Presence of Class I and Class II Integrons in Methicilin Resistant Staphylococci and Their Relations with Antibiotic Resistance: A Preliminary Study from Turkey

Background: Emergence of antibiotic resistance is a major public health concern. It is known that antibiotic resistance is transferred by different ways. Integrons as one of these mechanisims cause to spread antibiotic resistance in Gram negative bacteria but also it is shown to be effective for transferring genes in Gram positive bacteria. In the present study we aimed to examine the prevalence of class I and class II integrons in MRSA and MRCNS strains isolated from patients and to determine the relationship between antibiotic resistance and the presence of integrons. Methods: Sixty four MRSA and 62 MRCNS strains were included in this study. Antibiotic susceptibility testings were performed. Genomic and plasmid DNAs were extracted and Polymerase Chain Reaction (PCR) was used for the detection of the intI and intII genes. The PCR products were visualised in 1.5 % agarose gel electrophoresis. Pearson chi-square test and Fisher’s exact test were used for comparing categorical variables. Results: Among 126 staphylococci 11 (8.7% - 4 MRSA and 7 MRCNS) were shown to carry class I integron; whereas 7 MRCNS (5.5%) were class II positive. Both of class I and class II integrons were detected to possess in four MRSA (3.2%). There was no statistically significant relation between presence of integrons and resistance to each of antibiotics (p>0.05). Conclusion & Recommendation: In the present study we did not find any significant relation between resistance rates and the presence of integrons but we suggest that these results showed an important data about the extended distributions of integrons not only among Gram negative bacteria but also in staphylococci.Keywords: MRSA, MRCNS, class I integron, class II integron, anbiotic resistanceDOI: 10.7176/JHMN/75-0

Nosocomial meningitis with dual agents and treatment with intraventricular gentamicin

WOS: 000258416900016PubMed: 18822895Nosocomial central nervous system infections constitute 0.4% of all nosocomial infections. The responsible pathogens of nosocomial meningitis are quite different from community-acquired meningitis with high rates of morbidity and mortality. The most important prognostic factor is the appropriate choice of pathogen-specific antibacterial therapy. In this report, a 64 years old woman with nosocomial meningitis caused by Klebsiella pneumonioe and Acinetobacter spp. after lumbar disc hernia operation, has been presented. The risk factors were detected as recent history of neurosurgical operation for three times and long term (29 days) use of external ventricular drainaige (EVD) catheter. Empirical meropenem (3 x 2 g, IV) and vancomycin (2 x 1 g, IV) therapy was initiated upon the diagnosis of nosocomial meningitis based on the clinical and laboratory findings on the postoperative fifth day. Extended-spectrum beta-lactamase (ESBL) producing K. pneumonice (susceptible to amikacin, imipenem, meropenem, cefoxitine, ciprofloxacin, piperasillin-tazobactam and trimethoprim/sulfamethoxazole) was recovered from cerebrospinal fluid (CSF) and blood samples obtained on the same day. There was no change in the status of the patient on the eighth day of meropenem therapy, with high leukocyte number (1300/mm(3)) and presence of gram-negative bacilli in CSF, and ESBL positive K. pneumonioe (antibiotic susceptibility pattern same with the previous isolate) growth in CSF culture. Thereupon intravenous ciprofloxacin (3 x 400 mg) was added to the therapy and her EVD has been changed. However, ESBL positive K. pneumonioe (antibiotic susceptibility pattern same with the previous isolate) together with Acinetobacter spp. (susceptible to gentamycin, tobramycin, netilmicin, ciprofloxacin, levofloxacin and cefepime) were isolated from CSF and blood cultures obtained on the 13(th) day of meropenem and fifth day of ciprofloxacin therapy. Therefore intraventricular and intravenous gentamicin (15 mg/days and 3 x 120 mg, respectively) were added to the therapy. The patient recovered at the end of three weeks treatment without any additional sequela other than her primary illness. This case was the first case of nosocomial meningitis due to ESBL positive K. pneumonioe together with Acinetobacter spp. in the available literature

Association between active pulmonary tuberculosis and circulating microRNAs: a preliminary study from Turkey

Background/aim: Tuberculosis is a public health problem that still remains significant. For prevention, diagnosis, and treatment of tuberculosis more effective novel biomarkers are needed. MicroRNAs can regulate innate and adaptive immune responses, alter host-pathogen interactions, and affect progression of diseases. The relationship between microRNA expression and active pulmonary tuberculosis (APT) has not yet been investigated in the Turkish population. We aimed to test the potential diagnostic value of some microRNAs whose levels were previously reported to be altered in APT patients. Materials and methods: Using two different references (U6 and miR-93), we compared the expression levels of potentially important microRNAs in serum of APT patients with healthy individuals using quantitative polymerase chain reaction (qPCR). Results: miR-144 expression level was down-regulated in APT patients when either U6 or miR-93 was used for normalization. When data was normalized with miR-93, a statistically significant decrease in miR-125b (0.8 fold) and miR-146a (0.7 fold) expression levels were observed, while no differences were detected for U6. The receiver operating characteristic suggested that miR-144 may be a candidate biomarker for discriminating APT patients and controls (p < 0.05) both for U6 and miR-93. Conclusion: These findings suggest that miR-144 can have potential as a biomarker for APT. Using a single reference may be misleading in evaluation of microRNA expression. U6 and miR-93 can be used in combination as references for normalization of serum microRNA expression data

Microorganisms in Respiratory Tract of Patients Diagnosed with Atypical Pneumonia: Results of a Research Based on the Use of Reverse Transcription Polymerase Chain Reaction (RT-PCR) DNA Microarray Method and Enzyme-Linked Immunosorbent Assay

Background: Numerous molecular-based tests were applied for the laboratory-based diagnosis of viruses. In this cross-sectional case control study, in addition to bacteria, we aimed to determine respiratory viruses using, for the first time in our country, the Reverse Transcription PCR DNA Microarray method, and we also aimed to evaluate its diagnostic performance