Diarrhoeagenic E. coli pathotypes in children with and without diarrhoea in an Iranian referral paediatrics centre.

Diarrhoeagenic Escherichia coli can be considered as the most important etiologic agents of diarrhoea in the Islamic Republic of Iran, particularly in children. This study determined the frequency of diarrhoeagenic E. coli isolates collected from children with acute diarrhoea (n = 50) and a control group (n = 50) at an Iranian referral paediatric centre during a 1-year period. Using multiplex PCR, diarrhoeagenic E. coli was identified in 90% ofthe case group and 20% of controls. Enterotoxigenic E coli was the most frequently identified pathotype in both groups (26% in cases; 10% in controls). Shiga toxin-producing E. coli was the second most isolated pathotype (17%), followed by enteroaggregative E. coli (12%). No enteroinvasive E. coli and enteropathogenic E. coli strains were recovered. More than 80% of isolates harboured the fimH gene. This high proportion of diarrhoeagenic E. coli and diversity of E. coli types highlights the need for enhanced surveillance of gastroenteritis agents in children in this country.

Diarrhoeagenic E. coli pathotypes in children with and without diarrhoea in an Iranian referral paediatrics centre

Diarrhoeagenic Escherichia coli can be considered as the most important etiologic agents of diarrhoea in the Islamic Republic of Iran, particularly in children. This study determined the frequency of diarrhoeagenic E. coliisolates collected from children with acute diarrhoea [n= 50] and a control group [n= 50] at an Iranian referral paediatric centre during a 1-year period. Using multiplex PCR, diarrhoeagenic E. coli was identified in 90% of the case group and 20% of controls. Enterotoxigenic E. coli was the most frequently identified pathotype in both groups [26% in cases; 10% in controls]. Shiga toxin-producing E. coli was the second most isolated pathotype [17%], followed by enteroaggregative E. coli [12%]. No enteroinvasive E. coliand enteropathogenic E. colistrains were recovered. More than 80% of isolates harboured the fimHgene. This high proportion of diarrhoeagenic E. coli and diversity of E. coli types highlights the need for enhanced surveillance of gastroenteritis agents in children in this country

Genotypic characteristics of Pseudomonas aeruginosa strains circulating in the tertiary referral Children's Medical Hospital in Tehran, Iran.

Pseudomonas aeruginosa is an important pathogen with the ability to cause infection in all departments of the hospital, especially in intensive care units (ICUs). The aim of this study is to analyse the epidemiological relationships among clinical P. aeruginosa strains isolated from different wards of the Children's Medical Center Hospital (Tehran, Iran). These isolates were identified by standard laboratory procedures and tested for antimicrobial resistance to several antibiotic agents. The genetic similarity of the strains was investigated by amplification of the enterobacterial repetitive intergenic consensus sequence (ERIC-PCR). During the study period, 87 non-duplicate patients were colonised or infected with P. aeruginosa. Among the isolates, resistance to piperacillin/tazobactam was low (27%), followed by amikacin (31%), gentamicin (33%), imipenem (33%), ciprofloxacin (36%) and meropenem (39%). Thirty-five patients (40.2%) were either colonised or infected with a multidrug-resistant P. aeruginosa strain (MDRP) over a one-year period, and 17 isolates were non-susceptible to all the tested antibiotics. One predominant profile (D) was identified in 59 strains. This profile first appeared in the paediatric intensive care unit (PICU) and infection ward in June 2010, and circulated around all wards up to the end of the study period. Of the 35 MDRP, 22 (62.8%) were found to be profile D. Molecular typing of the isolates suggests considerable cross-transmission of P. aeruginosa not only between patients in one ward but also between patients from different wards. This can be explained partly by the high number of patients transferred between different wards of the hospital.

Prevalence of intestinal parasites among children referred to Children's Medical Center during 18 years (1991-2008), Tehran, Iran.

Epidemiological studies show that parasitic inections are among the most common infections and one of the biggest health problems of the society worldwide. Children at school age have the highest morbidity compared with other ages. Therefore, by treating these children, the disease burden in the total population is reduced. In this study, prevalence of parasitic infection in children referred to Children's Medical Center was compared in different years. In this retrospective cross-sectional study, the subjects were children under 13 years who were referred to Children's Medical Center Laboratory during 18 years (1991-2008) and underwent stool exam by any reason. The specimens were evaluated by different common methods of stool parasitology. In suspected cases, parasites was cultured in specific medium and stained as needed. Required data were obtained from the laboratory files and analysed according to study's purpose. Subjects were 124 366 children. Among them, 0.78% of cases had parasitic infections and 60.54% cases were male. Parasitic infections were related to protozoa in 95.33% cases and intestinal worms in 4.87%. Of them, 50.352% were pathogenic protozoa. The most parasitic infection was Giardia lamblia. Among intestinal worms, the highest prevalence was related to Hymenolepis nana (40.7%). A comparison between the first 10 years and the next 8 years of the study showed that the prevalence of intestinal parasites were 8% and 1% (P < 0.001) and the rate for protozoal infection were 14.9% and 4.3%, respectively (P < 0.001). The prevalence of intestinal parasites was reduced during recent years; however, more attempts should be performed to make it lower.

Prevalence of haemoglobinopathies in 34,030 healthy adults in Tehran, Iran.

BACKGROUND: Haemoglobinopathies are a group of inherited disorders of haemoglobin synthesis. Their frequency varies considerably with geographic location and ethnic group. AIMS: To establish the prevalence of haemoglobinopathies in a mainly healthy Iranian population. METHODS: All files of the haematology unit of the Boghrat laboratory over a period of 10 years (1998-2007) were analysed in relation to the age, sex, full blood count, haemoglobin electrophoresis results, high performance liquid chromatography (HPLC) findings, and iron profile of healthy subjects referred for consultation before marriage. Other tests were performed if indicated. RESULTS: There were 34,030 files; 13,432 (39.5%) were for men, and 20,567 (60.4%) for women. 0.74% of subjects (255) showed a haemoglobinopathy. The distribution of variant haemoglobins in these 255 subjects was: Hb D 75.67% (193 cases), Hb S 4.7%, Hb E 3.13%, Hb O-Arab 1.96% and Hb Lepore 0.39%. A fast haemoglobin was found in 4.71% of subjects. Of the subjects tested, 13.2% (4478) had beta-thalassaemia minor, 0.2% (52) beta-thalassaemia intermedia and 0.1% (30) beta-thalassaemia major. CONCLUSIONS: In comparison with other parts of world, there is a different pattern of haemoglobinopathy with a high prevalence of Hb D, which appears to be Hb D Iran.