Objective: To determine the sensitivities of various testing methods
for diagnosing brucellosis.
Methods: The 267 patients in our cohort were suspected to be
infected with Brucella and had been referred to a hospital in Mianeh
City, Iran. The mean (SD) age was 37.0 (11.3) years for female
patients and 37.1 (13.7) years for male patients. All serum specimens
from these patients were examined by the standard agglutination
test (SAT), Coombs Wright test, 2-mercaptoethanol (2ME) test,
enzyme-linked immunosorbent assay (ELISA) for determining levels
of immunoglobulin G (IgG) and immunoglobulin M (IgM), and multiplex
polymerase chain reaction (PCR). DNA was extracted. Extracted
DNA was checked with human PCR–targeting CRP gene–encoding
485 base pair (bp) as an internal control to ensure that the proper
extraction method had been used. Specific primers targeting IS 711
were used for Brucellosis melitensis, B abortus, and B suis.
Results: Brucellosis was confirmed in 110 patients (58.2% male
and 41.8% female) based on applied diagnostic methods and clinical
features. Results of ELISA, the SAT, and PCR were positive in 92,
42, and 51 patients, respectively. B abortus and B melitensis were
detected in 16 and 35 patients, respectively. B suis was not detected
in any of the specimens.
Conclusions: All methods tested in our study need to be used to
ensure accurate diagnosis of brucellosis, although ELISA displayed
the highest level of efficiency. Also, B melitensis showed a higher
frequency rate than B abortus in our cohort.
Keywords: B abortus, B melitensis, B suis, ELISA, Multiplex PCR, SAT
Lab Medicine. 01/2013;
ABSTRACT: In Iran, the measles, mumps and rubella vaccine (MMR) is administered in a two-dose protocol where the first dose is scheduled at 12 months of age. This study aims to determine the efficacy of the MMR vaccine by testing IgM and IgG antibody levels 4 - 7 weeks after primary vaccination.
A single group cohort study was performed on healthy children, 12 - 15 months of age, who were vaccinated at health centers affiliated with Shahid Beheshti University of Medical Sciences in Tehran, from January to April 2009. Children with negative vaccination and/or clinical history for measles, mumps or rubella were administered the first dose of the MMR live attenuated vaccine. IgG and IgM antibodies were checked by enzyme linked immunoassay (ELISA) in serum samples 4 - 7 weeks after vaccination. A child was considered seropositive if antibody levels were higher than the assay cut-off level set by the ELISA kit.
Samples from 240 children were checked for antibodies against measles and rubella. Measles serum IgM level was positive in 71.7% of samples and IgG in 75.8%. The rubella serum IgM level was positive in 71.7% of children and IgG in 73.8%. From 190 blood samples that were checked for mumps antibodies, serum IgM was positive in 68.9% and IgG in 95.3%. No significant relationship was found between seropositivity and age or gender.
IgG and IgM antibody levels were below the assay cut-off levels against measles and rubella in approximately one-fourth of the children following primary MMR vaccination. A second dose was necessary to raise the level of protection against measles and rubella.
Archives of Iranian medicine 01/2013; 16(1):38-41. · 0.97 Impact Factor
ABSTRACT: The purpose of this study was to determine the presence of integrons in Escherichia coli, which cause urinary tract infections, and to define the association between integrons and antimicrobial susceptibility. Susceptibility of 200 isolates from urine samples of patients suffering from urinary tract infections to 13 antibiotics was determined by the Kirby-Bauer disk diffusion method. The existence of class1 and 2 integrons in resistant isolates was assessed by polymerase chain reaction-restriction fragment length polymorphism and sequencing. Antibiotic resistance patterns were observed as follows: amoxicillin 78%, tetracycline 76.1%, co-trimoxazole 67.7%, cephalotin 60%, nalidixic acid 57.4%, chloramphenicol 49%, gentamicin 46.4%, ceftazidim 38.1%, ciprofloxacin 36.2%, nitrofurantoin 33.5%, amikacin 32.1%, norfloxacin 36.1%, and imipenem 27.1%. Of 200 isolates, 155 (77.5%) were multidrug resistant (MDR). The existence of integrons was confirmed in 50.3% of isolates. Three class 1 integron types, aadA2 being the most frequently found, and four class 2 integron types are described. Significant association between resistance to gentamicin, co-trimoxazole, cephalotin, ceftazidim, imipenem, chloramphenicol, and nalidixic acid with the existence of integrons was observed. Multidrug resistance suggests that the strategy for treatment of patients with E.coli infections needs to be revised. Furthermore, it was shown that integrons may be partly responsible for multidrug resistance. Imipenem and norfloxacin were the most effective antibiotics against isolates.
Microbial drug resistance (Larchmont, N.Y.) 07/2012; · 1.99 Impact Factor
ABSTRACT: BACKGROUND: Resistance to antimicrobial agents such as carbapenems among enterobacteriacea has been increasing, especially in Klebsiella pneumonia that produces variety of enzymes including Klebsiella pneumoniae carbapenemase (KPC). This study is the first report of its kind investigating the resistance to carbapenems among burns patients in Iran. METHOD: During a 6-month period, 28 hospitalized burn patients who required to be placed on broad spectrum antibiotics were studied. Isolated species identified by routine biochemical test. Susceptibility testing for these species was performed by recommended the CLSI guidelines method. The tested antibiotics included cefotaxime, cefepime, aztreonam, imipenem, amoxicillin+clavulonic acid, gentamicin, amikacin, tobramycin, tetracycline, and trimethoprim-sulfamethoxazole, and chloramphenicol. For determination of KPC in phenotypical forms, Modified Hodge Test was utilized as per CLSI recommendation. RESULTS: Thirty-five Klebsiella spp. were isolated from 28 hospitalized patients. Nineteen out of 35 Klebsiella isolates were resistant to imipenem and that all of them had positive KPC. Nine of imipenem resistant isolates were also resistant to all tested antibiotics. Mortality rate among patients with positive KPC was 33%. CONCLUSION: High rate of multi-drug resistant (MDR) strains in isolates with positive KPC is a major challenge in Iran and that it could cause an increase in both mortality and morbidity among burn patients. Thus, appropriate infection control measures and guidelines are needed to prevent such infections among burn patients.
Burns: journal of the International Society for Burn Injuries 06/2012; · 1.95 Impact Factor
ABSTRACT: One of the most common bacterial infections that causes ophthalmia neonatorum is Chlamydia trachomatis, (C. trachomatis). Very few studies have been performed in Iran using both cell culture and polymerase chain reaction (PCR) methods to determine the prevalence of C. trachomatis as an etiological agent of ophthalmia neonatorum. This study aimed to evaluate the prevalence of neonatal chlamydial conjunctivitis (NCC) as diagnosed by both methods in two hospitals in Tehran, Iran. From March 2008 to May 2009, out of 2253 neonates, 241 (10.7%) with clinical findings of conjunctivitis were included in this study. A total of 241 conjunctival swabs were tested by cell culture (as the gold standard test), PCR, and Giemsa staining. Cell cultures were positive for C. trachomatis in 31 (12.9%) neonates, C. trachomatis was positive in 40 (16.6%) neonates by PCR and 18 (7.5%) by Giemsa staining. The sensitivity of PCR was 100%, whereas Giemsa staining sensitivity was 558.1%. High sensitivity (100%) and specificity (95.7%) of PCR as compared to culture makes it a proper diagnostic method for the detection of C. trachomatis.
Archives of Iranian medicine 03/2012; 15(3):171-5. · 0.97 Impact Factor
ABSTRACT: Even with high coverage of vaccination programs, Bordetella pertussis is still reported in various countries. It causes a high rate of mortality and morbidity in infants while it could be asymptomatic in adults. At the present study, we are going to evaluate the frequency of B. pertussis among received specimens.
This cross-sectional study was performed on 138 children under one year who were suspected to have whooping cough from October 2008 to March in 2011. Nasopharyngeal dacron and rayon swabs and sera were used for PCR and serology respectively.
The mean age of the subjects was 1.9± 0.9 months. PCR was positive in 12 cases; ELISA was in agreement with PCR results except in one case that showed the specific antibody at borderline limit.
The rate of reported positive results showed that pertussis not only is still present in the community, but the number of the asymptomatic cases who are able to transmit the disease may be considerable.
The Open Respiratory Medicine Journal 01/2012; 6:34-6.
ABSTRACT: Urinary tract infections (UTI) caused by enterohemorrhagic Escherichia coli (EHEC) is one of the most important diseases in infants and children. If there would not be any useful diagnosis and treatment it may be resulted in diseases such as acute renal failure, thrombocytopenia and hemolytic anemia. The aim of this study was to determine frequency of verotoxigenic E.coli isolates in urine of children with (UTIs) in Mofid children Hospital.
During one year from September 2008 to august 2009, urine specimens were taken from children who suspected to UTI admitted to Mofid Children Hospital. E.coli strains that indicated beta hemolytic on sheep blood agar, negative sorbitol fermentation on SMAC (sorbitol macconky agar) and negative motility on SIM were tested by PCR and serologic (VITEC-RPLA kit) methods for detecting toxin genes and production of toxin, respectively.
Among 12572 urine specimens were taken from children admitted to Mofid hospital, we isolated 378 E.coli from urine samples which only 9 isolates were EHEC. Only five EHEC strains (55%) which produced vtx genes, were detected by serologic and PCR methods.
The prevalence of urinary infections caused by EHEC strains is very significant because it causes aggravating pathologic effects. Thus we suggest rapid method for identification of this bacteria and proper treatment to Inhibition of unwanted complications.
The Open Microbiology Journal 01/2012; 6:1-4.
The 7th World Congress of the World Society for Pediatric Infectious Diseases – WSPID, Melbourne, Australia, November 16-19, 2011; 11/2011