ABSTRACT
Objective: To investigate the antimicrobial resistance patterns and prevalence of integrons in Shigella species isolated from children with diarrhea in southwest Iran. Methods: In this study, 1 530 stool samples were collected from children under 15 years with diarrhea referred to teaching hospitals in Ahvaz and Abadan, southwest Iran. Shigella spp. were identified by standard biochemical tests and PCR. The antibiotic resistance pattern of all Shigella isolates was determined by the disk diffusion method and minimum inhibitory concentration (MIC) by E-test. Results: Of 1 530 stool samples, 91 (5.9%, 91/1 530) were positive for Shigella spp. the most common Shigella isolates were Shigella flexneri 47 (51.6%, 47/1 530). Antibiotic susceptibility tests showed that the highest antibiotic resistance was related to trimethoprim-sulfamethoxazole (87.9%, 80/91) and ampicillin (86.8%, 79/91). Multiplex PCR results revealed that 56% and 86.9% of Shigella isolates carried integron class I and integron class II genes, respectively. None of the isolates included the integron class III gene. Conclusions: The high prevalence of multi-drug resistance in Shigella isolates in our area increases the concerns about dissemination of the antibiotic-resistant isolates in this bacterium.
ABSTRACT
Botulism is one of the most important foodborne diseases and is caused by Clostridium botulinum toxin. The main manifestations are flaccid muscle paralysis and cranial nerve palsies. Botulism is an essential health problem because of its high mortality. The diagnosis of botulism, especially in sporadic cases, is a medical challenge and a high clinical suspicion is necessary for early recognition. So, every physician should be familiar with its signs and symptoms for early detection and treatment. We describe a family with dysphasia and acute paralysis after the ingestion of locally made cheese. The clinical presentations of the 1st patient were similar to myasthenic crisis and she, therefore, received plasma exchange. After the appearance of similar symptoms in the other family members, they were treated with polyvalent botulinum antitoxin and diagnosis was confirmed by toxicology and detection of serotype A botulinum toxin in cheese and stool samples. Uncommon clinical presentations and unusual sources of botulinum toxin should be kept in mind because of the importance of early diagnosis and treatment
ABSTRACT
Background: Tuberculosis is still one of the main causes of mortality and disability in developing countries. Despite of socio-economic development of communities and controlling majority of communicable diseases, With respect to importance and high incidence of Tuberculosis in marginal provinces, the present study was aimed to assess the epidemiology of Tuberculosis
Methods: In this Descriptive-Analytical Retrospective Study, documents of 6363 patients diagnosed with TB in the beginning of March 2005 to the end of the September 2012 in Khuzestan province, Iran, by used census sampling size, were used. Demographic variables and other necessity data were recorded by TB-Register software and then these data were analyzed by SPSS 16.0 software and Chi-square and independent t-tests with a significance level of less than 5%. For comparison Tuberculosis incidence in consecutive years used by Poisson tests [with a significance level of less than 5%]
Results: mean age of patients and median age of patients were 39.3+/-18 and 35+/-6.5 years, for women mean age was older 2.1 years than men and there was significant relationship to age [P=0.0001]
Of all patients 75.7% were pulmonary tuberculosis, 2.7% were infected with HIV and 91.2% were new cases. Cumulative incidence in province was 148.84/100,000. Most prevalent in Non-pulmonary TB was Lymphatic glands. Poisson test showed that changing trends of TB incidence in study years was statistically significant [P=0.05]
Conclusion: Increasing concurrent of HIV infection and TB and decreasing patients mean age [39.3+/-18] and median [35+/-6.5] in southwest of Iran has high prevalence. Screening, training and preventive activities for controlling of disease is highly recommended for the whole country and in margin provinces in particular
ABSTRACT
Approximately 1.8 million of the world's population is infected with both M.tuberculosis [TB] and HIV. HIV-seropositive patients with TB may have radiographically atypical presentations. This study aimed to determine whether there was any difference in radiological presentation of pulmonary TB between HIV-seropositive and HIV-seronegative patients. Information on 204 patients who were admitted with a diagnosis of pulmonary TB to the infectious ward of Razi Hospital, Ahvaz, between 2004 and 2008 was obtained from their records. They were divided into HIV-seropositive and HIV-seronegative groups. All clinical signs and symptoms and radiological findings were extracted from each patient file and recorded in a questionnaire. Normal thoracic radiography, pleural effusion, milliary pattern, and hilar and mediastinal lymphadenopathy were more common in the HIV-seropositive group. Pulmonary infiltration and cavitary lesions in Chest X-ray [CXR] were more frequent in the HIV-seronegative group. The prevalence of fibrosis in HIV-seronegative patients was higher than in HIV-seropositive subjects. Upper lobe pulmonary involvement in HIV-seropositive patients was less frequent than HIV-seronegative persons due to their immunodeficiency. Radiological presentation of pulmonary TB differs between HIV-seropositive and HIV-seronegative patients due to progressive immunodeficiency from HIV infection.