Diarrhoeagenic E. coli pathotypes in children with and without diarrhoea in an Iranian referral paediatrics centre

Diarrhoeagenic Escherichia coli can be considered as the most important etiologic agents of diarrhoea in the Islamic Republic of Iran, particularly in children. This study determined the frequency of diarrhoeagenic E. coliisolates collected from children with acute diarrhoea [n= 50] and a control group [n= 50] at an Iranian referral paediatric centre during a 1-year period. Using multiplex PCR, diarrhoeagenic E. coli was identified in 90% of the case group and 20% of controls. Enterotoxigenic E. coli was the most frequently identified pathotype in both groups [26% in cases; 10% in controls]. Shiga toxin-producing E. coli was the second most isolated pathotype [17%], followed by enteroaggregative E. coli [12%]. No enteroinvasive E. coliand enteropathogenic E. colistrains were recovered. More than 80% of isolates harboured the fimHgene. This high proportion of diarrhoeagenic E. coli and diversity of E. coli types highlights the need for enhanced surveillance of gastroenteritis agents in children in this country

Pediatric hydatidosis in Iranian referral pediatrics center

Hydatidosis is one of the major zoonotic diseases that cause considerable public health problems in Iran. The present study was designed to investigate pediatric hydatidosis in patients referred to the Children Medical Center Hospital in Tehran, Iran during 2005-2010. Data were collected from the records of 17 patients referred to the center with hydatidosis. Data included demographic data; laboratory results, type, and site of cysts, clinical manifestations, and treatment. Nine patients were boys [52.9%] and eight [47.1%] were girls. Most patients referred from central areas of Iran [58.8%]. Seven patients had cysts in their lungs [41.2%] and three cases [17.6%] in liver. Six cases [35.3%] had simultaneous lung and liver cysts, 3 patients [17.6%] had brain cysts [alone or in combination with other organs involvement] and 2 patients [11.7%] showed multi-organ involvement. All patients were treated by albendazole and underwent surgery, recurrence was seen in 4 [23.5%] of the cases and one patient died due to rupture of the cyst and anaphylactic shock. Multi-organ involvement seems to be on the rise in children, this has led to the necessity for physicians to be more aware of clinical features, search, and rule out other organs for involvement diagnosis once a cyst is detected in one organ

Polymorphism in the first intron of interferon-gamma gene [+874T/A] in patients with BCG adenitis

Cytokines and specially interferon-gamma [IFN- gamma] are largely responsible for the regulation of the protective immune response against mycobacterial infections. Several studies have clarified the importance of common variants of IFN-gamma gene regarding the susceptibility to tuberculosis. Bacille Calmette-Guerin [BCG] vaccine that is used to prevent severe forms of tuberculosis could produce local and systemic side effects. In this study we hypothesized that the IFN-gamma [+874T/A] polymorphism was associated with development of BCG adenitis. Thirty patients with BCG adenitis [18 males and 12 females] and 30 age and sex-matched healthy children, vaccinated with BCG during the first two days of life were chosen. All the patients and controls were of Iranian Fars origin and the study was conducted from 2005 to 2007. DNA samples were obtained from 30 patients with BCG adenitis and 30 age and sex matched healthy vaccines. Polymorphism at +874 was identified using allele specific polymerase chain reaction. Allele and genotype frequencies in cases and controls were compared using the chi [2] test and odds ratios [OR] and their 95% confidence intervals [CI] were calculated. The minor allele [T] frequency was significantly lower in patients with BCG adenitis compared to controls [35%vs 55%, P=0.02, OR =0.441, 95% CI= 0.211-0.919]. The Armitage trend test revealed a gradually increasing protection from the AA genotype through AT to TT [common odds ratio= 0.49; P=0.037]. Our data suggest that in an Iranian population, the IFN-gamma [+874T/A] polymorphism is associated with development of BCG adenitis in the vaccines

Detection of chlamydia trachomatis in endocervical specimens by an enzyme- linked polymerase chain reaction assay

Chlamydia trachomatis [CT] is the most common cause of sexually transmitted infections [STI] worldwide and its early detection and treatment can reduces the high morbidity associated with this infection. In this study a sensitive diagnostic polymerase chain reaction [PCR]-based enzyme immunoassay [PCR-EIA] method was developed which detects CT in women with cervicitis. Endocervical swabs collected from 123 women [20-55 years] with cervicitis were tested by both conventional PCR, and PCR-EIA assays, using identical sets of primers to amplify a CT-specific plasmid. For the conventional PCR, amplicons were detected by agarose gel electrophoretic analysis and the PCR-EIA assay used biotin-labeled primers, strepavidin-coated plates, a digoxigenin-labeled probe, and a final enzyme-linked colorometric analysis [405 nm] was used to measure the CT amplicon. The frequency of positive CT infection by conventional PCR and PCR-EIA assay was 7% and 17%, respectively. The highest frequencies of CT infection were among women of 31-40 years old group [25%]. The PCR-EIA limit of detection, calculated by linear regression analysis, was10 pg of CT DNA [r[2]=0.9642]. The degree of agreement [Kappa] between the conventional PCR and PCR-EIA method was 0.556 [p<0.0001]

Diagnosis of bacteremia using universal PCR in febrile ill children

Early diagnosis of bacteremia and its complications is the most important part of care and management of the febrile patients. However, a majority of patients who appear to be clinically septic have negative blood culture. The use of polymerase chain reaction [PCR] techniques has allowed identifying the pathogenic organisms rapidly and accurately. The objective of this study was to investigate the prevalence of bacteremia in febrile pediatric patients, comparing universal PCR and conventional blood culture. One hundred febrile children [45 males, 55 females] with suspected septicemia were evaluated. A total of 100 paired blood samples were collected from children to analyze for bacterial detection using universal PCR and culture. Twelve patients were blood culture positive. The most common pathogens isolated from blood culture were Staphylococcus aureus, coagulase negative staphylococci [CoNS] and Pseudomonas aeruginosa. The PCR were positive in 19 patients. The comparison revealed sensitively, specificity and accuracy of 91.67, 90.91 and 91%, respectively, for PCR. The present study shows that the use of PCR is more sensitive than the use of conventional blood techniques for the detection of bacterium pathogens based on patients' clinical context

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 chlamydia trachomatis from urine specimens by pcr inwomen with cervicitis

Chlamydia trachomatis is the most common agent of urogenital infections in both men and women. Diagnosis of chlamy-dial infections is based on isolation of bacteria in tissue culture media that requires at least 48 to 72h. Polymerase chain reaction [PCR] is a sensitive and specific method for detection of small quantity of bacterial DNA in clinical samples. The first goal of this study was to perform a PCR testing for detecting of C. trachomatis from urine samples and after that to identify the frequency of C. trachomatis among cervicitis women and at the end, to identify the potential risk factors for chlamydial genital infection. From August to October 2002, a total of 122 consecutive women with cervicitis who attended Obstetric and Gynecology Clinic of Shoosh, Tehran-Iran were involved into the study. After DNA extraction from urine specimens, PCR tests were performed. C. trachomatis genome was detected in 14 of 94 [14/9%] urine specimens. The highest C. trachomatis cervical infection frequency was found in women with 28 to 38 years old group, elementary education level group, and in users IUD for contraception. The results of this study indicate that PCR technique is a useful method for detecting C. trachomatis in urine

[ study of the frequency of adenovirus infections by immunofluorescence antibody method in patients with acute respiratory tract infection]

Background: Acute respiratory tract infections cause 4.5 million childhood deaths all over the world. Most of these deaths occur in the developing countries. Both bacterial and viral pathogens arc responsible for these deaths. Adenovirus respiratory tract infections are spread over the entire world, but the fatal disease is rarely seen

Methods: This descriptive case-series study has been conducted from October 2003 to September 2004 on 96 children of up to 5 year old. The relative frequency of adenovirus respiratory tract infection was studied. For this purpose, the nasopharyngeal secretions were obtained to detect adenovirus by Immmofluorescent Antibody [IFA] method. Seasonal incidence age distribution, and clinical signs and symptoms of this infection were studied

Findings: The relative frequency of Adenovirus respiratory infection was 10.4%. Most commonly it occurs in children aged less than 1 year and in autumn. In addition, cough and rhinorrhea are the most common signs [90%] and fever is the most common symptom [100%] in our patients. Similarly, pneumonia was the most common [40%] clinical manifestation in our patients

Conclusion: According to above data, the frequency of Adenoviurs infection and the common age for infection in this study are similar to other studies but pneumonia is the common illness which can be explained by the fact that this hospital is a referral center for these patients