Mikrobiyol Bul
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Acinetobacter baumannii is an important pathogen which causes severe nosocomial infections such as meningitis. Multidrug resistance is a growing problem throughout the world. In this report a case of multidrug resistant A.baumannii meningitis, treated with high dose of ampicillin-sulbactam (SAM) was presented. ⋯ Control CSF sample obtained on the 14th day of treatment revealed no leukocytes and no bacterial growth. The treatment was continued for 21 days and the patient recovered without any sequela. Since colistin which is one of the alternative antimicrobial treatment choices for resistant Acinetobacter infections, is not found in Turkey, sulbactam-ampicillin might be an effective and safe choice for the treatment of multi-resistant A. baumannii meningitis if the isolate was proven to be susceptible by antibiotic susceptibility tests.
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Nasopharyngeal carriage of Streptococcus pneumoniae plays an important role for the development of invasive disease and the spread of resistant strains within the community. The aims of this study were to determine the carriage rate of nasopharyngeal S. pneumoniae at healthy school children, to search the susceptibility of the strains to various antibiotics and to evaluate the risk factors for nasopharyngeal carriage of penicillin-resistant pneumococci. A total of 1440 healthy children (age range: 6-13 years old) attending to three primary schools which were chosen randomly in Mersin province (Mediterranean region of Turkey) were included to the study between April 2003 to March 2004. ⋯ Living in a crowded family (p = 0.009) and use of antibiotics in the last two months (p = 0001) were considered as the risk factors for nasopharyngeal carriage of penicillin-resistant pneumococci. When comparing our data with the results of the other studies reported in Turkey, the nasopharyngeal carriage rate was moderate between healthy children in Mersin, nevertheless the rate of high level penicillin-resistant S. pneumoniae strains was quite low. As a result, improving the living conditions and restriction of antibiotic use could minimize the nasopharyngeal carriage and penicillin-resistant pneumococci.
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Pseudomonas aeruginosa and Acinetobacter baumannii which are usually multiply antibiotic resistant, are the most important agents causing infections in intensive care units (ICUs). The aim of this study was to determine the antibiotic sensitivity patterns of P. aeruginosa and A.baumannii that cause infections in ICUs and hospital service units and to follow the variation in resistance between the years of 2003 to 2006. P. aeruginosa (n:1071) and A.baumannii (n:587) strains were isolated from blood, urine, wound, sterile body fluid, sputum and tracheal aspirate cultures of patients who were diagnosed to have infections in ICUs and hospital service units. ⋯ Decreasing sensitivities to imipenem (60.5%), meropenem (69%), cefepime (24%), ciprofloxacin (14%), gentamicin (13%), and amikacin (19%) for A.baumannii were statistically significant in 2006 (p < 0.05). Our data have indicated that P. aeruginosa and A.baumannii strains isolated in ICUs at our hospital showed multi-drug resistance in 2006, with significant increases since 2003 against certain antimicrobial agents. In conclusion there is an urgent need for effective strategies to control the use of antibiotics in our hospital.
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Pseudomonas aeruginosa is an important opportunistic pathogen. P. aeruginosa strains secrete several virulence factors, in the form of extracellular proteins. Adhesins, pyocyanin, proteases, hemolysins, exotoxin A and exoenzyme S are some of the virulence factors found in P. aeruginosa strains. ⋯ Mean total matrix protease and elastase activities were less than P. aeruginosa PAO1 activity in the test strains, however, some strains exhibited activity higher than PAO1. There was no significant difference for mean protease and elastase activities between the strains isolated from lower respiratory tract samples and the others (p > 0.05) [corrected] as well as no difference with respect to antibiotic resistance (p > 0.05) [corrected] It was found that ceftazidime and cefoperazone were the most resistant agents in both groups (67.9% and 57.9% for ceftazidime and 49.3% and 48.7% for cefoperazone, respectively). It was concluded that further in vivo studies are necessary to clarify the role of virulence factors of P. aeruginosa in the establishment of infection in different body sites.
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Listeria monocytogenes may lead to intrauterine infections which can be treated if diagnosed promptly. However, there is not a rapid routine screening test with high specificity and sensitivity for the diagnosis of listeriosis during pregnancy. We investigated the presence of different L. monocytogenes O antibodies for diagnosis of listeriosis in 275 paired maternal-cord sera using the agglutination test, and aimed to evaluate the correlation between poor pregnancy outcomes, level of L. monocytogenes serotype O antibodies and risk factors for listeriosis. ⋯ Risk factors such as non-specific febrile illness during pregnancy (p < 0.001), consumption of ready-made food (p = 0.008), consumption of raw milk and milk products (p < 0.001) were found to be related to the presence of > or = 1/320 titers of L. monocytogenes antibodies. The major limiting factor in this study was the inability to obtain second serum samples from the mothers and newborns following delivery, to confirm the diagnosis by seroconversion. These results emphasize the need for the development of rapid, simple and reliable tests, alternative to culture methods, for the early and proper diagnosis of Listeria infections during pregnancy.