Compliance of Healthcare Workers with Hand Hygiene Practices in the Northeast of Iran: an Overt Observation

Hand hygiene (HH) is one of the most effective methods to prevent transmission and spread of microorganisms from one patient to another, also, it used to reduce the spread of pathogens in clinical settings and to help control outbreaks but compliance is usually poor. The purpose of this study was to analyze the compliance of hand hygiene and affecting factors among healthcare workers (HCWs) of northeast hospitals in Iran. This study was conducted based on observation method for the compliance of hand hygiene according to the World Health Organization (WHO) guidelines. HCWs were observed during routine patient care in different shifts, also the technique of hand hygiene was assessed through hand washing with alcohol-based disinfectant. Data were collected during 1 year, from June 2014 to July 2015 by the infection control teams in the northeast hospital of Iran. By direct observation, we evaluated a total of 92518 hand hygiene opportunities from 29 hospitals in the northeast of Iran during 1 year, with overall compliance rates in these hospitals were 43.42%. Compliance rates differed by role: nurses43%, doctors 19 % and other health workers 29%. In this observational study, we identified that adherence to hand hygiene practice and use of alcohol-based disinfectant was very low in this hospitals, so effective intervention programs to promote adherence to hand hygiene and use of disinfectants could be effective to increase compliance

Prevalence of Mycoplasma Pneumoniae Infection in Patients with COPD Exacerbation; a Letter to the Editor

Dear editor;Currently, control and prevention of respiratory illnesses is considered a health priority in most developed countries and managing the risk factors is necessary for improving the population’s health. Chronic obstructive pulmonary disease (COPD) is the 5th cause of death around the world and estimations have indicated that due to an increase in environmental pollution, this disease will become the 3rd cause of death in the future.In previous studies, pulmonary infection with mycoplasma pneumoniae has been introduced as one of the causes for COPD exacerbation. Mycoplasma pneumoniae affects the upper and lower respiratory tract and its clinical manifestation is trachea-bronchitis accompanied by restlessness and dry coughs. The pathogenesis spectrum of this bacterium ranges from mild pharyngitis and trachea-bronchitis to acute pneumonia. Epidemiologic studies have shown that this bacterium is responsible for more than 20% of community acquired pneumonias.In a cross-sectional study by the authors of the present letter, 66 patients over the age of 18 years who had presented to the emergency department of Imam Reza Hospital, Mashhad, Iran, with diagnosis of COPD exacerbation were evaluated. Sputum sample of the patients was obtained and sent to the laboratory for performing polymerase chain reaction (PCR). Mean age of the patients participating in this study was 67.28 ± 13.68 years (60.6% male). The result of PCR was positive in 6 patients out of the total of 66 patients (9.1%). The results of the present study showed that there was no correlation between age (p=0.18), sex (p=0.25), duration of being affected with COPD (p=0.20), consumption of antibiotics (p=0.35), smoking (p=0.62), opioid abuse (p=0.44), corticosteroid use (p=0.57), underlying illness (p=0.94) and health care—associated pneumonia (HCAP) (p=0.46) with mycoplasma infection. However, prevalence of leukocytosis (p=0.01) and myalgia (p=0.02) was significantly higher in the mycoplasma group.Numerous studies have confirmed the presence of mycoplasma pneumoniae in exacerbation of COPD using serologic diagnosis. For instance, in a study by Lieberman et al. prevalence of mycoplasma pneumoniae in patients with COPD exacerbation was reported as 14.2% and in Meloni et al. study the prevalence of this infection was expressed to be 6.7%. These rates were reported between 5% and 14% in other studies.Thus, it seems that prevalence of mycoplasma is high in COPD exacerbation, but there is still no answer to the question if this infection results in exacerbation of COPD or not and there is controversy between the studies in this regard. Therefore, it is suggested to design case-control or cohort studies to find the answer to this question

Sealing Ability of Orthograde MTA and CEM Cement in Apically Resected Roots Using Bacterial Leakage Method

Introduction: The aim of this in vitro study was to determine the sealing ability of orthograde ProRoot mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) cement as root-end filling materials. Materials and Methods: Fifty four extracted single-rooted human teeth were used. The samples were randomly divided into 3 experimental groups. In group A and B, 4 mm of WMTA and CEM cement were placed in an orthograde manner and 3 mm of apices were resected after 24 hours. In group C the apical 3 mm of each root was resected and the root-end prepared with ultrasonic tips to a depth of 3 mm and subsequently, then filled with MTA. The apical sealing ability was performed with bacterial leakage method. Statistical analysis was carried out with Chi-square test. Results: There were no significant differences in the extent of bacterial leakage between the three experimental groups (P>0.05). Conclusion: Based on the limitations of this in vitro study, we concluded that MTA and CEM cement can be placed in an orthograde manner when there is a potential need for root-end surgery

In vitro Susceptibility of Helicobacter pylori to Licorice Extract

Abstract Helicobacter pylori is the causative agent of gastritis and peptic ulcer disease. Eradication of H. pylori is hard to achieve and often require multiple antibiotics regimens. These regimens are quite expensive and have substantial side effects. Licorice is a traditional drug which is frequently used for gastric discomforts in Iran. The susceptibility of H. pylori to the extract of licorice has been investigated in the present study. One hundred and eighty clinical H. pylori strains were isolated in this study. For comparison and control, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa were also included in this study. Agar dilution assay was used to test the susceptibility of the clinical isolates of H. pylori to the Glycyrrhiza extract at different concentration. The assay plates had 25, 50, 100, 150, 200, 300 and 400 mg/ml of licorice extract. Licorice extract inhibited the H. pylori strains with a MIC range of 50-400 mg/ml. The present results show that therapeutically administered concentrations of licorice extract could have growth-inhibiting effect on H. pylori in vitro. The above preliminary experiments indicated strongly that licorice extract has some anti-H. pylori property and H. pylori shows susceptibility to licorice extract in concentration ranges that are achievable in the stomach. The resistance of other bacterial species indicates the possibility of selective therapy without adverse effects on the normal bacterial flora

Antimicrobial Activity of Colloidal Selenium Nanoparticles in Chitosan Solution against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans

Objective: To investigate the antimicrobial activity of colloidal selenium nanoparticles in chitosan solution (Cts-Se-NPs) against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. Material and Methods: Cts-Se-NPs solution was prepared using a simple chemical reduction method. The MIC and MBC against S. mutans, L. acidophilus, and C. albicans were determined using the broth dilution assay. Results: The Cts-Se-NPs had remarkable antimicrobial activity against S. mutans, L. acidophilus, and C. albicans. The MIC values of the Cts-Se-NPs were lowest for S. mutans (0.068 mg/ml) compared to L. acidophilus (0.137 mg/ml), and C. albicans (0.274 mg/ml). The MBC values of the Cts-Se-NPs against the microorganisms after one, two, six, and 24 hours indicated that the concentration of 0.274 mg/ml of Cts-Se-NPs completely killed S. mutans, L. acidophilus, and C. albicans after one, two, and six hours, respectively. At the concentration of 0.137 mg/ml, S. mutans and L. acidophilus were killed after six and 24 hours, respectively. Conclusion: These findings encourage the potential use of Cts-Se-NPs in dentistry, while further clinical research is required in this area

Prevalence of Catheter-associated bacteriuria in patients who received short-term catheterization in the northeast of Iran

Background: Catheter-associated (CA) bacteriuria is a result of the extensive usage of urinary catheterization. Once a catheter is placed, many patients achieve bacteriuria, even with the use of greatest consideration and care of the catheter. In this study, we decided to evaluate the prevalence of Catheter-associated bacteriuria in patients who received short-term catheterization in the northeast of Iran.Materials and Methods: In this cross-sectional study during one year (among 2014-2015) 275 patients who have admitted recently and have no history of catheterization and drug consumption were included. Three samples were taken from patients before, one day after catheterization and after removal of the catheter. The urine samples were analyzed and cultured on the suitable media. Antibiotics susceptibility testing was performed by disk diffusion method. Then, data analyzed using SPSS software by Student t-test. In addition, the p values less than 0.05 were considered as significant.Results: In general, the rate of catheter-associated bacteriuria in these hospitals was 68% (187 cases of 275). The mean age of the participants and patients with bacteriuria were 41±1.2 and 24.8±6.2 years old, respectively. The most common isolated bacteria were Escherichia coli (50.6%) followed by Staphylococcus aureus and Klebsiella pneumonia (21.6%). The highest sensitivity was reported against kanamycin (68.9%) and highest resistance was observed against ampicillin with a rate of 96.3%.Conclusion: For prevention of healthcare-associated UTI, correct catheterization and use of the closed catheter system is recommended. In addition, before prescribing any antibiotics it should be paying attention to the antibiotics susceptibility testing results

Association of Chlamydia trachomatis and Neisseria gonorrhoeae with female infertility: a systematic review and meta-analysis

Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are commonly diagnosed sexually transmitted infections that have been associated with serious reproductive health outcomes for women. The association of CT and NG infection with female fertility is not completely established yet. This review aimed to determine the association of CT and NG with female infertility. Methods This systematic review and meta-analysis was conducted according to the PRISMA statement. We searched a range of electronic databases, including PubMed, Web of Science, Embase, and Scopus, from Sept 25, 2017 until February 1, 2021. From the 851 studies screened, 552 that failed to meet our eligibility criteria were excluded. Subsequently, we removed 290 studies for not having a possible correlation of CT and NG infections with female infertility. Nine studies comprising 1827 infertile patients met our inclusion criteria. Two investigators independently extracted a range of data. All analyses were performed using STATA (version 13.1, Stata Corp, College Station, TX, USA). Results CT infection potentiates female infertility, as 76.47% of the included studies found a positive correlation between them. However, due to the limited number of reported data, we were not able to compare NG infection prevalence in fertile and non-fertile patients. Overall prevalences of CT and NG infections among infertile patients were 12 % and 3%, respectively, while CT infection prevalence among the fertile group was 7%. Conclusion The prevalences of CT and NG infections were high in infertile women. Screening and treatment of C. trachomatis and gonococcal infections during infertility treatment might increase the pregnancy rate

Frequency of IMP-1 and VIM Genes among Metallo-beta-Lactamase Producing Acinetobacter spp. Isolated from Health Care Associated Infections inNortheast of Iran

Background: The emergence and rapid spread of metallo-beta-lactamase (MBL) producing Acinetobacter spp. are of great concern worldwide due to limited treatment options. Epidemiologic studies of the causing genes are important for prevention. Methods:  In  this  study,  70  imipenem-resistant  Acinetobacter  strains  were isolated from health care associated infections. These isolates were screened for detection of metallo-beta-lactamase (MBL) using inhibitor potentiated disk diffusion tests with thylenediaminetetraacetic acid (EDTA). PCR was designed for detection of bla vim and bla imp-1 using specific primers. Results: Among these 70 strains, 50 strains appeared to produce metallo-beta-lactamase. Three isolates were detected by PCR to carry metallo-beta-lactamase gene bla vim, but bla imp-1 gene was not detected. Conclusion: These findings suggest that in our area other genetic elements are responsible for resistance against metallo-beta-lactams

A National Survey: Desire of Dermatology Residents to Train in Cosmetic Dermatology and Its Association With Learning Medical Dermatology

The main challenge for training in cosmetic dermatology is the difference in the attitudes of residency programs and residents about the necessity and amount of education during the residency period. A national online survey conducted between September 6th and November 21st, 2017. Residents, members of the Iranian Board of Dermatology, faculty members and program directors (PDs) were asked to participate in the survey.174 participants from 12 residency programs participated in this study and the response rate of residents, professors, and Dermatology Board Directory Members (Boardmans) and PDs was 89.8%, 61.7%, and 81.8%, respectively. Residents declared greater tendency towards practicing medical dermatology (mean score, 5.165±0.8335) over the five years after graduation than that of was perceived by professors (4.043±1.2988), and Boardmans and PDs (4.059±1.0290) (P˂0.001). The first residents’ priority was practicing in medical dermatology (5.165±0.8335) during 5-years after graduation. However, professors (5.261±0.8282) and Boardmans and PDs (5.176±0.7276) predicted residents' first priority would be practicing cosmetic dermatology (P˂0.001). Forty one (60.3%) of the professors, Boardmans, and PDs agreed or strongly agreed that residents’ desire to learn more about cosmetic procedures resulted in their decreased interest in learning medical procedures (P=0.18). Medical dermatology is still clearly the basis for training in residency programs,and even for residents who have a high tendency to practice cosmetic dermatology, there is a strong tendency to work in the field of medical dermatology as well