Isolation of Citrobacter spp. from Blood Specimens in Patients Hospitalized in Kermanshah Imam Khomeini hospital .. and determination of the of isolates sensitivity to antibiotics: Short Communication

Background and Aim: Citrobacter is a gram-negative, nonsporeforming, facultative anaerobic and motile bacillus within the family of Enterobacteriaceae and is ubiquitous in nature. This opportunistic pathogen causes a wide spectrum of infections. The aim of the present study was to examine the isolation of Citrobacter spp. from blood specimens in patients hospitalized in Kermanshah Imam Khomeini hospital and to determine the isolates sensitivity to antibiotics. Materials and Methods: This cross- sectional study was carried out on 2285 blood specimens collected from hospitalized patients between March 2012 and February 2012. In the beginning, the blood samples were inoculated in blood culture tubes media. The Citrobacter spp. isolates were identified and their identification was confirmed by means of morphological and biochemical laboratory tests. Drug sensitivity test was carried out according to CLSI (2011) recommendations through using the standard disc diffusion method. Results: In this study Citrobacter spp. were isolated from 21 (15.8%) of 133 culture positive blood specimens collected from the hospitalized patients. The most effective antimicrobial agents against Citrobacter isolates were imipenem (90.4%), and amikacin (71.5%), respectively. The most frequent resistance observed was to cephalothin (76.2%), ciprofloxacin (76.2%), ceftazidime (66.6%) and co-trimoxazole (62%). Conclusion: Citrobacter isolates showed high resistance to betalactam antibiotics. Therefore, it is necessary that these drugs should only be administered to patients whose diagnostic isolates reveal sensitivity in vitro

Isolation Pseudomonas and Acinetobacter from Blood Specimens in Patients Hospitalized in Emam Khomeini Hospital (Kermanshah)

Background: Bloodstream infections (BSIs) are an important cause of morbidity and mortality. The rates of antibiotic resistance among pathogens causing health care-associated infections are increasing, principally among Gram-negative organisms such as Pseudomonas, and Acinetobacter. The goal of this study was isolation Pseudomonas spp. and Acinetobacter spp. from blood specimens in patients hospitalized in Emam Khomeini hospital (Kermanshah) and subsequently determination susceptibility patterns of isolates. Materials and Methods: In this cross-sectional study 2382 blood samples collected from 2285 hospitalized patients. Blood specimens were inoculated in blood culture tubes media, and subsequently subculture performed on common microbiological media. The isolated Pseudomonas, and Acinetobacter were identified and confirmed by morphological and biochemical laboratory tests. Antimicrobial sensitivity test was performed by using the standard disc diffusion method according to CLSI (2012) recommendations. Results: During present study 2382 blood samples were collected. 133 (5.6%) specimens were positive in bacterial culture. Acinetobacter, and Pseudomonas were isolated from 15 (11.2%) and 15 (11.2%) of positive blood cultures, respectively. The isolated Acinetobacter were most frequent resistant to cefixime (86.7%), ceftazidime (80.1%), cephalothin (73.4%), and co-trimoxazole (73.4%). The Pseudomonas isolates showed a high level of resistance to co-trimoxazole (86.7%), cefixime (86.7%), ceftriaxone (73.4%), cephalothin (73.4%), and ceftazidime (60%). Conclusion: In this research, drug-resistant Pseudomonas and Acinetobacter were identified in patient’s blood cultures. In the face of increasing antibiotic resistance, surveillance programs have become important in determination the species distribution and resistance patterns of pathogens causing bloodstream infection, and thus are providing the basis for appropriate empirical therapy of patients

An investigation into the sensitivity of endoscopic ultrasound in the diagnosis of malignant bile duct in patients with idiopathic acute pancreatitis

Introduction and Objective: Acute pancreatitis (AP) is an inflammatory process of the pancreas characterized by abdominal pain and increased pancreatic enzymes. This disease is diagnosed clinically. Endoscopic ultrasound (EUS), which is a technique with high sensitivity and specificity, is used to diagnose biliary disease. This study aimed to determine the sensitivity of EUS in the diagnosis of malignant bile duct in patients with idiopathic AP. Methods: This descriptive study was performed on 146 patients with pancreatitis hospitalized in the gastrointestinal tract section of the Imam Khomeini Hospital of Ahwaz Jundishapur University of Medical Sciences. The collected data were analyzed by the SPSS 22.0 and the significance level of the test was <0.05. Results: According to the results, 79 (54%) out of the 146 patients were female and 67 (46%) were male. The mean and standard deviation of the patients' age were 52.5 and 19.6 years, respectively. The findings showed that the sensitivity and specificity of the EUS were 33% and 99%, respectively. Compared to the endoscopic retrograde cholangiopancreatography (ERCP), the sensitivity and specificity of the abdominal ultrasound were 62% and 62.5%, respectively. Compared to the ERCP, the sensitivity and specificity of EUS were 92% and 50%, respectively. Conclusion: The findings of this study showed that the sensitivity and specificity of EUS were higher than those of abdominal ultrasound. Moreover, EUS was the preferred method to detect common bile duct stones (CBDS)