[Clinical Manifestations and mortality in neonatal septicemia; Children Medical Center]

To identify the clinical manifestations and mortality rate among neonates with early- and late-onset sepsis. We retrospectively reviewed the hospital records in Children's Hospital Medical Center, Tehran University of Medical Sciences of 104 neonates [50 females and 54 males] diagnosed with septicemia and treated from September 1994 to August 1995. Diagnosis of septicemia was based on standard criteria. According to the time of onset of disease, there were 50 neonate with early-onset and 54 with late-onset septicemia. Of the clinical signs in the 104 patients, respiratory signs were found in 31 patients, poor feeding in 57, jaundice in 42, apnea in 25 and hyporeflexia in 25. Blood cultures were positive in 31 [34.8%] of the neonates: the most common species isolated was Staphylococcus aureus with eight cases, while five had Staphylococcus epidermidis, all of whom had a single species of bacterium isolated. Seventy-three [70%] had normal birth weights [equal to or heavier than 2500 g] and 31 [30%] were classified as low birth weight [birth weight less than 2500 g]. Cerebrospinal fluid culture was positive in four [6%] of the patients, including one case of Escherichia coli, one Salmonella typhi, one Klebsiella, and one Staphylococcus aureus. The frequency of infection in male and female infants was 53% and 47%, respectively. Among the infants with early-onset sepsis, 16 [32%] were low birth weight. Overall, the mortality rate among these patients was 30%, including 18 out of the 50 with early onset and 14 out of the 54 with late onset sepsis. Of these infants, 23 had meningitis, including 13 [26%] with early-onset sepsis and 10 [9.6%] with late-onset sepsis. Among the low birth weight infants, the mortality rate was higher [42%] than that of the infants with normal birth weight [26%]. Because of the high mortality rate among low birth weight neonates with sepsis, we suggest that this group of patients should receive more care and there should be greater effort to ensure that they are treated with the appropriate antibiotics. Furthermore, all healthcare givers responsible for the management of neonates with sepsis should receive additional continuing education courses to ensure that they are aware of the risks, complications and mortality rate among these patients

[ investigation on the prevalence of intestinal parastitic infections in food handlers in Arak [Iran] during 2002-03]

Considering the main role of digestive system in human health, programs against alimentary infectious diseases is essential. Intestinal parasitic infections are important among infectious diseases in Iran. Since contaminated food is important in transmitting infections to human, we decided to study the intestinal parasitic infections in food handlers in Arak. Food handlers in Arak were categorized into five groups [Sandwich sellers, restaurants, ice-cream sellers, confectionaries and bakeries] in five different geographic areas in Arak. Stool samples were collected from 460 people [three times for each person] and examined for parasitic agents using Formaline-Ether Concentration Method. Using statistical methods, analysis was done to find the role of different variables such as age, education and so on in intestinal parasitic infections. The prevalence of intestinal parasitic infections was 43.7% in food handlers in Arak. Entamoeba coli and Blastocytis hominis were the most prevalent agants. Within pathogen parasites, Giardia lamblia was the most common [6.3]. No significant differences were seen between education and infection [P.value=0.261]. The high prevalence of intestinal parasitic infections in food handlers in Arak indicates the necessity of more consideration on health programs

[Effectiveness of glutaraldehyde in disinfecting of endoscopes]

Introduction and Objective: one of the main approaches for control of infections and preventing of nosocomial infection is by using antiseptics and disinfectants. There are reports regarding transmission of infection through those endoscopes which have not been properly disinfected. This study aimed to find out the effect of glutaraldehyde on those bacteria which might be transmitted by endoscope

Materials and Methods: samples were taken from the disinfectant in 14 days. The first days of sampling was considered as the activation day of the glutaraldehyde solution. Sampling was done on the cleaning machine every day after the end of each run for 14 days. The disinfectant have been circulated a total of 121 times in the washing machine which the endoscopes. Glutaraldehyde solution was tested for Staphylococcus aureus, Enterococcus, E.coli, Pseudomonas aeroginosa, Salmonella typhi and Mycobacterium tuberculosis in everyday

Results: results of this study show that after 20 min, the disinfectant had a proper complete effect on killing of the gram positive and negative bacteria. Effect of this disinfectant on Mycobacterium tuberculosis was somewhat different. At first we did not have any growth relating to the Mycobacterium tuberculosis but using the disinfectant 6 days its activation, the colonies started to grow in the culture media. We planned to study the number of times, which the disinfectant had cycled in the endoscopes washing machines. The results showed that after 74 times the disinfectant had lost its ability to kill Mycobacterium tuberculosis [even before 14 days]

Conclusion: glutaraldehyde loses its effectiveness on killing of M. tuberculosis if used in several cycles in endoscopes washing mashines

Organizing lobar penumonia: report of a case

Organizing Lobar Pneumonia is a rare form of Bronchiolitis Obliterans Organizing Pneumonia. Herein, we report a rare case of organizing pneumonia involving lung, mediastinum and esophagus. A 16-year-old girl was referred to our center with clinical signs and symptoms of dysphagia and weight loss. The main abnormal radiologic and endoscopic findings were stricture of the lower third of esophagus and calcified lobar pneumonia of the lung. Pathologic examination of biopsies taken from esophageal stricture and resected lung revealed fibrosis and organizing lobar pneumonia. This combination, to our knowledge, has not been reported previously