Hepatitis E virus seroprevalence in haemodialysis patients in Zanjan province, Islamic Republic of Iran

Hepatitis E virus [HEV] infection is the most common form of acute hepatitis in adults in endemic regions of Asia. In a descriptive, cross-sectional study, anti-HEV antibody was measured in patients referred to the 2 haemodialysis centres in Zanjan city, Islamic Republic of Iran. Among 93 patients with chronic renal failure, mean age 57.0 [SD 18.5] years, antibodies against HEV were positive in 25 [26.9%] patients. HEV infection was not significantly associated with sex, age, educational level, residence or water source. The rate of HEV positivity was higher in patients with > 1 than

[Study of nosocomial urinary tract infections in the intensive care unit [ICUs] of Hamadan besat and Ekbatan hospitals during the 2008-2010 period]

Nosocomial infections, with their associated increased hospital mortality and hospitalization costs, are discussed as one of the major health problems in communities. Urinary tract infections are known as the most common nosocomial infection that makes up over 40% of all hospital infections. In this study, the role of antibiotics usage before admission to the intensive care unit [ICU] and the frequency of urinary tract infections during ICU stay were studied. This prospective cross-sectional study was done on 353 patients admitted to the ICUs of Besat and Ekbatan Hospitals in Hamedan. Following up their weekly visits to the ICU, the Patients with urinary tract infections were identified during weekly visits to the ICUs, and variables including the type of antibiotic taken prior to the occurrence of UTI, and the organisms causing the infection were recorded. Data analyses were performed by SPSS program Chi-Square and Fisher exact tests. Among the 353 patients studied, with mean age of 51.2 +/- 21.9 years, 61 [17%] were suffering from nosocomial UTI. Most of them [19 patients [31.1%]] were over 65 years. The urine cultures were positive in 20% of the patients. Gram-negative and -positive bacteria, and fungi made up 41.7%, 33.3%, 25%of the infection cases, respectively. Eighty-five percent of the cases had received antibiotics prior to developing nosocomial UTI, and 55% of the taken antibiotics belonged to the cephalosporin group. Furthermore, 44% of the cases had taken more than one type of antibiotics. There was a significant relationship between the type of microorganism responsible for the infection and the type of antibiotic taken before admission to the ICU [P=0.011]. In this study, the frequency of nosocomial UTI was estimated at 17%, and it was found that taking inappropriate/unnecessary antibiotics before entering the ICU had a significant relationship with occurrence of nosocomial UTI. Therefore, educating the public for avoiding unnecessary consumption of antibiotics seems necessary

[Frequency of candiduria in patients hospitalized in intensive care units]

Some Candida species especially Candida albicans are known as flora of human and animals body and coexist in skin, throat and gastrointestinal and urinary tracts. They can primarily be colonized in hospitalized patients and cause diseases. Resent studies have reported increasing rate of candidauria in intensive care unit [ICU] patients. The aim of this study was to determine the frequency of candiduria in ICU patients with urinary tract catheterization. In a descriptive cross-sectional study, 110 hospitalized patients in ICU over 18 years old who had more than 7 days urinary tract catheter were studied. Urine sample was taken immediately after catheter replacement and sent to the laboratory in less than 1 hour and analyzed. Data collection was done by a questionnaire and check list. A total of 110 patients including 65 men [59.1%] and 45 women [40.9%] were studied of whom 29 ones [26.4%] had candiduria based on urine culture. Candida albicans was the most common species [34.3%]. Risk factors of candiduria were age, duration of hospitalization and urinary tract catheterization, using more than two antibiotics, corticosteroid consumption, and diabetes mellitus. Due to the increasing rate of candida infection in hospitalized patients especially ICU patients, more attention for prevention of candiduria especially in those with candiduria risk factors is recommended

[Frequency of pertussis among adults with prolonged cough]

Pertussis is a highly communicable respiratory infection which can cause chronic cough. Pertussis can attack any age. Despite childhood vaccination, adults or haven't immunity or have few immunity. The aim of this study was determination of frequency of pertussis among adults with prolonged cough. This descriptive cross sectional study was performed on adults who had coughed for more than 2 weeks and there were no reasons for prolonged cough. Diagnosis of B. pertussis was performed by culture on Bordet-Gengou medium, which gets by deep throat soap sample. The results were analyzed by SPSS with t and chi square tests. One hundred twenty three patients [57 [46.3%] men and 66 [53.7%] women] with the mean age of 41.4 +/- 17.7 years were enrolled to study. The mean duration of cough was 22. 6 +/- 14.6 days. Ninety five [77. 2%] had a history of vaccination. Culture of deep throat soap sample was positive among 23 [18.7%] patients [15 [12.2%] men and 8 [6.5%] women] who arrived in the study. In this study, B. pertussis confirmed in 23 adults [18.7%] by culture of deep throat soap sample. It's suggested that physician in the visit of adult patients with prolonged cough more than 2 weeks; also pay attention to pertussis as well as this group becomes a potential source of pertussis for infant, vast adult vaccination with acellular pertussis vaccine is noteworthy for public health organization

[ role of procalcitonin in severity and outcome of patients with sepsis in ICU during treatment]

Nowadays sepsis is one of the major causes of mortality in severely ill patients in ICU. At least part of mortality rate in sepsis is due to fewer number of specific clinical symptoms for prompt diagnosis. Moreover, due to lack of specific marker for detection of this disease, problems occur in differentiation of infectious and non-infectious factors. In recent years, there have been some reports of increase in serum level of procalcitonin in these patients but the correlation between PCT with severity and outcome of disease in patients with sepsis in ICU is not yet known. The aim of this study was to examine the correlation between severity and outcome with procalcitonin [PCT] levels in these patients. This descriptive cross-sectional study was conducted on patients with bacterial infectious diseases in ICU. Sampling was don on day 1 and day 3 and day 7 of admission to ICU. A semi-quantitative PCT-Q test for measurement of procalcitonin was used. After that sepsis severity and outcome of disease were compared with procalcitonin levels. Data were then analyzed by SPSS and the results were compared using Pearson chi-square test. Thirty five patients [22 men and 13 women] had internal criteria for inclusion in this study. Eighteen patients died. There was a direct correlation with severity of disease [p<0.01] but there was not any correlation between high Serum procalcitonin concentrations [>/-10ng/ml] known and mortality. The results of this study indicate that there is a correlation between severity of disease and procalcitonin levels. Therefore, it is recommended that measurement of serum procalcitonin be done to determine the severity and likely outcome of disease in all patients with sepsis admitted to ICU