42 research outputs found
Management of Hospital Infection Control in Iran: A Need for Implementation of Multidisciplinary Approach
AbstractNosocomial, or hospital-acquired, infections are considered the most common complications affecting hospitalized patients. According to results obtained from studies conducted in the Children Medical Center Hospital, a teaching children's hospital and a tertiary care referral unit in Tehran, Iran, improvements in infection control practices in our hospital seem necessary. The aim of this study was to identify risk management and review potential hospital hazards that may pose a threat to the health as well as safety and welfare of patients in an Iranian referral hospital. Barriers to compliance and poor design of facilities, impractical guidelines and policies, lack of a framework for risk management, failure to apply behavioral-change theory, and insufficient obligation and enforcement by infection control personnel highlight the need of management systems in infection control in our hospital. In addition, surveillance and early reporting of infections, evaluation of risk-based interventions, and production of evidence-based guidelines in our country are recommended
Frequency and antimicrobial susceptibility of Shigella species isolated in Children Medical Center Hospital, Tehran, Iran, 2001-2006
AbstractAppropriate antimicrobial treatment of shigellosis depends on identifying its changing resistance pattern over time. We evaluated 15,255 stool culture submitted from July 2001 to June 2006 to the Laboratory of Children Medical Center Hospital. Specimen culture, bacterial identification, and disk diffusion susceptibility testing were performed according to National Committee for Clinical Laboratory Standards guidelines. From 15,255 stool samples, 682 (4.5%) were positive for Shigella species. The most common species of Shigella were S. flexneri (48%) and S. sonnei (45%); other results were S. dysenteriae (5%) and S. boydii (2%). The rate of Sensitivity to ceftriaxone (95%), ceftizoxime (94%), and nalidixic acid (84%) were among our isolates. Resistance to co-trimoxazole and ampicillin was 87% and 86%, respectively. S. flexneri was more multiresistant than other species (47.9%). Our isolates are overall most sensitive to ceftriaxone, ceftazidime, and nalidixic acid (> 84%). They were most resistant to co-trimoxazole and ampicillin (> 86%). Because resistance varies according to specific location, continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy
Clinical Manifestations, Laboratory Findings, and Therapeutic Regimen in Hospitalized Children with Brucellosis in an Iranian Referral Children Medical Centre
Brucellosis is considered a known widespread zoonotic disease and is
endemic in Mediterranean region, like Iran. This study reviewed the
clinical manifestations, laboratory findings, and therapeutic regimen
in childhood brucellosis in Iran. In this retrospective study, we
reviewed hospital-records of 34 consecutive children with a confirmed
diagnosis of brucellosis among a total number of 10,864 patients
admitted to Children\u2019s Medical Center, Tehran, Iran, between 2002
and 2010. Among the patients diagnosed with brucellosis, 22 (65%) were
admitted during spring and summer. Clinical findings of these patients
at admission were arthritis, splenomegaly, hepatomegaly,
lymphadenopathy, maculopapular skin rashes, and fever. Anaemia (53%)
and leukopenia (33%) were the most common findings in the children.
Only one patient had presented with leukocytosis. Four children (12%)
were thrombocytopenic, and none of patients had pancytopenia. Blood
cultures were positive in 5 patients (23%). Only one patient underwent
bone-marrow aspiration and had positive culture for Brucella spp.
Positive titres were found in 33 cases (97%) in Wright test, 23 cases
(96%) in Coombs test, and 16 patients (72.7%) in 2ME
(2-Mercaptoethanol) test. In one case, Wright and Coombs test titres
were below 1:80 while Brucella spp. were isolated from blood at the
same time. It is concluded, prolonged fever with joint involvement and
organomegaly may increase possibility of infection with Brucella spp.
Appropriate treatment regimen by more tolerable oral drugs, with a
duration of at least 8 weeks, is recommended
Evaluation of procalcitonin and neopterin level in serum of patients with acute bacterial infection
High frequency of vancomycin resistant Enterococcus faecalis in children: an alarming concern
Introduction: Enterococcus spp. is considered as important etiological agents of nosocomial infections. However, a little is known about the epidemiology of vancomycin resistant Enterococcus faecalis (VREF). The aim of this study was to investigate the frequency of VREF and detecting of two prevalent resistance genes (vanA, vanB) in pediatric population in an Iranian referral pediatric Hospital.Material and methods: During January 2013 to December 2013, 180 E. faecalis was isolated from clinical samples of hospitalized children at Children Medical Center Hospital, tertiary care and teaching hospital in Tehran, Iran. Antimicrobial testing was performed by Kirby-Bauer disk diffusion and E-test method according to Clinical Laboratories Standards Institute (CLSI). Two prevalent resistance genes (vanA, vanB) were investigated in VREF isolates.Results: Cephalosporin resistance was found in majority of E. faecalis isolates. There were no linezolid-resistant E. faecalis among all isolates. Teicoplanin resistance was observed in 13.8% of E. faecalis (n=25). MIC â„32 ”g/ml for vancomycin was found in 29 isolates (16%) and vanA gene was detected in 21 (72%) VREF strains, while vanB gene was not detected in any of these isolates. The mortality rate of all cases was 3.4% and 10% of patients with VREF infection died.Conclusion: This study reveals high rate of multidrug-resistant as well as vancomycin resistance in E. faecalis strains. Thus periodic surveillance of antibacterial susceptibilities is recommended to detect emerging resistance.
Candiduria in children: a first reportfrom an Iranian referral pediatric hospital
Candida spp. especially Candida albicans is considered as one of the most common cause of fungal infections. The aim of our study was to determine epidemiology of candiduria in children who were referred to an Iranian referral hospital. During May 2011 to February 2013, among 4813 urine culture positive, 209 candida spp. isolates (4.3%) was found. Forty-one percent of cadiduria infection was seen in patients between 1 month and 1 year, 24% in neonatant and 24% in patients 1 to 5 years. Cadiduria was mainly found in patients who had received more than 2 or 3 antibiotic during their hospitalization (37% and 24%, respectively). In our study, the highest frequency of cadiduria was seen in patients who had received more than 2 antibiotics and more than 3 antibiotics during their hospitalization; therefore, the strategic goals to opti- mize antimicrobial use including optimizing choice and duration of empiric therapy as well as monitoring and providing feedback regarding antibiotic resistance are recommended
SARS-CoV-2 fecal shedding pattern in pediatric patients with acute COVID-19 or COVID-19-associated multisystem inflammatory syndrome
Frequency of Chlamydia trachomatis in Women with Cervicitis in Tehran, Iran
Chlamydia trachomatis (CT) is the most common cause of bacterial sexually transmitted infection (STI) worldwide, but current data concerning the prevalence of CT among women in Iran is scarce. Data regarding the frequency of CT infection among Iranian women can help to justify the implementation of a national CT screening program that can reduce the high morbidity associated with sequelae of CT infections by treating infected women. Endocervical secretions from 123 married women (20â55 years) with cervicitis were tested by a PCR-EIA method using primers to amplify a CT-specific plasmid. The digoxigenin-labeled amplicon was measured by hybridization to a biotin-labeled probe and a strepavidin-coated plate, followed by an enzyme-linked colorimetric analysis. Overall frequency of CT infection among women was 17% (21/123). The range of CT frequency among various age groups was 12â25%. The 31â40-year-age group comprised the majority (49%) of CT positive samples, followed by 20â30 year group (33%). Although the 20-to-30-year-old women reported the highest frequency of STI history, they had the lowest relative frequency of CT infection (12%). There is a high frequency of CT infection among women with cervicitis in Tehran, Iran, thus indicating a necessity to implement a routine CT screening program in the major cities of Iran and possibly nationwide. Identification of CT-infected women may prevent its spread, and thereby reduce the high morbidity associated with CT infections among women in Iran