Identification of P fimbriae virulence factor in uropathogenic Escherichia coli by PCR in Shaherkord Hospitals

Urinary tract infection is one of the most common bacterial diseases in human being.The most important etiologic agent is Eschrichia coli and the most important virulence factor in uropathogenic E.coli is P fimberiae. Construction of P fimbriae is coded by pap operon. The importance of P fimbriae is related to the incidence of urinary tract infection, especially infection of the upper tracts. The aim of this study was to identify and determine P fimbriae prevalence in isolated uroparhogenic E.coli. A total of 182 isolates of E.coli were evaluated .Bacterial DNA was extracted by boiling method and subsequently DNA samples were examined for pap operon [pap C gene] by use of PCR method. Then PCR products were stained and identified by polyacrylamid gel electrophoresis. Based on the results of PCR, among 182 isolated strains, 66 samples [36.3%] had pap operon[pap C gene]. The results indicated that prevalence of pap operon in isolated strains was within the global range. Pyelonephritis was more common than cystitis and asympthomatic bacteriuria

[Determination of CTX-M genes in enterobacteriaceae producing extended-spectrum beta-lactamase using PCR method]

Background and aims: Extended-spectrum beta-lactamase of CTX-M-type is considered as an important mechanism resistant to cephalosporin in the gram-negative patogene and is wildly growing. Enterobacteriaceae species are able to produce extended-spectrum beta-lactamases [ESBLs]. The aim of this study was to detect the prevalence of CTX-M genes in ESBLs producing enteric bacteria isolated in Shahrekord educational hospitals using Polymerase Chain Reaction method

Methods: In this analytical-descriptive study, antibacterial susceptibility patterns of 325 gram negative bacteria to Cefotaxim, Ceftazidim, Cefterixon and Azteronam tested using disk diffusion [Kirby-Buer] method. In addition, confirmatory tests for detecting ESBLs phenotypes were performed using Ceftazidim-clavulanic acid and Cefotaxim- clavulanic acid combination disks [MAST]. The presence of CTX-M gene was assessed using PCR

Results: Bacteria strains isolated in this study were Escherichia coli [59.4%], Klebsiella pneumoniae [30.4%], Enterobacter spp. [15.4%] and Proteus spp. [2.2%]. Confirmatory phenotypic test showed that 28% of the strains were ESBL positive. The prevalence of CTX-M gene in isolated Enterobacteriaceae was 50.5 %

Conclusion: High frequency of CTX-M gene in ESBL producing isolates indicates that this enzyme plays an important role in resistance to betalactam containing antibiotics

[ prevalence and antibacterial susceptibility pattern of enteropathogenic Escherichia coli [EPEC] strains isolated from less than 5 years old children with diarrhea hospitalized in Shahrekord Hajar hospital -2007]

Enteropathogenic Escherichia coli [EPEC] strains are among the most important diarrheagenic agents in developing countries. This study aimed to determine the common serotypes and antibacterial susceptibility pattern of EPEC strains isolated from less than 5 years old children with diarrhea hospitalized in Shahrekord-Hajar hospital in first six months of 2007. A total of 50 rectal swabs were collected from less than 5 years old children with diarrhea. In addition, 50 rectal swabs were obtained from outpatient children without history of diarrhea and gastroenteritis as control group. Stool samples were cultured on differential media EMB and Mac Conkey agar and incubated overnight in 35°C. Standard biochemical tests [IMVIC] were used for identification of bacteria. Confirmation of isolated bacteria as EPEC strains was performed with specific antisera [Bahar Afshan-Tehran] using slide agglutination method. Besides, antibacterial susceptibility pattern of 13 EPEC isolates against some common antibiotics: cephalotin, ampicillin, nalidixic acid, sulfamethoxazol- trimethoprim, gentamicin, ceftriaxone, ciprofloxacine and nitrofurantoin was evaluated using disk diffusion method. Data were analyzed using t-test, chi-square and logistic regression. EPEC strains were isolated from 26% of the children with diarrhea [13 patients] compared with 4% of children without diarrhea [2 cases]. Our data showed that fifty percent of the EPEC isolates were belonged to O44, O125, O126 and 0128 serogroups. In addition, 33.3% of the EPEC isolates were belonged to O20, O114 serogroups and finally, 16.6% were belonged to O26, O55 and O111 serogroups, Nitrofurantoin, ciprofloxacin and gentamicin were the most effective antibiotics against EPEC bacteria. The prevalence of EPEC demonstrates the important role of these strains in causing of acute diarrhea in children. Therefore, we suggest the application of routine diagnostic tests for identification and serogrouping of EPEC strains in bacteriologic laboratories

[Evaluation process in viewpoints of academic staff and students in Shahrekord university of medical sciences]

Evaluation is a routine process for developing teaching and learning methods. This qualitative process is challengeable among faculty members. Validity of student evaluation and managers are controversial. In this study we tried to assess viewpoints of students and faculty members regarding this process and to develop it. This cross sectional descriptive study was performed on 60 faculty members and 370 students using 2 questionnaires containing demographic information and evaluation process. Data were analyzed by t-test. Chi-square and one way ANOVA using SPSS13. Attitude of most faculty members were agree to be evaluated by students and managers, but they believed that the student proportion for evaluation should be higher than the managers. They also mentioned that the best persons for the evaluation are head of the departments, vice chairman and deans of faculties. Our results showed that 63% of faculty members were agreed with the evaluation by their colleagues and 37% were agreed with self evaluation. Despite of accepting the evaluation by 89% of the students, 53% of them believed that these evaluations had positive effect. The results also showed that 62% of the students thought that the faculty authorities had not chosen the best time for evaluation. Evaluation criteria and indices in viewpoint of both students and faculty members were almost the same. Scientific knowledge and teaching methods were selected as main criteria. Using the idea of faculty staff and students about evaluation process can increase quality of it and decrease unsatisfaction thoughts and reform evaluation

[ comparison of the antimicrobial resistance pattern [antibiotyping] of staphylococcus strains isolated from orange and apple juices with the strains isolated from clinical samples, Shahrekord, Iran, 2007]

One of the main routes in which bacterial resistance is transmitted is through food products. Antibiotic products are widely used in the nature to control diseases. It has been shown that these products can be transmitted to human through meat, milk, fruit, fruit juices and water and consequently they can cause antibiotic resistance problems. The aim of this study was to compare antimicrobial resistance of staphylococcus strains isolated from orange and apple juices and those strains isolated from clinical samples. This descriptive- analytical study was performed on 111 staphylococcus bacteria which were isolated from fruit juices or from patients referring to the educational hospitals in Shahrekord, Iran. Antibiotic susceptibility test was performed by disc diffusion method. The bacteria were classified by antibiotyping. Data were analyzed using Fishers exact test. The results of antibiotyping showed that 111 staphylococcus isolates were distributed in 36 patterns from which 10 isolates [53%] were Staphylococcus aureus belonged to 4 patterns. From the total staphylococcus isolates, 62 isolates [67%], were Staphylococcus epidermidis which were belonged to 11 patterns. These patterns were observed the same in fruit juices and clinical samples [P>0.05]. The rest of isolates [39 isolates] were belonged to 21 patterns. The results of our study showed that most of the staphylococcus isolates were resistant to one or more antibiotics. On the other hand, 65% of isolated samples showed the same antibiotic resistance pattern in fruit juices and clinical samples. It is possible that food products, including fruit juices have role in transmitting bacterial resistance. Therefore, it is necessary to restrict the use of antibiotics and to control the production, transportation and maintenance of fruit juices

Accuracy of dipstick urinalysis as a screening method for detection of glucose, protein, nitrites and blood

This study determined the reliability of dipstick urinalysis for detection of protein, glucose, blood and nitrites in non-random urine samples from 300 people aged > 50 years attending a health centre for check-up. The gold standards were fasting blood glucose for glucosuria and the sulfosalicylic acid method for urine protein. Microscopic examination of urinary sediment and urine culture were also performed for positive dipstick results for haematuria and nitrites. The sensitivity, specificity and positive and negative predictive values of the dipstick test for detection of protein were 80.0%, 95.0%, 22.2% and 99.6% and for glucose were 100%, 98.5%, 87.0% and 100% respectively. Dipstick urinalysis can be a reliable screening method for diagnosis of urinary tract infection and diabetes mellitus but not for proteinuria

[Comparison of agar screen and duplex-PCR in determination of methicillin resistant Staphylococcus aureus [MRSA] strains isolated from nose of personnel in Hajar hospital of Shahre-kord, 2007]

Methicillin resistant staphylococcus aureus strains are the most important agents of nosocomial infections. The conventional antibiotic susceptibility methods such as disk diffusion are not suitable for detection of these strains due to their heteroresistancy. Therefore, in this study, agar screen and duplex-PCR were compared in determination of methicillin resistant Staphylococcus aureus [MRSA] strains isolated from nose of personnel in Hajar hospital of Shahre-kord, 2007. In this experimental study a total of 204 nasal swabs from personnel of Hajar hospital over a period of 6 months were collected. The specimens were cultured on mannitol salt agar for primary isolation and identification of Staphylococcus aureus strains and their susceptibility pattern to oxacillin was assessed using agar screen method. Finally, using duplex PCR, the isolates were tested for the presence of mecA gene. Results were compared and sensitivity and specificity of the method was determined. In this study, 23 of the 52 [44%] Staphylococcus aureus isolates were resistant to oxacillin using agar screen method. However, mecA gene was detected in 27 of the 52 strains [52%]. Our results showed that the sensitivity and specificity of agar screen method in determination of MRSA strains were 81.5% and 96%, respectively comparing with PCR. Oxacillin agar screen, comparing PCR, is an inexpensive, applied and phenotypical method with low false positive and suitable for screening of MRSA. However, due to its relatively high false negative results is not appropriate for screening of MRSA strains isolated from hospital-employed nasal carriers

[Rate of satisfaction and evaluation of medical students [interns and externs] from the quality of clinical education in the Shahre-kord university of medical sciences-2005]

Revolution of information in medical sciences as one of the important parts of knowledge has made the attention to medical education more critical. This study was performed to evaluate the satisfaction of Shahre-kord university medical students [interns and externs] from the quality of education in clinical courses. In this descriptive-analytical study, the rate of satisfaction of 77 medical students [interns and externs] from the quality of education in Shahre-kord university clinical courses was evaluated using a locally standardized questionnaire. The findings were classified as: high, moderate and low. Data were analyzed using SPSS software [version 11]. A total of 77 students completed the questionnaire. The high rate of satisfaction from the quality of education in different clinical clerkship periods was reported as follows: Internal medicine 25/7%, surgery [general surgery and orthopedic] 27/4%, pediatric medicine 17/5%, gynecology 6/3%, infectious disease 54/5%, neurology 36/5%, ENT 54/5%, ophthalmology 47/5%, poisoning 21/2%, psychiatry 37/7%, urology 6/3%, health science 17/6%. In addition, high rate of satisfaction from professional skills teaching was reported by 17/4% of the students. The most satisfaction rate in internal and pediatric courses was from morning reports and in surgery clerkship period, from outpatient clinic and theory courses. In gynecology period the lowest rate of satisfaction was reported from outpatient clinic and theory courses. High rate of satisfaction in minor clerkship periods was reported from ENT, infectious disease, psychiatry, and neurology periods respectively. In major clerkship periods, the students were unsatisfied from teaching rounds, outpatient clinic and theory courses. In contrast, high rate of satisfaction belonged to morning report programs. Due to the low rate of satisfaction from gynecology, poisoning and urology courses and also un-satisfaction from CPR and labor management teaching, reviewing the educational programs by teaching managers is recommended

[Study of serum IgE and nasal secretion eosinophils count in patients with allergic rhinitis]

Allergic rhinitis is a chronic disease of upper respiratory tract which can be presented as asthma. Some investigators have reported a significant relationship between the disease and the number of eosinophils in nasal secretion of the patients. This study aims to evaluate the serum IgE and it's relation with nasal secretion eosinophils count in patients with allergic rhinitis. In this study, serum IgE of 92 patients with non anatomical nasal complication were investigated using ELISA method [IEMA WELL Q-D]. Nasal secretion smears of the patients were also evaluated for eosinophils count. Age, sex, profession and past history of allergic reactions in patients and their families were also investigated. 48. 9% of the patients had high titers of serum IgE [>100 IU/ml]. Also, eosinophils over 5/HPF were seen in 15. 6% of patients, nasal secretion smears. There was no significant relationship between eosinophils count and presence of allergic rhinitis in the patients. Otherwise, there was a significant correlation between rhinitis and patients, profession and their locality of living [P<0. 05]. Detection of serum IgE is mandatory for diagnosis of allergic rhinitis. Besides, it seems that nasal secretion eosinophils count alone is not a reliable finding for diagnosis of the disease

[Comparison of the causative bacteria and antibacterial susceptibility pattern of nosocomial and community-acquired urinary tract pathogens in 13-35 years old women, Shahrekord, 2004]

Treatment of urinary tract infections [UTIs], as one of the most common nosocomial and community acquired infections, has remained an important medical problem. Differentiation between susceptibility patterns of nosocomial and community acquired pathogens is important epidemiologically and helps the administration of appropriate antimicrobial drugs. The goal of this study was isolation of the most common causative bacteria, in two groups of 13-35 years old womn in Shahrekord city within 6 months period [April-september 2004]. Also, the resistance patterns of common isolated organisms in these two groups were compared. This is an analythical-cross sectional study. 100 urine samples from women aged 13-35 years old hospitalized in different wards of Hajar and Kashani hospitals [group one] with positive urine cultures were obtained performing cleancatch midstream method. Also 100 urine samples from 13-35 years old women with positve urine culture and acute UTI symptoms form Shahrekord private laboratory [group two] were obtained. The most common causative becteria in the two groups and the antibacterial sensitivity patterns of isolated organisms were evaluated. Data was analysed using T test. Totally, the most common nosocominal UTI pathogens were E.coli, Klebsiella spp., Staphylococcus saprophyticus, Pseudomonas and Enterobacter spp. In group two, E.coli, Klebsiella spp., Enterobacter spp., Proteus, Staphylococcus saprophyticus and Citrobacter spp. were isolated predominalty. The highest bacterial resistance rate belonged to Ampicillin and Co-trimoxazole. Antibiotics useful in treatment of nosocomial UTI were Ceftizoxim, Nitrofurantoin, Nalidixic acid, Cephalothin and Gentamicin respectively. Nitrofuranoin, Nalidixic acid, Ceftazidim, Gentamicin and Cephalothin were the most effective antibiotics in community acquired UTIs. The emergence of pathogens with alarming rates of resistance, highlights the need for a more rationalized an restricted use of antibiotics in order to minimize the spread of resistant bacterial strains