Mikrobiyol Bul
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Pyogenic liver abscesses usually develop secondary to biliary tract and intraabdominal infections and members of the Enterobacteriaceae family are usually implicated as the etiologic agents. In this report a case of hepatic abscess devoloped secondary to cervical lymphadenitis caused by Staphylococcus aureus, was presented. Twenty-one years old male patient was admitted to the hospital with complaints of fever, swelling and pain at the right side of the neck and difficulty in swallowing. ⋯ Treatment with ampicillin/sulbactam was continued for 6 weeks. Although it was considered that the hematogenous spread of MSSA that led to cervical lymphadenitis caused the hepatic abscesses, the agent was neither isolated from the blood culture nor from the hepatic abscess material. It should always be taken into consideration that liver abscesses might accompany distant infections and antibiotic therapy alone might not be sufficient for the complete resolution of such infections.
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Multi-drug resistant Pseudomonas aeruginosa and Acinetobacter spp. infections are becoming an important problem all throughout the world as well as in our country. In this study, we evaluated the drug resistance rates of P. aeruginosa and Acinetobacter spp. in the intensive care units of Dokuz Eylül University Hospital, Izmir, Turkey. Since by the year 2003, antibiotic consumption is started to be controlled by infectious disease and clinical microbiology specialists according to antibiotic policies ruled by the government, the antibiotic resistance rates were evaluated in two periods (2000-2002 and 2003-2006). ⋯ The data obtained in this study indicated that there were no decrease in the antibiotic resistance rates after 2003. In the year 2005, "Antibiotic use guideline" established in our hospital let the antibiotics used without infectious disease and clinical microbiology specialists consultation. The high antibiotic resistance rates may be attributed to the application of this antibiotic guideline leading to the uncontrolled use of antibiotics.
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Nosocomial infections by resistant gram-negative microorganisms are important causes of mortality in intensive care unit (ICU)'s. The treatment choices are limited in infections due to Acinetobacter baumannii and Pseudomonas aeruginosa, especially if they are panresistant. In these type of resistant infections, colistin--an old antibiotic--has become a current issue. ⋯ Microbiological response to colistin was obtained in 6 cases. Three cases died due to non-eradication of panresistant microorganisms and three cases died due to other infections during ICU follow-up. The data presented in this study demonstrates that colistin can be considered as a safe and effective antibiotic in the treatment of panresistant A. baumannii and P. aeruginosa infections.
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This study was conducted to investigate the antimicrobial susceptibility, Panton Valentine leucocidine (PVL) and toxin (enterotoxin A-J, staphylococcal toxic shock toxin) genes, agr types, staphylococcal cassette chromosome mec (SCCmec) types and pulsed field gel electrophoresis (PFGE) profiles of a total of 100 non-duplicate methicillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates collected between 2002-2005 at Ankara University Ibn-i Sina Hospital. Antimicrobial susceptibilities were investigated by a semi-automated system (miniAPI, BioMerieux, France); PVL, mecA and toxin (sea, seb, sec, sed, see, seg, seh, sei, sej, tst) genes by polymerase chain reaction (PCR) and SCCmec and agr typing were performed by multiplex PCR. While all isolates were susceptible to vancomycine, aminoglycoside and tetracycline resistance was determined in 91%, ciprofloxacine in 93%, rifampin in 92%, erythromycine in 79% and trimethoprim-sulphametoxazole in 8% of the isolates. mecA gene was detected in all of the isolates, however, PVL positive isolate was not detected. sea was the most frequently (77%) detected enterotoxin gene. ⋯ Multilocus Sequence Typing (MLST) of five representative isolates (two isolates with pattern A, one isolate each from patterns B, C and D) revealed sequence type (ST) 239. This study documented that the dominant MRSA clone in our hospital had SCCmec type III, agr type 1, PVL negative, sea positive and of ST 239. Larger scale intercity and nation wide studies are needed to find out the clonal characteristics of hospital acquired MRSA in Turkey.
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Nosocomial urinary tract infections (NUTI) which are usually in the first rank in health care associated infections, significantly influence mortality, morbidity, hospitalization period and cost. In this retrospective study, it was aimed to analyze the risk factors in NUTI and also to investigate the effect of urinary catheter application on the distribution of pathogens in patients with NUTI. The study included 1236 NUTI episodes in 1103 patients (age range: 18-95 years; 641 female, 462 male) between January 2000-December 2006. ⋯ C. albicans was the most frequent agent in catheter-associated NUTI and E. coli in non-catheter-associated NUTI, their isolation rates being statistically significant (p=0.007 and p=0.005, respectively). No statistically significant difference was detected in the distribution of the other organisms in the two study groups. These data revealed that in urinary tract infections Candida species have replaced the first rank which was occupied by E. coli previously.