Razine pentraksina 3 dobro su povezane s težinom bolesti kod prijma u bolesnika s COVID-19

Pentraxin 3 (PTX3), a long pentraxin, is not only released from dendritic cells and neutrophils but also from epithelial and endothelial cells such as alveolar epithelium. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) initially activates the innate immune system, causing a complex immune response. Clinical and experimental studies suggest that PTX3, a locally and systemically secreted marker, can be used as a predictor of the severity and mortality in respiratory infections. In the current study, serum PTX3 levels in patients hospitalized with COVID-19 were found to be significantly increased at admission and showed significant association with the disease severity.Pentraksin 3 (PTX3), dugi pentraksin, ne oslobađa se samo iz dendritičnih stanica i neutrofila, nego i iz epitelnih i endotelnih stanica poput alveolarnog epitela. Teški akutni respiracijski sindrom koronavirus-2 (SARS-CoV-2) u početku aktivira urođeni imuni sustav uzrokujući složen imuni odgovor. Klinička i eksperimentalna istraživanja ukazuju na to da se PTX3, lokalno i sistemski izlučeni biljeg, može koristiti kao prediktor težine i smrtnosti kod respiracijskih infekcija. U ovom istraživanju utvrđeno je da su razine PTX3 u serumu bolesnika hospitaliziranih s COVID-19 bile značajno povišene kod prijma i značajno povezane s težinom bolesti

Laboratory Tests in the Diagnosis of COVID-19

The gold standard for routine microbiological diagnosis of coronavirus disease 2019(COVID-19) is quantitation of viral RNA in respiratory specimens by reverse-transcriptionpolymerase chain reaction (RT-PCR). Detecting severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) specific IgM and IgG antibodies in patient sera are additionaldiagnostic tests. It has been known that virus release begins a few days before clinical signsappear, and therefore, beginning from 2-3 days before the manifestation of clinical symptoms,virus RNA can be detected in the respiratory tract during the symptomatic period of the disease.Since the viral load is higher in lower respiratory tract samples such as bronchoalveolar lavageand tracheal aspirate, PCR positivity rate might be found higher compared to nasopharyngealsamples. Confirmatory PCR tests require specific equipment and trained personnel, and theyare also time-consuming and costly. Antibody assays are simple, faster tests, do not requiremuch equipment and applicable in any laboratory. They can even be performed with 2-3 dropsof blood collected from the finger tip of patients using relatively inexpensive chromatographicrapid tests. These tests can be used in the later period of the disease since specific antibodiesappear on the 7-10th day of clinical signs in patients with COVID-19. Rapid antibody card testshave an average specificity and sensitivity, while antibody tests using microELISA have highersensitivity and specificity

Laboratory Tests in the Diagnosis of COVID-19

The gold standard for routine microbiological diagnosis of coronavirus disease 2019(COVID-19) is quantitation of viral RNA in respiratory specimens by reverse-transcriptionpolymerase chain reaction (RT-PCR). Detecting severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) specific IgM and IgG antibodies in patient sera are additionaldiagnostic tests. It has been known that virus release begins a few days before clinical signsappear, and therefore, beginning from 2-3 days before the manifestation of clinical symptoms,virus RNA can be detected in the respiratory tract during the symptomatic period of the disease.Since the viral load is higher in lower respiratory tract samples such as bronchoalveolar lavageand tracheal aspirate, PCR positivity rate might be found higher compared to nasopharyngealsamples. Confirmatory PCR tests require specific equipment and trained personnel, and theyare also time-consuming and costly. Antibody assays are simple, faster tests, do not requiremuch equipment and applicable in any laboratory. They can even be performed with 2-3 dropsof blood collected from the finger tip of patients using relatively inexpensive chromatographicrapid tests. These tests can be used in the later period of the disease since specific antibodiesappear on the 7-10th day of clinical signs in patients with COVID-19. Rapid antibody card testshave an average specificity and sensitivity, while antibody tests using microELISA have highersensitivity and specificity

Comparison of the Resistance of Diabetic Foot Isolates with Community and Intensive Care Unit Resistance Rates

Objective: Using proper antibiotics in diabetic foot infections can save an extremity. The goal of this study was to determine the antibiotic susceptibility of the most frequent isolates from diabetic foot infections, to compare these results with those for species obtained from both intensive care unit and community-acquired infections, and to re-evaluate the empirical antimicrobial therapy in diabetic foot infections. Material and Methods: Antibiotic susceptibility testing was performed on bacteria from diabetic foot cultures, ICU and community-acquired infections. Skin and soft tissue samples of a total of 181 patients have been studied. Sensitivity to ampicillin/ sulbactam (SAM), ciprofloxacin (CIP), piperacillin/tazobactam (TZP), cefoperazone/sulbactam (SCF), amikacin (AN), meropenem (MEM) and cefepime (FEP) has been investigated. Results: Among the samples, reproduction was detected in 154 (85%), 132 of which (79.5%) contained gram-negative bacteria (46 Enterobacter spp, 36 Pseudomonas spp, 30 Acinetobacter spp, 20 others). Resistance of bacteria isolated from diabetic foot cultures was less than the one of bacteria isolated from ICU and more than the one from community-acquired infections. However, an increased resistance was detected to ciprofloxacin, frequently used in urinary infections, in agents from community-acquired infections. Conclusion: In conclusion, due to the risk of possible loss of tissue/extremity and possible antibiotic resistance, treatment should be started empirically and continued considering the culture results. (The Me di cal Bul le tin of Ha se ki 2011; 49: 137-40

Blood Transfusion Applications Nurse Survey: Truths, Known to be Truths, Changes, Errors

Aim: Safe transfusion is one of the important steps in blood transfusion. This survey study evaluates the level of education and awareness of our nurses about safe blood transfusion. Method: 192 nurses working in our hospital were surveyed. Results: Only 16% of the participants were 40 years old or older, 18% worked for more than 20 years, 20% were high school graduates, and 25% of them never received training on blood transfusion (BT). All participants have been acquired awareness on cross match and record control. However, 20% were hesitant about the necessity of patient consent. It was observed that there was information confusion about premedication, and 25% were misinformed about blood transfusion procedures. For BTrelated reactions, 67% and 40% could exactly identify the symptoms and the findings, respectively. Of the participants, 15% were misinformed about the necessity of emergency kit and 50% were aware of what to be performed in case of a BT reaction. Discussion: Since increasing the safety in BT process is highly related to the level of knowledge and awareness of the transfusion nurses, it is important to establish inservice training programs and safety control systems. (The Me di cal Bul le tin of Ha se ki 2011; 49: 145-

Macrolide-Lincosamide-Streptogramin B (Mlsb) Resistance Phenotype in Staphylococcal Isolates

Aim: The aim of this study was to determine the incidence of macrolide-lincosamide-streptogramin B (MLSB) resistance in staphylococcal isolates from various clinical samples. Methods: In this study, we included a total of 100 staphylococcal isolates, 35 Staphylococcus aureus and 65 coagulase-negative staphylococci (CNS), from specimens obtained from patients followed up in our hospital between 2009 and 2010. Methicillin resistance of these isolates was determined using cefoxitin disc diffusion method. MLSB resistance was investigated by D-test method using erythromycin and clindamycin disks. Results: Of 35 S. aureus isolates, 14 were methicillin-resistant (MRSA) and 21 were methicillin-sensitive (MSSA). Of 65 CNS isolates, 41 were methicillin-resistant (MRCNS) and 24 were methicillin-sensitive (MSCNS). In 79 strains, there was at least one MLSB resistance phenotype. The most frequent resistance phenotypes were inducible (35%) and constitutive (30%) among all isolates, while the constitutive one was more common in S. aureus strains (62%). Conclusion: Since the resistant community- and hospitalacquired staphylococcal infections have become a therapeutic problem, it is very important to detect MLSB resistance routinely in microbiology laboratories. D-test is a cheap and reliable diagnostic method which can be performed in every laboratory. In order to prevent treatment failure, D-test should be routinely used and the results should be reported to the clinician before starting a therapy with MLSB group of antibiotics. (The Me di cal Bul le tin of Ha se ki 2011; 49: 102-4

Antibiotic Resistance: Experience in Pediatric and Neonatal Intensive Care Units

Objective: We retrospectively evaluated the culture results of patients hospitalized in the Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) at our hospital during 2008. Material and methods: In this study, the cultures results of the patients were analyzed. Identification of bacteria was performed by conventional methods and antibiotic susceptibility tests were done using disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: 222 materials sent from 5-bed PICU and 5-bed NICU consisted of 135 (61%) tracheal aspirates, 46 (21%) blood cultures, 21 (10%) urine cultures, 6 (3%) catheter tip cultures, 6 (3%) eye secretion cultures, and 8 (4%) other materials. Pseudomonas spp. were the most frequently isolated bacteria (33%). Carbapenem resistance was not detected for Enterobacteriaceae species and was very low for nonfermentative bacteria. Ciprofloxacin resistance was low and cephoperazone-sulbactam resistance was not detected for Acinetobacter species. Conclusion: Our ICUs are new and patient circulation is low due to long hospitalization period caused by underlying conditions of patients. The well-trained staff and effective infection consultation, along with the previously mentioned facts, resulted in low antibiotic resistance rates and absence of panresistant bacteria. (The Medical Bulletin of Haseki 2011;49: 73-6