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Aims: The present study aimed to determine the prevalence of nosocomial infections and their bacterial agents in patients admitted to Poursina Medical and Educational Center of Rasht.
Materials & Methods: The present retrospective descriptive study was conducted by referring to the Infection Control Unit of Poursina hospital and investigating the records of patients with culture-positive nosocomial infections from April 2013 until the end of September 2015. Bacterial agents were diagnosed based on the standard microbiological tests.
Results: During the research period, urinary tract and blood infections were reported as the highest and lowest nosocomial infections, respectively. The most common strains causing nosocomial infections were Acinetobacter spp. (24.7%) (as the most common strain causing respiratory infection), Escherichia coli (22.9%) (as the most common strain causing urinary tract infection), and Enterobacter spp. (19.9%) (as the most common strain causing postoperative infection). Based on the frequency distribution of bacterial strains in hospital wards, Acinetobacter spp was reported as the most common strain isolated from patients in the intensive care unit.
Conclusion: According to the present study results, Acinetobacter spp was the most common strain isolated, and UTIs were the most common type of infection. Due to the prevalence of UTIs and the financial, physical, and social damage they impose to the whole country and the constant change of common pathogens and their susceptibility and antibiotic resistance patterns, it is necessary to conduct studies on this issue in the academic centers of each province at regular intervals.
 

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Backgrounds: The present study aimed to determine the quick Sepsis-related Organ Failure Assessment (qSOFA) score in comparison with systemic inflammatory response syndrome (SIRS) criteria to predict adverse consequences of a suspected bacterial infection in patients outside the intensive care unit (ICU).
Materials & Methods: This retrospective study was conducted on patients during March 2018 to March 2019. All hospitalized patients with this suspected infection were positive for both SIRS and microbial cultures. Demographic and laboratory variables were recorded for all patients to determine the presence and time of various components of both SIRS criteria and the qSOFA score.
Findings: Out of 128 patients with suspected sepsis, 87 (68%) patients were confirmed to have septicemia based on SIRS criteria. SIRS criteria classified 68% of patients in the sepsis group (87 of 128), of which 39(44.8%) had a positive qSOFA score. The sensitivity and specificity ratios of qSOFA were 44.83 and 80.49%, respectively.
Receiver operating characteristic (ROC) curve analysis results showed that the area under the ROC curve (AUC) of pSOFA scores for predicting sepsis patients was not significantly different. Moreover, regarding the sepsis-related mortality, the area under ROC showed that qSOFA criteria (score ≥ 2) were able to predict mortality in patients with 71% sensitivity and 72% specificity.
Conclusion: This study findings revealed that the qSOFA score was significantly efficient in predicting mortality. However, SIRS criteria were more sensitive than the qSOFA score in predicting the definitive diagnosis of sepsis. Therefore, the qSOFA score seems to be an invaluable tool for predicting outcome in sepsis patients.

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Backgrounds: This study aimed to describe the aetiological profile of fever without focus (FWF) in children aged one to thirty-six months and to identify clinical and laboratory predictors of specific aetiologies, especially serious bacterial infection (SBI).
Materials & Methods: Children in the age range of one to thirty-six months, who were hospitalised due to FWF were included in this study. This prospective study was done over a period of 20 months in a medical college hospital in southern India. CBC (complete blood count) and CRP (c-reactive protein) tests, urine microscopic examination, blood and urine culture, Dengue antigen testing, and chest X-ray test were done for all feverish children. For those with fever beyond 5 days, additional tests including serological tests for Dengue, scrub typhus, and leptospirosis as well as Widal test were done. The final diagnosis was recorded, and clinical and laboratory parameters were analysed.
Findings: Among 141 children with FWF, 41 (29%) had SBI, and 21(14.9%) had Dengue fever (DF). Leucocytosis, neutrophilia, and raised CRP levels were good predictors of SBI. Thrombocytopenia was an excellent predictor of DF. High fever was significantly associated with SBI and Dengue (p=.004), and fever beyond 3 days at presentation was significantly associated with SBI (p=<.001). Pyuria had a high specificity (94.5%) for identifying urinary tract infection (UTI). About 50% of UTIs were caused by extended spectrum beta lactamase (ESBL) producing organisms.
Conclusion: SBI and DF were the most common causes of FWF. High fever, fever beyond 3 days at presentation, leucocytosis, neutrophilia, and a positive CRP test were predictors of SBI. Pyuria suggests UTI. Empirical antibiotic therapy should cover ESBL producing organisms. High fever and thrombocytopenia suggest Dengue fever.