[Evaluation of Mycobacterium tuberculosis Culture and Drug Susceptibility Test Results and the Distribution of Nontuberculosis Mycobacteria from the Clinical Specimens]. / Klinik Örneklerden Izole Edilen Mycobacterium tuberculosis Kültür ve Ilaç Duyarlilik Test Sonuçlarinin Analizi ve Tüberküloz Disi Mikobakterilerin Dagiliminin Incelenmesi.

Tuberculosis (TB) continues to pose a significant public health problem worldwide. For mycobacteriology laboratories, it is important to be able to diagnose active cases and to make a differential diagnosis of non-tuberculous mycobacteria (NTM). In this study, it was aimed to retrospectively evaluate the epidemiological status of the Mycobacterium [Mycobacterium tuberculosis complex (MTC) and NTM] obtained from the clinical specimens of patients with TB suspicion, and the resistance rates of MTC isolates against anti-TB drugs. Various clinical samples of TB suspected patients sent to the Balikesir Atatürk City Hospital Mycobacteriology Laboratory between 2011 and 2019, were included in the study. Microscopy, culture procedures, and the first-line anti-TB drug susceptibility tests were performed according to the instructions. Identification of NTM at the species level could be made during four years including 2012, 2013, 2016, and 2017. In our study, acid fast bacillus (AFB) positivity rate was 4% (1.867/47.235); the culture positivity rate for MTC was 5.1% (1.576/31.017) and 1.1% (333/31.017) for NTM. AFB positivity was detected in 837 (53.1%) of the clinical specimens isolated from MTC. In the presence of AFB positivity, it was determined that bacterial growth was significantly higher in both liquid culture systems (LCS) and Lowenstein-Jensen (LJ) media. The isolation rate of MTC isolates from LCS was determined as 95.3% (1.503/1.576) and the isolation rate from LJ was 67.4% (1.063/1.576). The bacterial growth rate was found to be significantly higher in LCS. The average bacterial growth time (ABGT) of AFB negative samples were 21.79 ± 9.96 days; 13.74 ± 8.13 days for AFB positive samples, and ABGT was significantly shorter in the case of AFB positivity. As the severity of AFB positivity increased, ABGT wasshortened which was statistically significant. While 783 (78%) of the isolates were found to be sensitive to all the tested drugs, 221 (22%) were found to be resistant to at least one drug. Eleven of them (1%) were identified as multidrug resistant-TB (MDR-TB) isolates. In our study, 16 different species were identified among 112 typed NTM isolates. Mycobacterium gordonae (25.0%), Mycobacterium avium complex (17.0%) (Mycobacterium intracellulare-11.6%, Mycobacterium avium-5.4%) and Mycobacterium abscessus (13.3%) were the most frequently isolated NTM species. As a result, nine-year results of the mycobacteriology laboratory in our region were analyzed and the MTC and NTM epidemiological data were determined for the first time.

Platelet-rich plasma as an additional therapeutic option for infected wounds with multi-drug resistant bacteria: in vitro antibacterial activity study.

PURPOSE: Infected wounds, such as diabetic foot infections, are mostly polymicrobial and microorganisms have high resistance rates to antimicrobials. Infected wounds in diabetic patients have high cost, morbidity, and mortality rates. Based on these facts, there is a need for supportive localized treatment options such as platelet-rich plasma (PRP) implementations. Demonstrating the in vitro antimicrobial effect, our aim was to lead up to clinical trials of localized PRP implementations in infected wounds such as diabetic foot infections. In this study, we aimed to demonstrate the in vitro antibacterial activity of PRP against methicilin-resistant Staphylococcus aureus (MRSA) and three more multi-drug resistant bacteria species that are important and hard-to-treat in wound infections. MATERIALS AND METHODS: In vitro antimicrobial activity of autologous PRP, platelet-poor plasma (PPP), and phosphate-buffered saline (PBS) on methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp., extended spectrum beta lactamase producing Klebsiella pneumoniae, and carbapenem-resistant Pseudomonas aeruginosa was compared by assessment of bacterial growth on agar plates and antimicrobial susceptibility test results. RESULTS: When compared to control group, PRP and PPP significantly suppressed bacterial growth of MRSA, K. pneumoniae, and P. aeruginosa at 1st, 2nd, 5th, and 10th hours of incubation (p < 0.05). VRE was the only bacteria that PRP and PPP showed limited activity against. When compared to PPP, PRP showed higher activity against MRSA, K. pneumoniae, and P. aeruginosa. However, the differences between PRP and PPP were statistically significant only against MRSA and P. aeruginosa at the first hour of incubation. CONCLUSIONS: Emerging PRP and other platelet-derived products seem to be promising alternative tools besides antibiotic treatment, debridement, negative pressure wound therapy, hyperbaric oxygen therapy, and other treatment options for treating diabetic foot infections.

Moxifloxacin-induced neutropenia in 26-year-old man.

Moxifloxacin is a fourth generation widely used fluoroquinolone antibiotic. There are three cases of moxifloxacin-induced neutropenia reported in the literature and we report the fourth case. A 26-year-old man with pneumonia was treated with moxifloxacin because of penicillin allergy. On the second day of therapy, leukopenia [White blood cell (WBC) count 2.7×10³/µL] and neutropenia (neutrophils 1.21×10³/µL) occurred. Rothia mucilaginosa was isolated in sputum culture. On the fourth day of hospitalization moxifloxacin treatment was stopped and clarithromycin 500 mg PO twice daily was started. Leukopenia and neutropenia resolved one day after discontinuation of moxifloxacin that WBC and neutrophil count rose 4.5×10³/µL and 1.97×10³/µL, respectively. On the sixth day of hospitalization, WBC and neutrophil count was 4.3×10³/µL and 2.29×10³/µL, respectively. The immunomodulatory effects of moxifloxacin may result in the changes of WBC count like leukopenia with neutropenia. Moxifloxacin induced neutropenia may be more common and is an important adverse effect. More observational studies about safety profiles of moxifloxacin are needed.

Genital region cleansing wipes: Effects on urine culture contamination.

INTRODUCTION: Urine culture is the gold standard test for revealing the microbial agent causing urinary tract infection (UTI). Culture results are affected by sampling techniques; improper sampling leads to contamination of urine and thus contamination of the culture with urogenital flora. We aimed to evaluate the effect of urogenital cleansing, performed with chlorhexidine-containing genital region cleansing wipes (GRCW) on contamination rates. METHODOLOGY: A total of 2,665 patients with UTI-related complaints and with urine culture requests from various outpatient clinics were enrolled in the study. Of the patients, 1,609 in the experimental group used GRCW before sampling, while 1,046 in the control group did not use any wipes. RESULTS: The contamination rate in the experimental group patients was 7.7%, while it was 15.8% in the control group. Contamination rates were significantly higher in the control group than in the experimental group for both women and men. Contamination rates for children and adults were also significantly lower in the experimental group than in the control group. CONCLUSIONS: Our study, conducted in a large population, showed that the use of chlorhexidine-containing cleansing wipes significantly reduced urine culture contamination rates in both genders, in both child and adult age groups. Using GRCW, collection of urine after urogenital area cleansing will decrease the contamination problem.

First report of macroscopic biofilm formation caused by Candida albicans on silver hydrogel-coated urinary catheters.

We report macroscopic biofilms on silver hydrogel-coated urinary catheters in 2 patients from 2 different intensive care units. The catheters were removed on observation of a white, jelly layer on the catheters, respectively, 9 and 21 days after insertion. Yeast cells and pseudohyphal structures were observed with microscopy. Both isolates were identified as Candida albicans. To our knowledge, these are the first cases demonstrating the formation of macroscopic biofilm layers on silver nitrate-coated catheters in the literature.