To Detect Vancomycin Resistant Enterococci From the Resistant Genes perspective

TEZ10435Tez (Doktora) -- Çukurova Üniversitesi, Adana, 2008.Kaynakça (s. 33-38) var.viii, 39 s. : tablo ; 29 cm.Vankomisin dirençli enterokoklar (VRE) dünyada önemli bir nosokomiyal patojen olarak önem kazanmıstır. Vankomisin, glikopeptid olarak nitelendirilen genis sınıflı antimikrobiyal ajanların bir üyesidir. Bu çalısmada vanA/vanB VRE genotipleri Adana Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesinin çesitli bölümlerinden gönderilen klinik örneklerden değerlendirildi. Mart 2005 ve Mart 2007 arasında yetmis bir bin klinik örnekten dört yüz on yedi VRE izole edildi. Türlerin identifikasyonu ve vankomisin hassasiyeti Vitek- 2 gram pozitif identifikasyon kartı ve hassasiyet kartı ile yapıldı. Hassasiyetler vankomisin E test ile doğrulandı. Bu çalısmada örneklerdeki vankomisin dirençli genlerin tanımlanması için LightCyler cihazı kullanıldı. Doksan örnek (%95,7) Enterococcus faecium, dört örnek (%4,3) ise Enterococcus faecalis olarak identifiye edildi. Doksan dört örnek vankomisine yüksek düzeyde (>256?g/ml ) dirençli idi. Doksan dört örneğin tamamı vanA VRE genotipinde bulundu. Bu çalımsa insanlardan vanA VRE lerin Adana’ daki ilk raporudur. Anahtar Kelimeler: VRE, VRE direnç genleri, vanAVancomycin- resistant enterococci (VRE) have emerged as important nosocomial pathogens in the world. Vancomycin is a member of a broader class of antimicrobial agents referred to as glycopeptides. In this study vanA/vanB VRE genotypes were evaluated from clinical samples of different departments of Çukurova University Medical Faculty Balcalı Hospital in Adana. Between March 2005 and March 2007, four hundred seventeen VRE were isolated from seventy one thousand clinical specimens. Identification to the species and vancomicyn susceptibility was made Vitek-2 gram positive identification card and vancomycin susceptibility card. Susceptibilities were confirmed by vancomycin E test. In this study kit for the detection of vancomycin resistance genes in samples was the LightCyler instrument system. Ninety isolates (%95, 7) were identified as Enterococcus faecium, four (%4, 3) as Enterococcus faecalis. Ninety four isolates were highly resistant to vancomycin (>256?g/ml). All ninety four isolates were found vanA VRE genotypes. This is the first report of vanA VRE from humans in Adana

Assessment of the Newborns Diagnosed with Phenylketonuria, Congenital Hypothyroidism and Biotinidase Deficiency by Newborn Screening Results in Adana in years 2010-2011

Amaç: Bu çalışmanın amacı Adana ilinde Halk Sağlığı Müdürlüğü tarafından yürütülen yenidoğan tarama programının 2010 ve 2011 yılı sonuçları incelenmesi ve ileri tetkiklerle kesin tanı konulan çocukların büyüme ve gelişmelerinin ve bunu etkileyen sosyodemografik faktörlerin değerlendirilmesidir.Gereç ve Yöntemler: 2010 ve 2011 yılında Adana ilinde doğan ve fenilketonüri (FKÜ), konjenital hipotiroidi (KH) ve biyotinidaz eksikliği (BE) tarama sonucunda tespit edilen çocuklar araştırmaya dâhil edildi. 2010 ve 2011 yıllarında 388 hipotiroidi, 7 biyotinidaz eksikliği ve 5 fenilketonüri tespit edilen toplam 400 çocuk çalışmamızın evrenini oluşturmuştur. Katılımcılara sosyodemografik özellikleri, büyüme ve gelişmeleri ile ilgili soruları içeren anket uygulandı.Bulgular: Adana ili 2010 yılı verilerine göre toplam 40.877 topuk kanı alınmış olup; insidansları hesaplandığında konjenital hipotiroidi 186 doğumda bir, Fenilketonüri 20.000 doğumda bir, biyotinidaz eksikliği 8.120 doğumda bir görülmüştür. 2011 yılında ise toplam 42.784 topuk kanı alınmış; insidansları hesaplandığında konjenital hipotiroidi 252 doğumda bir, Fenilketonüri 21.000 doğumda bir, biyotinidaz eksikliği ise 14.261 doğumda bir görülmüştür. Araştırma grubunda 322 (%80,5) kişiye ulaşılmıştır. Çalışmaya katılanların %39.7 (128)' si erkek, %60.3 (194)' ü ise kız idi. Çocukların gelişimleri ile ilgili sorulara baktığımızda, konjenital hipotiroidili çocukların %6'sının boyu %3 persentilin altında iken, kilosu %3 persentilin altında olanlar %10.5 idi. Fenilketonüri ve biyotidinaz eksikliği tanısı alanların ise hepsinin boyu ve kilosu %3 persentilin üzerinde idi.Tartışma: Yenidoğan tarama programı kapsamında olan fenilketonüri, biyotinidaz eksikliği, konjenital hipotiroidi tanısı alan çocuklar, erken tanı ve tedavi ile yaşıtlarıyla uyumlu bir şekilde yaşamlarına devam edebilirler. Ülkemizdeki insidanslarına baktığımızda her üç hastalığında diğer ülkere göre daha sık görüldüğü açıktır. Biz de çalışmamızda yenidoğan tarama programının önemini, olumlu sonuçlarını vurgulamak istedik.Objective: T he aim of this study is to examine the 2010 and 2011 results of the newborn screening program conducted by the Public Health Directorate in the province of Adana and to evaluate the growth and development of the children diagnosed with advanced examinations and the sociodemographic factors affecting them.Material and Methods: Children born in 2010 and 2011 in Adana were included in the screening of children diagnosed with phenylketonuria, congenital hypothyroidism and biotinidase deficiency. In 2010 and 2011, a total of 400 children with 388 hypothyroids, 7 biotinidase deficiencies and 5 phenylketonuria were identified. A questionnaire including questions about sociodemographic characteristics, growth and development of participant was applied.Results: A total of 40,877 heel blood were collected according to 2010 data; Congenital hypothyroidism was found at 186 births, Phenylketonuria at 20,000 births, and biotinidase at 8.120 births. In 2011, a total of 42.784 heel blood were taken; Congenital hypothyroidism was seen in 252 births, Phenylketonuria in 21.000 births, and biotinidase deficiency in 14.261 births. In the study group, 322 (80.5%) people were reached. 39.7% (128) of the participants were male and 60.3% (194) were female. When we look at the questions about the development of children, 6% of children with congenital hypothyroidism were 3% below the percentile, while those with a weight below 3% were 10.5%. In the field of diagnosis of phenylketonuria and biotinidase deficiency, the height and weight of all of them were above 3 percentile.Discussion: Children who are diagnosed with congenital hypothyroidism, phenylketonuria, biotinidase deficiency, congenital hypothyroidism, which are included in the newborn screening program, can continue their lives in accordance with their peers and early diagnosis and treatment. When we look at the incidence in our country, it is obvious that all three diseases are seen more frequently than the other countries. We also wanted to emphasize the importance and positive consequences of the newborn screening program in our study

The effect of body mass index on perioperative thermoregulation

Ayşe Belin Özer,1 Aysun Yildiz Altun,1 Ömer Lütfi Erhan,1 Tuba Çatak,2 Ümit Karatepe,1 İsmail Demirel,1 Gonca Çağlar Toprak3 1Department of Anesthesiology and Intensive Care, Firat University Medical School, Elaziğ, 2Department of Anesthesiology and Intensive Care Clinic, Bingol State Hospital, Bingöl, 3Department of Anesthesiology and Intensive Care Clinic, Elazig Training and Research Hospital, Elaziğ, Turkey Purpose: We evaluated the effects of body mass index (BMI) on thermoregulation in obese patients scheduled to undergo laparoscopic abdominal surgery. Methods: Sixty patients scheduled to undergo laparoscopic abdominal surgery with no premedication were included in the study. The patients were classified into 4 groups according to BMI <24.9, 25–39.9, 40–49.9, and >50. Anesthesia was provided with routine techniques. Tympanic and peripheral temperatures were recorded every 5 minutes starting with the induction of anesthesia. The mean skin temperature (MST), mean body temperature (MBT), vasoconstriction time, and vasoconstriction threshold that triggers core warming were calculated with the following formulas: MST = 0.3 (Tchest + Tarm) + 0.2 (Tthigh + Tcalf). MBT was calculated using the equation 0.64Tcore+0.36Tskin, and vasoconstriction was determined by calculating Tforearm-Tfinger. Results: There was no significant difference between the groups in terms of age, gender, duration of operation, and room temperature. Compared to those with BMI <24.9, the tympanic temperature was significantly higher in those with BMI =25–39.9 in the 10th, 15th, 20th, and 50th minutes. In addition, BMI =40–49.9 in the 5th, 10th, 15th, 20th, 25th, 30th, 40th, 45th, 50th, and 55th minutes and BMI >50 in the 5th, 10th, 15th, 20th, 25th, 30th, 50th, and 55th minutes were less than those with BMI <24.9 (P<0.05). There was no significant difference in terms of MST and MBT. Vasoconstriction occurred later, and that vasoconstriction threshold was significantly higher in patients with higher BMIs. Conclusion: Under anesthesia, the core temperature was protected more easily in obese patients as compared to nonobese patients. Therefore, obesity decreases the negative effects of anesthesia on thermoregulation. Keywords: anesthesia, obesity, body mass index, thermogenesi