Vancomycin and high-level aminoglycoside resistance in Enterococcus species

The aim of the study was to investigate vancomycin and high-level aminoglycoside resistance (HLAR) in Enterococcus species by phenotypic and genotypic methods. A hundred Enterococcus strains were included in the study. Antimicrobial susceptibilities of strains were investigated by automated system, betalactamase production was investigated by nitrocefin disks, vancomycin resistance and HLAR were investigated by gradient diffusion method (GDM) and disk diffusion method, respectively. For detection of vancomycin and high-level gentamicin resistance (HLGR) genes, polymerase chain reaction was used. Teicoplanin linezolid, vancomycin, ampicillin, penicillin are the most susceptible antibiotics and strains were detected not to produce beta lactamase. Vancomycin resistance was detected in ten isolates by automated system and in only five isolates by GDM. Five isolates carrying VanA gene were determined. The ratio of HLGR and high-level streptomycin resistance was found 40 and 63% respectively. aac (6’)-1eaph (2’’)-1a gene was detected in 58% of strains. E. faecium strains were found more resistant to the antibiotics than the other species. Beta lactamase was detected in none of strains. The automated system detected vancomycin resistance in more strains than GDM. Therefore it is concluded that strains, which were detected to be resistant to vancomycin, should be confirmed by GDM. The ratio of VanA gene in strains is consistent with other studies. The HLAR ratio was found in about half of strains. The ratio of aac(6’)-1e-aph(2’’)-1a gene, which is the most reported gene in our country and other countries and one of the HLGR genes investigated in our study, was detected 58%

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Serological evaluation of HSV-1 and HSV-2 infection in pregnancy

We performed a serological evaluation of herpes simplex virus (HSV) infections at the time of labor. In order to determine the seroprevalence of asymptomatic HSV infections in pregnant women, blood samples were collected for antibody measurement from 130 randomly selected pregnant women. Presence of HSV IgG and IgM antibodies in the serum samples was tested by ELISA. The prevalence of HSV-1 gG1 antibodies was 90% (117/130), that of HSV-2 gG2 antibodies was 63.1% (82/130) and that of HSV-2 IgM antibodies was 13.8% (18/130). Eight (44.4%) of the pregnant women with HSV-2 IgM were at the same time found to have HSV-2 IgG antibodies, and 10 (55.6%) women were determined to have HSV-2 IgM antibodies. Furthermore, 6 (4.6%) out of the 130 pregnant women were seronegative for HSV. In conclusion, the results of our study show that the prevalence of HSV-2 infection (63.1%) is relatively high among asymptomatic pregnant women in Adana, Turkey. Therefore, to take precautions for reducing the risk of neonatal herpes, the investigation of HSV-2 type specific antibodies in pregnant women should be offered by using HSV-2 gG2 type specific serological tests that allow the identification of women with asymptomatic or subclinical genital HSV-2 infection and women susceptible to primary genital HSV-2 infection.We performed a serological evaluation of herpes simplex virus (HSV) infections at the time of labor. In order to determine the seroprevalence of asymptomatic HSV infections in pregnant women, blood samples were collected for antibody measurement from 130 randomly selected pregnant women. Presence of HSV IgG and IgM antibodies in the serum samples was tested by ELISA. The prevalence of HSV-1 gG1 antibodies was 90% (117/130), that of HSV-2 gG2 antibodies was 63.1% (82/130) and that of HSV-2 IgM antibodies was 13.8% (18/130). Eight (44.4%) of the pregnant women with HSV-2 IgM were at the same time found to have HSV-2 IgG antibodies, and 10 (55.6%) women were determined to have HSV-2 IgM antibodies. Furthermore, 6 (4.6%) out of the 130 pregnant women were seronegative for HSV. In conclusion, the results of our study show that the prevalence of HSV-2 infection (63.1%) is relatively high among asymptomatic pregnant women in Adana, Turkey. Therefore, to take precautions for reducing the risk of neonatal herpes, the investigation of HSV-2 type specific antibodies in pregnant women should be offered by using HSV-2 gG2 type specific serological tests that allow the identification of women with asymptomatic or subclinical genital HSV-2 infection and women susceptible to primary genital HSV-2 infection

Primer tavşan böbrek hücre kültürünün krioprezervasyonu

TEZ2445Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 1997.Kaynakça (s. 60-65) var.66 s. : rnk. res. ; 30 cm.

Doğum sırasında annelerde HSV enfeksiyonu insidansının araştırılması

TEZ3883Tez (Doktora) -- Çukurova Üniversitesi, Adana, 2001.Kaynakça (s.56-63) var.x, 63 s. ; 29 cm.…Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi Tarafından Desteklenmiştir. Proje No: SBE2000D10

Hemodiyaliz hastalarının boğaz kültürlerinin ve antibiyotik duyarlılıklarının değerlendirilmesi

Amaç: Bu çalışmada, hemodiyaliz hastalarının boğaz kültürlerinin değerlendirilmesi, bu hastalardan izole edilen patojen mikroorganizmaların oranı ve bunların antibiyotik duyarlılıklarının tespit edilmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada, Antakya'da bulunan üç hemodiyaliz merkezinde 267 hemodiyaliz hastasından alınan boğaz sürüntü örnekleri incelenmiştir. Çalışma Haziran 2004. Eylül 2004 tarihleri arasında yapılmıştır. Hemodiyaliz hastalarından izole edilen patojen mikroorganizmalar ve onların antibiyotik direnç paternleri tespit edilmiştir. Duyarlılık testleri National Committee for Clinical Laboratory Standards (NCCLS) tarafından önerilen disk difüzyon yöntemiyle yapılmıştır. Bulgular: Çalışmada, toplam 267 hemodiyaliz hastasının 230'unda normal boğaz florasına ait mikroorganizmlar tespit edildi. Bununla birlikte 37 hastada çeşitli patojen mikroorganizmalar tespit edildi. Bunların 15'i çeşitli Gram negatif bakterilerdi. Bu 15 izolatın 6'sı Escherichia coli, l'i Acinetobacter baumannü, 2'si Enterobacter spp., l'i Pseudomonas cepacia, 3'ü Pseudomonas aeruginosa, l'i Citrobacter freundü ve l'i de Klebsielhı spp. idi. Bunun yanında 11 hastada Staphylococcus aııreus, 1 hastada da beta hemolitik streptokok ürediği görüldü. Bunlardan başka, 9 hastada da Candida spp. boğaz florasında dominant mikroorganizma olarak üredi. Boğaz kültüründe normal flora üremesi görülen hemodiyaliz hastaları ile, boğaz kültürlerinde patojen mikroorganizma üremesi görülen hemodiyaliz hastalarının hemodiyaliz tedavi süreleri arasında istatiksel olarak anlamlı bir farkın olduğu tespit edildi (p<0.05). Sonuç: Uzun süre hemodiyaliz tedavisi alan hastaların boğaz kültürlerinin atipik olduğu tespit edilmiştir. Bununla birlikte bu hastalardan izole edilen bakterilerin antibiyotik dirençlerinin oldukça yüksek olduğu tespit edilmiştir. Bizim sonuçlarımız hemodiyaliz hastalarında oral floranın hemodiyaliz hastaları için bir enfeksiyon kaynağı olabileceğini göstermiştir.Objective: The aim of this study was to evaluate the throat cultures of haemodialysis patients, and to determine the pathogen microorganisms and their antibiotic sensitivities. Methods: In this study we investigated the throat swab samples of 267 haemodialysis patients in the three haemodialysis centers in Hatay. This study was carried out between June 2004 and September 2004. The pathogen microorganisms that were isolated from haemodialysis patients and their antimicrobial resistance patterns were determined. Susceptibility tests of isolates were performed according to disc diffusion method recommended by National Committee for Clinical Laboratory Standards (NCCLS). Results: The microorganisms/belonged to normal throat flora were determined in/ 230 of 267 haemodialysis patients. Nevertheless, various pathogen microorganisms weTreaetermined in 37 haemodialysis patients. Fn 15 of them, Gram negative bacteria from various specieses were isolated. lischerichia coli, Acinetobucter baumannii, Enterobacter spp., Pseudomonas cepacia, Pseudomonas aeruginosa, Citrobacter freundii, Klebsiella spp. which are all pathogens were isolated in 6, 1, 2, 1,3, 1, 1 of 15, respectively. In addition, Staphylococcus aureus in 11 patients and beta hemolytic streptococci in 2 patients were reproduced. Besides this, in 9 patients, Candida spp. was detected as a predominant microorganism of the patients' throat flora. A significant correlation was found between the haemodialysis duration in the patients having an alteration in the throat flora and the haemodialysis duration in the patients having no alteration in the throat flora (p&lt;0.05). Conclusion: The throat flora of the patients receiving haemodialysis treatment for a long period were determined to be atypical. In addition, the rates of antibiotic resistance of the isolated bacteria jfrom these patients were found to be quite high. Our results support that the oral flora of the haemodialysis patients might be a source of infection for haemodialysis patients

THE RELATIONSHIP BETWEEN ENTEROBIUS VERMICULARIS INFECTION AND NOCTURNAL ENURESIS

Aim: The possible association between certain childhood infections and the propensity to develop nocturnal enuresis may include intestinal helminth infections. Objective: To explore the association between Enterobius vermicularis and nocturnal enuresis among children 4 to 7 years of age in a Turkish orphanage. Methods: Eighty children (45 boy, 35 girl, age range 4-7 years) participated in this study. The association between Enterobius vermicularis and enuressis was investigated after mebendazole therapy in the children with Enterobius vermicularis infection. The occurrence of Enterobius vermicularis was examined by adhesive cellotape anal swap method. Results: The occurrence of Enterobius vermicularis was examined by perianal tape tests in 80 children. Total egg positivity rates of Enterobius vermicularis were 71.3% (57/80). The egg positivity rates of boys and girls were 75.6% (34/45) and 65.7% (23/35), respectively. Total enuresis rate was 51.3% (41/80), and 60% (27/45) of the boys and 40% (14/35) of girls had enuresis. After the mebendazole therapy, while the total egg positivity rate of Enterobius vermicularis was 33.8% (27/80), this ratio was 35.6% (16/45) for boys and 31.4% (11/35) for girls. While before the mebendazole therapy, total enuresis rate was 51.3% (41/80), after the therapy it was was found to be 28.8% (23/80) in children. Conclusion: In this study, it was shown that Enterobius vermicularis infection was quite prevalent among orphan children in Antakya. Besides this, the results indicate that nocturnal enuresis could be more frequent in children with Enterobius vermicularis disease. It was concluded that nocturnal enuresis may be related with pinworm infestation

Rahim içi araç kullanımı ve Trichomonas vaginalis sıklığı arasındaki ilişkinin araştırılması

Objectives: We investigated the association between the frequency of Trichomonas vaginalis and using intrauterine contraceptive device (IUD). Patients and Methods: A total of 1058 vaginal swab samples were collected. The study population included 402 symptomatic and 656 asymptomatic women, between 18-45 years of age. Specimens were taken with a speculum and sterile cotton swabs from the posterior fornix of the vagina. Wet mount preparations were examined first, and then inoculated into Trypticase-yeast extract-maltose medium. Results: T. vaginalis was determined in 35 (3.31%) samples out of 1058 specimens using both diagnostic methods (direct examination and/or culture). While a total of 402 women were symptomatic, 656 women were asymptomatic. Among 190 IUD users, the frequency of T. vaginalis was determined as 6.84%, and among 868 non-users, this ratio was determined as 2.53%. Moreover, while among 100 symptomatic women with IUD, 11 women were positive for T. vaginalis (11%), of the 302 symptomatic women without IUD, 17 were positive (5.63%) for T. vaginalis. Significant correlation was determined between the use of IUD and the presence of T. vaginalis (p&lt;0.05). Conclusion: These results showed that IUD use may increase the growth of T. vaginalis in the vaginal mucosa. To reduce the incidence of this pathogen in IUD users, they should be followed up closely.Amaç: Bu çalışmada rahim içi araç (RİA) kullanımı ve Trichomonas vaginalis sıklığı arasındaki ilişki araştırıldı. Hastalar ve Yöntemler: Toplam 1058 vajinal sürüntü örneği toplandı. Çalışmaya dahil edilen kadınların 402'si semptomatik, 656'sı asemptomatik olup yaşları 18-45 arasındaydı. Steril eküvyon ile vajina arka forniksinden alınan örnekler, Trypticase-yeast extract-maltose besiyeri içine alınarak direkt bakı ve kültür yöntemi ile incelendi. Bulgular: Direkt bakı ve kültür yöntemi ile incelenen 1058 örneğin 35'inde (%3.31) T. vaginalis saptandı. Kadınların 402'si semptomatik infeksiyonlu iken, 656'sı da asemptomatikti. RİA kullananlar arasında T. vaginalis sıklığı %6.84 olarak bulunurken, RİA kullanmayan kadınlar arasında bu oran %2.53 olarak saptandı. Bunun yanında RİA kullanan 100 semptomatik kadın arasında arasında T. vaginalis sıklığı %11 olarak bulunurken, RİA kullanmayan 302 semptomatik kadında T. vaginalis varlığı %5.63 olarak bulunmuştur. RİA kullanımı ile T. vaginalis varlığı arasında anlamlı bir korelasyon olduğu saptanmıştır (p<0.05). Sonuç: Bu sonuçlar RİA kullanımının vajinal mukozada T. vaginalis'in üremesini artırdığını göstermektedir. Bu patojenin RİA kullanıcıları arasında ortaya çıkmasını azaltmak için RİA kullanıcıları yakından takip edilmelidir