ABSTRACT
Urinary Tract Infections [UTIs] are the most common infectious diseases in childhood. The Uropathogenic Escherichia coli [UPEC] strains account for as much as 80% of UTIs. From a clinical perspective, it is important to know which virulence factors and antibiotic resistance properties are present in UPEC strains in pediatrics. Therefore, this study was carried out to investigate the molecular characterization and antimicrobial resistance of UPEC strains isolated from hospitalized patients in pediatric ward of Baqiyatallah Hospital in Tehran. One hundred and twenty-one urine specimens were collected from the patients infected with UTIs [51 boys and 70 girls]. The urine samples were cultured immediately, and those with E. coli-positive were analyzed for the presence of antibiotic resistance genes and bacterial virulence factors using Polymerase Chain Reaction [PCR]. Also, antimicrobial susceptibility testing was performed using disk diffusion methodology with Mueller-Hinton agar according to the instruction of Clinical Laboratory and Standard Institute. Nineteen out of 51 [37.25%] urine samples from boys and 47 out of 70 [67.14%] urine samples from girls harbored E. coli. A significant difference was found between the frequency of UPEC strains in boys and girls [P <.05]. High resistance levels to tetracycline [69.6%], ampicillin [69.6%] and norfloxacin [63.6%] were also observed. Totally, 1.66% of tested strains were resistant to more than 8 antibiotics. The incidence of genes encoding resistance against gentamicin [aac [3]-IV], sulfonamide [sul1], beta-lactams [blaSHV and CITM], tetracycline [tetA and tetB], trimethoprim [dfrA1], and quinolones [qnr] were 25.7%, 22.7%, 83.2%, 71.1%, 19.6% and 21.2%, respectively. The most commonly detected virulence factors were fim [71.2%], set-1 [66.6%], iha [62.1], papGI [59%], usp [56%] and sen [22.7%]. Resistant strains of uropathogenic E. coli had the lower incidence of uropathogenic virulence factors. We suggested prescription of imipenem and amikacin to treat pediatric patients infected with UTIs
ABSTRACT
Sleep disturbance depends on factors such as noise and light in cardiac care unit [CCU]. It can lead to acute coronary syndrome in some patients. This study was designed to compare the effect of using eye mask and earplugs in improvement of sleep in CCU patients. This randomized clinical trial conducted on 90 patients in Imam Khomeini Hospital of Jiroft in 1390. The IRCT registration code was IRCT201205139731N1. Participants at the first night of admission were randomly divided into three groups: eye mask, earplugs and both eye mask and earplugs users. According to crossover method, half of the patients in each group were assumed control for themselves the first night and the other half on the second night. The VSH-scale was used. The data was analyzed by paired T-test. The mean score of sleep quality showed a significant difference before and after the intervention in all groups [P<0.05]. This difference was just on the sleep disturbance criterion in eye mask and earplugs group [p=0.044] and was in the criterion of sleep disturbance [p=0.003] and effectiveness [p=0.004] in eye mask group. Patient of earplug group showed advances in all criterion of sleep quality [supplement, disturbance and effectiveness] [P<0.001]. Results suggest that eye mask and earplugs improve sleep but earplugs are more effective. Eye mask and earplugs as low-cost, comfortable and uncomplicated devices can improve sleep quality in patients. Nurses can use these devices for reducing the environmental factors to help patient's sleep.