[Antimicrobial resistance of Enteropathogenic Escherichia coli isolated from diarrheal children in Zanjan during / 2012-13]

Background: Enteropathogenic E. coli [EPEC] is the predominant cause of infant diarrhea worldwide and represents a major endemic health threat to children living in developing countries. The increase in antibiotic resistance in pathogenic bacteria, especially in children, is considered as one of the world's health problems. The aim of this study was to evaluate the antibiotic resistance and multi-drug resistance in EPEC which isolated from children with diarrhea admitted to the hospital in Zanjan.

Materials and Methods: In this cross sectional study, 450 stool specimens were collected from children with diarrhea <5 years of age who referred to hospitals in Zanjan during 2012-2013. After culture and verifying of isolates by biochemical tests, Antimicrobial susceptibility was performed using the disk diffusion method [Bauer-Kirby] as recommended by CLSI to 13 antibiotics. Using PCR with specific primer pair's for eaeA gene, we detected EPEC in diarrheal and control samples.

Results: From 450 children with diarrhea in this study, 140 [31.1%] isolates of E. coli were identified. The frequency of EPEC isolated were 13.6% [19 isolates]. The most prevalent resistance profile were showed for erythromycin [100%], amoxicillin and co-amoxiclav 89/47%, respectively. Imipenem was found as an effective antibiotic with susceptibility rate of 84.21%. Also 90.6% of isolates were resistant to three or more agents and considered as Multidrug resistance [MDR].

Conclusion: The results showed increase in profile for antibiotic resistance. Therefore it suggest that application of antibiogram test is necessary before antibiotic prescription for successful treatment and prevention of diarrhea caused by multi-drug resistance agents.

Fear of being at risk of acquiring HIV, willingness to care, and discrimination in care and treatment of AIDS patients among nurses

Exposure to infectious blood and body fluids increase risk of occupationally acquired HIV among nurses. Discrimination in care and treatment of AIDS patient is one of the challenging ethical issues in nursing. The aim of this study was to determine fear of being at risk of acquiring HIV, willingness to care, and discrimination in care and treatment of AIDS patients among nurses. In this descriptive -cross sectional study, 165 nurses of internal and infectious wards from four selected hospitals of Tehran and Shahid Beheshti University of Medical Sciences participated. Data were collected by self-administered questionnaires. The instruments used included [demographic data form], [risk perception scale], [willingness to care for people living with HIV/AIDS]questionnaire, and [discrimination against AIDS] questionnaire. Data were analyzed by using SPSS 14, t-test, and pearson correlation. Out of 165 nurses, 36.4% had sever fear of being at risk of acquiring HIV, 81.8% were evaluated to be neutral in willingness to care of AIDS patients, and 54.5% agreed with moderately discrimination practice against AIDS patients. There was a significant correlation between fear of being at risk of acquiring HIV with discrimination in care and treatment of AIDS patients [p=0. 003] and willingness to care [p= 0.007]. It seems that education efforts about universal precautions, ethical issues, and patient rights should be made in order to reduce fear of being at risk of acquiring HIV, decrease discrimination in care and treatment of AIDS patients and increase willingness to care

Results of Dermal Patch Graft in the Treatment of Peyronie's Disease

To investigate the efficacy of "dermal patch graft" in surgical management of Peyronie's. Eighteen of Peyronie's disease cases, with a mean age of 49 and a history of penile curvature and painful erection were enrolled in this study. Diagnosis was made clinically by plaque palpation. All of them were in the chronic stage of disease with symptom duration of at least 6 months. We also evaluate their potency through Brief Sexual Function Inventory [BSFI] questionnaire before and after the operation, meanwhile the degree of penile curvature was measured with goniometry while artificial erection status was induced. Mean penile curvature, before and after the operation [58 and 5 degrees respectively], showed significant improvement [p<0.001]. The improvement of curvature was irrespective of the plaque size. All of our patients suffered from inability to intercourse due to significant penile curvature but after the procedure 11 of them [66.1%] could do so. Also the BSFI score improved significantly in this subgroup [p<0.05]. The remaining 7 cases [39%] already suffered from erectile dysfunction despite of operation; however, the penile curvature improved significantly in them. Six of this latter group had a plaque size greater than 4 cm2 and BSFI score was not significantly improved. Dermal patch graft as a cost effective method in the management of Peyronie's disease significantly corrects the curvature irrespective of plaque size and curvature severity. We found that if the fibrous plaque is less than 4 cm2 and the patient has no severe erectile dysfunction, this procedure will significantly improve his potency; however, if the patient suffers from a plaque sized greater than 4 cm2 and/or severe erectile dysfunction, to reach satisfactory erection, implantation of penile prosthesis or applying other methods of artificial erection in addition to dermal patch graft is suggested