ABSTRACT
Background: Klebsiella pneumoniae carbapenemase (KPC) is one of the carbapenemases that can cause multi-antibiotics resistance in Acinetobacter baumannii. A simple phenotypic rapid and accurate test for the detection of A. baumannii - KPC-producer can be useful in treating related infections. The aim of this study was to determine the synergism effect of boronic acid (BA), as an inhibitor, and meropenem to confi rm modifi ed Hodge test (MHT) positive strains for KPC-production. Materials and Methods: Totally, 126 A. baumannii isolates were used as clinical strains. Imipenem resistant isolates were identifi ed by disk diffusion method according to the Clinical Laboratory Standards Institute recommendations. Presence of KPC in imipenem resistant isolates was determined using the MHT. In addition, we used BA as a KPC inhibitor for fi nal confi rmation of the species of interest. Additionally, we employed the use of synergism effect of meropenem and cloxacillin to detect false positive cases. Results: Of 126 strains, 108 were resistant to imipenem, for which 93 strains were MHT positive. Totally, 68 out of 93 MHT positive isolates had at least 5 mm enlargement of the diameter of the zone of growth inhibition between the meropenem alone and meropenem combined with BA. Of these 68 isolates, 8 had at least 5 mm enlargement of the diameter of the zone of growth inhibition with BA alone and in 60 strains it was observed by cloxacillin. Conclusion: Our study suggests that MHT alone cannot confi rm KPC-producer microorganisms and that it requires other complementary tests such as the usage of inhibitors.
ABSTRACT
The aim of this study was to describe epidemiologic characteristics of intestinal parasites in a population in south of Tehran, Iran. A retrospective cross-sectional study of patients with suspicious intestinal parasitic infections referred to the Zakaria Razi Laboratory in Shahre-Ray, southern Tehran, Iran, was conducted from April 21, 2004 to October 20, 2005. All stool samples were examined and socio-demographic informations were retrieved. Of 4,371 referred patients, 466 (239 males and 227 females) were laboratory diagnosed with intestinal parasites, with a period prevalence of 10.7 percent. Blastocystis hominis (B. hominis) and Giardia lamblia (G. lamblia) were the most frequent intestinal parasites. More than half of patients aged ³ 18 years had a low level of educational attainment (e.g. illiterate, primary school, high school) (170/331, 54.1 percent). Further, majority of patients were homemakers (42.3 percent, 140/331) or workers (28.1 percent, 93/331) employed in various business settings such as food industry and construction. Findings of this study showed that intestinal parasitic infections are still a major public health challenge in Iran that needs to be addressed. We believe that public education, improving sanitation conditions of underdeveloped areas/communities, community involvement, and supporting evidence-based practice/programs are the major keys to success in preventing the spread of intestinal parasitic infections in Iran.
O própósito deste estudo foi descrever as características epidemiológicas dos parasitas intestinais em população do sul de Teerã, Irã. Um estudo retrospectivo seccional cruzado de pacientes com suspeita de infecções parasitárias intestinais enviados ao Laboratório Zakaria Razi em Shahre-Ray, sul do Teerã, Irã foi conduzido de 21 de abril de 2004 a 20 de outubro de 2005. Todas as amostras de fezes foram examinadas e as informações sócio-demográficas recuperadas. De 4371 pacientes enviados, 466 (239 homens e 227 mulheres) foram diagnosticados laboratorialmente como portadores de parasitas intestinais com prevalência no período de 10,7 por cento. Blastocystis hominis (B. hominis) e Giardia lamblia (G. lamblia) foram os parasitas intestinais mais frequentes. Mais da metade dos pacientes ³ 18 anos tinham baixo nível educacional (por exemplo: analfabetos, escola primária, 2º grau completo) (170/331, 54,1 por cento). Mais ainda, a maioria dos pacientes eram empregados domésticos (42,3 por cento, 140/331) ou trabalhadores (28,1 por cento, 93/331) empregados em diversos tipos de serviços, tais como a indústria de alimentos e construção. Achados deste estudo mostraram que as infecções parasitárias intestinais são ainda um desafio importante em saúde pública no Irã que necessita ser resolvido. Acreditamos que a educação pública, a melhoria das condições sanitárias em áreas pouco desenvolvidas/comunidades, envolvimento da comunidade, e programas práticos baseados nas evidências, são as principais chaves do sucesso na prevenção da disseminação das infecções parasitárias no Irã.