Ghobad Moradi, Seyyede Maryam Bechashk, Nader Esmailnasab , Behzad Mohsenpour, Rashid Ramazanzadeh , Daem Roshani , Ebrahim Ghaderi,
Volume 77, Issue 2 (May 2019)
Abstract
Background: Metronidazole resistant clostridium difficile is one of significant pathogens in Iran. It is one of the WHO-declared microbial resistance emergencies. Prevalence of metronidazole resistant clostridium difficile is rising. The aim of this study was to detect prevalence of metronidazole-resistant clostridium difficile using meta-analysis in Iran.
Methods: This study was conducted as a meta-analysis. Articles and derivatives were reviewed by two researchers. Initially, each of the researchers searched the databases separately and used all available Persian and English articles in Kurdistan University of Medical Sciences, Iran, from October 2017 to February 2018. Persian databases (including Magiran, Irandoc, Barakat and SID) and international databases (including PubMed, Sciencedirect, and Scopus) were searched during this period (2007-2016) with a combination of phrases and keywords. The list of references to these studies has also been evaluated and relevant articles have been included in the study. First, all the articles were extracted and then duplicated articles were deleted using the EndNote software, version X6 (Thomson Reuters™, New York, NY, USA) through the search for electronic banks. Such that the high heterogeneity (50% Results: From the search of medical databases at first, 68 articles were selected. In total, 19 remaining studies entered the meta-analysis phase. In this study, the overall prevalence of clostridium difficile is 32.57% (CI95%: 21.86-44.30); in 2016 it was 55.25% (CI95%: 50.22-60.19) and in 2009 was14.26% (CI95%: 12.32-16.37). The heterogeneity was estimated to be 98.7% (CI95%: 98.5-98.8).
Conclusion: Based on the results of this study, the prevalence of metronidazole resistant clostridium difficile in Iran is high and increasing.
Pedram Ataee, Maryam Manouchehri , Masoumeh Abedini, Daem Roshani, Arman Malekiantaghi, Kambiz Eftekhari,
Volume 78, Issue 7 (October 2020)
Abstract
Background: Excessive and irrational use of antibiotics in the treatment of acute diarrhea has caused increased resistance to these medications. It is well defined that most cases of diarrhea in children do not require the use of antibiotics. This study was aimed to determine the status of antibiotic administration for treatment of acute diarrhea in children younger than five years. All who admitted at the pediatric ward of Besat Hospital in Sanandaj.
Methods: First, the study was approved by the ethics committee of Kurdistan University of Medical Sciences. The archived files of all children under 5 years with a positive history acute diarrhea who were admitted in Besat Hospital of Sanandaj during the period of 1 years, from May 2016 to May 2016 were reviewed. Demographic information such as age, gender, type of diarrhea, type of nutrition, type of the prescribed antibiotic, results of the stool and blood samples were collected and recorded in the questionnaire.In Stool samples the contained a large number of WBCs and RBCs along with high fever, Shigellosis were considered. The results were analyzed by SPSS software, version 23 (SPSS Inc., Chicago, IL, USA).
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Results: A total of 1,029 cases were reviewed. 60% were boys. The highest incidence of diarrhea (75.5%) was observed at 12-24 months and the lowest rate of diarrhea was under 6 months (11.5%). The frequency of diarrhea was lower in winter than in other seasons. Only 31.49% of children received proper and rational treatment with antibiotics. The most commonly used antibiotics in hospitalized patients were ceftriaxone (94.5%) and before hospitalization was cefixime (39.5%). Based on the results of this study, it was found that 66.13% of children younger than 5 years with acute diarrhea had appropriate treatment. 31.94% of patients had inappropriate antibiotic therapy.
Conclusion: In most cases of acute diarrhea in children, no evidence of bacterial or parasitic infection was found. However, a high percentage of patients received antibiotics without laboratory evidence (stool testing).
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