Clinical features, risk factors, and antimicrobial resistance of pseudomonas putida isolates.

Pseudomonas putida rarely results in infection, primarily in patients undergoing invasive procedures or immunocompromised hosts. We aimed to investigate the characteristics of Pseudomonas putida infections. This is a retrospectively designed cross-sectional observational study. We retrospectively scanned the data from our hospital for the 10 years before February 15, 2022. The patients with Pseudomonas putida growth in the microbiological cultures and with antibiotic susceptibility tests were included in the study. We recorded culture isolates types, age, gender, comorbidities, immunosuppressive factors, symptoms, invasive medical procedures, length of hospital stay, and radiological findings. The mean age of the patients was 66.2 ±â€…14.5 years, and the male patients predominated (76.3%, n = 58/76). There was growth in bronchial lavage in 33 patients, sputum in 28, pleural effusion fluid in 12, and tracheal aspirate in 3 patients. The rate of antibiotic-resistant strains was 56.6% (n = 43). All strains were sensitive to colistin (100%), and carbapenem, amikacin, and gentamicin sensitivity rates were high. We observed that the risk of antibiotic resistance increased 4.29 times in the patients in the intensive care unit (Cl:1.27-14.47, P = .01). The patients with Diabetes Mellitus had a higher risk (OR 4.33, Cl:1.11-16.77, P = .03), and in cancer cases, the risk was 3.31 times higher (Cl:1.06-10.32, P = .03). The risk of Pseudomonas putida infection should be considered, particularly in patients with comorbid disorders causing immunosuppression, including Diabetes Mellitus and Cancer.

[Using of the Sensititre MycoTB Plate Method for the Detection of Anti-tuberculous Drug Susceptibility of Rifampin Resistant Mycobacterium tuberculosis Complex Isolates]. / Rifampisine Dirençli Mycobacterium tuberculosis Kompleks Izolatlarinin Antitüberküloz Ilaç Duyarliligi Için Sensititre MycoTB Plak Yönteminin Kullanilmasi.

Members of the Mycobacterium tuberculosis complex (MTBC) are the causative agents of tuberculosis (TB). Rifampin resistance in the clinical isolates of MTBC is an important indicator for multidrug resistant-TB (MDR-TB) cases. In this study, it was aimed to evaluate whether the Sensititre MycoTB plaque method is suitable for the routine use in determining drug susceptibility of rifampin resistant MTBC strains. Xpert MTBC/ RIF positive rifampin resistant 100 MTBC isolates were included in the study. Xpert MTBC/RIF (Cepheid, USA) test were performed after the samples were processed by homogenization and decontamination and acid-fast staining. Rifampin resistant clinical samples were cultured in automated MGIT/BACTEC 960 (Becton Dickinson, USA) system and acid fast bacteria (AFB) were investigated. The anti-TB drug susceptibility tests of all culture positive AFB and cord factor identified as MTBC by using a cart test (MPB64, Capilla TB-Neo, Tauns Laboratories, Inc., Numazu, Japan) were performed with the Löwenstein-Jensen proportion method (LJPM) and Sensititre MycoTB (Trek Diagnostic Systems, Cleveland, OH, USA) methods. For the comparison of the methods used, the tests were performed simultaneously. The standard LJPM was performed according to the previously described procedures by World Health Organization and the Sensititre MycoTB plate method was performed as defined by the manufacturer. The final concentrations of isoniazide, rifampin, rifabutin, ethambutol, ofloxacin, moxifloxacin amikacin, kanamycin, cycloserine, ethionamide and p-aminosalicylic acid in Löwenstein-Jensen media for LJPM were 0.2 µg/ml, 40.0 µg/ml, 20.0 µg/ml, 2.0 µg/ml, 2.0 µg/ml, 1.0 µg/ml, 4.0 µg/ml, 30.0 µg/ml, 30.0 µg/ml, 40.0 µg/ml, 40.0 µg/ml and 1.0 µg/ ml, respectively. The results were obtained in 14 days for all of the drugs in the Sensititre MycoTB plate method and in 28-42 days in the LJPM. In this study, the sensitivity and specificity percentages of the Sensititre MycoTB method and the categorical agreement between the two methods were calculated. The sensitivity and specificity percentages of the Sensititre MycoTB plate method were between 84.4-100% and 95.6- 100%, respectively. The categorical agreements between the two methods were 92-100% for the drugs tested in the study. Ethambutol was found to have the lowest sensitivity (84.4%) and specificity (95.6%). The sensitivities of isoniazide, ofloxacin, streptomycin, kanamycin, ethionamide and p-aminosalicylic acid were 98.8%, 90.0%, 94.3%, 87.5%, 91.7% and 95.6%, respectively, while rifampicin, rifabutin, moxifloxacin, amikacin, cycloserine were calculated as 100%. The specificities of isoniazid, rifampicin, rifabutin, ofloxacin, moxifloxacin, amikacin, kanamycin, and cycloserine were found to be 100%, streptomycin, ethionamide and p-aminosalicylic specificity were 96.9%, 97.4% and 98.9% respectively. The categorical agreement was 96-100% in all tested drugs except ethambutol (92%). As a result, although the cost is high, owing to the short incubation period, easy to perform, the possibility for evaluating both first and second line anti-TB drugs simultaneously, determination of minimum inhibitory concentration values of the drugs, long shelf life, high sensitivity, specificity and the categorical agreement values, the Sensititre MycoTB method was determined as an effective method that can be used especially in laboratories where the workload and the MDR-TB cases are high.

[Frequently Isolated Slow Growing Nontuberculous Mycobacteria from Pulmonary Samples and Evaluation of Drug Susceptibility Testing Results in a Referral Hospital in Turkey]. / Türkiye'de Bir Referans Hastanede Akciger Örneklerinden Siklikla Izole Edilen Yavas Üreyen Tüberküloz Disi Mikobakteriler ve Ilaç Duyarlilik Sonuçlarinin Degerlendirilmesi.

Most of the nontuberculous mycobacteria (NTM) are opportunistic pathogenic microorganisms and free-living in nature. NTM can cause a wide range of infections. However, pulmonary NTM disease is the most frequent clinical picture. The aim of this study was to identify and evaluate drug susceptibility of slow growing NTM isolated from pulmonary samples of patients prediagnosed as tuberculosis between 2014 and 2018 in Atatürk Chest Diseases and Chest Surgery Training and Research Hospital Microbiology Laboratory by a commercial microtube dilution plaque method. A total of 435 NTM strains obtained from suspected TB patients were included in the study. After the samples were processed by homogenization and decontamination and acid-fast staining, culture in two solid media (Löwenstein-Jensen, Ogawa) and in MGIT-BACTEC960 automated system were performed. Acid-fast bacilli isolated from culture media were identified by using cart test (MPB64, Capilla TB-Neo) and polymerase chain reaction (PCR) based reverse hybridization "line probe assay (LPA)" method (GenoType MycobacteriumCM/AS, Hain Lifescience, GmbH, Germany). After DNA isolation from the culture, PCR was performed by using the primers specific for mycobacterial 23S rRNA spacer region. PCR products were then hybridized with the probes specific for Mycobacterium species on nitrocellulose strips according to the recommendations of the manufacturer and the results were evaluated. In this study, Mycobacterium avium (n= 77, 17.7%), Mycobacterium intracellulare (n= 70, 16.1%), Mycobacterium szulgai (n= 19, 4.4%), Mycobacterium kansasii (n= 10, 2.3%) ve Mycobacterium smiae (n= 9, 2.1%) were isolated as slowly growing mycobacteria from the pulmonary patients. Susceptibility testing was performed in cation-adjusted Mueller-Hinton broth (CAMH), supplemented with "oleic acid, albumin dextrose catalase" according to CLSI/ M24-A2 guideline recommendations. For the antibiotic susceptibility test, ready-to-use plaque drugs for slow-growing mycobacteria (SLOMYCO-Sensititre, TREK Diagnostic Systems Ltd, UK), were used. M.intracellulare, M.avium, M.kansasii and M.smiae isolates were found to be sensitive to clarithromycin %100, %99, %100 and %100, respectively. For M.intracellulare and M.avium isolates, moxifloxacin and linezolid sensitivity values were found to be 91%, 64% and 80%, 74% respectively. M.kansasii isolates were more sensitive than M.simiae isolates to the most of the drugs. M.kansasii isolates, were susceptible to rifabutin, rifampin, moxifloxacin, amikacin, linezolid, trimethoprim-sulfamethoxazole (TMP-SMX), ciprofloxacin and etambutol, with the frequencies of 100%, 90%, 100%, 100%, 80%, 70% and 50%, respectively. The study showed that the species identification and drug susceptibility testing of frequently isolated slow-growing NTM's from pulmonary specimens could guide for the treatment.

Evaluation of intestinal parasites in patients with chronic spontaneous urticaria in a territory hospital in Turkey.

INTRODUCTION: Chronic spontaneous urticaria (CSU) which develops without a known stimulation is defined as the occurrence of spontaneous wheals, angioedema or both for longer than six weeks. Infections, autoimmunity, food intolerance and internal parasitic infections are supposed to be underlying causes of CSU. The aim of this study was to evaluate the intestinal parasites in children and adult patients diagnosed as CSU, to determine the frequency of parasites in chronic urticaria, and to compare these patients with healthy demographic control groups. METHODOLOGY: Seventy six children and 38 adult patients with CSU were examined in terms of parasitic infections. The patients whom parasites were detected received anti-parasitic therapy and the improvements in CSU symptoms were evaluated. Stool samples were examined with direct microscopic examination (native-lugol), stool concentration and trichrome staining methods. RESULTS: In pediatric patient group, 18.4% (n = 14) of the stool samples were positive for Blastocystis sp., 2.6% (n = 2), Dientamoeba fragilis and 1.3% (n = 1), Giardia duodenalis. In adult patient group, Blastocystis sp. was detected in 18.4% (n = 7) of the stool samples. Anti-parasitic therapy yielded substantial improvement in urticaria symptoms in 57.1% of pediatric and 60.0% of adult patients. CONCLUSIONS: Blastocystis sp. and D. fragilis may play a role in chronic urticaria which seriously disrupts the patient's quality of life. Parasitic infections should not be neglected in patients with cutaneous manifestations.