Tehran University Medical Journal

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Background: Infertility is a worldwide problem. Many different factors may cause infertility. Among them, bacterial infection of the reproductive system is one of the main factors. Recently, some limited investigation has revealed that H. pylori is capable of causing genital inflammation that may lead to infertility. Although known to be a causative agent of gastritis and duodenal ulcers, this species may be transferred orally to the vagina and asymptomatic infection leads to inflammation of the system and finally manifestation of infertility. In addition, infertility may be due to antibodies synthesized against H. pylori cross-reacting with the genital tissue.
Methods: In the present study, 180 women consisting of 90 cases referred to IVF center of Yazd and 90 matched controls were enrolled. Serum was taken from all women for detection of IgG and IgM using the ELISA technique.
Results: A total of 117 (65%) serum samples were positive for Helicobacter, of which 63.3% were from fertile and 66.7% from infertile women. The serum positive population was found to be predominantly in the age range of 25-35, although some 35-42 year olds were also serum positive. When the prevalence of Helicobacter infection status was compared with marriage duration in both groups, it was found that antibody titer in subjects from marriages with durations of greater than five years was significantly higher than those of five-year marriages. In addition, higher antibody titers were found in infertile women with fallopian tube (FT) factor and lower titers in those with polycystic factors.
Conclusion: Although the results were not significant, they nevertheless indicate that the Helicobacter antibody titers in infertile women were higher than those of fertile women (P =0.6). Therefore, further studies are necessary to determine the role that Helicobacter infection plays with regard to infertility among women. Since the antibody titer in infertile cases with FT factor was higher than others, it may indicate that inflammation caused by H. pylori plays an indirect role in the induction of infertility.

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Background: The misdiagnosis of urinary tract infection (UTI) may lead to kidney deficiency and even pyelonephritis. Since different species may cause this disease, urine culture (UC) and antibiogram of the isolated species should be performed and results compared to urine analysis (UA) parameters to obtain the best diagnosis.
Methods: The urine specimens from 1509 patients (1195 women and 314 men) were processed for UA, UC and antibiogram. First of all, the sterile urine samples were cultured using differential media, including EMB and blood agar. After 24 hr incubation, the colonies were identified and differentiated by biochemical tests. Antibiograms for all isolated species were determined using Muller Hinton agar. All results obtained from this survey were analyzed using SPSS software.
Results: Of the 1509 samples, 986 (65.3%) were positive for pathogenic bacteria, 170 (17.2%) of which were from men and 816 (82.8%) from women. E. coli was the most prevalent with 591 cases (58.7%), followed by Enterobacter 115 (11.4%) and Klebsiella 88 (8.8%). Data analysis revealed that the correlations between the WBC, RBC, nitrite, crystal, and protein were significantly higher in culture-positive samples. Of the antibiotics tested, isolated species were most sensitive to amikacin and most resistant to ampicillin.
Conclusion: The present study revealed a correlation between pyuria and bacteruria however, it should be noted that the clinical signs and the presence of WBC in urine could not be used to confirm the UTI. In addition, since different bacterial species are able to cause UTI, in order to administer proper treatment while controlling improper use of antibiotics, thorough testing, including UA and UC together with antibiogram, is strongly recommended.