Background:Multi-drug resistant Klebsiella pneumoniae has been considered as a serious global threat. This study was done to investigate carbapenemase producing genomes among K. pneumoniae isolates in Isfahan, Central Iran.Materials and Methods:In a cross-sectional study from 2011 to 2012, 29 carbapenem resistant (according to disc diffusion method) carbapenemase producing (according to modified Hodge test) K. pneumoniae strains were collected from Intensive Care Unit (ICUs) of Al-Zahra referral Hospital. In the strains with the lack of sensitivity to one or several carbapenems, beta-lactams, or beta-lactamases, there has been performed modified Hodge test to investigate carbapenmase and then only strains producing carbapenmases were selected for molecular methods.Results:In this study, there have been 29 cases of K. pneumoniae isolated from hospitalized patients in the (ICU). Three cases (10.3%) contained blaVIM, 1 case (3.4%) contained blaIMP, and 1 case (3.4%) contained blaOXA. The genes blaNDM and blaKPC were not detected. Then, 16 cases (55.2%) from positive cases of K. pneumoniae were related to the chip, 4 cases (13.8%) to catheter, 6 cases (20.7%) to urine, and 3 cases (10.3%) to wound.Conclusion:It is necessary to monitor the epidemiologic changes of these carbapenemase genes in K. pneumoniae in our Hospital. More attention should be paid to nosocomial infection control measures. Other carbapenemase producing genes should be investigated.

Background: Vitamin D plays an important role in regulating the immune system, calcium and phosphorus homeostasis, and bone formation. This micronutrient plays an important role in the incidence and severity of respiratory infections. Objectives: The aim of this study was to evaluate the vitamin D serum level in children with acute lower respiratory infections (ALRIs) and its association with the severity of infection with vitamin D serum level. Methods: This cross-sectional study was conducted on 99 children with ALRIs aged 20.13 ± 17.55 months who were selected with a simple random sampling technique. The children were examined and evaluated at the time of admission. Their data, including demographic characteristics and the findings of the physical examination and laboratory, were recorded in the questionnaires. Serum level of 1,25-dihydroxy vitamin D3 [1,25(OH)2D] and 25-hydroxyvitamin D3 [25(OH)D] were measured by HPLC method. Results: children with severe acute lower respiratory infection had a significant lower level of 25(OH) D (P = 0.02). Indeed, data analysis showed a level of 25(OH) D inversely associated with severity of acute lower respiratory infections in children (B =-0.7, P = 0.00). Conclusions: The severity of the lower respiratory tract infections was inversely proportional to the level of 25(OH)D, and it may be hoped that increasing 25(OH)D level may reduce the severity of ALRIs.

Purpose: This study aimed to assess the effect of omeprazole on urinary excretion of magnesium in children receiving omeprazole for treatment of peptic disease. What is the effect of omeprazole on urinary fractional excretion of magnesium? Methods: This single-armed clinical trial study was conducted on 44 children with a diagnosis of acid peptic disease who was treated with omeprazole (1-2 mg/kg/day) for 3 months in Gastroenterology clinics of Imam Hossein hospital, 2021, Isfahan, Iran. Before and after the intervention, serum levels of magnesium and creatinine and urine magnesium and creatinine levels were measured by Pars Azmoon Kit based on the guideline of the kit. Then fractional excretion of magnesium (Mg) was calculated based on the formula. Results: The mean urinary magnesium levels before and after intervention were 4.96±2.48 and 1.46±0.63, respectively (P<0.001). A significant decrease in serum Mg level was also observed after treatment versus before treatment (1.37±0.03 vs. 1.9±0.2, P<0.01). The mean fractional Mg excretion before and after therapy were 5.2±1.2 and 1.7±0.63, respectively (P<0.01). Serum creatinine level before and after therapy was 0.62±0.19 and 0.67±0.13, respectively (p=0.053). Urinary creatinine level was increased after intervention by 20.80±18.77 (p<0.001). Conclusion: The cause of hypomagnesemia is not increased urinary loss of magnesium, conversely, the kidney effort to compensate for the drop in blood magnesium following omeprazole treatment, by reducing urinary excretion of it and saving magnesium ions in the body.