Profile of community- and hospital-acquired pneumonia cases admitted to Basra General Hospital, Iraq

Over an 18- month period 485 throat swabs and sputum samples were taken from patients admitted to Basra General Hospital, Iraq, with a clinical diagnosis of pneumonia. Most patients [94.0%] had community- acquired pneumonia; 29 [6.0%] had hospital- acquired pneumonia. Patients aged

Escherichia coli, Shigella and Salmonella species in acute diarrhoea in Hamedan, Islamic Republic of Iran

This study investigated the frequency of Escherichia coli, Shigella and Salmonella species in stool specimens from patients with diarrhoea presenting to health centres in Hamedan province, Islamic Republic of Iran. From 144 samples, Shigella strains were isolated in 17 cases [11.8%]: 10 Sh. flexneri, 3 Sh. sonnei, 2 Sh. boydii and 2 untyped strains. No Salmonella strains were isolated. Using molecular diagnostic methods, diarrheogenic E. coli were detected in 37 cases [25.7%], the majority were enterotoxigenic [ETEC] [22 cases] and Shiga toxin- producing [STEC] strains [15 cases]. In 14 cases [9.7%] there was co- infection

Urinary tract infection in infants and children with diarrhoea

To determine when children with acute diarrhoea should be investigated for urinary tract infection [UTI], we studied 120 patients and 120 healthy age- and sex- matched controls aged 4 weeks to 5 years. In those with positive or suspicious urine cultures, bacteriuria or pyuria, urine culture was repeated. We detected UTI in 8 patients [all < 2 years] and 1 boy in the control group. In those with UTI, invasive diarrhoea was observed in 1, fever in 7 and vomiting in 5 patients. In children with acute diarrhoea, investigation for UTI is only recommended for febrile, female infants aged 5- 15 months

[Retrospective study on the isolated strains of Salmonella in an Iranian hospital in Kermanshah]

A survey of occurrence of Salmonella in blood and bone marrow cultures was conducted in 1989- 1990 and 1999- 2000 [Sina hospital, Kermanshah]. A total of 496 [12.3%] and 60 [2.4%] Salmonella strains were isolated [from 4020 and 2447 cultures]. In 1989- 1990, the isolated strains were: S. typhi 448 [98.5%], S. paratyphi A 40 [8%], S. paratyphi B 5 [1%] and S. paratyphi C 3 [0.5%]. In 1999- 2000, the isolated strains were S. typhi 59 [98%] and S. paratyphi B 1 [1.5%]. There was a 60.9% reduction in the number of specimens over the 2 periods. The rate of Salmonella isolation fell from 12.3% [1989- 1990] to 2.4% [1999- 2000]. There was a 10.2, 8.3 and 6.6 times increase in resistance of S. typhi strains to ampicillin, chloramphenicol and trimethoprim- sulfamethoxazole respectively

Primary and acquired drug resistance in childhood tuberculosis

This study determined the resistance pattern of Mycobacterium tuberculosis to 4 first-line anti-tuberculosis drugs in children with pulmonary tuberculosis at the Iranian National Research Institute of Tuberculosis and Lung Diseases from 1999 to 2004. There were 350 children with positive cultures over the study period: 7 [2%] were resistant to at least one of the 4 anti-tuberculosis drugs. Primary resistance was detected in 4 cases and secondary resistance in 3 cases. Most cases [6] were among Afghan refugees. Resistance to rifampicin both in primary and secondary resistances was high, showing that children in the Islamic Republic of Iran face the threat of drug-resistant tuberculosis transmission

Prevalence of bacteria in urenary tract infections among children

The aim of the study was to identify the most common bacteria responsible for the UTI's among the hospitalized children of various sex and age groups. The study was carried out in the Microbiology section of The Children's Hospital and Institute of Child Health, Lahore during July to October 2004. A total of hundred positive samples were included in this study. The pure growth of bacteria was isolated by inoculating the specimens on Cysteine Lactose Electrolyte Deficient [CLED] Agar. The organisms were identified with the help of biochemical testing. The most frequently isolated organisms in this study were E. coli and Klebsiella [both 37%], followed by pseudomonas [23], Proteus, Staphylococcus aureus and Acinetobacter 1% each]

[ survey of contamination with genital mycoplasma in women with bacterial vaginalis by PCR method]

Genital mycoplasmas can cause infection of the genitourinary tract. These organisms are associated with bacterial vaginosis, pelvic inflammatory disease, endometritis, cervicitis, Nongonococcal urethritis. Spontaneous abortion, premature birth, neonatal pneumonia and meningitis, and infertility. The aim of this study was to determine the ability of PCR method for diagnosis and identification of genital mycoplasma in culture negative samples taken from women suffering from bacterial vaginosis. 174 genital samples were taken from women suffering from bacterial vaginosis during January until December 2005. Two genital swabs were taken from each patient. One of them was cultured on the mycoplasma specific media for isolation of mycoplasma. The other swab was immersed in PBS buffer and frozen until DNA extraction. To detect the presence of mycoplasma and ureaplasma in genital DNA Samples: a 520-bp fragment of the 16S rRNA was amplified. The specific primers used for this purpose were: MGSO, UGSO, MY- ins. From 174 samples,71 samples [40.8%] were positive by culture for mycoplasma and ureaplasma. From 103 culture negative samples. According to PCR results, 14 samples [13.6%] were positive and 89 Samples [86.4%] were negative for mycoplasma and ureaplasma. This study showed that PCR method is more sensitive than culture for detection genital mycoplasma, Therefore PCR is a rapid, sensitive and easy method to detect genital mycoplasmas in urogenital swabs

Borrelia recurrentis as a cause of high grade fever in Rawalakot, Azad Kashmir

A descriptive study was conducted at Combined Military Hospital Rawalakot, Azad Kashmir to determine the frequency of Borrelia recurrentis. Both out door and indoor cases were included. A total of 80 febrile patients with temperature above 1000C were studied. Cases showing any other cause of fever on routine / available tests were excluded. Borrelia recurrentis was sought by Giemsa stain. All positive cases were treated with Doxycycline. Nine cases were positive [11.25%]. Treatment response was 100%. Borrelia recurrentis is found in a significant number of febrile cases at Rawalakot Azad Kashmir

Etiologic agents of cervicovaginitis in Turkish women

To investigate the distribution of microbiologic agents causing cervicovaginitis. We conducted the study between October 2002 and December 2004 in Abant Izzet Baysal University, Duzce School of Medicine Hospital, Turkey. The samples were obtained from the posterior vaginal fornix and cervix by swabs in 828 patients. Direct microscopic examination, culture and enzyme immune assay [EIA] methods were performed in all patients for diagnosis of microbiologic agents. Gardnerella vaginalis [G. vaginalis] were diagnosed in 254 [30.7%] patients, Candida albicans [C. albicans] in 152 [18.4%], Candida glabrata [C. glabrata] in 36 [4.3%], Candida species in 52 [6.3%], Staphylococcus aureus [S. aureus] in 62 [7.5%], Streptococcus group B in 28 [3.4%], Escherichia coli [E. coli] in 42 [5.1%], Klebsiella species in 24 [2.9%], and Streptococcus group D in 8 [1%] patients in culture. Less frequent enterobacteria in 30 [3.6%] were: Pseudomonas species, Proteus species Enterobacter species, Hafnia alvei and Nonfermenter species. Neisseria gonorrheae [N. gonorrheae] was detected in one patient [0.1%] in culture. The Chlamydia trachomatis [C. trachomatis] antigen was detected by EIA methods in 130 [15.7%] patients and Trichomonas vaginalis [T. vaginalis] was observed in 8 [1%] patients by direct microscopic examination. Performing the etiologic diagnosis of cervicovaginitis is necessary in order to take appropriate therapeutic and preventive measures. Therefore, we recommend G. vaginalis, C. albicans and C. trachomatis should be investigated in patients having a diagnosis of cervicovaginitis in our population, since these were detected in a considerable number of cases. Additionally, C. glabrata and T. vaginalis should be kept in mind as possible pathogens

Results of aerobic culture and antibiogram in 105 patients with acute bacterial pharyngitis

To study throat culture and antibiogram results in treatment of acute pharyngitis. 105 Patients with acute phartngitis were included in this prospective study. From all of the patients throat culture and gram-stained smear were provided. Antibiogram was done in patients with posit throat culture. 63 Patients of 105 patients [59%] gave negative throat culture and gram stained smear from pharyngeal secretions. 20 Patients [19%] have positive throat culture and gram stained smear. 12 Patients [12%] have positive throat culture and negative gram stained smear. Therefore 32 patients [31%] of 105 patients have bacterial pharyngitis. Fever, pharyngeal and tonsillar purulent exudates and adenopathy in patients with positive throat [31%] was more common than patients with negative throat cultures [69%]. The most common cause of bacterial pharyngitis was group A betahemolytic streptococcus. Antibiogram findings revealed that bacterial pharyngitis such as streptococcal, staphylococcal and pneumococcal were completely resistant penicillin, Amoxicillin and Ampicillin that are used routinely in out patient clinics, and on the other hand were sensitive to unusual antibiotics in treatment of acute bacterial pharyngitis. Including Doxycicline, Vancomycin and Erythromycin and they are better alternatives

Biodegradation of MTBE by a microorganism consortium

Methyl Tert-Butyl Ether [MTBE] is one of the ether oxygenates which its use has been increased within the last twenty years. This compound is produced from isobutylene and methanol reaction that is used as octane index enhancer and also increases dissolved oxygen in gasoline and decreases carbon monoxide emission in four phased motors because of better combustion of gasoline. High solubility in water [52 g/L], high vapor pressure [0.54 kg/cm3], low absorption to organic carbon of soil and presence of MTBE in the list of potentially-carcinogens of U.S EPA has made its use of great concern. The culture media used in this study was Mineral Salt Medium [MSM]. The study lasted for 236 days and in three different concentrations of MTBE of 200, 5 and 0.8 mg/L. A control sample was also used to compare the results. This research studied the isolation methods of microbial consortium in the MTBE polluted soils in Tehran and Abadan petroleum refinery besides MTBE degradation. The results showed the capability of bacteria in consuming MTBE as carbon source. Final microbial isolation was performed with several microbial passages as well as keeping consortium in a certain amount of MTBE as the carbon source

Direct urease test and acridine orange staining on bactec blood culture for rapid presumptive diagnosis of brucellosis

Brucellosis is one of the most common zoonotic diseases in Iran and human brucellosis is endemic in all parts of the country. Growth of Brucella is slow and blood culture of these bacteria by use of classical methods is time-consuming. Furthermore, in endemic area culture is required for definitive diagnosis. In the present study, direct urease test and acridine orange staining were tried on the BACTEC blood culture broths for early presumptive identification of Brucella growth. Blood cultures were attempted in 102 seropositive patients. In the forty one blood cultures positive for Brucella, coccobacilli were seen in broth smears stained with acridine orange stain, and also were urease test positive, thus providing presumptive identification of Brucella growth. Urease test was negative and bacteria were not seen in the broth smears of the remaining 61 broths negative for Brucella growth. Because of simplicity, reliability and reproducibility, these tests can be routinely incorporated in the laboratory for diagnosis of brucellosis

Bacterial infections in renal transplant recipients

Urinary tract infection [UTI] is considered as one of the important bacterial infections seen among renal transplant recipients. In the present study, bacterial urinary tract infections in renal transplant recipients were investigated. Eighty-seven renal transplant recipients [57 males and 30 females] were included to study the bacterial UTIs. Clean- catch midstream urine specimens were obtained from patients and studied using microscopic analysis and culturing on appropriate bacteriologic media. Bacterial isolates were identified by standard biochemical and serological tests. UTIs were diagnosed in 29 percent of patients [18 males and 11 females]. The most common causative bacterial strains were coagulase negative Staphylococci [31%] and Entrobacter spp [20.7%]. The results showed that all of Proteus spp, Pseudomonas spp, Klebsiella spp, and Enterococcus spp were resistant to most of tested antibiotics, so this research reflects that these multiple resistant bacteria can be accounted as the most cause of UTI in renal transplant recipients

Comparison of occurrence and antimicrobial susceptibility rates in common bacterial urinary tract infections isolates from patients at Firouzgar Hospital [Tehran Iran] between 1997-1998 and 2003-2004

Urinary tract infections [UTIs] remain a worldwide infection problem. Geographic variations in pathogen frequency and susceptibility profiles require monitoring to provide information to guide new therapeutic options. The aims of this study were to assess the changes of the prevalence and susceptibility patterns of UTI bacterial pathogens, over a 6-years period. Retrospective study of prevalence of bacterial pathogens and their susceptibility patterns by the disc diffusion technique, was done as defined by the National Committee for Clinical laboratory Standards [NCCLS] which were isolated in cultures of urine of adult patients of Firouzgar Hospital, in 1997-1998 and 2003-2004. Out of 2914 and 3895 urine specimens, 309 [10.6%] and 853 [21.9%] were culture positive in 1997-1998 and 2003-2004, respectively. E coli was the most common urinary isolate [42.1% and 46.9%] in these years. The antibiotic susceptibility rates for all gram negative bacilli in 1997-98 and 2003- 2004 were: Amikacin [87.7%, 94.7%], Ciprofloxacin [91.4%, 87.1%], Nitronirantoine [66.8, 52.9%], Nalidixic Acid [73.1%, 62.6%], Co-trimoxazole [37.5%, 30.6%], Tetracyclin [27.9%, 6.2%], Ampicillin [4%, 1.1%], Gentamicin [72.1%], Ceftizoxime [72.5%] Also the antibiotic susceptibility rates, commonly in community acquired UTIs, were higher than nosocomial UTIs. Overall susceptibility testing demonstrated decreased usefulness of common antibiotics which indicate need to monitoring antibiotics susceptibility and re-evaluation of antibiotics used in the therapy of UTIs. Also strict control on the use of antibiotics and appropriate measures against over the counter availability and self medication is recommended

Comparing transesophageal echocardiography and transthoracic echocardiography for diagnosis of infectious endocarditis

Infectious endocarditis [IE] is caused by a variety of microbial agents and poses severe complications such as embolic and septic events. This condition is aggravated among elderly patients and is associated with a high morbidity rate. Recent advances in diagnostic modalities, especially transesophageal echocardiography [TEE] have revolutionalized early diagnosis, prediction of emboli, treatment and evaluating the outcomes of interventions. In this article, we explain our experience with 4 cases of infectious endocarditis. Having had the clinical suspicions to IE, patient underwent routine diagnostic procedures including transthoracic echocadiography [TTE] and blood culture. Surprisingly, TTE was negative for all patients; however, the clinical symptoms and the presence of complications were favoring IE, therefore, all were subjected for TEE. TEE confirmed the diagnosis of IE in all 4 cases. There were mitral valve vegetations measured 0.5-3cm in three cases, whereas the other one presented with aortic valve vegetation measured 1cm. Three patients had blood culture positive for staphylococcus aureus and one patient with aortic valve vegetations had enterococcus positive blood culture. All patients had developed various complications and one had splinter hemorrhage. Two patients underwent surgical valvuloplasty, however, one of them was re-operated for splenectomy due to splenic abscess. All patients received an appropriate antibiotic regimen including vancomycine and cefteriaxon and were discharged in satisfactory state. Patients were routinely admitted for follow up TEE, while none developed symptoms or complications compatible with IE. Our results revealed that TEE is significantly superior to TTE for diagnosis and follow up of IE

Prevalence of tuberculosis in patients with chronic cough

Identifying cases of pulmonary TB and their prompt treatment is an effective tool in order to control TB. Chronic cough is an important sign for screening tuberculosis. This study was performed to evaluate the prevalence of tuberculosis in patients with chronic cough. In this cross sectional study, 546 suspicious patients with chronic cough were evaluated by preparing sputum smear and culture and chest radiography, when appropriate. Of 546 cases, 53.7% were male and 46.3% were female. Totally, 80 [15.6%] had smearpositive pulmonary TB, 39 [7.7%] had smear-negative pulmonary TB, and 427 [77.7%] had other diagnosis or were improved cases following antibiotic therapy. Results have revealed that 15% of sputum cultures were positive for acid fast bacilli that is quite higher than other reports, therefore, patients who are referred with chronic cough and do not respond to antibiotic, should be advised to perform sputum culture and chest radiography

Effect of centrifugation of milk samples on bacteriologic culture

In this study the frequency of isolation of bacteria from quarter milk samples were compared with the frequency of recovery of bacteria from sediment after centrifugation of the same samples. A total number of 52 quarter milk samples that had normal appearance from 20 cows were obtained prior to milking, taken from four problematic herds. The results of bacteriological culture showed that culture of sediment of quarter milk samples increased the number of positive samples to 154.5% [P<0.01]. Centrifugation could enhance sensitivity of standard bacteriological culture methods, especially in the case of milk samples from sub-clinical mastitis in which they were infected and in cattle shedding bacteria at concentrations not detected by the use of standard bacteriologic techniques

Comparative evaluation of different selective media for isolation of Helicobacter pylori from gastric biopsies

Four selective [Dent's, Egg Yolk, Glupezynski's, Skirrow's] media and the non selective blood agar were evaluated for the isolation of Helicobacter pylori from 42 antral biopsy specimens of 42 patients, with various upper gastrointestinal tract conditions. From the same enrollees other 42 biopsy specimens were tested for urease activity at room temperature. The organism was isolated from 31 biopsy specimens [73.8%], however none of the media revealed all the 31 isolates. The Dent's medium showed the highest sensitivity [77.4%], followed by the Egg yolk medium [61.3%] the two media together had sensitivity of 100% for Helicobacter pylori isolation. The urease test was 100% sensitive but 90.91% specific. The utilization of Dent's and Egg yolk media is recommended during culture of biopsy specimens, for the maximum isolation of the organism. The urease test must only be taken as a predictive preliminary test