Mikrobiyol Bul
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Direct demonstration of bacterial and/or fungal nucleic acids in the clinical samples of patients with blood stream infections is crucial in terms of rapid diagnosis, early and accurate therapy and patient management. This study was aimed to determine the presence of bacteria and fungi by polymerase chain reaction (PCR) in the clinical samples of experimental sepsis induced animals, to compare the results with culture and to evaluate the efficiency of PCR in the discrimination of bacteremia and fungemia. A total of 12 rabbits experimentally infected with standard strains of Staphylococcus aureus, Escherichia coli, Aspergillus fumigatus and Candida albicans to generate bacteremia (n= 4), fungemia (n= 4) and polymicrobial blood stream infection (n= 4), were included in the study. ⋯ Detection limit of all PCR applications was 50 cfu/ml for simulated blood samples. It was concluded that the adaptation of the tested PCR method to the clinical samples obtained from patients might help to the early diagnosis of blood stream infections. However, further clinical studies are necessary to support the results of this study.
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Probiotics which are non-pathogenic live microorganisms ingested along with food or as dietary supplements, are thought to be beneficial to the host by supporting the microbial balance in digestive system. Various studies suggest that the effects of probiotics on the intestinal mucosa and immunity are protective against bacterial translocation. We aimed to investigate bacterial translocation related to the amount of CO2 insufflation given during laparoscopy and the effect of probiotic bacteria in an experimental peritonitis model. ⋯ It was also found that these results were correlated with bacterial translocation per gram of tissue. As an example, the quantitative bacterial growth values detected in mesenteric lymph node were 5.4 ± 2.9 x 103, 10.6 ± 3.3 x 103 and 21.5 ± 12.4 x 103 cfu/g in groups 1, 3 and 5, fed without probiotics, respectively; and 2.0 ± 1.3 x 103, 3.8 ± 1.9 x 103 and 9.0 ± 3.1 x 103 cfu/g in groups 2, 4 and 6, fed with probiotics, respectively. Our data emphasized that probiotic bacteria may be used as prophylactic agents for the prevention of bacterial translocation during laparoscopy, however comprehensive and clinical studies are needed to support these experimental results.
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Comparative Study
[Comparison of endotracheal aspiration and mini-BAL culture results in the diagnosis of ventilator-associated pneumonia].
The objective of this study was to compare the results of cultures obtained by mini-bronchoalveolar lavage (BAL) and endotracheal aspiration (ETA) techniques, used for rapid and accurate determination of pathogens causing ventilator-associated pneumonia (VAP) in intensive care units. Of the 92 patients on mechanical ventilation followed at the emergency intensive care unit of our hospital between June 2010 and June 2011, 30 (32.2%) patients were diagnosed as VAP and they were included in this study. VAP diagnosis were based on the clinical and radiological findings. ⋯ Similarly, of the six negative ETA samples, 5 (83%) yielded bacterial growth (two E.coli, two K.pneumoniae, one P.aeruginosa) in mini-BAL samples. Statistical analysis with Spearman test indicated no positive correlation between the culture results of mini-BAL and ETA (p= 0.464), and the concordance between the culture results of those methods was found as 50%. It was concluded that the use of mini-BAL instead of ETA samples for the isolation of causative microorganisms of VAP seemed to be more useful due to the high contamination risk in ETA culturing techniques and higher bacterial isolation rates in mini-BAL sampling.
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Infections due to methicillin-resistant Staphylococcus aureus (MRSA) are important health care problems since they are usually multidrug resistant. Although MRSA is isolated especially from nosocomial infections, community-acquired MRSA infections are increasing. Methicillin resistance is due to the expression of mecA gene, which is located on SCCmec gene cassette. ⋯ Two of the three SCCmec type IV strains were type IVa. Ten (2.2%) PVL positive strains, three of which were from the control group; were all methicillin susceptible S.aureus (MSSA). Although PVL positive MRSA was not common, detection of SCCmec type IVa, a marker for CAMRSA, and PVL positive MSSA strains which might act as a reservoir for PVL positive MRSA, indicated the importance of ongoing surveillance for MRSA.
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Case Reports
[A severe falciparum malaria case successfully treated by exchange transfusion as an adjunct therapy].
Plasmodium falciparum malaria is a type of malaria with high fatality rate despite optimal antimalarial treatment. Exchange transfusion (ET) is successfully used as a means of supportive therapy in severe P. falciparum malaria cases with hyperparasitemia. Herein, we present a case with hyperparasitemia, who received erythrocyte ET therapy due to lack of clinical response to antimalarial treatment. ⋯ It was decided to apply automated erythrocyte ET. After ET, patient's medical status was quickly improved and patient was discharged on the 7th day of hospitalization. In conclusion, it was noted that in addition to antimalarial treatment, erythrocyte ET may provide dramatic improvement in severe cases of P.falciparum malaria with hyperparasitemia.