Microbial contamination of staffs hand while going out of hospital

Cross-transmission of microorganisms by the hands of health care workers is considered as a main transmission route of nosocomial infections. The aim of this study was to investigate the microbial contamination of health-care worker s hands while going out of hospital. Wearing the sterile glove with liquid culture, we obtained 100 Samples from the staffs hands of three departments [clerical department, emergency ward and central laboratory] of Emam Reza hospital. After that, the samples were cultured. Of all personnel, 40% have the habit of washing their hands. Of these, 95 percent wash their hands with water and soap, and 5 percent with alcohol rubs. Of 100 cultured samples, 90 have microorganisms including non-pathogen gram-positive Bacillus [29%], coagulase-positive staphylococcus [39%], coagulase-negative staphylococcus [47%], Enterococci [3%], Micrococcus [25%] and Candida [3%]. Contamination in those who had not washed their hands is 62.6% and in those who washed is 37.7% [P=0.04]. Hands of health-care workers become progressively contaminated by the potential pathogens during daily activities. To reduce the rate of contamination, it is helpful if we ask staff to wash their hands while going out of hospital

[ prevalence of pharyngeal carriers of group A Beta-hemolytic Streptococcus and antibiotic susceptibility pattern of this bacteria in Zahedan, southeast of Iran]

Group A Beta-Hemolytic Streptococcus [GABHS] is the most important and common bacterial cause of acute pharyngitis in children. Nowadays, cases of resistance to antibiotics have been reported due to unnecessary and extensive usage of antibiotics. The aim of this study was to determine the prevalence of healthy pharyngeal carriers and evaluate the antibiotic susceptibility of GABHS. In this study among guidance school students of Zahedan aged 12 to 14 years, 1092 cases were selected randomly. After culturing the pharyngeal samples, GABHS was isolated and its susceptibility to different antibiotics was examined. Results were statistically analyzed by Chi-square and Exact fisher tests. 76 specimens of GABHS were isolated from 1092 cultivated specimens and the differences in the prevalence of GABHS between different age groups of two sexes and different age groups of each sex were not statistically significant. The antibiotic susceptibility ratios were 98.68% for cephalexin and cefazolin, 97.37% for erythromycin and 92.11% for penicillin and the difference was not statistically significant. The susceptibility to amoxicillin was 80.26%, which was significantly different from susceptibility to cephalexin and cefazolin [p<0.001], erythromycin [p=0.001] and penicillin [p=0.034]. In spite of widespread resistance to antibiotics, penicillin still is the first drug of choice for treatment of GABHS pharyngitis and erythromycin is the best alternative drug for patients sensitive to penicillin

Study of the sensitivity of neisseria gnorrhoeae to ciprofloxacin

Background and Purpose: Gnorrhoeae is one of the most common sexually transmitted diseases in the developing and developed countries. This bacterium has gained some resistance agaist several antibiotics used as promary medication in the past deccade; therefore, the use of ciprofloxacin has been recommended. On the basis of reportsd on the reducation of this bacterium to ciprofloxacin, this study in conducted to determine its sensitivity

Methods and Materials: This descriptive research was conducted on the population of patients admitted to medical laboratories in Mashad, Iran, who were suspicious of having Neisseria Gnorrhoeae. They were selected by convenient sampling. 1348 cases with urethral discharge were examined from 2003 to 2004; two swaps were taken for smear and culture. After colony growth and the identification of the Neisseria Gnorrhoeae, antibiogram was performed via disc diffusion with penicilin, tetracyclin, erythromycin, and ciprofloxacin discs. Then the minimal inhibitory concentration was deetermined for ciprofloxacin

Results: 71 cases of Neisseria Gnorrhoeae were identified, of which 16.9% were sensitive to penicilin, 25.3% to tetracyclin, 67.6% to erythromycin, and 70.3% to ciprofloxacin. 6 cases were resistant to ciprofloxacin and their MIC ranged from 1 to 16 microgr/ml

Conclusion: Since ciprofloxacin is currently the primary treatment for Neisseria Gnorrhoeae, it seems that with the increased resistance obsered in the present study, ciprofloxacin can no longer be considered as the preferred antibiotic against Neisseria Gnorrhoeae. Therefore, self treatment without medical prescription is strongly prohibited

level of antibody against Chlamydia trachomatis among patients with genital infections in Mashhad

Chlamydia trachomatis is a common cause of sexually transmitted disease which can cause severe consequences. Appropriate preventive requires knowledge of epidemiology of infection in different population in order to target interventions in a cost-effective manner. In this study prevalence of C. trachomatis infections were determined according to some parameter in Mashhad. In this study serum from 76 patients with STD were examined by ELISA and IFA for C. trachomatis. Statistical evaluation was done using SPSS program. ELISA showed that 11 and 3 patients with IgG and IgM against C. trachomatis, respectively. IFA analysis showed that 1 patient had titer of 1/32, 6 patients with 1/64 and 3 patients with 1/128. One female patient showed titer of 1/256. This study provides strong evidence that Chlamydia prevalence in our region is significantly high which necessitate screening and treatment. It is, therefore, suggested that detection test for chlamydial genito-urinary infections become a routine part of STD investigations

[Determine the inducible resistance phenotype in methicillin resistance staphylococcus aureus and coagulase negative staphylococci]

Macrolide, lincosamide and streptogramin B [MLSB] antimicrobial agents are widely used in the treatment of staphylococcal infection. Clindamycin is the medicine of choice for some staphylococcal infections, particularly skin and soft tissues infections. Erythromycin and clindamycin are two distinct classes of antimicrobial agents which inhibit protein synthesis in bacterial cells. Inducible resistance to clindamycin is not diagnosed using conventional antibiotic susceptibility testing and most of the physicians do not prescribe clindamycin in cases where isolates show resistance to erythromycin. However, not all of the erythromycin resistant strains are resistant to clindamycin. To detect co-resistance to both antibiotics, the inducible test should be performed to determine the potency of clindamycin for treatment. The aim of this study was to detect inducible clindamycin resistant isolates of methicillin resistant isolates of Staphylococcus aureus and coagulase negative staphylococci. The inducible test was performed by disk diffusion, placing an erythromycin disk adjacent to a clindamycin disk on Muller Hinton agar plate. If the isolates were resistant to erythromycin and this resistance was induced to clindamycin an inhibitiom zone shaped like the letter D was produced. In this study all methicillin resistance Staphylococcus aureus and coagulase negative staphylococci were tested for induced resistance. Of 128 isolates of Staphylococci, 6 were D and 1 was D[+]. The inducible test correctly identified the inducible resistance to clindamycin caused by erythromycin. The resistance to clindamycin was not induced by erythromycin in the majority of isolates of staphylococci in our collection of isolates. We recommend the test routinely be used for correct determination of resistance to clindamycin

[Frequency of beijing genotype in mycobacterium tuberculosis strains isolated from tuberculosis patients in city of Mashhad]

The Beijing genotype is one of the most important strains of Mycobacterium tuberculosis involving outbreaks of tuberculosis in various parts of the world. Unsought regarding Beijing genotype in Iran, is the reason this study is undertaken in order to evaluate the frequency of this genotype in Mashhad. This descriptive study was carried out on 113 M.tuberculosis Specimens isolated from patient with pulmonary tuberculosis in hygienic centers, located at Ghaem and Imam Reza hospitals in the City of Mashhad. In this study, Beijing genotypes were detected with PCR-based method, and spoligotyping. Results were processed with descriptive statistics and CI was evaluated. Beijing genotype was detected in 8 specimens of all the 113 isolated M.tuberculosis strains [7.1%, CI 95%, 2.36-11.84]. Out of 8 isolated specimens, 5 isolates belonged to Afghan patients and 3 specimens were isolated from Iranian patients. Out of 8 patients that were infected with Beijing genotype, 2 patients were male and 6 patients were female. Although the rate of Beijing family is low in Iran, in comparison to other Asian countries, however, one needs to adopt a suitable policy in order to prevent its spread

[ prospective study of 34 cases of hospital and community-acquired klebsiella pneumoniae bacteremia]

This prospective study attempted to determine the epidemiology, clinical manifestations and prognosis of patients with hospital and community-acquired bacteremia of Klebsiella pneumoniae. From July 1, 2004, to March 31, 2005, we prospectively studied 34 episodes of klebsiella pneumoniae bacteremia in 34 patients, treated in Imam Reza Hospital, Mashhad-IRAN. The disease was nosocomially acquired in 58.8% and community acquired in 41.2%. The different types of infection were sepsis [44.1%], burn wounds [26.5%], pneumonia [1 1.8%] endocarditis [2.9%], urinary tract infection [2.9%], and hepatic abscesses [2.9%]. Bum which was found in 9 [45%] patients, was the most common underlying disease, followed by renal failure in 3 [15%], Diabetes mellitus in 2 [10%], leukemia in 2 [10%], and intravenous drug abuse in 1 [5%]. The most frequent clinical findings in adult patients were fever [100%], leukocytosis [75%], thrombocytopenia [45%], jaundice [40%], cough [30%], tachycardia [30%], tachypnea [25%], rigors [25%], Hemoptysis [15%] and anemia [11.1%]. Carbenicillin and ciprofloxacin were the most active antibiotics. We observed that nosocomial infections are more prevalent than community aquired. Sepsis without focous, burn and neonatal infections were some of the most significant diseases in this study

[Comparison between nasal sinuses and nasopharynx with regard to bacteriologic culture in chronic sinusitis patients]

Chronic sinusitis afflicts a significant percentage of the population and causes long-term morbidity. Common use of broad-spectrum antibiotics may alter pattern and frequency of bacterial pathogens. Regarding the fact that postnasal discharge [PND] is a common symptom and sign in patients, in this study we evaluated not only the bacteriology of sinuses but also we assessed the relationship of sinus culture results and PND culture results. It is done as a prospective study in 50 patients [21 female and 29 males]. In spite of long-term broad-spectrum use of antibiotics at least for 3months, they had persistent chronic sinusitis. In next step we suggested them endoscopic surgery. Endoscopic visualized swab samples from afflicted meatus and nasopharynx were obtained and cultured in aerobic and anaerobic condition and results were compared with each other. Coagulase negative staphylococcus [36%] staphylococcus aureus [20%] and Entrobacter auroginosa [36%] were the commonest bacteria cultured in sinuses. Culture was positive in 96% and negative in 4%. Concerning sinus and nasopharynx, statistical significant correlation was found in all three bacteria mentioned above in culture results. In comparison with other studies, it showed similar results even in long-term antibiotic treated patients, and it had less effect on bacteriologic composition. On the other hand, nasopharynx culture was a reliable marker for sinus bacteriology