ABSTRACT
Background and study aim: this study aimed to determine the antibacterial resistance patterns of extended spectrum b-lactamase [ESBL]-producing enteropathogenic Escherichia coli [EPEC] isolated from Iranian children and to investigate its genetic patterns
Patients and methods: 192 non-repeats EPEC isolates were collected from stool samples of the children with and without diarrhoea. The EPEC strains were isolated from 1355 stool specimens obtained from 247 children with diarrhoea [0-10 years old; mean age, 5.5 years] and 1108 children without any gastrointestinal symptoms [0-10 years old; mean age, 6.8 years] during the summer months in three Iranian provinces, Tehran, Ilam and Mazandaran. Strains biochemically identified as E. coli were selected and were identified by the presence of eaeA and bfpA as EPEC virulence genes. Antimicrobial susceptibilities were determined by disc diffusion method. The isolates were confirmed to be ESBL producers by the double disk synergy test [DDST]. The b-lactamase genes [blaTEM, blaSHV, blaCTX-M, blaOXA] and insertion sequence ISEcp1 were detected by PCR method
Results: the highest antibiotic susceptibility was detected to imipenem [100%], followed by gentamicin [82.3%] and ciprofloxacin [79.2%]. The highest resistance was detected to cefpodoxime [97.9%], trimethoprim [60.7%], and tetracycline [58.4%], respectively. Totally, 153 EPEC strains [79.7%] were ESBLproducing by DDST test. The PCR showed that 84 [43.8%] EPEC isolates were positive for ESBLs encoding genes. Among 153 ESBLs-producing EPEC, TEM was present in 9.2% of isolates. Also, CTX-M and SHV genes were detected in 7.2% and 7.8%, respectively. The SHV positive strains were associated with the highest resistance rate to tetracycline [56.5%], although the TEM and OXA were associated with the highest resistance rate to gentamicin [23.1%] and ciprofloxacin [21.4%]
Conclusions: the study revealed that 79.7% of EPEC isolates from Iranian children were ESBL-producing and were comparable with the non ESBL-producing isolates regarding susceptibility to the antibiotics
ABSTRACT
The purpose of this study is to propose an innovative method of knowledge transfer that aims to improve health literacy about pediatric infectious diseases prevention in families. Children have an appreciable role in this scheme. This study is a before and after trial that has been conducted in Hamedan in 2009. After changing seven infectious disease topics into childish poems, we selected five kindergartens randomly and taught these poetries to the children. Teaching process held after a pretest containing 24 questions that examined 103 of parents about mentioned topics. The same post-test was given after 4 months of teaching process. The mean of correct answers to the pretest was 59.22% comparable with 81.00% for post-test [P<0.00]. Gender and knowledge degree could not change the results significantly. Assuming one's correct answers to the questions as his/her Knowledge Mark, the mean of this variable increased to 5.32 by this method. This cost-effective and joyful method had successful results in promoting health knowledge. Children are able to play an active role in family's health situation. Learning within family atmosphere without any obligations makes our scheme a solution for paving the knowledge transferring way
ABSTRACT
Methicillin resistant staphylococcus aureus [MRSA] is a frequent cause of infections in children. The purpose of this study was to determine the frequency of nasal colonization of S. aureus in children and detection of inducible clindamycin resistance [ICR] by disk approximation test [D-test]. This was a cross-sectional study conducted in Hamedan from 2007 to 2008. 520 nasal swabs were obtained from children under 12 years of age at the time of admission and 287 swabs at the time of discharge. Antibiogram was performed by method of disk diffusion for oxacillin, erythromycin, clindamycin, cefazolin and vancomycin as well as D-test. Chi-square test was applied for statistical analysis. Out of 520 patients, 118 [22.3%] were colonized with S. aureus as community-acquired [CA-S. aureus]. Of 287 patients, 64 [22.3%] were colonized with isolates of S. aureus at discharge time. Of these 64 patients, 32 cases were colonized with hospital acquired [HA-S. aureus] isolates after admission. Only one CA-MRSA isolate was resistant to clindamycin, 5% of 118 CA-S. aureus isolates and 6.3% of HA-S. aureus isolates had inducible clindamycin resistance [D-test]. Also 37.5% of CA-MRSA isolates at the time of admission and 22.2% of HA-MRSA isolates at discharge had positive D-test. We emphasize that D-test should be used routinely and clindamycin should not be used in patients with infections caused by inducible resistant S. aureus