Postoperative fever

Postoperatif ateş herhangi bir ameliyatı takiben, infeksiyona bağlı veya infeksiyon dışı nedenlerle gelişebilir. İlaçlar, kan ve kan ürünleri, ameliyat öncesinde bir travma veya infeksiyon olması ameliyat esnasında veya ayılma odasında ortaya çıkan ani bir ateşin nedeni olabilir. Ameliyattan sonraki ilk birkaç günde ameliyata bağlı doku harabiyetinin neden olduğu inşamatuvar uyarı nedeniyle ateş görülebilir. Bu erken dönemde aspirasyon pnömonisi, klostridiyal miyonekroz, A grubu streptokokların neden olduğu nekrotizan infeksiyonlar ateş nedeni olabilirse de pulmoner emboli, tromboşebit, pankreatit, miyokard enfarktüsü, atelektazi vb. infeksiyon dışı bir çok neden esas etkendir. Ameliyattan 4-5 gün sonra ortaya çıkan ateşin en sık görülen nedenleri hastane kökenli mikroorganizmalara bağlı cerrahi alan, üriner sistem infeksiyonları, pnömoni, kateter ilişkili infeksiyonlar gibi infeksiyöz nedenlerdir. Postoperatif ateşi olan bir hastayı değerlendirirken ateşin infeksiyona bağlı olduğunu var saymadan önce ayrıntılı bir ayırıcı tanı yapılması gerektiği akılda tutulmalıdır.Postoperative fever may occur after any kind of surgery due to infectious and noninfectious conditions. Drugs, blood and blood products, trauma or infections prior to surgery can cause fever in the operative room or in the recovery area. The inşammatory stimulus of tissue injury due to surgery can cause fever in the Şrst few days after operation. Although aspiration pneumonia, clostridial myonecrosis and necrotizing infections due to group A Streptococcus may occur as the cause of fever at this early postoperative period, the main causes are noninfectious conditions such as pulmonary embolism, trombo-phlebitis, pancreatitis, myocardial infarction, atelectasis, etc. The most common causes of fever 4-5 days after surgery are infections due to nosocomial pathogens such as surgical site infections, urinary tract infections, pneumonia and intravascular catheter related infections. In evaluating a patient with postoperative fever it must be considered a detailed differential diagnosis to Şnd the etiology before to assume the fever is due to infection

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

Evaluation of Resistance Transfer by Conjugation, in Escherichia coli, Klebsiella and Salmonella Species, on Solid Phase at Different Temperatures

Conjugation means transfer of genetic material via bacterial membranes. Fimbrial characters that are responsible for this transfer are coded by conjugative plasmids that multiply in the cytoplasm. This transfer efficiency may be different in solid, liquid phases or on membranes. Conjugation in some of the members of Enterobacteriaceae family is also temperature dependant. This study was carried out to determine the optimal temperature and donor-acceptor ratios for transconjugation in Escherichia coli, Klebsiella and Salmonella species which belong to Enterobacteriaceae family. Fifteen strains, five from each of these species that mentioned above, which were determined to be multiresistant, were introduced to standart recipient E. coli J53-2 in two different concentration [(a) donor:recipient ratio 4:1; and (b) donor:recipient ratio is 1:4] and three different temperatures 32°C, 37°C and 42°C. “Multivariate” analysis was done with “repeated measures one way ANOVA test” whereas “univariate” analysis was done with “Wicoxon Sign Rank” tests. The results of these two tests correlated well and the results were found to be statistically different. In conclusion, transconjugation on solid phase was found to be optimal for group (b) where the recipient:donor ratio was 4:1 and the temperature was 37°C