Species level identification and antifungal susceptibility of yeasts isolated from various clinical specimens and evaluation of Integral System Yeasts Plus

It is essential to use easy, standard, cost-effective and accurate methods for identification and susceptibility testing of yeasts in routine practice. This study aimed to establish the species distribution and antifungal susceptibility of yeast isolates and also to evaluate the performance of the colorimetric and commercially available Integral System Yeasts Plus (ISYP). Yeast isolates (n=116) were identified by conventional methods and ISYP. Antifungal susceptibility testing was performed by the microdilution method according to the standards of CLSI M27-A3 and ISYP. Candida albicans (50%) was the most common species isolated, followed by C. parapsilosis (25%) (mostly in blood samples). According to the CLSI M27-S3 criteria, resistance rates for amphotericin B, flucytosine, fluconazole, itraconazole, and voriconazole were 0%, 0%, 4.6%, 4.5% and 1.8%, respectively. Resistance for miconazole (MIC >1 mg/L) was found as 17.9%. Sixty-two (53.4%) of the isolates which were analyzed by ISYP showed disagreement with those identified by the conventional methods and API ID 32C identification kit or a specific identification code could not be assigned by ISYP. The performance of ISYP could be indicated as low for all antifungal drugs tested according to the ROC analysis (AUC: 0.28-0.56). As the current version of ISYP displays a poor performance, it is recommended to use the other commercial systems whose results are approved as reliable and in agreement with those of the reference methods in identification and susceptibility testing of yeasts

Maximum Inspiratory Pressure: Can it Be A Helpful Parameter for Predicting Successful Weaning in Chronic Obstructive Pulmonary Disease Patients?

Objective: To evaluate the predictive value of maximum inspiratory pressure (MIP) besides rapid and shallow breathing index (RSBI) in the weaning of chronic obstructive pulmonary disease (COPD) patients. Material and Methods: Fifty-six COPD patients with acute exacerbation and type II respiratory failure requiring invasive mechanical ventilation for more than 24 hours were enrolled in this study. Extubation was planned if the patients tolerated pressure support mode for at least two hours and spontaneous breathing during a 30 minutes T-piece trial. Breathing frequency, exhaled tidal volume, rapid and shallow breathing index (RSBI), minute ventilation (Vmin), MIP and vital capacity measurements were recorded prior to extubation. Patients were divided into two groups according to weaning success (WS) and failure. WS was defined as 48 hours of independence from mechanical ventilation after extubation. Results: Although RSBI values between two groups were not significantly different, there were statistically significant differences between the two groups in terms of MIP (30 vs 18 cmH2O; p= 0.008) and Vmin (10.40 vs 8.25; p= 0.032). Patients with a MIP value greater than or equal to 25 cm H2O had greater WS when compared to those with values lower than 25 cm H2O. Conclusion: RSBI alone seems not reliable enough to predict weaning outcome in COPD patients with type II respiratory failure due to acute exacerbation. Supported with MIP, better results may be achieved to predict weaning outcome

TÜRKIYE’DE YOĞUN BAKIM ÜNITELERINDE VENTILATÖR ILIŞKILI PNÖMONIYI ÖNLEMEK IÇIN ALINAN GÜNCEL ÖNLEMLER: TÜRK TORAKS DERNEĞI SOLUNUM YETMEZLIĞI VE YOĞUN BAKIM ÇALIŞMA GRUBU NOKTA PREVALANS ÇALIŞMASI

Objectives: The inadequate quality and nature of sleep is a commonly reported problem among hospitalized patients. The purpose of this study is to examine the effects of progressive muscle relaxation training program on sleep quality, sleep state, pain and life quality of patients who underwent pulmonary resection