Polyclonal outbreak of bacteremia caused by Burkholderia cepacia in the intensive care unit

Aim: Burkholderia cepacia is a multidrug-resistant, opportunistic pathogen of humans and outbreaks of infection in hospitals have been described. In this study, we aimed to report an outbreak in patients without cystic fibrosis or chronic granulomatous disease involving different species of Burkholderia cepacia. Material and Methods: A small outbreak of nosocomial Burkholderia cepacia complex occurred in a 6-bed intensive care unit. We isolated Burkholderia cepacia from blood cultures of the patients admitted to our intensive care unit. All isolates from patients and the environment were identified by standard microbiological techniques and VITEK system. Antibiotic susceptibility testing was performed using Kirby Bauer's disk diffusion method and the VITEK system Results: All isolates exhibited identical patterns of antibiotic susceptibility and all isolates were sensitive to trimethoprim-sulfamethoxazole, ceftazidime and meropenem. The isolates were typed using pulsed-field gel electrophoresis using the restriction enzymes XbaI and SpeI. Accordingly, while 4 strains were similar, one was different. Discussion: The experience from this outbreak reminded us of the importance of outbreak investigation in such small outbreaks and keeping the health care workers educated and constant attention on this issue. The results of this study emphasized once again the necessity to maintain our sensitivity to the basic principles of sanitation and to raise our awareness of such outbreaks

Strain relatedness in gram-negative bacteremia: Cause or contamination?

Aim: Bloodstream infections are a major cause of mortality, 25% of which are associated with gram-negative bacteremia. To avoid the inappropriate use of antibiotics, it is important to differentiate the bacteremia from contamination. In general, gram-positive bacteria were more likely to be contaminants than gram-negative-bacteria. There is little information in the literature concerning the epidemiology of gram-negative bacteria isolated from sequential blood cultures. Therefore, we aimed to examine the molecular epidemiology of gram-negative bacteria isolated from sequential blood cultures. Material and Methods: A total of 56 patients (112 samples and strains) with two or more sequential positive blood cultures for gram-negative bacteria with the same antibiogram were included in the study. Pulsed-field gel electrophoresis (PFGE) and arbitrarily primed PCR (AP-PCR) were performed for the determination of strain relatedness. Results: While PFGE analysis demonstrated relatedness in 6 isolates, AP-PCR demonstrated 9 relatedness in 112 isolates. Discussion: The results of our study suggest that, although the possibility of contamination is very low in gram-negative bacteremia, this can still take place, as shown in sequential blood cultures with the same antibiogra

Distribution and antimicrobial susceptibilities of stenotrophomonas maltophilia strains ısolated from various clinical samples: an 8-year study

Amaç: Hastane enfeksiyonları ve buna bağlı mortalitenin artması çoklu ilaç direncine sahip fırsatçı patojenleri her zamankinden daha fazla gündeme getirmiştir. Bunlar arasında yer alan stenotrophomonas maltophilia önemi giderek artan fırsatçı bir patojendir. Bu çalışmanın amacı,sekiz yıllık süre boyunca hastanemizde çeşitli klinik örneklerden izole edilmiş S. maltophilia izolatlarının dağılımını ve antimikrobiyal duyarlılıklarını araştırmaktır. Yöntemler: Ocak 2011-Aralık 2019 tarihleri arasında çeşitli klinik örneklerden izole edilen toplam 149 S. maltophilia suşunun antimikrobiyallere direnç oranları araştırıldı. Bakteri identifikasyonu ve antibiyotik duyarlılığı rutin konvansiyonel mikrobiyolojik yöntemler ve VİTEK 2 kompakt otomatize sistem (BioMerieux, France) ile yapılmıştır. Bulgular: S. maltophilia en sık yoğun bakım ünitelerinde izole edilirken 50 (%33,5), en az 1 örnekle ( %0,6) Kardiyovasküler cerrahi servisi, Pediatri servisinden izolasyon gerçekleşmiştir. Örneklerin 85’i (%57,) solunum yolu izolatları olurken (trakeal aspirat, lavaj, balgam), en az 1 örnek ( %0,6) ile plevra ve eklem sıvısı olmuştur. Karbapenemlere doğal direnç gösteren S. maltophilia’da levofloksasin direnci % 6 iken, trimetoprim/sulfametoksazol’de %12, seftazidim’de %45 olarak tespit edilmiştir. Tartışma ve Sonuç: Çalışmada saptanan yüksek direnç oranları nedeniyle, S. maltophilia suşlarının etken olduğu nozokomiyal enfeksiyonların tedavisinde mümkün olduğunca in vitro duyarlılık testlerinin yapılması gerekir. Bunun yapılamadığı durumlarda ise tedavi planlamasında trimetoprim-sulfametoksazol ve levofloksasin iyi birer tedavi seçeneğidir. Ayrıca tedaviye başlamadan önce kolonizasyon - etken ayrımı klinik bulgularda göz önünde tutularak birlikte karar verilmelidirObjective: Hospital infections which associated with increased mortality have brought opportunistic pathogens like Stenotrophomonas maltophilia, with multiple drug resistance into focus. The aim of this study was to investigate the distribution and antimicrobial susceptibility of S. maltophilia isolates obtained from various clinical samples in our hospital for a period of eight years. Method: Antimicrobial resistance rates of 149 strains of S. maltophilia isolated from various clinical samples between January 2011 and December2019 were investigated. Bacterial identification and antibiotic susceptibility were performed with routine conventional microbiological methods and the VITEK 2 compact automated system (BioMerieux, France). Results: While S. maltophilia was most frequently isolated in intensive care units, from a total of 50 samples (33.5%), the rate was 0.6% (1 sample) the cardio vascular surgery service and pediatrics services. 85 (57%) of the samples were respiratory tract isolates (tracheal aspirate, lavage, sputum) with at least 1 (0.6%) pleural and joint fluid. Among these isolates of S maltophilia, which shows natural resistance to carbapenems, resistance for levofloxacin was 6% and for trimethoprim/ sulfamethoxazole was 12%. Conclusion: Due to the high resistance rates observed in the study, in vitro susceptibility tests should be used as much as possible in the treatment of nosocomial infections caused by S. maltophilia strains. In cases where this is not possible and empirical treatment is required, trimethoprim-sulfamethoxazole and levofloxacin are reasonable treatment options. Also, before starting treatment, the separation between colonization and agent should be decided in accordance with the clinical findings

Skin diseases in tea collectors

International audiencemars 2013 - mars 201

The role of protozoa in the etiology of chronic urticaria

Background: Urticaria is a condition characterized by short-lived swellings of the skin, mouth, and genitalia due to transient leakage of plasma from small blood vessels into the surrounding connective tissues. Although infectious agents such as bacteria and virus causing acute urticaria have been reported previously, very little research has been carried out to understand the relationship between parasitosis and urticaria. This study was designed to contribute to the understanding of the relationship between parasitosis and urticaria. Methods: A total of 49 patients with chronic urticaria and 36 healthy participants were included in the study. Three stool samples were taken from each patient on different days before treating the patients with antiparasitic drugs. Fecal parasite concentrator and native Lugol's method were used for the microscopic examination of the stool samples. Stain samples were prepared by acid fast and modified trichrome stain methods. Serum immunoglobulin E (IgE) levels of both groups were measured using the nephelometric method. Results: Our results revealed that protozoa were detected in 38.8% of patients and in 11.1% of healthy participants. There was a fourfold increase in the total serum IgE levels of patients detected with protozoa when compared with patients in whom protozoa were not detected. Conclusion: In patients who have urticaria with undetectable etiology, stool parasite screening would be prudent and identification of parasite-specific IgE in patients with urticaria would be useful in defining the mechanisms by which the parasite causes these lesions

The relationship between severity of the disease and circulating nucleosomes in psoriasis patients

WOS: 000322029100004PubMed: 23567920Psoriasis was initially considered to represent a disease of abnormal epidermal keratinocyte proliferation. Proliferation of keratinocytes is restricted by apoptotic cell death to maintain a constant thickness of epidermis. Nucleosomes are mainly released by apoptotic cells. Tumor necrosis factor-alpha (TNF-alpha) is an important factor affecting the apoptosis. in the present study, the relationship between TNF-alpha, nucleosome and the Psoriasis Area and Severity Index (PASI) score was investigated. the patients were divided according to PASI score into three groups (mild, moderately, severe). Serum TNF-alpha and nucleosome levels were measured using Enzyme-linked immunosorbent assay (ELISA) method. Our findings show a correct relationship between PASI scores and TNF-alpha and an inverse relationship between nucleosome and PASI score. According to the results obtained from the study, we believe that serum nucleosome levels can be used as a new indicator in follow-up of patients with psoriasis and monitoring of the effectiveness of drugs which used in the treatment of psoriasis

Epidermoid cyst on the nipple: a rare location

WOS: 000332600200016PubMed: 24405334A 27-year-old woman presented to our department with a small, painful, white, soft tissue growth on the nipple of her right breast