[Paraclinical disorders and prevalence of viral infections in injection drug users]

It is reported that 24-40% of hospital admissions in the world are related to addiction and its complications. Considering hepatitis, AIDS, cirrhosis and various malignancies following these complications, addiction is one of the most important problems in treatment centers worldwide. To determine Para clinical disorders and prevalence of viral infections in injection drug users This was a cross-sectional study in which Para clinical derangements including lab results, chest radiography, and abdominal and pelvic sonography of all patients admitted to infectious diseases ward at Al-Zahra hospital in Isfahan were evaluated during 2005. Also, the presence of HIV, HCV, and HBV infections in these patients during two consecutive years of 2004 and 2005 was taken into consideration. The total number of patients during 2 years was 92 among those 53 hospitalized during 2005 and 39 in 2004. The mean age was 31.7 years with an age range between 20 and 53. The mean length of injection was 3.9 years with a minimum of 2 months and a maximum of 21 years. Among patients hospitalized in 2005, 47% were abnormal for chest radiographs and 17% found to have splenomegaly based on sonography. Among these patients, leucocytosis [85.5%], anemia 86%], higher levels of ESR [74%], derangement in liver tests [60%] and coagulation disorders [55%] were also observed. Viral infections in patients admitted during 2004 were HCV [71%], HBV [12.8%], and HIV [7.6%] while 25.6% were negative for viral infection. In patients hospitalized through 2005, the viral infections were due to HCV [74.3%], HBV [14.3%], and HIV [17%] whereas 17% of patients found to be without viral infection. Based on data found in our study, the high prevalence of viral infection and Para clinical disorders in these patients highlights the importance and the urgency of such laboratory measurements at the very beginning following hospitalization

[Antibiotic resistance of nosocomial staphylococcus infections with E test method]

Staphylococcus aureus is one of the most important etiologic agents causing severe infection in human. Extravagant use of vancomycin as first line treatment of infections caused by this organism, has led to production of vancomycin resistant staphylococci and enterococci, as an important health problem. The recommendations of international societies to control nosocomial infections, regarding making policies for vancomycin usage in health and treatment centers in order to prevent development and spread of vancomycin resistant Enterococcus and staphylococcus aureus. The goal of this study is determining sensitivity of S. aureus isolated from clinical specimens hospitalized patients using E-Test in order to find suitable primary therapeutic method. This study is Analytic descriptive, and 14 different antibiotics were evaluated using E-Test method at Al-Zahra hospital in Isfahan. Quality control was implemented using staphylococcus ATCC 29213. Data were analyzed by SPSS -13 software and WHOnet-5 after editing and entering into computer. This study was done on 72 patients, 25 of whom were women and the rest were men. There was no meaningful relation between patients sex and the place of isolation of organisms, but regarding ward of hospitalization and resistance rate, highest resistance was observed in ICU and surgical wards [P<0.05]. Highest sensitivity is to vancomycin [93.5%] and then to Rifampin [87%] and amikacin [71.4%]. Highest resistance is against doxycycline and oxacillin [75%] and then cotrimoxazole and ofloxacin with 69% resistance stand at next level. Because of inadvertent use of antibiotics, specially in hospitals ICU and surgical wards, the resistance of potentially dangerous and lethal bacteria like staphylococcus aureus is high and presently only a few drugs like vancomycin exist that can cover this Bacterium

[Common bacteria, infection area and appropriate treatment in hospitalized addicts]

The use of narcotics leads to immunodeficiency and infection these patients. Hence, recognition of common germs and appropriate antibiotics is of special importance. This cross-sectional study was performed among all patients hospitalized within 2002-2005, in the ward of infectious diseases, in Alzahra hospital. First, the patients were divided into 4 groups of skin, limb, heart and lung involvement, then microbial culture was obtained and type of bacterium and effective drug. Overall, 493 patients with a mean age of 27.75 years, and a minimum of 15 years. The number of deaths was 59 [11.96], of which, more than half have been affected by infective endocarditis. The most common complication [58.6%] was related to injection site complications. The lung was second [19%] followed by cardiac involvement equivalent to 13.8%. 60% of existing scopes were on tricuspid valve. The most common bacterium, staphylococcus aureus was obtained at a rate of 82.8% from these patients, which responded mostly to cefazolin and gentamicin. The need for vancomycin was present in 2% of patients, which were all hospitalized in the last year of the study [2005], and cefepime was used in only one case. Considering that the most common bacterium was Staphylococcus aureus, with a remarkable majority of patients has given appropriate response to simple and inexpensive drugs cefazolin, gentamicin, ceftriaxone and cloxacillin which are first line of treatment against this bacterium, therefore vancomilyn should be kept for special cases