Should we leave the paper currency? A microbiological examination / ¿Deberíamos dejar de usar los billetes? Análisis microbiológico

OBJECTIVES: Pathogens can be transmitted to banknotes due to the personal unhygienic habits. The aim of study was to find the possible pathogens on the banknotes circulating in the market and also to present their antibacterial resistance and their various virulence factors using genotypic and phenotypic methods. MATERIAL AND METHODS: A total of 150 samples of bank-notes were randomly collected between August 2017 and March 2018. VITEK systems were used for identification and antimicrobial susceptibility testing respectively. Antimicrobial resistance genes (mecA, van, extended-spectrum β-lactamase [ESBL] and carbapenemases) and staphyloccoccal virulence genes (staphyloccoccal enterotoxins [SEs], pvl, and tsst-1) were determined using with real-time PCR. RESULTS: Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Enterococcus spp., Gram-negative enteric bacteria, non-fermentative Gram-negative bacteria and Candida spp. were detected 48%, 54.7%, 56%, 21.3%, 18.7%, and 4%, respectively. Methicillin-resistant S. aureus, vancomycin-resistant enterococci and ESBL producing Gram-negative were found 46.8%, 1.3%, and 28.7%, respectively. Pvl, tsst-1, and SEs genes were found in a 2.8/4.9%, 1.4/1.2%, and 100/ 87.8% of the S. aureus/CoNS strains, respectively. The sea gene was found the most common enterotoxigenic gene. blaTEM, blaSHV, blaCTX-M-2, blaCTX-M-1, blaKPC, and blaOXA-48 were found 55.8%, 46.5%, 41.2%, 18.6%, 18.6%, and 18.6%, respectively in Gram-negative strains. CONCLUSION: These results is very important to highlight hygienic status of paper currencies. This can be considered as an indication that banknotes may contribute to the spread of pathogens and antimicrobial resistance. Therefore, we may need to start using alternative products instead of banknotes

OBJETIVO: Los patógenos se pueden transmitir a los billetes debido a los hábitos antihigiénicos personales. El objetivo del estudio fue buscar los posibles patógenos en los billetes que circulan en el mercado y también observar su resistencia antibacteriana así como sus diversos factores de virulencia utilizando métodos genotípicos y fenotípicos. MATERIAL Y MÉTODOS: Se recogieron al azar un total de 150 muestras de billetes entre agosto de 2017 y marzo de 2018. Se utilizaron los sistemas VITEK para la identificación y las pruebas de sensibilidad a los antimicrobianos, respectivamente. Los genes de resistencia a los antimicrobianos (mecA, van, betalactamasas de espectro ampliado [BLEA] y carbapenemasas) y los genes de virulencia estafilocócica (SE, pvl y tsst -1) se determinaron mediante PCR a tiempo real. RESULTADOS: Se detectó la presencia de cepas de Staphylococcus aureus, Staphylococcus coagulasa negativos (SCN), Enterococcus spp, bacterias gramnegativas, bacterias gramnegativas no fermentativas y Candida spp en un 48%, 54,7%, 56%, 21,3%, 18,7% y 4% de los billetes, respectivamente. Se observó la presencia de S. aureus resistente a meticilina, Enterococcus resistentes a vancomicina y gramnegativos productores de BLEA en un 46,8%, 1,3% y 28,7%, respectivamente. Los genes Pvl, tsst-1 y SE se encontraron en un 2,8/4,9%; 1,4/1,2% y 100/87,8% de las cepas de S. aureus/SCN, respectivamente. El gen sea fue el gen enterotoxigénico más frecuente. Los genes blaTEM, blaSHV, blaCTX-M-2, blaCTX-M-1, blaKPC, y blaOXA-48 se encontraron 55,8%, 46,5%, 41,2%, 18,6%, 18,6%, y 18,6%, respectivamente en cepas gramnegativas. CONCLUSIÓN: Estos resultados son muy importantes para resaltar el estado higiénico de los billetes. De este modo, los billetes pueden contribuir a la propagación de patógenos y de la resistencia a los antimicrobianos. Por lo tanto, es posible que debamos comenzar a utilizar productos alternativos a los billetes

An in Vitro Experimental Study on the Antimicrobial Activity of Silicone Oil against Anaerobic Bacteria.

PURPOSE: To investigate the in vitro antimicrobial activity of silicone oil against anaerobic agents, specifically Propionibacterium acnes, Peptostreptococcus spp., Peptostreptococcus anaerobius, Bacteroides fragilis, Fuobacterium spp., and Clostridium tertium. METHOD: A 0.5 McFarland turbidity of Propionibacterium acnes, Peptostreptococcus spp., Peptostreptococcus anaerobius, Bacteroides fragilis, Fuobacterium spp., and Clostridium tertium was prepared, and 0.1 mL was inoculated into 0.9 mL of silicone oil. Control inoculations were performed in anaerobic blood agar and fluid thioglycollate medium without silicone oil. RESULTS: Propionibacterium acnes retained their viability on the 3rd day in the presence of silicone oil. In total, 9.7 × 10(6) colonies were enumerated from 1 mL of silicone oil. After a prolonged incubation of 7 days, the number of colonies observed was 9.2 × 10(6). The other bacteria disappeared after the 3rd day of incubation in silicone oil. CONCLUSIONS: Propionibacterium acnes, which is the most common chronic postoperative endophthalmitis agent, is thought to be resistant to silicone oil.

Hemophilus Influenzae Infections with Abscess Formation in Adults: a Retrospective Study Covering an Eleven-Year Period.

BACKGROUND: The aim of this study was to investigate the presence of Haemophilus influenzae in abscesses in adults and to determine their antibiotic resistance patterns. METHODS: H. influenzae strains isolated from abscesses during an eleven-year period were determined retrospectively and the stored strains were tested for ampicillin, amoxicillin/calvulanic acid, cefuroxime, cefotaxime, ceftriaxone, ciprofloxacin, azithromycin, tetracycline, and imipenem resistance by broth microdilution method. The production of ß-lactamase was detected using the nitrocefin disc test and real-time PCR. RESULTS: A total of 26 H. influenzae isolated strains were found. According to ampicillin resistance and ß-lactamase production, 2 strains were determined as BLPAR, 1 strain BLNAR, 1 strain BLPACR, and 22 strains as BLNAS. Cefuroxime resistance was detected in 4 strains, tetracycline resistance was detected in 4 strains, and no resistance to cefotaxime, ceftriaxone, imipenem, azithromycin and levofloxacin was detected. CONCLUSIONS: H. influenzae should be taken into account for the proper management of abscesses.

The prevalence of enterotoxin and antibiotic resistance genes in clinical and intestinal Bacteroides fragilis group isolates in Turkey.

This study was conducted to measure the antibiotic susceptibilities, corresponding gene contents, and the enterotoxin gene bft, in 50 Bacteroides fragilis group isolates, 25 of which were clinical and 25 intestinal. The resistance rates to amoxicillin/clavulanic acid, imipenem and metronidazole were low; ampicillin and tetracyclin resistance was high; clindamycin resistance and ermF gene presence was also high. Regarding phenotypical bacterial resistance and the presence of resistance genes, there was not statistically significant difference between clinical and intestinal isolates and bft positive and negative isolates.

Presence of vancomycin, aminoglycosides, and erythromycin resistance genes in enterococci isolated from clinical samples in Turkey.

BACKGROUND: Emergence of high-level aminoglycoside and glycopeptide resistance causes more severe prognosis, higher mortality, and recurrence in enterococcal infections. The present study was conducted to investigate the antimicrobial resistance patterns, prevalence of AMEs, erm and van genes of enterococci isolated from various clinical samples at Istanbul University, Cerrahpasa Medical School hospital. METHODS: During the period of 2012-2013, a total of 128 enterococcal isolates collected from various clinical samples were typed with the API 20 strep test, and antibiotic sensibilities were analysed with the disc diffusion and E-test methods. The detection of resistant genes was determined by a multiplex PCR method. RESULTS: Forty-nine percent E. faecalis, 46% E. faecium, 4 E. avium and 2 E. durans were detected. E. faecium resistance rates were significantly higher than E. faecalis (p < 0.001). The resistant genes were analysed in 50 enterococcus strains. The vanA gene was found in 29 of the 30 VRE strains. The most prevalent AMEs genes were aac (6')-Ie-aph (2")-Ia gene (72%), followed by aph (3')-IIIa gene (30%). The ermB gene was found in 49 of a total of 50 strains. CONCLUSIONS: This study shows that aac (6')-Ie-aph (2")-Ia, ermB, and vanA genes are common among enterococci isolates in our hospital and spread of VRE along with acquisition of resistance to most of the antibiotics used in therapy.

Prevalence and antimicrobial susceptibilities of anaerobic bacteria isolated from perforated corneal ulcers by culture and multiplex PCR: an evaluation in cases with keratitis and endophthalmitis.

BACKGROUND: Anaerobic bacteria play an important role in eye infections; however, there is limited epidemiologic data based on the the role of these bacteria in the etiology of keratitis and endophthalmitis. The aim of this re- search is to determine the prevalence of anaerobic bacteria in perforated corneal ulcers of patients with keratitis and endophthalmitis and to evaluate their antimicrobial susceptibilities. METHODS: Corneal scrapings were taken by the ophthalmologist using sterile needles. For the isolation of anaerobic bacteria, samples were inoculated on specific media and were incubated under anaerobic conditions obtained with Anaero-Gen (Oxoid & Mitsubishi Gas Company) in anaerobic jars (Oxoid USA, Inc. Columbia, MD, USA). The molecular identification of anaerobic bacteria was performed by multiplex PCR and the susceptibilities of an- aerobic bacteria to penicillin, chloramphenicol, and clindamycin were determined with the E test (bioMerieux). RESULTS: 51 strains of anaerobic bacteria belonging to four different genuses were detected by multiplex PCR and only 46 strains were isolated by culture. All of them were found susceptible to chloramphenicol whereas penicillin resistance was found in 13.3% of P.anaerobius strains, clindamycin resistance was found in 34.8% of P.acnes and 13.3% of P. anaerobius strains. Additionnaly, one strain of P. granulosum was found resistant to clindamycin, one strain of B. fragilis and one strain of P.melaninogenica were found resistant to penicillin and clindamycin. CONCLUSIONS: Routine analyses of anaerobes in perforated corneal ulcers is inevitable and usage of appropriate molecular methods, for the detection of bacteria responsible from severe infections which might not be deter- mined by cultivation, may serve for the early decision of the appropriate treatment. Taking into account the in- creasing antimicrobial resistance of anaerobic bacteria, alternative eye specific antibiotics effective against anaer- obes are needed to achieve a successful treatment.

The diagnostic value of Western blot method in patients with cystic echinococcosis.

Cystic echinococcosis (CE) is the larval cystic stage (called echinococcal cysts) of a small taeniid-type tapeworm (Echinococcus granulosus). Carnivores such as dogs are usually definitive hosts. Intermediate hosts are typically herbivores such as sheep and cattle. CE can be detected using various imaging techniques such as ultrasonography or radiology. Moreover the primary diagnosis has to be confirmed by serological tests since the clinical signs of the disease are non-specific. This study examined the antigenic band patterns useful for serologic diagnosis of hydatidosis. We also report on the post-operative evolution of patients treated for this disease and also determined the diagnostic performance of Western blot IgG kit. Twenty-five (16 females and 9 males) non-operated patients with hydatid cysts (NOP) and 33 (21 females and 12 males) operated patients with hydatid cysts (OP) were included as study group and 22 healthy individuals (14 females and 8 males) with no known chronic diseases were included as a control group. The ages of the patients and control group individuals were between 16-83 years. Patient and control groups were matched for age and sex. Cyst hydatid IgG antibodies were detected in the sera from all patient groups but no antibodies were found in the sera from the control group using ELISA IgG method. Twenty-three (92%) non-operated patients and 18 (54.5%) operated patients exhibited positive results when Western blot IgG kit was used. The P7 band pattern was detected in the sera from all operated and non-operated patients. Twenty-seven of these positive cases had p7 and (p7+p16/18), (p7+p24/26) or (p7+p16/18+p24/26). No antibodies against p7, p16/18 ve p24/26 band patterns were seen in sera from the control group A statistically significant difference was detected between operated and nonoperated patients for Western blot positivity.(p<0.01). p: 0.018- X2=5,604- OR: 0.176- 95% CI: 0.037- 0.841. The sensitivity, specificity, positive prediction and negative prediction values of Echinococcus granulosus Western blot kit for 25 cases with CE and 22 healthy controls were calculated as 92%, 100%, 100% and 91.7%, respectively. In conclusion, we suggest that monitoring p7 in all non-operated patients may be useful to determine the efficiacy of medical treatment and that monitoring p7 antibodies using serological and Western blot methods in operated patients may be useful for the screening of post-operative evolution in patients with hydatid cyst.

Do infections trigger juvenile idiopathic arthritis?

Juvenile idiopathic arthritis (JIA) is a disease that was prominent with increased inflammation response in immune system, appeared mostly with peripheral arthritis and endogenous and exogenous antigens play a role in the pathogenesis of disease. Two major reasons were thinking to be considerably important. First of them is immunological predisposition and the second one is environmental factors. Infections are considered to be the most important between environmental factors but also stress and trauma are also important in the etiology of the disease. However, the relation between JIA and infections is not clearly defined but the relation between adult chronic arthritis and infections was well-defined. A total of 70 patients, 26 with primer JIA, 20 with recurrent JIA, 24 healthy control were included in this study. Mycoplasma pneumoniae, Chlamydophila pneumoniae and C. Jejuni were detected in 4, 1 and 1 of 10 (38.46%) patients with primer JIA, respectively. Salmonella enteritidis, EBV, M. pneumoniae, C. jejuni and Borrelia burgdorferi were detected in 1, 2, 2, 2, and 1 of the 8(40%) patients with recurrent JIA, respectively. S. enteritidis were isolated in feces culture and also identified by agglutination method. Infection was detected in total 18 (39.13%) of patient groups. C. pneumoniae and C. jejuni were detected in 1 and 1 of 2(8.33) healthy control groups, respectively. Throat culture positivity was not detected in any of the patient and healthy control groups. In conclusion, etiopathogenesis of JIA is not clearly understood and suggested that various factors can trigger the disease and it is the most common rheumatoid disease of childhood. However, there are some studies focusing especially on one infectious agent but this is the first study including such a big range of infectious agents in the literature for the microorganisms that can be suggested to have a role in the etiopathogenesis of JIA. We have a conclusion in the light of our results and suggest that some microorganisms can trigger and increase the intensity of clinical situation according to the case. When we evaluate the primer and recurrent JIA groups; M. pneumoniae and C. jejuni come forward and seen common in JIA cases. We also suggest that the pre-diagnosis of microorganisms, which can play a role as primarily or by intervening in the etiopathogenesis of JIA and adding specific antimicrobial therapy to the standard JIA therapy, it is possible to perform new, extended, especially molecular based serial case studies.

Aneurysm and Helicobacter pylori relationship: the seropositivity of CagA, VacA and other antigens of Helicobacter pylori in abdominal and ascending aortic aneurysms.

Helicobacter pylori is thought to be related to atherosclerosis and aneurysm development. We aimed to detect virulance factors of H. pylori and examine the potential etiopathogenetic relationship between aortic aneurysm and H. pylori, 58 abdominal aortic aneurysm (AAA) and 38 ascending aortic aneurysm (AsAA) cases and 57 Healty control group (HCG) were included. We investigated H. pylori IgG by ELISA and virulance factors by Western-Blot (WB) method. No difference was found between AAA (67.24%), AsAA (73.68%) and HCG (57.89%) for H. pylori IgG (p > 0.05). A significant difference was found between AsAA (78.95%) and HCG (57.89%) for H.pylori IgG (p < 0.05) by ELISA and a significant difference was found only between AsAA (100%) and HCG (37.5%) for H. pylori IgG in the 45-55 age group by WB. A statistically significant difference was found between AAA and AsAA for VacA and CagA + VacA and CagA + VacA + UreA antigens and also a significant difference was found between AsAA and HCG for CagA + UreA antigens (p < 0.05). Finally, we suggest that H. pylori VacA has a more important role than CagA in the development of two aneurysms especially in ruptured AAA. New extended studies detecting H. pylori DNA are needed to detect the aetiopathogenesis between aneurysm types and H. pylori.

The role of latent toxoplasmosis in the aetiopathogenesis of schizophrenia--the risk factor or an indication of a contact with cat?

We assessed IgG antibody to Toxoplasma gondii in 300 inpatients with schizophrenia (SG), 150 outpatients with anxiety and depressive disorders (PCG), and 150 healthy blood donors (HCG). Seropositivity rates were 60.7% for SG, 36.7% for PCG, and 45.3% for HCG (p<0.001). The seropositivity rate for anti-Toxoplasma IgG antibodies in SG was significantly higher that in PCG (chi2 = 23.11, OR = 2.66, p = 0.001) and HCG (chi2 = 9.52, OR = 1.86, p = 0.002). Among SG, 85% of those who reported close cat contact had IgG antibodies to T. gondii. Close cat contacts were reported by 59% of SG, 6% of PCG, and 9% of HCG (p<0.001). There was a nonsignificant positive association between toxoplasmosis and schizophrenia for people with a contact with a cat (OR = 2.221, p = 0.127, CI95 = 0.796-6.192), and significant negative association between toxoplasmosis and schizophrenia for people without contact with a cat (OR = 0.532, p = 0.009, CI95 = 0.332-0.854). Close cat contact (OR = 2.679, p<0.001), 51-65-year age group (OR = 1.703, p<0.001) and education [illiterate+primary (OR = 6.146, p<0.001) and high school (OR = 1.974, p = 0.023)] were detected as independent risk factors in multivariate logistic regression. The effect of toxoplasmosis on risk of schizophrenia disappeared in the complex model analyzed with multivariate logistic regression. In conclusion, our data suggest that the toxoplasmosis has no direct effect on the risk of schizophrenia in Turkey but is just an indication of previous contacts with a cat.

Oropharyngeal flora changes after tonsillectomy.

OBJECTIVE: We aimed to investigate the effect of tonsillectomy on oropharyngeal flora in children who underwent tonsillectomy for chronic recurrent tonsillitis. STUDY DESIGN AND SETTING: A prospective study was performed comprising patients with chronic recurrent tonsillitis who underwent tonsillectomy at the Department of Otolaryngology, Cerrahpasa Medical School. Incisional core biopsies of excised tonsils were also performed. Swabs and core biopsy specimens were transferred and maintained in Stuart's medium and sent to the Department of Microbiology and Clinical Microbiology at Cerrahpasa Medical School for microbiologic evaluation. SUBJECTS AND METHODS: Oropharyngeal swabs and tonsillar core biopsy specimens from 31 patients operated on for recurrent tonsillitis were cultured. Follow-up oropharyngeal swabs were cultured one month after tonsillectomy. RESULTS: There was no significant difference between the preoperative and postoperative isolation rate of the potentially pathogenic bacteria. Normal aerobic flora did not change significantly. However, the isolation rate of the Neisseria species dropped (P = 0.097) but did not reach statistical significance. Among anaerobes, Bacteroides fragilis, one of the major anaerobic bacteria, dropped significantly (P = 0.007). The Propionibacterium acnes isolation rate increased significantly (P = 0.009). CONCLUSION: Oropharyngeal anaerobic bacterial flora decreases after tonsillectomy in recurrent tonsillitis patients. The isolation rate for bacteria of the normal flora and potentially pathogenic bacteria does not change. Tonsils with recurrent infections may become a nidus for anaerobic bacteria. In patients with chronic recurrent tonsillitis, tonsillectomy may help change anaerobic bacterial oropharyngeal flora to the normal flora found in healthy individuals.

Comparison of in vitro activities of tigecycline with other antimicrobial agents against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in two university hospitals in Istanbul, Turkey.

BACKGROUND: We compared the in vitro activities of tigecycline with those of other agents against 97 Streptococcus pneumoniae, 140 Haemophilus influenzae and 54 Moraxella catarrhalis strains isolated in two large university hospitals in Istanbul. METHODS: For analysis, the agar dilution method was used. RESULTS: For S. pneumoniae isolates, 32% were not susceptible to penicillin (28.9% intermediate and 3.1% resistant). Cefotaxime, telithromycin, moxifloxacin and linezolid were fully active. Tigecycline had a 90% minimum inhibitory concentration (MIC(90)) of 0.12 microg/ml. For H. influenzae, 8.57% were not susceptible to ampicillin, among which 8 possessed beta-lactamase (5.7%). Four (2.87%) H. influenzae isolates with beta-lactamase-negative and ampicillin-resistant phenotype were found. All isolates were susceptible to ceftriaxone, azithromycin, ciprofloxacin, levofloxacin and moxifloxacin. MIC(90) for tigecycline was 0.5 microg/ml. Of 54 M. catarrhalis isolates, 88.9% possessed beta-lactamase. Tigecycline and fluoroquinolones were highly active (MIC(90) < or =0.12 microg/ml). CONCLUSIONS: Linezolid, telithromycin, newer fluoroquinolones and tigecycline all have excellent in vitro activities against the 3 respiratory pathogens.

Higher prevalence of toxoplasmosis in victims of traffic accidents suggest increased risk of traffic accident in Toxoplasma-infected inhabitants of Istanbul and its suburbs.

Reflexes of drivers who have toxoplasmosis have been shown to deteriorate from the actions of the parasitic cysts. The cysts can change the level of the neurotransmitters such as dopamine in the brain and by doing so extend the muscle response time and change personality profiles. In this study, we aimed to determine the frequency of the latent toxoplasmosis (LT) in the driver population who were either injured or died in traffic accidents reported in Istanbul and its suburbs. We compared the results with a control group and discussed the relationship between the LT and the traffic accidents. We included 218 (89.7%) non-fatal, 25 (10.3%) fatal cases in our study as study groups. A total 243 subjects, 234 (96%) male, 9 (4%) female (who were alcohol negative) compared with 191 (95.5%) male and 9 (4.5%) female subjects (control group) who had a traffic accident before but no history of toxoplasmosis were studied. Serologic tests, enzyme immunoassay (EIA) for IgG and IgM, and microimmunoflorescence (MIF) for IgG were used as the reference test, the Sabin-Feldman Dye test (SFDT) was used. According to serologic test results, LT seroprevalence in the study groups was 130 (53.5%) and in the control group 56 (28%) (p<0.0001). A LT was present in 126 out of 234 (53.8%) males in the study groups, and 54 out of 191 (28.3%) males in the control group (p<0.0001). In the 31-44 year age group, there was a significant difference with regard to toxoplasmosis between the study subjects and control groups (p<0.0001). This difference was statistically very significant in (recent and former) cases with middle-aged men (31-44 years old). The results of this retrospective study suggest that LT in drivers, especially those who are between 31 and 44 years might increase the risk for getting involved in a car accident. In a prospective study, Toxoplasma positive and negative subjects can be monitored before they are involved in a traffic accident to clarify the cause and result relationship.

Pharyngeal carriage and antimicrobial resistance of Haemophilus influenzae in non-type-b-vaccinated healthy children attending day care centers in Turkey.

BACKGROUND: The true prevalence of Haemophilus influenzae carriage rates in Turkey is unknown. As surveillance of pharyngeal carriage of resistant strains is important for initiating adequate empirical antimicrobial therapy, with the present study, we aimed to determine the carriage rates and antimicrobial resistance patterns of H. influenzae isolated from healthy children attending day care centers (DCCs) in Istanbul, Turkey. METHODS: A total of 195 healthy children were included from two DCCs. Pharyngeal swabs were cultured for H. influenzae which were identified according to standard microbiologic procedures. Antimicrobial susceptibility tests were performed by the agar dilution method in accordance with the guidelines of the National Committee for Clinical Laboratory standards. beta-Lactamase production was determined by the nitrocefin disc test. RESULTS: The average pharyngeal carriage rate of H. influenzae was determined as 48.7%: 7.2% type b, 7.6% other capsulated strains, 33.9% noncapsulated strains, with a carriage peak between 0 and 11 months (68.1%). The ampicillin resistance observed in 7.3% of H. influenzae isolates was associated with a presence of beta-lactamase, except for one isolate which was interpreted as beta-lactamase-negative ampicillin-resistant strain. The resistance of H. influenzae to sulbactam/ampicillin, cefuroxime, azithromycin, tetracycline and cotrimoxazole was 0.5, 1.5, 0.5, 2.9 and 28.6%, respectively. Cefotaxime, ceftriaxone, ciprofloxacin and imipenem resistance was not detected. CONCLUSION: Our data show that the upper respiratory tract of about 48.7% of children was colonized with H. influenzae. This high colonization rate indicates that there is a need for surveillance of pharyngeal carriage of resistant strains in healthy Turkish children attending DCCs.

Microbial changes in conjunctival flora with 30-day continuous-wear silicone hydrogel contact lenses.

PURPOSE: To determine the effect of 30-day continuous-wear silicone hydrogel contact lenses on the conjunctival flora in asymptomatic wearers. METHODS: The authors studied 29 eyes of 15 patients wearing Focus NIGHT & DAY silicone hydrogel contact lenses for up to 30 nights of continuous wear. The average age of the patients was 25.54 +/- 8.98 years. Cultures of the inferior cul-de-sac were taken bilaterally from all eyes, before and after lens wear in asymptomatic patients. The isolation and identification of bacteria were made by standard clinical laboratory methods. RESULTS: The number of eyes whose conjunctival cultures were sterile before using the lenses significantly decreased (P = 0.0005), and the number of eyes with a growth of coagulase-negative staphylococci and diphtheroid rods in their conjunctival cultures significantly increased after using these lenses (P = 0.001 and P = 0.031, respectively). Conversely, a statistically significant difference was not found in the number of eyes that carried Propionibacterium acnes and Fusobacterium nucleatum in their conjunctival cultures before and after using the 30-day continuous-wear silicone hydrogel lenses (P = 0.998 and P = 0.488, respectively). CONCLUSIONS: The results suggest that the sterility of the conjunctiva significantly decreased after using 30-day continuous-wear silicone hydrogel contact lenses. In addition, the number of bacteria of the normal conjunctival flora significantly increased after the use of these lenses. Contamination by the bacteria of the eyelids may be a possible colonization factor in this study group. Therefore, it is appropriate to examine the patients who wear these lenses more frequently.

Mobiluncus species in gynaecological and obstetric infections: antimicrobial resistance and prevalence in a Turkish population.

The purpose of this study was to determine the prevalence and antimicrobial resistance of Mobiluncus species isolated from specimens collected from Turkish women with gynaecological infections. Mobiluncus species were isolated on enriched Schaedler agar and RLK agar plates under anaerobic conditions. The MICs of various antibiotics were evaluated using an agar dilution procedure. The prevalence of Mobiluncus species isolated from vulvo-vaginal abscesses, endometrial smears, salpingitis and bacterial vaginosis was 2%, 4.7%, 3.8% and 49%, respectively. Mobiluncus isolates were only resistant to metronidazole (81% resistance). The isolation rate of M. curtisii was higher than M. mulieris in Turkish women with bacterial vaginosis, vulvo-vaginal abscesses, endometritis or salpingitis.

Antimicrobial resistance and beta-lactamase production of clinical isolates of prevotella and porphyromonas species.

BACKGROUND: This study determined the beta-lactamase production and the antimicrobial resistance of 72 Prevotella species and 48 Porphyromonas species isolated from different clinical specimens. METHODS: All strains were identified using API 32 ID. The beta-lactamase production was determined by nitrocefin disks. E test strips of benzylpenicillin, ampicillin + sulbactam, cefoxitin, clindamycin, metronidazole and imipenem were tested for each strain. RESULTS: Nineteen Prevotella melaninogenica, 18 Prevotella intermedia, 16 Prevotella denticola, 11 Prevotella loescheii and 8 Prevotella bivia strains were identified. Four were clindamycin resistant. The highest beta-lactamase production was found at a rate of 68.4% in P. melaninogenica species. Additionally, 33 Porphyromonas asaccharolytica and 15 Porphyromonas gingivalis strains were identified. None of them produced beta-lactamase. CONCLUSION: In view of the emerging antibiotic resistance among anaerobes, the current local susceptibility profile of our Prevotella and Porphyromonas species will establish the basis for additional surveys tracing significant changes in the antimicrobial resistance of our clinical isolates.

Microbiologic evaluation of frequent-replacement soft contact lenses.

PURPOSE: This article reports a microbiologic study of two kinds of monthly frequent-replacement daily wear soft contact lenses, with different amounts of water content, in asymptomatic contact lens wearers. METHOD: We studied 35 lenses of 18 patients who wear frequent-replacement soft contact lenses with a water content of 38% and 40 lenses of 20 patients using frequent-replacement contact lenses with a water content of 55%. The lenses worn by patients regularly for 1 month were removed from their eyes in a sterile manner on the 30th day and were studied microbiologically to isolate pathogenic agents. RESULTS: In the group of monthly frequent-replacement soft contact lenses with a water content of 38%, microorganisms were isolated at a rate of 91%; and in the group of monthly frequent-replacement soft contact lenses with a water content of 55%, microorganisms were isolated at a rate of 85%. When the two groups were compared, there was no statistically significant difference (P=0.31). Although coagulase-negative staphylococci, Corynebacterium spp, and gram-negative rods were detected in both groups, Staphylococcus aureus, non-hemolytic streptococci, Neisseriae spp, and Penicillium spp also were isolated in the group with the higher water content. CONCLUSION: Bacteria spreading from the environment or from skin flora to the eyes showed more diversity in the group of frequent-replacement soft contact lenses with a high water content. Additionally, Penicillium spp also was isolated in this group. Therefore scrupulous attention to daily lens care is crucial for people who wear frequent-replacement soft contact lenses.