Showing 8 results for Pneumonia
Mohtaram Nasrollahi , Mahdi Sharif, Ali Reza Khalilian,
Volume 6, Issue 1 (3-2003)
Abstract
Introduction: The aim of this study was to investigate the prevalence of pneumococcal infections, to determine penicillin and ceftriaxone susceptibility pattern among Streprococcus pneumoniae and to evaluate the risk factors of acquisition of pneumococcal infections in patients of Sari hospitals.
Materials and Methods: In this prospective study during one year (2002-2003), all patients admitted with pneumococcal infections in teaching and non-teaching hospitals were included. Diagnosis of pneumococcal infection was performed based on positive microbiological and appropriate clinical and standard laboratory findings. MICs of penicillin and ceftriaxone were determined by Agar dilution method and interpreted by NCCLS methodology. For statistically analysis Chi-square and Fisher's exact tests were used and P<0.05 was defined statistically significant.
Results: Seventy five episodes of pneumococcal infections among 32 pediatric patients and 43 adults were identified. The pattern of Streprococcus pneumoniae infections were similar between children and adults, and the most common infections were pneumonia (65.3%) and bacteremia (24%). The rate of penicillin and ceftriaxone nonsusceptible Streprococcus pneumoniae isolated from pediatric patients was higher than that in adult patients (93.8% versus 53.4%, P<0.01). This finding was correlated to prior penicillin use that was more common in children (37.5%) than in adults (7%). P=0,001. The susceptibility pattern of Streprococcus pneumoniae to penicillin and ceftriaxone isolated form pediatric patients and adults was different (6.2% from children, 46.6% in adults, P=0.0009). Eighty four percent of adults and 6.2% of pediatric patients had major underlying diseases (P<0.0001). This findings explain why adult patients tended to run higher mortality (30.2%) than children (6.8%).
Conclusion: This survey emphasis on vaccination of young children and elderly with major underlying diseases to prevent pneumococcal infections.
Hadi Darvishi Khezri, Tahmasebi Homeyra ,
Volume 17, Issue 10 (1-2015)
Abstract
Background: Ventilator-associated pneumonia is the most frequent infection occurring in mechanically ventilated patients in the intensive care unit. Ventilator-associated pneumonia is a serious issue and remains a significant clinical problem for critically ill patients. The aim of this review article is to evaluate studies to conclude the best existing evidence for providing oral hygiene to intensive care unit patients receiving mechanical ventilation, determine the clinical evidence considering chlorhexidine, and to document a research to improve care interventions used for oral care in the critical patients.
Materials and Methods: Searching was performed in the databases: Sciencedirect, SID, CINAHL, Google Scholar, Cochrane Library, Springer and PubMed for accessibility to the studies carried out regarding with chlorhexidine mouthwash and ventilator-associated pneumonia between 1991 to 2014 years by using keywords: chlorhexidine mouthwash and ventilator-associated pneumonia.
Results: Although oral care with chlorhexidine cause a reduce the incidence of ventilator-associated pneumonia, but no evidence exists on decrease of mortality in patients undergoing mechanical ventilation admitted in the intensive care unit following its using. Conclusion: Base on this current review article can be said that protective effect of chlorhexidine mouthwash has proved in oral health and prevention of ventilator-associated pneumonia in the critical patients, but unfortunately no evidence exists to the appropriate protocol for using of chlorhexidine mouthwash in these patients.
Mohammad Hosein Feiz Sarshar, Alisha Akya,
Volume 19, Issue 2 (5-2016)
Abstract
Background: The dissemination of extended-spectrum β-lactamases (ESBL) in Klebsiella pneumoniae isolates has resulted in the increase of antibiotic resistance and mortality among patients. The aim of this study was to determine the prevalence of ESBL and SHV-2a, SHV-5 and SHV-12 genes in K. pneumoniae isolates from Kermanshah.
Materials and Methods: In this descriptive – analytical study, from 112 clinical samples of patients admitted at Kermanshah medical centers in 2014, 60 K. pneumoniae isolates were recognized by standard methods of bacteriology and API Kit. Antibiotic susceptibility of isolates was determined by disk diffusion method and the isolates were screened for ESBL-producerig using the combination disc method. The SHV-2a, SHV-5 and SHV-12 genes were determined among isolates using PCR method. Primers were designed in this study.
Results: Of 60 isolates tested, the highest and the lowest resistance was for ampicillin and carbapenem antibiotics, respectively. Forty-five percent of isolates were ESBL-producer. Among 60 isolates tested, 5 (8.3%), 57 (95%) and 43 (71.7%) isolates contained SHV-2a, SHV-5 and SHV-12 genes, respectively. Five isolates contained all the three genes of SHV-2a, SHV-5 and SHV-12.
Conclusion: The results indicate the relatively high prevalence of SHV type beta-lactamase genes in K. pneumoniae isolates in Kermanshah. Given this high prevalence, the surveillance of antibiotic resistant patterns and relevant genes is necessary among gram-negative bacilli in Kermanshah region. Due to the high resistance of K. pneumoniae isolates to antibiotics and to reduce the dissemination of resistant genes, susceptibility testing to choose more affective antibiotics is recommended even for isolates from outpatients.
Mohsen Heidary, Aghil Bahramian, Hossein Goudarzi, Gita Eslami, Ali Hashemi, Saeed Khoshnood,
Volume 19, Issue 4 (7-2016)
Abstract
Background: The efflux pumps are one of the main mechanisms of resistance to antibiotics in E. coli and K. pneumoniae strains. The aim of this study is to study the association between genes coding efflux pumps AcrAB and Qep A and ciprofloxacin resistance among E. coli and K. pneumoniae clinical strains
Materials and Methods: This study was done on 100 strains of E. coli isolated from Taleghani and Labbafinejad Hospitals and 100 strains of K. pneumoniae isolated from Taleghani and Mofid Children Hospitals. Antimicrobial susceptibility tests were performed by disk diffusion method based on CLSI guidelines. Identification of genes encoding efflux pumps Acr AB and Qep A was done by PCR technique.
Results: In this study, fosfomycin and imipenem had the best effect against E. coli clinical isolates and fosfomycin and tigecycline had the best effect against K. pneumoniae clinical isolates. PCR assay demonstrated that the prevalence of AcrA, AcrB and QepA genes among E. coli isolates were 92%, 84% and 0%, respectively and among K. pneumoniae isolates were 94%, 87% and 4%, respectively.
Conclusion: The prevalence of genes encoding efflux pumps in E. coli and K. pneumoniae clinical strains, which causes resistance to fluoroquinolones, is cause for concern. Therefore, controlling infection and preventing the spread of drug-resistant bacteria needs to manage medication carefully and identify resistant isolates.
Homeyra Akbarzadeh, Abbas Alipour, Abolfazl Firuozian, Hadi Darvishi Khezri, Ghahraman Mahmoudi,
Volume 19, Issue 12 (3-2017)
Abstract
Abstract
Background: Ventilator-associated pneumonia (VAP) is one of the most important causes of mortality in intubated traumatic patients admitted in ICU. The aim of current study was to determine correlation between blood products transfusion with incidence of VAP in traumatic patients under mechanical ventilation in ICU.
Materials and Methods: This study was a prospective descriptive-analytical study. Current study was carried out on traumatic patients under mechanical ventilation admitted to Imam Khomeini hospital ICU wards of Sari city, from September 2015 to September 2016. In addition to demographic data, patients' clinical information were daily recorded.
Results: Of total of 2304 patients admitted to ICU, 186 traumatic patients under mechanical ventilation longer than 48 hours were reviewed and analyzed. Among patients infected with VAP, 36 persons(87.8%) had transfusion of blood products before VAP incidence. Blood products transfusion (before and / or after 48 hours) had the highest adjusted risk ratio in the incidence of VAP (Odds ratio; OR=3.58). Also, amount of injected Packed Red Blood Cells and platelet were significantly higher in patients infected with VAP (p<0.005).
Conclusion: Considering remarkable increase in incidence of VAP following blood products transfusion and its correlation with injected PRBC and platelet, considering these modifiable risk factors for controlling and preventing the incidence of VAP in traumatic patients under mechanical ventilation in ICU is necessary and reasonable.
Abdollatif Moini, Leila Mehraban,
Volume 22, Issue 2 (6-2019)
Abstract
Background and Aim: Mucormycosis represents a group of life threatening infections caused by fungi of the order mucorales. Mucormycosis results in higher rates of morbidity and mortality than many other infections. A high index of suspicion and considering risky factors are critical for diagnosis and early initiation of therapy is necessary to optimize outcomes. In this paper, we report a woman with pulmonary mucormycosis.
Case Report: A 47-year old woman with a history of uncontrolled diabetes presented with cough, hemoptysis, dyspnea and dysphagia from 3 weeks ago. On physical examination, course crackles, generalized wheezing and stridor were found along with fever. Laboratory testing demonstrated a high-titer ESR, CRP3+ and leukocytosis. The ENT examination revealed a mild erythema of the vocal cords. An initial chest-x-ray was compatible with a pulmonary infiltration in the right middle lobe. Ct-scan of the sinuses was unremarkable. Bronchoscopy findings and lung biopsy was consistent fibrinoleukocytic exudates with extensive necrosis and broad hyphae and was reported fungal infection in favor of mucormycosis. She was eventually treated with amphotericin B.
Ethical Considerations: This study with research ethics code IR.ARAKMU.REC.1398.48 has been approved by research ethics committee at Arak University of Medical Sciences.
Conclusion: Mucormycosis has high mortality in diabetic patients and has even higher rates in uncontrolled diabetics. Therefore, due to underestimation and undertreatment of the condition, mucormycosis must be considered in diabetics underestimate pneumonia.
Behrooz Ghanbari, Mojtaba Hedayat Taghavi, Behamin Astani, Mahmoud Bakhtiari, Mohsen Yadegari, Yazdan Shafikhani,
Volume 26, Issue 0 (8-2023)
Abstract
Abstract:
Background
CAP ( community acquired pneumonia ) is one of the most common infectious diseases that leads to hospitalization of patients. Also, the effects of vitamin D deficiency on the functioning of the immune system and its association with infectious diseases such as CAP have received much attention in recent years. Therefore, we decided to investigate the relationship between serum vitamin D levels and the incidence and severity of CAP pneumonia in this study.
Methods
In this case-control study, 75 patients with CAP and 75 healthy individuals were evaluated and serum levels of vitamin D in these two groups were measured and compared.
Results
The present study shows that for each unit increase in serum vitamin D level, the need for hospitalization in the ICU according to the IDSA criterion is reduced by seven percent and according to the CURB65 criterion, the need for hospitalization in the ward and ICU is reduced by fifteen percent. Vitamin D deficiency also increases the chance of developing community-acquired pneumonia by 3.08 times. And for every unit increase in vitamin D, the chance of developing community-acquired pneumonia decreases by 4 percent. And in people with vitamin D deficiency, the chance of being admitted to the ICU according to IDSA is 2.05 times and according to CURB65 is 2.84 times.
Conclusions
Overall, based on the results of this study, it is concluded that vitamin D deficiency is associated with an increased incidence as well as a greater severity of community acquired pneumonia.
Ensiyeh Abbaspour Naderi, Mohammad Ali Bepouei, Mahzad Diar, Matin Mohamadi, Mohammad Hedayati, Mahdi Shahriarinour,
Volume 26, Issue 4 (11-2023)
Abstract
Introduction: Urinary tract infection (UTI) is one of the most important and common infections in children. The aim of this study was to investigate the frequency of qnrB and qnrS genes in Escherichia coli and Klebsiella pneumoniae isolated from urinary tract infections of children in 17 Shahrivar Hospital in Rasht.
Materials and methods: In this descriptive cross-sectional study, 49 strains of Escherichia coli and Klebsiella pneumoniae were isolated from 17 Shahrivar Hospital in Rasht and identified using biochemical methods. Sensitivity and resistance of strains to antibiotics were determined by Kirby Bohr and dilution broth methods. PCR method was used to evaluate the frequency of qnrS and qnrB genes in isolates.
Results: In this study, the highest resistance was observed in piperacillin (81.5%) and cefazolin (88.9%) isolates from Escherichia coli and in Klebsiella pneumoniae (cefazolin (90.9%) and amoxicillin (95.5%) isolates from 49 Isolated, 73.4% had qnrB gene and 97.9% had qnrS gene.
Conclusion: It seems that one of the reasons for increasing multidrug resistance in hospital isolates of urinary tract infection (UTI) in Rasht is the increased transfer of plasmid genes between these isolates.
