Antibiotic resistance in community-acquired urinary tract infections: Prevalence and risk factors

PubMedID: 20424552Background: This study aimed to identify the agents causing community-acquired urinary tract infections (CAUTIs) and their resistance patterns and to investigate risk factors for ESBL production. Material/Methods: Patients diagnosed at the Department of Infectious Diseases in the Cukurova University School of Medicine Hospital with CAUTI between January 2006 and April 2007 were included prospectively. Patient data were recorded and the microorganisms and their sensitivity patterns were evaluated by the university's central microbiology laboratory. Results: A total 146 patients with CAUTIs, 109 women and 37 men (mean age: 50.9±18.44 years), were included in the study. The most common infectious agents were Escherichia coli (76.9%), Klebsiella pneumoniae (9.2%), Proteus mirabilis (4.1%), and Enterococcus spp. (1.6%). The ciprofloxacin resistance rate for E. coli was 35% and resistance to TMP-SMZ 43%, whereas amikacin resistance was substantially low (3%). Four of 12 K. pneumoniae strains were resistant to ciprofloxacin and 2 to TMP-SMZ. Resistance to amikacin was not found in the K. pneumoniae strains. ESBL production was identified in 25 of the 112 E. coli and K. pneumoniae strains. A history of a UTI within the last 6 months (p=0.029) and a history of frequent UTI (p=0.028) were found to be significant risk factors for ESBL production by univariate analysis. The only independent risk factor was a history of urinary system infection in the past 6 months (p=0.025) according to multivariate regression analysis. Conclusions: These high resistance rates to antimicrobials and particularly the extremely high rate of ESBL production in CAUTI should be carefully considered. © Med Sci Monit, 2010

Sistatin C, KIM1 and NGAL as biological markers for detecting early kidney injury in HIV positive patients

WOS: 000494690300318

Telaprevir experience from Turkey

Background: In patients with chronic hepatitis C, triple drug regimens containing a protease inhibitor, peginterferon and ribavirin were found to significantly increase sustained virologic response rates compared to dual drug regimen containing pegylated interferon and ribavirin, especially in genotype 1. Objectives: In Turkey, telaprevir has been used since March 2013. We aimed to evaluate results of patients with chronic hepatitis C treated with telaprevir, peginterferon and ribavirin. Patients and Methods: We evaluated 28 patients with genotype 1 chronic hepatitis C infection treated with triple drug regimen containing telaprevir, in three medical centers in Turkey, retrospectively. Demographic data of patients, treatment indications, adverse events and outcomes were recorded. Results: Of 28 patients intended to treat, 25 (89.2%) patients completed the treatment. Overall, 21 (82.1%) patients had relapse and five patients were non-responder. Regarding the treatment outcomes of Telaprevir based regimen, 20/26 patients achieved sustained virological response. Pruritus, rash, dysgeusia, anorectal discomfort and anemia were main adverse effects. Blood transfusion and ribavirin dose reduction required for 7 and 11 patients, respectively. Due to several adverse effects, 10 patients were hospitalized. Conclusions: Although more frequent and severe adverse effects, telaprevir has been promising for patients with treatment-experienced hepatitis C. © 2015, Kowsar Corp

The causes of postoperative meningitis: The comparison of gram-negative and gram-positive pathogens

PubMedID: 30192362AIM: To determine the microbiological etiology in critically ill neurosurgical patients with nosocomial meningitis (NM) and to show the impact of Gram-negative rods and the differences between patient characteristics and the clinical and prognostic measures in Gram-negative and Gram-positive meningitis. MATERIAL and METHODS: In this prospective, single-center study, we reviewed all adult patients hospitalized during a 12-year period and identified pathogens isolated from post-neurosurgical cases of NM. Demographic, clinical, and treatment characteristics were noted from the medical records. RESULTS: Of the 134 bacterial NM patients, 78 were male and 56 were female, with a mean age of 46±15.9 and a median age of 50 (18-80) years. One hundred and forty-one strains were isolated; 82 (58.2%) were Gram-negative, 59 (41.8%) were Grampositive. The most commonly isolated microorganism was Acinetobacter baumannii (34.8%). Comparison of mortality data shows that the patients who have meningitis with Gram-negative pathogens have higher mortality than with Gram-positives (p=0.034). The duration between surgery and meningitis was shorter in Gram-negative meningitis cases compared to others (p=0.045) but the duration between the diagnosis and death was shorter in Gram-positive meningitis cases compared to Gram-negatives (p=0.017). Cerebrospinal fluid protein and lactate levels were higher and glucose level was lower in cases of NM with Gram-negatives (p values were respectively, 0.022, 0.039 and 0.049). CONCLUSION: In NM, Gram-negative pathogens were seen more frequently; A. baumanni was the predominant pathogen; and NM caused by Gram-negatives had worse clinical and laboratory characteristic and prognostic outcome than Gram-positives. © 2018 Turkish Neurosurgical Society

The effectiveness of E/C/F/TAF in treatment-naive (TN) or treatment-experienced (TE) adult HIV-infected patients in a real-world setting, results from southern Turkey

WOS: 000494690300158

Rickettsia sibirica mongolitimonae infection, Turkey, 2016

PubMedID: 28628458In 2016, Rickettsia sibirica mongolitimonae was diagnosed for a man in Turkey. He had been bitten by a Hyalomma marginatum tick, from which PCR detected rickettsial DNA. Sequence analysis of the DNA identified R. sibirica mongolitimonae. Immunofluorescence assay of patient serum indicated R. conorii, which cross-reacts. PCR is recommended for rickettsiosis diagnoses. © 2017, Centers for Disease Control and Prevention (CDC). All rights reserved

Physical Characterization of Turbot (Psetta Maxima) Originated Natural Hydroxyapatite

Nowadays hydroxyapatite is one of the most popular biomaterials, which is used in various medical and dental applications areas as graft material. Bovine bone is the biggest source for natural hydroxyapatite production, but its production can lead to very dangerous disease, like mad cow disease, without high degree calcination. Hydroxyapatite produced from marine sources is much safer and easier to produce than bovine hydroxyapatite. Here in this study natural hydroxyapatite and related phases were produced from a local source turbot (Psetta maxima). Beside the main bony internal structure, there are koshers (cycloid scale) on its skin. Koshers are bulky bumps, looking like flat, small and rounded structures. Internal bones and those bulky bumps were cleaned from flesh with chemicals and calcined at 850°C for 4 hours. After calcinations, especially those bulky bumps, were formed into mesoporous structures with very light bluish color. Those mesoporous structures can be used as natural mesoporous hydroxyapatite structures for bone grafting purposes. The internal bones have also formed hydroxyapatite. Scanning electron microscope and X-ray diffraction studies were performed. I this study it is found that the bones of turbot consist of hydroxyapatite and TCP related phases. The aim of this study is to produce natural hydroxyapatite structures from turbot scale with low carbon footprint, without harming the environment and without using complex chemicals

Starch/PCL composite nanofibers by co-axial electrospinning technique for biomedical applications

Abstract Background In this study, starch and polycaprolactone (PCL), composite nanofibers were fabricated by co-axial needle electrospinning technique. Processing parameters such as polymer concentration, flow rate and voltage had a marked influence on the composite fiber diameter. Fourier transform infrared spectroscopy, scanning electron microscopy (SEM), mechanical and physical properties (such as density, viscosity and electrical conductivity) of the composite fibres were evaluated. Moreover, a cell culture test was performed in order to determine their cytotoxicity for wound dressing application. Results The effect of starch ratio in the solution on the properties and morphological structure of the fibers produced was presented. With lower starch concentration values, the fibers have greater ultimate tensile strength characteristic (mostly 4 and 5 wt%). According to SEM results, it can be figured out that the nanofibers fabricated have good spinnability and morphology. The mean diameter of the fibers is about 150 nm. According to results of cell culture study, the finding can be determined that the increase of starch in the fiber also increases the cell viability. Conclusions Composite nanofibers of starch/PCL have been prepared using a co-axial needle electrospinning technique. PCL was successfully encapsulated within starch. Fiber formation was observed for different ratio of starch. With several test, analysis and measurement performed, some important parameters such as quality and effectuality of each fiber obtained for wound dressing applications were discussed in detail