Importance of viral pathogens in children with acute gastroenteritis in the south of Iran

Different types of viruses are the leading cause of acute diarrhea among infants and young children worldwide. Epidemiological surveillance of viral agents is critical for the develop.ment of effective preventive measures, including vaccines. This study aimed to determine the prevalence of the four major enteropathogenic viruses-rotavirus, norovirus, adenovirus and astrovirus-in children over 7 years of age. DESIGN AND SETTING: A cross-sectional descriptive study conducted on stool specimens of children with acute gastroenteritis admitted to the Pediatrics Unit of 17 Shahrivar Hospital in Borazjan, Iran from October 2008 to September 2010. PATIENTS AND METHODS: Acute gastroenteritis was defined as >=3 loose watery stools per 24 hours. A total of 375 stool samples were collected from hospitalized children aged < 7 years old with acute gastroenteritis. All samples were investigated by using enzyme-linked immunosorbent assay for the presence of viral antigens. RESULTS: Rotavirus was detected in 91 (24.3%) of the patients whereas the prevalence of norovirus, adenovirus and astrovirus was 12.5%, 5.1% and 2.4%, respectively. On average, 75.9% of children with viral diarrhea were younger than 2 years old (P=.023). All the strains of viral gastroenteritis studied peaked in the autumn, except for adenovirus which peaked in spring (P=.015). The most common clinical symptoms included diarrhea (92.2%), vomiting (68.7%), abdominal cramp (60.8%) and moderate dehydration (57.2%). CONCLUSION: Since nearly half of gastroenteritis cases (44.3%) were due to viral agents, testing for the viral antigens may guide the clinical approach to those patients with acute diarrhea particularly in the case of children less than 2 years old, and during cold seasons

The association of metabolic syndrome and Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, and herpes simplex virus type 1: The Persian Gulf Healthy Heart Study

BACKGROUND: The metabolic syndrome together with insulin resistance and their consequences are basic factors in pathogenesis of atherosclerosis. Chronic infections with herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), and Chlamydia pneumoniae are associated with the development of atherosclerosis and coronary heart disease. The infectious aspects of metabolic syndrome have not been investigated. METHODS: In a cross-sectional, population-based study, we used National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP)-III criteria in 1791 subjects, aged 25 years and over, selected by cluster random sampling in three Iranian ports in the northern Persian Gulf. Sera were analyzed for IgG antibodies to Chlamydia pneumoniae, HSV-1, Helicobacter pylori (H. pylori) and CMV using ELISA. RESULTS: In multiple logistic regression analysis, of the infectious agents, CMV [OR = 1.81 (1.05–3.10); p = 0.03], H. pylori [OR = 1.50 (1.12–2.00); p = 0.007] and Chlamydia pneumoniae [OR = 1.69 (1.27–2.25); p < 0.0001] showed a significant association with the metabolic syndrome in men and HSV-1 [OR = 1.95 (1.22–3.11); p = 0.005], H. pylori [OR = 1.45 (1.09–1.94); 0.01] and Chlamydia pneumoniae [OR = 1.65 (1.23–2.21); p = 0.001] in women. CONCLUSION: The metabolic syndrome, which occurs very frequently in the general population, has a significant association with prior infection with Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus and herpes simplex virus type 1. Hypothesis about participation of infection in pathogenesis of metabolic syndrome should be investigated

Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

<p>Abstract</p> <p>Introduction</p> <p>Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations.</p> <p>Case presentation</p> <p>A 73-year-old cachectic Asian man (Iranian) presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP) were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement.</p> <p>Conclusion</p> <p>Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.</p

Concurrent increased high sensitivity C-reactive protein and chronic infections are associated with coronary artery disease: A population-based study

BACKGROUND: An elevated serum level of C-reactive protein (CRP) is an independent predictor of coronary artery disease (CAD). Chronic infections have also been implicated in the pathogenesis of CAD. AIMS: To investigate how concomitant chronic infection and CRP related to electrocardiogram-defined CAD in a general population. SETTING AND DESIGN : A population-based cross-sectional study, which was conducted in three Iranian ports in the northern Persian Gulf. MATERIALS and METHODS : For evaluation of CAD, we used Minnesota coding criteria of a 12-lead resting electrocardiogram in 1,754 subjects, aged 25 years and over, selected by cluster random sampling. Sera were analyzed for IgG antibodies to Chlamydia pneumoniae (C. pneumoniae), Herpes simplex virus type 1 (HSV-1), Helicobacter pylori (H. pylori) and cytomegalovirus (CMV) using ELISA. Measurement of CRP by a high-sensitivity CRP assay was done. STATISTICAL ANALYSIS: Multiple logistic regression analysis was used. RESULTS: None of the infectious agents (CMV, H. pylori, C. pneumoniae and HSV-1) showed a significant association with electrocardiogram-defined CAD after adjusting for sex and age. Elevated CRP levels did not show significant association with electrocardiogram-defined CAD independent of seropositivity to one of the four infectious agents, but concurrent elevated CRP levels (>10.0 mg/L) and anti-C. pneumoniae [OR = 1.68 (CI, 1.24-2.59; P=0.04)], H. pylori [OR = 1.98 (CI, 1.26-3.13; P=0.003)], CMV [OR = 1.66 (CI, 1.10-2.49; P=0.01)] or HSV-1 [OR=1.79 (CI, 1.18-2.72; P=0.006)] IgG antibodies were associated with prevalence of electrocardiogram-defined CAD in the general population, after adjustment for multiple risk factors, including age, sex and the components of the metabolic syndrome. CONCLUSIONS: Beyond traditional cardiovascular risk factors, concomitant chronic infection and elevated CRP are significantly correlated with electrocardiogram-defined CAD

Levofloxacin Resistance in Blood and Urine Culture Samples in Khalij Fars Hospital of Bushehr

Background: Due to broad spectrum antimicrobial activity of Levofloxacin, it has been used widely around the world. Recently levofloxacin-resistance reports have been published. This study was done to evaluate resistance to levofloxacin in positive urine and blood cultures in Persian Gulf hospital in Bushehr, during 2015-16. Materials and Methods: In&nbsp; this cross- sectional study all positive urine and blood cultures were enrolled, if the amount of the isolated pathogen&nbsp; colony counts were more than 105. Culture samples were divided into 3 groups including sensitive, intermediate and resistant; based on bacterial growth around discs. SPSS version 18.0 was used as the statistical analysis program, and a p-value of less than 0.05 was considered statistically significant. Results: Cultures belonged to 150 patients including 61 (%40.7) male and 89 (%59.3) female subjects with mean age of 42.98 &plusmn; 29.25 years were studied. Culture samples were consisted of urine (% 50.7) and blood cultures (% 49.3). E.coli was the most common pathogen (% 46) and Klebsiella (% 16.7) was the second pathogen in all cultures. Regarding sensitivity to&nbsp; levofloxacin, 119 (% 79.3) samples were sensitive, 22 (% 14.7) culture had intermediate sensitivity and 9 (%6) samples were resistant to levofloxacin. The only&nbsp; resistant pathogen was E.coli. Conclusion: This study showed that Levofloxacin has good activity against many pathogens except for E.coli infections that showed some resistance. However , it can still be a good choice in treatment of most infections. &nbsp

The association of metabolic syndrome and Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, and herpes simplex virus type 1: The Persian Gulf Healthy Heart Study

Abstract Background The metabolic syndrome together with insulin resistance and their consequences are basic factors in pathogenesis of atherosclerosis. Chronic infections with herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), and Chlamydia pneumoniae are associated with the development of atherosclerosis and coronary heart disease. The infectious aspects of metabolic syndrome have not been investigated. Methods In a cross-sectional, population-based study, we used National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP)-III criteria in 1791 subjects, aged 25 years and over, selected by cluster random sampling in three Iranian ports in the northern Persian Gulf. Sera were analyzed for IgG antibodies to Chlamydia pneumoniae, HSV-1, Helicobacter pylori (H. pylori) and CMV using ELISA. Results In multiple logistic regression analysis, of the infectious agents, CMV [OR = 1.81 (1.05–3.10); p = 0.03], H. pylori [OR = 1.50 (1.12–2.00); p = 0.007] and Chlamydia pneumoniae [OR = 1.69 (1.27–2.25); p Conclusion The metabolic syndrome, which occurs very frequently in the general population, has a significant association with prior infection with Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus and herpes simplex virus type 1. Hypothesis about participation of infection in pathogenesis of metabolic syndrome should be investigated.</p

Prevalence of Measles Antibodies in Medical Students in Bushehr

Background: Measles is one of the most highly communicable of all infectious diseases in healthcare settings, and may transmit to medical personnel. This study was designed to assess measles immunity in a group of healthcare workers (medical students) and its relationship with age, sex and duration of working in hospital. Material and Methods: All medical students of the clinical courses were informed of the study in spring and summer of 2016. After collecting demographic information, 5 ml of blood was drawn from each student. Serum level of measles IgG was measured using IBL-America enzyme-linked immunosorbent assays kits in the laboratory of the Persian Gulf Research Center for Infectious Diseases. Results: A total of 90 students with a mean age of 25&plusmn;3.2 years were included. All students had a history of one shot of measles vaccination. The positivity rate of measles antibody was found 48.9% (44 cases) while 12.2% (11 cases) had borderline titers and 35 (38.9%) were reported negative. No relationship was observed between positivity of measles antibody and the variables of age, sex and duration of working in hospital. Conclusion: This study demonstrates more than one-third of medical students were at risk of measles, which mandates periodic surveillance and revaccination of susceptible healthcare workers. Furthermore, adequate respiratory precautions should be taken when visiting patients with febrile exanthema and cough

Cytomegalovirus infection in NICU admitted neonates in Boushehr

Background: Cytomegalovirus is the most prevalent cause of congenital infections and the most important cause of congenital deafness. Which it's spread is about 0.64% of all birth which differ based on geolocation, race and socioeconomically situations. This proposal accomplished in the end of July until middle of February 2014 with the goal of studying Cytomegalovirus infection distribution among newborns who are hospitalized in Bushehr Shohadaye Khalij Fars hospital NICU. Material & Method: 80 urine samples were collected between July until February 2014 in NICU of Bushehr Khalij Fars hospitalized neonates. Samples were tested by PCR method on urine samples to find if they are infected by cytomegalovirus. Results: Mean age of neonates was 30.59&plusmn;9.30 days. Only one newborn under 30 days had Cytomegalovirus and 11 cases older than 30 days had positive reaction. The relation between age and CMV seropositivity was statistically valid (p<0.05).this means only 1.2% of newborns are CMV and 55% are older than 1 month. Conclusion: The pattern of CMV seropositivity shows that most infections may be acquired from environment. According to low prevalence of congenital CMV infection, there is no need to introduce preventive methods and following present guidelines is enough

Presence of Shiga Toxin Gene in Clinical Iso-lates of Shigella Species from the Past to Present in Bushehr, Iran

Background: The Shiga cytotoxin (Stx) is involved in serious human intestinal diseases. Recently stx has been found in non-S dysenteriae1 Shigella species. This study aimed to identify stx gene in clinical strains of Shigella isolated from two shigellosis outbreaks in previous years in Bushehr, southwest of Iran. Materials and Methods: Purified DNA of 143 Shigella isolates was used for PCR to detect stx and ipaH genes. The number of PCR products in various Shigella species isolates was sequenced with the same&nbsp;primers (evt) used to amplify this region. Results: Fourteen (22.3%) out of 63 shigella isolates related to previous shigellosis outbreaks during 2002-2004 contained the PCR positive result with evt primers. The sequencing results indicated that the evt PCR product had the most identity (97%) with Shigella dysentery shiga toxin subunit A. All clinical shigella strains isolated&nbsp;during 2013-2015 yielded PCR negative results with primers stx and evt. PCR results revealed that ipaH was present in all isolates. According to biochemical and species-specific antiserum tests, the stx gene harboring&nbsp;isolates included 9 (14.3%) S. flexneri, 4 (6.4%) S. sonnei, and 1(1.6%) S. boydii. Conclusion: The stx gene has already been distributed in different Shigella species of Bushehr region.&nbsp;However, the absence of this gene in the clinical isolates of recent shigellosis outbreaks may be temporary. Because stx gene increases the pathogenic potential of Shigella, it is necessary to monitor the prevalence of the stx harboring Shigella species by molecular methods in the future