Archives of Clinical Infectious Diseases
Volume:4 Issue: 4, Oct 2009

Chronic sinusitis is one of the most common medical problems affecting 30 million people in USA annually. In the present study, we compared the efficacy and safety of clarithromycin XL and co-amoxiclav on clinical and CT scan findings of patients suffering from chronic sinusitis.Patients and In this clinical trial, a total of 59 subjects (37 males and 22 females, mean age 28 years) with clinical symptoms and CT scan findings of chronic sinusitis were assigned randomly in two groups and treated with clarithromycin XL or co–amoxiclav. Clinical success rates were similar at the end of therapy period, however, subjects receiving clarithromycin XL showed better CT scan findings when compared with co-amoxiclav-treated subjects (53% versus 29%). Gastrointestinal discomfort was the most frequent treatment–related adverse effects in both groups (NS). Results revealed that clarithromycin XL and co-amoxiclav have similar efficacy when considered for treatment of chronic sinusitis.

Staphylococcus aureus is one of the most important causes of nosocomial infections and most clinical isolates are multidrug resistant. Resistance to β-lactam antibiotics is most often due to bacterial β-lactamase production. Characterization of β-lactamases is important for choosing appropriate antibiotic therapy. Thirty methicillin resistant Staphylococcus aureus (MRSA) were identified by standard biochemical methods. Antibacterial susceptibility to 9 β-lactam antibiotics was determined. β-lactamase production was shown in all isolates using the colony iodometric test and nitrocefin discs. β-lactamase typing was carried out by measuring the relative substrate hydrolysis rates. The MRSA isolates were resistant to the majority of β-lactam antibiotics. The results showed that 90% of the isolates displayed type A substrate hydrolysis profile of β-lactamase. The alarming high level of resistance to β-lactam antibiotics including methicillin and 3rd generation β-lactams show the need for extensive studies on alternative treatment protocols and use of new drugs.

Vitamin–D receptor (VDR) and tumor necrosis factor–alpha (TNF-α) genes are thought to be important in the intracellular killing of mycobacteria. This study aimed to determine the association of VDR and TNF-α variant with development of pulmonary tuberculosis (PTB) among Iranian patients.Patients and Selected regions of VDR and TNF-α were amplified, and then the PCR products were digested using restriction enzyme (RFLP). Digested products were run on 8% polyacrylamide gel, and were stained with silver–nitrate. Single nucleotide polymorphisms (SNPs) at restriction sites of BsmI, and FokI of VDR gene and SNPs of TNF-α at -238,-308, -244,-857,-863 positions were analyzed by PCR-RFLP among 117 PTB cases and 60 healthy controls. No statistically significant difference was observed in allele frequencies of FokI of VDR and TNF-α at -238,-244,-863 and –857 position. Although, the frequency of b allele of BsmI (p=0.001) and -308 A variant in TNF-α promoter region (p=0.006) were significantly more in PTB patients than healthy controls. The frequency of extended diplotypes were different in patients and control subjects (p

Listeria monocytogenes is the causative agent of listeriosis, a highly fatal opportunistic food borne infection. Listeriolysin O is a major virulence factor in this bacterium, which is encoded by hlyA. The aim of the present study was to determine the relation of Listeria monocytogenes hlyA gene isolated from fresh cheese with habitual abortion in Marvdasht. In this cross-sectional study, 428 fresh cheese samples from four geographical area of Marvdasht were collected, then cold enriched and cultured in Hicrome Listeria Agar and Palcam Agar. Specific biochemical and sugar fermentation tests were used for identification of probability bacteria. Finally, hlyA gene was determined by PCR method. Of 428 samples, 56 (13.1%) L. monocytogenes were isolated, among which 91.7% were revealed to encode hlyA. Data analysis revealed significant association between months of sampling and isolated bacteria (p

Antimicrobial resistance of Staphylococcus aureus especially methicillin resistant S. aureus (MRSA) continues to be a problem for clinicians worldwide. Although difference in epidemiology and antibiotic susceptibility of methicillin resistant S. aureus (MRSA) and methicillin susceptible S. aureus (MSSA) isolates has been proposed by investigators, few data have been reported to now. Patients and Disk diffusion method was used for determination of in vitro susceptibility of S. aureus isolates to 15 antibiotics. Susceptibility pattern of 192 non-duplicates S. aureus isolated from clinical specimens in four university hospitals in Tehran, from November 2007 to August 2008, were compared. In addition, distribution of MRSA and MSSA isolates were investigated in different specimens, on various wards, and in different age groups. MRSA isolates were constituted 49% of all isolates. While only 1.7% of the MSSA isolates were multidrug resistant, all of MRSA were shown resistance to at least five antibiotics. Majority of isolates from patients ≥65 years old were MRSA and prevalence of methicillin resistance was highest among S. aureus isolated from respiratory specimens. Also, MRSA appeared to be more prevalent in intensive care units and operation wards than in other departments. This study has shown a relationship between methicillin resistance and resistance to other antibiotics in S. aureus isolates. Also, considerable differences were observed in epidemiology of MRSA and MSSA isolates.

Animal bites are potentially harmful for people. The prophylaxis approach is effective and safe, however, it is expensive and sometimes may be used without clear indication. Prophylaxis programs depend on local epidemiology. The aim of this study was to survey the animal bites and rabies epidemiology in northern Iran.Patients and We performed a descriptive study on all animal bites and rabies in the Mazandaran Province during 2001 to 2005. Initial data including age, sex, site of bite, incidence, type of animal, geographical distribution, number of vaccinations and death by rabies were gathered and analyzed by SPSS soft ware. Annual frequency of animal bites was between 3,174 and 4,670 in the Mazandaran Province. One hundred sixty bites per 100,000 persons occur annually, with a cost of approximately US $0.5 million in health care expenditures and loss of income. Twenty thousand animal bites occurred during the year of 2001 to 2005. Behshar, with 302.88 cases per 100,000 persons was the most prevalent city. We found that the majority of bites are from dogs (84.87%), especially stray dogs. Men are frequently bitten by dogs (79.62%), while adolescence is the most frequent victims of dog bites, especially in rural areas. Dog bites resulted in 2 deaths, both of which had bites on their faces. Exposure to dogs, especially stray dogs in Mazandaran Province, reported the majority of cases of human bites and post-exposure prophylaxis.

It is difficult to diagnose Mycobacterium tuberculosis infection due to a lack of rapid, sensitive, and specific tests. Newer methods, which are easy and reliable, are required to diagnose TB at an early stage. Our aim is to evaluate the polymerase chain reaction (PCR) technique, using primers directed against the IS6110 gene, for the detection of M. tuberculosis in the sputum samples, and calculate the sensitivity and specificity of PCR.Patients and A total of 248 sputum samples from patients suspected of mycobacterial diseases were studied. DNA was extracted by boiling method. IS6110 PCR method by a specific pair of primers designed to amplify 123bp and 245bp sequences of the insertion sequence, 6110, in the M. tuberculosis genome was used to analyze sputum samples. Totally, 32 (12.9%) samples had positive culture. PCR yielded a sensitivity of 93.8% and specificity of 99.1% for the diagnosis of TB, when diagnosis was confirmed by culture. There were 2 out of 32(6.3%) PCR-positive cases among the patients with non-TB disease. We concluded that the performance of an IS6110 PCR assay is valuable in the rapid diagnosis of tuberculosis.

Cytomegalovirus (CMV) pneumonia is one of the most important infections in immunocompromised host. Immunosuppressive therapy plays a major role in reactivation of CMV.Patient: 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.