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2.
Epidemiol Infect ; 143(12): 2613-8, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25524454

RESUMO

Two hundred and fourteen patients who had a cough illness lasting at least 2 weeks were studied to investigate Bordetella pertussis as a cause of prolonged cough in adolescents and adults. Medical history and nasopharyngeal swab specimens for culture and polymerase chain reaction (PCR) were obtained at presentation. Three (1·4%) patients were B. pertussis culture-positive; 15 (7%) were B. pertussis PCR-positive (including the culture-positive patients) and 11 (5·1%) were Bordetella spp. PCR-positive. Symptom combinations were significantly high both in patients with pertussis and patients with indeterminate results (P < 0·05). We conclude that B. pertussis should be considered among differential diagnoses of prolonged cough in adolescents and adults and PCR and culture should be used to detect these cases and facilitate public health response.


Assuntos
Bordetella pertussis/isolamento & purificação , Tosse/microbiologia , Coqueluche/epidemiologia , Adolescente , Adulto , Bordetella pertussis/genética , Criança , Doença Crônica , DNA Bacteriano/análise , Feminino , Humanos , Masculino , Anamnese , Nariz/microbiologia , Faringe/microbiologia , Turquia/epidemiologia , Vômito/microbiologia , Coqueluche/complicações , Coqueluche/diagnóstico , Adulto Jovem
3.
Transplant Proc ; 44(10): 3029-32, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23195020

RESUMO

To show drug interactions between tacrolimus and ertapenem, we retrospectively evaluated 13 renal transplant recipients who had been treated with ertapenem for urinary tract infections during prescription of a constant dose. The mean dose of tacrolimus to achieve desired therapeutic concentrations decreased significantly after beginning ertapenem. The decrease from 0.079 mg/kg to 0.043 mg/kg occurred 2 days after initiation of ertapenem (P < .005). These results suggest that ertapenem, which is not metabolized through the cytochrome (CYP) P450 3A metabolic pathway, interacts with tacrolimus by an unknown mechanism. This report recommends tacrolimus concentration monitoring and dose reductions when the two drugs are administered in combination.


Assuntos
Antibacterianos/uso terapêutico , Imunossupressores/administração & dosagem , Transplante de Rim/imunologia , Tacrolimo/administração & dosagem , beta-Lactamas/uso terapêutico , Adulto , Idoso , Antibacterianos/efeitos adversos , Citocromo P-450 CYP3A/metabolismo , Cálculos da Dosagem de Medicamento , Interações Medicamentosas , Monitoramento de Medicamentos , Ertapenem , Feminino , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/sangue , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tacrolimo/efeitos adversos , Tacrolimo/sangue , Adulto Jovem , beta-Lactamas/efeitos adversos
4.
Transplant Proc ; 43(9): 3557-60, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22099841

RESUMO

In September 2010, a bilateral hand allotransplantation was performed on a 28-year-old man who had suffered amputations at the level of 1/3 of the proximal forearm on the right and 1/3 of the distal forearm on the left 2 years previously. This was the first hand transplantation case in Turkey. Preoperative organization, legal difficulties, technical aspects of the operation, and immunosuppressive regimen are detailed herein. The early results of the first composite tissue allograft (CTA) transplantation are also reported. The results were encouraging for all future types of CTA transplantation, including hand and face. Following the early promising outcome of the first case of hand transplantation in Turkey, we have accelerated preparation of regulations for CTA transplantation, including hand and face allotransplantation.


Assuntos
Transplante de Mão , Adulto , Amputação Cirúrgica , Cadáver , Rejeição de Enxerto , Teste de Histocompatibilidade , Humanos , Imunossupressores/farmacologia , Masculino , Transplante Homólogo , Turquia
5.
Indian J Med Microbiol ; 29(1): 42-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21304194

RESUMO

PURPOSE: Differentiation of Staphylococcus aureus (S. aureus) from coagulase-negative staphylococci is very important in blood stream infections. Identification of S. aureus and coagulase-negative staphylococci (CoNS) from blood cultures takes generally 18-24 h after positive signaling on continuously monitored automated blood culture system. In this study, we evaluated the performance of tube coagulase test (TCT), slide agglutination test (Dry Spot Staphytect Plus), conventional polymerase chain reaction (PCR) and LightCycler Staphylococcus MGrade kit directly from blood culture bottles to achieve rapid identification of S. aureus by using the BACTEC 9240 blood culture system. MATERIALS AND METHODS: A total of 129 BACTEC 9240 bottles growing gram-positive cocci suggesting Staphylococci were tested directly from blood culture broths (BCBs) with TCT, Dry Spot Staphytect Plus, conventional PCR and LightCycler Staphylococcus MGrade kit for rapid identification of S. aureus. RESULTS: The sensitivities of the tests were 99, 68, 99 and 100%, respectively. CONCLUSION: Our results suggested that 2 h TCT was found to be simple and inexpensive method for the rapid identification of S. aureus directly from positive blood cultures.


Assuntos
Bacteriemia/diagnóstico , Técnicas Bacteriológicas/métodos , Sangue/microbiologia , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/isolamento & purificação , Bacteriemia/microbiologia , Coagulase/análise , Coagulase/genética , Humanos , Sensibilidade e Especificidade , Infecções Estafilocócicas/microbiologia , Fatores de Tempo
6.
Transpl Infect Dis ; 12(3): 190-4, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20624259

RESUMO

The American Society of Transplantation Infectious Diseases (ID) Community of Practice has established an education workgroup to identify core components of a curriculum for training specialists in transplant ID. Clinical, laboratory, and research training form the triad of components on which an additional year of ID training, dedicated to the care of solid organ and hematopoietic stem cell transplant recipients, should be based. The recommended training environment would have access to adequate numbers of transplant patients, along with qualified faculty committed to teaching specialized fellows in this area. The learning objectives for both inpatient and outpatient clinical training are presented. The laboratory component requires trainees to attain expertize in utilizing and interpreting cutting-edge diagnostics used in transplant medicine. The research component may involve basic science, and translational or clinical research individualized to the trainee. Finally, suggestions for evaluation of both the fellows and the training program are provided.


Assuntos
Doenças Transmissíveis , Currículo , Educação de Pós-Graduação em Medicina , Transplante/educação , Diretrizes para o Planejamento em Saúde , Humanos , Sociedades Médicas/normas
8.
Clin Microbiol Infect ; 10(5): 385-7, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15113313

RESUMO

Fasciola hepatica, a zoonotic liver fluke, can also cause disease in humans. Common symptoms are epigastric pain, upper abdominal pain and malaise. Fever and arthralgia are common in acute fascioliasis. Eosinophilia is the predominant laboratory finding, especially in patients with the acute form of the disease. Diagnosis and treatment is not easy, as physicians rarely encounter this disease, and effective drugs are not available in many countries. Human fascioliasis may be underestimated. Patients with eosinophilia and abdominal pain should be evaluated for F. hepatica infestation by parasitological, radiological and serological tests.


Assuntos
Fasciolíase/diagnóstico , Fasciolíase/tratamento farmacológico , Praziquantel/análogos & derivados , Adulto , Idoso , Albendazol/uso terapêutico , Animais , Anticorpos Anti-Helmínticos/análise , Antiplatelmínticos/uso terapêutico , Benzimidazóis/uso terapêutico , Fasciola hepatica/efeitos dos fármacos , Fasciola hepatica/imunologia , Fasciolíase/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Praziquantel/uso terapêutico , Triclabendazol
9.
J Chemother ; 16(6): 608-11, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15700856

RESUMO

Vancomycin-resistant enterococci are unusual etiologic agents of bacterial meningitis and pose significant therapeutic difficulties. We report the first confirmed case of nosocomial vancomycin-resistant Enterococcus faecium meningitis in Turkey. The patient was treated with chloramphenicol and cerebrospinal fluid cultures became negative, but clinical success was not achieved. We also review the previously reported cases of vancomycin-resistant Enterococcus faecium meningitis.


Assuntos
Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/patogenicidade , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Resistência a Vancomicina , Adulto , Antibacterianos/uso terapêutico , Líquido Cefalorraquidiano/microbiologia , Cloranfenicol/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Humanos , Masculino , Turquia
10.
Acta Microbiol Immunol Hung ; 49(1): 93-7, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12073829

RESUMO

Hepatitis A and hepatitis E are enteric transmitted viral diseases occurring in epidemic and sporadic forms especially in developing countries. Previous studies in Turkey showed that most residents are infected with HAV by the second decade of life. Since HEV is generally transmitted by the same route as HAV we conducted a community-based seroprevalence study for HAV and HEV infection in Ahatli area in Antalya, Turkey where socioeconomic conditions are low. Anti-HAV total immunoglobulin was tested by using a microparticle EIA (Axsym-Abbott Lab). Anti-HEV IgG was assayed by a micro ELISA method (Genelabs-Singapore). Of the 338 sera tested, 112 (33.1%) were positive for anti-HAV total antibody. Anti-HEV IgG was detected in three (0.89%) of the serum samples. Seropositivity rates of HAV in preschool and school children were 19.9% and 43.9% respectively (p < 0.001). No antibody to HEV was detected in preschool children, while the prevalence of anti-HEV IgG was 1.6% in children attending school. Our data showed that seroprevalence of anti-HAV is high among children samples but HEV infection appears to be relatively rare in pediatric age groups.


Assuntos
Vírus da Hepatite A Humana/imunologia , Hepatite A/epidemiologia , Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E/imunologia , Hepatite E/epidemiologia , Criança , Pré-Escolar , Hepatite A/virologia , Anticorpos Anti-Hepatite A/sangue , Hepatite E/virologia , Humanos , Imunoglobulina G/sangue , Lactente , Prevalência , Estudos Soroepidemiológicos , Turquia/epidemiologia
12.
J Antimicrob Chemother ; 45(5): 695-9, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10797096

RESUMO

With the participation of eight major reference hospitals in Turkey, 749 aerobic Gram-negative isolates obtained from 473 intensive care patients in 1997 were tested for their susceptibility to 13 commonly employed antibacterial agents. The frequency with which species were isolated and resistance rates were compared with data from the previous 2 years. Imipenem was the most active agent against the majority of isolates (75%), followed by ciprofloxacin, cefepime and amikacin. The per cent susceptibility to all antibiotics declined from 1995 to 1996. With the exception of imipenem, for which there was no change in resistance, the per cent susceptibility somewhat increased in 1997. However, it was still lower than in 1995.


Assuntos
Antibacterianos/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/epidemiologia , Unidades de Terapia Intensiva , Resistência Microbiana a Medicamentos , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Testes de Sensibilidade Microbiana , Vigilância da População , Turquia/epidemiologia
13.
J Antimicrob Chemother ; 43(3): 373-8, 1999 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10223593

RESUMO

This study was carried out with the participation of eight hospitals in Turkey to determine the frequency of gram-negative bacteria isolated in intensive care units (ICU) and to compare their resistance rates to selected antibiotics. Aerobic gram-negative bacteria isolated from ICUs during 1996 were studied. Antibiotic susceptibilities to imipenem, ceftazidime, ceftazidime-clavulanate, ceftriaxone, cefotaxime, cefepime, cefodizime, cefuroxime, piperacillin/tazobactam, amoxycillin-clavulanate, gentamicin, amikacin and ciprofloxacin were determined by Etest. A total of 748 isolates were obtained from 547 patients. The majority of organisms were isolated from the respiratory (38.8%) and urinary tracts (30.9%). Pseudomonas spp. were the most frequently isolated gram-negative species (26.8%), followed by Klebsiella spp. (26.2%). Escherichia coli, Acinetobacter spp. and Enterobacter spp. were the other commonly isolated organisms. High resistance rates were observed for all antibiotics studied. Imipenem appeared to be the most active agent against the majority of isolates. Although resistance rates exceeded 50%, ciprofloxacin, cefepime and amikacin were found to be relatively effective. Extended-spectrum beta-lactamase (ESBL) production appeared to be a major mechanism of resistance to beta-lactam antibiotics. In contrast to ceftazidime-clavulanate, piperacillin/tazobactam showed poor activity against organisms thought to produce ESBL, suggesting the presence of an enzyme resistant to tazobactam action. This study has yielded high rates of resistance in aerobic gram-negative isolates from ICUs in Turkey. High resistance rates to all the other antibacterials studied leave imipenem as the only reliable agent for the empirical treatment of ICU infections in Turkey.


Assuntos
Resistência Microbiana a Medicamentos , Bactérias Gram-Negativas/efeitos dos fármacos , Hospitais , Humanos , Unidades de Terapia Intensiva , Testes de Sensibilidade Microbiana , beta-Lactamases/fisiologia
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