Prevalence and risk assessment of CA-MRSA nasal colonization in patients of loghman hospital Tehran, Iran

Community-associated methicillin-resistant staphylococcus aureus [CA-MRSA] is a serious pathogen and its nasal carriage is a risk factor for subsequent infections. This study aimed to determine the prevalence of and risk factors for CA-MRSA colonization at the time of hospital admission in our community. During 2007, patients admitted to the emergency department of Loghman Hakeem hospital were interviewed and anterior nares cultures were obtained within 24 hours of admission. A cross-sectional study and antibiotic susceptibility tests [E-Test] were performed. A positive culture of MRSA within 24 hours of admission was considered as CA-MRSA. Chi-square test was performed to assess associations between culture results and the studied risk factors, using SPSS version 15. 56 [14%] and 11 [2.7%] of 400 patients had a nare culture positive for staphylococcus aureus and MRSA, respectively. HIV infection [P = .001], nursing home residence [P = .033] and nasal anatomic abnormalities [p= .033] had significant association with CA-MRSA cultures. However, in logistic regression, no statistically significant association was found. 45% of MRSA cultures showed induced resistance to clindamycin on D-test. On tigacyline E-test, based on a 12|microgram/ml cutoff for susceptibility, 6 [54.5%] showed resistance. Our study showed CA-MRSA prevalence to be 2.7% and did not demonstrate any association between recent hospitalization, antibiotic use and IV drug abuse with CA-MRSA carriage status unlike other studies. This may have been a result of CA-MRSA low prevalence and a small sample size. We recommend a study with a larger sample size for appropriate evaluation of risk factors

[Prevalence of alloimmunization against RBC antigens in thalassemia major patients of Lorestan province in 1383]

Thalassemia major patients should continuously receive blood to survive. Permanent blood injection will expose patients' immune system to a broad spectrum of new antigens located on the surface of injected RBCs. Continuous exposure to foreign antigens may provoke antibody production against them in the patients who lack those Ags. This phenomenon is termed alloimmunization and can cause problems for preparation of compatible blood for transfusion. 65 patients were studied in this research. At first, questionnaires eliciting information about age, race, date of blood injection, splenectomy, presence of any underlying diseases, and any certain drugs[in patients' records] were filled out by all patients. For alloantibody screening, patients' serum samples were tested by the panels prepared in IBTO. Phenotypes of RBCs for Ags of ABH and Rh[D, C, E, c, e] were also determined by relevant antisera. Out of 65 patients, only one case [1.53%] had been allommunized. The age range of males and females were 13 +/- 6 and 13 +/- 5 respectively. All of the patients were of Lurish race. The first blood transfusion in all of them occurred at the age below 3. Seventeen subjects were splenectomized. The reasons for low prevalence of alloimmunization against RBCs in thalassemia major patients may pertain to similarity of patients and donors by descent, blood transfusion before the age 3, and splenectomy in a few patients. Identification of alloantibodies by using the panel cells was the best method to provide patients with antigen negative and compatible blood for transfusion