Antibacterial resistance patterns of Acinetobacter baumannii complex:The results of Isfahan Antimicrobial Resistance Surveillance-1 Program

Objective: To determine the antibiotic resistance patterns of the Acinetobacter(A.) baumannii complex isolates that cause the confirmed infection. Methods: The present descriptive study was performed from March 2016 to March 2018 in three referral hospitals in Isfahan, Iran. All A. baumannii complex strains isolated from different clinical samples were identified by conventional phenotypic methods and antibiotic susceptibility pattern was detected. After the clinical investigation, contaminated samples were excluded and the source(hospital/community) and site of the infection were determined. Data on antibiotic susceptibility testing were extracted from WHONET software and analysis was done with SPSS.Results: From 254 patients who had confirmed A. baumannii complex infection, 158(62.20%) cases were male, 27(10.63%) were less than 20 years old, 172(67.72%) had healthcare-associated infections and 96(37.79%) were admitted in intensive care units. The most frequent infection was bloodstream infections(111, 43.70%). Our results showed that most of the isolates were resistant to most of the antibiotics(more than 75.00%) and a lower rate of non-susceptibility was observed against minocycline(20, 44.44%) and colistin(0%). The rate of multidrug-resistant isolates was 88.97%. There was no significant difference between resistance of A. baumannii complex isolates according to age. However, the resistance to amikacin and minocycline and the rate of multidrug resistance(MDR) were significantly different between males and females. In patients with healthcare associated infection(HAI), MDR isolates were significantly different regarding admission in ICU ward. Resistance to levofloxacin and ciprofloxacin were lower in isolates from patients with bloodstream infections in comparison to other diagnoses.Conclusions: In our study, a high level of antibiotic resistance was detected in both community-acquired and healthcare-associated A. baumannii complex infections. Appropriate antibiotic prescription in a clinical setting is an essential need for the control and prevention of A. baumannii resistant infections.

Effects of synbiotic supplementation on anthropometric indices and body composition in overweight or obese children and adolescents:a randomized,double-blind,placebo-controlled clinical trial

Background Recently,beneficial effects of probiotics and/or prebiotics on cardio-metabolic risk factors in adults have been shown.However,existing evidence has not been fully established for pediatric age groups.This study aimed to assess the effect of synbiotic on anthropometric indices and body composition in overweight or obese children and adolescents.Methods This randomized double-blind,placebo-controlled trial was conducted among 60 participants aged 8-18 years with a body mass index(BMI)equal to or higher than the 85th percentile.Participants were randomly divided into two groups that received either a synbiotic capsule containing 6x109 colony forming units(CFU)Lactobacillus coagulans SC-208,6 x 109 CFU Lactobacillus indicus HU36 and fructooligosaccharide as a prebiotic(n=30)or a placebo(n=30)twice a day for eight weeks.Anthropometric indices and body composition were measured at baseline and after the intervention.Results The mean(standard deviation,SD)age was 11.07(2.00)years and 11.23(2.37)years for the placebo and synbiotic groups,respectively(P=0.770).The waist-height ratio(WHtR)decreased significantly at the end of the intervention in comparison with baseline in the synbiotic group(0.54±0.05 vs.0.55±0.05,P=0.05).No significant changes were dem-onstrated in other anthropometric indices or body composition between groups.Conclusions Synbiotic supplementation might be associated with a reduction in WHtR.There were no significant changes in other anthropometric indices or body composition.

伊朗伊斯法罕新生儿重症监护中心新生儿气胸的发病因素、发生率和死亡率调查(英文)

目的该研究旨在调查伊朗伊斯法罕新生儿重症监护中心(NICU)住院新生儿气胸的发病因素、发生率和死亡率。方法 738例入住NICU的新生儿中,43例发生了气胸。回顾性分析气胸患儿的临床资料,包括胎龄、出生体重、Apgar评分、出生方式、母亲年龄、产次、围产期窒息、出生时复苏、气胸发生部位、机械通气情况、肺表面活性物质治疗、肺部疾病等。结果气胸患儿平均胎龄为31周,出生体重为1596g。12例(28%)患儿胎龄小于28周。28例(65%)出生体重低于1500g。共43例(5.8%)新生儿发生了气胸。97%的气胸为单侧(n=63),双侧气胸仅占3%(n=2)。呼吸窘迫综合征(40/43,93%)和机械通气(37/43,86%)是导致气胸发生的常见原因。共28例(65%)患儿死亡。死亡患儿与幸存患儿出生体重、胎龄及胸管留置时间差异有统计学意义。需要肺表面活性物质治疗的气胸患儿死亡率显著增加,与无需表面活性物质治疗的气胸患儿比较差异有统计学意义。结论该研究中气胸的发生率与死亡率高于其他报道,其原因可能是该研究中新生儿出生体重和胎龄都较低。呼吸窘迫综合征和机械通气是导致新生儿气胸发生的常见原因。患儿胎龄越小,体重越低,肺部疾病越严重,死亡率则越高。

伊朗东北部儿童代表性样本中儿童肥胖的膳食预测因素

目的伊朗儿童的肥胖患病率不断升高。这项研究旨在评价伊朗东北部城市Neishabour的儿童代表性样本中肥胖的某些膳食决定因素。方法在这项病例对照研究中,病例组为114名在校学生,年龄6～12岁,体重指数(BMI)≥第95个百分位(根据伊朗儿童的参考值),而对照组为102名年龄和性别匹配的非肥胖同班同学。由受过训练的营养师在儿童在场的情况下与母亲面谈,进行两次24 h膳食回顾调查,收集了营养摄入数据;使用食物频率问卷调查了零食摄入模式;使用SPSS软件(第16版)进行了单因素和多因素logistic回归分析。结果单因素logistic回归分析显示,总能量、蛋白质、碳水化合物、脂肪(包括饱和脂肪、单不饱和脂肪和多不饱和脂肪)和膳食纤维是学生肥胖的正向预测因素;玉米膨化食品、碳酸饮料、薯片、快餐食品和巧克力的摄入频率的粗估比值比(OR)有统计学意义。多因素logistic回归分析显示,肥胖与能量摄入量(OR=2.489,95%CI:1.667～3.716)、玉米膨化食品摄入频率(OR=1.122,95%CI:1.007～1.250)及薯片摄入频率(OR=1.143,95%CI:1.024～1.276)显著相关;而膳食纤维摄入量(OR=0.909,95%CI:0.835～0.988)和天然果汁摄入量(OR=0.601,95%CI:0.368～0.983)是预防肥胖的保护因素。结论该研究结果证实了不健康饮食对儿童肥胖的作用,尤其是高热量零食。应鼓励儿童养成健康的饮食习惯,如摄入高纤维食物。

Impact of dyslipidemia on estimated glomerular filtration rate in apparently healthy children and adolescents:the CASPIAN-V study

Background Chronic kidney disease(CKD)is a leading risk factor for development of cardiovascular disease(CVD).Dyslipidemia is also known as risk factor for CVD development.However,the association of dyslipidemia with glomerular injury among healthy children and adolescents remains controversial.We aimed to investigate the relationship between estimated glomerular filtration rate(eGFR)and lipid profile risk factors among healthy children and adolescents.Methods In this nationwide survey,3808 participants(1992 males,1816 females),aged 7-18 years,were selected by cluster random sampling method from 30 provinces in Iran.Body mass index(BMI)and systolic and diastolic blood pressures were measured.Blood samples were obtained for serum creatinine,fasting blood glucose,total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and triglyceride(TG)determinations.GFR was estimated using Schwartz equation.Results Girls had higher eGFR than boys(P=0.04).In a multiple regression analysis,eGFR demonstrated a positive correlation with systolic blood pressure,BMI,fasting glucose,TC,HDL-C,and TG.By the analysis of covariance,TC,HDL-C,and TG showed a negative correlation with eGFR after adjustments for BMI,systolic and diastolic blood pressures,and fasting glucose(OR=0.56,95%CI=0.29-0.89).Conclusion The study showed that dyslipidemia is associated with reduced eGFR among the healthy children and adolescents.

神经系统疾病儿童的血铅水平调查:单中心初步研究(英文)

目的儿童铅中毒具有很大的潜在危害。慢性低水平铅暴露会导致学习障碍及行为问题,如腹痛,失眠,多动,生长发育落后,听力损失,上肢无力。该研究旨在调查神经系统疾病儿童的血铅水平,并与健康儿童作比较。方法100名患有神经系统疾病的1～10岁儿童作为研究对象。100名年龄和性别匹配的健康儿童作为对照。采用火焰原子吸收光谱法检测血铅含量。结果神经系统疾病组儿童的平均血铅含量显著高于对照组,差异有显著性(113.2±47.5μg/Lvs84.7±38.0μg/L;P<0.01)。神经系统疾病组和对照组分别有44%和19%的儿童血铅超标(>100μg/L)。结论儿童血铅水平增高可能与神经系统疾病有关。建议对患神经系统疾病的儿童常规作血铅测定。

Periconceptional care and offspring health at birth and long term,from the perspective of Avicenna

Periconceptional care such as lifestyle plays an important impact role in offspring health. The aim of the present study was to clarify the perspective of Avicenna on periconceptional care. Avicenna(980–1037 A.D.) was one of the outstanding Persian physicians, who made great contributions to the field of medical sciences, in particular, obstetrics. In advance, Avicenna's book, Canon of Medicine, was considered to find his perspectives on periconceptional care. Then, his ideas and theories were compared to the current findings by searching the keywords in main indexing systems including PubMed/MEDLINE,Scopus and Institute for Scientific Information Web of Science as well as the search engine of Google Scholar. Current investigations show that gamete quality, pregnancy outcome, and offspring health at birth and long term depend on both parents' lifestyle in pre-and periconceptional period, as well as the intrauterine environment. Avicenna believed that seminal fluid, sperm, ovum, and developing conditions in utero were influenced by the stages of food digestion and the function of some organs.On the other hand, food digestion and function of the organs also depend on each parent's lifestyle and environmental factors. He mentioned 6 principles of healthy lifestyle: exercise, nutrition, sleep and awareness, excretion of body wastes and retention of necessary materials, psychic features, as well as air and climate. Thus, a multicomponent healthy lifestyle should be considered by parents of child-bearing age in an appropriate period before and in early pregnancy as well as elimination of any disorders in parents, to give birth to more healthy offspring.

Socioeconomic inequality in screen time frequency in children and adolescents: the weight disorders survey of the CASPIAN IV study

Background This study aimed to assess the socioeconomic inequality and determinants of screen time (ST) frequency in Iranian children and adolescents. Methods This nationwide study was conducted as part of a national school-based surveillance program among 36,486 students consisting of 50.79% boys and 74.23% urban inhabitants, aged 6–18 years, living in urban and rural areas of 30 provinces of Iran. Socioeconomic inequality in ST, including the time spent for ST, watching TV and leisure-time work-ing with computer, was assessed across quintiles of SES using concentration index (C) and slope index of inequality (SII). Results Overall, 36,486 students completed the study (response rate 91.25%). Their mean (SD) age was 12.14 (3.36) years. The national estimation of frequency of ST was 31.66% (95% CI 31.16–32.17) with ascending change from 20.80% (95% CI 19.81–21.82) to 36.66% (95% CI 35.47–37.87) from the first to the last quintal of SES. EstimatedC value at national level was positive (0.08), which indicate inequality was in favor of low SES groups. Considering the SII values, at national level [? 0.16 (? 0.39, 0.06)], the absolute difference in ST frequency between the bottom and top of the socioeconomic groups had descending trends. In multivariate logistic regression model, family history of obesity, generalized obesity and age were the main significant determinants of prolonged ST, watching TV, and computer working (P < 0.001). Conclusions Socioeconomic inequality in ST frequency was in favor of low SES groups. These findings are useful for health policies, better programming and future complementary analyses.

Pediatric-specifi c reference intervals in a nationally representative sample of Iranian children and adolescents: the CASPIAN-III study

Background:This study aimed to determine for the fi rst time the age-and gender-specific reference intervals for biomarkers of bone,metabolism,nutrition,and obesity in a nationally representative sample of the Iranian children and adolescents.Methods:We assessed the data of blood samples obtained from healthy Iranian children and adolescents,aged 7 to 19 years.The reference intervals of glucose,lipid profile,liver enzymes,zinc,copper,chromium,magnesium,and 25-hydroxy vitamin D[25(OH)D]were determined according to the Clinical&Laboratory Standards Institute C28-A3 guidelines.The reference intervals were partitioned using the Harris–Boyd method according to age and gender.Results:The study population consisted of 4800 school students(50%boys,mean age of 13.8 years).Twelve chemistry analyses were partitioned by age and gender,displaying the range of results between the 2.5th to 97.5th percentiles.Significant differences existed only between boys and girls at 18 to 19 years of age for low density lipoprotein-cholesterol.25(OH)D had the only reference interval that was similar to all age groups and both sexes.Conclusions:This study presented the first national database of reference intervals for a number of biochemical markers in Iranian children and adolescents.It is the fi rst report of its kind from the Middle East and North Africa.The fi ndings underscore the importance of providing reference intervals in different ethnicities and in various regions.