The evaluation of staphylococci strains isolated from nasal and bone cultures in patients with chronic osteomyelitis

Objectives: In this study, it was aimed to determine theprevalence of nasal carriage of S. aureus in chronic osteomyelitis,assessed trends in methicillin resistance withtime, and evaluated the bone and nasal cultures in staphylococcalchronic osteomyelitis.Materials and methods: Bone and nasal cultures wereperformed intra-operative and pre-operatively from 43patients with chronic osteomyelitis. Inoculation was performedon 5% sheep blood and eosine-methylen-blueagar. The samples were incubated at 37°C for 24 hours.Catalase and coagulase tests were performed on Grampositive coccus strains. Antimicrobial susceptibilities of allS. aureus strains were evaluated by disc diffusion methodaccording to CLSI for oxacillin and other antibiotics.Results: In this study pre-operative nasal cultures andintra-operative bone cultures obtained between May 2005and September 2006 were evaluated retrospectively. Ofthe 43 nasal cultures, 31 (72%) yielded staphylococcalstrain, of these 18 (58%) were S. aureus. Of the 18 S.aureus strains, 13 (72.2%) have methicilline resistance.On the other hand, of the 43 bone cultures, 29 (67.4%)yielded staphylococci strain, of these 23 (79.3%) were S.aureus. Of the 23 S. aureus strains, 52.1% have methicillineresistance. Overall the similarity rate of staphylococcalstrains was 38% (11/29), while considering the statusof strains resistant to antibiotics; this ratio was 24% (7/29).Conclusions: Nasal S. aureus carriage rate (58%) in patientswith chronic osteomyelitis was higher than the communityand the other patient groups. However, the surveillancecultures can give knowledge about the causativepathogen of 25% of the culture negative cases.Key words: Chronic osteomyelitis, nasal carriage, Staphylococcusaureus, bone cultur

Četverogodišnja studija učinkovitosti i sigurnosti entekavira u bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije

Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naive HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4}41.5 IU /L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA <300 copies; at month 48, 90% of patients had HBV DNA <50 IU /mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.Entekavir je analog gvanozina koji djeluje protiv virusa hepatitisa B. Cilj ove četverogodišnje studije bio je procijeniti liječenje entekavirom kod bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije. Ukupno je 49 bolesnika primalo entekavir, a devetoro ih se povuklo s terapije na kraju 96. tjedna. Početna srednja vrijednost alanin aminotransferaze bila 79,4}41,5 IU /L, dok je nakon 4 godine vrijednost alanin aminotransferaze bila u normalnim granicama kod 90% bolesnika. U 96. tjednu je <300 kopija HBV DNA zabilježeno u 91,7% bolesnika, a u 48. mjesecu je 48,90% bolesnika imalo <50 IJ/mL HBV DNA. Gubitak HBeAg zabilježen je u 7,1% bolesnika u 96. tjednu te u 12,5% bolesnika u 48. mjesecu. Stopa serokonverzije HBeAg iznosila je 4,8% u 96. tjednu i 7,5% u 48. mjesecu. Stopa serokonverzije HBsAg bila je 2,1% u 96. tjednu i 2,5% u 48. mjesecu. Sigurnost terapije bila je dobra. Bolesnici su dobro podnosili entekavir, snažan i siguran lijek koji dovodi do ustaljenog suzbijanja virusa

Četverogodišnja studija učinkovitosti i sigurnosti entekavira u bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije

Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naive HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4}41.5 IU /L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA <300 copies; at month 48, 90% of patients had HBV DNA <50 IU /mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.Entekavir je analog gvanozina koji djeluje protiv virusa hepatitisa B. Cilj ove četverogodišnje studije bio je procijeniti liječenje entekavirom kod bolesnika s kroničnim hepatitisom B pozitivnih na HBeAg bez prethodne nukleoz(t)idne terapije. Ukupno je 49 bolesnika primalo entekavir, a devetoro ih se povuklo s terapije na kraju 96. tjedna. Početna srednja vrijednost alanin aminotransferaze bila 79,4}41,5 IU /L, dok je nakon 4 godine vrijednost alanin aminotransferaze bila u normalnim granicama kod 90% bolesnika. U 96. tjednu je <300 kopija HBV DNA zabilježeno u 91,7% bolesnika, a u 48. mjesecu je 48,90% bolesnika imalo <50 IJ/mL HBV DNA. Gubitak HBeAg zabilježen je u 7,1% bolesnika u 96. tjednu te u 12,5% bolesnika u 48. mjesecu. Stopa serokonverzije HBeAg iznosila je 4,8% u 96. tjednu i 7,5% u 48. mjesecu. Stopa serokonverzije HBsAg bila je 2,1% u 96. tjednu i 2,5% u 48. mjesecu. Sigurnost terapije bila je dobra. Bolesnici su dobro podnosili entekavir, snažan i siguran lijek koji dovodi do ustaljenog suzbijanja virusa

Impact of an educational meeting on knowledge and awareness of general practitioners on upper respiratory tract infections

Objectives: This study aimed to evaluate knowledge ofprimary care physicians regarding the use of antibioticsfor the upper respiratory tract infections (URTIs) and thespecific outcomes of a health educational meeting in twocities using a self -administered questionnaire.Materials and methods: A standard questionnaire wasfilled by the participants before and after the meeting. Thequestionnaire had seven questions about definition, epidemiology,diagnosis and treatment of URTIs. The knowledgeand approaches of practitioners concern about diagnosisand antibiotic use in URTIs were evaluated. Theproportion of overall satisfied answers before and afterthe meeting was compared.Results: Totally 110 primary care physicians joined intothe study. Before the educational meeting, more than30% of participants stated that the at least 50% of thecausative agents of the URTIs are bacteria. Eighty-eightpercent declared that anaerobes or Neisseria are not theplausible causative agents in URTIs. Only 14% of them indicatedthat procaine penicillin is the primary agent for thetreatment of Streptococcus pyogenes. On the other hand,95% of survey participants considered that penicillin isthe first choice for URTI with Beta-hemolytic Streptococcus.After the educational meeting, most of participants’knowledge showed a significant improvement in knowledge.There were a significantly more correct answers toall questions after the educational meeting compared tobefore the meeting. (27.7% of doctors before vs.92.7%after, p<0.001).Conclusion: As a conclusion, attending the educationalmeetings helps primary care physicians’ to increase theirknowledge and it provides to gain a standard approach intheir professional life

Behçet disease: evaluation of clinical manifestations in Turkish children

PubMe

The Evaluation of Nasal Cultures in Patients with Hematological Malignancies During Febrile Neutropenic Episodes

Aim: Febrile neutropenia is a common complication in patients receiving cancer treatment. According to the results of several investigations, bacterial infections are the most common causes of morbidity and mortality in these patients. In this study, we aimed to determine the prevalence of nasal carriage of S. aureusin patients with febrile neutropenia, to assess the frequency of methicillin resistant S. aureus, and to compare the blood and nasal cultures in these patients. Methods: Nasal and blood cultures were performed in 51 patients with hematological malignancies during febrile neutropenic episodes. Antimicrobial susceptibilities of all S. aureus and Gram-negative strains were evaluated by disc diffusion method according to the National Committee for Clinical Laboratory Standards (NCCLS) for oxacillin and several other antibiotics. Results: In this study, blood and nasal cultures obtained between March 2006 and September 2006 were evaluated retrospectively. The overall nasal S. aureus carriage rate was 23.5%. On the other hand, of all blood cultures performed in 51 patients, nine (17.5%) were positive and the bacteria were not isolated in 87.5% of patients. The overall compliance rate of strains isolated from both blood and nasal cultures was 17.5%, while it was 11.7% when considering the status of strains resistant to antibiotics studied. Conclusion: It is concluded that, the surveillance cultures made occasionally in patients with febrile neutropenia may give an idea to the physicians in cases in which the causative pathogen cannot be determined. (The Me di cal Bul le tin of Ha se ki 2012; 50: 136-41