فهرست مطالب

International Journal of Infection - Volume:4 Issue: 2, Apr 2017

International Journal of Infection
Volume:4 Issue: 2, Apr 2017

  • تاریخ انتشار: 1396/02/22
  • تعداد عناوین: 20
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  • Batool Sharifi-Mood*, Roshanak Sharifi Page 1
    ==Hepatitis E virus (HEV), a member of Hepeviridae family, is the major cause of waterborne hepatitis in tropical and subtropical countries (1, 2). There are four genotypes and a single serotype of hepatitis E virus infection. Genotype 1 is usually observed in the developing countries and causes community-level outbreaks, while genotype 3 is usually reported in the developed countries and does not cause outbreaks. Identification of swine hepatitis E virus in many countries, such as Japan and the United States, and its close relationship with human HEV showed and proved that HEV is a zoonotic infection (1, 3, 4). Wild deer, domestic swine and boars are considered the reservoirs of HEV in the nature (3, 4). Transmission of this infection usually occurs via the fecal-oral route. Recently many outbreaks occurred in war zones such as Syria, Iraq and Afghanistan and in the refugee camps worldwide (1, 2, 5, 6). It is estimated that 20 million infections (3.3 million acute cases) with 56,600 deaths occur annually (2, 5, 6). Incubation period of this virus is three to eight weeks. Typical signs and symptoms of HEV are, jaundice, anorexia, abdominal pain, fever, nausea, vomiting and liver enlargement. Rarely, acute hepatitis E can lead to a fulminant hepatitis and acute liver failure and finally death. Fulminant hepatitis occurs more during pregnancy, especially during third trimester (1, 2, 5, 7). The mortality rate among pregnant females is high and sometimes can reach 15% - 20%. Diagnosis of hepatitis E infection is based on the detection of specific IgM and IgG antibodies in the patient’s blood. Other tests include reverse transcriptase polymerase chain reaction (RT-PCR) to show the RNA of HEV in blood and stool. HEV E is a self-limiting disease and hospitalization is required for patients with fulminant hepatitis and it should also be considered in symptomatic pregnant females (2, 5, 7). The risk of transmission can be reduced by proper disposal systems to eliminate sanitary waste, considering hygienic practices such as hand washing with safe water, particularly before handling food, avoiding drinking water and ice of unknown origin, and the most important of all maintaining quality standards for public water supplies in the endemic countries (1, 2, 5, 7). A cell culture system is described to propagate the virus, and a very successful phase II vaccine trial should be completed (8). Finally, it should be considered that sanitation is the most important way to prevent hepatitis E virus. Standard routes for public water supplies, disposal of human waste, improved personal hygiene and sanitary food preparation are required.
    Keywords: Hepatitis E Transmission_Prevention
  • Somayeh Jahani, Saphora Bazi *, Zahra Shahi, Maryam Sheykhzade Asadi, Fahimeh Mosavi, Gelareh Sohil Baigi Page 2
    Background
    Medicinal plants are widely used throughout the world. Since these plants are known to have minimal side effects, many people embrace them. This study aims to investigate the antifungal effects of the extracts of the plants against Candida albicans.
    Methods
    The extracts of Echinophora platyloba, Peganum harmala, Heracleum persicum and Rosmarinus officinalis were prepared using a rotary device. The inhibitory concentration against Candida albicans was determined using incubation in media.
    Results
    The results show that highest MIC of R. officinalis against C. albicans was 100 ppm and low MIC was 12.5 ppm against C. albicans (Table 1) and the highest MIC of E. platyloba against C. albicans was 150 ppm and low MIC was 12.5 ppm against C. albicans. The results of this study showed that by increasing the concentration of plant extracts inhibited by the fungus has also been increased. Futhermore, Heracleum persicum extract concentration inhibited growth of fungal ppm 25 while Peganum harmala extract concentration inhibited growth ppm 50.
    Conclusions
    The results showed good antifungal activity Peganum harmala, Echinophora platyloba, Rosmarinus officinalis and Heracleum persicum has expressed Feb plants can be used to treat infections caused by these.
    Keywords: Antifungal, Echinophora platyloba, Rosmarinus officinalis, Peganum harmala, Heracleum persicum, Candida albicans
  • Maryam Shojaee, Saeed Zibaee * Page 3
    Background
    Foot-and-mouth disease (FMD) is an acute and contagious disease in domestic ruminants, which is currently the most economical viral disease that threatens livestock industry. The virus that causes the disease is belongs to Aphthovirus genus from the picornaviridae family. This family contains seven serotypes and is about 30 nanometers in diameter and no external membrane similar to other picornaviruses.
    Objectives
    The current study aimed to introduce ion exchange chromatography as a convenient method to purify specific antibody against 146S antigen.
    Methods
    The study was performed in vaccine and serum research of Razi institute, Tehran, Iran, after purification of 146S antigen of foot-and-mouth disease virus serotypes A using sucrose gradient procedure; two Guinea pigs were immunized with 30 µg 146S antigen combined with complete Freund’s adjuvant (CFA) and booster with incomplete Freund’s adjuvant (IFA) according to the protocol. After bleeding and serum obtaining, agglutination assay, dot blot and the enzyme linked immunosorbent assay (ELISA) were used to confirm specific antibody against 146S. Ion exchange chromatography was used to purify specific antibody against 146S antigen. Finally, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) electrophoresis was used to evaluate the purification.
    Results
    The interaction of 146S antigen with the immunized rabbit resulted in agglutination reaction. Assaying with the heterologous antigen showed negative result that confirmed the production of specific antibody in the rabbit. In dot blot, presence of brown spots was confirmed by binding specific antibody with 146S antigen. The result of ELISA showed that each antigen of different serotypes reacted better with homolog antibody. Since IgG containing positive charge and 25, 2-diethylaminoethyl (DEAE) Cephadex gel in ion exchange chromatography also had positive charge, IgG was eluted at the first step by buffer (pH = 9) and the other proteins were eluted by buffer at different pH levels. The absorbance amount of IgG was 0.197 that showed IgG = 0.725 mg/mL.
    Conclusions
    With respect to the results as well as the speed of ion exchange chromatography, this method is advised to purify antibodies.
    Keywords: Specific Antibody, S146 Antigen, Foot, and, Mouth Disease Virus, Serotype A, Ion Exchange Chromatography
  • Azizollah Ebrahimi *, Atefe Eshraghi, Mohammad Reza Mahzoonieh, Sharareh Lotfalian Page 4
    Background
    Multidrug resistant (MDR) Gram-negative bacteria have resistance to many antimicrobial compounds by multiple mechanisms including reduced outer membrane permeability, and active efflux mechanisms by efflux pumps.
    Objectives
    The current study was planned to search the antibacterial activities of the ethanol and chloroform extracts of Levisticum officinale L., and their synergistic effects with ciprofloxacin against some Gram-negative pathogenic bacteria; also to analyze the extracts if they contain inhibitors of efflux pumps of the examined bacteria.
    Materials And Methods
    After grinding, the resulting powder of Levisticum officinale L. was extracted with 85% ethanol and chloroform by maceration method. The studied microorganisms included the reference strains of Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Salmonella enteritidis. Broth micro-dilution methods were used to determine the minimum inhibitory concentrations (MICs) of the extracts alone or in association with ciprofloxacin and phenylalanine-arginine-β-naphtylamide (PAβN) as an efflux pump inhibitor (EPI). The presumptive efflux activity was detected by the ethidium bromide (EB) well diffusion method.
    Results
    MIC determination indicated that the Levisticum officinale L. extracts inhibited the growth of all the studied bacteria within a concentration range of 3125 to 25000 μg/mL. The synergistic effects were noted between the Levisticum officinale L. extracts and ciprofloxacin on all tested bacteria. In S. enertidis and E. coli both extracts of L. officinale, but in P. aeruginosa and A. baumannii only ethanolic extract increased the amount of EB accumulation (i e, reduced efflux).
    Conclusion
    The overall results of the current study provided information for the possible use of the Levisticum officinale L. extracts to control bacterial infections caused by the examined bacteria.
    Keywords: Antibacterial Activities, Gram, Negative Bacteria, Efflux Pumps, Levisticum officinale L
  • Nawfal R. Hussein *, Ibrahim Mohammed Abdullah, Omar Mohammed Younus, Azad M. Taher, Ashti A. Salim, Farhad I. Shahab Page 5
    Background
    Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are public health problems worldwide. Population mobility such as that occurs in war may play a role in changing the prevalence of infectious diseases.
    Objectives
    This study was conducted to determine the prevalence of HBV, HCV and HIV among Syrian refugees in Iraq and compare it to native Iraqis.
    Methods
    In this cross-sectional study, 880 Syrian refugees and 2975 native Iraqi volunteers were recruited. Subjects were tested for evidence of hepatitis B surface antigen (HBsAg), HCV antibody (Ab) and HIV Ag and Ab.
    Results
    From a total of 880 refugees, 34 cases (3.86%) were positive for HBsAg. None of the recruited samples was positive for HCV. For the indigenous people, 2975 subjects agreed to contribute in the project. Among them, 30 (1.09%) were positive for HBsAg and only one was positive for HCV. All the examined samples were negative for HIV in both populations.
    Conclusions
    While the prevalence rates of HCV and HIV are low and almost the same, the prevalence of HBV among the refugees is nearly fourfold higher than that found in indigenous population. This may put extra burden on health institutions in the host country.
    Keywords: HBV, HCV, HIV, Syrian Refugees, Iraq
  • Rasool Jafari *, Shadab Sadeghpour, Forough Sharifi, Hossein Yousofi Darani, Bahram Bagherpour, Pegah Soleimani Salar, Seyedeh Maryam Sharafi, Fereshteh Mohammadi, Nasim Adibpour, Davod Jafari Page 6
    Background
    Toxoplasma gondii, a zoonotic parasite, is one of the wide spread parasitic causes of asymptomatic infection in human, yet can cause severe disease and disorders in infants, when infected during pregnancy, and also in immunocompromised individuals. Thus, updated information about the prevalence of the infection in each region and time period is necessary.
    Objectives
    The aim of the present study was to determine the prevalence of the infection in patients referred to Dr. Sharifi clinical laboratory of Isfahan, Iran, during January 2014 to January 2015.
    Methods
    In a retrospective study, 1287 patients that had anti-Toxoplasma IgM and/or IgG test from January 2013 to January 2015 were selected and included in the study. Quantitative determination of anti-Toxoplasma IgM and IgG was performed using antibody capture chemiluminescence immunoassay (CLIA) kits (LIAISON® Toxo IgM and IgG, DiaSorin S.P.A, Italy) applied using the LIAISON (DiaSorin, Germany) device. All the available variables such as anti-Toxoplasma IgG and IgM concentrations, gender and age were recorded and analyzed.
    Results
    Overall, 1287 cases including 1215 (94.4%) females and 72 (5.6%) males with mean age of 28.64 years (min: 1, max: 78) were studied. The results showed that 36 (2.8%) out of 888 and 325 (25.3%) out of 1243 studied individuals were anti-Toxoplasma IgM and IgG seropositive, respectively. The mean age observed significantly higher in IgG positive humans (P
    Conclusions
    According to the results of the present study, prevalence of infection with T. gondii is high in Isfahan, yet it is still lower than most of the other studied regions in the country. Also, the risk of the infection rises with increasing age.
    Keywords: IgG, IgM, Iran, Toxoplasma
  • Maliheh Metanat, Seyed Mehdi Tabatabaei, Anita Alenabi, Mohammad Hasan Amirian Mojarad, Nahid Sepehri Rad *, Elham Pahlavani Page 7
    Background
    Detection of the clinical phase of chronic hepatitis B virus (HBV) infection is highly important in determining the treatment protocol. The aim of this study was to evaluate the diagnostic value of high-sensitivity C-reactive protein (hs-CRP) level as a non-invasive parameter in distinguishing different phases of chronic HBV infection.
    Methods
    In this cross-sectional study, 163 patients with chronic HBV infection were studied in Zahedan, Iran in 2015. The patients were classified into different phases of chronic HBV infection, based on the criteria recommended by the European association for the study of the liver (EASL). The serum level of hs-CRP was compared between different groups, using Mann-Whitney U test and Kruskal-Wallis test. Receiver operating characteristic (ROC) curve analysis was also used to investigate the predictive value of serum hs-CRP level in distinguishing cases of active HBV infection from inactive carriers.
    Results
    The present study included data from 163 patients with chronic HBV infection (males: 110, 68.3%; females: 53, 31.7%). Based on the findings, hs-CRP level was 2.3 ± 5.8 mg/L in patients with chronic HBV infection and 1.6 ± 2.5 mg/L in inactive carriers (P = 0.449). The optimal hs-CRP cut-off point for differentiation of chronic carriers was identified as 0.27 mg/L, with sensitivity, specificity, and positive and negative predictive values of 62.7%, 48.1%, 15.1%, and 99.9%, respectively.
    Conclusions
    The present study showed that serum hs-CRP level is not a predictive marker for the clinical phase of chronic HBV infection. Given its low specificity and sensitivity, hs-CRP level should be evaluated along with the viral load and other variables for determining the severity of chronic HBV infection.
    Keywords: Hepatitis B, High, Sensitivity C, Reactive Protein, Viral load, Real, Time PCR
  • Mohammad Rahnama, Barat Ali Fakheri, Mohammad Amin Mashhady *, Saeide Saeidi, Somayeh Jahani Page 8
    Objectives
    This paper aimed to explore the antimicrobial effects Mentha piperita, Solanum nigrum, Mentha longifolia, and Withania somnifera on food pathogens.
    Methods
    Plant extracts were obtained using the rotary system, the minimum inhibitory concentration and diluting method, and examined against bacteria such as Staphylococcus aureus ATCC1189, Shigella dysenteriae ATCC1188, Listeria monocytogenes ATCC1298, Vibrio cholera ATCC1611, and Bacillus cereus ATCC101.
    Results
    The results showed that extracts with various inhibitory ppm could inhibit the growth of antigenic bacteria so that the extract of Solanum nigrum could strongly inhibit S. aureus, Listeria, and Vibrio; and the extract of Mentha longifolia with 6.25 ppm can inhibit B. cereus.
    Conclusions
    The obtained results revealed that the extracts could strongly inhibit the bacteria in foods and that Solanum nigrum showed the highest antibacterial effect.
    Keywords: Antimicrobial Activities, Food Pathogens, Plant Extracts
  • Azizollah Ebrahimi *, Zohreh Arvaneh, Mohamadreza Mahzounieh, Sharareh Lotfalian Page 9
    Background
    Biocides (disinfectants) are crucial for controlling various infections and are widely used in environments for the control of microorganisms. Exposure of bacteria to biocides can select for mutants with decreased biocide susceptibility that often display a decrease in susceptibility to antibiotics.
    Objectives
    The present work was done during 14 months from February 2015, at the microbiology laboratory of the Veterinary college of Shahrekord university with the aim of investigating the impact of benzalkonium chloride exposure on antibiotic resistance in some common nosocomial pathogens.
    Methods
    Standard strains of Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Staphylococcus aureus were used, and in parallel to each standard strain four hospital isolates collected from Shahrekord and Esfahan hospitals were examined. Tube double serial dilution method was used for determination of minimum inhibitory concentration (MIC) of antibiotics and Benzalkonium Chloride (BKC). Spontaneous mutants were developed by exposure of examined species to BKC, and their mean MICs to examined drugs were evaluated.
    Results
    The mean MICs of the BKC and antibiotics used in this study were not similar between the parent and mutant strains of the examined isolates. In E. coli, A. baumannii and S. aureus isolates, differences between the mean MICs of BZK and ciprofloxacin had a similar pattern and were statistically significant (P
    Conclusions
    Vast use of BKC in various environments and their accumulation represents a potential risk for selective pressure towards selection of bacteria with decreased antibiotic susceptibility.
    Keywords: Pseudomonas aeruginosa, Acinetobacter baumannii, E. Coli, Staphylococcus aureus, Benzalkonium Chloride, Antibiotics
  • Abbasali Eskandarian, Somayeh Jahani, Hossein Hejazi, Hossein Yousefi, Vahid Raissi * Page 10
    Background
    Toxoplasma gondii, the etiologic agent of toxoplasmosis, is the most prevalent protozoan parasite in the world.
    Objectives
    Due to high prevalence of toxoplasmosis as well zoonotic cutaneous leishmaniasis with Leishmania major origin in Isfahan, the main objective of this study was to determine, whether there is any correlation between these two protozoan infections and the intensity of the high prevalence of co-infection.
    Methods
    All the case and control samples (80 individuals), collected from suspected patients that had referred for a skin test to the Isfahan dermatology and Leishmaniasis research center from August to November 2014, were investigated. About 2 mL of venipuncture blood was taken from each case and control group member, and serum was separated and stored at -20°C until the enzyme linked immunosorbent assay (ELISA) for detection of anti-Toxoplasma gondii specific IgM and IgG antibodies.
    Results
    Overall, 27 (33.8%) candidates in the control group and 33 (41.3%) patients with Cutaneous Leishmaniasis (CL) were positive for Toxo-IgG. All samples were found to be Toxo-IgM negative. The prevalence difference of Toxoplasma infection in healthy controls and CL patients was not significant.
    Conclusions
    The results of the present study showed that the prevalence difference of Toxoplasma infection in healthy controls and CL patients was not significant. This means, there was no relationship between infection with CL and toxoplasmosis, thus infection with Toxoplasma gondii wasn''t a risk factor for infection with Leishmaniasis; Toxoplasma gondii didn''t show a preventive or inhibitory role against Leishmania infection.
    Keywords: Cutaneous leishmaniasis, ELISA, Isfahan, Toxoplasma gondii
  • Mohammad Reza Vafaei, Somayeh Jahani, Hamed Kalani, Nader Pestehchian* Page 11
    Background
    Malaria is caused by a parasitic protozoan called Plasmodium with an estimated mortality rate of one million people annually and it is estimated that half of the world''s population are at risk for this disease.
    Objectives
    The current study aimed to compare the effect of hydroxychloroquine and pyrimethamine with sulfadoxine-pyrimethamine to treat Plasmodium berghei infection in mice. Pyrimethamine, hydroxychloroquine and sulfadoxine-pyrimethamine were used in the current study.
    Methods
    Four groups of mice each including nine mice were selected. The mice were infected by intraperitoneally injection of Plasmodium berghei infected red blood cells. One group was considered as a positive control and three other ones received each one of the drugs. On days 4, 7, 14, 21 and 28, a blood smear was prepared from each mouse, stained with Giemsa and the parasitemia rate was calculated.
    Results
    Parasitemia in the positive control group showed an increase on days four and seven at a level of 5.9% and 23.7%, respectively, which was statistically significant compared with the other groups (P
    Conclusions
    The results of the article suggested that malaria treatment strategy shifts completely from the monotherapy; therefore, the combination drugs should be used for this purpose, especially in endemic areas.
    Keywords: Sulfadoxine, Pyrimethamine, Pyrimethamine, Pyrimethamine, Plasmodium berghei
  • Javad Abkhoo, Naser Panjehkeh* Page 12
    Background
    Silver nanoparticles (AgNPs) are between 1 nm and 100 nm in size.
    Objectives
    Different concentrations of AgNPs were tested in this research to examine antifungal activity on Fusarium oxysporum.
    Methods
    Antifungal activity of AgNPs on basis of colony formation was evaluated by in vitro Petri dish measurement.
    Results
    Different concentrations of AgNPs inhibit colony formation of F. oxysporum at different levels. As concentration of AgNPs was increased, there was a decrease in colony formation. Silver nanoparticles at the highest concentration (5000 ppm) did not fully inhibit F. oxysporum colony formation. Silver nanoparticles (5000 ppm) and colonize F. oxysporum to decrease to 35% after one hour of exposure, 27% after three hours of exposure, and 24% after five hours of exposure. The antifungal activity of AgNPs to the reduce colony formation was apparent within one hour. The spore extended time exposure to AgNPs from one to five hours significantly reduced colony formation.
    Conclusions
    The antifungal activity of AgNPs has a great potential for use in control of fungal spores.
    Keywords: Fusarium oxysporum, Antifungal Activity, Control, Silver Nanoparticles
  • Shahnaz Sali, Farhad Soori, Zahra Arab-Mazar * Page 13
    Background
    Cytomegalovirus (CMV) is one of the most frequently encountered opportunistic viral pathogens in renal transplantation. Approximately, in 60% of the transplant recipients CMV infection can be observed and in > 20% symptomatic diseases can be developed. However, antiviral prophylaxis and treatment have reduced the CMV morbidity and mortality at the time of development of antiviral-resistance CMV strains that can significantly contributed to the adverse clinical outcomes in transplant recipients. Mutations in the human CMV UL97 kinase gene are a major mechanism of viral resistance to the anti-CMV drug “Ganciclovir (GCV)”. GCV, as the most widely used and recognized therapy for CMV, is a substrate for the UL97 kinase.
    Methods
    The studied patients were renal transplant recipients in Tehran Labbafinejad hospital who were positive for CMV-DNA PCR test and have been treated with Ganciclovire. Patients who have been treated for at least 3 weeks with GCV and have not shown a proper therapeutic response were candidate for UL97 gene mutations associated with GCV resistance evaluation.
    Results
    About 60 patients with positive CMV DNA PCR were hospitalized during one year study. Eventually, after 2 times measurement of CMV viral load at the end of the third week and third month of therapy with Ganciclovire, 5 cases were candidate for antiviral resistance evaluation. Genotypic testing was performed, but no mutation neither in UL97 nor in UL 54 was detected by the laboratory.
    Conclusions
    The increasing use of antiviral drugs in transplant patients associated with the narrow range of antiviral agents effective to treat CMV have increased our need for further understanding of the risk factor for development of CMV antiviral resistance and it’s clinical impacts. Detection of UL97 gene mutation plays a major role to determine therapeutic strategies to treat patients infected with the resistant viruses.
    Keywords: Cytomegalovirus, Ganciclovire, Drug Resistance Mutations, UL97 Gene
  • Shakir S. Jabaly, Zana Sidik M. Saleem, Nawfal R. Hussein *, Abdulghany Rasheed Page 14
    Background
    Renal transplant is considered the treatment of choice for end stage renal disease. During the transplantation, stents are placed routinely at duhok transplant center (DTC) to protect the ureter-bladder anastomosis and to decrease anastomosis-related complications.
    Objectives
    The aim of this study was to compare the incidence of urinary tract infection (UTI) and other postoperative complications in patients undergoing renal transplant with or without stent insertion.
    Methods
    All recipients of kidney transplantation at DTC between January 2012 and December 2013 took part in this study. The patients were followed up at the same center and those who developed post-operative complications were referred back to DTC for management. The study included data of following up the patients for 12 months.
    Results
    No significant difference was found in GFR between the two groups 12 months after transplant (Mean ± SD: 74.11 ± 12.2 for stented group versus 77.4 ± 14.6 for non-stented group, U test, P > 0.05). 29.4% (10/34) of stented patients developed UTI in the first 14 days, while only 7.4% (2/27) of the patients in the non-stented group developed this complication (P = 0.045) (OR: 5; CI95: 1-26.3). 44% (15/34) of the stented subjects developed late UTI which was significantly higher than that found in non-stented group where only 20.8% (5/24) of subjects developed UTI (P = 0.039) (OR: 3.5; CI95: 1-11.3).
    Conclusions
    Stents increased the risks of urological infections and might have a detrimental effect on graft survival. It might be inferred that stenting should not be placed routinely; but only used in selective patients with strong indications.
    Keywords: Double J, Stent, Kidney, Renal, Transplant, UTI, Iraq
  • Abdelmoneim Khashana * Page 15
    Background
    Neonatal bacterial meningitis and its complications are considerably recuperated by adjunctive treatment with corticosteroids. However, in those neonates, the cortisol level is not well recognized. The aim of this study was to investigate cortisol levels in neonates with bacterial meningitis and comparing the outcomes with those without bacterial meningitis.
    Methods
    In the study, thirty consecutive neonates with bacterial meningitis were used and a group of 30 neonates with non-bacterial meningitis were considered for comparison.
    Results
    Regarding serum cortisol (µg/dL), no statistically significant difference was found in bacterial (9.9 ± 0.4) and non-bacterial meningitis (10.3 ± 1.3) neonates (P = 0.112), but neonates with lower level of cortisol had a poor outcome.
    Conclusions
    Cortisol levels showed no significant differences between bacterial and non-bacterial meningitis but it affected the outcome.
    Keywords: Corticosteroids, Meningitis, Bacteria, Neonate
  • Simin Dokht Shoaei, Shabnam Tehrani *, Zahra Arab-Mazar Page 16
    Background
    The orbital septum is a membranous sheet acting as the anterior boundary of the orbit. Preseptal cellulitis is a kind of an infection of the eyelid and portions of skin around the eye, anterior to the orbital septum. Preseptal cellulitis is different from orbital cellulitis in epidemiology, etiology and treatment of choice. The current study aimed to evaluate the frequency of major risk factors of preseptal cellulitis.
    Methods
    This descriptive prospective study was conducted on 40 patients with preseptal cellulitis admitted to two educational hospitals in Tehran, Iran, during 2014 - 2015. Epidemiologic and clinical findings of the patients with CT scan documented preseptal cellulitis were recorded as risk factors and complete history of trauma. All the patients were scanned for sinus involvement (axial and coronal paranasal sinus CT scan). Complete physical exam for cutaneouse lesions predisposing to preseptal cellulitis as varicella was performed. Blood samples were cultured. Data were analyzed using the SPSS Software version 20.
    Results
    During the study period, 40 patients including 21 females and 19 males with preseptal cellulitis were studied. The mean age of the patients was 38.95 ± 16.20 years. The most common underlying factors was trauma (57.5% of the patients) following sinusitis (25%) with the ethmoid sinus being the most common involved sinus. Ophtalmic Zoster, dacryocystitis and hordeolum were predisposing factors in 17.5% of the cases. Most cases occurred in spring (47.5%) and the least in summer (5%).
    Conclusions
    Sinusitis was the most common predisposing factor of preseptal cellulitis in previous studies, but in this study trauma was the most common one. Recognition of major risk factors of preseptal cellulitis can be effective in planning the treatment of choice in preseptal cellulitis in different communities.
    Keywords: Orbital Septum, Preseptal Cellulitis, Risk Factor, Trauma, Sinusitis
  • Javad Abkhoo, Somayeh Jahani * Page 17
    Background
    Medicinal plants have been known since ancient times, as an anti-microbial spectrum against microorganisms. The production of secondary plant metabolites creates an important source of bactericide and various pharmaceutical drugs. In this study, the antimicrobial activity of aqueous and ethanolic extracts of the leaves of Glycyrrhiza glabra, Mentha spicata and Rosmarinus officinalis was evaluated against resistant strains of Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus.
    Methods
    Antimicrobial effects of plants were investigated using a strain of Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus, at the standard bacterium laboratory of the Veterinary Department, University of Islamic Azad, Tehran, Iran.
    Results
    Minimum inhibitory concentration (MIC) values ranged from 6.25 to 100.0 ppm, while Minimum bactericidal concentration (MBC) ranged from 12.5 to 200 ppm. The ethanol extract of Glycyrrhiza glabra had the lowest MIC (6.25 ppm), while the ethanol extract of Rosmarinus officinalis and Mentha spicata had the highest MIC (100 ppm), respectively. The MBC of the ethanolic extract of G. glabra, with the highest bacteria strains, was valuable against the lowest (12.5 PPM). The MBC of the ethanolic extract of G. glabra was valuable against the lowest bacteria strains.
    Conclusions
    Our findings showed good antibacterial activity for G. glabra extract that can be utilized as a treatment for infections, caused by P. aeruginosa, E. coli and S. aureus.
    Keywords: Glycyrrhiza glabra, Mentha spicata, Rosmarinus officinalis, Antimicrobial Effect, Extract
  • Ujjwala N. Gaikwad *, Neeta Gade, Atul Jindal, Padma Das, Sanjay Singh Negi, Sarika Kombade, Anudita Bhargava Page 18
    Background
    Ventilator-associated pneumonia is the second most common nosocomial infection in neonatal intensive care unit (NICU) patients. The recent trend signifies multidrug resistant (MDR) Acinetobacter baumannii and Pseudomonas aeruginosa as the most frequent causative agents in these cases.
    Objectives
    The aim of this research was to study the trends in the isolation of MDR pathogens from a newly constructed NICU.
    Methods
    A retrospective analysis of six months data on isolation of MDR pathogens from newborns on mechanical ventilation in a newly established NICU was done.
    Results
    Out of seven, MDR Acinetobacter baumannii was isolated from four (57.14%) newborns on mechanical ventilation. The strain was sensitive only to polymyxin B and colistin and was isolated repeatedly from the initial three samples collected at an interval of two to three days. In one case, Pseudomonas aeruginosa was also isolated in association with Acinetobacter with same sensitivity pattern. While expecting recovery from illness in two babies, sudden change in the type of microbial flora was noticed in the samples collected on the 4th instance. This time, the initial polymyxin-sensitive organisms were replaced by intrinsically polymyxin resistant organisms like Serratia species and Burkholderia cepacia.
    Conclusions
    Repeated isolation of MDR Acinetobacter baumannii along with other resistant phenotypes of gram-negative bacteria is a cause of concern for any newly established NICU setup. Long-term use of reserved antibiotics leads to selection pressure, resulting in establishment of the relatively less common environmental opportunists as new, more troublesome pathogens. It may further complicate the treatment decisions and lengthen the hospital stay and associated morbidity.
    Keywords: Pneumonia, Ventilator, Associated, Intensive Care Units, Neonatal, Drug Resistance, Multiple, Acinetobacter baumannii, Pseudomonas aeruginosa
  • Toxoplasmosis in a Patient with HIV: A Case Report
    Seyed Alireza Mousavi, Zahra Abna, Somayeh Jahanabadi, Seyed Hossein Shahcheraghi *, Mohadeseh Arjmand Page 19
    Introduction
    Toxoplasma gondii is one of the most frequent infectious parasites distributed worldwide.
    Case Presentation
    A 26-year-old male patient was diagnosed as HIV positive. Finally, immunological and biological studies showed increased neutrophils count, increased C-reactive protein and positive Toxo-IgG.
    Conclusions
    It seems that checking the level of Toxo-IgG in patients with HIV infection is needed and in case of uncertainty, the magnetic resonance imaging (MRI) will be helpful.
    Keywords: Toxoplasma sp., HIV, Toxo, IgG
  • Seyed Hossein Shahcheraghi *, Jamshid Ayatollahi, Mohammad Darabi Mohebbi Page 20