Vol. 9 (2023)

Research/Original Article- Bacteriology

Central Catheter Infection in Patients on Acute and Chronic Hemodialysis: A Cross Sectional Study

Leila Akhavan, Hamidreza Najjari, Behzad Bijani, Arash Kordi, Abbas Allami

Archives of Medical Laboratory Sciences, Vol. 9 (2023), 15 January 2023, Page 1-11 (e5)

Background and Aim: The most common complication of central venous catheter (CVC) in hemodialysis (HD) is infection. Identifying CVC- related infection (CVC-RI) risk factors and causative micro - organisms is essential for setting prevention policies. This study aims to determine the prevalence of CVCRIs and identify any associated risk factors among these patients.

Methods: We conducted a cross-sectional study from 2017 to 2018 to determine the prevalence of central catheter - related infections among all adult patients on both acute and chronic hemodialysis who had central catheters in place at a tertiary care hospital in Qazvin City. Data on demographics, comorbidities, dialysis duration, catheter - related complications, catheter removal, dialysis details (frequency, duration), catheter insertion site, and any history of central catheter - related infections were collected from medical records. A central catheter - related infection is defined as a positive blood culture obtained from a central venous catheter tip or any other related site (e.g., tunnel, exit site) with clinical signs of infection such as fever, chills, or localized pain and tenderness. Micro - organisms isolated from cultures of CVC, catheter tips, and blood cultures were identified. Chi-square and t-test were performed to compare demographic and clinical variables.              P < 0.05 was considered statistically significant.

Results: 171 patients (214 hospital admissions) enrolled in the study. Of these hospital admissions, 91 (42.5%) had              CVC-RI. There was no significant relationship between CVC-RI and age, gender, body mass index (BMI), marital status, education, residency, comorbidities, addiction, and etiology of kidney failure. Variables such as smoking (p = 0.012), catheter type (p = 0.031), CVC location (p = 0.026), emergency catheter placement (p = 0.005), previous catheter history          (p = 0.004), and number of previous catheter (p = 0.006), previous catheter infection history (p = 0.002), and antibiotic use in the recent month (p = 0.001) were associated with an increased CVC-RI. Of the positive blood cultures, the majority were gram - positive bacteria.

Conclusion: CVC-RI in HD is high and smoking, CVC location, number of previous catheters and their infection history, and antibiotic use in the recent month are risk factors related to CVC-RI. Education on proper hygiene for the prevention of CVC-RI is essential for patients that had no previous intravascular line. Staphylococcus aureus must be taken into account for empirical therapy.


*Corresponding Author: Abbas Allami; Email: allami@qums.ac.ir

Please cite this article as: Akhavan L, Najjari H, Bijani B, Kordi A, Allami A. Central Catheter Infection in Patients on Acute and Chronic Hemodialysis: A Cross Sectional Study. Arch Med Lab Sci. 2023;9:1-11 (e5). https://doi.org/10.22037/amls.v9.39205

Identification of Candida Species Associated with Blood Infection by Multiplex PCR and Phenotypic Characteristics

Bahareh Fallah, Masoomeh Shams-Ghahfarokhi, Mohammadreza Salehi

Archives of Medical Laboratory Sciences, Vol. 9 (2023), 15 January 2023, Page 1-9 (e1)

Background and Aim: The correct identification of Candida species is one of the most critical procedures in prognostic and therapeutic significance, allowing an early and appropriate antifungal therapy. This study aimed to evaluate multiplex PCR as a rapid diagnostic method and traditional phenotypic tests in identifying Candida species isolated from candidemia cases.

Methods: In this study, 38 Candida spp were isolated from culturing of human blood obtained from patients suspected to candidemia. The isolated species were evaluated by phenotypic and molecular methods including carbohydrate assimilation test, colony colour on CHROMagar Candida, chlamydoconidia production, germ tube formation and Multiplex PCR. Multiplex PCR was performed using specific primers of 4 common species. The results of multiplex PCR were compared with those obtained from phenotypic tests.

Results: According to multiplex PCR findings, the isolated Candida species were identified as C. albicans, C. parapsilosis, C. glabrata, and C. tropicalis. Phenotypic tests identified that 23 (60.52%), 8 (21.05%), 5 (13.15%), and 2 (5.26%) isolates belonged to C. albicans, C. parapsilosis, C. glabrata, and C. tropicalis, respectively, that were confirmed by multiplex PCR results. C. albicans and C. parapsilosis had the same carbohydrate assimilation pattern but were differentiated based on their colonies color on CHROMagar and the ability of C. albicans to produce chlamydoconidia and germ tube. C. glabrata (100%) and C. tropicalis (100%) assimilated trehalose and cellobiose, respectively.

Conclusion: Our study showed that the both phenotypic and molecular techniques provide appropriate information for identification of Candida spp from blood samples.

*Corresponding Author: Masoomeh Shams-Ghahfarokhi; Email: shamsm@modares.ac.ir; ORCID ID: 0000-0003-2562-965X

Please cite this article as:  Fallah B, Shams-Ghahfarokhi M, Salehi M. Identification of Candida Species Associated with Blood Infection by Multiplex PCR and Phenotypic Characteristics.  Arch Med Lab Sci. 2023;9:1-9 (e1). https://doi.org/10.22037/amls.v9.38406

Background and Aim: Bacterial infections are the most frequently occurring infections in pets. Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) have been recognized as two opportunistic pathogens that are prevalent in pets. The aforementioned organisms play a vital role in the development and propagation of infections that affect the urinary tract, respiratory system, and gastrointestinal tract. The growing emergence of multidrug resistance among the bacteria is a global concern. The investigation of antibiotic resistance and genotypic characterization of Extended- spectrum β-lactamases (ESBLs) and Metallo - β - lactamase (MBL) - producing Enterobacteriaceae (CPE) in companion animals in Iran has been infrequently documented. The aim of this study was to identify the phenotypic and genotypic characterization of ESBL and MBL - producing Escherichia coli and Klebsiella pneumoniae strains that were isolated from dogs and cats stool.

Methods: A total of 65 stool samples of dogs and cats were collected from five veterinary hospitals between February to August 2022. The antimicrobial susceptibility test (AST) was evaluated by using disk diffusion according to The Clinical and Laboratory Standards Institute guidelines (CLSI). The detection of ESBLs and MBLs producing isolates was performed by Combination Disk Diffusion Test (CDDT). The presence of blaCTXM, blaTEM,blaSHV, blaNDM, blaVIM, blaIMP genes was detected by PCR technique.

Results: Among 65 samples, 24 E. coli and 6 K. pneumoniae strains were identified. According to our findings, the most effective antibiotics against bacterial isolates were piperacillin - tazobactam imipenem and meropenem, respectively. The prevalence of ESBL and MBL was found to be 66.66% and 0%, respectively. The PCR assay revealed the presence of blaCTXM-15, blaTEM, blaSHV, blaIMP genes 28, 28, 18, 1 number, respectively. Whereas blaNDM, and blaVIM genes were not detected.

Conclusion: The increasing prevalence of antibiotic resistance genes is a significant concern in the field of medicine. The excessive utilization of antibiotics may lead to the acquisition of genes that contribute to resistance.

*Corresponding Author: Ali Hashemi; Emails: ali.hashemi@sbmu.ac.ir; hashemi1388@yahoo.com

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Please cite this article as: Havaei-Ahari D, Hashemi A, Jafarian Dehkordi M. Identification of Extended - Spectrum β - Lactamases and Metallo - Beta - Lactamases Producing Escherichia Coli and Klebsiella Pneumoniae Strains Isolated from Stool Samples of Dogs and Cats. Arch Med Lab Sci. 2023;9:1-6 (e2). https://doi.org/10.22037/amls.v8.42459

Research/Original Article- Biochemistry

Antioxidant Activity of Methanolic Extracts of Borago Officinalis, Teucrium Polium, Mentha Aquatica and Allium Taradox

Fatemeh Shahdadi , Ali Salehi Sardoei

Archives of Medical Laboratory Sciences, Vol. 9 (2023), 15 January 2023, Page 1-7 (e4)

Background and Aim: Free radicals and the oxidative stress they generate are implicated in a wide range of disorders in the human body. One of the important approaches to eliminate free radicals and prevent their side effects is to use natural antioxidants. Plants contain significant amounts of phenolic compounds in all their parts that give them antioxidant properties. This study aims to evaluate the antioxidant activity and phenolic content of methanolic extracts from aerial parts of some medicinal plants.

Methods: Methanolic extracts from the leaves of Wild Borage (Borago officinalis), Teucrium (Teucrium polium), Water Mint (Mentha aquatica) and Wild Leek (Allium taradox) were prepared and evaluated for their free-radical scavenging capacity or their antioxidant activity. The amount of total phenolic content was determined using the folin-ciocalteu method and the amount of anti - radical activity was determined using the DPPH free radical scavenging method and determining inhibitory concentration (IC50). All experiments were performed in triplicate.

Results: The obtained results and statistical analyses showed that the methanolic extracts of Borago officinalis and Teucrium polium contain high amounts of phenolic compounds and also had more free radical inhibition due to the lower IC50 values. Also, Borago officinalis had significant antioxidant activity compared to other plants.

Conclusion: Our investigation indicates that Borago officinalis leaves are a promising source of natural antioxidants. 


*Corresponding Author: Ali Salehi Sardoei; Email: Alisalehisardoei@gau.ac.ir; ORCID ID: 0000-0002-4054-3750

Please cite this article as: Shahdadi F, Salehi Sardoei A. Free Radical Scavenging Capacity and Antioxidant Activity of Methanolic Extracts of Borago Officinalis, Teucrium Polium, Mentha Aquatica and Allium Taradox. Arch Med Lab Sci. 2023;9:1-7 (e4). https://doi.org/10.22037/amls.v9.38310

Hepatic and Renal Function Tests and Routine Hematological Markers in Patients with Cerebrovascular Accident and Transient Ischemic Attack

Abdollah Monfared, Mohammadreza Fadavipour, Sahar Golabi, Naser Kamyari, Atefeh Zahedi, Alireza Hazbenejad, Khadijeh Kanani, Saeed Jelvay, Mahboobeh Tajvidi, Esmat Radmanesh

Archives of Medical Laboratory Sciences, Vol. 9 (2023), 15 January 2023, Page 1-9 (e3)

Background and Aim: Cerebrovascular accident (CVA), also known as stroke, is a vascular syndrome that is the second leading cause of death in the world after ischemic heart disease. Transient ischemic attacks (TIAs) is a warning sign for CVA so that 20% of patients with TIA experience a subsequent stroke within 90 days. Hence, identification of laboratory markers is crucial for the prognosis and diagnosis of patients with CVA and TIA. Changes in some laboratory markers occur in patients with CVA and TIA. Thus, the present study aimed to evaluate hepatic and renal function tests and routine hematological markers in patients with CVA and TIA.

Methods: The present study was a cross - sectional analytical study. The study population was patients with CVA and TIA who were hospitalized in Abadan and Khorramshahr educational hospitals from March 21, 2019, to March 19, 2020. One hundred patients with CVA and one hundred patients with TIA were randomly selected and the necessary information (age, sex, liver enzymes, renal function tests, FBS, and routing hematologic markers including CBC, ESR, PT and PTT) of the patients was collected from HIS (Hospital Information System) of Abadan and Khorramshahr educational hospitals. Liver, kidney and hematologic diagnostic markers were evaluated by age and gender. Data analysis was performed using a t -test (to compare gender difference of laboratory markers in CVA and TIA groups) and one-way ANOVA (to compare laboratory markers among age groups of patients with CVA and TIA). Simple linear regression was used to examine the relationships between changes in FBS (mg / dl) and changes in laboratory diagnostic factors.

Results: The results of this study showed that the highest frequency of patients with CVA (n= 130, 27.3%) and TIA (n= 49, 23.8%) was observed in the age group of 55-64 years. The results indicate that the mean level of some laboratory markers such as FBS (CVA: 174.32 ± 105.83; TIA: 150.32 ± 83.32), creatinine (CVA: 1.37 ± 1.32; 1.42 ± 1.09), LDH (CVA: 696.29 ± 344.90; TIA: 538.17 ± 230.76), and ESR (CVA: 52.41 ± 37.61; TIA: 14.00 ± 8.40) was higher than the normal range in both CVA and TIA. The mean of SGOT (34.10 ± 26.40 IU / L) and ALK (331.44 ± 370.78 IU / L) enzymes were higher than normal only in CVA patients and the mean of SGPT (33.08 ± 38.55 IU / L) was higher than normal only in TIA patients. It was also observed that in patients with CVA, with each unit increase in FBS, a significant increase occurs in K+ level (P < 0.001), WBC (P= 0.003), and RBC (P= 0.031) count, as well as a significant decrease in Na+ level (P= 0.008).

Conclusion: The results of the present study showed an increase in the level of FBS, ESR and LDH both in CVA and TIA. While SGOT and ALK increased only in CVA patients, SGPT showed an increase only in TIA patients.


*First Corresponding Author: Esmat Radmanesh; Email: e.radmanesh@abadanums.ac.ir; ORCID ID:                                        0000-0003-1369-6580

Second Corresponding Author: Sahar Golabi; Email: s.golabi@abadanums.ac.ir

Please cite this article as:  Monfared A, Fadavipour M, Golabi S, Kamyari N, Zahedi A, Hazbenejad A, Kanani K, Jelvay S, Tajvidi M, Radmanesh E. Hepatic and Renal Function Tests and Routine Hematological Markers in Patients with Cerebrovascular Accident and Transient Ischemic Attack. Arch Med Lab Sci. 2023;9:1-9 (e3). https://doi.org/10.22037/amls.v9.39255