Genişlemiş Spektrumlu Beta Laktamaz Üreten Escherichia coli'nin Neden Olduğu Üriner Sistem İnfeksiyonlarında Aynı Etkenin Dışkıda Taşıyıcılığının Saptanması: Araştırma Makalesi

Introduction-Objective: We aimed to determinate the risk factors, contribution of fecal carriage to the infection and precautions to be taken in the prevention of infection in (+) E. coli-induced UTIs in urinary tract infections (UTI) caused by ESBL (+) E. coli Method: This study was designed as a single-center, prospective and cross-sectional. 64 patients between the ages of 18-79 who were hospitalized and ESBL(+) E.coli isolated in their urine culture were included. Stool samples taken from the patients (0,3,5 and 7 days) were inoculated on EMB agar containing cefotaxime and ceftazidime and IMVIC was used to identify colonies. Strains determined as E. coli according to their reproductive characteristics were included in the study. Phenotypic confirmation tests for the detection of ESBL(+) strains. Genotyping was performed using the ERIC PCR method. Descriptive statistics were expressed as numbers and percentages. Chi-square and trend chi-square tests were used for analytical comparisons. A P value of <0.05 was considered statistically significant. Results: Of the 64 patients 40 (62.5%) were female and the mean age was 56.5 ± 17.5 (18-79). 47 (69%) were diagnosed with CA- UTI, and 17 (31%) with HA-UTI. Having more than three episodes per year and presence of a foreign device were found to be a risk factor for CA- ESBL (+) E. coli-induced UTI (p:0.035and 0.006). It was found that faecal colonization of ESBL (+) E. coli persisted in 15 (23%) of 64 patients after UTI treatment, and, of them 20% (n: 3) was in the same phylogenetic class with the ERIC PCR method. Faecal colonization was found to be significantly higher in patients with invasive intervention in the previous year (p:0.037). Conclusion: Unnecessary antibiotic use should be avoided due to resistant infections and increased colonization. The importance of fecal colonization in infections with ESBL-producing bacteria (especially UTI) has been demonstrated in studies. More prospective studies are needed to understand the epidemiology of ESBL enzyme types.Giriş-Amaç: GSBL (+) E. coli’nin neden olduğu ÜSİ’de aynı etkenin dışkı kolonizasyonunun ve hem idrar hem de dışkı izolatlarından elde edilen fenotipik olarak benzer etkenlerin moleküler olarak birbirleriyle benzerliklerinin araştırılması ve GSBL (+) E. coli kaynaklı ÜSİ’ lerde risk faktörleri, fekal taşıyıcılığın infeksiyona katkısı ve infeksiyonun önlenmesinde alınması gereken önlemlerin belirlenmesi amaçlanmıştır. Yöntem: Tek merkezli, ileriye dönük, kesitsel çalışmada idrar kültüründe GSBL üreten E.coli izole edilen, 18-79 yaş aralığında 64 hasta çalışmaya dahil edildi. Hastalardan alınan dışkı örnekleri sefotaksim ve seftazidim içeren içeren EMB agara ekildi ve Enterobacteriaceae ailesine ait kolonilerin identifikasyonunda IMVIC testi kullanıldı. Üreme özelliklerine göre E. coli olarak belirlenen suşlar çalışmaya alındı. GSBL taşıyan kökenlerin tespiti için fenotipik doğrulama testleri ve DNA izolasyonu için ERIC PCR yöntemi kullanıldı.Tanımlayıcı istatistikler sayı ve yüzde olarak ifade edildi. Analitik karşılaştırmalar için ki-kare ve trend ki –kare testleri kullanıldı. p<0.05 değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: 64 hastanın 40’ı (%62.5) kadın ve yaş ortalaması 56.5 ± 17.5 (18-79) idi. Hastaların 47 (%69)’ si TK 17 (%31)’ si ise HK-ÜSİ tanısı almıştı.Yılda üçten fazla ÜSİ atağı geçirmek ve yabancı cisim bulunması TK- GSBL (+) E. coli’ ye bağlı ÜSİ için risk faktörü olarak bulunmuştur (p:0.035 ve 0.006). 64 hastanın 15 (%23)’inde ÜSİ tedavisi sonrası GSBL (+) E. coli’nin fekal kolonizasyonunun persiste ettiği ve bunların üç (%20)’ ünün dışkı ve idrar izolatlarının aynı filogenetik sınıfta olduğu bulunmuştur. Son bir yılda invazif girişim varlığı olanlarda fekal kolonizasyon anlamlı olarak yüksek saptanmıştır (p:0.037). Sonuç: Dirençli infeksiyonlar ve kolonizasyon artışı nedeni ile gereksiz antibiyotik kullanımı önlenmelidir. GSBL üreten bakterilerle meydana gelen infeksiyonlarda fekal kolonizasyonun önemi ve GSBL enzim tiplerinin epidemiyolojisinin anlaşılabilmesi için ileriye dönük daha büyük çalışmalara ihtiyaç vardır

Evaluation Of Mueller-Hinton Agar For Germ Tube Test

Aims: The aim of this study is to evaluate Mueller-Hinton Agar (MHA) as a simple medium for the determination of germ tube test (GTT).Methods: A total of 86 Candida species isolated from different clinical specimens were included. All isolates were cultured onto Sabouraud Dextrose Agar (Salubris, Turkey) and incubated at 37°C for 24-48 hours. They were identified by VITEK MS (Biomérieux, France). For serum GTT, a single Candida colony was inoculated into 0.5 ml freshly obtained human serum. For MHA GTT, an inoculum of single colony was streaked by Dalmau technique onto MHA and covered by a sterile coverslip. After incubation at 37°C for 1.5 h and 3 h, all sera and MHA plates were examined using a light microscope. Serum GTT was accepted as gold standard method for the determination of sensitivity and specificity values.Results: The identification results were as follows: 51 Candida albicans, one C. dubliniensis, 12 C. parapsilosis, 12 C. glabrata, 4 C. kefyr, 3 C. tropicalis, 3 C. krusei. Serum GTT was positive in 30 (58.8%) and 36 (70.6%) of C. albicans isolates at 1.5 h and 3 h, respectively. MHA GTT was positive in 21 (41.2%) and 40 (78.4%) of C. albicans isolates at 1.5 h and 3 h, respectively. All non-albicans species except C. dubliniensis were found as negative using both tests. Both GTTs were positive for C. dubliniensis at 1.5 h and 3 h. MHA sensitivity and specificity was determined as 58% and 92% at 1.5 h; 86% and 81% at 3 h, respectively.Conclusions: MHA is safer and easier medium for GTT that may be used as alternative to serum GTT. The evaluation of GTT on MHA after 3 h incubation is recommended since it has higher sensitivity compared to 1.5 h

In-vitro activities of imipenem–colistin, imipenem–tigecycline, and tigecycline–colistin combinations against carbapenem-resistant Enterobacteriaceae*

© 2018, © 2018 Edizioni Scientifiche per l'Informazione su Farmaci e Terapia.The aim of the study is to determine in-vitro effects of imipenem–tigecycline, imipenem–colistin and tigecycline–colistin against carbapenem-resistant Enterobacteriaceae (CRE) isolates. A total of 25 CRE isolates were included to the study. The minimum inhibition concentrations of imipenem, colistin-sulphate and tigecycline were determined with broth dilution method. Synergistic effects of imipenem–tigecycline, imipenem–colistin and tigecycline–colistin were investigated by microdilution checkerboard technique. All of the isolates were resistant to imipenem, whereas 25% of the isolates were resistant to colistin and tigecycline. Imipenem–colistin, imipenem–tigecycline and tigecycline–colistin combinations were synergistic against 40% (10/25), 24% (6/25), and 36% (9/25) of the isolates, respectively. Antagonism was observed in 8% (2/25) of the isolates in tigecycline–colistin combination. Tigecycline–colistin was the most effective (70% synergy) combination in Klebsiella spp. strains; whereas imipenem–colistin was the most effective (75% synergy) combination in Escherichia coli strains. Synergistic effect was variable and strain-depended against CRE isolates that have been tested

Occupational Risks of Podologists: A Combined Assessment of VOCs, Vibration, Noise Levels and Health Complaints

Podologists are exposed to many occupational hazards, including volatile organic compounds (VOCs) from insole manufacturing and noise/vibration during nail or tissue grinding. In this study, VOCs, noise, and vibration were measured in five podiatry clinics and three offices. Questionnaires were administered to 23 podologists and 19 office workers to inquire about their pain, ocular, skin and respiratory complaints. The results showed that the podologists’ exposure to the total VOC concentrations was approximately twice as high as that of the office workers. The podologists’ complaints regarding pain were found to be correlated with ambient noise and hand-arm vibration levels. Ocular, skin, and respiratory complaints were also found to be correlated with total VOC concentrations. These results suggest that VOCs, noise and vibration in the working environment may impair podologists’ health and that they have an intensifying effect on each other, increasing the severity of health issues.</p