Geriatric Assessment In Oncology: G8 Screening Too Validation And Reliability Study

OBJECTIVE The present study aimed to test the validity and reliability of the Geriatrics 8 (G8) tool, a risk-screening tool for further comprehensive geriatric assessment, with hematologic cancer patients aged 65 years and older. METHODS This methodological study included 110 patients followed up for hematologic cancer. Data were collected using the patient identification form, the G8 screening tool, and the Edmonton Frail Scale. Language and content validity, internal consistency, confirmatory factor, sensitivity and specificity and concurrent validity analyses were also used. RESULTS Patients (mean age: 73.9 +/- 6.10) were diagnosed with lymphoma (30.9%), multiple mycloma (21.8%), leukemia (20.9%), myelodysplastic syndrome (19.1%). Confirmatory factor model fit index analysis chi(2)/df and p-values (0.14) showed a good fit and GFI, AGFI, SRMR, and RMSEA values showed acceptable fit. The Cronbach's alpha coefficient was 0.655, area under the ROC curve was 0.824 (95%, 0.745-0.904), and sensitivity and specificity were 61.0% and 88.9%, respectively. CONCLUSION The findings indicated that the G8 screening tool was found a valid and reliable tool for geriatric patients diagnosed with cancer to determine the risk and need for further comprehensive geriatric assessment.WoSScopu

Investigation of in-vitro susceptibility of multidrug-resistant Acinetobacter baumannii strains isolated from clinical specimens to tigecycline

The management of infections due to A. baumannii is difficult because of rapidly developing resistance, however, tigecycline, a glycylcycline antimicrobial, is in use for several years. In the present study, it was aimed to determine the susceptibility rates of A. baumannii to tigecycline. A total of 90 A. baumanniisolates were tested using three methods such as disk diffusion, broth microdilution, and E-test. The MIC50and MIC90 values and the MIC range were found as 2 μg/ml, 4 μg/ml, and 0.1-8 μg/ml by microdilution; and 2 μg/ml, 6 μg/ml, and 0.1-12 μg/ml by E-test, respectively. There were a few major errors as well as the minor rates were all high as between 35.7%-46.7%. The accuracy rates between the methods were low as 53.3% (48/90) between disk diffusion and E-test, 51.1% (46/90) between disk diffusion and microdilution, and 60.0% (54/90) between E-test and microdilution. In the ROC curve analysis, an inhibition zone diameter of susceptibility breakpoint of 21.5 mm had sensitivity between 68.8%-88.9%; specificity between 81.9%-87.9%; and accuracy between 80.0%-83.33%. An analysis based on EUCAST’s non-species breakpoints, the MIC tests showed higher accuracy with a rate of 96.7%, however, performance of disk diffusion got worse as lower than 25%. In conclusion, we showed that the reliability of the methods even did not remain as high as the past. Our study presented that none of three methods revealed reliable results in determination of susceptibility of A. baumanni to tigecycline, so the clinical response should be followed up carefully in such cases

Carriage of Class 1 and 2 Integrons in Acinetobacter baumannii and Pseudomonas aeruginosa Isolated from Clinical Specimens and a Novel Gene Cassette Array: bla(OXA-11)-cmlA7

SANDALLI, Cemal/0000-0002-1298-3687WOS: 000332131600005PubMed: 24506715The dissemination of antibiotic resistance genes between bacteria leads to serious problems in the treatment of infectious diseases. It has been shown that resistance genes can also be carried by the integrons. There are limited studies regarding the carriage of class 1 and 2 integrons in Acinetobacter baumannii and Pseudomonas aeruginosa clinical strains in Turkey. the aims of this study were to investigate the carriage rates of class 1 and class 2 integrons in A.baumannii and P.aeruginosa strains isolated from clinical samples in Abant Izzet Baysal University Hospital, and to characterize the antibiotic resistance gene cassettes in these integrons by sequence analyses. A total of 137 strains (77 A.baumannii and 60 P.aeruginosa) isolated from various clinical specimens (56% were sputum, 19% wound, 11% urine, 11% blood, 3% catheter), between March 2010-December 2012, were included in the study. the identification and antibiotic susceptibility tests of the isolates were performed by Vitek 2 Compact (bioMerieux, France) and BD Phoenix 100 (Becton Dickinson, USA) systems. the presence of integrons were screened by PCR method using specific primer pairs targeting class 1 (intil1) and 2 (intl2) integrase regions. All the samples that revealed integron amplification were subjected to DNA sequence analysis, both in the forms of cloned products and PCR amplicons. in the study, the highest susceptibility rates were found against colistin (96%) and tigecycline (78%) in A.baumannii, and against piperacillin/tazobactam (97%) and piperacillin (93%) in P.aeruginosa isolates. the highest resistance rate was determined for piperacillin/tazobactam (95%) in A.baumannii strains. the presence of intl1 gene was detected in 33% (26/77) of A.baumannii and 10% (6/60) of P.aeruginosa isolates. When variable regions in intl1 positive strains were amplified by PCR, eight (8/77, 10%) A.baumannii and three (3/60, 5%) P.aeruginosa strains were found to harbor antibiotic resistance gene cassettes. Intl2 gene was not detected in any of the isolates. Resistance to piperacillin/tazobactam, ceftazidime, cefepime, ceftriaxone and ampicillin/sulbactam was detected as the common resistance pattern in all integron-positive A.baumannii strains, whereas resistance to ceftazidime, gentamicin and ciprofloxacin was the common pattern in all integron-positive P.aeruginosa strains. DNA sequence analysis of variable regions of integrons indicated that two separate gene cassette arrays (aacC1-aadAl and aac(3)-1) were carried by A.baumannii strains, and two types of gene cassette arrays (bla(OXA-30)-aadA1 and bla(OXA-11)-cmlA7) were carried by P.aeruginosa strains. To our best knowledge, this is the first report of the gene sequence of bia(OXA-11)-cmlA7 defined in an integron gene cassette of P.aeruginosa

Is Haemophilus influenzae better satellite for Enterococcus faecalis?

Background — Haemophilus influenzae can grow on blood agar media with Staphylococcus aureus which can provide factor V as it is called “Satellite phenomenon”. Objectives — In this study we tested and compared three different beta-haemolytic genus including three Staphylococcus aureus, three coagulase-negative staphylococci, and two Enterococcus faecalis strains in order to determine an alternative microorganism to be used for satellite test to identify H. influenzae conventionally. Materials and Methods — We used suspensions of H. influenzae in two different tribudities as 0.5 and 4 McFarland for each strain. Five totally-blinded reviewers examined the test results and scored both the colony sizes of H. influenzae and the diameter of the growth-zone. The sum of the scores for the colony sizes and the growth-zones were determined as “total diagnostic score” (TDS) as being between 0-6 points for each test. Results — A total of 320 test scores were analysed. The mean TDS of E. faecalis group was significantly higher than the other groups (p<0.001). In the S. aureus group, 23 (19.2%) tests had 0 points as TDS; but in enterococci group no isolates had lower scores than 3 points. In enterococci group, the rate of isolates which had 5 or 6 points was 77.5% (62/80); but in S. aureus group no isolate had higher than 4 points. Conclusions — Our study shows that using a beta-haemolytic E. faecalis strain will provide significantly more accurate results and will significantly reduce false-negative results for satellite test instead of S. aureus, which is particularly proposed to be used

In vitro Activity of Ceftaroline to MRSA Isolates: A Multicenter Study

Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging pathogen that cause severe community- and hospital-acquired infections. Studies continue on searching alternatives due to the limited number of therapeutic options in MRSA infections. Ceftaroline is a wide-spectrum new generation cephalosporin which has been begun to be used in treatment of skin and respiratory tract infections caused by MRSA. The aim of this study was to investigate the in vitro activity of ceftaroline against MRSA strains isolated from various clinical specimens in microbiology laboratories of seven hospitals located at different provinces (Bolu, Samsun, Rize, Tekirdag, Sakarya, Amasya, Osmaniye) of Turkey. A total of 192 MRSA isolates (89 skin/wound/abscess, 38 blood, 36 respiratory tract, 29 urine/sterile body fluids/catheter) were included in the study, and ceftaroline susceptibilities of the strains were detected by broth microdilution method. MIC values of 181 (94.3%) isolates were determined as 0.05). MIC50 and MIC90 values in Samsun and Bolu isolates were found to be the same with the whole group, however, MIC50 and MIC90 were 0.5 mu g/ml and 0.5 mu g/ml in Amasya isolates and 1 mu g/ml and 1 mu g/ml in Rize, Tekirdag, Osmaniye and Sakarya isolates, respectively. When evaluating MIC50 and MIC90 values and isolation rates of intermediate strains according to the specimen types, there were no significant differences (p > 0.05). Susceptibility rates to ceftaroline and the distribution profiles of MIC values of the isolates obtained from seven centers of Turkey have been detected similar with the previous American and European reports. With this study, initial data on the activity of ceftaroline against MRSA were obtained from Turkey. These preliminary findings indicate that ceftaroline is effective even on Turkish isolates and can be a suitable treatment in cases requiring wide-spectrum antimicrobiotic use, however further large-scaled studies are needed

Fatal Adenovirus Pneumonia Despite Extracorporeal Life Support Treatments

Adenovirus is an important etiological agent of lower respiratory tract infections in all age groups. Its infections are very difficult to distinguish from other viruses and bacterial agents by clinical and laboratory findings. Although adenovirus is rarely causes acute respiratory distress syndrome, it has higher morbidity and mortality compared to other viruses. In this manuscript, an adenovirus infection in a pediatric patient with preliminary diagnosis of bacterial pneumonia by clinical and laboratory findings has been presented. Pneumonia has rapidly progressed to acute respiratory distress syndrome and the patient died despite extracorporeal life support treatments

Decreased Superoxide Dismutase Activity after ECT and Correlation between Higher Oxidant Levels and Poor Response to ECT in Depression

Objective: The literature regarding effects of electroconvulsive therapy (ECT) on oxidative metabolism (OM) reports conflicting changes in oxidant and antioxidant status in animal studies. The goal of this first human study was to investigate the changes in oxidants and antioxidants in plasma of depressed patients after ECT

Fatal Adenovirus Pneumonia Despite Extracorporeal Life Support Treatments

Adenovirüs alt solunum yolu enfeksiyonlarının tüm yaşlarda önemli bir etkenidir. Klinik ve laboratuvar olarak diğer virüs ve bakteriyel enfeksiyon-lardan ayrımı oldukça zordur. Akut solunum sıkıntısı sendromuna nadiren sebep olsa da diğer etkenlerle karşılaştırıldığında daha yüksek morbidite ve mortaliteye sahiptir. Bu makalede klinik ve laboratuvar bulguları ile bakteriyel pnömoni ön tanısı alan ve hızlı bir şekilde akut solunum sıkın-tısı sendromuna ilerleyen çocuk hastada, vücut dışı destek tedavilerine rağmen ölümcül seyreden adenovirüs enfeksiyonundan bahsedilmiştir.Adenovirus is an important etiological agent of lower respiratory tract infections in all age groups. Its infections are very difficult to distinguish from other viruses and bacterial agents by clinical and laboratory find-ings. Although adenovirus rarely causes acute respiratory distress syn-drome, it has higher morbidity and mortality compared to other viruses. In this article, an adenovirus infection in a pediatric patient with prelim-inary diagnosis of bacterial pneumonia by clinical and laboratory find-ings has been presented. Pneumonia has rapidly progressed to acute respiratory distress syndrome and the patient died despite extracorpor-eal life support treatments