Evaluation of C - reactive Protein, Albumin and the C - reactive Protein/Albumin Ratio as Prognostic Markers in Trauma Patients Admitted to Intensive Care Unit.

Background and Objectives: Deaths, injuries and disabilities resulting from Road traffic injuries (RTIs) are considered as the major concerns in public health and they are the second highest cause of mortality in Iran. Traumatic injury accounts for approximately one of six hospital admissions and almost 20% of the cases include admission to intensive care units (ICU). Laboratory diagnostic tests can help predict the clinical outcome of these patients. This study aimed to determine the ability of C-reactive protein (CRP), albumin and the CRP/albumin ratio to predict the outcome of trauma patients admitted to ICU. Methods: We evaluated 76 patients with traumatic injury admitted to ICU for more than 48 h. CRP, albumin and the CRP/albumin ratio were measured on day one and three after admission to ICU and analysed with regard to predictability of mortality and survival. Results: There was a significant association between CRP, albumin and the CRP/albumin ratio on the first and the third day upon admission (t-test, p=0.03). The mortality rate was correlated with an increase in the CRP/albumin ratio, and patients with a ratio of 4.01–9 had a poorer clinical outcome in comparison with other patients. High mortality and a poor outcome were seen in patients with a CRP concentration more than 12 mg/dl and an albumin level less than 3 g/dl in our study. Conclusion: Albumin, CRP and the CRP/albumin ratio are simple and reliable prognostic markers in ICU patients with traumatic injury.

Development of sandwich-form biosensor to detect Mycobacterium tuberculosis complex in clinical sputum specimens

Mycobacterium tuberculosis, the causing agent of tuberculosis, comes second only after HIV on the list of infectious agents slaughtering many worldwide. Due to the limitations behind the conventional detection methods, it is therefore critical to develop new sensitive sensing systems capable of quick detection of the infectious agent. In the present study, the surface modified cadmium-telluride quantum dots and gold nanoparticles conjunct with two specific oligonucleotides against early secretory antigenic target 6 were used to develop a sandwich-form fluorescence resonance energy transfer-based biosensor to detect M. tuberculosis complex and differentiate M. tuberculosis and M. bovis Bacille Calmette–Guerin simultaneously. The sensitivity and specificity of the newly developed biosensor were 94.2% and 86.6%, respectively, while the sensitivity and specificity of polymerase chain reaction and nested polymerase chain reaction were considerably lower, 74.2%, 73.3% and 82.8%, 80%, respectively. The detection limits of the sandwich-form fluorescence resonance energy transfer-based biosensor were far lower (10 fg) than those of the polymerase chain reaction and nested polymerase chain reaction (100 fg). Although the cost of the developed nanobiosensor was slightly higher than those of the polymerase chain reaction-based techniques, its unique advantages in terms of turnaround time, higher sensitivity and specificity, as well as a 10-fold lower detection limit would clearly recommend this test as a more appropriate and cost-effective tool for large scale operations.

Bacterial infections in burn patients at a burn hospital in Iran.

BACKGROUND & OBJECTIVE: The major challenge for a burn team is nosocomial infection in burn patients, which is known to cause over 50% of burn deaths. Most studies on infection in burn patients focus on burn wound infection, whereas other nosocomial infections in these patients are not well described. We undertook this study to determine three types of nosocomial infections viz., burn wound infection, urinary tract infection, and blood stream infection in burn patients in a burn hospital in Iran. METHODS: During the one year period (May 2003 to April 2004), 182 patients were included in this study. Blood, urine and wound biopsy samples were taken 7 and 14 days after admission to Taleghani Burn hospital. Isolation and identification of microorganisms was done using the standard procedure. Disk diffusion test were performed for all the isolates for antimicrobial susceptibility. RESULTS: Of the 182 patients, 140 (76.9%) acquired at least one type of infection of the 140, 116 patients (82.8%) were culture positive on day 7 while 24 (17.2%) on 14 days after admission. Primary wound infection was most common (72.5%), followed by blood stream (18.6%) and urinary tract infections (8.9 %). The microorganisms causing infections were Pseudomonas aeruginosa (37.5%), Staphylococcus aureus (20.2%), and Acinetobacter baumanni (10.4%). Among these isolates P. aeruginosa was found to be 100 per cent resistant to amikacin, gentamicin , carbenicillin, ciprofloxacin, tobramycin and ceftazidime; 58 per cent of S. aureus and 60 per cent of coagulase negative Staphylococcus were methicillin resistant. INTERPRETATION & CONCLUSION: High prevalence of nosocomial infections and the presence of multidrug resistant bacteria, and methicillin resistant S. aureus in patients at Taleghani Burn Hospital suggest continuous surveillance of burn infections and develop strategies for antimicrobial resistance control and treatment of infectious complications.