33 research outputs found
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