Mikrobiyol Bul
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Multidrug-resistant Acinetobacter boumannii is a challenge in the treatment and control of nosocomial infections. This retrospective study was aimed to investigate the prevalence of multidrug resistant A. boumannii in a respiratory intensive care unit (ICU), related risk factors and its impact on disease prognosis. Of 218 patients who were hospitalized in our ICU during the last two years; 37 (17%) patients (21 males, mean age 61.6 +/- 19.8 years) developed pneumonia and/or bacteremia due to multidrug-resistant A. baumannii. ⋯ The rates of re-intubation and tracheotomy were higher in patients infected with A. boumannii compared to the control group (59.5% vs. 7.7%, p < 0.0001 and 21.6% vs. 3.9%, p = 0.001, respectively). There was no significant difference between two groups in terms of mortality, however, durations of ICU and hospital stays were longer in patients with multidrug-resistant A. baumannii infection than without infection (24.2 +/- 18.3 vs. 8.2 +/- 8.3 days, p < 0.001 and 33.3 +/- 19.8 vs. 15.4 +/- 11.4 days, p < 0.001, respectively). In conclusion, due to the high rates of drug-resistance in nosocomial A.baumannii isolates, the use of invasive procedures and durations of ICU and hospital stays exhibit an increasing trend.
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Community-acquired pneumonia (CAP) is a common infectious disease with high morbidity and mortality. In this study, demographic features, underlying conditions, causative pathogens and factors affecting length of hospital stay and mortality were retrospectively investigated in patients who were diagnosed as CAP and followed-up in our unit between January 2005-December 2007. Among 97 patients 65 (67%) were male, 32 (33%) were female and the mean age was 62.7 (age range: 18-94) years. ⋯ However, mechanical ventilation was found as a significant risk factor (p < 0.05). In the evaluation of the factors that affect mortality, mechanical ventilation (p < 0.001), staying in intensive care unit (p < 0.001), being group 4 CAP (p < 0.001) and fever continuing for > 3 days despite antibiotic therapy (p = 0.05) were found to be significant risk factors. In conclusion, length of hospital stay, mortality and treatment costs in CAP patients could be reduced by defining the risk factors and starting empirical antibiotic therapy according to the national and international guidelines.
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Sertralin is a psychotropic drug which acts by inhibiting the selective serotonin re-uptake in the synaptic area. Previous studies have shown that some antidepressant agents have antibacterial activity. The aim of this study was to investigate the in vitro antibacterial activity of sertralin. ⋯ The MIC values of sertralin against standard strains were as follows; 16 microg/ml for S. aureus ATCC 29213 (methicillin-susceptible), 32 microg/ml for S. aureus ATCC 43300 (methicillin-resistant), 16 microg/ml for E. faecalis ATCC 29212, 32 microg/ml for K. pneumoniae ATCC 700603, 32 microg/ml for E. coli ATCC 25922 and > 128 microg/ml for P. aeruginosa ATCC 27853. Sertralin has showed antibacterial activity mainly against gram-positive bacteria, and it was surprising that MIC values of vancomycin-resistant enterococci were lower than those of vancomycin-susceptible ones. Further in vivo and in vitro studies are required to provide reliable data about the use of sertralin as an adjuvant agent in the antibacterial treatment of infections caused by multidrug-resistant bacteria.