A new modification for staining of acid fast bacilli in tissue

This article describes a technique for staining acidfast bacteria (leprosy bacillus and tuberculosis bacillus) in tissue. It is combination of the classic Ziehl-Neelsen technique and a technique described by Lavallee. In the present technique, the tissue preparation which has been brought to water, is first stained with Ziehl-Neelsen carbol fuchsin by heating. After washing the slide with tap water, a solution containing 1% methylene blue, 1% concentrated HCl and 70% ethyl alcohol is used as a counter stain. With this method of staining, it is possible to detect far more bacteria in a tissue preparation than with the classic Ziehl-Neelsen method. Thus, the possibility of detecting acidfast bacteria in tissues is greatly increased

Antibiotic resistance in Acinetobacter species in nosocomial and outpatient infections

Purpose: Acinetobacter spp. are the second most frequently isolated non-fermenter in the hospital environment after Pseudomonas aeruginosa and may cause a variety of infections. The purpose of this study was to determine the rate of infections caused by Acinetobacter spp. in both outpatients and hospitalized patients as well as to determine the antibiotic susceptibilities of the Acinetobacter spp. Methods: Specific identification and the determination of the antibiotic susceptibility of the Acinetobacter spp. was carried out using the Sceptor system. A panel which includes 24 biochemical tests and 16 suitable antibiotics for the organism being tested is evaluated by the Sceptor system. Since certain antibiotics are used only for urinary infections and other antibiotics for the remaining infections caused by gram negative oxidase negative bacilli, we used 2 different panels for testing these organisms. Results: In this study carried out between Dec. 19, 1994-March 11, 1996, 426 (0.7%) Acinetobacter spp. from a total of 60,000 clinical specimens were evaluated. The only species of Acinetobacter isolated in this study were A. baumannii and A. Iwoffii. The majority (293 (68.8%)) of the Acinetobacter spp. came from hospitalized patients and of these, 174 (59.4%) were considered to be the cause of nosocomial infection. Most of the Acinetobacter spp. isolated from nosocomial infections came from wounds (33.3%), peritonitis (14.4%), sepsis (13.2%), urinary infections (11.5%), lung infection (8.1%). and throat infection (6.3%). The overall rate of resistance was high. But there was a low rate of resistance to imipenem in Acinetobacter spp. isolated from both nosocomial infections (8.7%) and from the entire group of hospitalized patients (7.7%). Conclusion: The resistance of these species to antibiotics was higher in nosocomial infections. Imipenem in combination with other antibiotics to which the Acinetobacter spp. are sensitive should be used in the treatment of these infections

Oxacillin resistance in Staphylococcus aureus isolated in the central laboratory of Balcali Hospital, Cukurova University Medical School

Purpose: Recently, there has been an increase in the isolation of oxacillin-resistant Staphylococcus aureus (ORSA) which are particularly important in no-socomial infections. The ORSA are not only intrinsically resistant to oxacillin and other beta lactamase antibiotics, they are also resistant to a great many other antibiotics. The purpose of this study was to determine the rate of ORSA in specimens taken from hospitalized patients and out patients of the Balcali Hospital and their antibiotic resistance. Methods: Staphylococcus found to be S. aureus using the tube coagulase test were definitely identified using the staphylococcus MIC/ID panel of the Sceptor system. Confirmation of oxacillin resistance detected with this panel was carried out using the oxacillin agar screen plate according to the NCCLS procedure. Results: Out of 988 strains of S. aureus, 478 were found to be intrinsically resistant to oxacillin (ORSA); 89, borderline-resistant; and 421, sensitive. There was a much higher rate of ORSA detected in hospitalized patients in comparison to outpatients, 58.39% and 18.87%, respectively. Almost all of the S. aureus strains were resistance to ampicillin and penicillin and there was also a very high rate of resistance of the ORSA strains to ciprofloxacin, clindamycin, erythromycin, gentamicin and rifampin. Conclusion: Since there are very few antibiotics which can be used in treatment of S. aureus infections, it is very important to carry out a drug susceptibility test before attempting to treat a patient

Antibiotic resistance in coagulase negative staphylococci isolated in the clinical laboratory of Balcali Hospital

Purpose: This study was carried out in order determine the antibiotic resistance in coagulase negative staphylococci isolated in the clinical laboratory of the Balcali Hospital. Methods: A total of 1114 coagulase negative staphylococci (CNS) investigated in this study. Results: Out of the 398 (35.73%) were found to be intrinsically resistant to oxacillin. The majority of the CNS produced beta lactamase (94.52%) and thus were resistant to penicillin and ampicillin. The intrinsic oxacillin resistant CNS were also resistant to amoxicillin/clavulanate, ampicillin/sulbactam, cefazolin, ceftriaxone and cephalothin. Staphylococci isolated from hospitalized patients showed a much higher rate of intrinsic oxacillin resistance in comparison to those from outpatients, 39.70% and 16.76%, respectively. Methods: The Sceptor system used in this study for identification of the CNS uses a panel which includes biochemical and antibiotic tests. This system usually did not classify the staphylococci to the species level. The majority of the CNS were identified as the S. epidermidis species group (81.15%). The sensitivity of the intrinsic oxacillin resistant CNS to other antibiotics such as clindamycin, erythromycin, gentamicin, rifampin and trimethoprim/sulfamethoxazole was very low (3.23- 17.59%). Conclusion: With the exception of vancomycin, ciprofloxacin was the most effective antibiotic

Manifestation of cellulitis after saphenous venectomy for coronary bypass surgery

PubMedID: 12428833A few cases of onset of cellulitis after saphenous venectomy for coronary by-pass surgery were first reported by Baddour and Bisno in 1982. We reviewed the clinical characteristics of 31 subjects followed up in our department following onset of manifestations of cellulitis after saphenous venectomy for coronary by-pass surgery. In all the subjects the cellulitis originated at the scar of the saphenous venectomy, and most presented ill-defined, mildly erythematous, slightly oedematous lesions. Mycologically confirmed tinea pedis was found in 25 subjects. All the patients responded well to penicillins or cephalosporins. In this report we comment on the pathogenesis of this complication of saphenous venectomy based on the clinical features of the cases reviewed. We suggest that saphenous venectomy may destroy the lymphatics in the lower leg, that are located adjacent to the great saphenous vein, and thus microorganisms penetrating into the skin may easily cause cellulitis in areas with impaired lymphatic drainage

Comparison of the Bactec system and Lowenstein-Jensen medium for the isolation of Mycobacterium tuberculosis and determination of drug sensitivity with Bactec

A total of 2058 different specimens (sputum, cerebrospinal fluid, pleural fluid, gastric aspirate, urine, bronchial lavage, lung aspirate) sent to the central laboratory from clinics and but-clinics of Balcali Hospital of Cukurova University, Faculty of Medicine, Adana, were evaluated for Mycobacterium tuberculosis using Bactec system and Lowenstein-Jensen (L.J.) media. Out of a total of 112 cultures positive for M. tuberculosis, 100 (89.28%) were positive in the Bactec system and 76 (67.85%) with L.J. media. The average day on which the culture was found to be positive was 11.59 for the Bactec system and 22.41 with L.J. medium. The rate of sensitivity to drugs was as follows; Ethambutol (EMB) 97.32%, Rifampin (RFP) 87.5%, Streptomycin (SM) 85.71% and Izoniazid (INAH) 83.09%. The rate of primary contamination was 120 (5.89%) with the Bactec system and 94 (4.56%) with L.J. medium. However using the decontamination method of the Bactec system, the results of 72 cultures were evaluated whereas it was impossible to decontaminate the L.J. cultures. Thus, the final rate of contamination with the Bactec system was found to be 2.33 percent

Penicillin resistance in Streptococcus pneomoniae isolated in the Balcali hospital in Adana, Turkey [1]

PubMedID: 9661955[No abstract available

Serum copper, zinc and magnesium levels in children with enterobiosis

PubMedID: 9176872Levels of serum copper (Cu), zinc (Zn) and magnesium (Mg) were determined in the sera of 250 children aged between 6 and 13. Of these children, 180 were infected only with Enterobius vermiculuris. The remaining 70 children were without parasitic or bacterial infection and made up the control group. The cellophane tape method was used to detect E. vermicularis infection. The levels of Cu, Zn and Mg in the serum samples were measured with the Perkin- Elmer 2380 Atomic Absorption Spectrophotometer. Evaluation by the student-t test showed that the means of the Cu, Zn and Mg in the serum were significantly lower in the infected group than in the control group. Thus, in this study, we found that E. vermicularis adversely affects the level of elements such as Cu, Zn, and Mg in serum

Penicillin resistance in Streptococcus pneumoniae isolated in the Balcali Hospital in Adana, Turkey

Purpose: There is a continuing increase in resistance to penicillin which is commonly used in treatment of Streptococcus pneumoniae infections. This study was carried out in order to determine the rate of resistance to penicillin in S. pneumoniae isoleted in our hospital. Methods: Colonies on blood agar which resembled pneumonoccoccal colonies were tested with optochin disks. Identification of the bacteria was made using Sceptor system panels each of which contain 24 biochemical test including bile solubility and bile esculin as well as antibiotic susceptibility tests. Results: Between October 1993 and June 1995, 231 Streptococcus pneumoniae strains were isolated from various specimens from hospitalized patients and outpatients. Forty five (19%) of these strains were found to be resistant to penicillin (MIC > 1 µg/ml); 68 (29%), moderately resistant (MIC 0.1-1 µg/ml); and 118 (51%), susceptible (MIC < 0.06 µg/ml). The highest rates of penicillin resistance were detected in S.pneumoniae isolated from wound infections, spinal fluid, and blood (31%, 26%, 23%, respectively). There was no resistance to vancomycin. Conclusion: The results of this study indicated that S.pneumoniae infections should not be treated with penicillin or other antibiotics without confirmation of sensitivity with susceptibility tests