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1.
J Gen Virol ; 105(5)2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38717926

RESUMEN

Background. Respiratory tract infections are among the most important causes of mortality and morbidity in children worldwide. The COVID-19 pandemic has affected the distribution of seasonal respiratory viruses as in all areas of life. In this study, we have aimed to evaluate the changes in the rates of seasonal respiratory viruses with the onset of the pandemic.Methods. This study included patients who were admitted to the Pediatrics Clinic of Eskisehir Osmangazi University Faculty of Medicine Hospital between December 2018 and February 2022 with respiratory tract infections and in whom pathogens were detected from nasopharyngeal swab samples analysed by multiplex PCR method.Results. A total of 833 respiratory tract pathogens were detected in 684 cases consisting of male (55.3 %), and female (44.7 %), patients with a total mean age of 42 months. Single pathogen was revealed in 550, and multiple pathogens in 134 cases. Intensive care was needed in 14 % of the cases. Most frequently influenza A/B, rhinovirus and respiratory syncytial virus (RSV) were detected during the pre-pandemic period, while rhinovirus, RSV, and adenovirus were observed during the lockdown period. In the post-lockdown period, the incidence rates of rhinovirus, RSV, human bocavirus (HboV) (12 %), influenza virus infections increased, and patients with RSV and bocavirus infections required intensive care hospitalization.Conclusion. It is thought that the COVID-9 pandemic lockdown measures may have an impact on the distribution of seasonal respiratory viruses, especially RSV and influenza. Current, prospective and large case series regarding the mechanism of action and dynamics are needed.


Asunto(s)
COVID-19 , Infecciones del Sistema Respiratorio , SARS-CoV-2 , Estaciones del Año , Humanos , Femenino , Masculino , COVID-19/epidemiología , COVID-19/virología , Preescolar , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Lactante , SARS-CoV-2/genética , SARS-CoV-2/aislamiento & purificación , Niño , Rhinovirus/aislamiento & purificación , Rhinovirus/genética , Nasofaringe/virología , Adolescente , Gripe Humana/epidemiología , Gripe Humana/virología , Pandemias , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/virología
2.
Children (Basel) ; 11(1)2024 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-38275444

RESUMEN

OBJECTIVES: Septic arthritis (SA) is a serious bacterial infection that must be treated efficiently and timely. The large number of culture-negative cases makes local epidemiological data important. Accordingly, this study aimed to evaluate the etiology, clinical characteristics, and therapeutic approach of SA in children in Turkiye, emphasizing the role of real-time polymerase chain reaction (PCR) techniques in the diagnosis. METHODS: In this multi-center, prospective study, children hospitalized due to SA between February 2018 and July 2020 in 23 hospitals in 14 cities in Turkiye were included. Clinical, demographic, laboratory, and radiological findings were assessed, and real-time PCR was performed using synovial fluid samples. RESULTS: Seventy-five children aged between 3 and 204 months diagnosed with acute SA were enrolled. Joint pain was the main complaint at admission, and the most commonly involved joints were the knees in 58 patients (77.4%). The combination of synovial fluid culture and real-time PCR detected causative bacteria in 33 patients (44%). In 14 (18.7%) patients, the etiological agent was demonstrated using only PCR. The most commonly isolated etiologic agent was Staphylococcus aureus, which was detected in 22 (29.3%) patients, while Streptococcus pyogenes was found in 4 (5.3%) patients and Kingella kingae in 3 (4%) patients. Streptococcus pyogenes and Kingella kingae were detected using only PCR. Most patients (81.3%) received combination therapy with multiple agents, and the most commonly used combination was glycopeptides plus third-generation cephalosporin. CONCLUSIONS: Staphylococcus aureus is the main pathogen in pediatric SA, and with the use of advanced diagnostic approaches, such as real-time PCR, the chance of diagnosis increases, especially in cases due to Kingella kingae and Streptococcus pyogenes.

3.
Microorganisms ; 11(10)2023 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-37894049

RESUMEN

INTRODUCTION: Lower respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. It is crucial to promptly conduct diagnostic investigations in order to determine the microbiological cause of pneumonia, since this is necessary to ensure the appropriate delivery of antibiotic therapy to each individual patient. We evaluated the results of a rapid molecular diagnostic pneumonia panel in children with LRTI in a pediatric intensive care unit (PICU). PATIENTS AND METHODS: Rapid molecular diagnostic pneumonia panel (BioFire®, FilmArray Pneumonia Panel plus; FA-PP) findings (71 results from 46 children) in a tertiary care PICU between 2019 and 2023 were retrospectively reviewed. RESULTS: At least one bacterial pathogen was detected in 57 cases. A total of 77% of children had underlying conditions. A total of 70.4% of children needed invasive mechanical ventilation and 54.4% had ventilator-associated pneumonia. Pseudomonas aeruginosa (50.8%), Acinetobacter calcoaceticus baumannii complex (42%), and Klebsiella pneumoniae (38.6%) were the most common pathogens detected with the FA-PP. Of the 33 cases diagnosed with VAP, more than one pathogen was identified in 65.9% of cases, with the most commonly identified bacteria being K. pneumoniae (43.1%), P. aeruginosa (38.6%), and Acinetobacter calcoaceticus baumannii complex (31.8%). According to the FA-PP results, the same antibiotic therapy was continued in 39.4% of cases, escalated in 54.5%, and de-escalated in 6.1%. CONCLUSIONS: The utilization of the FA-PP has some beneficial effects, including more prompt delivery of findings compared to conventional approaches. Additionally, this approach enables the identification of resistance profiles in children diagnosed with pneumonia in the PICU. Consequently, these test results facilitate the organization of antibiotic treatment strategies, including escalation and de-escalation approaches. The detection of resistance patterns was exclusively determined via the implementation of molecular testing, prompting a reevaluation of the isolation technique in accordance with the obtained data.

4.
Mikrobiyol Bul ; 57(2): 252-263, 2023 Apr.
Artículo en Turco | MEDLINE | ID: mdl-37067209

RESUMEN

Hepatitis C virus (HCV) infections are an important public health issue across the world because of the high risk of chronicity potential, impossibility of protection by vaccination and serious complications such as hepatocellular carcinoma. The aim of this study was to evaluate the correlation of HCV core antigen test with HCV RNA in the diagnosis and treatment follow-up and to discuss the status of being an alternative test in routine use. In the first step of the study, the compatibility of the methods was investigated by applying the HCV core antigen test to 600 serum samples from patients with pre diagnosis of HCV infection for whom anti-HCV and HCV RNA tests were routinely studied in the molecular microbiology laboratory of medical microbiology department between December 2016 and December 2018. In the second step, in addition to the routine HCV RNA test, HCV core antigen test was studied in serum samples taken before the start of the treatment, at the eighth week of the treatment and at the end of the treatment of 150 patients whose treatment were decided by the gastroenterology department within this period. The correlation between the two tests was evaluated during the treatment follow-up. Forty-nine of 600 patients were diagnosed according to test results. In 28 patients, HCV core antigen was positive in addition to HCV RNA and anti-HCV which were routinely studied. The sensitivity of HCV core antigen test was 91.49%, specificity was 100%, PPD was 100%, NPD was 97.30%, accuracy was 87.76%. There was a high correlation between HCV RNA and HCV core antigen results. In the second step of the study, sensitivity (96.52%), specificity (95.28%), PPD (95.11%), NPD (95.80%) and accuracy (92.58%) of the HCV core antigen test were determined. These results show that there is a high correlation between the two tests and that HCV core antigen test can be used as an alternative test to HCV RNA test as it is an easily applicable and cost effective test during diagnosis and treatment follow-up.


Asunto(s)
Hepacivirus , Hepatitis C , Humanos , Hepacivirus/genética , Estudios de Seguimiento , ARN Viral/genética , Proteínas del Núcleo Viral , Hepatitis C/diagnóstico , Hepatitis C/tratamiento farmacológico , Antígenos de la Hepatitis C/genética , Sensibilidad y Especificidad
6.
BMC Med Imaging ; 22(1): 128, 2022 07 20.
Artículo en Inglés | MEDLINE | ID: mdl-35858851

RESUMEN

BACKGROUND: It is important to determine the correlation of the CO-RADS classification and computed tomography (CT) patterns of the lung with laboratory data. To investigate the relationship of CO-RADS categories and CT patterns with laboratory data in patients with a positive RT-PCR test. We also developed a structured total CT scoring system and investigated its correlation with the total CT scoring system. METHOD: The CT examinations of the patients were evaluated in terms of the CO-RADS classification, pattern groups and total CT score. Structured total CT score values were obtained by including the total CT score values and pattern values in a regression analysis. The CT data were compared according to the laboratory data. RESULTS: A total of 198 patients were evaluated. There were significant differences between the CO-RADS groups in terms of age, ICU transfer, oxygen saturation, creatinine, LDH, D-dimer, high-sensitivity cardiac troponin-T (hs-TnT), CRP, structured total CT score values, and total CT score values. A significant difference was also observed between the CT pattern groups and oxygen saturation, creatinine and CRP values. When the structured total CT score values and total CT score values were compared they were observed to be correlated. CONCLUSIONS: Creatinine can be considered as an important marker for the CO-RADS and pattern classifications in lung involvement. LDH can be considered as an important marker of parenchymal involvement, especially bilateral and diffuse involvement. The structured total CT scoring system is a new system that can be used as an alternative.


Asunto(s)
COVID-19 , COVID-19/diagnóstico por imagen , Creatinina , Humanos , Pulmón/diagnóstico por imagen , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/métodos
7.
Indian J Med Microbiol ; 40(4): 567-571, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35817630

RESUMEN

PURPOSE: We aimed to compare the results of the BD Phoenix (TM) M50 ID/AST system and the gold standard broth microdilution method. We also evaluated the potential of a new therapeutic combination (colistin/sulbactam) for colistin resistance among Acinetobacter baumanni strains. METHODS: Growth in blood samples was detected with the BACTEC (BD Becton Dickinson, ABD) continuous monitoring blood culture system. Strains were identified by Phoenix (BD Phoenix™ M50, ABD) automated bacterial identification system and antimicrobial susceptibility results were obtained. A total of 92 A. baumannii complex isolates showing resistance to at least three antibiotic classes were included in the study. Colistin susceptibility results (both susceptible and resistant strains) detected by the Phoenix device were confirmed by the reference method, the liquid microdilution method. The concentration index (FIC) was used to determine the efficacy of fractional inhibitor drug combinations, the efficacy of colistin/sulbactam combination against 50 multiresistant A. baumannii complex strains was investigated using the checkerboard method. RESULTS: 10 (10.9%) of 92 isolates were resistant to colistin and 80 (86.9%) to sulbactam. With the automation system, only 2 of 10 isolates were found resistant to colistin, while 8 isolates were susceptible. For this reason, the very major error rate of the Phoenix M50 automatic system among resistant isolates was determined as 8/10. It was determined that 6 (12%) of the colistin/sulbactam combination had a synergistic effect and 44 (88%) had an additive interaction. No antagonistic interaction was detected with the colistin-sulbactam combination in this study. CONCLUSION: A. baumannii strains should be confirmed by the broth microdilution method, which is the reference method, against the MIC results detected by automated systems. It was concluded that the use of colistin alone should be avoided in the treatment of A. baumannii infections.


Asunto(s)
Infecciones por Acinetobacter , Acinetobacter baumannii , Infecciones por Acinetobacter/tratamiento farmacológico , Infecciones por Acinetobacter/microbiología , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Colistina/farmacología , Combinación de Medicamentos , Farmacorresistencia Bacteriana Múltiple , Sinergismo Farmacológico , Humanos , Pruebas de Sensibilidad Microbiana , Sulbactam/farmacología , Sulbactam/uso terapéutico
8.
J Med Microbiol ; 69(7): 944-948, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32490795

RESUMEN

Introduction. Polymicrobial infections including yeasts and bacteria are not rare and patients with polymicrobial bloodstream infection have higher early and overall case fatality rates. The diagnosis of invasive fungal and bacterial infections is mainly based on blood culture.Aim. The aim was to reveal the effect of concomitant bacteraemia on the detection of fungi from blood cultures in the presence of polymicrobial bloodstream infections involving Candida and non-Candida fungi and to show the superiority of blood culture bottles including selective fungal media in such situations.Methodology. Twenty-four polymicrobial bloodstream infection models - involving one fungus and one bacterium - were constituted by using clinical blood culture isolates (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, Candida glabrata, Fusarium solani and Trichosporon asahii). The Plus Aerobic/F (PAF) and Mycosis IC/F (MICF) culture bottles were used with the BACTEC 9240 device. After a bottle signalled positive, direct microscopic examination and subcultures on agar plates were performed.Results. All of fungi that were inoculated alone and in combination were detected by both direct microscopic examination and subcultures on agar plates from MICF bottles, whereas direct microscopic examination only revealed the bacterial agents from PAF bottles including combinations. Furthermore, fungal growth was hidden by bacterial growth on blood agar subcultures from PAF bottles including combinations of F. solani, C. glabrata or T. asahii with bacteria.Conclusion. Blood culture bottles including selective fungal media that can allow selective growth of fungi and earlier detection of some species should be preferred in addition to non-selective blood culture bottles, especially in specific patient populations. Further, the use of selective agar plates such as inhibitory mould agar may contribute to the solution of this problem in clinical laboratories.


Asunto(s)
Bacteriemia/diagnóstico , Cultivo de Sangre/métodos , Bacteriemia/sangre , Bacteriemia/microbiología , Bacterias/crecimiento & desarrollo , Bacterias/aislamiento & purificación , Infecciones Bacterianas/sangre , Infecciones Bacterianas/diagnóstico , Candida/aislamiento & purificación , Candidemia/sangre , Candidemia/diagnóstico , Candidemia/microbiología , Medios de Cultivo , Hongos/crecimiento & desarrollo , Hongos/aislamiento & purificación , Humanos , Técnicas Microbiológicas/métodos , Micosis/sangre , Micosis/diagnóstico
9.
Pol J Microbiol ; 67(1): 81-88, 2018 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-30015428

RESUMEN

The accurate diagnosis of Epstein-Barr virus (EBV) infections is important, as many other infectious agents or diseases can cause similar symptoms. In this study, sera of pediatric patients who were suspected to have an EBV infection, were sent to Eskisehir Osmangazi University Faculty of Medicine, Department of Clinical Microbiology, and investigated by IFA, ELISA, immunoblotting and Real-time PCR. The performances of these tests were compared with IFA. The rates of agreement between ELISA and IFA were found as 100% for seronegative, 100% for acute primary infection, 22.2% for late primary infection, 92.1% for past infection. The rates of agreement between immunoblotting and IFA were found as 80.8% for seronegative, 68.8% for acute primary infection, 55.6% for late primary infection, 86.6% for past infection. The sensitivity of immunoblotting for anti-VCA IgM was identical with ELISA, and higher for anti-VCA IgG, anti-EBNA IgG, anti-EA antibodies, while the specificity of immunoblotting for these antibodies were found to be lower. The sensitivity and specificity of Real-time PCR for detection of viremia in acute primary infection were found as 56.25% (9/16) and 97.89% (139/142), respectively. The diagnostic methods should be chosen by evaluating the demographic characteristics of patients and laboratory conditions together.


Asunto(s)
Ensayo de Inmunoadsorción Enzimática , Infecciones por Virus de Epstein-Barr/diagnóstico , Técnica del Anticuerpo Fluorescente Indirecta , Immunoblotting , Reacción en Cadena en Tiempo Real de la Polimerasa , Adolescente , Anticuerpos Antivirales/sangre , Niño , Preescolar , ADN Viral/genética , Infecciones por Virus de Epstein-Barr/sangre , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Sensibilidad y Especificidad , Viremia/diagnóstico
10.
J Infect Dev Ctries ; 10(5): 465-71, 2016 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-27249521

RESUMEN

INTRODUCTION: Early detection of methicillin-resistant Staphylococcus aureus (MRSA) in colonized patients is very important for infection control procedures to prevent MRSA spread. We aimed to monitor MRSA carriage in intensive care unit (ICU) patients and to evaluate the speed and efficiency of conventional culture, immunological, chromogenic, and molecular methods together with genotyping. METHODOLOGY: Nasal and axillar swab specimens were obtained from patients in the ICUs of the general surgery and neurosurgery wards in a tertiary hospital once a week over four weeks between December 2009 and July 2010. Oxacillin and cefoxitin disk diffusion tests, oxacillin agar screening test, latex agglutination test, chromogenic agar, and real-time polymerase chain reaction (PCR) tests were used for isolation and identification of MRSA. MRSA isolates were typed using ribotyping and pulsed-field gel electrophoresis (PFGE) typing. RESULTS: MRSA colonization was detected in 48 of 306 patients by real-time PCR. The MRSA colonization rate was 6.2%, 15.5%, and 38.5% at admission and in the first and second weeks, respectively. Sensitivity, specificity, positive and negative predictive values for all phenotypic tests were 98%, 99.6%, 98%, and 99.6%, respectively. The shortest handle time was observed in PCR. A total of three banding patterns were obtained from MRSA isolates by ribotyping, and PFGE analyses revealed 17 different pulsotypes varying from 11 to 18 distinct bands, showing high genetic diversity among the samples. CONCLUSION: Phenotypic MRSA screening tests in our study exhibited similar performances. The superiority of real-time PCR is its short turnaround time.


Asunto(s)
Portador Sano/epidemiología , Staphylococcus aureus Resistente a Meticilina/clasificación , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Tipificación Molecular , Reacción en Cadena en Tiempo Real de la Polimerasa , Infecciones Estafilocócicas/epidemiología , Técnicas Bacteriológicas , Portador Sano/diagnóstico , Portador Sano/microbiología , Electroforesis en Gel de Campo Pulsado , Femenino , Genotipo , Humanos , Inmunoensayo , Unidades de Cuidados Intensivos , Masculino , Staphylococcus aureus Resistente a Meticilina/genética , Fenotipo , Sensibilidad y Especificidad , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/microbiología , Centros de Atención Terciaria , Factores de Tiempo
11.
J Microbiol Methods ; 86(1): 121-3, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21530594

RESUMEN

We tested 200 clinical Acinetobacter baumannii isolates against imipenem and meropenem using the methods of broth microdilution, disk diffusion, agar dilution, MicroScan/WalkAway automated system. Very major errors were mostly obtained between MicroScan/WA system and disk diffusion test. MicroScan/WA system generated unacceptable errors. Combined disk and modified Hodge tests used for detection of metallo-ß-lactamase production were practical and useful.


Asunto(s)
Infecciones por Acinetobacter/microbiología , Acinetobacter baumannii/efectos de los fármacos , Acinetobacter baumannii/enzimología , Antibacterianos/farmacología , Carbapenémicos/farmacología , Farmacorresistencia Bacteriana , Pruebas de Sensibilidad Microbiana/métodos , beta-Lactamasas/metabolismo , Acinetobacter baumannii/aislamiento & purificación , Animales
12.
Pediatr Blood Cancer ; 55(2): 349-51, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20582969

RESUMEN

Corynebacterium jeikeium has been recognized as an important cause of infection, particularly among neutropenic patients who have central venous catheter (CVC). Routine use of tigecycline in children is not yet approved. Here in we present a child with relapsed-refractory lymphoblastic leukemia who was successfully treated with tigecyline due to multi-drug-resistant C. jeikeium sepsis without removal of CVC. Our case highlights the use of tigecycline where there are no alternatives. Further studies regarding the efficacy and safety of tigecycline in pediatric patients are needed.


Asunto(s)
Infecciones por Corynebacterium/tratamiento farmacológico , Resistencia a Múltiples Medicamentos , Minociclina/análogos & derivados , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Antibacterianos/uso terapéutico , Infecciones Relacionadas con Catéteres , Cateterismo Venoso Central/efectos adversos , Niño , Femenino , Humanos , Minociclina/uso terapéutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/patología , Recurrencia , Inducción de Remisión , Tigeciclina
13.
Expert Opin Pharmacother ; 9(9): 1441-9, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18518776

RESUMEN

OBJECTIVE: To evaluate the in vitro effect of ertapenem, imipenem and meropenem in clinical isolates of extended-spectrum beta-lactamase (ESBL)-producing strains of Escherichia coli and Klebsiella pneumoniae. DESIGN/METHODS: We studied 82 consecutive clinical isolates of ESBL-producing E. coli (n = 49) and K. pneumonia (n = 33) between February 2006 and September 2007. The minimum inhibitory concentration for each carbapenem was determined using the agar dilution method. RESULTS: Eighty two consecutive microorganisms from sterile sites were evaluated. A total of 48.8% of patients had a history of surgical intervention, 78.0% needed urinary catheterization, 57.3% required vascular access and 40.3% mechanical ventilation; and 70.7% had a history of ICU stay. High resistance rates were shown for both E. coli and K. pneumoniae against cefepime (81.7%), ciprofloxacin (50.9%), tetracycline (75.0%), co-trimoxazole (47.4%), and gentamicin (48.7%). In addition, most K. pneumoniae and E. coli isolates were susceptible to amikacin (78.3%) and piperacilline-tazobactam (91.5%). Meropenem and imipenem showed activity against 100% of the isolates. Ertapenem showed activity against 100% of K. pneumoniae isolates, against 95.9% of E. coli isolates and against 97.5% of the 82 ESBL-producing microorganisms. Two E. coli isolates showed ertapenem resistance. CONCLUSION: In recent literature, carbapenems were the most active antimicrobial agents against ESBL-producing Enterobacteriaceae, as in our study. This is the first study on the in vitro activity of ertapenem against ESBL-producing E. coli and K. pneumoniae conducted in Turkey. In view of the serious infections caused by ESBL-producing microorganisms, therapeutic interventions are still problematic in serious clinical conditions. Ertapenem may be a good choice for treatment, with the additional advantage of being a once a day regimen.


Asunto(s)
Antibacterianos/farmacología , Carbapenémicos/farmacología , Escherichia coli/efectos de los fármacos , Klebsiella pneumoniae/efectos de los fármacos , beta-Lactamasas , beta-Lactamas/farmacología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Ertapenem , Escherichia coli/enzimología , Escherichia coli/aislamiento & purificación , Femenino , Hospitales Universitarios , Humanos , Lactante , Recién Nacido , Klebsiella pneumoniae/enzimología , Klebsiella pneumoniae/aislamiento & purificación , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Turquía , Inhibidores de beta-Lactamasas , beta-Lactamasas/biosíntesis
14.
Saudi Med J ; 28(12): 1850-4, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18060215

RESUMEN

OBJECTIVE: To determine the resistance of antibiotics for complicated urinary tract infection (UTI), including urinary tract anomaly (UTA), for empirical antibiotic therapy of complicated UTI. METHODS: Four hundred and twenty urine isolates were obtained from 113 patients with recurrent UTI, who used prophylactic antibiotics between February 1999 and November 2004 in the Eskisehir Osmangazi University, Eskisehir, Turkey. RESULTS: Reflux was found to be the most important predisposing factor for recurrent UTI (31.9%). Renal scar was detected more in patients with UTA than without UTA (59.2% versus 12.4%, p<0.05). Gram-negative organisms were dominant in patients with and without UTA (91.5% and 79.2%). Enterococci and Candida spp. were more prevalent in children with UTA than without UTA (p<0.001). Isolates were significantly more resistant to ampicillin, trimethoprim-sulfamethoxazole, amikacin, co-amoxiclav, ticarcillin-clavulanate, and piperacillin-tazobactam in patients with UTA than without UTA. We found low resistance to ciprofloxacin and nitrofurantoin in UTI with and without UTA. Enterococci spp. was highly resistance to ampicillin and amikacin in patients with UTA. CONCLUSION: Aztreonam, meropenem, and ciprofloxacin seemed to be the best choice for treatment of UTI with UTA due to Escherichia coli and Klebsiella spp. Nitrofurantoin and nalidixic acid may be first choice antibiotics for prophylaxis in UTI with and without UTA. The UTI with UTA caused by Enterococci spp. might not benefit from a combination of amikacin and ampicillin, it could be treated with glycopeptides.


Asunto(s)
Farmacorresistencia Bacteriana , Infecciones Urinarias/tratamiento farmacológico , Adolescente , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Masculino , Recurrencia , Infecciones Urinarias/etiología , Infecciones Urinarias/patología
15.
Saudi Med J ; 27(5): 608-12, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16680246

RESUMEN

OBJECTIVE: To determine the prevalence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli), risk factors of ESBL-producing strains and antimicrobial susceptibility pattern of ESBL-producing and non producing strains. METHODS: The study took place at the Faculty of Medicine, Osmangazi University, Eskisehir, Turkey from March to November 2002. We evaluated 100 K. pneumoniae and 100 E. coli strains isolated from various clinical specimens, as well as the patients from whom these strains were isolated. The double-disk synergy test was performed on the isolates for the detection of ESBL. We visited the patients with a growth of E. coli or K. pneumoniae or both from their clinical specimens in their wards if they were hospitalized, while the outpatients with a growth of these microorganisms were evaluated from their hospital records. RESULTS: The prevalence of ESBL-producing K. pneumoniae was 47% and E. coli was found as 12%. The ESBL-producing isolate rates were 50% (14/28) in intensive care units, 36.1% (35/97) in wards and 13.3% (10/75) in outpatients. Foley catheter (p<0.001), intravenous catheter (p<0.001), central venous catheter (p=0.002), intubation (p<0.001), surgery (p<0.001) and mechanical ventilation (p=0.002) were found as the risk factors for the acquisition of E. coli and K. pneumoniae with ESBLs. CONCLUSION: In our study, the prevalence of ESBL-producing isolates was high. The results of the study suggest that an antimicrobial policy and early removal of interventional apparatus be of importance for the control of ESBL-producing K. pneumoniae and E. coli.


Asunto(s)
Infecciones por Escherichia coli/epidemiología , Escherichia coli/enzimología , Escherichia coli/aislamiento & purificación , Klebsiella pneumoniae/enzimología , Klebsiella pneumoniae/aislamiento & purificación , Neumonía Bacteriana/complicaciones , beta-Lactamasas/biosíntesis , Adulto , Antiinfecciosos/administración & dosificación , Catéteres de Permanencia/efectos adversos , Femenino , Cirugía General , Hospitales de Enseñanza , Humanos , Intubación/efectos adversos , Masculino , Pruebas de Sensibilidad Microbiana , Prevalencia , Factores de Riesgo , Turquía , Cateterismo Urinario/efectos adversos , Ventiladores Mecánicos/efectos adversos
16.
Mikrobiyol Bul ; 39(4): 465-71, 2005 Oct.
Artículo en Turco | MEDLINE | ID: mdl-16544548

RESUMEN

The relationship between the airborne contaminants obtained from operating theatres and intensive care units and the colonizing and infecting microorganisms isolated from patients were investigated. Air samples were obtained with the biocollector air IDEAL (BioMerieux, France). During the study period (19 weeks), a total of 77 air samples and 870 clinical specimens (swabs from throat, nose, conjunctiva and skin) from 174 patients were collected weekly. Microorganisms were identified by using Vitek system (BioMerieux, France) and conventional methods. According to the criteria of Federal Standard 209E (FD 209E) on cleanrooms, the conventionally ventilated operating- and general surgery rooms, and the anesthesia intensive care unit have been ranked as less than class 3.5 and 3, respectively. The frequency of nosocomial infection related to air-colonization was higher in patients of anestesia intensive care unit (16.4%), than in those of general surgery intensive care unit (4.9%). In general surgery rooms and anesthesia intensive care unit, the most frequent air-colonization related nosocomial infections were surgical wound infections and bacteremia, respectively. The most frequently isolated microorganisms were methicillin resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii. It can be concluded that, total number of airborne viable particles in the critical areas such as operating theatres and intensive care units, seems to be a significant risk factor for the development of nosocomial infections in immunocompromised patients.


Asunto(s)
Microbiología del Aire , Bacteriemia/microbiología , Infección Hospitalaria/microbiología , Infección de la Herida Quirúrgica/microbiología , Acinetobacter baumannii/aislamiento & purificación , Adolescente , Adulto , Anciano , Bacteriemia/epidemiología , Conjuntiva/microbiología , Infección Hospitalaria/epidemiología , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Resistencia a la Meticilina , Persona de Mediana Edad , Cavidad Nasal/microbiología , Quirófanos , Faringe/microbiología , Factores de Riesgo , Piel/microbiología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Infección de la Herida Quirúrgica/epidemiología , Turquía/epidemiología
17.
Am J Infect Control ; 32(7): 409-13, 2004 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-15525916

RESUMEN

BACKGROUND: The purpose of this study is to estimate the prevalence of nosocomial infections in a university hospital, as well as determining the groups at high risk of such infections. MATERIALS AND METHODS: Two surveys based on a modification of the British National Survey protocol for nosocomial infection were conducted in July and December 1998. RESULTS: In the first survey, hospital infections were found in 41 (13.4%) of the patients, and in the second survey in 34 (10.9%). The study showed that the risk of nosocomial infection was associated with being in the intensive care unit, undergoing surgery, and invasive procedures. CONCLUSION: Prevalence data are consistent with results reported in many other regions of the world. These findings provide the principal information for future surveillance in association with prevention programs in Turkish hospitals.


Asunto(s)
Infección Hospitalaria/epidemiología , Adolescente , Adulto , Niño , Preescolar , Intervalos de Confianza , Femenino , Encuestas Epidemiológicas , Hospitales Universitarios/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Unidades de Cuidados Intensivos/estadística & datos numéricos , Medicina Interna/estadística & datos numéricos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Factores de Riesgo , Servicio de Cirugía en Hospital/estadística & datos numéricos , Turquía/epidemiología
18.
Mikrobiyol Bul ; 38(4): 471-85, 2004 Oct.
Artículo en Turco | MEDLINE | ID: mdl-15700676

RESUMEN

Bite wounds are common injuries that are often mistakenly considered innocuous by both patients and physicians. These wounds consist of laserations, evulsions, punctures, and scratches. While many of these wounds require minimal or no therapy, a significant number results in infections, which may even be life-threatening. The bacteria associated with bite-wound infections generally originate from the oropharyngeal flora of the biting animal. The clinical presentation and appropriate treatment of infected bite wounds vary according to the causative microorganisms. This review focuses on dog, cat, small rodents, monkey, and snake bite-wound infections, risk factors, bacteriology, antimicrobial susceptibility patterns of the causative organisms, and recommended treatment strategies.


Asunto(s)
Mordeduras y Picaduras/complicaciones , Infección de Heridas/microbiología , Animales , Capnocytophaga , Gatos , Perros , Infecciones por Bacterias Gramnegativas/microbiología , Haplorrinos , Humanos , Pruebas de Sensibilidad Microbiana , Orofaringe/microbiología , Infecciones por Pasteurella/microbiología , Factores de Riesgo , Roedores , Mordeduras de Serpientes/microbiología
19.
J Clin Microbiol ; 41(2): 819-21, 2003 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12574291

RESUMEN

We tracked and documented the time of positivity of blood cultures by using the BACTEC 9120 (Becton Dickinson Diagnostic Instrument Systems) blood culture system over a 5-year study period. A 7-day protocol of the incubation period was selected, and a total of 11156 blood cultures were evaluated. The clinically significant microorganisms (32.95%) were isolated in 3676 specimens. Gram-positive and -negative bacterial isolation rates were found to be 41.07 and 44.88%, respectively. Yeasts were found in 14.03% of all pathogens. Both the false-positivity and -negativity rates were very low (0.1 and 0.3%, respectively). The mean detection times for all of the pathogens were determined to be 19.45 h. Yeasts, nonfermentative gram-negative bacteria, and Brucella melitensis strains were isolated within 5 days. By taking these data into account, we decided to establish a 5-day-incubation protocol in our laboratory instead of the 7 days that are commonly used.


Asunto(s)
Bacterias/aislamiento & purificación , Juego de Reactivos para Diagnóstico , Levaduras/aislamiento & purificación , Hospitales Universitarios , Humanos , Factores de Tiempo , Turquía
20.
Mikrobiyol Bul ; 36(3-4): 259-69, 2002.
Artículo en Turco | MEDLINE | ID: mdl-12838659

RESUMEN

Bactericidal efficacy of seven different disinfectants (chlorhexidine gluconate, povidone-iodine, glutaraldehyde, benzalkonium chloride, sodium hypochloride, ethoxydiamino acridine, the mixture of "12% ethandiol + 0.5% pentanediol + 7.5% didecyldimethylammonium cloride") commonly used at Osmangazi University, Medical Faculty Hospital, was investigated against frequent nosocomial bacterial pathogens (19 Gram-negative and 25 Gram-positive strains) by using modified Kelsey-Sykes method. Chlorhexidine gluconate, povidone-iodine and glutaraldehyde were determined as the most effective disinfectants against all of the pathogens. There was no significant difference in terms of biocide resistance between antibiotic sensitive and resistant strains. All of the P. aeruginosa strains were found to be resistant to 0.01% benzalkonium chloride and 0.25%, 0.5% and 1% concentrations of "12% ethandiol + 0.5% pentanediol + 7.5% didecyldimethyl ammonium cloride" mixture. One vancomycin resistant E. faecium strain and one extended spectrum beta-lactamase (ESBL) positive K. pneumoniae strain were found to be resistant to 0.55% sodium hypochloride. Ethoxydiamino acridine showed little or no activity against all tested strains.


Asunto(s)
Antiinfecciosos Locales/farmacología , Infección Hospitalaria/microbiología , Desinfectantes/farmacología , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Farmacorresistencia Bacteriana , Humanos , Pruebas de Sensibilidad Microbiana
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