The evaluation of staphylococci strains isolated from nasal and bone cultures in patients with chronic osteomyelitis

Objectives: In this study, it was aimed to determine theprevalence of nasal carriage of S. aureus in chronic osteomyelitis,assessed trends in methicillin resistance withtime, and evaluated the bone and nasal cultures in staphylococcalchronic osteomyelitis.Materials and methods: Bone and nasal cultures wereperformed intra-operative and pre-operatively from 43patients with chronic osteomyelitis. Inoculation was performedon 5% sheep blood and eosine-methylen-blueagar. The samples were incubated at 37°C for 24 hours.Catalase and coagulase tests were performed on Grampositive coccus strains. Antimicrobial susceptibilities of allS. aureus strains were evaluated by disc diffusion methodaccording to CLSI for oxacillin and other antibiotics.Results: In this study pre-operative nasal cultures andintra-operative bone cultures obtained between May 2005and September 2006 were evaluated retrospectively. Ofthe 43 nasal cultures, 31 (72%) yielded staphylococcalstrain, of these 18 (58%) were S. aureus. Of the 18 S.aureus strains, 13 (72.2%) have methicilline resistance.On the other hand, of the 43 bone cultures, 29 (67.4%)yielded staphylococci strain, of these 23 (79.3%) were S.aureus. Of the 23 S. aureus strains, 52.1% have methicillineresistance. Overall the similarity rate of staphylococcalstrains was 38% (11/29), while considering the statusof strains resistant to antibiotics; this ratio was 24% (7/29).Conclusions: Nasal S. aureus carriage rate (58%) in patientswith chronic osteomyelitis was higher than the communityand the other patient groups. However, the surveillancecultures can give knowledge about the causativepathogen of 25% of the culture negative cases.Key words: Chronic osteomyelitis, nasal carriage, Staphylococcusaureus, bone cultur

Knowledge and Prejudice about HIV/AIDS among Physicians and Nurses at a University Hospital

INTRODUCTION: The prejudice of healthcare personnel may be reflected as an important problem in patient follow-up. This study aimed to evaluate knowledge and prejudice regarding HIV/AIDS among physicians and nurses working in a university hospital. METHODS: The sample size of this cross-sectional study was calculated as 191 by taking distance from confidence limit(s) to mean 1 and standard deviation 7 in two-sided 95% confidence interval. In Dicle University Hospitals, 6 nurses, 4 assistant physicians and 1 specialist physician/lecturer/teaching staff were invited by random sampling method from each of the 23 clinics. Total of 218 physicians and nurses were included. A questionnaire including demographic variables and 30 statements about HIV/AIDS was applied. The data obtained were analyzed using R-3.5.1 program. RESULTS: 33.5% of the participants stated that they were involved in the follow-up of a HIV-infected patient. The mean HIV knowledge score was 76.3+-13.7; higher in men(78.9+-13.5) and doctors(83.2+-11.1). The mean HIV prejudice score was 39.0+-21.2; higher in nurses(42.0+-22.3) and lower in participants with HIV-infected relatives/friends(23,6+-14,3). There was a weak negative correlation between HIV knowledge and prejudice scores. 40.6% of the participants stated that HIV/AIDS is not a curable disease. 52.5 percent stated that they would not prefer to follow HIV/AIDS patients. DISCUSSION AND CONCLUSION: Considering that the healthcare professionals working in Turkey, which is located in a high endemic area in terms of HIV/AIDS, will encounter this disease more, the results are worrying. Health personnel should be considered as a special group in all studies that will be done to reduce HIV/AIDS stigma

The Evaluation of Nasal Cultures in Patients with Hematological Malignancies During Febrile Neutropenic Episodes

Aim: Febrile neutropenia is a common complication in patients receiving cancer treatment. According to the results of several investigations, bacterial infections are the most common causes of morbidity and mortality in these patients. In this study, we aimed to determine the prevalence of nasal carriage of S. aureusin patients with febrile neutropenia, to assess the frequency of methicillin resistant S. aureus, and to compare the blood and nasal cultures in these patients. Methods: Nasal and blood cultures were performed in 51 patients with hematological malignancies during febrile neutropenic episodes. Antimicrobial susceptibilities of all S. aureus and Gram-negative strains were evaluated by disc diffusion method according to the National Committee for Clinical Laboratory Standards (NCCLS) for oxacillin and several other antibiotics. Results: In this study, blood and nasal cultures obtained between March 2006 and September 2006 were evaluated retrospectively. The overall nasal S. aureus carriage rate was 23.5%. On the other hand, of all blood cultures performed in 51 patients, nine (17.5%) were positive and the bacteria were not isolated in 87.5% of patients. The overall compliance rate of strains isolated from both blood and nasal cultures was 17.5%, while it was 11.7% when considering the status of strains resistant to antibiotics studied. Conclusion: It is concluded that, the surveillance cultures made occasionally in patients with febrile neutropenia may give an idea to the physicians in cases in which the causative pathogen cannot be determined. (The Me di cal Bul le tin of Ha se ki 2012; 50: 136-41

The evaluation of geriatric infections: Dicle experience [Geri?atri?k i?nfeksi?yonlarin de?erlendi?ri? lmesi?: Di?cle deneyi?mi?]

• Objective: Although successes have been achieved in the treatment of the infectious diseases with antibiotics in nowadays, infectious diseases are still serious problem in the elderly. This study was conducted in order to determine the pattern of clinical infectious diseases in hospitalized elderly patients. • Material and Method: In this study, the data of all elderly patients aged 65 and older, were hospitalized to our clinic between May 2000 and May 2005 were evaluated retrospectively. We reviewed 301 patients for diagnostic studies, risk factors, isolated microorganisms and morbidity and mortality rates. • Results: Infections as a cause of hospitalization were identified as the following frequency; sepsis (19.2%), pneumonia (17.9%), acute gastroenteritis (16.9%), acute bacterial meningitis (5.3%) and urinary tract infection (3.6%), respectively. E. coli was the most isolated microorganism in these patients. Hypertension, chronic obstructive pulmonary disease and diabetes were seen as risk factors in our patients. Seventy-three patients died during hospital stay due to their infection and chronic diseases. • Conclusion: Under diagnosis of the elderly diseases is very common due to many factors related to elderly, family members and health workers. Prognosis is rather worse especially in sepsis due to pneumonia and urinary tract infections

Antibiotic Consumption Index and Effects of Restricted Antibiotic Use in Dicle University Hospital

The objective consumption rate of antibiotics at our hospital has been measured using “antibiotic consumption index (ACI)” described by World Health Organization. In our hospital, ACI was found 90.7 DDDs/100-Bed Day (BD). In the first level of study, antimicrobial consumption was measured. In the second level, an educational intervention program was started for four of the departments (the study departments). The incidence of hospital infections was monitored during the first and second six-month periods. The index was 128 to 83 in burn unit, 109.8 to 84 in department of nephrology, 102.7 to 90 in thoracic and cardiac surgery (TCS) and 71.5 to 64 in neurosurgery. There was no remarkable change in control departments that 62.7 to 60.7 in gastroenterology and 103 to 106.5 DDDs/100-BD in haematology. Approximately 80.000 dollar were saved from antibiotic budget in the four study departments during the second semester. In the study departments, nosocomial infection rate was found 8.3% in the first semester and 4.9% in the second semester. As a conclusion, educational programs for rational antibiotic consumption and consultations from infectious diseases department are thought to be effective to prevent irrational antibiotic consumption and our new antibiotic policy did not resulted in an increase in nosocomial infection in our hospital

Ventilatör ilişkili pnömoni tanısında endotrakeal aspirat kültürünün ve izole edilen bakterilerin de?erlendirilmesi

Aim: The aim of this study was to determine the ventilator-associated pneumonia (VAP) agents in isolates from endotracheal aspirate samples obtained from patients in intensive care unit (ICU) on mechanical ventilation and their susceptibility to several antibiotics. Material and Methods: Patients that received mechanical ventilation for longer than 48 hours in the ICU were diagnosed as VAP with the clinical and microbiological criteria, were enrolled in this study. Bacteria isolated from the endotracheal aspiration samples of them were identified by conventional methods and Sceptor systems, and their antibiotic susceptibilities were investigated by the National Committee for Clinical Laboratory Standards (NCCLS). Findings: A total of 72 patients were involved in this study and 84 strains were isolated. Among these patients, 12 (14.3%) had polymicrobial etiologic agent. Most commonly encountered microorganisms were Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter spp., respectively. Most of the Gram-negative bacteria were susceptible to imipenem, amikacin and ciprofloxacin. Although methicillin resistant S. aureus rate was found %100, glycopeptides resistance was not found. It was determined that 58 (92%) of the Gram-negative bacteria produced ESBL. Results: As a result, VAP is an important and frequently seen infection in ICU. High resistance rates for antibiotics suggested that the treatment of the empirical antibiotics recommended for VAP cases should be updated according to the surveillance data. © 2011 Düzce Medical Journal

NASOPHARYNGEAL CARCINOMA IN THE ETIOLOGY OF FEVER OF UNKNOWN ORIGIN

Geyik, Mehmet Faruk/0000-0002-0906-0902WOS: 000281404900018Fever of unknown origin is defined as a temperature higher than 38.3 degrees C lasting three weeks or longer and not beind diagnosed even after one week of study in-hospital settings. Infections and malignancies had been the most common causes of fever of unknown origin overall. Nasopharyngeal carcinoma,constituting less than 0.03% of all malignant tumors and only 2% of all head and neck cancer. Ebstein Barr virus infection consumption of smoked and salted fish and vitamin-C deficient diet have been blamed in its etiology. In this study,we present two cases who were admitted to our clinic with fever of unknown origin initially and later diagnosed with nasopharyngeal carcinoma atypically progressing

The evaluation of geriatric infections: Dicle experience [Geri?atri?k i?nfeksi?yonlarin de?erlendi?ri? lmesi?: Di?cle deneyi?mi?]

• Objective: Although successes have been achieved in the treatment of the infectious diseases with antibiotics in nowadays, infectious diseases are still serious problem in the elderly. This study was conducted in order to determine the pattern of clinical infectious diseases in hospitalized elderly patients. • Material and Method: In this study, the data of all elderly patients aged 65 and older, were hospitalized to our clinic between May 2000 and May 2005 were evaluated retrospectively. We reviewed 301 patients for diagnostic studies, risk factors, isolated microorganisms and morbidity and mortality rates. • Results: Infections as a cause of hospitalization were identified as the following frequency; sepsis (19.2%), pneumonia (17.9%), acute gastroenteritis (16.9%), acute bacterial meningitis (5.3%) and urinary tract infection (3.6%), respectively. E. coli was the most isolated microorganism in these patients. Hypertension, chronic obstructive pulmonary disease and diabetes were seen as risk factors in our patients. Seventy-three patients died during hospital stay due to their infection and chronic diseases. • Conclusion: Under diagnosis of the elderly diseases is very common due to many factors related to elderly, family members and health workers. Prognosis is rather worse especially in sepsis due to pneumonia and urinary tract infections