The effects of ozone on bacterial growth and thiol-disulphide homeostasis in vascular graft infection caused by MRSA in rats

Abstract: Purpose: To investigate the microbiological, inflammatory and oxidant effects of adjuvant ozone administration in experimental rat vascular graft infection model which has not been previously investigated. Methods: Forty adult Wistar rats were divided into Sham, Control, Vancomycin, Ozone, Vancomycin+Ozone groups. Grafts were inoculated with Methicillin-resistant Staphylococcus aureus (MRSA) strain and implanted subcutaneously. Rats were treated intraperitoneally with ozone and /or intramuscularly with vancomycin for 10 days. Grafts were evaluated by quantitative bacterial cultures. Blood samples were harvested for determination of thiol-disulphide and cytokine profiles. Results: There was no significant difference in bacterial counts between Control and Ozone Groups. In the Ozone Group median colony count was significantly higher than the Vancomycin and Vancomycin+Ozone Groups. Total thiol and disulphide levels increased and disulphide/native thiol and disulphide/total thiol ratios decreased in Ozone Group significantly. Albumin levels decreased significantly in Vancomycin and Vancomycin+Ozone Groups compared to the Sham Group. IL-1 and TNF-alpha levels significantly increased in infected rats. Decreased levels of VEGF due to infection reversed by ozone therapy in control and vancomycin groups. Conclusions: We didn't observe any benefit of the agent on MRSA elimination in our model. Likewise, effects of ozone on thiol-disulphide homeostasis and inflammatory cytokines were contradictory.

Renal cyst infection caused by Brucella abortus.

A 49-year-old man with a medical history of polycystic kidney disease was presented to the emergency department with fever and left flank pain. Abdominal examination revealed an enlarged and painful left kidney. The C-reactive protein level was significantly high and the magnetic resonance imaging revealed areas of abnormal intensity and fluid-fluid levels in renal cysts. Brucella abortus was yielded from both blood and cyst fluid culture. Standard therapy (rifampicin plus doxycycline) of brucellosis was started, but the clinical and laboratory signs subsided after the addition of ciprofloxacin. There was no need for aspiration of infected cyst fluid. Hereby, according to the medical database search, we report that the first renal cyst infection caused by B. abortus was successfully treated with triple antibiotic therapy.

Peri-operative antibiotic prophylaxis: adherence to guidelines and effects of educational intervention.

BACKGROUND: This study was aimed to determine the propriety of perioperative antimicrobial prophylaxis, to evaluate the effects of a training intervention on correction. METHODS: This prospective educational intervention study was performed on clean, clean-contaminated, and contaminated wounds in elective procedures. The accuracy of the antimicrobial prophylaxis was analyzed according to international guidelines. The outcome measures were appropriateness of prophylactic antibiotic indication, choice, dose and duration; and cost of inappropriate administration. RESULTS: Before the intervention, 312 procedures were recorded compared with 322 after the intervention. Total compliance rate decreased from 34.3% to 28.5% after the intervention, though insignificantly (p=0.59). Educational training intervention did not change the rate of inappropriate antibiotic choice statistically, and prolonged antibiotic use was significantly higher after the intervention (p=0.01). The positive impact of the intervention was observed in decreased "not indicated but administered" rate (p=0.009) and absence of procedures with "indicated but not administered" and "inappropriate antibiotic dose" which also decreased significantly (both p<0.001). The total cost of irrational antibiotic use was US$26,230.20. CONCLUSIONS: Although this educational intervention study achieved improvements in indications, choice, and dosing of surgical antimicrobial prophylaxis, it failed to improve prolonged use and total compliance rate, and to lower the costs sufficiently. It will probably provide better results by means of compulsory measures for surgeons to comply with available protocols and guidelines, as well as education programs, in order to change the antibiotic utility habits on surgical prophylaxis and to achieve accurate prophylactic administrations.

Neuraminidase produces dose-dependent decrease of slime production and adherence of slime-forming, coagulase-negative staphylococci.

BACKGROUND: Slime is one of the important structures of certain bacterial strains involved in nonspecific adherence. This study was conducted to determine the role of neuraminidase on slime formation and adherence of slime-forming coagulase-negative staphylococci to inert surface. METHODS: Quantitative biofilm and qualitative bacterial adherence assays were performed with increasing concentrations of neuraminidase extracted from Clostridium perfringens-treated bacteria in polystyrene plates and polypropylene tubes. RESULTS: Slime production of slime-forming, coagulase-negative staphylococci was significantly decreased dose dependently at > or =100 mU/mL (p <0.001). Bacterial adherence to smooth surface was impeded at > or =100 mU/mL of neuraminidase treatment and adherence results were comparable with slime production assay results. CONCLUSIONS: Sialic acid may be a constituent molecule of slime and involved in bacterial adherence to inert surface. These results represent new insight into the mechanism of slime production and adherence of slime-forming, coagulase-negative staphylococci to inert surface.

Effect of preventive applications on prevalence of hepatitis B virus and hepatitis C virus infections in West Turkey.

OBJECTIVE: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are community health problems in developing countries and the most common causative agents of chronic hepatitis, cirrhosis and hepatocellular carcinoma. This study investigates the prevalence and the effect of preventive applications on prevalence of HBV and HCV infections in blood donors. METHODS: Blood donors enrolled to the University and State Hospital Blood Banks in Aydin region of Turkey through the years 1993 to 2002 were retrospectively analyzed. Blood donors were investigated in 2 groups, Group I (1993-1997) and Group II (1998-2002) to compare the prevalence difference in 10-years period. Serum hepatitis B antigen (HbsAg) and anti-HCV were tested by commercially available enzyme-linked immunosorbent assay kits and anti-HCV positive results were confirmed by recombinant immune blot assays HCV test. RESULTS: The prevalence of HBV and HCV infections was determined as 1.5% and 0.19% over the period 1993-2002. Although, the prevalence of HBV infection declined significantly in Group II (1.17%) in comparison with Group I (2.27%) (p<0.0001), there was no significant difference in both groups regarding HCV infection (p=0.238). CONCLUSION: Preventive applications against blood transfusion related diseases succeed to decrease HBV infection significantly in West Turkey. Vaccination seems to be the most effective method to prevent hepatitis infection.