A surveillance of nosocomial candida infections: epidemiology and influences on mortalty in intensive care units

Introduction: it was aimed to investigate the frequency of Candida infections (CI) in the intensive care units (ICU), to determine typing of candida to evaluate risk factors associated with CI and mortality, and to evaluate influence of CI on mortality. Methods: the prospective cohort study was carried out between Jan 1, 2009 and Dec 31, 2010 in ICUs, and the patients were observed with active surveillance. VITEK 2 Compact System (BioMerieux, France) kits were used for the identification of isolates from various clinical samples. Results: a total of 2362 patients had enrolled for 16135 patients-days into the study. During the study, 63 (27,5%) of patients developed 77 episodes of CI were observed. Of the patients; 54% were male, 46% were female. Duration of hospitalization (OR=1,03, p=0,007), hyperglycemia (OR=17,93, p=0,009), and co- infections (OR=3,98, p=0,001) were identified as independent risk factors for CI. The most common infections were bloodstream (53%). 77 of 135 candida strains was isolated as causative pathogens. C. albicans (63,6%) was the most frequent species. Overall mortality rate was 78%. The rates of mortality attiributable to CI and candidemia were 27%, and 18,3% respectively. Species- specific mortality rates of C.albicans and C.tropicalis were determined as 12%. High APACHE II scores (OR=1,37; p=0,002), and the use of central venous catheter (OR=9,01; p=0,049) were assigned as independent risk factors for mortality. Conclusion: CI is an important problem in our hospital. CI and associated mortalty can be prevented by controlling of risk factors. Updating of epidemiological data is required for successful antifungal treatment

The effect of the doxycycline-rifampicin and levamisole combination on lymphocyte subgroups and functions of phagocytic cells in patients with chronic brucellosis.

Background: Brucellosis is one of the important health problems for both humans and animals in Turkey since agriculture and stock raising appears to be the most important means of subsistence. Investigations on the pathogenesis of brucellosis reveal that the etiologic agent can survive in phagocytic cells, and cell-mediated immunity plays an important role in immunity against bacteria. Methods: In this study, we investigated whether supplementation of levamisole, a well-known antihelminthic agent with immune-stimulating activity to conventional antibiotic therapy, would improve the anergy against Brucella . Results: The results of our study reveal that a 6-week course of levamisole as a supplement to conventional antibiotic therapy in chronic brucellosis is not superior to conventional antibiotic treatment alone with respect to lymphocyte subgroup ratios and phagocytic function. Conclusion: In chronic brucellosis, levamisole administered as a supplement concomitantly with conventional antibiotic therapy has no immunostimulating effect on the basis of the lymphocyte subgroups ratios measured and the ability of phagocytosis in the present study. Further large clinical and laboratory trials are necessary to investigate the immunological and physiological effects of levamisole on T H1 subtypes and cytokine secretion

A surveillance of nosocomial candida infections: epidemiology and influences on mortalty in intensive care units

Introduction: it was aimed to investigate the frequency of Candida infections (CI) in the intensive care units (ICU), to determine typing of candida to evaluate risk factors associated with CI and mortality, and to evaluate influence of CI on mortality. Methods: the prospective cohort study was carried out between Jan 1, 2009 and Dec 31, 2010 in ICUs, and the patients were observed with active surveillance. VITEK 2 Compact System (BioMerieux, France) kits were used for the identification of isolates from various clinical samples. Results: a total of 2362 patients had enrolled for 16135 patients-days into the study. During the study, 63 (27,5%) of patients developed 77 episodes of CI were observed. Of the patients; 54% were male, 46% were female. Duration of hospitalization (OR=1,03, p=0,007), hyperglycemia (OR=17,93, p=0,009), and coinfections (OR=3,98, p=0,001) were identified as independent risk factors for CI. The most common infections were bloodstream (53%). 77 of 135 candida strains was isolated as causative pathogens. C. albicans (63,6%) was the most frequent species. Overall mortality rate was 78%. The rates of mortality attiributable to CI and candidemia were 27%, and 18,3% respectively. Species-specific mortality rates of C. albicans and C. tropicalis were determined as 12%. High APACHE II scores (OR=1,37; p=0,002), and the use of central venous catheter (OR=9,01; p=0,049) were assigned as independent risk factors for mortality. Conclusion: CI is an important problem in our hospital. CI and associated mortalty can be prevented by controlling of risk factors. Updating of epidemiological data is required for successful antifungal treatment

A surveillance of nosocomial candida infections: epidemiology and influences on mortalty in intensive care units

Abstract Introduction: it was aimed to investigate the frequency of Candida infections (CI) in the intensive care units (ICU), to determine typing o

Parotitis Cases Due to Measles-Mumps-Rubella Vaccine

We report ten cases with parotitis following the measles-mumpsrubella (MMR) vaccine which contains Edmonston-Zagreb measles strain, Leningrad-Zagreb mumps strain and Wistar RA 27/3 rubella strain (Tresivac (R), Serum Institute of India, India). The MMR mass immunization was performed in 1875 young adults in the recruit military center in January 2009. Nine of the vaccinated persons developed vaccine-associated parotitis as an adverse event approximately three weeks following immunization. One person, who had not been vaccinated recently, developed parotitis three weeks after contact with the vaccinated persons. The diagnosis of mumps was proven in eight patients by detection of serum IgM anti-mumps antibody and clinical fi ndings. Two patients with negative serology for mumps diagnosed by clinical and epidemiological fi ndings. Although it is well known that parotitis can occur as an adverse event after mumps vaccination, there are only a few reports of transmission of mumps via contact with vaccinated people. Following MMR vaccination, clinicians should consider parotitis as an adverse event and also the possibility of horizontal transmission of the vaccine strain

A meta-analysis of antibiotic resistance rates in Pseudomonas aeruginosa isolated in blood cultures in Turkey between 2007 and 2017

OBJECTIVE: The prevalence of Pseudomonas aeruginosa has remained stable in recent years, and resistant strains has increased dramatically. In this meta-analysis, we aimed to analyze the P. aeruginosa strains isolated from blood cultures in Turkey during the last 11 years and to reveal their antimicrobial susceptibility

Assessment of the antibody response in 110 healthy individuals who have been subject to Vi capsular polysaccharide vaccine.

Typhoid fever is a disease predominant in underdeveloped and developing countries. Typhoid fever is more prevalent, in fact endemic, in countries where fecal contamination of water and food sources are very common. The majority of the reported cases are in the adult age group. There are three different vaccines which can be used to prevent typhoid fever. In this study, we have used the parenteral Vi vaccine which was developed using the polysaccharide Vi antigen that covers the bacterial surface, thus, concealing the O antigen protecting the bacteria against Anti-O antibodies and regarded as virulence factor. A total of 110 individuals whose sera were negative for seroconversion prior to vaccination were included in this study in which we have assessed Anti-Vi antibodies by tube agglutination. Serum and stool samples of 110 individuals were assessed 1 month after the vaccination. A total of 105 (95.5%) of the vaccinated people were considered to have positive (1/40 and higher) response and this result was regarded as prophylactic seroconversion. None of the people in the study group had Salmonella typhi, S. paratyphi A,B,C isolated from their stool cultures