Pandemic Influenza A (H1N1) Virus Infection During Pregnancy

Human infection with novel influenza A (H1N1) virus was first reported in April 2009 in Mexico and then spread to the United States and other countries worldwide. Pandemic influenza A (H1N1) virus infection generally presents mild disease with symptoms similar to those of seasonal influenza A infection. Pregnant women are at higher risk for severe complications and death from influenza. Changes in the immune, respiratory and cardiovascular systems result in pregnant women being more severely affected by influenza. Influenza infections in pregnancy have been associated with adverse maternal and fetal outcomes, including preterm labor, preterm birth, preterm premature rupture of membranes, renal failure, pulmonary embolus, pneumonia, acute respiratory distress syndrome, and death. The rate of hospital admission for H1N1 infection in pregnant women is much higher than for non-pregnant women. Nearly onethird of the pregnant women with H1N1 influenza infection have been hospitalized during the current pandemic, and most of them had severe respiratory distress. Because of high complication rates, the Centers for Disease Control and Prevention (CDC) recommends that pregnant women be started on antiviral drugs as soon as possible after the onset of influenza symptoms. Treatment should not be delayed for laboratory confirmation. The benefit of treatment is greatest if started within 48 hours of onset. Pregnant women are in a high-priority group for pandemic influenza vaccine because of increased risk of morbidity and mortality. H1N1 monovalent vaccine can be given to pregnant women in any trimester

Invasive Group A Streptococcus Infections

In the pre-antibiotic era, severe group A streptococcal infections and their non-suppurative sequelae were major causes of mortality and morbidity. During the past 50 years, the incidence and severity of these infections have declined largely because of the effect of antibiotic therapy, improved living conditions, and decreased virulence of the infecting organisms. However since 1985 there has been an apparent increase in the number of invasive group A streptococal infections reported worldwide. These infections were seen mostly in healthy young adults and the course were frequently rapid and fatal. The epidemiological differences were due to the change in the virulence of organizms causing disease. In this paper epidemiology, microbiological features and clinical forms of the invasive group A streptococcal infections seen recently, is reviewed

Crimean-Congo Hemorrhagic Fever

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic infectious disease caused by the CCHF virus belonging to the genus Nairovirus of the Bunyaviridae family. Transmission occurs mainly as a result of Hyalomma m. marginatum (from Ixodidae family) tick bite. Nosocomial, laboratoryrelated transmission and travel-related cases have also been reported. Contact with the blood and infected products of viremic animals is another mode of transmission. Crimean-Congo hemorrhagic fever was first described in 1944 in the former Soviet Union on the peninsula of Crimea. In Turkey, the disease was recognized in 2002 and the first laboratory-confirmed case was reported in 2003. Crimean-Congo hemorrhagic fever has been reported in more than 30 countries in Asia, the Middle East, Europe, and Africa since it was first described. It is characterized by fever, muscle and joint pain, thrombocytopenia, elevation of liver and muscle enzymes, bleeding, and shock in serious cases. Although the case-fatality rate has been reported between 5-80%, this rate is 5% on average for Turkey. There is currently no effective treatment or safe vaccine specific to CCHF. With its wide geographical distribution and mortality, CCHF continues to be an important health problem in endemic regions such as our country

Antimicrobial Susceptibility of Enterococcus Species Collected from Clinical Specimens

Seventy isolates of enterococci with species identification were collected from clinical specimens between August 1996-June 1997 and antimicrobial susceptibility tests were performed. Using conventional tests, 67.2% of the isolates were identified as Enterococcus faecalis, 28.6% of the isolates as E. faecium and 2.8% of the isolates as E. gallinarum. Penicillin and ampicillin resistance were present in 21.4% of the isolates and there was no β-lactamase producer. High-level resistance to gentamicin and streptomycin were detected in 31.4% and 22.8% of the isolates, respectively. While there was no vancomycin and teicoplanin resistance in E. faecalis and E. faecium strains, E. gallinarum strains were moderately susceptible to vancomycin but susceptible to teicoplanin. Ciprofloxacin resistance was present in 20% of the isolates. Penicillin, ampicillin, ciprofloxacin and gentamicin resistance were significantly higher in E. faecium strains than that in E. faecalis strains (p 0.05)

Brucellar spondylitis.

We carried out a prospective analysis of 86 patients with brucellosis, and 26 (30%) cases were diagnosed as brucellar spondylitis. Two patients had cervical involvement, two thoracic, and 21 lumbosacral as seen in MRI. Four patients had epidural abscess and two had paravertebral abscess. All patients received combined antibiotic therapy for 4 to 12 months. Those with cervical involvement underwent surgical treatment because of medullar compression. Neither death nor severe sequelae were observed

Detection of Antimicrobial Susceptibilities of Imipenem-Resistant Pseudomonas and Acinetobacter Strains Isolated from Nosocomial Infections to Frequently Used Antibiotics

Imipenem-resistance is a growing problem among Acinetobacter and Pseudomonas aeruginosa strains. In this study, antimicrobial susceptibilities of imipenem-resistant 33 P. aeruginosa and 29 Acinetobacter strains isolated from nosocomial infections between January 2003-July 2003 were investigated. Twenty-seven isolates were isolated from the patients hospitalized in the wards and 35 isolates from the patients hospitalized in the intensive care units. Seventeen of the isolates were from blood, 14 from wound, 13 from deep endotracheal aspirate, 10 from urine, 6 from abdominal drenage fluid, 1 from ascites and 1 from central venous catheter cultures. Antibiotic susceptibilities were determined by E-test. Antibiotic resistance rates for P. aeruginosa and Acinetobacter strains were 70% and 72% for meropenem, 40% and 93% for amikacin, 61% and 93% for ciprofloxacin, 18% and 21% for cefoperazone-sulbactam, 33% and 24% for cefepim, 48% and 76% for ceftazidime, 48% and 86% for piperacillin-tazobactam, respectively

Spontaneous bacterial peritonitis due to Brucella melitensis.

Peritonitis is an extremely rare complication of brucellosis. A case is reported of blood and ascitic culture-proven spontaneous bacterial peritonitis caused by Brucella melitensis, in a patient who had also cirrhosis