective antibiotics therapies.
Davood Mansury , Mahdis Ghavidel , Kiarash Ghazvini ,
Volume 75, Issue 10 (January 2018)
Abstract

The members of Mycobacterium tuberculosis complex (MTBC) known as causative agents of human tuberculosis. Tuberculosis infection is one of the most important occupational risks for healthcare workers (HCWs) in most countries, such as Iran. In general, there are two types of tuberculosis, they include: latent infection and active TB. Latent tuberculosis infection (LTBI) means: a patient is infected with Mycobacterium tuberculosis but, the patient does not have active tuberculosis, clinical symptoms and radiological findings. According to studies, TB infection from patients to health care workers, depending on geographic region and economic situation is two to five times more than general population. The lowest incidence and the highest rates of LTBI prevalence among HCWs were 7% in Mashhad and 82.8% in Zahedan respectively. The risk factor acquisition of TB infection was a significant relationship with certain hospital wards (lung disease unit, laboratory, etc.), Increasing age and duration of employment. And results of this study show that TB is a significant problem among HCWs in Iran. Infection control and personal protective measures with training programs to patients and HCW is required to reduce the occupational risk of TB. Early detection of Mycobacterium tuberculosis and prevention treatment in people with latent TB are key elements in control of tuberculosis. Until now, different methods for detection of latent tuberculosis infection has been introduced that are not gold standard none of them. However, the most important methods, tuberculin skin test and the tests that based on measuring the production of interferon gamma are recommended, but each one of them has advantages and disadvantages. However, in all the articles of the tuberculin skin test is used for screening and early diagnosis of latent tuberculosis infection. So, the aim of this study was to Incidence and prevalence of latent tuberculosis infection in health care workers and risk factors, advantages and disadvantages of each method for diagnosis of latent tuberculosis infection and evaluate different strategies for reducing the incidence of latent tuberculosis infection in health care workers.


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