Healthcare-associated infections and the distribution of causative pathogens in patients with diabetes mellitus.

Diabetes mellitus (DM) is one of the most common diseases worldwide, and is a significant risk factor for healthcare-associated infections (HAIs). Our aim in this study was to compare the distributions of HAIs and the causative pathogens between diabetic and non-diabetic patients. In this study, 716 HAIs in 465 diabetic patients and 761 HAIs in 465 non-diabetic patients were evaluated. HAIs in patients with DM were most frequently urinary tract infections (UTIs) [266 infections (37.2 %)], followed by blood stream infections (BSIs) [161 infections (22.5 %)], surgical site infections (SSIs) [127 infections (17.7 %)], pneumonia [107 infections (14.9 %)] and any other infections [161 infections (22.5 %)]. The rates of UTIs, BSIs, SSIs, pneumonia and any other infections were similar between diabetic and non-diabetic patients. In terms of the causative pathogens, Staphylococcus aureus more frequently caused SSIs and Candida spp more frequently caused UTIs in diabetic patients compared with non-diabetic patients. We found no differences in the distribution of HAIs between patients without and with DM. However, S. aureus and Candida spp were more common causative pathogens of SSIs and URTIs, respectively, in diabetic patients than in non-diabetic patients.

Effect of pegylated interferon treatments for chronic active hepatitis C on quality of life.

Health-related quality of life (HRQoL) during therapy was found to be improved in patients treated with peginterferon alpha-2a compared to patients receiving interferon alpha-2a. This study aimed to assess the effect of different pegylated interferon therapies used in the treatment of patients with chronic hepatitis C on HRQoL. Forty chronic hepatitis C patients were enrolled. 22 patients were given a combination of peginterferon alpha-2a plus ribavirin and 18 patients received a combination of peginterferon alpha-2b plus ribavirin for 48 weeks. Patients completed a Short Form-36 (SF-36) questionnaire at the start of treatment and at week 12, week 24 and week 48 of treatment and week 24 posttreatment to evaluate HRQoL. In conclusion, the effect of both combination treatments on quality of life was similar.

Comparison of different treatment combinations for chronic hepatitis B infection.

Chronic hepatitis B virus (HBV) infection is a leading cause of cirrhosis and hepatocellular carcinoma worldwide. Its prevalence approaches 10% in hyper endemic areas. The aim of treating chronic HBV infection is to halt progression of liver injury by suppressing viral replication or eliminating infection. This study was planned to evaluate the advantages of combination therapy with interferon-alpha plus second-generation nucleoside analogues (lamivudine or famciclovir), or vaccination with a pre-S2 and S proteins containing vaccine in chronic HBV infection. 29 patients were divided into three groups and were treated with the following combinations: (1) IFN-alpha2a 9 million units 3x week for 6 months with HBV vaccine 20 microg given on 0, 1 and 2 months; (2) IFN-alpha2a 6 million units 3x week plus famciclovir 250 mg 3x day for 6 months; (3) IFN-alpha2a 6 million units 3x week plus lamivudine 100 mg/day for 6 months. Complete response was suspected in 3 patients in group 1, in 4 patients in group 2, and in 7 patients in group 3. Partial response was suspected in 4, 1 and 2 patients in groups 1, 2 and 3, respectively. The results of the present study suggest that the combination of IFN-alpha with lamivudine is more effective than the combination of IFN-alpha with HBV vaccination or famciclovir.

Spinal toxoplasmic arachnoiditis associated with osteoid formation: a rare presentation of toxoplasmosis.

STUDY DESIGN: An extremely rare presentation of an isolated spinal toxoplasmic arachnoiditis is described. OBJECTIVE: To draw attention to the fact that spinal arachnoid membranes may be a potential reservoir for Toxoplasma gondii. SUMMARY OF BACKGROUND DATA: Central nervous system toxoplasmosis is a common manifestation in patients who are immunodeficient. Reports on the spinal toxoplasmosis are rare and focused on spinal cord involvement. METHODS: An adult patient presented with symptoms of spastic paraparesis that had begun 13 years before admission. Thoracic spinal magnetic resonance imaging showed small lesions in posterior subarachnoid space at Th7-Th8. A Th7-Th8 laminectomy was performed. Intradural-extramedullary lesions were excised. RESULTS: Clinical, immunologic, and pathologic examinations showed adhesive spinal arachnoiditis associated with osteoid formation caused by past toxoplasmic infection. There was no impairment of the immunologic defense system. CONCLUSION: Where no causative factor is found in serious spinal adhesive arachnoiditis, the possibility of spinal toxoplasmosis should also be investigated.

Efficacy of prophylactic and early fluconazole treatment on systemic candidiasis in experimentally neutropenic rabbits.

The efficacy of prophylactic and early fluconazole treatment on experimental systemic candidiasis was investigated in neuropenic rabbits. Fifteen rabbits were used and divided into three groups: fluconazole was started 24 h before the inoculation of Candida albicans in the first group, and 24 h after the inoculation in the second group. The third group was the control group without antifungal therapy. Prophylactic and early fluconazole treatment for 7 days after C. albicans inoculation did not reduce the mortality and tissue culture positivity in the rabbits significantly. Four of the five rabbits survived 7 days both in the prophylactic and early treatment groups. However, only one rabbit survived for 7 days in the control group. In diagnostic procedures, histopathological examination and evaluation with periodic acid-Schiff stain was found to be the most sensitive. In this study, prophylactic and early fluconazole treatment were found to be insufficient for treatment of systemic candidiasis in neutropenic rabbits.

[Comparison of the Wright, indirect Coombs and enzyme immunoassay IgG methods for the diagnosis of chronic brucellosis]. / Kronik Brusellozis tanisinda wright, indirekt coombs ve enzim immuno assay IgG yöntemlerinin karsilastirilmasi.

Incomplete IgG and IgA class immunoglobulins are formed in chronic brucellosis and these antibodies do not detect with classical Wright agglutination test (WAT). However these antibodies are measured with indirect Coombs and enzyme immune assay (EIA) techniques. In this study 90 patients serum samples were tested with WAT, indirect Coombs and EIA. All of the patients had chronic brucellosis. EIA was used to determine the levels of brucella specific IgG antibodies in 44 patients whose WATs were negative and indirect Coombs assays were positive and 46 patients whose WATs and indirect Coombs tests were negative. Thirty-seven (84.08%) of the 44 patients whose WAT negative and indirect Coombs positive were found positive for EIA IgG. Sixteen (34.7%) of the 46 patients whose WAT and indirect Coombs negative were found positive EIA IgG. The importance of EIA and indirect Coombs tests was discussed at the diagnosis of chronic brucellosis.

[Grouping of beta-hemolytic streptococci isolated from clinical specimens and their sensitivity to penicillin G]. / Cesitli klinik örneklerden izole edilen beta hemolitik streptokoklarin gruplandirilmasi ve penisilin G'ye duyarliliklarinin arastirilmasi.

260 beta hemolytic streptococci were isolated from clinical specimens sent to Microbiology Laboratory, Faculty of Medicine, Anadolu University between September 1988 - September 1989. They were grouped according to their sensitivity to bacitracin and trimethoprim/sulfamethoxazole (SXT) and also serologically. Of 260 isolates, 83.8% were group A, 1.2% group B, 6.5% group C, 3.5% group D and 5% were group G. All of 121 group A isolates confirmed serologically were susceptible to bacitracin. Excluded 9 strains, all of them were resistant to SXT. Other groups were mostly resistant to bacitracin. While group C and G generally were susceptible to SXT, B and D were resistant. Streptococci were documented according to distribution of clinical specimens. From throat 191 group A, 16 group C, 1 group D and 11 group G; from nose 7 group A; from pus 19 group A, 4 group D and 1 group G; from vagina 1 group A, 3 group B, 2 group D and 1 group G; from urine 2 group D; from blood 1 group C were isolated. All isolates were tested for penicillin G sensitivity by Kirby-Bauer disc diffusion method. While one of three group B strains and four of eight group D strains were resistant to penicillin G, all the other isolates were susceptible to penicillin G.

[Stability of cefazolin sodium as eyedrops in various solutions]. / Cesitli sivilar ile göz damlasi olarak hazirlanan sefazolin sodyumun stabilitesi.

Cephazolin sodium prepared with four different solutions (NaCl 0.9%, Protagent, Liquifilm and phosphate buffer) to be used as eye drops, was evaluated as to its physicochemical features at +4 degrees C, +37 degrees C and at room temperature and its activity in terms of minimal inhibition concentration. In conclusion, cephazolin sodium prepared with artificial tears at acidic pH can be kept for 3 days at room temperature and at +4 degrees C without any loss of its activity.