Predictors of bacterial meningitis in adult patients of South West Iran

To study the clinical and lab parameters in adult patients with suspected or confirmed bacterial meningitis [BM] to find out the usefull predictors. This was a retrospective study conducted in Razi hospital, a training center affiliated to Ahvaz Joundishapoor University of Medical Sciences in Iran. All patients with meningitis aged 18 years or more between 2003 and 2007, with CSF pleocytosis and who had not received antibiotic treatment before lumbar puncture were reviewed. Among 312 patients with CSF pleocytosis, two hundred fifteen [68.9%] had BM and ninety seven [31.1%] had aseptic meningitis [ASM]. The mean age for patients with BM was 34.7 +/- 17.7 years and for ASM was 32.2 +/- 15.5 years [P=0.22, NS]. Sixty percent of the cases of BM and 61.2% of the cases of ASM occurred in men [P=0.70, NS]. We identified the following predictors of BM: CSF-WBC count>100 per micro liter, CSF-glucose level<40 mg/dl, CSF-protein level>80 mg/dl. Sensitivity, specificity, PPV, NPV of these predictors, and LR for BM are 86.5%,52.6%,80.2%, 63.7% and 104.1 for CSF-WBC count and 72.1%, 83.5%, 90.6%,57.4% and 164.2% for CSF glucose, and 49.7%, 91.8%, 93.4%,45.2% and 104.5% for CSF protein. The CSF WBC count should not be used alone to rule out bacterial meningitis. When it is combined with other factors such as CSF glucose and protein it helps in decision making in patients suffering from bacterial meningitis

Seroprevalence of Legionella pneumophila in admitted patients with pneumonia in training hospitals, Ahvaz, Iran

To determine the seroprevalence of Legionella pneumophila [LP] in patients with pneumonia. During a 12-month study period, from December 2007 and November 2008 121 randomized selected patients admitted to the three training hospitals of Jundishapoor University of Medical Science in Ahvaz [a city southwest Iran] with pneumonia were investigated to determine the serprevalence of LP. The diagnosis of LP infection was based on positive serology. Sera were tested for L. pneumophila IgG and IgM by using Elisa kit [Vircell, Spain]. All analyses were done using the SPSS, version 16 statistical package. Of a total of 121 serum samples tested, 21 [17.3%] were positive for LP- IgG, IgM. Fifty percent of pneumonia patients in ICU were seropositive. Age, gender and area of residency did not significantly [p >0.05] affect the seroprevalence of LP. Overall, the prevalence of LP seropositivity was not significantly [p >0.05] affected by co-morbidities except diabetes melitus. Smoking and receiving antibiotic was observed in 86% and 100% seropositve patients. Legionella pneumophila is a prevalent infectious agent in the region of study and should be considered as potential invader patients with pneumonia especially in diabetic, smoker and ICU patients