ABSTRACT
Background and Objective: Tuberculosis [TB] is the main cause of death in the world. Half of the patient eventually will die during first 5-year of infection if they do not receive suitable treatment. According to WHO's report, treatment success in Iran is lower than the regional and global mean. This study was conducted to identify the effective factors of treatment failure among tuberculosis patient in golestan province- Iran
Methods: This cross- sectional study was conducted on 331 new smear positive tuberculosis patients that detected in TB laboratory in in golestan province-north of Iran during 2014. Inclusion criteria included weight more than 30kg, age greater than 13 years, diabetes, immune deficiency, liver or kidney diseases. Patients were treated according to a protocol for a period of two months on the DOTS strategy. The criterion of treatment outcome was sputum smear at the end of the second month of treatment. The effect of gender, medication regiment, age, weight, smoking, addiction and severity of smear basilli load on treatment outcome was assessed
Results: 50.8% and 49.2% of patients were treated with combination and separate medicinal regiments, respectively. The conversion rate of smear positive was 67.7% at the end of the second months. According to multivariate logistic regression, the age of the patient [95% CI: 0.96-0.99, OR: 0.98, P=0.017], addiction [95% CI: 1.26-4.54, OR: 2.4, P=0.008], ethnicity [95% CI: 1.86-7.02, OR: 3.62, P=0.0001] and diagnostic smear bacilli load [P=0.0001] were the important effective variables
Conclusion: The success of two months treatment was fairly low and the important factors on treatment success during the intensive phase were patient age, smoking, addiction and diagnostic smear bacilli load
ABSTRACT
P. aeruginosa is one of the causes of nosocomial infections with an unusual resistance to antibiotics. The source of resistance in this bacterium may be chromosomal or plasmid. The aim of the present study was to investigate the antibacterial susceptibility patterns with the presence of plasmids in P. aeruginosa isolates. In this study, 140 P. aeruginosa isolates were collected from hospitals in Urmia/Iran. The susceptibility patterns were determined against antibiotics. Plasmids were extracted by alkaline lysis method, electrophoresed and investigated by a UV transilluminator. Single digestion of plasmids with EcoR1 and HincII were performed and the restriction patterns were compared using a ladder. The rates of resistances to antibiotics were as follows: gentamicin 49.3%, cephalothin 99.3%, ticarcillin 100%, ceftizoxime 79.3%, co-trimoxazole 97.7%, amikacin 35%, carbenicillin 67.1%, ceftriaxone 65.7%, ciprofloxacin 58.6%, piperacillin 52.8%, imipenem 1.4%, kanamycin 65.7%, ofloxacin 72.1% and ampicillin 100%. In Whole, 65.7% of isolates harbored plasmids. Restriction enzyme analysis of plasmids showed unique pattern for all of plasmid positive isolates. All the plasmid positive isolates were resistant to ceftriaxone and kanamycin. The plasmid source of resistance to ceftriaxone was proved by plasmid elimination and transformation in E. coli DHS alpha and the plastid source of resistance to kanamycin was proved by plasmid elimination. Also there was a significant correlation between the presence of plasmid in isolates and resistance to some of antibiotics. There was a high frequency of plasmids in P. aeruginosa isolates, indicating that plasmids have an important role in transferring of resistance genes in this bacterium