Prevalence of erm genes encoding macrolide-lincosamide-streptogramin (MLS) resistance among clinical isolates of Staphylococcus aureus in a Turkish university hospital.

This study investigated the prevalence of the erm(A), erm(B) and erm(C) genes among 122 MLS-resistant clinical isolates of Staphylococcus aureus from a Turkish university hospital. Of these isolates, 44 were inducibly resistant and 78 were constitutively resistant. The presence of one or more erm genes was demonstrated in 114 isolates; the erm(C) gene was detected in 97 isolates, and the erm(A) gene was detected in 96 isolates. Seventy-eight isolates harboured both erm(A) and erm(C). The combination of erm(A), erm(B) and erm(C) genes was detected in only one isolate.

Phenotypes of staphylococcal resistance to macrolides, lincosamides and streptogramin B (MLS) in a Turkish university hospital.

Resistance to macrolides, lincosamides and streptogramin B (MLS) which is expressed either constitutively or inducibly, is mediated by erm genes (erm A, erm B, and erm C in staphylococci). The transposon TN 554, harbouring the erm A gene also encodes spectinomycin resistance. In Turkey, data related to MLS resistance phenotypes of staphylococci are not available. In this study, we screened 500 consecutive clinical isolates of staphylococci isolated in Hacettepe University Hospital, for MLS and spectinomycin resistance by the standard disk diffusion method. All MLS-resistant isolates were further tested for spectinomycin susceptibility by the agar screening method. Of 500 staphylococcal isolates, 368 (73.6%) were susceptible and 132 (26.4%) were resistant to MLS antibiotics. Ninety-one (18.2%) of the resistant isolates exhibited a constitutive resistance pattern, whereas 40 were inducibly resistant. MS (resistance to macrolides and lincosamides only) resistance was detected in only one isolate (0.2%). Of 40 inducibly resistant isolates, 21 were found to be resistant to spectinomycin by both the disk diffusion and agar screening tests, probably indicating a presence of the erm A gene. These results suggest that MLS resistance has been considerably high among clinical isolates of staphylococci in our hospital. On the whole, constitutive resistance was the pattern most frequently encountered. In contrast, MS resistance was very rare. Further epidemiological and molecular investigations are required for clarification of the data presented.

Evaluation of the microbiology of chronic sinusitis.

Chronic sinusitis is one of the most common diseases treated in outpatient centres. In this prospective study, 49 patients with the diagnosis of chronic maxillary sinusitis were evaluated microbiologically by using sinus swab, irrigation fluid and sinus mucosal tissue specimens obtained during endoscopic sinus surgery. There was no bacterial growth in seven cases. In the remaining 42 cases a total of 89 bacteria were isolated, 28 of them being classical pathogens and 61 being non-classical pathogens. Among the classical pathogens Staphylococcus aureus was the most common one. The correlation between the isolates obtained from maxillary sinus and isolates obtained from throat, nose and nasopharynx did not have a predictive value. Since the overall rate of classical pathogen isolation from patients with chronic sinusitis was not significantly high, the possible role of factors other than bacterial growth should be identified in the pathogenesis of chronic sinusitis.

[Trichomonas vaginalis in women attending gynecology clinics]. / Jinekoloji poliklinigine basvuran kadinlarda Trichomonas vaginalis arastirilmasi.

In this study Trichomonas vaginalis was investigated in vaginal swab specimens from 234 women attending to the Gynecology Outpatient Clinics with various reasons. Trichomonas vaginalis was detected by wet mount in 8 women (3.4%) and, by culture using modified Diamond's medium in 9 women (3.8%). Of 9 cases only 2 were suspected for trichomoniasis by gynecological examination.

[Penicillin resistance in Streptococcus pneumoniae strains]. / Streptococcus pneumoniae suslarinda penisilin direnci.

In this study a total of 87 Streptococcus pneumoniae strains were tested for their susceptibility to penicillin with disk diffusion method by using 5 micrograms methicillin disks. In 68 strains susceptibility to penicillin was also determined by using agar dilution method performed in Mueller-Hinton agar supplemented with 5% sheep blood. Of 63 adult isolates tested with disk-diffusion method 35 strains (55.6%) were susceptible to penicillin, 24 strains (38.1%) had low level resistance and 4 strains (6.3%) had high-level resistance to penicillin. Of 24 S. pneumoniae isolates recovered from children 5 (20.8%) were penicillin susceptible, while 11 (45.8%) had low level resistance and 8 (33.4%) had high level resistance to penicillin. These values were 40 (45.9%), 35 (40.3%) and 12 (13.8%) in total isolates respectively. Of 44 isolates in which MIC values of penicillin were determined by agar dilution method, 34 strains (77.3%) were penicillin susceptible and 10 strains (22.7%) had low level resistance while none of these strains had high level resistance to penicillin. Of 24 children isolates tested with agar dilution method 11 strains (45.8%) were susceptible to penicillin, 8 strains (33.4%) showed low level resistance and 5 strains (20.8%) showed high level resistance to penicillin. For total of 68 isolates these values were 45 (66.1%), 18 (26.4%) and 5 (7.3%) respectively. These findings indicate the need to perform antibiotic susceptibility testing of all pneumococcal isolates to avoid therapeutic failure.

Effect of systemic doxycycline administration on the subgingival microbial flora: a dark-field microscopy study.

The effect of systemically administered doxycycline hydrochloride on subgingival microbial plaque morphotypes was evaluated using dark-field microscopy. After 1 week of drug administration, while the percentage of coccoid bacteria showed a significant increase, the percentages of spirochetes, motile rods and non-motile rods tended to decrease. Since spirochetes and/or motile rods are considered to be associated with the pathogenesis of periodontal disease, the significant decrease in the proportions of these bacteria are considered to be important. Therefore, it is suggested that doxycycline may be beneficial for the treatment of periodontal disease as an adjunct to traditional therapeutic methods.

[Comparison of two different media-atmosphere combinations on the isolation of group A beta-hemolytic streptococci from throat cultures]. / Farkli iki besiyeri-atmosfer kombinasyonunun bogaz kültürlerinden A grubu beta hemolitik streptokok izolasyonuna etkilerinin karsilastirilmasi.

In this study effects of incubation of sheep blood agar medium in aerobic conditions and incubation of sulfamethoxazole-trimethoprim containing sheep blood agar medium in 5 to 10% CO2, of the isolation of group A beta hemolytic streptococci from throat cultures were compared. 608 throat swab specimens were studied. Each agar medium was evaluated after 24 and 48 hours of incubation period. The aerobic incubation of sheep blood agar plates for 24 hours yielded 108 (17.7%) strains of beta hemolytic streptococci, of these 96 (15.8%) strains being group A. 113 (18.5%) strains of beta hemolytic streptococci were isolated after 48 hours of incubation and 100 (16.4%) of these were group A. The number of beta hemolytic streptococci isolated in 5 to 10% CO2 atmosphere for 24 hours was 62 (10.2%), and 57 (9.3%) of these were group A. When the incubation period was prolonged to 48 hours, the total number of beta hemolytic streptococci isolated increased to 82 (13.5%) and 76 (12.5%) of these were determined as group A. The difference between these two combinations was significant for 24 hours of incubation, but not significant for 48 hours of incubation. The highest isolation rate for group A streptococci was achieved in aerobic incubation of sheep blood agar plates for 48 hours.

[Identification of Pseudomonas species isolated from various clinical specimens and their susceptibility to ofloxacin]. / Klinik örneklerden izole edilen pseudomonas türlerinin saptanmasi ve ofloksasin'e karsi duyarlilik durumlarinin arastirilmasi.

In this study Pseudomonas species isolated from various clinical specimens were identified and susceptibility of these species to ofloxacin was investigated. The identification of 88 Pseudomonas isolates was performed according to their pigment production, type of haemolysis, growth on cetrimide medium and growth at 42 degrees C. Oxidase test was also employed to all of these strains. Macrodilution method was used in order to investigate in vitro activity of ofloxacin against these strains. All of 88 isolates were identified as P. aeruginosa. Ofloxacin was found to have an MIC 50 value of 2 micrograms/ml and an MIC 90 value of 16 micrograms/ml for these isolates. Susceptibility to ofloxacin was observed in 86.4% of 88 P. aeruginosa.

[The in vitro activity of ofloxacin, pefloxacin and ciprofloxacin against various gram negative bacteria isolated from urinary tract infections]. / Idrar yolu infeksiyonlarindan izole edilen çesitli gram negatif bakteri türlerine karsi ofloxacin, pefloxacin ve ciprofloxacin'in in vitro aktiviteleri.

In this study the in vitro activity of ofloxacin, pefloxacin and ciprofloxacin against various gram negative bacteria isolated from urinary tract infections was examined. Of 80 isolates (24 E. coli, 10 Enterobacter, 10 Klebsiella, 23 Proteus, 10 Pseudomonas, 2 Morganella and 1 Serratia) 49 were from inpatients, and 31 were from outpatients. Ciprofloxacin was the most potent compound and no resistant strain was found against ciprofloxacin, while 1 Enterobacter strain and 1 Pseudomonas strain were found to be resistant to both ofloxacin and pefloxacin. Another Pseudomonas strain was resistant to pefloxacin only. All of the resistant bacteria were from nosocomial infections.

[Anaerobic bacteria in various infections and their antibiotic susceptibility patterns]. / Anaerobik bakterilerin çesitli infeksiyonlardaki rolü ve antibiyotiklere duyarlilik durumlari.

In this study we have examined antibiotic susceptibility of anaerobic bacteria isolated from various samples of 75 patients. Anaerobic bacteria from 22 (29.3%) patients, and only aerobic bacteria from 29 (38.7%) patients have been isolated; there has been no growth in cultures from 24 (32%) patients. Of 75 isolates from 51 patients 38 (50.6%) are anaerobic and 37 (49.4%) are aerobic bacteria. Following anaerobic bacteria have been isolated: Peptostreptococcus (13), Peptococcus (5), microaerophilic streptococci (2), Veillonella (1), Bacteroides (9), Fusobacterium (4) and non spore forming anaerobic gram positive bacilli (4). Among the 38 anaerobic bacteria the highest resistance has been shown against tetracycline (65.8%). Resistance rates for cephalothin, erythromycin and penicillin G are 28.9%, 15.8% and 7.8%. In our investigation we have shown no resistance against carbenicillin, clindamycin and chloramphenicol.