ABSTRACT
BACKGROUND: Viral infections are the most common cause of opportunistic infections after kidney transplantation. Among hepatotropic viruses that induce kidney graft failure and rejection, hepatitis B virus (HBV) has an important and critical role. Extrahepatic HBV-related disorders increase morbidity and mortality in kidney transplant recipients. OBJECTIVE: To analyze the molecular prevalence of HBV infection in kidney transplant recipients and donors before and after transplantation. PATIENTS AND METHODS: This cross-sectional study included 273 serum samples collected between 2005 and 2008 in 96 kidney transplant recipients and 59 donors. Detection of HBV DNA was via amplification of the S gene fragment of HBV genome using a qualitative simple polymerase chain reaction assay. Also analyzed were statistical relationships between HBV infection and laboratory and clinical demographic data in all kidney transplant donors and recipients. RESULTS: The HBV genome was detected in 102 of 273 serum samples. Molecular HBV infection was demonstrated in 2 of 13 serum samples (15.4%) from recipients tested before transplantation. HBV DNA was detected in 42 of 96 patients (43.7%) after kidney transplantation. The HBV genome was demonstrated in 21 of 59 donors (35.6%).Significant relationships were observed between HBV infections and hematologic and biochemical indices after kidney transplantation. CONCLUSION: Detection of a high molecular prevalence of HBV infection in kidney recipients enforces the importance of HBV infection in clinical outcome.
Subject(s)
Hepatitis B virus/genetics , Hepatitis B/complications , Kidney Failure, Chronic/complications , Kidney Transplantation/methods , Adolescent , Adult , Aged , Child , Cross-Sectional Studies , DNA, Viral/genetics , Female , Genome, Viral , Humans , Male , Middle Aged , Polymerase Chain Reaction , PrevalenceABSTRACT
BACKGROUND: Risk factors for colonization with vancomycin-resistant enterococci (VRE) vary by population and locale. The objective of this study was to determine the prevalence of and risk factors for VRE colonization in children with acute lymphoblastic leukemia (ALL) in Tehran. METHODS: Stools were collected from children with ALL at the Ali Asghar Children's Hospital and the Mahak Pediatric Oncology Center between March 2007 and October 2008. Demographic features and potential risk factors for VRE colonization, including duration of ALL, presence of severe neutropenia in the preceding month, receipt of antibiotics in the preceding 3 months, concurrent medical problems, days of hospitalization, and the need for intensive care since the time of diagnosis of ALL, were recorded. RESULTS: VRE was identified from stools in 33 of 130 children with ALL (25%). No clear risk factors were identified for VRE colonization in the current study, but there was a trend towards an increased prevalence in children admitted to the intensive care unit since their ALL diagnosis (p=0.07). The VanA genotype was found in 28 of the 33 stools (85%), with all other enterococci being VanB. CONCLUSIONS: The prevalence of VRE colonization in children with ALL in Tehran is high. Modifiable risk factors have not been identified. The implementation of routine surveillance for colonization and an increased emphasis on adherence to standard infection control precautions may prevent spread.
