[Molecular study of Clostridium difficile isolated from beef in Isfahan, Iran]

Background: clostridium difficile [C. difficile] infection is one of the most important diseases in healthcare facilities and community. Ribotypes 027 and 078 are known as hyper- virulent strain of C. difficile in molecular study. PCR-ribotyping is a suitable method to interpret the relation of C. difficile isolated from food and hospital

Objectives: in the present study, the clostridim difficile binary toxin [cdtB] and ribotype pattern evaluated in toxigenic C. difficle isolated from beef

Methods: detection of cdtB in 12 toxigenic C. difficile [encoding tcdA and tcdB gene] isolated from 100 beef samples was determined through PCR. Afterwards, PCR-ribotyping was performed to examine the ribotype patterns of C. difficile

Results: cdtB gene was not detected in any positive isolate. Ten different patterns were observed in 12 toxigenic isolates. No similarity existed in the ribotypes of our study with ribotypes 027 and 078

Conclusions: albeit ribotyp 027 and 078 were not found in our study, the isolation of toxigenic C. difficile with new ribotypes in Iran may indicate the probable hazard of this bacterium in public health. Comprehensive research about C. difficile in different food sources is recommended on a national level

Identification of hepatitis B virus surface antigen [HBsAg] genotypes and variations in chronic carriers from Isfahan province, Iran

Hepatitis B virus [HBV] gene and protein variations are frequently been seen in chronic patients. The aims of study were to determine the genotypes as well as the patterns of variations distribution in chronically-infected patients from the central part of Iran. The surface gene was amplified, sequenced and subsequently aligned using international and national Iranian database. All strains belonged to genotype D, subgenotype Dl and subtype ayw2. Of all 62 mutations occurred at 39 nucleotide positions, 31 [50%] were missense [amino acid altering] and 31 [50%] were silent [no amino acid changing]. At the amino acid level, 30 substitutions occurred, however, 3 were in positions 122 and 127, corresponded to subtypic determination. 22 [73%] out of 30 amino acid mutations occurred in different immune epitopes within surface protein, of which 12 [54.54%] in B cell epitopes in 10 residues; 5 [45.45%] in T helper epitopes in positions; 5 [22.73%] in inside CTL epitopes in 4 residues. The distribution of amino acid mutations as well as the ratio between silent and missense nucleotide mutations showed a narrowly focused immune pressure had already been on the surface protein in these patients, led to the emergence of escape mutants in these patients

Sero-epidemiology of hepatitis E virus infection in Isfahan-Iran: a community-based study

Hepatitis E virus [HEV] is an enterically transmitted acute viral hepatitis with the highest incidence in Asia, Africa, Middle East and Central America. There is little published data on the epidemiology of the infection in Iran. Thus, this study was carried out to evaluate anti-HEV sero-prevalence in Isfahan Province [Iran]. In a cross sectional study extending over 6 years, 816 subjects were selected from urban and rural areas of Isfahan Province in 2005 using multi stage cluster sampling method. Demographic data and blood samples were collected and anti-HEV antibodies were measured by ELISA method. Chi-square test was used for statistical analysis and P<0.05 was considered significant. The subjects of this study included 428 females [52.5%] and 388 males [47.5%]. The overall anti-HEV sero-prevalence rate was 3.8%. There was no significant difference in HEV sero-positivity between the subjects grouped according to sex [4.2% in females and 3.4% in males, P=0.78], household number [P=0.095] and living area [2.7% in rural and 4.1% in urban areas, P=0.09]. HEV sero-prevalence increased with age from 0.9% in children 6-9 years to 8% in persons over 50 years without statistical differences in them [P=0.08]. There was statistical difference between HEV sero-positivity in different regions of Isfahan Province, with the highest prevalence in Khomeini Shahr [13.3%] [P< 0.001]. HEV sero-prevalence in Isfahan Province is lower than previous reports from other parts of Iran and Middle East. Further -studies in other parts of Iran are needed to obtain a prevalence map for planning preventional strategies

Comparison of HBs-antibody serum levels between patients with type 2 diabetes mellitus and controls following vaccination against hepatitis B

Diabetic patients are at risk to viral hepatitis. It is reported that vaccination with routine doses is not sufficient for diabetic patients especially those with type I, but there is some controversies. The aim of this study was to the assessment and compare of HBs-Ab titer in type II diabetics and controls after vaccination against hepatitis B. In a semi-experimental study, 91 patients with type II diabetes mellitus and 55 non diabetic healthy individuals matched in age, sex, body mass index and smoking were selected by simple non-random sampling. The positive cases for HBs-Ag, HBs-Ab and HBc-Ab were excluded. Vaccination against hepatitis B was carried in 3 times [0, 1, 6 month] with a dose of 20 microg. Then, 3 and 6 months after the last dose, Hb-A1C and HBs-Ab were tested. HBs-Ab titers were compared between two groups using Mann-Whitney U test and the correlation between HBs-Ab and Hb-A1C in two groups. Three months after vaccination, both in diabetics and controls, the mean HBs-Ab level was 335.8 +/- 275.7 and 420.1 +/- 348.4 mIU/ml, and 6 months after vaccination it was 530.7 +/- 387.9 and 552.5 +/- 410.7 mIU/ml respectively [p > 0.05]. There was an inverse but non-significant correlation between HB A1C and HBs-Ab in diabetics. The findings of the current study confirm that the routine vaccination is sufficient for patients with type II diabetes

[Differentiation of exudates from transudate pleural effusion by measuring cholesterol and bilirubin]

Differentiating exudates from transudate is the first step in examining pleural effusion. Moreover, it is a guide for determination of pathologic trend of background diseases and differential diagnosis. Although Light's criteria are considered as standard in differentiating exudates from transudate, in some studies pleural fluid cholesterol, ratio of pleural fluid cholesterol to serum and ratio of pleural fluid bilirubin to serum have been considered. This study was performed to investigate the diagnostic efficacy of cholesterol and bilirubin of pleural fluid in differentiating exudates from transudate pleural effusion. This cross-sectional study was performed in Al-Zahra Hospital, Isfahan in 1384, where 86 cases of pleural effusion were assessed by easy and consecutive sampling method. After differentiation of patients with exudates from transudate pleural effusion, based on light's criteria, related parameters were measured. Using ROC [Receiver Operative Characteristics] curves, area under the curve was determined following by determination of sensitivity, specificity and positive and negative predictive values. Results were analyzed by MC Nemar test. From 86 studied patients, 59 cases were exudates and 27 cases were transudates. Considering the pleural cholesterol above 43 mg/dl as cut off, a sensitivity of 73.8% and specificity of 92% were obtained for the method. Decreasing the cut off level to 35.5 mg/dl, the sensitivity was increased and reached to 81.4%. Ratio of pleural fluid cholesterol to serum more than 0.3 had a sensitivity of 65%, 88% specificity and 85% efficiency for differentiation of pleural effusion while ratio of pleural fluid bilirubin to serum more than 0.6 had 76.3%, 74.1% specificity and 75.6% efficacy. The criterion on 3 g/dl protein had the highest sensitivity and specificity in differentiating exudates from transudate pleural effusion and can be used as the best determinant alone. Also pleural fluid cholesterol more than 35.5 mg/dl has suitable sensitivity and specificity and the combination of pleural fluid protein and cholesterol can be used as the best practical determinant. The criterion of pleural fluid protein cholesterol to serum ratio more than 0.3 has low sensitivity and with reduction of this ratio to 0.14, its sensitivity increases but its specificity will decrease

relationship between frequency and duration of imprisonment and the prevalence of HBsAg, Anti HCV and HIV antibody seropositivity in Iranian prisoners

Imprisonment is an important issue in the area of contagious disease transmission. On the other hand, different risk factors are responsible for the transmission of hepatitis and HIV in prisoners, of which intravenous drug abuse is notable. Whether the frequency and the duration of imprisonment can affect the chance of transmission of these diseases is a question. This study tried to explore this issue in some prisons in central regions of Iran. This was an analytical, cross-sectional, descriptive study performed in 4 prisons during 1382. The prisoners were grouped according to the periodicity and duration of their imprisonment. Then, blood samples were obtained from selected prisoners and tested for HBsAg, Anti HCV, and HIV antibody. Data was then analyzed. 1431 male prisoners were studied. 51 [3.6%] subjects were HBsAg positive, 541 [37.8%] were Anti HCV positive, and 95 [6.6%] were positive for HIV antibody. The prevalence of positivity for HBsAg, AntiHCV and AntiHIV was higher in prisoners with more periodicity and/or longer duration of imprisonment. Regarding the prevalence of infection with these viruses, our results are similar to the results of previous studies in foreign countries. However, former studies had not evaluated the relationship between periodicity and duration of imprisoning and the risk of these infections. We recommend harder effort for preventing the transmission of these diseases in prisons, and consideration of strategies for decreasing the periodicity and duration of imprisonment

Survey of hepatitis B risk factors in blood donors at Isfahan province

Viral hepatitis B is a dangerous disease with high mortality and morbidity rate in the world. It has been prevalence in different areas depends on risk behaviors and people's awareness level. This paper was prepared to detect the risk factors of hepatitis B in blood donors in Isfahan province. In cross-sectional study, 39 seropsitive blood donors and 261 seronegeative ones in 2004 were studied. HBsAg was examined via ELISA. Standard hepatitis B risk factor questionnaires were completed for all of the samples and the prevalence of each risk factor in case and control subjects was compared through X[2] test, using SPSS-10 software with p<0.05. This study indicated that history of surgeries, use of shared razors, jaundice of mother, presence of HBsAg+ patients and drug addicts in families were statistically significant in the two groups. There was not any heamodialysis history, accident of needle sticks and needle sharing by drug addicts. Since the relative frequency of surgery history in the two groups was significant different, attending to hospital and operation room hygine seems to be important. Moreover, since hepatitis B can be prevented with education and vaccination, the families of HBsAg+ patients and drug addicts should be encouraged to use education and vaccination. Using the results of this study, it is necessary to pay attention to hospitals and raise people awareness about hepatitis B transmission routes vaccination of high risk individuals