Treatment of Ventilator-Associated Gram-Negative Pneumonia with Imipenem-Cilastatin/Amikacin Versus Ticarcillin-Clavulanate/Amikacin

Ventilator-associated pneumonia (VAP) is a common nosocomial infection in the intensive care unit (ICU). This study was performed in the Reanimation and Emergency ICUs of the Ankara D›flkap› Education and Research Hospital between January 1997 and January 2000. In a randomized, prospective trial, we compared imipenem-cilastatin (500 mg four times a day) + amikacin (1 g single dose a day) with ticarcillin/clavulanate (3.1 g four times a day) + amikacin (1 g single dose a day) for the treatment of VAP in 35 adult ICU patients. In this study, there was no statistically significant difference between the mortality rates and risk factors of the group I patients and group II patients (p> 0.05). Our results demonstrate that in patients with VAP, there is no significant difference between combination therapy with ticarcillin-clavulanate/amikacin and imipenem-cilastatin/amikacin in terms of bacteriological eradication and clinical response

Brucellosis: Evaluation of 72 Cases

Clinical, laboratory, treatment characteristics and complications of 72 patients with brucellosis treated in our clinic between January 2000 and December 2004 have been investigated retrospectively. The main symptoms were artralgia (80.6%), malaise (80.6%), fever (76.4%), sweating (63.9%), myalgia (62.5%), lumbar and back pain (62.5%), headache (22.2%) and anorexia (19.4%). There were signs of fever (30.5%), hepatomegaly (15.3%), splenomegaly (9.7%), lymphadenopaty (5.6%). Osteoarticular involvement in 30 (41.6%) patients, neurobrucellosis in 10 (13.9%) patients, orchitis in 2 (2.8%) patients, hepatitis in 2 (2.8%) patients, pancytopenia in 2 (2.8%) patients were determined as complications

Evaluation of 244 Central Nervous System Infection Cases

In this study, etiologic factors, morbidity and mortality ratio were evaluated retrospectively in a total of 244 central nervous system infection cases, between January 1998 and December 2004, in S.B. Ankara D›flkap› Teaching Hospital, Department of Infectious Diseases and Clinical Microbiology. Of 244 cases, 133 (54.5%) were bacterial, 81 (33.2%) were viral, 21 (8.6%) were tuberculous, 8 (3.3%) were Brucella meningitis and 1 (0.4%) was neurosyphilis. Cerebrospinal fluid cultures of 133 bacterial meningitis revealed Streptococcus pneumoniae in 16 (12%) cases, Neisseria meningitidis in 1 (0.8%) case, Acinetobacter spp. in 1 (0.8%) case, methicillin resistant Staphylococcus aureus in 2 (1.5%) cases, Pseudomonas aeruginosa in 2 (1.5%) cases, and Escherichia coli in 1 (0.8%) case. With regard to tuberculous meningitis cases, Mycobacterium tuberculosis was cultured in 2 (9.5%) cases. The highest morbidity ratio was in tuberculous meningitis cases followed by acute bacterial and viral meningitis cases. Of the 21 tuberculous meningitis cases, 7 (33.3%) cases had visual disability, 9 (42.9%) cases had confusion, 8 (38.1%) cases had focal neurological deficit, 10 (47.6%) cases had hydrocephalus. In the patients with bacterial meningitis 3 (2.3%) cases had hearing loss, 5 (3.8%) cases had visual disability, 7 (5.3%) cases had focal neurological deficit. Four of the patients with herpes encephalitis had behavioral disability. Sixteen (6.6%) bacterial meningitis, 8 (1.6%) tuberculous meningitis and 7 (2.9%) viral encephalitis were died. Case fatality rate was 11.1%