Staphylococcus aureus infections in children in an Iranian referral pediatric Hospital

Introduction. Staphylococcus aureus is associated with various infections ranging from skin and soft tissues such as surgical site infections and abscesses to lower respiratory tracts and blood- stream. The aim of this study was to evaluate underlying condi- tion of patients with S. aureus infections in an Iranian referral pediatric Hospital. Material and methods. Information was extracted retrospec- tively from the medical records of patients who were diagnosed with S. aureus infections. Data obtained about the study subjects included basic demographics, reason for admission, culture site, length of hospital stay, and methicillin susceptibility. Results. The underlyning condition of of patients with S.aureus infection during November 2011 and March 2013 were included in the study. The most frequent diagnosis in patients with S. aureus infection was jaundice (12%), abscess (10%), cellulitis (10%), wound infection (8%), septic arthritis (7%) and sezeire (5%). Wound was the most common infection sites among all subjects 34/98 (35%) following by blood (20/98, 20%) as well as skin and soft tissue (19/98, 19%). The proportion of MRSA infections among all S. aureus isolates was 79% (77/98) during the study period. In addition, 58/74 (78%) met the definition of Hospital-Associated Methicillin-Resistant S. aureus (HA- MRSA) infections and the rest; 20/24 patients (83%), were classified as Community-Associated Methicillin-Resistant S. aureus (CA- MRSA). Conclusion. In our study, the high frequency of MRSA was found not only in HA S. aureus but also in CA S. aureus isolates; there- fore, the strategic goals to optimize antimicrobial use includin

Wide distribution of carbapenem resistant Acinetobacter baumannii in burns patients in Iran

Antimicrobial resistance in carbapenem non-susceptible Acinetobacter baumannii (CNSAb) is a major public health concern globally. This study determined the antibiotic resistance and molecular epidemiology of CNSAb isolates from a referral burn center in Tehran, Iran. Sixty-nine CNSAb isolates were tested for susceptibility to antimicrobial agents using the E test methodology. Multiple locus variable number tandem repeat analysis (MLVA), Multilocus sequence typing (MLST) and multiplex PCR were performed. PCR assays tested for ambler classes A, B, and D β-lactamases. Detection of ISAba1, characterization of integrons, and biofilm formation were investigated. Fifty-three (77) isolates revealed XDR phenotypes. High prevalence of blaOXA-23-like (88) and blaPER-1 (54) were detected. ISAba1 was detected upstream of blaADC, blaOXA-23-like and blaOXA51-like genes in, 97, 42, and 26 of isolates, respectively. Thirty-one (45) isolates were assigned to international clone (IC) variants. MLVA identified 56 distinct types with six clusters and 53 singleton genotypes. Forty previously known MLST sequence types forming 5 clonal complexes were identified. The Class 1 integron (class 1 integrons) gene was identified in 84 of the isolates. The most prevalent (33) cassette combination was aacA4-catB8-aadA1. The IC variants were predominant in the A. baumannii lineage with the ability to form strong biofilms. The XDR-CNSAb from burned patients in Iran is resistant to various antimicrobials, including tigecycline. This study shows wide genetic diversity in CNSAb. Integrating the new Iranian A. baumannii IC variants into the epidemiologic clonal and susceptibility profile databases can help effective global control measures against the XDR-CNSAb pandemic. � 2015 Farshadzadeh, Hashemi, Rahimi, Pourakbari, Esmaeili, Haghighi, Majidpour, Shojaa, Rahmani, Gharesi, Aziemzadeh and Bahador

Wide distribution of carbapenem resistant Acinetobacter baumannii in burns patients in Iran

Antimicrobial resistance in carbapenem non-susceptible Acinetobacter baumannii (CNSAb) is a major public health concern globally. This study determined the antibiotic resistance and molecular epidemiology of CNSAb isolates from a referral burn center in Tehran, Iran. Sixty-nine CNSAb isolates were tested for susceptibility to antimicrobial agents using the E test methodology. Multiple locus variable number tandem repeat analysis (MLVA), Multilocus sequence typing (MLST) and multiplex PCR were performed. PCR assays tested for ambler classes A, B, and D β-lactamases. Detection of ISAba1, characterization of integrons, and biofilm formation were investigated. Fifty-three (77) isolates revealed XDR phenotypes. High prevalence of blaOXA-23-like (88) and blaPER-1 (54) were detected. ISAba1 was detected upstream of blaADC, blaOXA-23-like and blaOXA51-like genes in, 97, 42, and 26 of isolates, respectively. Thirty-one (45) isolates were assigned to international clone (IC) variants. MLVA identified 56 distinct types with six clusters and 53 singleton genotypes. Forty previously known MLST sequence types forming 5 clonal complexes were identified. The Class 1 integron (class 1 integrons) gene was identified in 84 of the isolates. The most prevalent (33) cassette combination was aacA4-catB8-aadA1. The IC variants were predominant in the A. baumannii lineage with the ability to form strong biofilms. The XDR-CNSAb from burned patients in Iran is resistant to various antimicrobials, including tigecycline. This study shows wide genetic diversity in CNSAb. Integrating the new Iranian A. baumannii IC variants into the epidemiologic clonal and susceptibility profile databases can help effective global control measures against the XDR-CNSAb pandemic. � 2015 Farshadzadeh, Hashemi, Rahimi, Pourakbari, Esmaeili, Haghighi, Majidpour, Shojaa, Rahmani, Gharesi, Aziemzadeh and Bahador

Effects of oral probiotic feeding on toll-like receptor gene expression of the chicken's cecal tonsil

Background: It was proposed that probiotics may influence immune system through direct or indirect exposure. Direct exposure is mostly mediated by surface receptors. Toll-like receptors (TLRs) are conserved molecular sensors which could be triggered via some pathogen associated structures, hence, modulate the immune responses. This study was conducted to elucidate the impact of lactobacillus acidophilus as a common probiotic on the expression level of TLRs in the chicken's cecal tonsil. Methods: Thirty one-day-old chicken were selected and separated into three groups as probiotic-fed, dairy-fed and control. In addition to commercial powder supply, each chicken in the probiotic-fed group received 109 CFU/Kg of L. acidophilus daily. While, chickens in the dairy-fed group were provided with commercial powder feed and sterile dairy milk. After 14 and 21 days of oral feeding the cecal tonsil was removed and the expression of TLR2, TLR4 and TLR5 were examined by real-time PCR. Results: At the age of 14-day, there was a slight upregulation in the expression levels of TLR2 (118.9), TLR4 (129.6) and TLR5 (123.7) of the cecal tonsil in the probiotic-fed group; however, these alterations were not statistically significant. At the age of 21-day, a non-significant downregulation was observed in TLR expression level of both dairy-fed (TLR2, 85; TLR4, 79.5; and TLR5, 86.5) and probiotic-fed (TLR2, 88.8; TLR4, 81; and TLR5, 87.2) groups in comparison to controls. Conclusions: The findings revealed that although the probiotic supplementation could be useful but it did not significantly affect innate immunity state through alteration of TLRs

Effects of oral probiotic feeding on toll-like receptor gene expression of the chicken's cecal tonsil

Background: It was proposed that probiotics may influence immune system through direct or indirect exposure. Direct exposure is mostly mediated by surface receptors. Toll-like receptors (TLRs) are conserved molecular sensors which could be triggered via some pathogen associated structures, hence, modulate the immune responses. This study was conducted to elucidate the impact of lactobacillus acidophilus as a common probiotic on the expression level of TLRs in the chicken's cecal tonsil. Methods: Thirty one-day-old chicken were selected and separated into three groups as probiotic-fed, dairy-fed and control. In addition to commercial powder supply, each chicken in the probiotic-fed group received 109 CFU/Kg of L. acidophilus daily. While, chickens in the dairy-fed group were provided with commercial powder feed and sterile dairy milk. After 14 and 21 days of oral feeding the cecal tonsil was removed and the expression of TLR2, TLR4 and TLR5 were examined by real-time PCR. Results: At the age of 14-day, there was a slight upregulation in the expression levels of TLR2 (118.9), TLR4 (129.6) and TLR5 (123.7) of the cecal tonsil in the probiotic-fed group; however, these alterations were not statistically significant. At the age of 21-day, a non-significant downregulation was observed in TLR expression level of both dairy-fed (TLR2, 85; TLR4, 79.5; and TLR5, 86.5) and probiotic-fed (TLR2, 88.8; TLR4, 81; and TLR5, 87.2) groups in comparison to controls. Conclusions: The findings revealed that although the probiotic supplementation could be useful but it did not significantly affect innate immunity state through alteration of TLRs

Identification of Etiologic Agents of the Pertussis-like Syndrome in Children by Real-time PCR Method

The aim of this study was to recognize the identity and frequency of etiologic agents of the pertussis-like syndrome in children < 2 years of age. A cross-sectional hospital-based study conducted from August 2014 to August 2015. All children < 2 years of age (n=100) who were suspected as pertussis infected were enrolled in this study and tested for Bordetella pertussis, adenovirus (Adv), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza virus A (INF-A) by real-time PCR technique. RSV was the most detected pathogen (20), followed by B. pertussis (18), Adv (16), INF-A (11), and hMPV (10). Co-infection was observed in 8 patients (11) and the combinations of RSV/INF-A (n=3, 4), and AdV/B. pertussis (n=3, 4) were more frequent. RSV, B. pertussis, and hMPV were more frequent pathogens among infants < 4 months of age. However, Adv and INF-A were more frequent pathogens among children > 6 months of age. In this study, RSV was the most frequent identified pathogen (n=20, 20), followed by B. pertussis (n=18, 18) and AdV (n=16, 16). Pertussis was more frequent in spring (8) and summer (6). In addition, clinical symptoms of pertussis were the same as some viral pathogens, which can lead to misdiagnosis of infection. Therefore, diagnosis of pertussis should be established on the bases of both the clinical symptoms and the laboratory methods

Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students

Objectives: We conducted this study to assess the seroprevalence of Varicella zoster virus (VZV) antibodies in a group of Iranian medical sciences students that were at risk of Varicella and the value of self-reported history as a predictor of immunity. Material and Methods: 255 medical, nursing and obstetrics students who had not entered as a student or worked in a hospital from 3 different schools were enrolled in the study in 2012 (Qazvin province, Iran). Demographics and other information as well as the history of Varicella were obtained through a self-administered questionnaire. Blood samples were collected to determine the Varicella IgG levels via an enzyme-linked immunosorbent assay. A statistical analysis was performed by calculating prevalences and their 95% confidence intervals. Sensitivity, specificity, positive and negative predictive values, Cohen's kappa and positive and negative likelihood ratios of recalled history were determined. p < 0.05 was considered statistically significant. Results: The mean age of participants was 21.3±4.3 years. Seropositivity rate was 74.5%. The relationships between marital status, number of family members, and acquired VZV history with immunity against the virus were statistically significant. The overall rate of reported history was 57%. The positive and negative predictive values of self-reported history of Varicella were 91% and 47.3%, respectively. Conclusions: Immunization of students of Iranian medical sciences seems logical in the near future. Also, they should be tested for Varicella immunity regardless of the history of previous infection

Multi-area Environmentally Constrained Active-reactive Optimal Power Flow: A Short-term Tie Line Planning Study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)This study presents a tie line planning and its effects on the operating cost and environmental issues of power systems via a novel multi-area active-reactive optimal power flow (MA-AROPF) model. In this study, the authors focus on the significant role of tie line planning on power system operation. To select an appropriate tie line, a modified sensitivity index is used, which not only reduces the operating cost and emissions, but also enhances the voltage stability of individual areas and the entire power system. These benefits are obtained by increasing the degree of freedom of the power system through providing uniform economic and emission dispatch. Moreover, in this study, to address the drawbacks of commonly used decomposition methods for solving MA-AROPF, an integrated model is proposed. An AROPF that considers the environmental effects is a highly non-linear problem, and the multi-area consideration of such problems via tie line planning makes it an even more complicated and exceedingly non-linear problem. For didactic purposes and to verify the model, a small two-area system is considered in detail, while to show the effectiveness of the proposed approach, a three-area system consisting of 14-, 30-, and 118-bus IEEE test systems is conducted.10299309FAPESP [2014/22828-3, 2013/23590-8]CAPESCNPq [305371/2012-6]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq