Bloodstream Infections by Extended-spectrum β-lactamase-producing Klebsiella Species in Children

Infections caused by resistant Gram-negative bacteria are a serious public health problem, with Klebsiella spp. being the most common cause and increasing over the years. There is a striking increase in antibiotic resistance worldwide. The aim of this study was to retrospectively evaluate the characteristics and treatment of bloodstream infections (BSIs) caused by Klebsiella spp. and to identify possible risk factors for extended-spectrum β-lactamase (ESBL) resistance in our hospital between August 2019 and March 2023. Of 250 Klebsiella isolates, 112 (44.8%) were ESBL producers and 138 (55.2%) were ESBL nonproducers. Catheter-related BSIs (CRBSIs) accounted for 49.6% of infections and were more common in the ESBL nonproducer group. Most of the Klebsiella spp. were K. pneumoniae (233/250). Most of the infections were healthcare-associated infections (85.6%). Most patients had an underlying disease, the most common underlying disease in the ESBL-producing group was neurometabolic disease (26.8%), whereas in the ESBL-non-producing group it was malignancy (35.5%). The median age of the ESBL-producing group was 14 months and was younger (p=0.01). Previous antibiotic use in the last 30 days, especially aminoglycosides (p<0.006), β-lactam-β-lactamase inhibitor combinations (p<0.001) and cephalosporins (p<0.001), increased ESBL-resistant infection. Use of β-lactam-β-lactamase inhibitor combinations in the last 30 days increased the risk of ESBL resistance by approximately 7.4 times, and cephalosporins increased the risk by 5 times. In the ESBL-producing group, the median duration of treatment was longer at 14 days (p=0.01), and carbapenems were most commonly used (p<0.001). Thrombocytopenia (p=0.003), elevated C-reactive protein (p<0.001), CRBSI (p=0.009), presence of central venous catheter (p=0.03), urinary catheter (p<0.001), mechanical ventilation (p<0.001), intensive care admission (p=0.005), previous use of carbapenems, aminoglycosides, fluoroquinolones in the last 30 days (p=0.003, p=0.001, p=0.006, respectively) and colistin treatment (p<0.001) increased the risk of mortality. The 28-day mortality rate was 11.6%. Appropriate use of narrow-spectrum antibiotics and reduction of invasive procedures is important in reducing ESBL resistance and BSI-related mortality

Human Papillomavirus (HPV) and Pregnancy; Prevalence and Diagnostic Methods

OBJECTIVE: To investigate the prevalence of Human Papillomavirus (HPV) and type detection of Human Papillomavirus as the most important causative agent of cervical cancer by PCR in pregnant women applying to Obstetrics and Gynecology outpatient clinic in Gazi Hospital. MATERIAL AND METHOD: Two hundred asymptomatic pregnant women applying to Obstetrics and 102 asymptomatic women applying to Gynecology outpatient clinic were included. HPV DNA was extracted from cervical smear samples by using phenol chloroform isoamyl alcohol and amplified by MY09/11 primers. Specific primers were used for type 16/18 detection. RESULTS: Five (2.5%) of 200 pregnant women were HPV DNA (+), two (1%) of which were type 16,two (1%) of which were type 18 and one(0.5%) of which was type 11.Two(2%) of 102 women in contol group were positive, both of which were type 16. CONCLUSION: HPV prevalence in pregnant women is lower than indicated in the literature. The probable reason may be common monogamy in Turkey and the non-smoking, young patient profile with high social and economic level in our study group. However, asymptomatic but HPV positive patients were directed to clinicians for follow-up and treatment

Human-Derived Fibrin Glue: In Vitro Antibacterial Effects and Antibiotic Permeation

Objectives: This study investigated the in vitro antibacterial efficacy and antibiotic permeation of human-derived fibrin glue (FG). Materials and Methods: FG was prepared under sterile conditions by the Blood Bank of Gazi University Faculty of Medicine. In this study, cultivations were performed in 5 main groups: Group 1 (control) - only FG; Group 2a (control) - pure Staphylococcus aureus (SA) and Group 2b (control) - pure Staphylococcus epidermidis (SE); Group 3a (control) - SA+antibiotic and Group 3b (control) - SE+antibiotic; Group 4a - FG+SA and Group 4b - FG+SE; Group 5a - FG+SA+antibiotic and Group 5b - FG+SA+antibiotic. Results: Group 1 showed no bacterial growth, whereas Group 2a and Group 2b, Group 4a and Group 4b showed bacterial growth. Group 5a and Group 5b showed no growth. Conclusion: Although FG has no antibacterial efficacy in vitro, it may be used safely due to antibiotic permeation in diseases with either infected or non-infected ocular surface that require suturing. (Turk J Ophthalmol 2014; 44: 347-50

Investigation of SARS-CoV-2 in vaginal secretions of women with coronavirus disease 2019

The present study investigates the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the vaginal swabs of female patients diagnosed with coronavirus disease 2019 (COVID-19) based on a positive real-time reverse transcription polymerase chain reaction (RT-PCR) test on a combined throat and nasopharyngeal swab