Treatment of Helicobacter Pylori Infection and the Colonization of the Gastrointestinal System by Resistant Bacteria.

BACKGROUND AND AIMS: Helicobacter pylori (H. pylori) infections are widely treated with antibiotic regimens such as "Amoxicillin 1 gr 2 × 1 tablet, Clarithromycin 500 mg 2 × 1 tablet, and Lansoprazole 30 mg 2 × 1 tablet" for 14 days. We conducted a prospective observational study to explore whether this treatment protocol serves as a predisposing factor for the colonization of resistant gastrointestinal microflora, namely vancomycin-resistant enterococci (VRE), extended-spectrum beta-lactamase Enterobacterales (ESBL-E), and carbapenem-resistant Enterobacterales (CRE). MATERIALS AND METHODS: Pre- and post-treatment stool samples from 75 patients diagnosed with H. pylori, without a prior treatment history, were cultured and evaluated based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. RESULTS: Of the 75 evaluated patients, a pronounced surge in ESBL-E positivity was observed. Before initiating antibiotic treatment, 12 patients (16%) had ESBL-E-positive strains in their gastrointestinal tract. Notably, this number surged to 24 patients (32%) after the conclusion of the 14-day treatment regimen. The change was statistically significant, with a P value of less than 0.002, indicating a clear association between treatment for H. pylori and heightened ESBL-E colonization. Notably, VRE and CRE remained undetected in patients throughout the study, suggesting that the treatment regimen may specifically amplify the risk of ESBL-E colonization without affecting VRE and CRE prevalence. CONCLUSIONS: As the inaugural report from Turkey on this issue, our study suggests that antibiotic regimens for H. pylori eradication contribute to the increased risk of ESBL-positive bacterial colonization in the gastrointestinal tract.

Fecal carriage of extended-spectrum beta-lactamase and ampc beta-lactamase-producing enterobacteriaceae in a turkish community.

BACKGROUND: Community-acquired infection caused by extended-spectrum beta-lactamase (ESBL)-producing microorganisms has an increasing frequency. AIM: The aim of this study was to determine the fecal carriage of ESBL and AmpC beta-lactamase-producing Enterobacteriaceae in community and to investigate cefotaxime-M (CTX-M) genes among ESBL isolates. MATERIALS AND METHODS: A total of 1402 fecal specimens which were collected from outpatients included in the study. ESBL screening, ESBL production, and AmpC beta-lactamase detection were performed. Matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) was used for identification of species. Antibiotic susceptibilities of the isolates were detected by disk diffusion method. CTX-M beta-lactamase genes were investigated by polymerase chain reaction. RESULTS: During the study period, a total of 1402 fecal samples were analysed with ESBL screening test and 490 Enterobacteriaceae strains isolated from these samples (Escherichia coli [n = 461, 94.1%], Klebsiella pneumoniae [n = 25, 5.1%], and Enterobacter cloacae [n = 4, 0.8%]). Fecal carriage of ESBL-producing Enterobacteriaceae in the community was 34.3%. AmpC beta-lactamases were detected in 26 (5.3%), and the frequency of CTX-M was found as 96.9%. The resistance rates of the E. coli strains to fluoroquinolones, trimethoprim-sulfamethoxazole, and carbapenems were 31.2%, 33.3%, and 0%, respectively. CONCLUSION: The relative high prevalence of fecal carriage of ESBL-producing bacteria in community warrants further study in this field including developing policies about antimicrobial use and close monitoring of resistance patterns.

Evaluation of hepatitis B surface antigen, anti-hepatitis C virus and anti-human immunodeficiency virus antibodies and syphilis seropositivity in blood donors: six years' seropositivity.

This retrospective study was carried out to evaluate the seropositivity of hepatitis B surface antigen (HbsAg), anti-hepatitis C virus (HCV), anti-human immunodeficiency virus (HIV) and syphilis in blood donors in Manisa Government Hospital. Data were evaluated in 10,189 blood donors between April 1, 1997, which is the time from which regular records began to be collected, and April 1, 2003. The blood samples of the blood center from April 1, 1997, to January 1, 1998, were examined via the card method, those between January 1, 1998, and January 1, 2002, were examined via micro enzyme-linked immunosorbent assay (ELISA) method and the rest were evaluated with macro ELISA methods. In blood donors, the positivity of HbsAg, anti-HCV anti-HIV and the rapid plasmin reagin test were 2.95%, 0.68%, 0.00% and 0.16%, respectively.

Eristalis tenax as a cause of urinary myiasis.

Eristalis tenax, belonging to order Diptera, family Syrphidae seldomly causes intestinal myiasis. Urinary myiasis caused by Eristalis tenax larvae is a rare manifestation found in both humans and other vertebrate animals. We report a 58-y-old woman presented with painful mixing and bilateral costo-lumbar pain. The larva in her urine sample was identified as Eristalis tenax related to its typical morphology.

[An isolated sacral fracture and a fracture dislocation in two pediatric patients]. / Iki çocuk hastada izole sakrum kirigi ve kirikli çikigi.

Isolated sacral fractures are very rare in children. Two children, aged eight and 12 years, presented with an isolated sacral type III fracture and a fracture dislocation, respectively, both of which were not associated with any neurologic problems. Without any attempts for reduction, the fractures healed completely with conservative treatment. These cases demonstrated a high remodeling potential in children for spontaneous healing.

[Comparison between the efficacies of two different methods of preparing Esmarch bandages for sterilization]. / Iki farkli yöntemle sterilizasyona hazirlanan Esmarch bandajlarinda sterilizasyon etkinliginin karsilastirilmasi.

OBJECTIVES: Sterile Esmarch bandages have a widespread use in orthopedic surgery. We evaluated the efficacy of two different methods of preparing Esmarch bandages for sterilization. METHODS: Two groups of Esmarch bandages were used, each group consisting of 25 bandages. The size of the bandages was 6.3 cm in width and 450 cm in length. Before sterilization, the bandages were tightly rolled in one group and loosely folded at a length of 10 cm in the other. An indicator was inserted at every five layers of all bandages. Sterilization was evaluated by subjecting both groups to ethylene oxide cycles and the autoclave method. A standard orthopedic surgical set was used as a control during each sterilization. RESULTS: Following sterilization with ethylene oxide, all the indicators were found sterile in both groups. Similarly, complete sterilization was obtained in the loosely folded bandages with the autoclave method. However, only the indicators placed in the first 15 layers and the fiftieth layer were fully sterile in the tightly rolled bandages after autoclaving. The number of sterile indicators in the remaining layers ranged from nine (36%) to 23 (92%). CONCLUSION: Ethylene oxide is a reliable technique for sterilizing Esmarch bandages. The bandages must be loosely folded, instead of tightly rolling, when the autoclave technique is used.