Risk of contamination of nasal sprays in otolaryngologic practice

BACKGROUND: Reusable nasal-spray devices are frequently used in otolaryngologic examinations, and there is an increasing concern about the risk of cross-contamination from these devices. The aim of our study was to determine, by means of microbiologic analysis, the safety of a positive-displacement or pump-type atomizer after multiple uses. METHODS: A reusable nasal spray bottle, pump, and tips were used in the nasal physical examination of 282 patients admitted to a tertiary otolaryngology clinic. The effectiveness of 2 different methods of prophylaxis against microbiologic contamination (the use of protective punched caps or rinsing the bottle tip with alcohol) was compared with that of a control procedure. RESULTS: Although there was no statistically significant difference in positive culture rates among the types of nasal spray bottles tested, methicillin-resistant coagulase-negative staphylococci were isolated in 4 of 198 cultures. CONCLUSION: Given these findings, we concluded that additional precautions (such as the use of an autoclave between sprays, disposable tips, or disposable devices) are warranted to avoid interpatient cross-contamination from a reusable nasal spray device

A Case of Brucellosis Presenting with Multiple Hypodense Splenic Lesions and Bilateral Pleural Effusions

Brucellosis is a zoonotic infectious disease, which mainly present with lymphoreticular system invovement. However any organ system can be attacked by the microorganism. In this paper we present a 52-year-old female patient who was admitted to the Infectious Diseases Department with complaints of fatigue, arthralgias, fever, and weight loss. In the medical examination and radiological analysis bilateral pleural effusions and hepatosplenomegaly were detected. Serum transaminase levels were two times higher than the upper limits of normal. Abdominal ultrasound revealed sludge in the gallbladder and multiple hypodense splenic lesions (the largest was 1 cm in diameter). Brucella melitensis was isolated from the blood culture of the patient. Rifampicin (600 mg/day) and doxycycline (200 mg/day) therapy was started. Follow-up chest radiography and ultrasonography revealed the absence of pleural effusion. Splenic lesions and hepatosplenomegaly were totally regressed. The patient has been followed for 3 months after 6 week antibiotic regimen without recurrence. Brucellosis was expected to be the cause of all pathological signs

Smilax Excelsa L. Ekstraktlarının Ames/Salmonella/Mikrozom Test Sistemi İle Antimutajenik Etkisinin Araştırılması

Bu çalışmada, Smilax excelsa L. yaprak ve meyve ekstraktlarının antimutajenik aktiviteleri Ames/Salmonella/mikrozom test yöntemi ile incelenmiştir.  Smilax excelsa L. yaprak ve meyve ekstraktlarının 10-100 mg/mL doz aralığında sitotoksik etki göstermediği belirlenmiştir. Antimutajenite çalışmaları S9 (+) ve S9 (-) olmak üzere Salmonella typhimurium TA98 ve TA100 suşları ile gerçekleştirilmiştir.  Maksimum antimutajenik etki yaprak ekstraktı ile 100 mg/plak dozunda TA98 suşu üzerine S9 karışımı yokluğunda %88 olarak elde edilmiştir. Ayrıca, Smilax excelsa L. bitkisinin tüm ekstraktlarının farklı oranlarda antimutajenik aktiviteye sahip oldukları belirlenmiştir

The Turkish Clinical Microbiology and Infectious Diseases Society (KLİMİK) Evidence-Based Guideline for the Diagnosis and Treatment of Brucellosis, 2023

Bruselloz, dünyada ve ülkemizde çok yaygın olarak görülmesine rağmen hastalığın tanı ve tedavisini yönlendirmede kullanılabilecek kanıta dayalı bir rehber bulunmamaktadır. Bu rehber, brusellozun tanı ve tedavisi ile ilgilenen farklı uzmanlık alanlarından hekimlere kanıta dayalı öneriler sunmak üzere Türk Klinik Mikrobiyoloji ve İnfeksiyon Has- talıkları Derneği tarafından hazırlanmıştır. Rehberin hazırlanmasında, ABD İnfeksiyon Hastalıkları Derneği (IDSA)’nin Klinik Uygulama Rehberi Geliştirme Kı- lavuzu önerileri esas alınmıştır. Rehberi hazırlayan grup üyeleri tarafından, bruselloz tanı ve tedavisinde önemli olduğu düşünülen 20 soru belirlenmiş ve PICO [hasta/popülasyon (P), müdahale/indikator (I), karşılaştırma/kontrol (C), sonuç (O)] formatında oluşturulan bu sorulara yanıt verebilecek yayınlar, ULAKBİM TR Dizin, PubMed ve Cochrane veritabanlarından, tarih kısıtlaması olmadan taranmıştır. Her bir PICO sorusu ve her bir ayrı sonlanım için kanıtların derecelendirilmesinde ve önerilerin gücünün belirlenmesinde “Grading of Recommendations, Assessment, Develop- ment and Evaluation (GRADE) Working Group” yöntemi kullanılmıştır. PICO sorularına yanıt oluşturabilecek şekilde karşılaştırmalı klinik araştırmaların olması halinde bunların meta-analizleri, olmaması halindeyse olgu sunumları ve olgu serilerinden elde edilen verilerle “individual participant data” (IPD) meta-analizleri yapılmıştır. Önerilerin yeni çalışmaların sonuçları doğrultusunda belli aralıklarla güncellenmesi planlanmaktadır.Although brucellosis is very common in the world and Türkiye, there are no evidence-based guidelines to guide the diagnosis and treatment of the disease. This guide has been prepared by the Turkish Society of Clinical Microbiology and Infectious Diseases to provide evidence-based recommendations to physicians from different specialties interested in the diagnosis and treatment of brucellosis. The recommendations of the Clinical Practice Guide Development Guide of the Infectious Diseases Society of Amer- ica (IDSA) were taken as the basis for preparing this guide. The guideline preparation group determined 20 questions considered to be important in the diagnosis and treatment of brucellosis, and the publications that could answer these questions prepared in PICO (Population/Patient [P], Intervention [I], Comparison [C], Outcome [O]) format, were searched in ULAKBİM Tr Dizin, PubMed, Cochrane databases without date restrictions. The Grading of Recommen- dations, Assessment, Development, and Evaluation (GRADE) Working Group method was used to rank the evidence and determine the strength of the recommendations for each PICO question and for each individual outcome. Me- ta-analyses of comparative clinical studies were performed to answer the PICO questions. Individual participant data (IPD) meta-analyses with data obtained from case reports and case series were conducted in the absence of comparative clinical studies. It is planned to update the recommendations at regular intervals in line with the results of new studies

The Effects of Different Drugs on Slime Production 150

ABSTRACT Objectives: Higher rate of slime production has been found in pathogen bacteria strains. Accordingly, the factors that contribute to higher slime production rate increase the infection risk, while the factors that reduce the slime production rate will reduce the infection risk. The effect of some drugs that are administered through catheters in intensive care units on slime production with coagulase negative Staphylococci was investigated. Materials and methods: In this study, the effect of four different preparations containing Glyceryl trinitrate (Perlinganit®), Dexmedetomidine (Precedex®), Esmolol (Brevibloc®), and Propofol (Propofol®) on slime production of 24 Staphylococcus epidermidis strains isolated from blood cultures of patients, and reference strain were investigated. Slime production was determined using 'the quantitative microdilution plaque test' described by Christensen. Results: Under controlled medium, eight strains formed slimes, and in the media containing esmolol, glyceryl trinitrate, dexmedetomidine, and propofol slimes were positive for five, 21, 15, and 18 strains, respectively. The rate of slime production in glyceryl trinitrate, dexmedetomidine, and propofol containing media were higher than that of the controls. Conclusions: In the light of the results of this study, it is concluded that the drugs and/or additives increase the rate of slime production. The effects of the preparations administered through catheters on slime production should be investigated, and these effects should be kept in mind during their use. Bulgular: Kontrol kuyucuklarında 8 bakteri slime oluşturdu. Esmolol içeren besi yerinde 5, Glyceryl trinitrate'lı besiyerinde 21, dexmedetomidine olan besiyerinde 15, propofol'lü besiyerinde 18 bakteri slime pozitif bulundu. Glyceryl trinitrate, dexmedetomidine ve propofolün slime pozitifliğini kontrole göre anlamlı ölçüde arttırdığı saptandı. Sonuç: Bu çalışmanın sonuçlarının ışığında; ilaç ve/ veya katkı maddelerinin slime üretimine etkili olabileceği sonucuna varıldı. Kateter yoluyla uygulanan preparatların etkileri araştırılmalı ve kullanımları sırasında bu etkilerinin olabileceği akılda tutulmalıdır. Anahtar kelimeler: Slime üretimi; koagülaz negatif Stafilokok, parenteral ilaç J S Göçmen et al. The Effects of Different Drugs on Slime Productio