Drug resistance of acinetobacter in selected hospitals

Nowadays, nosocomial infection with multidrug-resistant Acinetobacter is an important problem in the world, which is facing wide spectrum antibiotics and hence has become resistant. In this study, positive cultures of Acinetobacter from one hundred clinical samples in seven hospitals from Tehran during 2012-2013 were collected for checking antibiotic susceptibility. Samples test with Ceftazidim, Cefepime, Amikacine and Imipenem by E-test and for Tazocin, Colistin and Tigecycline was performed with disk diffusion method. For Colistin 10 samples, and for Tazocin, 40 samples were performed by E-test method. Then boumannii species of bacteria and non-baumannii Acinetobacter were separated by PCR and antibiotic susceptibility testing was performed on them. 89% of Acinetobacter samples were boumannii species, which was isolated from respiratory secretions at ICU. Boumannii and non-boumannii species of bacteria with a high percentage were resistant to Ceftazidim, Amikacine, Cefepime, Tazocin and Imipenem. All baumannii and non-boumannii Acinetobacter were sensitive to Colistin, were only 75% sensitive to Tigecycline, which is a new glycylcycline. Colistin and Tazocin results in samples limited to the E-test method were similar with disk diffusion

[ relation between hepatitis B antibody and number of hepatitis B vaccinations in the personnel of a hospital in Tehran]

Hepatitis B is one of the most prevalent chronic and persistent hepatitis infections which may lead to chronic hepatitis and hepato-cellular carcinoma. Since hospital personnel are more susceptible to hepatitis B this study was done to determine the relation between number of hepatitis B vaccinations and the presence of anti HBS antibody in personnel working in a large hospital in Tehran. This was a cross-Sectional study conducted in 2010 on 530 personnel working in Khatam-ol-Anbiya Hospital. Blood samples were collected from the subjects selected through convenience sampling and the level of anti-HBS antibody checked: antibody levels >10 mIU/ml were considered to be protective. Antibody levels were less than the stated cut-off in 78 individuals, [14.7%]. Mean antibody levels were 9.5 mIU/ml in the 27 unvaccinated persons; 86.6 mIU/ml in 7 individuals who had received the vaccine only once; 160 mIU/ml in the 32 who had been vaccinated twice; 192 mIU/ml after 3 doses of the vaccine in 276 persons and in the 58 subjects who had received >3doses, the mean level of the antibody was 321 mIU/ml, [p=0.001]. Anti-HBS antibody levels show a significant rise after repeated vaccinations

Elicitation of IgY in chicken egg yolk by recombinant fragments of UreC and its efficacy against Helicobacter pylori

Helicobacter pylori multiplies and causes infection in human gastric mucosal layer. New approaches have focused on using specific treatments, such as immunotherapy, to limit this infection. Urease, as one of the most important virulent and antigenic factors of the bacterium, is a suitable target for this purpose. In order to prepare recombinant proteins, the synthetic genes for total ureC protein [UreCt] and its N [ureCn] and C [ureCc] terminal fragments were ligated into pET28a. The recombinant proteins were expressed in E. coli BL21[DE3]. White leghorn hens were injected with the purified recombinant proteins. IgY recovered from egg yolk, using PEG precipitation. Finally, urease neutralizing ability of the antibodies was evaluated by urease activity assay in presence of the purified IgY. SDS-PAGE analysis revealed a good expression and purification of the recombinant proteins. Indirect ELISA observation demonstrated high antibody titer in sera and egg yolks and high ability of IgY Anti-UreCt and IgY Anti-UreCc antibodies in recognition of urease subunit C. Anti-UreCT and Anti-UreCc IgYs were more potential H. pylori urease inhibitors than Anti-UreCn. While all three UreC fragments induce prophylactic responses. UreCt and UreCc possess almost equal responses. Anti-UreCc IgY has advantage of smaller size and is preferred for its activity and easier protein recovery and purification process. These features emphasize on importance of simpler, easier and cost effective antibody production

Pneumonitis due to cytomegalovirus in an immunocompromised patient

Cytomegalovirus [CMV] pneumonia is one of the most important infections in immunocompromised host. Immunosuppressive therapy plays a major role in reactivation of CMV. The patient was a 56-year old lady, known case of chronic lymphocytic leukemia [CLL], had been taking prednisolone and chlorambucil, who presented with dyspnea and productive cough. After bronchoalveolar lavage [BAL], transbronchial lung biopsy [TBLB] and CT-guided biopsy, CMV pneumonia was diagnosed. CMV should be suspected as a cause of pneumonia in immunocompromised patient and diagnosis may require invasive procedures

Increase in prevalence of vancomycin resistant isolates of Enterococcous faecium at Labbafinejad hospital

Vancomycin resistant isolates of Enterococcous faecium [VRE] have previously been reported from Tehran Hospitals. However, little data were available on the genetic heterogeneity of VRE isolates among the Iranian population. Therefore the emergence of infections with the new clones of VRE needs to be investigated. The drug resistance surveillance program at Labbafinejad hospital has to be continued. Overall, 103 non-replicative isolates of enterococci grown from urine samples in the first quarter of 2005 were screened for their susceptibilities to different antibiotics. Ribotyping was then used to genetically characterize the isolates of VRE. Using disk diffusion method, all isolates were found susceptible to linezolid. Resistance to high level concentration of gentamicin was detected in 65.7% of isolates. All isolates of F. faecalis [n=86] were susceptible to vaneomycin. Conversely, over 70% of E. faecium isolates [n=12] showed resistance to this glycopeptide. The VRE isolates recovered from patients in 2005 were heterogeneous comparing with those of 2000. Conventional bacteriology confirmed the increase in the rate of VRE. It appears that a variety of new VRE clones have arisen recently at different wards of this hospital as determined by ribotyping

Invasive aspergillosis of pituitary gland in an immunocompetent patient

Invasive aspergillosis is a major cause of morbidity and mortality in immunosuppressed patients. This infection is caused by Aspergillus, a hyaline mold, which is the etiologic agent for many different manifestations. A 63 year old diabetic housewife woman, living in northern Iran, presented with the history of right eye ptosis after a mild head trauma since about 3 weeks ago. She had positive history of intermittent headache several weeks before ptosis. On physical examination, the patient was afebrile and other vital signs were normal. Brain MRI showed a pituitary mass measuring about 4 cm. Pathological study showed hyphae in favor of aspergillosis. Amphotericin B was started and after 10 days changed to itraconazole. It is important to consider fungal infection as a differential diagnosis of cerebral lesions even in the immunocompetent hosts. The clinical presentation of cerebral aspergillosis is nonspecific and is characterized by focal neurologic signs, alteration in mental status and headache