Molecular genotyping of methicillin-resistant Staphylococcus aureus strains in a teaching hospital in Turkey.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major causes of nosocomial infections in our hospital. Therefore, we aimed to characterize MRSA isolates phenotypically from patients with nosocomial infections at Cumhuriyet University Hospital between December, 1999, and June, 2001, in Sivas by analysis of antibiotic patterns and genotypically using pulsed-field gel electrophoresis (PFGE) and repetitive element sequence-based polymerase chain reaction (rep-PCR). Forty-three nosocomial isolates were collected from various wards. All isolates were resistant to penicillin, tetracycline, oxacillin, and gentamicin. By rep-PCR and by separation of SmaI fragments of genomic DNA using PFGE, one major type (eight subtypes with PFGE) was identified among the strains. This clone was found to be different than some clones such as Iberian, Brazilian, and a major clone that was found in another Turkish University Hospital in Ankara. According to our results, there is a major MRSA clone with a potential to spread in our hospital. Infection control measures should be directed toward restricting the further spread of this clone. Therefore, in accordance with these findings, a surveillance culturing program should be established.

Are plasma and synovial fluid leptin levels correlated with disease activity in rheumatoid arthritis ?

Leptin is an adypocyte derivated peptide hormone that plays a major role in preventing obesity development by the effects at the hypothalamic level. In our study leptin levels of 41 rheumatoid arthritis (RA) patients and 25 healthy subjects as control group were assessed. Synovial fluid from 21 RA patients were collected to detect leptin levels. Synovial fluid and plasma leptin levels were analysed and correlated with RA duration, ESR, CRP, X ray changes (erosive or non-erosive disease) and negative or positive test for rheumatoid factor. There wasn't any significant difference at plasma leptin levels between RA patients (3.91 +/- 6.15) and control group (4.94 +/- 6.44) (p > 0.05). Plasma leptin levels were correlated with body mass index (BMI) in both healthy subjects and RA patients (r = 0.37; p = 0.018). Therefore in RA patients, plasma and synovial fluid leptin levels were not correlated with disease duration, ESR, CRP, negative or positive test for rheumatoid factor and erosive or non-erosive disease (p > 0.05). In conclusion leptin is correlated with BMI both in RA patients and healthy individuals but no considerable relation with disease activity.

Cold dissection versus bipolar cauterizing tonsillectomy for bacteriemia.

OBJECTIVE: The purpose of this study is to compare transient bacteriemia ratios between cold dissection tonsillectomy and bipolar cauterizing tonsillectomy, and also to analyze the bacteria detected with superficial/central tonsillar cultures. METHODS: A total of 86 patients that were grouped as 46 patients of cold dissection tonsillectomy and 40 patients of bipolar cauterizing tonsillectomy were included in this study. Preoperative surface swab cultures, intraoperative central swab cultures of tonsils, and preoperative and postoperative blood culture samples were obtained. Antibiotic sensitivity tests were determined. Fischer exact chi 2 test was performed to compare the results of postoperative bacteriemia of both techniques statistically. RESULTS: Postoperative bacteriemia was detected in 6 (13%) patients of cold dissection tonsillectomy group. In 5 (83.3%) of the 6 postoperative bacteriemia patients of cold dissection tonsillectomy group, isolated microorganism was confirmed both in the blood cultures and in the central swab cultures of tonsils, and resistance to penicillin was established. No patient of bipolar cauterizing tonsillectomy group appeared with postoperative bacteriemia. There was a statistically significant difference (P=.028) for postoperative bacteriemia between cold dissection tonsillectomy group and bipolar cauterizing tonsillectomy group. CONCLUSION: We recommend bipolar cauterizing tonsillectomy for high-risk patients.