Determination Of Appropriate Antibiotic In Bacterial Meningitis Of Children Based On MIC

Background: Bacterial meningitis is one of the most serious infections in infants and children. Three organisms include S.Pneumo;N.mening;H.Influ are the most common cause of meningitis in children between 2M-14y age.Etest is a new method for determination the MIC of some antimicrobial drugs in agarose .This method is useful for some organisms like as S .Pneumo; N.mening; H.Influ;sensitive Streptococcus and anaerobic ;aerobic gram negative. Materials and Methods: In this descriptive cross sectional study; In 57 suspected meningitis children ; organisms isolated from blood; CSF or other sterile boy fluid after culturing and antibiogram;. .MIC of someorganisms detected by Etest method. Results: Streptococcuswas the most prevalent ( 70%) and S.pneumon( 90% of all Streptococcus); H.infl 2%;N.mening 4%and L.monocyt 6%(more than expected);Gram negative (Ecoli; Klebsiella; entrobacter and psudomona) 18%. There was significant difference (P =0.01)in type of organisms between age groups. S.pneumonia was more frequent in children > 2 year ;N.meningitis in>4yr old .Site of isolation :blood; CSF (35.8*;28.3%)other sterile site 18.4%;concomitant positive culture in two site:17%.Mean age in Streptococcus was significantly different with Listeria (p=0.05); N.meningitis (p=0.04);H.influ (p=0.04);.but no difference with Staphylococcus;Klebsiella and E.coli Two type of H.inf were sensitive to Ampici or chloram ;both of them were sensitive to ceftiaxon. GBS were sensitive to PNC or Ampici Strep.nonAnonBnon- Cotrimoxazol>32mic/ml /PNC >256mic/ml/ Vanco>256mic/ml Strep.D: Cotrimoxazol>0.062mg/ml/ /PNC >0.016mic/ml/Imipenem>0.032mic/ml. Strep Pneumonia: All fo them were sensitive except 3 cases /Cotrimoxazol>2ic/ml /PNC =0.01mic/ml/Vanco>0.125mic/ m Vanco>0. 25mic/ ml/.Cotrimoxazol>2ic/ml / PNC =0.01mg/ml Vanco>0.125mic/ ml / Cotrimoxazol>2mic/ml /MIC-PNC >0.016mic/ml Therefore high dose of PNC is adequate for S.pneu ;because of Interm resistance to PNC All 3 N.menin were sensitive to PNC;Chlora;Ceftria and vanco Resistant to all drugs and high MIC for cefotaxime;CIPRO>32mic/ml. E coli: Pseudomona Aerogenosa:: Ceftriaxon>256mic/ml/ /Genta>0.038mg/ml Imipenem>32mic/ml. Klebsiella; only Sensitive to Cipro Staph .Aureous:Sensitive to Clinda;Cipro;Chlora;Resistant toCeft;PNCand Cotri Conclusion: Most type of N.meningitidis;H.inf and S.pneumonia were sensitive to many drugs. Only minority of them were resistant to Ampicillin but sensitive to chloramphenicol and vice versa. limited number of pneumococcal resistance to penicillin is medium resistance( MIC:0.1-1) .we can treat this resistant type by increasing of penicillin dosage .The others were sensitive to all drugs. Therefore ampicillin and chloramphenicol are the drug of choice in empiric treatment of bacterial meningitis after neonatal period

Soot aggregate complex morphology: 3D geometry reconstruction by SEM tomography applied on soot issued from propane combustion

International audienceCharacterization of soot is of interest to many researchers working on environmental aerosol and combustion diagnostics over decades. In this study the morphology of soot aggregates issued from incomplete combustion is investigated based on the need of their radiative properties. The state-of-art of the work on soot from incomplete combustions comprises the characterization techniques based on in situ and ex situ techniques. Due to the limitations and uncertainties arising from in situ measurements in a combustion flame for the definition of morphology for a dispersed group of aggregates, ex situ observations under electron microscopy are often referred to in the literature for aggregate samples collected inside the flame. The latter ex situ observations include the fractal analysis of 2D SEM/TEM images, the derivation of 3D geometry obtained by TEM tomo-graphy and the generation of numerical aggregates based on common fractal parameters. In our study, soot aggregates are extracted from a laboratory scale rich propane-air flame by thermophoretic sampling onto metal thin plates. Different from the previous researches , 3D geometry of soot is obtained here by SEM tomography: the geometry reconstruction techniques are successfully applied to a relatively small series of tilted SEM images of high resolution using the " seeing through " phenomenon occurring in nano-sized material samples with low atomic number. The observation of soot monomer size under TEM microscopy allows us to test the errors that may arise from the SEM imaging technique (like the pollution deposition on the substrate due to charging, the image artifacts due to the nature of secondary electron emissions) and from the simplified sampling procedure (not using the conventional holey carbon films but metal thin plates). The obtained 3D soot geometry is promising in terms of reducing the analysis time, simplifying the sampling procedure and expanding the 3D observation applicability by not limiting the material sampling to depositing soot and aerosols on TEM grids.

Molecular analysis of typical and atypical enteropathogenic Escherichia coli (EPEC) isolated from children with diarrhoea

Diarrhoea continues to be one of the most common causes of morbidity and mortality among infants and children in developing countries. To investigate the incidence, antimicrobial resistance and genetic relationships of enteropathogenic Escherichia coli (EPEC) in children with diarrhoea, a total of 612 stool specimens were collected in Tehran, Iran, and cultured to isolate strains of EPEC. The disc diffusion method was used to determine the susceptibility of the isolates according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The presence of eae, stx and bfp-A genes was determined by PCR. The genetic relationships between EPEC isolates were determined by pulsed-field gel electrophoresis (PFGE). Out of the 412 strains of E. coli obtained from 612 diarrhoeal stool specimens, 23 (5.6) were identified as EPEC, of which seven (30.4) were classified as typical strains of EPEC and 16 (69.6) were classified as atypical. Out of the 23 EPEC isolates, 69.5 were resistant to ampicillin, 39.1 were resistant to tetracycline and cotrimoxazole, 30.4 were resistant to cefpodoxime, ceftazidime, ceftriaxone and aztreonam, and 26.1 were resistant to imipenem. The isolates were classified into 21 pulsotypes by PFGE profiles. The present study shows that typical and atypical EPEC isolates displayed considerable heterogeneity in PFGE profiles and EPEC infections were only sporadic in Tehran. Overall 69 of isolates were resistant to at least one of the antibiotics tested

Antimicrobial resistance of nosocomial strain of Acinetobacter baumannii in Children's Medical Center of Tehran: a 6-year prospective study

There are increasing reports of emergence of multiple drug resistant (MDR) Acinetobacter spp in the world; however there are a few reports in our country. 145 A. baumannii isolates from distinct wards and Children's Medical Center (CMC) in Tehran were studied in order to find the profile of antibiotic resistance among them. 40.6 (59/145) of A. baumannii isolates were identified as MDR. Overall susceptibility rates to cotrimoxazole, chloramphenicole and ciprofloxacin were 23.4, 16.9 and 20.1, respectively. Frequency susceptibility rates to amikacin, kanamycin, gentamycin and tobramycin decreased gradually from 81.2, 50, 50 and 62.5 in 2002 to 25, 15.6, 28.1 and 25 in 2007 respectively. Overall susceptibility rates to cephalosporines cephalotin, ceftazidime, cefteriaxon, ceftizoxime and cefixime were 9.3, 14.7, 16.2, 15.9 and 18, respectively. Susceptibility to carbapenems was assessed only in 2007. The susceptibility rates of Imipenem and meropenem were shown to be 50 and 46.8, respectively. Our data indicates that MDR A. baumannii strains are spreading and carbapenem resistance is becoming more common in Iran. Our findings also highlight the importance of clinicians' access to updated susceptibility data regarding A. baumannii in developing countries such as Iran

Detection of Haemophilus influenzae Type B in cerebrospinal fluid of suspected children with meningitis by PCR

Background: A polymerase chain reaction (PCR) assay with primers from "hpd" gene was compared with culture for the detection of Haemophilus influenzae type b (Hib) in CSF samples from children suspected of meningitis. Methods: 300 cerebrospinal fluid (CSF) samples from suspected meningitis cases were studied by culture (Leventhal & Chocolate Agar) and PCR. Results: The latter method could detect Hib in all 5 culture positive and in 2 of 295 culture negative cases, showing sensitivity, specificity, and an accuracy index of 100%, 99% and 99%, respectively. The PCR result was available within a day. Conclusion: This study has shown that PCR is a rapid, sensitive, and specific diagnostic test for Hib from CSF samples. Furthermore, to maximize management of meningitis cases to reduce the morbidity, mortality, and complications of invasive Hib infection a combination of culture and PCR is necessary for the detection of Hib infection. The incidence of Hib meningitis among children in Children's Medical Center in Tehran based on culture and PCR results were 2.4 % and 1.7% respectively. Based on culture results, Hib causes 15.6% of all cases of bacterial meningitis in children

Zinc-Imidazolate Films as an All-Dry Resist Technology

Motivated by the drawbacks of solution phase processing, an all-dry resist formation process is presented that utilizes amorphous zinc-imidazolate (aZnMIm) films deposited by atomic/molecular layer deposition (ALD/MLD), patterned with electron beam lithography (EBL), and developed by novel low temperature (120 °C) gas phase etching using 1,1,1,5,5,5-hexafluoroacetylacetone (hfacH) to achieve well-resolved 22 nm lines with a pitch of 30 nm. The effects of electron beam irradiation on the chemical structure and hfacH etch resistance of aZnMIm films are investigated, and it is found that electron irradiation degrades the 2-methylimidazolate ligands and transforms aZnMIm into a more dense material that is resistant to etching by hfacH and has a C:N:Zn ratio effectively identical to that of unmodified aZnMIm. These findings showcase the potential for aZnMIm films to function in a dry resist technology. Sensitivity, contrast, and critical dimensions of the patterns are determined to be 37 mC cm-2, 0.87, and 29 nm, respectively, for aZnMIm deposited on silicon substrates and patterned at 30 keV. This work introduces a new direction for solvent-free resist processing, offering the prospect of scalable, high-resolution patterning techniques for advanced semiconductor fabrication processes