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ABSTRACT: Aim: Catheter-related bloodstream infection (CR-BSI) is considered as an important complication of hemodialysis catheters. The purpose of this prospective study was to evaluate the incidence and risk factors of temporary hemodialysis catheter-related bloodstream infection. Materials and methods: Prospective data related to temporary hemodialysis catheters inserted in our institution were collected for duration of three years. The risk factors of CR-BSI of patients between the CR-BSI group and the control group were compared. Results: A total of 248 temporary hemodialysis catheters were inserted in 201 patients and remained in situ for a cumulative total of 5192 catheter days. There were 3254 dialysis sessions. CR-BSI was found in 63 cases. CR-BSI rate was 12.1/1000 catheter-days and 19.4/1000 dialysis sessions. In multivariate analysis, acute renal disease (OR = 2.29), administration of antibiotics at the time of catheterization (OR = 2.09), insertion in the femoral vein (OR = 2.14), emergency situation for catheter insertion (OR = 2.41), high number of catheter manipulation (OR = 2.49), and inadequate hand hygiene prior to catheter manipulations (OR = 3.02) were found to be risk factors of CR-BSI. The most frequently isolated microorganisms were coagulase-negative staphylococci (31.3%), S. aureus (26.9%), Enterococcus spp. (10.4%), and Pseudomonas aeruginosa (9.0%). Conclusion: This prospective study of temporary hemodialysis catheters has shown high rates of infectious complications. The education of both the patients and medical staff in prevention of CR-BSI is important. Geçici hemodiyaliz kateterlerinden kaynaklanan kan dolaşımı infeksiyonlarının risk faktörleri ve insidansı Amaç: Kateter ilişkili kan dolaşımı infeksiyonu (KİKDİ) hemodiyaliz kateterlerinin önemli komplikasyonu olarak sayılmaktadır. Bu prospektif çalışmanın amacı geçici hemodiyaliz kateterleri ile ilişkikili kan dolaşımı infeksiyonlarının risk faktörleri ve insidansını değerlendirmektir. Yöntem ve gereç: Kurumumuzda takılan geçici hemodiyaliz kateterleri ile ilişkili prospektif bilgiler üç yıllık sürede toplandı. KİKDİ risk faktörleri gelişen grup ve kontrol grubunda karşılaştırıldı. Bulgular: İkiyüzbir hastaya toplam 248 geçici hemodiyaliz kateteri takıldı ve 5192 kateter günü takip edildi. Hastalara 3254 dializ seansı uygulandı. Atmışüç vakada KİKDİ tespit edildi. KİKDİ hızı 12.1/1000 kateter günü ve 19.4/1000 dializ seansı idi. Çok değişkenli analizde akut böbrek yetmezliği (OR = 2,29), kateterizasyon sırasında antibiyotik alıyor olma (OR = 2.09), kateterin femoral vene takılması (OR = 2.14), acil şartlarda kateter takılması (OR = 2.41), yüksek sayıda kateter manüplasyonu (OR = 2.49) ve kateter manüplasyonu öncesi yetersiz el hijyeni (OR = 3.02) KİKDİ risk faktörleri olarak bulundu. En sık izole edilen mikroorganizmalar coagulase-negative staphylococci (% 31,3), S. aureus (% 26,9), Enterococcus spp. (% 10,4) ve Pseudomonas aeruginosa (% 9) idi.
835 Turk J Med Sci. 01/2010;
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ABSTRACT: Aim: Crimean–Congo hemorrhagic fever (CCHF) is a disease that is known since 1944 affecting many people across the world and causing a high mortality rate. The aim of this study was to determine the epidemiological and clinical characteristics of the CCHF cases in our region. Materials and methods: The present study was conducted in patients with CCHF who were hospitalized between 2004 and 2006 at Karadeniz Technical University. Demographic, geographic, climatic, and clinical characteristics of all patients were investigated. Results: A total of 102 patients with confirmed CCHF were investigated in this study. All of the patients were from rural areas. Eighty-seven patients (85.2%) were livestock workers. None of the cases was from the region where mountain range faced the sea and all cases were from areas of Harşit, Kelkit, and Çoruh valleys situated at 1100-2265 m above sea level where the mountain ranges ceased to separate the sea and inner regions and streams reached the sea. Conclusion: CCHF case series have been reported from Turkey as well and particularly Middle Anatolia and northeastern regions have been determined as endemic areas recently. Population of those regions mostly earns their life from livestock breeding and agriculture, which increases the risk of exposure to ticks and development of CCHF. Therefore, especially in cases coming from regions categorized as endemic, it has been concluded that mortality can be reduced by carefully taken medical history and practice of rapid medical treatment and replacement therapies in consideration of CCHF pre-diagnosis. Türkiye'nin Doğu Karadeniz bölgesindeki kırım-kongo kanamalı ateş vakaları: demografik, coğrafik, iklimsel ve klinik özellikler Amaç: Kırım-Kongo Kanamalı Ateşi (KKKA) 1944 yılından beri bilinen, dünyada birçok insanı etkileyen ve mortalite oranı yüksek olan bir hastalıktır. Bu çalışmanın amacı bölgemizdeki KKKA olgularının epidemiyolojik ve klinik özelliklerini belirlemekti. Yöntem ve gereç: Sunulan çalışma Karadeniz Teknik Üniversitesinde 2004-2006 yılları arasında hastanede yatırılan KKKA'lı hastalarda yapıldı. Hastaların demografik, coğrafik, iklimsel ve klinik özellikleri incelendi. Bulgular: Bu çalışmada KKKA'li toplam 102 hasta incelendi. Hastaların hepsi kırsal kesimde yaşıyor ve %85.2'si hayvancılık yapıyordu. Hiçbir vaka sıradağların denize bakan yüzeyindeki bölgeden olmayıp, vakaların deniz ile iç bölgeleri ayıran sıradağların kesildiği ve akarsuların denize ulaştığı Harşit, Kelkit ve Çoruh Vadileri'ndeki denizden yükseklikleri 1100-2265 m arasındaki yerleşim alanlarından geldiği tespit edildi.
829 Turk J Med Sci. 01/2010;
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ABSTRACT: The efficiency of ribavirin for treatment of Crimean-Congo hemorrhagic fever (CCHF) is unknown. In the literature, prospective randomized studies investigating the efficacy of ribavirin are not found.
To investigate the efficacy of ribavirin in treatment of patients with CCHF.
In this prospective randomized cohort study 136 cases were included between June 2004 and August 2007. The diagnosis was confirmed in the CCHF reference laboratory of Refik Saydam National Hygiene Central Institute of the Turkish Ministry of Health. Patients either received ribavirin plus supportive treatment (Group A) (n=64) or only supportive treatment (Group B) (n=72). For the evaluation of efficacy of ribavirin, various parameters were compared between Group A and Group B.
As well as the similarity of demographic features between the two groups, there were no statistical differences in incubation time; hospitalization time; patients requiring platelet replacement therapy; the time taken for platelet levels to return to normal levels and mortality. In Group B, the rate of tick contact was higher (p=0.03). In Group A, leukocyte levels took longer to return to the normal levels (p=0.02).
In our study, there was no positive effect determined on clinical or laboratory parameters in CCHF patients treated with ribavirin, also it was observed that leukocyte levels took longer to return to normal (p=0.02) and, while not statistically significant, the longer period of hospitalization (p=0.09) needed was observed as a negative effect. Because of these reasons, it is thought that the use of ribavirin makes no significant contribution to the prognosis of the CCHF disease.
Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 12/2009; 47(1):65-8. · 3.12 Impact Factor
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Emine Alp,
Corné H W Klaassen,
Mehmet Doganay,
Ulku Altoparlak, Kemalettin Aydin,
Aynur Engin,
Cigdem Kuzucu,
Cuneyt Ozakin,
Mehmet Ali Ozinel,
Ozge Turhan,
Andreas Voss
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ABSTRACT: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of life-threatening human infections. The clinical impact of MRSA is mounting, not only due to the ever-increasing prevalence but also due to the occurrence of new, community-acquired MRSA strains. The aim of this prospective, multi-centre study was to determine the prevalence and genetic relatedness of clinically relevant MRSA isolates, in Turkey.
During a 1-year period, data from 20 successive patients with invasive S. aureus infections were collected from eight university hospitals, geographically distributed over the six main regions of Turkey. Among these S. aureus isolates, the genetic association of MRSA isolates was investigated by pulsed-field gel electrophoresis (PFGE) and spa typing. A selected number of isolates were also analyzed by multilocus sequence typing (MLST). Furthermore, Panton Valentine leucocidin (PVL) genes were examined.
In this study, the rate of methicillin resistance in S. aureus in patients with apparent infections (sepsis, meningitis, lung abscess or septic arthritis) ranged from 12 to 75% within the seven participating centres. Typing by pulsed-field gel electrophoresis and spa typing revealed the presence of 22 closely related genotypes. According to the PFGE and spa typing results, 53 out of 54 MRSA isolates were closely related. These isolates were of spa type t030 or a related spa type, contain an SCC mec type III element and belong to sequence type ST239. None of the isolates contained the PVL genes.
Despite the broad surface area of Turkey, a single predominant clone of ST239 circulates in hospitals in different regions and only few new types of MRSA were introduced over the past years. These results place Turkey in the epicenter of ST239 prevalence.
The Journal of infection 05/2009; 58(6):433-8. · 4.13 Impact Factor
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Nazif Elaldi,
Hurrem Bodur,
Sibel Ascioglu,
Aysel Celikbas,
Zulal Ozkurt,
Haluk Vahaboglu,
Hakan Leblebicioglu,
Neziha Yilmaz,
Aynur Engin,
Mehmet Sencan, Kemalettin Aydin,
Ilyas Dokmetas,
Mustafa Aydin Cevik,
Basak Dokuzoguz,
Mehmet Ali Tasyaran,
Recep Ozturk,
Mehmet Bakir,
Ramazan Uzun
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ABSTRACT: The aim of this study was to evaluate the efficacy of oral ribavirin treatment in patients with Crimean-Congo haemorrhagic fever (CCHF).
In 2004, all patients diagnosed with CCHF were treated with oral ribavirin, however in 2003 none of the CCHF patients had been given treatment due to lack of confirmatory diagnostic information at that time in Turkey. In this study, patients treated with ribavirin in 2004 (n=126) were compared with ribavirin-untreated CCHF patients (n=92) in 2003. Patients only with a definitive diagnosis of CCHF (clinical symptoms plus the presence of specific IgM antibodies against CCHF virus and presence of viral antigen) were included in this study.
There was no difference in the case-fatality rate between treated and untreated patients (7.1% vs. 11.9%; P>0.05). A Cox Proportional Hazards regression analysis revealed that altered sensorium and prolonged international normalized ratio were independent predictors of mortality.
Our results showed that oral ribavirin treatment did not improve the survival rate in CCHF patients. Ribavirin and supportive care are the only available choices for treatment of CCHF patients, but to ascertain the efficacy of ribavirin, more laboratory and observational studies are necessary and ultimately, to elucidate these conflicting results and evaluate the efficacy undoubtedly, a multicenter randomised controlled trial will be needed.
The Journal of infection 02/2009; 58(3):238-44. · 4.13 Impact Factor
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ABSTRACT: The relationship of changes in the peripheral blood lymphocyte subgroups during Crimean-Congo hemorrhagic fever (CCHF) to prognosis has not been reported.
To determine peripheral blood lymphocyte subgroups in CCHF patients at the time of diagnosis and relate these to clinical outcome.
Peripheral blood samples were obtained from the patients treated at the Karadeniz Technical University Hospital for CCHF in 2004. Lymphocyte subgroups were analyzed by flow cytometry on these samples and their association with patients' risk group (severe vs. non-severe) and mortality was recorded.
There were significantly more peripheral blood natural killer (NK) cells in severe risk CCHF patients than in non-severe risk group CCHF patients. A positive correlation was found between NK cell count and aspartate transferase (AST), alanine transferase (ALT) and activated partial thromboplastin times (aPTT). In addition, NK cell counts were observed to be higher in two patients who died.
Elevated NK cell counts may be a prognostic marker in CCHF patients.
Journal of Clinical Virology 09/2008; 42(4):415-7. · 3.97 Impact Factor
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ABSTRACT: Necrotizing fasciitis is a life- and limb-threatening soft tissue infection. Due to its underlying predisposition and rapid progression, treatment should be started quickly using antibiotherapy and surgical intervention. Although necrotizing fasciitis is mainly caused by streptococci and staphylococci, it may also be polymicrobial. Other peptostreptococci have been reported as necrotizing fasciitis agents in the literature, though we encountered no cases of necrotizing fasciitis caused by Ruminococcus productus. Here, we describe a case of necrotizing fasciitis caused by R. productus, a Gram-positive, obligatory anaerobe.
Journal of Medical Microbiology 03/2008; 57(Pt 2):246-8. · 2.50 Impact Factor
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ABSTRACT: Fungal infections are common and life threatening among immunosupressive patients. Rare side effects may occur related to the use of voriconazole, which is the drug of choice in invasive aspergillosis.
Neuropathy was determined through clinical and electromyographic findings during the course of voriconazole therapy in 2 patients developing invasive aspergillosis.
Since examinations revealed no neuropathy capable of ascription to any other cause and improvement followed the cessation of the drug, this suggested that neuropathy may be linked to voriconazole use.
Neuropathy may be seen as a side effect during voriconazole treatment. Voriconazole-induced side effects should be borne in mind and patients carefully monitored during its use.
Chemotherapy 02/2008; 54(3):224-7. · 1.82 Impact Factor
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ABSTRACT: Shewanella putrefaciens is a facultatively anaerobic, non-motile, Gram-negative, non-fermentative bacterium. It is found in various environments and has been isolated worldwide. S. putrefaciens is a rare cause of brain abscesses and meningitis. This is a case report of a cerebellar abscess and meningitis caused by Shewanella putrefaciens and Klebsiella pneumoniae in a river trap fisherman.
Journal of Medical Microbiology 12/2007; 56(Pt 11):1558-60. · 2.50 Impact Factor
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ABSTRACT: Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal viral infection. The exact mechanism for hemorrhage remains unknown. Thrombin activatable fibrinolysis inhibitor (TAFI) is a plasma procarboxypeptidase B-like proenzyme and synthesized in the liver, down-regulating fibrinolysis. In this study, we measured the TAFI activity in plasma of patients with CCHF to examine the relationship between hemorrhage and the pathogenesis of CCHF.
Twenty-one patients and similar number of controls were included in the study. The diagnosis of CCHF was confirmed through detection of IgM by ELISA and/or PCR. TAFI activity was measured in plasma samples.
TAFI activity in CCHF patient group was mean 7.2+/-2.3 microg/ml (range: 0.95-10.31 microg/ml) and in the control group was mean 11.7+/-4.1 microg/ml (range: 3.07-23.9 microg/ml). There was a significant decrease of TAFI activity in CCHF patients when compared to controls. A positive correlation between CRP, PT, INR, serum albumin and TAFI activity levels were found. We suggest that the decrease of TAFI activity may be due to liver dysfunction during viral active disease state.
Low TAFI activity may be an attributable factor, leading to imbalance in fibrinolysis, resulting in bleeding complications in CCHF.
The Journal of infection 09/2007; 55(2):184-7. · 4.13 Impact Factor
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Burçin Sener,
Ferda Tunçkanat,
Sercan Ulusoy,
Alper Tünger,
Güner Söyletir,
Lütfiye Mülazimoğlu,
Nezahat Gürler,
Lütfiye Oksüz,
Iftihar Köksal, Kemalettin Aydin,
Ata Nevzat Yalçin,
Dilara Oğünç,
Asli Acar,
Jörg Sievers
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ABSTRACT: To determine the prevalence of antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolated in Turkey as part of Survey Of Antibiotic Resistance, a surveillance programme in the Africa and Middle East region examining the antimicrobial susceptibility of key bacterial pathogens involved in community-acquired respiratory tract infections (CARTIs).
Susceptibility was evaluated against a range of antimicrobial agents using disc diffusion and Etest methods.
Six centres in five cities collected 301 S. pneumoniae and 379 H. influenzae isolates between October 2004 and November 2005. Among S. pneumoniae, the prevalence of isolates with intermediate susceptibility (MICs 0.12-1 mg/L) and resistance to penicillin (MICs >or=2 mg/L) was 24.6% and 7.6%, respectively; there was a wide variation between cities (2.4% to 36.9% intermediate and 0% to 23.8% resistant phenotypes). Macrolide-azalide resistance rates exceeded those of penicillin resistance in all cities. Overall, 5.0% of isolates were co-resistant to penicillin and erythromycin and 10.0% were multidrug-resistant (joint resistance to erythromycin, co-trimoxazole and tetracycline). Agents tested to which over 90% of countrywide S. pneumoniae isolates remained susceptible were amoxicillin/clavulanate (98.7%), chloramphenicol (94.7%) and cefprozil (90.6%). Overall, the percentage of H. influenzae isolates producing beta-lactamase was 5.5%, differing widely across the country with the highest prevalence of beta-lactamase production detected in Trabzon (14.0%) and no beta-lactamase-positive isolates found in Izmir. H. influenzae had the highest per cent susceptibility to amoxicillin/clavulanate (99.5%) and ofloxacin (99.2%) while >20% were resistant to co-trimoxazole.
Prevalence of penicillin and macrolide-azalide resistance among S. pneumoniae appears to be on the increase in Turkey while overall beta-lactamase production in H. influenzae remains relatively low. To adequately monitor the spread of drug-resistant phenotypes among these two important CARTI pathogens, ongoing collection of resistance surveillance data is required-where possible locally as resistance patterns can vary substantially between cities and institutions.
Journal of Antimicrobial Chemotherapy 09/2007; 60(3):587-93. · 5.07 Impact Factor
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ABSTRACT: Brucellosis is a significant public health problem particularly in developing countries. People are frequently infected through milk, milk products, urine and pregnancy material of animals with brucellosis. Epididymoorchitis is the most frequent genitourinary complication of brucellosis and is often unilateral. In this report, a 35 years old male patient who was diagnosed as epididymoorchitis based on clinical presentation, laboratory findings and imaging techniques, has been presented. Brucella melitensis was isolated from blood, bone marrow and ejaculate cultures of the patient. The patient was treated with rifampicine and doxycycline combination therapy for six weeks and no complication has developed in the one year follow-up period. In areas where brucellosis is endemic, such as our country, Brucella infection should be considered in the differential diagnosis of epididymoorchitis and in addition to blood and bone marrow cultures, ejaculate cultures should also be evaluated.
Mikrobiyoloji bülteni 08/2007; 41(3):465-8. · 0.40 Impact Factor
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ABSTRACT: Staphylococcus aureus and coagulase-negative staphylococci (CNS) are recognized as causing nosocomial and community-acquired infections in every region of the world. The resistance to antimicrobial agents among staphylococci is an increasing problem. Clindamycin (CL) is considered to be one of the alternative agents in these infections. This study demonstrates a simple, reliable method (double-disc diffusion test) for detecting inducible resistance to CL in erythromycin-resistance (ER-R) isolates of S. aureus and CNS. A total of 883 (52.3%) isolates of S. aureus and 804 (47.7%) isolates of CNS were selected from recent (2003-2005) clinical isolates recovered in the laboratory of the authors; duplicate isolates were not included. A total of 214 (12.6%) S. aureus and 308 (18.3%) CNS isolates were selected based on ER-R and CL sensitivity using standard National Committee for Clinical Laboratory Standards disc diffusion testing. A total of 1687 staphylococcal isolates were included, consisting of 27.5% meticillin-resistant S. aureus, 24.8% meticillin-sensitive S. aureus, 36.1% meticillin-resistant CNS and 11.6% meticillin-sensitive CNS isolates: 30.9% of staphylococcal isolates (214 S. aureus and 308 CNS) that were erythromycin resistant and CL sensitive were tested for inducible resistance using the D-test. A D-shaped zone around the CL was observed for 70.9% of staphylococcal isolates (81.8% of S. aureus isolates and 63.3% of CNS isolates) with an ER-R and a clindamycin-sensitive (CL-S) phenotype. The organism was positive for inducible clindamycin resistance (CL-R). There was a 21.9% level of inducible macrolide-lincosamide-streptogramin B resistance phenotype among all the staphylococcal isolates. When the S. aureus and CNS strains among all the staphylococcal isolates were compared statistically, inducible CL-R in CNS strains was determined to be 23% more positive (P=0.028, odds ratio 0.77, 95% confidence interval 0.61-0.98). When a statistical comparison was performed among ER-R but CL-S staphylococcal isolates inducible CL-R in S. aureus strains was determined to be 2.6 times more positive (P=0.000, odds ratio 2.6, 95% confidence interval 1.68-4.04). A simple, reliable method of detecting inducible resistance to CL in ER-R isolates of S. aureus and CNS is described. Clinical microbiology laboratories should use the double-disc diffusion test as standard practice with all ER-R staphylococci. CL should not be used in patients with infections caused by inducibly resistant staphylococcal isolates. Therapeutic failures may thus be avoided.
Journal of Medical Microbiology 04/2007; 56(Pt 3):342-5. · 2.50 Impact Factor
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ABSTRACT: Pseudomonas aeruginosa isolates carrying IMP- or VIM-type metallo-beta-lactamase (MBL) have been increasingly reported in hospitals worldwide. One hundred P. aeruginosa clinical isolates from unrelated inpatients hospitalized at a Turkish university hospital were screened for the presence of bla(IMP) and bla(VIM) genes by polymerase chain reaction (PCR). One (1%) isolate was found to carry a VIM-type MBL gene, whereas nine (9%) carried an IMP-1 MBL gene carried on a cassette inserted into a class 1 integron. Only four of the IMP producers were detected as MBL producers according to E-test MBL. Minimum inhibitory concentrations (MICs) of imipenem for the IMP-1 and VIM-type MBL-producers were highly variable (MIC values, 8-128 mug/ml). Imipenem resistance was not plasmid-mediated according to the transformation assays. Piperacillin/tazobactam was the only effective drug in antimicrobial susceptibility testing. No aztreonam-resistant IMP and VIM producers were detected to produce an extended-spectrum beta-lactamase (ESBL). Three class 1 integrons of approximately 2,300 bp, 1,800 bp, and 1,500 bp in size were detected in each of the nine IMP-positive isolates. Sequencing revealed three novel gene cassette arrays, aac(3)-1c-cmlA5, bla(IMP-1)-aadA7-like, and aacA7-smr-2-orfD. Enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) indicated that a clonal spread of IMP-1-producers had occurred in this hospital.
Microbial Drug Resistance 02/2007; 13(3):191-8. · 2.15 Impact Factor
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ABSTRACT: The genus Ruminococcus which are anaerobe Gram positive cocci, previously classified as Peptostreptococcus, may colonize the upper respiratory tract, gastrointestinal tract, vagina and skin of humans and animals. In this report a case of liver abscess and a case of infective endocarditis caused by Ruminoccocus productus, which is very rarely encountered in the clinical practice were presented. The first case was a 32 years old male who was admitted to the hospital in 2002, with the complaints of fever lasting for 20 days and pain while breathing. The abdominal ultrasonography revealed the presence of a liver abscess, and the drainage material from the abscess yielded Ruminococcus productus, identified in BACTEC 9200 (Becton Dickinson, Sparks, Md) anaerobe system. As the isolate was found to be sensitive to penicilin, the empirical gentamicin and ampicillin/sulbactam therapy was continued. The second case was a 25 years old male who was admitted to the hospital in 2005, with the signs of fever lasting for 3-4 months, chills, bone and joint pains. As multiple vegetations were detected in echocardiography, blood cultures were collected and empirical therapy with ceftriaxone and gentamicin was initiated with the preliminary diagnosis of infective endocarditis. Bacteria which were isolated from blood cultures by BACTEC 9200 system have been identified as R. productus. As this strain was also sensitive to penicillin, the empirical therapy was changed to penicilin and gentamicin. These two cases indicated that R. productus should be considered in complicated infections even if it is a rarely isolated species from the clinical samples.
Mikrobiyoloji bülteni 11/2006; 40(4):389-95. · 0.40 Impact Factor
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ABSTRACT: Alcaligenes xylosoxidans is an aerobic, motile, oxidase and catalase positive, nonfermentative Gram negative bacillus. This bacterium has been isolated from intestine of humans and from various hospital or environmental water sources. A.xylosoxidans is both waterborne and results from the poor-hygienic conditions healthcare workers are in. In this case report, the bacteremia which appeared in a patient with pancreas cancer after ERCP was described.
Annals of Clinical Microbiology and Antimicrobials 02/2006; 5:19. · 2.64 Impact Factor
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ABSTRACT: To investigate the effects of G-CSF addition to antibiotic treatment of experimental sepsis on pulmonary lung tissue.
Fifty Sprague-Dawley rats were used. The first four groups received a bolus intraperitoneal injection of Pseudomonas aeruginosa. The first group (Group SAG) received a combined therapy of imipenem and G-CSF, the second group (Group SA) received only imipenem, the third group (Group SG) received only G-CSF, and no antibiotic or G-CSF was given to the fourth group (Group S). The fifth group (Group C) served as the control. Survival rates, peripheral leukocyte counts (PLC) and absolute neutrophil counts (ANC) were obtained, and lung tissues were examined under light microscopy.
Survival rates at the 120th hour were 100% in groups SAG, SA and C; 20% in group SG; and 0% in group S. PLC and ANC values reached their highest levels at the 36th hour in the SAG group and at the 60th hour in the SA group. Pulmonary architecture was better preserved in the SAG, SA and SG groups--in that order--than in the S group.
Particularly in the early phase of infection, the administration of G-CSF in combination with antibiotics would be appropriate for maximizing the effect of antibiotics as soon as possible and for minimizing the damage caused by inflammation.
Journal of the National Medical Association 12/2005; 97(11):1489-95. · 1.16 Impact Factor
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ABSTRACT: In this study, the rate of blood culture contamination, bacterial pathogens and their antimicrobial susceptibilities causing nosocomial and community acquired bloodstream infections were investigated prospectively during the period February 2003 to February 2004. In the study period, among the 5994 blood culture samples obtained from 3114 patients, 1091 (18%) yielded positive results. Seventy-four of them (1.2%) were evaluated as false positive, 514 (9%) were pseudobacteremia or contamination. According to patients' clinical features, 503 (8%) blood culture samples were associated with blood stream infections, and 358 of them (71%) were primary episodes. Twohundred and ninetyfour of primary episodes (82%) were hospital acquired and 64 were community acquired bloodstream infections. Staphylococcus aureus was the most frequently isolated agent in the hospital and community acquired bloodstream infections at the rates of 16% and 20%, respectively. In hospital acquired blood stream infections, Escherichia coil (9%) and Pseudomonas aeruginosa (8%); in community acquired bloodstream infections Streptococcus spp (17%) and E. coli (15%) were the other most frequently isolated bacterial agents. Methicillin resistance of S. aureus isolates was determined as 54% in hospital acquired blood stream infections and 25% in community acquired blood stream infections.
Mikrobiyoloji bülteni 11/2005; 39(4):455-64. · 0.40 Impact Factor
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ABSTRACT: To determine the optimal time to start nutritional support after traumatic brain injury (TBI).
Rats were divided into six groups of seven. All but one of these groups were subjected to moderate closed head trauma under general anesthesia. Groups Ia and Ib were commenced on immunonutrition and standard enteral nutrition, respectively, 8 h later; groups IIa and IIb were commenced on immunonutrition and standard enteral nutrition, respectively, 72 h later; and group III was commenced on a parenteral saline infusion 8 h later. Group IV was a control group fed a laboratory diet and not subjected to trauma. The rats were killed 7 days later, and ileal segments were examined using light and electron microscopy. We used the deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) technique to detect intestinal mucosal apoptosis.
Group III had a lower body weight than the other groups (P < 0.005). The mean villous height was highest in groups Ia and IV and lowest in group III. The villi count was lower in groups Ib, IIa, IIb, and III than in group IV (P < 0.005). The apoptotic index counts were higher in groups IIa, IIb, and III than in group IV (P < 0.005).
The addition of enriching immunonutrients to early enteral feeding helps preserve an almost normal gut mucosa.
Surgery Today 01/2005; 35(9):751-9. · 1.22 Impact Factor
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ABSTRACT: The aim of this investigation was to evaluate the epidemiology of Stenotrophomonas maltophilia in a university hospital of Turkey. From June 2000 to December 2001, S. maltophilia strains were collected, clinical presentations were noted, and MIC determinations were performed by means of E-test. Enterobacterial repetitive intergenic consensus sequences-PCR (ERIC-PCR) was used for molecular typing of the strains. Forty-four strains of S. maltophilia were isolated from 41 hospitalized patients in a teaching hospital. The majority of specimens were from the blood and respiratory tract. Antimicrobial sensitivities of these strains were as follows: 97.7 % trimethoprim-sulfamethoxazole, 15.9% ticarcillin, and 95.4% ticarcillin- clavulanate. The strains were evaluated using the ERIC-PCR method. It was of interest to note that epidemiological typing revealed three small outbreaks that were caused by a total of 12 strains. The remaining isolates generated singular DNA patterns. DNA amplification was possible in 38 isolates and yielded 26 different patterns in a period of 20 months, leading to the suggestion that commensal bacteria becomes selected in the presence of a suitable host.
Japanese journal of infectious diseases 05/2004; 57(2):37-40. · 1.49 Impact Factor
