Jundishapur Journal of Microbiology
Volume:2 Issue: 2, Apr-June 2009

The best treatment schedule for eradication of Helicobacter pylori in Iran is a type ofquadruple therapy for a minimum duration of two weeks. Since, clarithromycin andfurazolidone based quadruple regimen has the highest eradication rate, it can beconsidered as the first line therapy. Metronidazole based quadruple therapy may beused as an alternative choice of first line therapy. It is also important to note thatfurazolidone based regimens could induce side effects and are highly contraindicated inpatients with G6PD deficiency. We recommend triple therapy with a proton pumpinhibitor (PPI) (eg, lansoprazole 30mg twice daily, omeprazole 20mg twice daily,pantoprazole 40mg twice daily, rabeprazole 20mg twice daily, or esomeprazole 40mgonce daily), amoxicillin (1g twice daily), and clarithromycin (500mg twice daily) for 10days to two weeks. We suggest substitution of amoxicillin with metronidazole (500mgtwice daily) only in penicillin-allergic individuals since metronidazole resistance iscommon and can reduce the efficacy of treatment. An initial attempt at eradicating H.pylori fails in as many as 20 percent of patients. For patients failing one course of H.pylori treatment, we suggest either an alternate regimen using a different combination ofmedications, or preferably quadruple therapy consisting of a PPI twice daily andbismuth-based triple therapy preferably given with meals and an evening snack for 14days. For those failing two attempts at treatment, it is especially important to reinforcecompliance with medications. Culture with antibiotic sensitivity testing can be done toguide subsequent treatments but generally we forgo culture in favor of "rescue"therapy. We suggest levofloxacin (250mg), amoxicillin (1g) and a PPI each given twicedaily for two weeks. Alternative dosing regimens have also been suggested.

BK virus, a member of polyomaviridae, infects humans asymptomatically in their earlyinfancy and remains latent in the kidney and urinary tract cells. Reactivation of BKvirus in renal-transplanted patients occurs frequently and sometimes leads tonephropathy and rejection of grafted organ. In this study, prevalence of this virus inrenal allograft recipients is discussed before and after transplantation. This crosssectionalstudy performed on 78 renal recipient cases. Blood and urine samples ofpatients were collected three times; before graft, one month following operation andfour months after receiving the graft. All the patients were taking similar drug regimen.The extracted DNA of the samples was investigated by double PCR and semi-nested-PCR. PCR results were analyzed by SPSS software version 11.5 and Mac Nemar test.Out of 78 samples collected from kidney transplanted cases, five urine specimens (6.4%)were positive for BK virus, 10 urine samples (12.8%) turned out as positive for this virusone month after operation and 30 of urine specimens (38.5%) became positive for BKvirus four months post-transplantation. Of 78 plasma samples of the same cases, none ofthem was positive for BK virus before transplantation. One plasma specimen (1.3%)turned out as positive for BK virus and 16 plasma samples (20.5%) were positive for thisvirus four months after grafted kidney. The difference between the results of the urinesamples collected before and four months after kidney transplantation from thepatients, was statistically significant (P<0.05). Based on the gleaned data it is concludedthat BK virus infection increased in a considerable fraction of kidney transplantpatients. Therefore, investigation for reactivation of BK virus is recommended in thesepatients after kidney graft.

Because of resistance and side effects to common antifungal drugs, there have beenmany studies on the use of herbal antifungal essential oils. In this study, theanti-Candida activities of thyme, pennyroyal and lemon essential oils in comparison toantifungal drugs were assessed. The paper disc diffusion method was used to study theinhibitory effects of the essential oils of thyme, pennyroyal and lemon and amphotericinB and fluconazole on different species of Candida including Candida albicans, C. kruseiand C. glabrata, which are isolated from patients who suffered from vulvovaginalcandidiasis, at 25°C and 37°C. The transparent zone around the paper discs showed thatthyme essential oil has the greatest effect against different Candida species, followed bypennyroyal and lemon. The inhibitory effects of essential oils on the growth of Candidaat 37°C were better than 25°C. The inhibitory effect of amphotericin B was better thanfluconazole. The results of the present study showed that amphotericin B and thymeessential oil had inhibitory effects on the growth of different Candida species. Therefore,after performing controlled studies and experimenting with different types of honeyformulation, thyme essential oil may be used in treating empirical candidiasis. Inconclusion, these essential oils have anti-Candida activity, in vitro and related to theirconcentration on paper disc

Onychomycosis is a fungal infection of nails that caused by several dermatophytes andsaprophytes (yeasts and moulds). In addition, tinea pedis is a fungal infection of feet dueto dermatophytes. Due to the importance of high prevalence rate of above diseases, thisstudy was conducted to determine the epidemiologic condition of diseases in Kashan. Inthe present study, 137 patients suspected to onychomycosis and tinea pedis wereexamined. Disease was confirmed in 26 subjects (18.9%), 11 were males and 15 werefemales. The common etiologic agents was yeasts (11 cases) followed by dermatophytes(9 cases) and saprophytes (6 cases). This study showed that there is a high prevalencerate of onychomycosis and tinea pedis in Kashan. Therefore, due to importance of thedisease, it is necessary to diagnose and cure the disease immediately.

Scabies is a common world-wide parasitic contagious skin disorder and one of the mostcommon itching dermatosis in the less developed countries among the poor populations.Scabies is considered as a major public health problem in Iran too. This descriptivestudy was conducted in the Dr. Jalayer parasitology lab, Isfahan, Iran between 1996-2003. The samplings were carried out on the patients with pruritic, nodules and popularrash. The mite infestation was distinguished using scraping test. The most frequency ofscabies infestation was recorded in 1996 with 25% and the least one in 2002 with 5.6%of total infected population during the current study research. Finally, it is concludedthat the rate of Sarcoptes infestation is depended on some factors, which is included: sex,age, social relation and sex age, overcrowding, and the weather conditions.

Tinea imbricata is an uncommon dermatophytosis caused by the anthropophilicdermatophyte Trichophyton concentricum in endemic regions. In the present study, a 10-year-old girl was examined for tinea imbricata. Microscopic examination revealed thepresence of hyaline, septate, branching hyphae and its cultures on Sabouraud dextroseagar yielded T. concentricum. The patient responded to treatment with oral terbinafine250mg/day topical clotrimazole (1% ointment), topical miconazole (2% cream) twotimes daily and potassium permanganate for daily washing for four weeks. In thepresent study, we reported the first case of tinea imbricate from Iran.

Brucellosis is a zoonosis with nonspecific signs and symptoms that some times associatedwith neurological manifestations. In this report, we present a 41-year-old female whopresented with inappropriate speech, an unusual presentation of the neurobrucellosis.