Evaluation of the Troponin Measurements Results in Patients with Acute Coronary Syndrome; a Brief Report

مقدمه: مطالعه حاضر با هدف بررسی میزان موارد مثبت اندازه­گیری سطح سرمی تروپونین در بیماران مراجعه کننده به بخش اورژانس با شکایت درد قفسه سینه که با احتمال سندروم کرونری حاد به بخش مراقبت های ویژه بیماران قلبی منتقل شدند، انجام گرفت. روش کار: این مطالعه مقطعی در فاصله زمانی شهریور 1393 تا شهریور 1394 در بخش های اورژانس و سی سی یو بیمارستان شهید مدرس، تهران، ایران انجام شد. با مراجعه به واحد بایگانی پرونده­ کلیه بیماران منتقل شده از بخش اورژانس به سی سی یو با تشخیص سندروم کرونری حاد بررسی گردید. هیچگونه محدودیت جنسی و سنی برای این مطالعه لحاظ نشد. با استفاده از یک چک لیست اطلاعات پرونده­ بیماران حاوی نکات مورد نظر در شرح حال و نتایج تست های تروپونین انجام شده استخراج و ثبت گردید. تست تروپونین در ساعت صفر یعنی بدو مراجعه­ بیماران و همچنین 3، 6، 12، 18، 24، 36، 48 و 72 ساعت بعد از نوبت اول انجام گرفت و سطح سرمی تروپونین بالاتر از 6/0 میکروگرم در دسی لیتر مثبت گزارش شد. يافته ها: در کل تعداد 384 بیمار با میانگین سنی 00/12 ± 34/62 (30 تا 93 سال) وارد مطالعه شدند (7/66 درصد مرد). 230 (9/59 درصد) نفر با تشخیص انفارکت قلبی، 149 (8/38 درصد) نفر با تشخیص آنژین صدری ناپایدار و 5 (3/1 درصد) نفر با سایر تشخیص ها بستری شده بودند. 252 (6/65 درصد) نفر از کل بیماران هنگام مراجعه از درد تیپیک قفسه­ سینه شکایت داشتند. شایعترین علامت همراه تنگی نفس بود که در 107 (9/27 درصد) نفر مشاهده شد. پرفشاری خون، هایپرلیپیدمی و  دیابت به ترتیب با 49، 2/35 و 5/30 درصد شایعترین بیماری های همراه بودند. در مجموع نتایج تست تروپونین 275 (6/71 درصد) بیمار مثبت گزارش شد. 362 (3/94 درصد) نفر با حال عمومی خوب از بخش سی سی یو ترخیص شده و 22 (7/5 درصد) نفر فوت شدند. نتيجه گيری: بر اساس یافته های حاصل از مطالعه حاضر، در فاصله زمانی 72 ساعت بعد از پذیرش، سطح سرمی تروپونین حدود 70 درصد بیمارانی که با احتمال منشا قلبی به بخش سی سی یو منتقل شده بودند، مثبت گزارش گردید که در حدود 50 درصد این بیماران تست تروپونین بدو مراجعه مثبت بود.Introduction: The present study aimed to evaluate the rate of positive cases in measurement of serum troponin level in patients presenting to emergency department (ED) with complaint of chest pain who were dispositioned to coronary care unit (CCU) due to probable acute coronary syndrome. Methods: This cross-sectional study was carried out between September 2014 and September 2015 in ED and CCU of Shahid Modarres Hospital, Tehran, Iran. Using the archives, profiles of patients dispositioned from ED to CCU with diagnosis of acute coronary syndrome were evaluated. No age or sex limitation was imposed in this study. Data were extracted from the profiles and were recorded using a checklist consisting of points considered in history taking and results of troponin tests. Troponin tests were taken on admission, and 3, 6, 12, 18, 24, 36, 48, and 72 hours after that. A serum troponin level higher than 0.6µg/dL was considered positive. Results: 384 patients with the mean age of 62.34 ± 12.00 years (range: 30 -93) were included in the study (66.7% male). 230 (59.9%) patients with diagnosis of myocardial infarction, 149 (38.8%) with unstable angina, and 5 (1.3%) with other diagnoses were hospitalized. 252 (65.6%) of the patients had complained of typical chest pain. The most common accompanying symptom was shortness of breath present in 107 (27.9%) patients. Hypertension, hyperlipidemia, and diabetes were the most common accompanying diseases with 49, 35.2, and 30.5%, prevalence respectively. In total, 275 (71.6%) of troponin tests were reported to be positive. In the end, 362 (94.3%) patients were discharged from CCU with good general health and 22 (5.7%) died. Conclusion: Based on the findings of the present study, in the initial 72 hours of admission, troponin test result was positive in 70% of patients who were dispositioned to CCU with probability of cardiac chest pain, in 50% of which the test result was positive on admission.

Genotyping of Clinical Isolates of Salmonella enterica serovar Typhimurium from Medical Centers of Kerman Province Using ERIC-PCR Method

Background and Objectives: Salmonella enterica serovar Typhimurium is one of the most common Salmonella serotypes in gastroenteritis cases. ERIC-PCR method is used for genotyping studies and examinations in order to apply appropriate preventive and controlling conditions. This research was carried out with the objective of investigating the genotyping of Salmonella typhimurium strains in the treatment centers of Kerman province.   Methods: In this descriptive study, different strains of Salmonella Typhimurium, were isolated from different treatment centers. All strains were examined using standard methods of microbiology, biochemistry, and molecular biology. Genetic relationship between the strains was evaluated by ERIC-PCR method.   Results: In this study, Among 891 stool and blood samples of patients with diarrhea, 48 strains of Salmonella typhimurium, were isolated. The isolates were classified in terms of genotyping into 15 different groups using ERIC-PCR method, which the highest number of the strains was in the 14th group (25%, 12 strains).   Conclusion: The results of the present study showed high discrimination power of ERIC-PCR method for molecular typing and genetic diversity of Salmonella typhimurium strains isolated from human samples. Therefore, this method can be used for epidemiological studies in order to investigate the source of contamination, genetic diversity and its relationship with geographical distribution and drug resistance of the isolated strains

Molecular Typing Isolates of Salmonella Enterica Serovar Infantis Using Eric-PCR Method

Background: Salmonella is the important bacteria of the Enterobacteriaceae family that are very diverse biochemically and serologically, and mainly transmitted through food. The spread of non-typhoid Salmonella is one of the challenging issues in current research. Therefore rapid diagnosis and typing of the pathogensprovide efficient information about detection and controlling of infection. The aim of this study is typing the clinical strains of Salmonella Infantis. Materials and Methods: In this study, strains of Salmonella Infantis were isolated from different health centers. All of the strains were identified by standard microbiology, biochemical and molecular methods. Genetic relationship between strains was analyzed by ERIC-PCR method. Results: In this study, from 842 stool and blood sample of patients with diarrhea, 48 different strains were isolated which related to Salmonella Infantis. Strains categorized into 14 different groups by genotyping using ERIC-PCR method that highest number of the strains were placed in group 5 (20%, 10 strains). Conclusion: Results of this study demonstrated that strains of Salmonella Infantis which are examined genetically were diverse which can be due to the prevalence of polyclonal strains in human samples. It was also shown that ERIC-PCR method has great differential power for the molecular typing. &nbsp

Evaluation of class 1, 2 and 3 integrons in clinical Salmonella enteritidis strains by PCR method

Background & Objective: Gastroenteritis is one of the most common Salmonella infections in human which is caused by Salmonella serotypes especially S.enteritidis and S.typhimurium. The spread of multi-drug resistant (MDR) Salmonella strains is a serious global issue. Obtaining integrons is considered as one of the most important factors in multi-drug resistance among gram-negative microorganisms, particularly in intestinal bacteria. The aim of this study was to investigate the molecular level of class 1, 2 and 3 integrons which are the most important integrons in Salmonella enteritidis isolated from patients using Multiplex PCR. Methods: In this study, 567 stool and blood samples were collected from patients with acute gastroenteritis and Salmonella enteritidis were detected using culture method, standard biochemical test, and PCR. After DNA extraction, the presence of class 1, 2, and 3 of integrons was analyzed by multiplex PCR. Results: From 567 samples, 48 strains were identified as Salmonella enteritidis. Of all 48 strains, 45 strains (95%) had the intI gene, 7 strains (14.5%) had the intII gene, and 2 strains (4%) had the intIII gene. Conclusion: In this study, high incidence of class 1, 2 and 3 integrons was detected. Screening integrons as a sign of obtaining and expansion of antibiotic resistance could be considered as an important mechanism to deal with antibiotic resistance in microorganisms

Identification and assessment of Salmonella typhimurium, infantis and enteritidis serotypes in clinical samples from medical centers of Kerman province

Background and Aim: Salmonellosis is one of the important infectious diseases and can be as spread disease between humans and animals that make it essential for identification and detection of Salmonella. Housekeeping genes are typically important genes which are necessary for maintenance and survival of basic cells and can be considered as a gene diagnostic screening bacterial agents. The aim of this study was analysis of Flic, Sdf1 and FljB, housekeeping genes for screening of typhimurium, infantis and enteritidis serovars isolated in Kerman’s hospitals. Materials and Methods: In a descriptive study from February 2015 to August 2015, 132Salmonella specimens were taken from patients with acute gastroenteritis referred to different medical centers and hospitals in Kerman. The specimens were transferred to microbiology laboratory for identification of Salmonella with serological and bacteriological standard methods. DNA of Salmonella genus strains were extracted by CTAB and, specific primers of housekeeping genes of Salmonella genus (invA) and typhimurium(fliC), infantis(fljB) and, enteritidis(sdfI) serotypes are used in PCR test. Results: Using PCR technique, the presence of Salmonella genus were confirmed by amplification of invA gene in 130 out of 132 specimens which are identified as a Salmonella by microbiological and biochemical methods (98%). Also results indicating the prevalence of 19% in infantis, 22% in Salmonella typhimurium and 32% in Salmonella enteritidis. Conclusions: Results showed that the prevalence of Salmonella enteritidis is more than any other serotypes in this region, but as the global statistics, the prevalence of typhimurium and Infantis are increasing