Post-ERCP bacteremia caused by Alcaligenes xylosoxidans in a patient with pancreas cancer

Alcaligenes xylosoxidans is an aerobic, motile, oxidase and catalase positive, nonfermentative Gram negative bacillus. This bacterium has been isolated from intestine of humans and from various hospital or environmental water sources. A.xylosoxidans is both waterborne and results from the poor-hygienic conditions healthcare workers are in. In this case report, the bacteremia which appeared in a patient with pancreas cancer after ERCP was described

Total hip arthroplasty performed in secondary hip osteoarthritis caused by hartofilakidis type 2 and type 3 developmental dysplasia of the hip; evaluation of outcomes and comparison of clinical scores of these two types

The aim of this study was to evaluate the outcomes of Total hip arthroplasty (THA) performed for hip osteoarthritis caused by Hartofilakidis type 2 and 3 developmental dysplasia of the hip (DDH) and to compare these two types in terms of clinical scores. Thirty-six hips of thirty patients who suffered from hip osteoarthritis caused by DDH and who underwent THA operations from January 2005 to May 2010 were included in the study. In the case of insufficient coverage of the acetabular cup, roof reconstruction was performed using femoral head autografts. Subtrochanteric transverse femoral osteotomy was performed when required. Clinical evaluations were performed using Harris Hip Score (HHS). 3 male and 27 female patients were included in this study. Mean age was 57.2 (25-76) years. Mean follow up time was 34.3 (1265) months. 24 hips were classified as Hartofiladikis type 2, and 12 as type 3. HHS was 43.2 (38-54) points and 90.1 (76-96) points at the preoperative and postoperative last control visits, respectively (p [Med-Science 2018; 7(2.000): 378-82

Incidence and Risk Factors for Intravascular Catheter-Related Infections

Introduction: Intravascular catheters, which are among the indispensable procedures of medical practice, are the leading cause of nosocomial infections, particularly in intensive care units. In our study, we aimed to determine the rates of intravascular catheter-related infections, risk factors and causative microorganisms. Materials and Methods: Patients admitted to the Karadeniz Technical University Faculty of Medicine Hospital between October 2003- November 2004 were followed prospectively in terms of infections and risk factors associated with intravascular catheters. Results: A total of 770 intravascular catheters inserted in 434 patients were followed for 11.385 catheter days. Overall, 116 catheter-related infections (CRIs) were determined. The rate of CRI was 10.2, and the rate of CR-blood stream infection (BSI) was 6.4. In the multivariate analysis of risk factors affecting the development of CRI, independent factors causing an increase were found to be high Acute Physiology Assessment and Chronic Health Evaluation (APACHE) II scores (OR = 1.07, 95% CI = 1.02-1.13; p< 0.0005), prolongation of the duration of catheterization (OR = 1.03, 95% CI = 1.02-1.04; p< 0.0005), use of anti-pseudomonal penicillin before and during the catheterization (OR = 4.5, 95% CI = 1.85-10.96; p< 0.0005), use of quinolones (OR = 3.1, 95% CI = 1.04- 9.13; p= 0.038), use of the catheter for total parenteral nutrition purposes (OR = 3.9, 95% CI = 2.17-7.05; p< 0.0005) or for hemodialysis purposes (OR = 6.3, 95% CI = 3.28-11.96; p< 0.0005), insertion of the catheter under emergency conditions (OR = 5.02, 95% CI = 2.65-9.49; p< 0.0005), and insertion of the catheter by inexperienced healthcare staff (OR = 1.9, 95% CI = 1.10-3.35; p= 0.030). Maintenance of hand hygiene during the insertion of the catheter and taking the maximum barrier precautions reduced the rate of CRI by 87% and 58%, respectively (OR = 0.13, 95% CI = 0.07-0.24, p< 0.0005; OR = 0.42, 95% CI = 0.24-0.73; p< 0.0005, respectively). The causative microorganisms isolated in CRIs were gram-positive microorganisms in 69 (58.5%), gram-negative microorganisms in 41 (34.8%) and Candida spp. in 8 (6.8%) of the patients. Conclusion: Our study shows that taking certain precautions against risk factors including hand washing, higher level barrier precautions, and frequent manipulation will reduce the incidence of CRIs. Furthermore, hospital staff should be well informed about catheter insertion and care in conformity with the rules of antisepsis and about intravascular CRIs

Evaluation of 32 Episodes of Infective Endocarditis

In spite of developments in the diagnosis and management of infective endocarditis, this disease still carries high rates of morbidity and mortality. Between 1997-2001, 32 episodes of endocarditis in 30 patients were treated in our department. Twenty-two patients were male and eight female; their ages ranged from 21-84 (mean years). Of these episodes 78% associated with native valve and 21% with prosthetic valve. Fever, fatigue, chills, dyspnea were the most common clinical findings. Blood cultures were positive in 78.1% (25/32) of the episodes, revealing Staphylococcus spp. (12), Streptococcus spp. (6), Enterococcus spp. (3), Stenotrophomonas maltophilia (2), Pseudomonas aeruginosa (1), Listeria spp. (1). During follow-up 34.3% of the episodes were complicated by emboli and the overall mortality rate was 40.6%. The presence of congestive heart failure was found as the major risk factor affecting the prognosis of the disease. In view of this grave outcome of this disease, prompt diagnosis and medical therapy and when indicated early surgical intervention is essential

Antimicrobial susceptibility of Brucella melitensis isolates from blood samples

WOS: 000256861200012Aim: Brucellosis is a worldwide zoonotic disease that remains an important public health problem in rural Turkey. The aim of the present study was to identify Brucella, species and biotypes, and to assess the antimicrobial susceptibility of isolates from blood samples. Materials and Methods: The study included 46 Brucella isolates from the Kirikkale region of central Anatolia. The identification and biotyping of the isolates were based on conventional methods. The minimal inhibitory concentration (MIC) values of tetracycline, rifampin, streptomycin, ciprofloxacin, and azithromycin were determined using the E test method. Results: All isolates were identified as B. melitensis (45 isolates, biotype-3) and were sensitive to tetracycline, streptomycin, ciprofloxacin, and azithromycin. In all, 2 isolates showed intermediate sensitivity to rifampin, whereas the others were sensitive. MIC90 values of tetracycline, streptomycin, rifampin, ciprofloxacin, and azithromycin were 0.25 mg/l, 0.50 mg/l, 1.0 mg/l, 0.25 mg/l, and 1.0 mg/l, respectively. Conclusions: In recent years there has been tremendous interest in the identification of Brucella strains and their antimicrobial susceptibility. According to antimicrobial susceptibility test results, none of the isolates in the Kirikkale region of Turkey were resistant to the currently recommended antibiotics. The present study's findings were discussed along with a brief review of similar studies from Turkey