---

History and Objectives: Due to hepatitis B prevalence and complications resulting from the infection and the fact that prevention of the disease through vaccination has prime importance and because of reported discrepancy concerning the effectiveness of intradermal vaccination of hepatitis B, this study was conduced to compare the effectiveness of intradermal and intermuscular injection of the hepatitis B vaccine among female high school students of Kashan in 1996-1997.

Materials and Methods: In a clinical double-blind randomized trial on 200 students, HBsAg and HBSAb were measured by ELISA method before vaccination and positive cases were eliminated. Hundred and ninety students were randomly divided into two groups based on age and high school grade. In the experimental group, 0.1 ml of recombinant hepatitis B vaccine (Herber Biotech S.A Cuba) was injected by health center technicians intradermally at the three intervals of 0, 1 and 6 months in the flexor surface of forearm intradermally. In the control group, 1ml of the same vaccine with the same time intervals was injected intermuscularly by the same health technicians at the same deltoid region. Three weeks after the last injection, the effect of the vaccination was assessed by ELISA method by laboratory technicians who were unaware of the student group designations. Statistical Fischer test was conducted.

Results: The prevalence of HBsAg and HBSAb in population was 4.5 and 0.5% respectively. Experimental and control groups were matched on the basis of age and high school grade. The control group displayed 97.6% positive response, 1.2% weak positive response and 1.2% negative response, whereas the experimental group displayed 93.7%, 2.1% and 4.2% respectively. The differences were statistically significant.

Conclusion: It seems that due to a very small difference in the effectiveness of 2 methods and low cost of vaccination of intradermal injection, a larger size clinical trial is recommended. A study on the effectiveness of the time intervals for vaccination is also recommended.

---

History and Objectives: Due to importance of the intestinal parasite in the personal as well as social hygiene and role of producers and distributors of the food stuff in the spread of the infection and in light of variation of the spread of the disease in the country and lack of accurate epidemiological data in Kashan, this study was conducted in 1996.

Materials and Methods: The present study is a descriptive analysis of total population of 2010 subjects of various food producers and distributors. Type of vending activity was recorded and after necessary instructions, 2 fecal samples were collected from each individual and analyzed by microscopic direct examination and formalin-ether method.

Results: The prevalence of the infection in the population was 54.4%. The prevalence of Giardia lamblia, Entamoeba histolytica, Himonolypis nana and ascaris was 16.3%, 5.2%, 1% and 0.9% respectively. Maximum rate of infection of Giardiasis (20.6%) and Ascaris (5.3%) were in food factory workers and histolytica (9.1%) and Himonolypis nana (2.4%) in fast food restaurant workers.

Conclusion: The investigation points out to the fact that the prevalence of single cell parasitic agents is high in the population studied. Therefore, it is recommended that factor contributing to the high prevalence of infection be identified and preventive measures are undertaken to reduce prevalence of infection.

---

History and Objectives: Since epidemiology of Tuberculosis is unclear in the country and in Kashan and due to presence of high numbers of Afghan refugees in the region, this study was conducted to determine the epidemiology of the disease on patients referred to the Tuberculosis Center in Kashan in 1993-1996.

Materials and Methods: Patient’s records during the 1993-1996 period were studied. Patient’s profile including age, sex, nationality, skin reaction to tuberculin, method of diagnosis of the disease and pulmonary and non-pulmonary complication were recorded.

Results: 183 patients were diagnosed for having Tuberculosis. 33% of patients were in the 10-30 age group and 33% were in the 50-70 age group. Female and male patients were 107 (58.8%) and 76 (41.5%) respectively. Housewives and carpet weaving were the main female carrier groups (90%). One third of male patients were general laborers. 67% of patients were Iranian and 33% were Afghan refugees. Urban dwellers and rural residents formed 55% and 45% of the population. 53.5% of the patients were suffering from pulmonary Tuberculosis and the rest were suffering from non-pulmonary Tuberculosis. Pulmonary Tuberculosis were diagnosed in 60% of patients by direct examination and throat culture and 70% of non-pulmonary Tuberculosis were detected by pathological examination. Negative Tuberculin test was observed in 10% of pulmonary and 30% of non-pulmonary Tuberculosis patients.

Conclusion: Non-pulmonary Tuberculosis is higher in Kashan compared to other regions in Iran and other countries. Along with pathological finding, microbiological studies seem necessary and the cooperation of surgical department is needed. Due to the prevalence of the infection in the region, especial attention should be given to contain the disease.

---

History and Objectives: Due to importance of anemia and since little information is available on the first grade students in the city of Kashan the present study was carried out in 1997.

Materials and Methods: A descriptive study was conducted on the first grade primary school students in the city of Kashan who had blood hemoglobin levels less than 11.5 g/dl, hematocrit lower than 34% and MCV lower than 80fL.

Results: In this study, from 4577 first grade primary school students, 1731 (37.8%) on the basis of hemoglobin values, 1031 individuals (22.7%) on the basis of hematocrit and 1638 individuals (35.8%) on the basis of MCV values were considered as anemic.

Conclusion: Due to high prevalence of anemia among the first grade primary school students, further study is needed to elucidate the causes and influencing factors and nutritional-educational programs are recommended.

---

History and Objectives: In light of high prevalence of the backache due to the discopathy and since the majority of the patients are from active individuals of the society and since patients are referred for different reasons and various anatomical complications and since little information is available about such patients in Kashan, the present research is carried out to determine the epidemiology of the patients with discopathy referred to the Shaheed Beheshti hospital of Kashan in 1992-1994.

Materials and Methods: The present study was carried on the existing data on patient with discopathy diagnosis. Personal records, reason for referral, site of implication and type of treatment were extracted for patient’s files. Statistical analysis was carried out.

Results: One hundred patients (61 males, 39 females) with mean age of 48±14.5 were included in the study. Discopathy was observed in 2 age groups (31-40 and 61-70). Mean age for male patients was lower than the female group (43.7 years for men and 48 for women). Female patients were mostly housewives and carpet weavers (61.6% and 38.4% respectively). Majority of male patients were laborer and with color workers (37.7% and 24.5% respectively). 72 patients and positive SLR, 47 achils reflex, 31 sensory differences and 2 patients with muscular atrophy. Five patients had esphangteric complication. 80% of patients had acute backache and radicular shaki and the rest had nonspecific pain. L4-L5 and L5-S1 were the most prevalent site of pain in females respectively (38.5% and 33.3%) and the prevalence of L4-L5 and L5-S1 among male patients were 55.7% and 36% respectively. Absolute rest and drug therapy were the treatment of choice for most patients.

Conclusion: Discopathy among men are more prevalent than women (Almost 2 fold). L4-L5 and L5-S1 are the most prevalent site of complication. 4th and 6th decade of life is the most frequent age period and blue color and white color workers are most effect. Most backaches patient had acute pain. Further work on the causes and treatment of the illness is required

---

History and Objectives: Due to the increase in life expectancy in the society and the enhancing numbers of the menopausal individuals and also the broad range of changes in the body metabolism after menopause and in order to define the age of menopause and the effective factors on it, this research was performed in women of Reye town during the year 1371.

Materials and Methods: A descriptive study was performed on 400 women aged 49-60 years and they were asked whether they are menopausal or not? And also the role of hereditary factors menstruation status individual and environmental characteristics on menopausal phenomenon were evaluated and presented with descriptive statistics and using the calculation method of life table the probability of menopause for different ages were calculated and in a multi regression the role of the main factor and or factors in the development of menopause was determined.

Results: In the individuals under study 88% were menopausal and the average age at menopause was 47.3% years. The probability of menopause is zero at the age of 28 years and one at the age of 60 years. Half of the total population of the evaluated women aged 48-49 years. The most important effective factors on menopausal age were hereditary factors in this study (P<0.0001) and other factors such as family and the menopausal age of the sisters had significant roles (P<0.01). There was no correlation between the appearance of body mass number of childbirths and pregnancies number of abortions method of birth control, cigarette, ethnicity, socioeconomic, status, … and age at menopause.

Conclusion: Age at menopause is low and considering the sample volume and lack of diversity of socioeconomic status in this population, further studies are recommended.

---

History and Objectives: Minor thalassemia is one of hereditary diseases, due to different prevalence of this disease in first and second degree relatives of patients with major Thalassemia and in order to determine the prevalence of minor thalassemia in these individuals this study was performed in Kashan in 1377-1378.

Materials and Methods: A descriptive study was performed on the first and second-degree relatives of 20 patients with major thalassemia. In this study first-degree relatives were considered as grandfather, grandmother, sister and brother and second-degree relatives were considered as uncles and aunts. Minor thalassemia was defined as MCV less than 80 and HbA2 more than 3.5%. In this study after obtaining permission, patients with major thalassemia were included in the study and then their first and second degree relatives were evaluated from the following points: Sex, inhabitant, educational level, familial marriage, HbA2, MCV and the presence of minor thalassemia.

Results: From the 124 persons, 24 of them (39.5%) were urban and 75 (60.5%) were rural inhabitants. Minor thalassemia was most commonly found among illiterate persons (16.9%) and less commonly observed among highly educated individuals (0.8%). This study showed that the prevalence of minor thalassemia in the population under study is 37.9% (14.5% in females and 26.5% in males). Familial marriages occurred in 54% of the affected persons (60.5% in rural and 39.5% in urban inhabitants).

Conclusion: Considering Iranian culture in which familial marriages are common, increasing numbers of patients with major thalassemia is anticipated. Therefore increasing public knowledge by mass media, radio and television can help to improve this problem. In order to decrease the prevalence of minor thalassemia in general population, education as schools in this regard recommended.

---

History and Objective: Iron deficiency anemia and minor beta-thalassemia are common causes of microcytic anemia. Due to the high frequency of Iron deficiency anemia especially in developing countries and its multiple complications and importance of its diagnosis and also its differential diagnosis from minor beta-thalassemia, this study was performed on volunteers for marriage referred to Golabchi outpatient clinic in Kashan in order to determine the prevalence of Iron deficiency anemia and minor beta-thalassemia and comparison of their red cells indices.

Materials and Methods: In this descriptive study all referrers to the clinic were selected by consensus. Anemic individuals were defined by low hemoglobin and/or low MCV and then with the aid of serum Ferritin level and hemoglobin electrophoresis, individuals affected by Iron deficiency anemia and minor beta-thalassemia were detected.

Results: From the 3066 referrers, the prevalence of Iron deficiency anemia and minor beta-thalassemia were 10.76% and 3.22% respectively. Iron deficiency anemia was three times more common in women than men (16.11% versus 5.47%). MCV, RBC count and hemoglobin level showed significant relationship with the type of anemia (P<0.05). Such as most patients with Iron deficiency had MCV more than 70 and normal RBC count, whereas most cases with minor beta-thalassemia had MCV less or equal to 70 and abnormality increased RBC count.

Conclusion: Iron deficiency anemia, especially in women, is still common and reserves more attention. Considering the close relationship between RBC indices and kind of anemia, it is recommended that the diagnostic accuracy of RBC indices for differentiation between minor beta-thalassemia and Iron deficiency anemia be evaluated.

---

History and Objectives: Considering the goal of WHO to eradicate the polio viruses type I, II and III and it is also executed by our health authorities, it is very important to immunize well the children. Therefore, this study was carried out to determine the degree of immunization following Polio vaccination in children at an age range of 7-10 years in Ahwaz.

Materials and Methods: The descriptive strategy of this study was performed on 324 samples of serum. At first, the polio viruses type I, II and III were cultured in Hela Medium and then the viruses were isolated by ultracentrifuge (40000 RPM) for one h. for determination of antibody titer of polio viruses, the ELISA method was used for which 30?g of related antigen was added. The immunization rate was determined in samples and then it was extrapolated to society.

Results: The study was performed on 324 cases consisting of male and female ones in equal ratio at an age of 8.4±3 years. It was found out that 281 cases (86.7%) had antibodies against viruses type I, II and III. Furthermore, there was no significant difference among groups with different degrees of immunization.

Conclusion: A high level of immunization was observed in immunized children. Therefore, it is recommended to perform similar studies in other sects of society including rural areas.

---

History and Objectives: Regarding the prevalence of chronic abdominal pain and its known complications and absence of knowledge on the prevalence of Helicobacter pylori and different reports on the diagnostic value of fast urease test, this research was conducted on children referred to the endoscopy section of the Shaheed Beheshti hospital in Kashan from 1999 to 2000.

Materials and Methods: The descriptive method of this study was performed on 39 children with an age range of 3-18 years with symptoms of chronic abdominal pain. Endoscopy was done on all of the patients and then, the specimens was surveyed by rapid urease test and evaluated pathologically for the presence of Helicobacter. The characteristics, age, gender and family members were studied. The findings of endoscopy (Being normal and/or presence of esophagitis, nodularity, gastric ulcer, duodenitis and duodenal ulcer) were recorded. The prevalence of Helicobacter was determined in specimens and the confidence interval was calculated and the diagnostic power of rapid urease test was measured.

Results: The research was performed on 39 children at an age of 9.9±4.1 years old comprised of 17 males (43.6%) and 22 females (56.4%) and having chronic abdominal pain for at least 3 months with an average of 13 months. The prevalence of Helicobacter was 30.8% and the positive predictive value of rapid urease test was 50% and its negative value was 77.8%.

Conclusion: Helicobacter pylori was not observed in the majority of children with chronic abdominal pain and it is a matter of concern to cure all of the afflicted patients. Although the number of specimens was few, it seems that fast urease test do not have a high diagnostic power in Iran and it is recommended to perform more studies in this field.

---

History and Objectives: Inappropriate antibiotic treatment can lead to resistance with various incidences in different populations and is one of the major problems facing treatment of diarrhea. This study was carried out to determine the incidence of antibiotic resistance in referrals of reference laboratory of Kashan University of Medical Sciences from 2000 to 2001.

Materials and Methods: The descriptive strategy of this study was conducted on 1800 patients with acute diarrhea. Fecal specimens were collected and transferred to specific culture medium. Antibiotic discs of ciprofloxacin, ceftizoxime, chloramphenicol, co-trimoxazole, nalidixic acid, doxycyclin, tetracycline, cephazolin, furazolidone, cephalotin and amikacin were used for determination of sensitivity of Shigella, Salmonella, Vibrio cholera.

Results: Out of 1800 fecal specimens, there was a growth rate of 11.9% (215 cases), that is 58.1% (125 cases), 30.7% (66 cases) and 11.2% (24 cases) for Shigella, Salmonella and Vibrio cholera respectively. For Shigella, the sensitivity to ciprofloxacin, ceftizoxime, chloramphenicol, nalidixic acid, co-trimoxazole, doxycyclin, cephazolin, furazolidone, ampicillin and cephalotin was 99%, 97%, 84%, 74%, 58%, 54%, 47%, 35%, 23% and 22% respectively. For Salmonella, the sensitivity to ciprofloxacin, chloramphenicol, ceftizoxime, co-trimoxazole, cephazolin and furazolidone was 100%, 96%, 78%, 20% and 12% respectively. For Vibrio cholera, the sensitivity to ciprofloxacin, doxycyclin, tetracycline, ceftizoxime, co-trimoxazole, nalidixic acid, furazolidone, cephazolin, cephalotin and ampicillin was 100%, 100%, 100%, 95.8%, 87.5%, 83.3%, 79.2%, 79.2%, 75% and 62.5% respectively.

Conclusion and Recommendations: Considering the incremental trend for antibiotic resistance for Shigella, Salmonella and Vibrio cholera, it is strongly recommended to avoid inappropriate and unnecessary use of antibiotics in patients with diarrhea.

---

History and Objectives: Considering the increasing incidence of Tuberculosis and its high rate of mortality and complications, this study was carried out to evaluate the clinical and paraclinical signs and drugs complications in Loghman Hakim hospital in Tehran from 1993 to 1996.

Materials and Methods: The descriptive strategy of this study was carried out on patients with a diagnosis of Tuberculosis. In this regard, their history was taken, clinical signs were recorded and the tests Alk-Ph, SGOT, SGPT, PT, ESR, PPD, CBC, billirubin and uric acid were done until the end of study. Data for drugs side effects were analyzed using McNemar test.

Results: Out of 190 patients, 51% were male and 49% were female. Cases with an age less than 5 years had the least incidence and cases with a greater than 66 years had the highest incidence. In addition, 56.3% out of patients had pulmonary Tuberculosis. The most important clinical signs were fever (82%), cough and sputum (62.5%), nightly perspiration (20%), respiratory distress (16%) and bloody sputum (11.2%). Meanwhile, 44.2% out of them had positive smear of sputum, 32.1% had positive biopsy and for 33.6%, diagnosis was made according to clinical and X-ray findings. 90% out of the cases had normal CBC, 94% had a high CRP, 69% had a high ESR, 17% had a negative PPD and 25.8% showed an increase in SGOT and SGPT after treatment. Billirubin level also increased up to 8.4% after treatment and in 7.6% out of them there was abnormal PT after treatment.

Conclusion and Recommendations: Considering the elevated level of hepatic enzymes in patients with Tuberculosis and under treatment, especially in those with an old age, it is recommended to chose appropriate treatment according to hepatic toxicity.

---

Background: Hepatitis B and C viruses are the most common causes of viral hepatitis, chronic hepatic disorders and cirrhosis. Since the true profile of hepatitis B and C was unknown in Kashan, the present study was performed on blood donors in Kashan during a 6-year period, 1996-2001.

Materials and methods : For this descriptive study, all blood donors were included. Having their inclusion criteria fulfilled, they were asked for another 7cc venous blood before the cannula removed. HBSAg and HCVAb were determined using ELISA technique.

Results : Of 43731 blood donors, 273 (0.6%) were HBSAg positive. The prevalence of hepatitis B was revealed to be 0.49-0.82. Meanwhile, 477 subjects (1.1%) were AntiHCV positive, thus the prevalence was 0.38-1.71.

Conclusion : With respect to the prevalence of hepatitis C, this should be considered as a social health problem in Kashan. Fortunately, hepatitis B was controlled during the recent decade due to vaccination, observing health issues and improved monitoring of blood products. 

---

---

Background: Considering the high prevalance of brucellosis and lack of definite data about its situation in our district this study was conducted to update our in knowledse and determine the frequency of clinical manifestations of hospitalized brucellosis patients in Beheshti Hospital of Kashan University of Medical Sciences during 1996-2003

Materials and Methods: This descriptive study was carried on the existing data in medical records of 380 hospitalized patients with brucelosis in Beheshti Hospital of Kashan University of Medical Sciences (KAUMS). The subjects were the patients with symptoms compatible with brucellosis and wright titer≥1.160. Demographic, clinical and laboratory findings were extracted and the collected data analyzed.

Results: 59% of the patients were male and 41% female. Most of the patients (80=21%) were in the age range of 10-19. The most common chief complaint of the patients was fever (19 . 2 % ) followed by low back pain (14 . 6 % ). The most common general complaints were fever (75 % ), arthralgia ) 70 (% , sweating (59.7 % ), anorexia (33.6 % ), and weight loss (14.7 % ). The wright, coombs wright, and 2 ME were positive in 94.8 % , 100 % , 92.2% of cases, respectively.

Conclusion: Because of the high frequency of fever, low back pain and arthralgia in our patients, brucellosis must be considered in differential diagnosis of any prolonged febrile disease with low back pain and arthralgia. Wright test was positive in most of the patients (94.8%), so it can be used as a reliable and sensititve test for the diagnosis of brucellosis.

---

Background: The first outbreak of Influenza A (H1N1), the first pandemic influenza in the present century,  in Kashan was in July 2009. This study was carried out to describe the stages of spread and also the outcome of influenza A (H1N1) in terms of incidence and death in Kashan, Aran and Bidgol cities during 2009-10.

Materials and Methods: In this case series-study of confirmed influenza A (H1N1), clinical and demographic data of all confirmed cases were recorded using SPSS software and were analyzed by Mann-Whitney test.

Results: The total number of confirmed cases (mean and median of age were 29.8±18.7 and 26 years, respectively) was 86 with a male/female ratio of 1:1. Among the 7 cases who died (mortality rate: 8.1%) the mean age for death was 46.9±27.9 years, though greater than that of the recovered cases (30.01±18.1 years), but non-significant statistically.

Conclusion: Beginning of new educational year for schools was identified as the most important factor in spread of the disease. Considering the mortality rate and other related variables, no significant difference was seen between Kashan, Aran and Bidgol cities compared to other countries. However, comparing the present findings with the findings of other domestic medical universities can disclose the reasons for disparities. Moreover, a 10 week time interval between the first outbreak and the peak for pandemy highlights the presence of an efficient surveillance system for disease control.

---

Background: Cholera is an acute diarrhoeal disease that can cause severe dehydration and death within the hours of its onset. Considering the importance of the disease, this study was carried out to assess the antibiotic resistance pattern of Vibrio cholerae (V. cholerae) strains isolated from the stool of cholerae patients in Kashan during 1998-2009.

Materials and Methods: This cross-sectional study was carried out on stool specimens obtained from acute diarrhea cases referred to health care centers in Kashan. The samples were identified according to the guidelines established by the National Committee for Clinical Laboratory Standards (NCCLS) and then the biotype and serotype of V. cholerae isolates were identified using the enzymatic method. Finally, antibiotic sensitivity testing was performed using the Kirby-Bauer disk diffusion method.

Results: Resistance to all antibiotics except erythromycin was seen in all isolates of V. cholerae (58 isolates). The highest antibiotic resistance rate was seen for ampicillin (31%) and the lowest ones for doxycycline, ciprofloxacin and tetracycline (7.1%), respectively. Moreover, among different V. cholerae serotypes, the lowest and highest levels of antibiotic resistance were seen for Inaba and Ogawa serotypes, respectively. There was no significant difference in resistance pattern between the different age and gender groups.

Conclusion: According to the results of this study, an increased antibiotic resistance in V. cholerae has been observed which can result in the emergence of multidrug resistance and therapeutic complications.

---

Background: Skin cancer is the most prevalent cancer in Iran. However, its epidemiology has not been completely reviewed and limited research has been undertaken in this area. This study aimed to review the skin cancer epidemiology and changes in its trends in Iran over the last decade.

Materials and Methods: In this study, articles from national and international scientific databases published during 2000-2011 on epidemiology and risk factors of skin cancer were systematically reviewed. In total, 15 articles from national databases and five articles from other databases were selected reports from the national cancer registry were also reviewed.

Results: According to the national cancer registry reports since 2003 to 2008, age-standardized incidence rate for skin cancer increased significantly the highest and lowest age-standardized incidence rates were observed in the 80-84 and 0-4 age groups, respectively. Although the percentage of cases with skin cancer to all cancers declined from 15.8% to 13.1% over the period, skin cancer still has the highest prevalence among all cancers in Iran. The most common morphologic form of skin cancer in Iran is basal cell carcinoma its incidence rates in women and men decreased from 75.9% to 65.9% and 69% to 59.1%, respectively. Face, head and neck were the most common sites for skin cancer in 92% of the cases.

Conclusion: Considering the increasing incidence of skin cancer and limited research done in this area in Iran, further studies are needed to investigate the risk factors, prevention strategies and survival for this cancer.

---

Background: Hepatitis B infection is a major public health problem worldwide. An important way to prevent hepatitis infection, especially among the high-risk populations including healthcare workers is vaccination. So, this study was conducted to evaluate the post- vaccination immunologic response of health staff in Kashan University of Medical Sciences during 2012-2013.

Materials and Methods: A cross-sectional descriptive study was performed on 227 staff randomly selected from the ones received the last dose of vaccine three months ago. Their blood samples were tested for Anti-HBs and Anti-HBc using the ELISA and RAPID tests, respectively.

Results: Among 227 subjects, 167(75.6%) cases were female and 56 (24.4%) male (mean age, 31.35±7.85 years). Ninety-five percent of the women responded to the vaccine (10.8% hypo-response 14.4% intermediate-response and 70.1% hyper-response). On the other hand, 95.3% of the men responded to the vaccine (20.4% hypo-response, 20.4% intermediate- response and 55.6% hyper-response).

Conclusion: The results of this study reveal the appropriate immune responses to vaccine one year after the vaccination. Although among the subjects the immunologic response to vaccine after one period of vaccination has not been 100%, the current protocol for hepatitis B vaccine yields the remarkable response.

---

Background: An increasing occurrence of antimicrobial resistance among uropathogenic bacterial isolates has complicated the treatment process. The aim of this study was to evaluate the ciprofloxacin and imipenem resistance among uropathogenic bacterial strains isolated from patients with urinary tract infection (UTI).
Materials and Methods: This cross-sectional study was conducted in Kashan from December 2012 to June 2013. A total of 391 urine samples were collected from patients with UTI and identified by standard biochemical tests. Antimicrobial susceptibility pattern screening was determined using the disk diffusion method. The minimum inhibitory concentrations (MICs) of Escherichia coli, Klebsiella spp isolates that were resistant to ciprofloxacin and imipenem by disk diffusion were determined using the E-test method.
Results: Among 391 positive urine cultures, 72.1% were from females and 27.9% from males. Escherichia coli were identified as the most prevalent uropathogenic bacteria. Resistance to ciprofloxacin among E. coli, Klebsiella spp, Enterococcus spp and Acinetobacter baumannii isolates were 37.8%, 22.5%, 36.8% and 62.5%, respectively. Resistance to imipenem was not found in any isolate. We found that all ciprofloxacin resistant E. coli and most (94%) of the ciprofloxacin resistant Klebsiella isolates had ciprofloxacin MICs in the resistance level by the E-test method.
Conclusion: Ciprofloxacin resistance among prevalent uropathogenic bacterial isolates is increasing. However, imipenem is still effective against these bacterial infections and needs to be saved to maintain the effectiveness.