prevalence and antimicrobial susceptibility of bacterial uropathogens isolated from pediatric patients

Urinary tract infection [UTI] is considered as the most common bacterial infectious disease seen among the pediatric patients. The aim of this study was to investigate the prevalence and antimicrobial susceptibility of bacterial uropathogens isolated from the pediatric patients with urinary tract infections. This descriptive study was conducted in Children Medical Center, Tehran, Iran from March 2006 to Feb 2007. Clean-catch midstream urine specimens were obtained from the patients and cultured on the appropriate bacteriological media. Bacterial isolates were identified by standard biochemical and serological tests. Antimicrobial susceptibility testing was performed according to CLSI guidelines. From 14199 urine specimens, 16.2% had positive results for bacterial cultures. Nine hundred twenty one strains were identified as Escherichia coli; 412 as Klebsiella spp., 285 as Coagulase negative Staphylocococci, 202 as Enterococcus spp., 158 as Pseudomonas spp., and 83 as Staphylococcus aureus. E. coli isolates showed high resistance to carbenicillin [68%], ampicillin [96%], trimethoprim-sulfomethoxazol [70%] and kanamycin [65%]. More than 30% of isolates of Klebsiella spp., Pseudomonas spp. and Enterobacter spp. have shown high degree of resistance to commonly used antibiotics. Our findings reinforce the need for ongoing investigation to show trends in antibiotic resistance, which can help to prescribing of antibiotics in clinics

[Effects of topiramate in the prevention of drug resistant migraine headache]

Migraine is the most common cause of headache. The aim of the present study was to evaluate the effects of topiramate [TPM] in the prevention of drug-resistant migraine headache. This is a double-blind clinical trial conducted on 70 patients between ages 15 to 45 years referred to the Bu Ali Sina Hospital in Sari with a history of migraine attacks based on International Headache Society criteria for a period of more than one years with a minimum incidence of 1 to 6 attacks per month. The drug rate performance was assessed by response rate to treatment, mean changes in the number and severity of migraine attacks compare with the placebo group for 3 months. Collected data were analyzed using analysis of variance [ANOVA], Newman-Keuls and Spearman's Coefficient Rank Correlation as the post hoc tests. GRAPHPAD software was used for analysis of the data. 66 of 70 patients completed the study. The mean age of the patients was 30.33 +/- 7.9 years. A significant reduction in the severity and frequency of migraine attacks was seen in all months [P<0.0001] for topiramate treated group in compare to placebo group. Responder rate for patients treated with TPM was significantly higher than placebo group [64.6%, P<0.0001] in the 3 rd month of the treatment side effects of treatment were transient and well tolerated. Low dose of TPM showed significant efficacy in prevention of migraine attacks within the first, second, and third month of treatment. Low dose of TPM seems to be a good therapeutic option for the patients with refractory migraine

Quality of life among multiple Sclerosis patients

MS is one of the progressive and chronic demyelinative disorders involving active members of society. The study of quality of life in these patients could decrease relieve some disabilities and promotes residual abilities to maximal levels. Regarding relatively high prevalence of MS in Mazandaran province, this study was designed to measure the quality of life in Multiple sclerosis patients living in Mazandaran Province. In this discriptive study, the community of research included members of Mazandaran Multiple Sclerosis Association [MMSA]. The census sampling method was used. The volunteers [101 patients] were assessed from october 2005 to March 2006. Assessment tool for data collection was standard questionnaire SF-36. This questionnaire consists of 36 questions and its validity has already been determined in many countries including Iran and it has high reliability [alpha chronbach 0.77-0.90]. Clinical manifestations and the severity of the disease were evaluated with history and physical examination taken by Neurologist and using EDSS criteria. The results showed that 76% of the patients were females and 26% were males. The age range was 18-60 years [mean age 33.27 +/- 8.31]. The emergence of disease was at age 12-54 years [mean age 27.12 +/- 8.03]. About%7 of the patients had positive family history of multiple sclerosis. The mean score [based on 100] of general health, physical health, mental health, vivacity, social health, and physical pain were, respectively, 41.34 +/- 10.22, 54.75 +/- 30.25, 53.25 +/- 22.03, 54.75 +/- 24.44, 56.62 +/- 20.96, and 35.75 +/- 31.68.. In this study, the quality of life was relatively good in all aspects. This may be due to mildness of disease in majority of the patients, low age at time of disease emergence and shorter duration of disease

Etiology and antibacterial resistance of bacterial urinary tract infections in children's medical center, Tehran, Iran

Urinary tract infection [UTI] is a common bacterial illness in children. Knowledge of the antimicrobial resistance patterns of common uropathogens in children according to local epidemiology is essential for providing clinically appropriate, cost effective therapy for UTI. The aim of this study was to determine the distribution of urinary tract infections in a referral hospital, Children's Medical Center, and determination of in vitro susceptibility of these organisms to antimicrobial agents. Of the 1231 bacterial isolates the most frequent isolates were Escherichia coll [38.66%], Klebsiella spp. [22.25%], Coagulase-negative staphylococci [10.1%], Pseudomonas spp. [8.7%], enterococci [8.28%], Enterobacter spp. [4.1%], staphylococcus aureus [3.24%], and proteus mirabilis [2.9%]. Among Enterobacteriaceae, 79.80% of E. coli were amikacin-sensitive. Of Gram-positive cocci, 66.66% of staphylococcus aureus were vancomycin-sensitive. Our data show the original distribution of uropathogens from UTIs in children referred to Children's Medical Center in Tehran and the emergence of multidrug resistant strains

Study of antibiotics resistance in pediatric acute bacterial meningitis with E test method

Appropriate treatment of bacterial meningitis especially in children is a important problem due to multiple drug resistance. The determination MIC of conventional antibiotics for bacterial meningitis with quantitative E. test is exactly practical and essential. We studied MIC of conventional antibiotics in pediatric acute bacterial meningitis older than two months, center children hospital, 1382-1384. In this prospective and cross sectional process research we measured MIC of antibiotics in 30 positive bacterial culture in CSF or blood with quantitative E. test and compared with qualitative disk diffusion test. Antibiotic resistance of 10 Haemophilus influenzae type b patient was: ampicillin resistance in 90%, co- Amoxiclave R. in 10%, chlorampheicol R. in 40%, third gerenation cephlosporins R.[ceftriaxone and cefotaxime] in 0% and cotrimoxazole R. in 100% and antibiotic resistance of 20 streptococcous pneumoniae patient was: penicillin R. in 35%, chloramphenical R. in 10%, third generation cephalosporins R. in 5%,rifampin R. in 10% and cotrimoxazole R. in 60% .In comparison of two methods E-Test and Disk Diffusion we found insignificant difference. Antibiotic Resistance of our study is compatible with other studies. Therefore it seems that composition of ampicillin and chloramphenicol as empiric therapy for bacterial meningitis for many years ago,aren't appropriate today and third generation cephalosporins alone or with vancomycin is a suitable therapy

Detection of haemophilus influenzae type b in cerebrospinal fluid of suspected children with meningitis byPCR

A polymerase chain reaction [PCR] assay with primers from "hpd" gene was compared with culture for the detection of Haemophilus influenza type b [Hib] in CSF samples from children suspected of meningitis.300 cerebrospinal fluid [CSF] samples from suspected meningitis cases were studied by culture [Leventhal and Chocolate Agar] and PCR.The latter method could detect Hib in all 5 culture positive and in 2 of 295 culture negative cases, showing sensitivity, specificity, and an accuracy index of 100%, 99% and 99%, respectively. The PCR result was available within a day.This study has shown that PCR is a rapid, sensitive, and specific diagnostic test for Hib from CSF samples. Furthermore, to maximize management of meningitis cases to reduce the morbidity, mortality, and complications of invasive Hib infection a combination of culture and PCR is necessary for the detection of Hib infection. The incidence of Hib meningitis among children in Children's Medical Center in Tehran based on culture and PCR results were 2.4% and 1.7% respectively. Based on culture results, Hib causes 15.6% of all cases of bacterial meningitis in children

[Relationship of neurologic signs with Schizophrenia]

Background and Objective: Schizophrenia is one of the most prevalent diseases in psychiatry. A lot of efforts have been made to find out the biologic and organic causes of this disease. One of the cases, which more attract the attention of researchers, is soft neurologic signs and their relationship with Schizophrenia. The objective of this study was to compare the prevalence of soft neurologic signs between Schizophrenia patients and their sisters and brothers, and normal group

Methods: 30 Schizophrenia patients, 30 persons of their sisters and brothers, and 30 persons of normal group were chosen and evaluated in view of soft neurologic signs. Then a total score was obtained in view of signs for each case. Finally these groups were compared with each other

Findings: The average of soft neurologic signs in Schizophrenia patients was more than in their sisters and brothers and in normal group. The average of scores of soft neurologic signs in these patients' sisters and brothers was also more than in the normal group. There was also a significant relationship between the total score of the soft neurologic signs and the family history of Schizophrenia in Schizophrenia patients [P=0.034], it means that the patients having a family history for Schizophrenia, had a higher total score than other patients in view of soft neurologic signs. There was no relationship between age, sex and the average of total score of these signs

Conclusion: This findings that neurologic signs in Schizophrenia patients were more than in the 2 other groups confirms the biologic and organic view about the etiology of Schizophrenia, these signs can be raised as a strong biologic marker of Schizophrenia. Considering the early beginning of treatment by anti-psychotic drugs, these signs can influence the outcome of this disease