International Journal of Infection
Volume:9 Issue: 1, Jan 2022

The inappropriate consumption of antibiotics in hospital wards increases antimicrobial resistance, morbidity, mortality, and associated treatment costs.

This cross-sectional study was carried out to measure antibiotic utilization in a tertiary care hospital in Zahedan, southeast of Iran.

In this study, antibiotic utilization was measured using the defined daily dose (DDD)/100 bed-days (DBD) index based on the anatomical therapeutic chemical/defined daily dose classification system that is proposed by the World Health Organization. By the adoption of the stratified random sampling method, the hospital records of a total of 525 patients admitted to seven hospital wards were extracted from the hospital health information system.

The consumption of antibiotics was 85.9 DBD. More than 73% of the patients were prescribed antimicrobials during admission. The highest proportion of antibacterial therapy was observed in the obstetrics and gynecology ward, followed by surgical and internal medicine wards. Cephalosporins and cotrimoxazole were the most commonly prescribed antibiotic class and individual antibiotic, with 37.1 and 13.4 DBD, respectively. Generally, 261 of 384 patients who were given antibiotics (68%) received parenteral antibiotic therapy. A total of 173 out of 225 patients admitted to surgical wards underwent surgery, 75% of whom received antibiotics as prophylaxis.

Although the pattern of antibacterial consumption was lower than other hospitals in Iran, the total amount of DBD was more than the data published for some developing and developed countries. Specific strategies should be employed to develop guidelines for rational antibiotic utilization for reducing future resistant strains and increasing antimicrobial efficacy.

Acute Toxoplasma gondii infection during pregnancy period can cause congenital toxoplasmosis. The aim of this study was to assess the seroprevalence rate of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against T. gondii infection during pregnancy and the associated risk factors in southwest Iran.

This study was performed on 88 pregnant women from October to December 2019 in Khorramshahr County, Khuzestan province, Iran. Anti-T. gondii IgG and IgM antibodies were tested through enzyme-linked immunosorbent assay (ELISA) method.

Following serological assays, 38.63% (34/88) and 2.27% (2/88) serum samples were positive for IgG and IgM antibodies, respectively. Also, a statistically significant association was observed between IgG seroprevalence and drinking of unpurified water (P = 0.015).

The serological evidence revealed that pregnant women of southwest Iran had moderate exposure to T. gondii parasite. Since the risk of acquiring acute toxoplasmosis in pregnant women is clinically important, we highly recommend regular screening tests for T. gondii infection during pregnancy period.

Prophylactic antibiotics effectively reduce the incidence of infection associated with cesarean section after labor. The use of a first-generation cephalosporin for antibiotic prophylaxis has been suggested in these patients, but in some studies, increasing the spectrum of antibiotic prophylaxis by adding another antibiotic to standard cephalosporin may provide greater protection against post-cesarean wound infections.

The present study aimed to compare the effects of conventional prophylaxis with cefazolin with a combination of cefazolin and azithromycin in reducing wound infection.

In this quasi-experimental study, 200 cesarean section candidates admitted to Ali Ibn Abi Taleb Hospital in Zahedan, Iran, in 2019 - 2020 were divided into two groups of 100 patients. The control group received cefazolin alone, and the intervention group received cefazolin and azithromycin. Finally, in addition to demographic factors, various underlying diseases, causes of cesarean section, non-infectious wound complications, and post-surgery wound infection were investigated.

The two groups were homogenized in terms of age and BMI of patients. Surgical wound infection occurred after cesarean section in 3% of patients in the control group. Only 1% of infections were observed in patients in the intervention group, and the two groups had a statistically significant difference (P = 0.01).

Compared with cefazolin alone, the combination of cefazolin and azithromycin was more effective in preventing cesarean section wound infection. Therefore, the combined use of these two antibiotics instead of cefazolin alone is recommended for this desirable clinical outcome.

Tuberculous meningoencephalitis (TBM) is the most severe, life-threatening form of tuberculosis that contributes to as much as 5% of cases of extrapulmonary tuberculosis. Emerging at the end of 2019, COVID-19 has been shown to affect various organs, including the brain. In this case report, a 21-year-old woman diagnosed with TBM, being in the intensive phase of tuberculous therapy, came with dysphagia and dysphonia as new complaints felt one day before admission accompanied by a positive meningeal sign, diplopia, and cephalgia, which became heavier after previously getting better. Cough and fever followed this complaint two days before admission. About the laboratory results, the PCR was positive for COVID-19, and CT scans showed increased leptomeningeal enhancement when compared with CT scan one month earlier. The patient received intravenous dexamethasone, anti-tuberculosis drugs, phenytoin, aspirin, oseltamivir, and hydroxychloroquine. The patient died four days after being hospitalized due to respiratory failure. This case report shows the coinfection of COVID-19 and TBM resulting in a poor tuberculosis treatment response and outcome.