RESUMO
Background and aim: Neisseria meningitidisis is a cause of some serious disease like Meningitis which can rapidly lead to death. The Majority of person suffering from Meningitis have not had any contact with patients and it seems that asymptomatic carriers are the main source of diseases. This descriptive study aimed to investigate the prevalence of nasopharyngeal Neisseria meningitidis carriers and antibiotic resistance in preschools and primary schools children in Kermanshah.
Material and methods: in this cross-sectional study, 554 kindergartens and schools children with a range of 2-12 years were recruited from different regions of Kermanshah, during November to March 2012. Samples were collected using a sterile swab from the back part of the pharynx [the area of the palatine tonsils] with prevention of contacting with teeth and transported to the laboratory in transport environment. After this, they were cultured on a selective culture medium which followed by performing confirmatory and antibiotic resistance tests to determine the antimicrobial susceptibility.
Results: the prevalence of Neisseria meningitides was investigated 10.6% among 554 healthy children with a mean age of 7.4 years, The resistance percentage of isolated samples to Azithromycin, Amoxicillin, Rifampin, Amoxicillin clavulanic acid, Cotrimoxazole and Ceftriaxone was 54.2 %, 100 %, 6.8 %, 96.6 %, 54.2%, 13.6%, respectively.
Conclusion: the increasing use of antibiotics has led to a high level of antibiotic resistance, particularly Azithromycin, Amoxicillin, Rifampin, Amoxicillin clavulanic acid and Cotrimoxazole, which indicates the necessity of educating physicians and general population regarding indiscriminate usage of antibiotics.
RESUMO
The infection in the neonatal period is a significant cause of mortality in the preterm neonates. The transfer of the immunoglobulin from mother to fetus occurs mainly after 32 to 34 weeks of gestation. Therefore, preterm neonates are relatively immune compromised. The aim of the study was to evaluate the impact of intravenous immunoglobulin on mortality rates reduction in preterm neonates. A randomized clinical trial conducted from Jan2008 to July 2009 in Imam Reza hospital of Kermanshah - Iran. The population was 40 preterm neonates with gestational age less than 34 weeks admitted in the NICU with probable sepsis [clinical sepsis + Lab test]. They have been divided into two case and control groups with 20 subjects in each group. The case group received 500 mg/kg intravenous immunoglobulin during first 24 hours of admission in addition to routine treatments, which were the same in both group. Before and 6 hours after administration of intravenous immunoglobulin serum level of IgG was measured in treatment group. Then data were analyzed with SPSS software and Fisher's exact test and Chi [2] test were analyzed. Mortality rate was higher in control than treatment group, but it was no statistically significant. There were not significant differences in variables including the need for ventilation, exchange transfusion, admission duration and positive blood culture. Serum IgG levels significantly increased after administration of immunoglobulin in treatment group [p=0.001]. Using intravenous immunoglobulin in the treatment of sepsis increased serum level of IgG but did not effect on mortality rate and admission duration in preterm neonates