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Showing 27 results for Infections
Urinary tract infection in renal transplant patients in Sina University Hospital
Mr Pourmand, M Keshtvarz, Mm Soltan Dallal , M Talebi, R Bakhtiari, Gh Pourmand,
Volume 71, Issue 2 (5-2013)
Abstract

Background: Renal transplantation is the treatment of choice in patients with end-stage  renal disease. Urinary tract infection (UTI) is one of the most common complications after renal transplantation and it has serious consequences. The aim of this study was assessing UTIs in renal transplanted patients and evaluation of risk factors associated with post-transplant UTI.
Methods: In this prospective study, 173 patients (48 hospitalized patients and 125 outpatients) were enrolled in this study. These renal transplant recipients evaluated for bacterial urinary tract infection in urology research center at Sina Hospital. After collecting urine samples from symptomatic and asymptomatic patients, urinalysis and colony count were performed. Identification of bacteria was performed by routine microbiological tests in the Department of Pathobiology, School of Public Health, Tehran, Iran, in 2011.
Results: UTI was observed in 47 patients and the most prevalent microorganism was Escherichia coli (E.coli) 18(38.2%). Nearly 71% of UTI cases were diagnosed during the first three months post transplantation. Risk factors for post transplant UTI were female gender, age, length of hospitalization and diabetes mellitus. Female patients were more susceptible than males (OR=0.50 and P=0.047) to infection. There were no significant difference between diabetes mellitus and UTI. Most of the isolated bacteria were susceptible to imipenem and resistant to tetracycline and trimethoprim- sulfamethoxazole.
Conclusion: Our study confirmed that bacterial infections remain as the most common infectious complication in the early post-transplant period, and antibiogram rather than empirical treatment is needed to find the best effective antibiotics. Moreover, risk factors such as female gender, increased age and length of hospitalization are predisposing factors to increased urinary tract infection in renal transplantation.


Vitamin A, D and zinc serum levels in children with and without acute respiratory tract infection in two university hospitals
Shima Javadi-Nia , Samileh Noorbakhsh , Anahita Izadi , Mohammad Reza Shokrollahi , Ramin Asgarian , Azardokht Tabatabaei ,
Volume 71, Issue 12 (3-2014)
Abstract
Background: Severity of respiratory infection in children is depended on various fac-tors such as causative organism and the host immunologic response to the organism. Vitamins and micronutrients play an important role in this response with supporting the immune system and therefore, the response to infections. Nutritional deprivations in children, especially vitamins and micronutrients such as zinc, vitamin A and vitamin D are very common in middle east and other countries in Asia, which is due to inappro-priate diet and nutrient loss in recurrent infections. This study aimed to evaluate the se-rum levels of vitamins A, D and zinc in hospitalized children aged six months to five years. Methods: This analytic cross-sectional study was performed in 65 children aged six months to five years who were hospitalized in pediatric and surgical wards of Rasul Akram Hospital and Bahrami Hospital in Tehran. All of samples were evaluated ac-cording to WHO cri-teria for acute respiratory infection, and underwent measurement of serum vitamin A, vitamin D and zinc levels by using Atomic, Elisa and spectropho-tometer methods. Results: Serum levels of vitamins A in patients with acute respiratory infection was 0.27±0.16 µg/ml and in children without infection was 0.41±0.2 µg/ml, that different wasn’t statistically significant (P=0.4). Serum levels of vitamins D in patients with acute respiratory infection was 35.37±34.68 ng/ml and in children without infection was 45.78±21.05 ng/ml, that different wasn’t statistically significant (P=0.1). Serum levels of zinc in patients with acute respiratory infection was 87.93±23.34 µg/dl and in chil-dren without infection was 106.95±23.70 µg/dl, the difference was statistically signifi-cant (P=0.002). Conclusion: According to finding in this trial, there is a correlation between lower levels of zinc in serum, and chance of respiratory tract infection in children. Future larger studies could provide the correlation between serum levels of vitamins A & D and chance of respiratory tract infection.
The relationship between Helicobacter pylori infection and hyperemesis gravidarum in pregnant woman
Leila Ghasempour Shirazi, Shirin Rafie Tari,
Volume 73, Issue 3 (6-2015)
Abstract
Background: Hyperemesis gravidarum (HG) starts between four and seven weeks after the first day of the last period, and ends at twenty weeks of pregnancy. The etiology of HG, is unknown. Recent studies worldwide show the Helicobacter pylori (H. pylori) infection as a possible cause of the severe nausea and vomiting in pregnancy, recent studies showed H. pylori to have a role in occurrence of it during pregnancy. The current study assessed the immunoglobulin G (IgG) and immunoglobulin M (IgM) titer to H. pylori in pregnant women with HG. Methods: This is a case-control study of the pregnant patients of a gynecologist's office in the Marvdasht city from April to September 2013. One hundred and twenty three patients were randomly chosen based on their conditions and were divided into two groups (case n1= sixty three and control n0= sixty). The IgG and IgM titers against H. pylori were measured by ELISA method. Data analysis was performed using Chi-square test, Mann-Whitney U-test, and T-test in SPSS software, version 20 (SPSS, Inc., Chicago, IL, USA). The significant level of the test was considered (P= 0.05). Results: Totally, 123 pregnant women were evaluated 63 women with hypermesis gravidarum and 60 without HG. Forty nine women out of 63 in HG group and 48 women in the control group were IgG positive for H. pylori. Also, mean serum level of IgG was 51.6 in the HG group (P= 0.685). Twelve women out of 63 in HG group and 20 women in the control group were IgM positive for HP. Also, mean serum level of IgM was 27.7 in the HG group (P= 0.675) Except for the mother's blood type, there were no other statistically significant differences found between the two types of antibodies against H. pylori. Conclusion: There is no relationship between helicobacter pylori and hyperemesis gravidarum in pregnant woman. Considering the high prevalence of H. pylori infection in our country, there is a need for studies with more samples and more diagnostic methods.
Comparison of phenotypic detection of extended spectrum beta-lactamases using the E-test ESBL and combined disk method clinical isolates of Klebsiella pneumoniae: brief report
Mohammad Motamedifar , Davood Mansury , Hadi Sedigh Ebrahim-Saraie, Jamal Sarvari ,
Volume 73, Issue 4 (7-2015)
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.
Determination the bacterial etiologies for sepsis in premature newborns admitted in neonatal intensive care unit
Nastaran Khosravi , Samileh Noorbakhsh , Shima Javadinia , Sarvenaz Ashouri ,
Volume 74, Issue 11 (2-2017)
Abstract

Background: Bacterial sepsis is a main cause of mortality and morbidity especially in preterm newborns. The aim of this study was to search the bacterial etiologies of neonatal sepsis in NICU admitted preterm neonates.

Methods: A descriptive cross-sectional study had done in NICU of Ali Asghar Hospital, Tehran, Iran from March 2007 to March 2009. Seventy septicemic preterm newborns (<37 weeks) were studied. At admission day, for blood culture, 1-2 ml of venous blood was drawn after swabbing the venipuncture site with alcohol. After centrifugation of blood samples, deposits were cultured on sheep blood agar and incubated in a candle jar at 37 °C for 48 h and followed by subcultured. Isolates were identified using standard techniques (Nima pouyesh, Iran). Type of isolated bacterial organisms determined. Its correlation with gestational age, birth weight, premature rupture of membranes (PROM) and other variables determined we used the nonparametric two independent sample test, Mann-Whitney U test. Chi-square values (CI 95%, P< 0.05) were calculated for all categorical variables. P-value less than 0.05 considered statistically significant.

Results: Of 70 studied septicemic preterm cases, 17 (10.6%) cases had positive blood culture. Overall gram-negative organisms were more frequent than gram-positive organisms, Klebsiella (K.) pneumoniae, Escherichia (E.) coli and Staphylococcus (S.) aureus organisms were the 3 common causes of bacterial sepsis in studied cases. Early onset sepsis produced by K. pneumonia (40%), E. coli (20%) and S. aureus (20%). K. pneumonia, E. coli, S. aureus had equal incidence in late onset sepsis (26.8%). K. pneumonia was more frequent in early onset sepsis (P= 0.05), and in low birth weight (< 1500 g) neonates (P= 0.005, and PROM (P= 0.05).

Conclusion: Three causes for sepsis in premature newborns were determined: K. pneumonia, E. coli and S. aureus, it is so important for initial antibiotic treatment in admission day. Low birth weight, prematurity, and, PROM were the common risk factors for sepsis in cases. By preventing of low birth weight, low gestational age, and PROM the risk of sepsis could be decreased. We recommend empiric antibiotic in septic preterm newborns which can cover: K. pneumonia, E. coli and S. aureus in our center.

The importance of hyponatremia in febrile urinary tract infection in children: brief report
Farshid Kompani , Ashrafalsadat Hakim , Mohammad Bahadoram , Rasool Poornasir ,
Volume 74, Issue 12 (3-2017)
Abstract

Background: Urinary tract infection is a common infectious disease in children and associated with the risk for renal scarring and long-term complications, usually consists of pyelonephritis and may cause complications such as scars in kidney, hypertension and renal failure. Some studies demonstrated association between urinary tract infection and electrolyte disturbances such as hyponatremia. The present study has been designed for assessment of association between urinary tract infection and hyponatremia in children.

Methods: This is a descriptive, cross-sectional study has been conducted on 120 children have referred to the Golestan Hospital, Ahvaz Jundishapur University of Medical Science from 21 March 2011 until 20 March 2013. A total of 120 children who were aged 6 months to 12 years and had febrile urinary tract infection. The study population and were classified into two group of sixty children: hyponatremic and nonhyponatremic. We compared the laboratory findings in two groups with each other. The data included serum sodiom level, white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and ddimercaptosuccinic acid (DMSA) scan results collected from children with febrile urinary tract infections admitted in pediatric ward. Data analysis was performed using descriptive statistics, chi-square and independent T-test with SPSS software, ver. 20 (IBM, Armonk, NY, USA).

Results: In this study, 120 patients, 104 females (86.7%) and 16 males (13.3%) aged six months to 12 years were evaluated. All the patients were studied in terms of positive DMSA Scan. In the first group (hyponatremic) 31, and the second group (without hyponatremia) 13 patients were identified. There was a significant association between hyponatremia and WBC count, ESR, CRP, duration of fever and abnormal DMSA scan.

Conclusion: We conclude that there is significant association between hyponatremia and severity of urinary tract infection in children.

Correlation between chronic hypertension and occurrence of urinary tract infection
Parviz Saleh , Kian Alipasandi, Mohammadamin Rezazadehsaatlou , Negar Azizi , Amin Abdi Raad ,
Volume 75, Issue 6 (9-2017)
Abstract
Background: Urinary tract infections are very common in patients with high blood pressure. Hypertensive patients experience an average of three times of urinary tract infection per year. Blood pressure control is very important for preventing complications and also for identifying high-risk groups. Since, there is no national related study in this regard, the present study was conducted to investigate the effect of chronic hypertension on the incidence and recurrence of urinary tract infections.
Methods: In this case-control study, the required data were collected from outpatient cases referring to Taleghani Hospital and Sina Hospital related to Tabriz University of Medical Sciences in Tabriz city, Iran. Data needed for the control group included patients accompanying patients who had no symptoms of urinary tract infection and with no history of blood pressure.
Results: 60 patients with urinary tract infections were examined: 57 (47.5%) of the subjects were men and 63 (52.5%) women. There was a significant relationship between the rate of red blood cell deposition in the first hour and systolic blood pressure. There was no significant correlation between the numerical value of white blood cell count and systolic or diastolic blood pressure in the studied patients.
Conclusion: According to the results of the present study, there was a significant difference in systolic blood pressure in patients ESR 1 hour (red blood cell deposition rate in the first hour) with hypertension in case and control groups. There was a significant correlation between the ESR of the first hour and systolic blood pressure in the study, so that with an increase in ESR 1h, the systolic blood pressure increased in the examined patients, however, no significant correlation was found between ESR 1hour and diastolic blood pressure. Also, there was no meaningful correlation between the numerical value of white blood cell count and systolic or diastolic blood pressure in the studied patients. There was no significant correlation between systolic and diastolic blood pressure and age.

Evaluation of clinical course and laboratory findings in HIV/HTLV-1 co-infection compare with HIV mono infection
Ashraf Tavanaee Sani , Lida Jarahi , Marzieh Saberi,
Volume 76, Issue 12 (3-2019)
Abstract
Background: In the last 10 years, co-infection of human immunodeficiency virus/human T-cell leukemia virus-1 (HIV/HTLV-1) has emerged as a worldwide health problem. These viruses has the same route to infect human but different effects on CD4 positive T-cells. There was controversial results about the influence of co-infection HIV/HTLV-1 pathogenesis. This study compared clinical course and laboratory findings in HIV/HTLV-1 co-infection with HIV mono infection.
Methods: This historical cohort study carried in Mashhad Consultation Center of Infective and Behavior Diseases, Mashhad, Iran, from April 2013 to march 2017. Persons who referred evaluated by the enzyme-linked immunosorbent assay (ELISA), then patients with positive ELISA test rechecked by ELISA and Western blot. Platelet count, WBC count, neutrophils count, positive CD4 T-cells, staging and disease severity evaluated at diagnosis, in starting and after of antiretroviral therapy in mono and co-infected patients. Demographic characteristics, including age, educational level, occupational state, marriage situation, past medical history and high-risk behaviors were extracted from the files.
Results: Of 64 patients enrolled in this study, 61 persons were male. Of 64 participants patients, 42 persons were infected with HIV (35 persons of them were positive for hepatitis C virus), other 22 positive HIV cases, were co infected by HTLV-1 too (18 persons were positive for hepatitis C virus (HCV). Co infected patients had more history of high-risk situations specially intravenous drug abuse. The most common opportunistic infections was cryptogenic tuberculosis (TB), candidiasis and military TB. Opportunistic infections and lab findings (except for CD4 positive T-cell) were the same in both group. Clinical severity and disease staging did not differ significantly between two groups. Death was more common in co-infected group.
Conclusion: Clinical course in human T-cell leukemia virus-1 (HTLV-1) co-infection has not obvious differences with previously HIV patients compare with only HIV infected patients. In co-infection with the onset of treatment the increase in the level of CD4 positive cells was higher than that HIV infection.

Investigation of pulmonary fungal infections in immunocompromised patients
Ali Arash Anoushiravani , Abdollatif Moini , Reza Hajihossein , Abbas Alimoradian , Mojtaba Didehdar ,
Volume 77, Issue 5 (8-2019)
Abstract
Background: With increasing immunocompromised patients, fungal infections especially lung infection, have also increased. In this study, fungal contamination of the respiratory system in immunocompromised patients was evaluated.
Methods: This descriptive cross-sectional study was conducted in immunocompromised patients suspicious of pulmonary infections referring to specialized lung clinic of Amir-Al-Momenin University Hospital in Arak City, Iran, from April 2017 to June 2018. Of these 64 patients, including 35 women and 29 men, were selected. After recording the demographic information, a bronchoalveolar lavage (BAL) sample was prepared by the physician from these patients and was immediately sent to the medical mycology laboratory, school of medicine. Bronchoalveolar lavage specimens were investigated by Grocott-Gomori's methenamine silver (GMS) staining and culture method. Data were analyzed by SPSS software, version 16 (IBM SPSS, Armonk, NY, USA).
Results: Of 64 patients, 9 (14%) were infected with pulmonary fungal infections. Among the patients infected with fungal infection, 9 (100%) were positive in the culture examine and 8 (72%) by GMS staining. Among infected people, 7 (77.8%) were female and 2 (22.2%) were male. The most common isolated fungi were Candida albicans, Aspergillus fumigatus and Mucor species (2 cases). The highest infection was seen in the age group of less than 60 (33.3%). 66.7% of infections were among the unemployed persons and 33.3% of other cases of infection were seen in people with free jobs, workers and employees. The most important factors in the development of pulmonary fungal infections in the patients were: 5 cases of malignancy (33.3%), corticosteroid use in 2 cases (33.3%), tuberculosis in 1 case (22.2%) and diabetes mellitus in 1 case (11.2%). There was no significant relationship between fungal contamination with sex, age, occupation, marriage and type of disease.
Conclusion: The results of this study showed that immunocompromised patients are prone to fungal infections, especially Candidiasis and Aspergillosis. Therefore, the use of control methods to reduce the probability of such patients to fungal infections should be considered.

Comparison of the prevalence of HBV, HCV, HIV, EBV and CMV infections in patients with scleroderma and healthy population
Javad Moayedi , Zahra Musavi , Tayebeh Hashempour , Mohammad Ali Nazarinia , Behzad Dehghani , Zahra Hasanshahi ,
Volume 77, Issue 5 (8-2019)
Abstract
Background: Scleroderma is a chronic systemic disorder that affects the connective tissues. It is characterized by several immune manifestations, inflammation, vascular damage, and fibrosis. Some of the viral infections with complex mechanisms are involved in the development and progression of many autoimmune diseases, such as scleroderma. The present study aimed to investigate the serological prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) infections in Iranian patients with scleroderma.
Methods: In this descriptive study 65 patients with scleroderma and 65 healthy individuals who had no autoimmune diseases and matched for age and sex, from May 2017 to April 2018 at Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, were included. The serum of study participants were evaluated for cytomegalovirus specific immunoglobulin G (CMV-IgG), Epstein-Barr virus viral capsid antigen immunoglobulin G (EBV-VCA-IgG), hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCVAb), and human immunodeficiency virus antibody (HIVAb) using commercially available the enzyme-linked immunosorbent assay (ELISA) kit.
Results: CMV-IgG was diagnosed in serum of all patients with scleroderma, while 49 (98%) healthy subjects had positive results for this test. In addition, EBV-VCA-IgG was diagnosed in 58 (89.2%) sclerodermic patients and 40 (80%) healthy subjects. The prevalence of CMV-IgG and EBV-VCA-IgG was not significantly different between patients and healthy subjects and had no significant relationship with age and sex. However, the titer of antibodies against CMV and EBV infections in the scleroderma group was higher than that in the control group (P<0.0001, and P<0.0001), respectively. The presence of HBsAg and HIVAb was not confirmed in any of the patients with scleroderma, but HCVAb was detected only in one patient. All of the individuals in control group were serologically negative for HBsAg, HCVAb, and HIVAb.
Conclusion: Serological prevalence of HBV, HCV, HIV, EBV, and CMV infections in patients with scleroderma is similar to the healthy group.

Determination of the frequency and response to treatment of ocular lesions in children with various types of intrauterine infections (cytomegalovirus and toxoplasmosis): brief report
Samileh Noorbakhsh , Fahimeh Ehsanipour , Niusha Masalegooyan ,
Volume 77, Issue 9 (12-2019)
Abstract
Background: Intrauterine infections (TORCH) lead to the involvement of various organs of the body of the fetus, including the eye. The aim of this study was to determine the frequency and clinical response of eye lesions to specific drugs, in infants with confirmed TORCH induced ocular lesions.
Methods: This historical cohort study from 2011 to 2017, had done in Pediatrics and Ophthalmology Department of Rasoul Akram Hospital, Tehran, Iran. Cases included; 78 infants with confirmed intrauterine infection (TORCH) with ophthalmologic disorders (glaucoma, cataract, and retinitis), 3 cases died (without any treatment). The cases with incomplete diagnosis, no treatment or without follow-up excluded from study. Out of 74 children with confirmed TORCH induced ophthalmologic disorders, finally 37 children (25 cytomegalovirus, 12 toxoplasma) were treated with specific drugs, and clinical response to treatment was followed-up to 1 year by ophthalmologic examination.
Results: From 12 cases with ophthalmologic disorders due to congenital toxoplasmosis, 5 cases had full treatment, 4 cases had complete response. One case had not any improvement. From 25 cases with congenital cytomegalovirus (CMV), 18 patients continued treatment, 9 cases with complete clinical response, 9 cases had not response to antiviral treatment, indeed most non responder cases had central nervous system involvement from birth. The best response observed in CMV infected cases accompanied with sensory hearing loss (without CNS involvement).
Conclusion: Good clinical response of ophthalmic diseases in 80% of congenital toxoplasma; and 50% of congenital cytomegalovirus infected cases. Probably with initial diagnosis and rapid treatment of cases with TORCH induced ophthalmic disorders (especially cases without CNS involvement) it would lead to stopping ocular lesions.

Frequency of device-associated infections in intensive care units
Mojtaba Hedayat Yaghoobi , Mohammadmahdi Sabahi , Elahe Ghaderi , Mohammad Ali Seifrabiei , Farshid Rahimi Bashar ,
Volume 77, Issue 11 (2-2020)
Abstract
Background: Health care associated infections (HAIs) are a class of infections that infect patients during hospital admissions and receive medical services. These infections occurs within 48 to 72 hours of admission and up to 6 weeks after discharge. Surveillance of device-associated infections (DAIs) in intensive care units (ICUs) is substantial in planning healthcare strategies. This study was conducted to determine the device-associated infections' burden and antimicrobial resistance patterns.
Methods: In this descriptive-analytic study, three common device-associated infections included central line-associated bloodstream infection (CLA-BSI), ventilator associated pneumonia (VAP), and catheter-associated urinary tract infection (CA-UTI), were assessed in intensive care units of Besat Hospital in Hamedan from April 2017 to April 2018. In order to determine the incidence of device-associated infections, the number of device-associated infection cases was calculated during the study period and divided into the number of device-days used. The device-days included all days of exposure to that device (vascular catheter, endotracheal tube (ventilator), or urinary catheter) in all patients in the study population.
Results: Out of 1806 intensive care unit admitted cases, 168 patients (9.3%) were device-associated infection with distribution of 92 cases (55%) of ventilator-associated pneumonia (VAP), 56 cases (34%) of catheter-associated urinary tract infection (CA-UTI) and 20 cases (11%) of central line-associated bloodstream infection (CL-BSI). The incidence of VAP, CA-UTI and CL-BSI was 44.7, 17.5, and 21.61 days, respectively. The most organisms were Acinetobacter (27.4%), Klebsiella (18.3%), Escherichia coli (E. coli) (15.4%). Vancomycin-resistant enterococcus (VRE) was 75%. Acinetobacter resistance to colistin and carbapenem was 16.8%. About half of Pseudomonas isolates were resistant to meropenem.
Conclusion: According to the present findings of this study, a high incidence of device-associated infections and resistant organisms in our intensive care units were documented, which represents a need to reinforce the preventive and control programs. Various results in different studies can be due to differences in the level of health care in different centers and countries.

Measurement of serum zinc level in adult patients with cutaneous warts and comparison with the healthy control group
Armaghan Kazeminejad , Hamed Jafarpour , Laleh Mirmohammadi , Isar Khalil Nejad , Lotfollah Davoodi,
Volume 78, Issue 2 (5-2020)
Abstract
Background: Human papillomavirus (HPV) is a large group of DNA viruses that cause skin and mucosal warts. Zinc is used in the treatment of skin diseases. Zinc has been used in the treatment of various skin and systemic diseases. Warts are benign proliferation of the skin and mucosa. The prevalence of skin warts is higher in children and its peak is in adolescence and then decreases with age. Some species of HPV can cause malignancies. The effective role of zinc in the treatment of warts has recently been discussed. This study aimed to evaluate the serum zinc levels in patients with cutaneous warts compared to healthy controls.
Methods: This case-control study was performed on patients, aged 18 to 60 years old, referred to the Dermatology Clinic of Bo’Ali Sina and Razi Hospitals, Mazandaran Province in, Iran, from April to March 2016. Serum zinc level and severity of disease were assessed in case and control groups. Data were analyzed by SPSS software, version 22 (SPSS Inc., Chicago, IL, USA).
Results: A total of 94 subjects (47 in the case and control group) entered the study. The mean age of the case group was 26.40±9.33 years and in the control group 28.32±7.35 years. The gender status was 42 (44.7%) male and 52 (56.3%) female. Single and married were 63.8% and 36.2%, respectively. The mean zinc level in patients with cutaneous wart was 82 and the control group was 85.65. The mean number of warts was 5.09±6.33. The most frequent site of lesions were on the hands and foot with 48.93% and 40.42%, respectively, and the face (3.2%) had the lowest rate. Almost half of the patients were affected by the disease for 12 to 18 months. There was no significant relationship between age, sex, and severity of disease with serum zinc level (P>0.05). Serum zinc level was significantly associated with the duration of warts involvement (P=0.043).
Conclusion: Serum zinc levels were lower in patients with cutaneous warts than in healthy controls, but this difference was not statistically significant. Serum zinc level and duration of warts involvement were related. The duration of warts and serum levels were inversely correlated.

Prevalence of infectious diseases in patients with end stage renal disease in Gorgan City in Iran
Roghieh Golsha, Aref Gooran Orimi , Behnaz Khodabakhshi, Fatemeh Mehravar,
Volume 78, Issue 4 (7-2020)
Abstract
Background: The mortality rate of sepsis and pneumonia is higher in end-stage renal disease (ESRD) patients than in the general population. Bacterial infections are the most common cause of hospitalization in dialysis patients and the most common source of bacteremia is vascular access in these patients. The aim of this study was to determine the prevalence of infectious causes of hospitalization in patients with end-stage renal failure in Gorgan.
Methods: This cross-sectional study was performed on patients with ESRD who were admitted to the 5 Azar Medical Education Center of Gorgan City during 2014 to 2016. Patients' information was collected through their clinical records and analyzed statistically.
Results: The prevalence of infectious diseases in ESRD patients during the 3 years was 12.7%, out of 100 hospitalized patients with ESRD and infectious causes, the most common type of infectious disease was catheter infection (43%) and sepsis (18%), urinary tract infection (11%) and pneumonia (8%) were the next. The most common infectious causes leading to hospitalization in men with the ESRD were catheter infection, sepsis, and pneumonia, respectively, and in women, catheter infection, sepsis, and urinary tract infection. The highest incidence of catheter infection was in the age group of 66-70 years (30.2%), 71-75 (25.6%), and above 71 years (25.6%), respectively. The highest incidence of sepsis occurred in the age group of 75-71 years (38.9%) and also the highest incidence of urinary tract infections in the age group of less than 65 years. Age (P=0.003), sex (P=0.01), duration of disease (P=0.009), addiction (P=0.01), and diabetes (P=0.01) were the most common risk factors for infectious diseases in patients with ESRD.
Conclusion: The results of this study showed that catheter infection is the most common cause of infection in patients with end-stage renal disease (ESRD). Therefore, avoiding multiple vascular manipulations, disinfection of the catheter, timely replacement, and training of dialysis staff are effective in reducing catheter infections.

Climate changes and emerging fungal infections
Hossein Khodadadi, Mohammad Taghizadeh, Firozeh Shabankareh, Keyvan Pakshir ,
Volume 78, Issue 10 (1-2021)
Abstract
Background: Candida auris is a globally emerging yeast pathogen that has shown not only resistance to most anti-fungal drugs but also thermo-tolerance to temperatures higher than the mammalian’s body temperature. Although it has been only a decade since the fungus was identified, its spread of infections has been rapid and quasi-epidemics have been reported. Co-occurrences of the fungus infections in all five continents are one of the strangest aspects of this fungus. All isolates, despite slight genetic differences, belong to a common genetic ancestor. However, different clades appear to have independent evolutionary paths. We have discussed the relationship between the acquired thermal tolerance of C. auris and the environmental temperature changes with the genetic affinities of the isolates.
Methods: This basic science survey was carried out at the Shiraz University of medical sciences from July to December 2019. Phylogenetic analysis was used to compare the temperature sensitivity of C. auris and the species with which it is genetically related. The sequences of Internal transcribed spacer (ITS) region and the growth temperature ranges for C. auris and yeasts belonging to the Candida haemulonis complex as well as other environmental yeasts isolated from different geographical areas of the world were randomly selected and evaluated. Their phylogenetic relationship was investigated with the mapping of the phylogenetic tree based on ITS sequences.
Results: Study of temperature ranges which the fungi are capable of growing clearly shows that all species of C. auris can tolerate temperatures higher than the mammalian body temperature. Genetic distances, as well as geographic distances between species of C. auris are visible during phylogenetic studies. These results illustrate the possibility that, despite these distances, the temperature tolerance attribute for each C. auris clade was independently and under a common external pressure such as global warming.
Conclusion: The results of this study have discussed the increased incidence of emerging fungal infections due to climate changes; however the role of other contributing factors in the spread of these infections needs further investigation.

Comparison of the prevalence of HBV, HCV, HIV, CMV and EBV infections in patients with systemic lupus erythromatosus and healthy population
Ava Hashempour, Javad Moayedi, Zahra Musavi, Mohammad Ali Nazarinia , Zahra Hasanshahi, Farzaneh Ghasabi, Mehrdad Halaji ,
Volume 79, Issue 2 (5-2021)
Abstract
Background: Systemic lupus erythematosus is a systemic autoimmune disease that affects almost all organs of the body, and viral infections are involved in its development and progression. The present study aimed to evaluate the serological status of some viral infections in patients with systemic lupus erythematosus and a healthy population.
Methods: This descriptive study conducted from May 2017 to April 2018 at Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran on 70 patients with systemic lupus erythematosus and 70 healthy individuals who had no autoimmune diseases and were matched with the patient group for age and sex. All patients had active records and were routinely visited in rheumatology clinic of Hafez hospital, affiliated with Shiraz University of Medical Sciences. The evidence of active disease was assessed by the physicians of this practice according to the American College of Rheumatology criteria. Peripheral blood samples were collected in tubes containing EDTA and centrifuged at 3000 rpm for 5 min. The plasma of study participants was evaluated for HBsAg, HCVAb, HIVAb, EBV-VCA-IgG, and CMV-IgG using a commercially available ELISA kit.
Results: The seropositivity of CMV-IgG and EBV-VCA-IgG in the systemic lupus erythematosus group was 70 (100%) and 65 (92.9%), and in healthy individuals was 68 (97.1%) and 57 (81.4%), respectively. The prevalence of EBV-VCA-IgG in the systemic lupus erythematosus group was significantly higher than healthy ones (P=0.043). The optical density (OD) of CMV-IgG and EBV-VCA-IgG in patients with systemic lupus erythematosus was significantly higher than in healthy individuals (P<0.0001). All patients with systemic lupus erythematosus were negative for HBsAg and HIVAb, but HCVAb was detected in 1 (1.4%) patient.
Conclusion: Considering the higher frequency of EBV-VCA-IgG and the higher titer of antibodies against CMV and EBV in patient groups compared to healthy individuals group, it seems that periodical assessment of viral load in patients with systemic lupus erythematosus will be beneficial to prescribe medication by physicians if it is needed.

Diagnosis and treatment of diabetic foot infections: adopted IWGDF guidline
Mohammad Reza Amini , Mohammad Reza Mohajeri-Tehrani, Neda Mehrdad, Mahnaz Sanjari, Maryam Aalaa, Neda Alijani,
Volume 79, Issue 2 (5-2021)
Abstract
Background: Diabetic foot infection is the most common complication of diabetic foot ulcer (DFU) leading to amputation. The treatment requires special attention to disease conditions, proper diagnosis, appropriate sampling for cultures, careful selection of antibiotics, rapid determination of the patient’s need for surgical intervention, and wound care. Clearly a systematic approach or, if possible, an evidence-based approach by using clinical guidelines about diabetic foot infections will lead to better outcomes. In this regard, this article aims to adopt the IWGDF clinical practice guideline on DFU infection.
Methods: In this study, the adoption of the international evidence-based clinical guidelines on the DFU infection was carried out using the ADAPTE methodology, which involved three stages of setup, adoption, and finalization. AGREE II tool was used to evaluate the quality of the selected clinical guideline.
Results: The results of this adopted clinical guideline according to the national facilities and access to equipment are described with 26 recommendations along with related reasons for the diagnosis and treatment of diabetic foot ulcer infections. The recommendation categorized into six different categories including Classification/ Diagnosis, Osteomyelitis, Assessing severity, Microbiological considerations, Surgical treatment, Antimicrobial therapy.
Conclusion: The mentioned recommendations in the diagnosis and treatment of diabetic foot ulcer infections extracted based on the methodology of systematic review studies. Actually the opinion of experts have been prepared and adjusted according to the limitations, equipment and facilities in the country. But in general, there are some challenges in diabetic foot infections should be considered as well. So monitoring the treatment of infection, optimal duration of antibiotic treatment, optimal treatment of infection in low-income countries, time and type of imaging studies, selection of medical or surgical treatments and hospitalization conditions are some of these challenges. However the definition and practical clinical application for the concept of bacterial bioburden of the wound for wound healing, evaluating the cost-effectiveness of new technologies in improving treatment and appropriate interpretation of microbiological (genotypic) microbiological tests are important too.

Prevalence of mycoplasma pneumoniae and macrolide resistance in children with community-acquired pneumonia: a case study in a teaching hospital
Ali Hosseininasab, Fatemeh Karami Robati , Fatemeh Hosseininasab , Azam Dehghani,
Volume 79, Issue 7 (10-2021)
Abstract
Background: Mycoplasma pneumoniae is one of the causes of upper and lower respiratory tract infections especially in children, and antibiotics affecting the cell wall do not affect this type of infection. This study aimed to evaluate the prevalence of Mycoplasma pneumoniae and macrolide resistance in children with community-acquired pneumonia in Kerman city.
Methods: This cross-sectional study was conducted in a selected teaching hospital in Kerman city from July 2018 to July 2019. Fifty-one children hospitalized in the pediatric ward were diagnosed with bacterial pneumonia acquired from the community. These children were included in the study by census method. The data collection tool was a standard checklist. The checklist was completed by parents. Pharynx and nasal swab samples were taken from all patients. PCR was used to identify mycoplasma.
Results: The highest number of patients with bacterial pneumonia acquired from the community were male (52.9%). The average age of these cases was 5.52±3.93 years and the average weight of these patients was 17.23±10.55 kg. Lung involvement was one-sided in more than half of the patients. The most of lung involvements were lobar (31.4%). More than half of the patients didn’t have any associated involvement (52.9%). The most common type of associated involvement was peribronchial thickening (29.4%). The most commonly used antibiotic was Ceftriaxone (76.5%). The prevalence of Mycoplasma pneumoniae infection in children with pneumonia was 2%. These children had an rRNA gene at position 2063 that had high levels of macrolide resistance.
Conclusion: The results of this study showed very low rates of Mycoplasma pneumoniae infection in children with bacterial pneumonia acquired from the community. Therefore, it can be concluded that in addition to Mycoplasma pneumoniae, other viral and bacterial agents are also involved in respiratory infections that need to be identified and addressed.

Investigating the antibiotic resistance pattern of MRSA isolates from blood and wound samples of patients admitted in a number of Tehran university of medical sciences hospitals: a brief report
Monireh Rahimkhani,, Zahra Rajabi,
Volume 80, Issue 7 (10-2022)
Abstract
Background: Considering the frequency of MRSA strains in hospitals and medical centers as well as in different communities, it seems necessary and important to observe the use of appropriate drugs in order to reduce antibiotic resistance and reduce the economic costs of treatment. This study aimed to investigate the antibiotic resistance pattern of MRSA isolated from blood and wound samples of patients. The study patients were hospitalized in different departments in a number of Tehran University of Medical Sciences hospitals.
Methods: In this descriptive cross-sectional study from September 2021 to February 2022, the blood and wound samples of the patients were collected and referred to laboratory. Staphylococcus aureus had identified by phenotypic and biotypic tests. MRSA isolates were screened by showing resistance to Cefoxitin by disc diffusion method and finally confirmed by examining the mecA gene by PCR. The microbial resistance pattern of MRSA was also measured by disk diffusion method and resistance to Vancomycin was confirmed by E.test.
Results: 41 isolates from 87 Staphylococcus aureus samples were confirmed as MRSA by present the mecA gene. The mecA gene was detected in all MRSA by PCR method. The antibiotic resistance pattern showed the highest sensitivity to Vancomycin and Linezolid with 100% sensitivity and the highest resistance to three antibiotics Erythromycin, Ceftriaxone and Cloxacillin with 97.57%by disk diffusion method. The most MRSA strains were isolated from the ICU department with 13 cases and the least MRSA strains were isolated from the two NICU and pediatric departments with one case.The majority of the population infected with MRSA belonged to the age group of 40-65 years.
Conclusion: The prevalence of microbial resistance with high dispersion was obtained among MRSA strains isolated from clinical samples; which indicates a significant increase in resistant strains and requires a quick and timely diagnosis to prescribe the appropriate antibiotic.

Strategies for prevention, diagnosis and treatment of Post Covid-19 Fungal Infections in Immunocompromised Patients: A systematic review
Abdolahad Nabiolahi , Najmeh Khammari, Nasser Keikha,
Volume 82, Issue 1 (4-2024)
Abstract
Background: Nowadays, understanding healthy treatment strategies is crucial in the post-COVID era where immunocompromised patients are more likely to get exposure to fungal infections. The aim of the research was to investigate studies of fungal infections after COVID-19.
Methods: The systematic review study was conducted from 11 July 2023 to 04 February 2024 in Zahedan, Iran. To extract articles on fungal infections, the vocabulary of selected Medical Subjects Headings (Mesh), other specialized literature was determined and a search strategy was formulated in three databases, Web Science, Scopus, and PubMed, without any time limitation. In addition, the articles were analyzed according to the research objectives, types of fungal infections encountered in immunocompromised patients, their incidence in different immunocompromised patient groups, diagnostic and detection strategies, treatment methods and other background information.
Results: A 15 number of related articles were included. The most common type of study was case report. From the lens of Aspergillus and mucormycosis fungal infections, they were given more attention, and in terms of the type of immunodeficiency, patients with a history of diabetes, including groups of diabetic patients, cancer groups, AIDS patients, and some groups with genetic disorders, were investigated in the studies. Appropriate treatment methods; particularly the use of corticosteroid drugs such as methylprednisolone as intravenous injection, systemic antifungal drugs such as liposomal amphotericin B, Antifungal treatment using high-dose amphotericin B, the use of prophylactic drugs, and isolation of the damaged tissue are recommended as the best treatment strategies. In order to prevent fungal infections in groups of Immunocompromised Patients, it is recommended to use simple hygiene Recommendations.
Conclusion: Analyzing the conditions of cocvid-19 patients and recognizing effective treatment strategies is inevitable, especially in the post- COVID era. A review of the literature showed that prevention and control of fungal infections after covid-19 was critical among immunodeficiency patients and the use of the recommended treatment method for their lifecycle continuity should be more considered by health care providers, health system managers and health policy makers.

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