Haji Abdolbaghi M, Makarem J, Rasoolinejad M, Afahami Sh, Fazeli Ms, Unesian M, Adili F, Alavi S. Sh,
Volume 64, Issue 8 (13 2006)
Abstract
Background: Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods.
Methods: In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient’s discharge. Review of patient’s history and daily records and interview with patient’s surgeon and the head-nurse of the ward considered as a gold standard for surveillance.
Results: The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended.
Conclusion: The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended.
Alizadeh R, Ziaee V, Movafegh A, Yunesian M, Azadi Mr, Mehraein A,
Volume 64, Issue 10 (2 2006)
Abstract
Background: Both hypoxia and hypocapnia can cause broncho-constriction in humans, and this could have a bearing on performance at high altitude. The objective of this study was to examine how pulmonary ventilatory function during high-altitude trekking.
Methods: This study was a before and after study on spirometric parameters at Base line (1150 m above sea level), and after ascending at 4150 m above sea level. This study was performed in summer 2004 at Cialan Mountain in Iran. Fifty six healthy male University student volunteers were enrolled in the study. Respiratory function was assessed in participants before ascending at baseline (1150 meter) and after ascending at 4150 meter in Cialan Mount with a Spirolab II. Spirometric parameters changes were compared using paired t-test statistical analysis computations were performed by spss 11.5 and p≤0.05 was considered significant.
Results: The mean age and body mass lindex of our subjects were 22.9±5.3 years and 21.5±2.5, respectively. Forced vital capacity (FVC) was significantly decreased with increasing altitude from baseline level (P<0.01). Forced expiratory volume in 1 second to forced vital capacity ratio (FEV1/FVC) and maximal midexpiratory flow rate (FEF 25-75%) were significantly increased with increasing altitude (P=0.001). There was no significant change in forced expiratory volume in 1 second and peak flow (P>0.05). FVC fell by the average of 7.1% at 4150m (2.4% per 1000m increased altitude) in comparison to 1150m.
Conclusion: The changes in some pulmonary ventilatory parameters were proportional to the magnitude of change in altitude during a high-altitude trek.
Hadadi A, Rasoulinejad M, Maleki Z, Mojtahedzadeh M, Younesian M, Ahmadi S.a, Bagherian H,
Volume 65, Issue 4 (3 2007)
Abstract
Background: The object of this study was to investigate the antimicrobial resistance pattern among common nosocomial Gram-negative bacilli isolated from patients with nosocomial infections.
Methods: From June 2004 to December 2005, 380 isolates of common Gram-negative bacilli (Klebsiella, Pseudomonas, Acinetobacter and E. coli) from 270 patients with nosocomial infections in Sina and Imam Hospitals, Tehran, Iran, were evaluated for susceptibility to Imipenem, Cefepime, Ciprofloxacine, Ceftriaxone and Ceftazidime by Disc diffusion and E-test methods.
Results: The most frequent pathogens isolated were Klebsiella spp. (40%), followed by Pseudomonas (28%), Acinetobacter spp. (20%) and E. coli (12%). The most active antibiotic was imipenem (84%). 26% of all isolates were sensitive to Cefepime, 26% to Ciprofloxacin, 20% to Ceftazidime and 10% to Ceftrixone. The susceptibility rates of Klebsiella to Imipenem, cefepime, ciprofloxacin, Ceftazidime and Ceftriaxone were 91, 25, 21, 13 and 7 percent, respectively and 91, 19, 17, 21 and 21 percent, respectively, for E. coli. Among Acineto- bacter spp., the susceptibility rate was 77% for Imipenem and 21% for Ciprofloxacin. Among Pseudomonas spp., 75% of isolates were susceptible to Imipenem and 39% to Ciprofloxacin. The comparison of the resistance status of microorganisms by both Disc diffusion and E-test methods showed a clinically noticeable agreement between these two tests.
Conclusions: Since antibiotic resistance among Gram-negative bacilli has increased, enforcement of policy regarding proper antibiotic use is urgently needed in order to delay the development of resistance. Although it is widely accepted that E-test is more accurate in determining the resistance of microorganisms, our study showed that the Disc diffusion test will give the same results in most occasions and is therefore still considered useful in clinical practice.
