Background: Blood culture is the criterion standard for identifying children with bacteremia. However, elevated false-positive rates are common and are associated with substantial health care costs. The aims of this prospective study were to: 1) determine the rate of blood culture contamination 2) determine variety and frequency of contaminant bacteria 3) compare the duration of hospital stay and antibiotic administration in patients with true bacteremia vs those have false positive blood culture.
Materials and Methods: Cross-sectional study conducted April through July 2004 among patients aged 14 years or younger who were admitted at Doctor Garib Children Medical Center of Tehran and had a blood culture obtained as part of their care. Bacterial isolates were identified to species level and medical records were reviewed in all cases with a positive blood culture. A number of clinical and laboratory criteria were used to deciding whether a blood isolate is a pathogen or a contaminant. These include the identify of the micro-organism itself, clinical features such as fever and leukocytosis the proportion of blood culture sets positive as a function of the number of sets obtained and to have an indwelling vascular catheter or prosthetic device.
Results: During the study period, 2877 sets of blood culture were evaluated and the rates of positive blood cultures associated with significant bacteremia and contamination were 1.04% and 5.4% respectively. Among the positive blood cultures, over the 84% of isolates were due to contamination and only 15.95% of isolated strains associated with true infection. The frequency of isolated bacteria with respect to true infection and contamination are as following: S. Aureus (infect: 9.0%, contam: 0.0%), S. Epidemidis (infec: 0.0%, contam: 13.3%), Micrococcus sp. (infec: 0.0%, contam: 4.3%), pseudomonas and related species other than P. aeruginosa (infec: 2.1%, contam: 60.6%), viridans group of streptococci (infec: 1.1%, contam: 2.1%), E.coli (infec: 1.06%, contam: 0.0%), Klebsiella pneumoniae (infec: 0.53%, contam: 0.0%), Enterobacter cloacae (infec: 0.53%, contam: 0.0%), and Acinetobacter baumannii (infec: 0.25%, contam: 0.53%). The mean of hospital stay for patients with true bacteremia, 14.83 days, was not significantly higher than that for patients with false-positive blood cultures (10.08 days). 43 patients had administrated one to three antibiotics after false-positive blood cultures.
Conclusion: The findings indicate that blood culture contamination rate in studied hospital is higher than standard levels, and very high rate of contamination with environmental pseudomonas species shows an unusuall epidemic condition. The findings also suggests high resource utilization and prolong patients stay due to pseudobacteremia.
Background: The resistance of Pseudomonas aeruginosa strains to broad spectrum cephalosporins may be mediated by extended spectrum b-lactamases (ESBLs). These enzymes are encoded by different genes located either on chromosome or plasmids. In this study, we determined the antimicrobial resistance patterns of P. aeruginosa isolates and screened for ESBL production.
Methods: After isolation from burn patients in Tehran Hospital, identification of P. aeruginosa isolates were assessed using biochemical tests. We then performed disk agar diffusion (DAD) according to CLSI guidelines to determine the pattern of antimicrobial resistance. The frequency of ESBLs and prevalence of the OXA-10 and PER-1 genes were determined with combined disk and polymerase chain reaction (PCR) methods, respectively.
Results: One hundred strains of P. aeruginosa were isolated. The resistance of these strains to cephpodoxime, aztreonam, ciprofloxacin, ofloxacin, ceftazidime, cefepime, imipenem, meropenem, cefotaxime, levofloxacin, piperacilin- tazobactam and ceftriaxon was 100%, 90%, 83%, 92%, 85%, 88%, 63%, 66%, 98%, 89%, 70% and 91%, respectively. Of these, 40 strains (40%) were ESBL positive, 29 strains (29%) were OXA-10 positive and 18 strains (18%) were PER-1 positive.
Conclusion: Our results confirm the need for proper antimicrobial therapy in burn hospitals, considering the resistance pattern and frequency of strains producing ESBLs and the presence of the OXA-10 and PER-1 genes. Since an increase in the prevalence of ESBL in P. aeruginosa strains might lead to the transfer of these ESBL genes to other gram-negative bacteria, we recommend the use of appropriate drugs, especially cephalosporins, in burn hospitals.
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Background: Human
amniotic membrane (HAM) forms the inner wall of the membranous sac that surrounds and
protects the embryo during gestation.
The main advantages of amniotic membrane transplantation (AMT) in the treatment of bacterial
keratitis are its epithelial bandage properties. Previous studies have
documented the presence of some antimicrobial proteins and peptides in amniotic
fluid such as lactoferrin, lysozyme, bactericidal or permeability increasing
protein, calprotectin (MRP8/14 protein complex), LL37, and neutrophil defensins (Human Neutrophil Peptides, HNP
1-3). Furthermore, the amniotic membrane does
not express HLA-A, B, C or DR surface antigens, which may help avoid rejection after its transplantation.
Thus, it can be used as a biological immune barrier. The purpose of this study was
to evaluate the effectiveness of the amniotic membrane's healing properties in
rabbits with pseudomonas keratitis.
Methods : By using an animal model, 14 rabbits were divided into two groups of controls and cases. A syringe was used to inoculate
the corneal stroma of the animals by Pseudomonas aeruginosa ATCC27853. After 20 hours
pseudomonas keratitis was created and amniotic membrane was transplanted to the
cornea of the case group. The infiltration size were observed on the first, third
and seventh days after the experiment.
Results : Corneal perforation was seen in the controls (P<0.001) but amniotic membrane
prevented perforation in the case group (P=0.02).
Conclusion: Transplantation of
amniotic membrane in the primary stages of pseudomonas keratitis treatment remarkably
prevents corneal perforation and it can be used to control the disease process.
Background: Burns and its complications are regarded as a major problem in the society. Skin injuries resulted from ultraviolet radiation, radioactivity, electricity or chemicals as well as respiratory damage from smoke inhalation are considered burns. This study aimed to determine the epidemiology and outcome of burn patients admitted to Motahari Hospital, Tehran, Iran.
Methods: Two hundred patients with second-degree burns admitted to Motahari Referral Center of Burn in Tehran, Iran. They were studied during a period of 12 months from May 2012 to May 2013. During the first week of treatment swabs were collected from the burn wounds after cleaning the site with sterile normal saline. Samples were inoculated in blood agar and McConkey agar, then incubation at 37 C for 48 hours. Identification was carried out according to standard conventional biochemical tests. Treatment continued up to epithelial formation and wound healing. Results of microbial culture for each patient was recorded. Healing time of the burn wounds in patients was recorded in log books. Chi-square test and SPSS Software v.19 (IBM, NY, USA) were used for data analysis.
Results: Our findings indicate that the most causes of burns are hot liquids in 57% of cases and flammable liquid in 21% of cases. The most cases of burns were found to be in the range of 21 to 30 percent with 17.5% and 7% in male and female respectively. Gram-negative bacteria were dominated in 85.7% and among them pseudomonas spp. with 37.5% were the most common cause of infected burns, followed by Enterobacter, Escherichia coli, Staphylococcus aureus, Acinetobacter and Klebsiella spp.
Conclusion: The results of this study showed that the most cause of burns in both sex is hot liquid. Men were more expose to burn than women and this might be due to the fact that men are involved in more dangerous jobs than female. Pseudomonas aeruginosa was the most common organism encountered in burn infection.
Background: Multidrug-resistant bacteria make many problems in clinical therapy, design and manufacture of synthetic drugs. Pseudomonas aeruginosa is one of the most important multidrug-resistance bacteria leads to variety infections in human especially in immunocompromised, patients with severe burns, and nosocomial infections. It Recent years, this organism makes a big challenge in clinical treatment of infections using a wide range of antibiotics. Medicinal herbs for thousands of years to prevent or treat infectious diseases were considered. Today, pharmacists have high interest of using medicinal herbs to prepare a new antimicrobial compounds. The goal of this study was to investigation the effect of aqueous and alcoholic extract of fresh garlic on the expression of genes encoding elastase and exotoxin A virulence factors, in P. aeruginosa PAO1 strain.
Methods: Present study was an experimental study and performed from 2015 to 2016 in Hamadan University of Medical Science, Iran. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of aqueous and alcoholic extract of garlic was determined. Then in order to investigation the gene expression of elastase and exotoxin A genes, quantitative real-time polymerase chain reaction (qPCR) method was performed at sub-MBC concentrations. Results: According to the results aqueous extracts of garlic had better impact in comparison with alcoholic alone. At concentration of 64 and 8 mg/ml of aqueous extract the expression of both elastase and exotoxin A genes were decreased. Although, the expression of elastase gene was most affected by garlic at different concentrations than exotoxin A. |
Conclusion: The results suggested that the compositions of garlic extracts can inhibit the production of virulence factors in P. aeruginosa. So in order to treat infectious diseases in the near future, medicinal plants known as new antimicrobial drugs can be used alone or with antibiotic drugs against pathogenic bacteria.
Background: Breast cancer is a malignant proliferation of epithelial cells that lining the ducts or lobules of the breast. It is the second common cancer, after lung cancer in women. Since growth inhibition is an important strategy in cancer treatment, many attempts are in program to find new apoptotic inducer agents. Today there is some reports about effect of metabolites of Pseudomonas on cancer cells, hence, metabolites of Pseudomonas sp. UW4, were isolated and anti-cancer and anti-microbial activity of these metabolites was studied. Methods: This experimental study was performed in cellular and developmental biology of Shahrekord Islamic Azad University from April 2015 to August 2015. Anti-microbial activity of metabolites of Pseudomonas sp. UW4 was tested against a pathogenic bacteria, including Escherichia coli, Bacillus cereus and Staphylococcus aureus. For anti-cancer activity, in this study SKBR3 cells and normal fibroblast cells (HU-02) were cultured in DMEM medium with 10% fetal bovine serum (FBS). The cells were treated by various concentrations of these metabolites 5, 10, 15 and 20 mg/ml for 24, 48 and 72 h. Cell viability was assessed by MTS assay. Cells were seeded at 5×103 cells/ml in 96 well plates and incubated for 24 hr. Then metabolites of bacteria were added, after indicated times MTS (20 µl) was added and the absorbance was measured at 492 nm using ELISA plate reader. Results: Pseudomonas sp. UW4 was able to produce antimicrobial metabolites against Staphylococcus aureus. Metabolites decreases the viability of SKBR3 cell line in a time and dose dependent manner, so that the most effective concentration of this substance was 20 mg/ml and 72 h after treatment (P< 0.01). While Pseudomonas sp. UW4 in various concentrations had no significant effect on normal fibroblast cells (P= 0.24). Conclusion: Bioactive compounds produced by of Pseudomonas sp. UW4 could be used for elimination of infections and treatment of breast cancer SK-BR3. |
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