Vancomycin versus Linezolid in the Treatment of Methicillin-Resistant Staphylococcus aureus Meningitis

Abstract Background: Vancomycin is the mainstay of treatment for methicillin-resistant Staphylococcus aureus (MRSA) meningitis. However, successful outcomes with linezolid have not been reported in a large series of patients. We conducted a single-center retrospective cohort study to compare vancomycin with linezolid in the treatment of MRSA meningitis. Methods: We extracted data and outcomes for all adult patients (age > 18 years) with culture-proved MRSA meningitis who received vancomycin or linezolid between January 2006 and June 2011. A definite diagnosis of meningitis was based on the isolation of MRSA in at least one cerebrospinal fluid (CSF) culture and findings in CSF that are typical of the infection. Linezolid was given intravenously (IV) at a dosage of 600 mg q12h and vancomycin IV at 500 mg q6h. Results: A total of 8 patients with MRSA meningitis (5 male, 3 female; age [mean -SD] 61.6 -13.2 years) received vancomycin and 9 patients (7 male, 2 female; age 59.1 -15.6 years) received linezolid. All isolated strains of MRSA were susceptible to both vancomycin and linezolid. The rates of microbiologic success with linezolid or vancomycin, in terms of clearance of MRSA from CSF on day 5, were 7/9 and 2/8 (p = 0.044, Fisher exact test). No severe adverse events occurred in either treatment arm of the study. One-month survival of the patients in whom treatment was successful microbiologically was 2/2 in the vancomycin-treated group and 4/7 in the linezolidtreated group. Minimum inhibitory concentration (MIC) data for vancomycin were available for 5/6 treatment failures with vancomycin, and vancomycin MIC values of these five strains were 2 mg/L. Conclusion: Analysis of the findings in the limited cohorts in our study suggests that linezolid is superior to vancomycin for treating MRSA meningitis, especially in cases in which there is a high MIC (2 mg/L) for vancomycin. A clinical study involving larger cohorts may increase the evidence available in relation to this question

The effect of COVID-19 on tourists' attitudes and travel intentions: an empirical study on camping/glamping tourism in Turkey during COVID-19

Purpose - In this study, visitors' attitudes and behavioural intentions towards camping/glamping tourism in Turkey during the pandemic were investigated using the extended theory of planned behaviour (TPB). The model has been extended to include constructs such as risk perception and risk aversion attitudes that stem from COVID-19 to predict visitors' attitudes and behavioural intentions. Design/methodology/approach - The data were collected through an online questionnaire from 432 participants who have experience and interest in camping/glamping tourism in Turkey. The responses were analysed using the structural equation modelling (SEM). Findings - The findings show that besides the basic TPB structures, other added variables also significantly affect visitors' attitudes and intentions. Moreover, it has been observed that the risk perception and risk aversion attitude derived from COVID-19 increase negative emotions in visitors and decreased behavioural intentions. Research limitations/implications - The results of the study are discussed for future research as well as its academic and practical implications. Originality/value - This theoretical expansion is thought to increase the theory's predictive power in predicting visitors' behaviour during the pandemic

Vancomycin versus linezolid in the treatment of methicillin-resistant Staphylococcus aureus meningitis in an experimental rabbit model

WOS: 000314393900001PubMed ID: 23111752Background: The aim of this study was to compare the antibacterial efficacy of vancomycin and linezolid in a rabbit model of methicillin-resistant Staphylococcus aureus (MRSA) meningitis. Material/Methods: Meningitis was induced by intracisternal inoculation of ATCC 43300 strain. After 16 h incubation time and development of meningitis, the vancomycin group received vancomycin 20 mg/kg every 12 h. The linezolid-10 and linezolid-20 groups received linezolid in 10 and 20 mg/kg dosages every 12 h, respectively. The control group did not receive any antibiotics. Cerebrospinal fluid bacterial counts were measured at the end of 16-h incubation time and at the end of 24-h treatment. Results: Bacterial counts were similar in all groups at 16 h. At the end of treatment the decrease in bacterial counts in the vancomycin group was approximately 2 logs higher than the linezolid-20 group (p>0.05) and approximately 4 logs higher than in the linezolid-10 group (p: 0.037) (Vancomycin group: -2.860 +/- 4.495 versus Linezolid-20: -0.724 +/- 4.360, versus Linezolid-10: 1.39 +/- 3.37). Full or partial bacteriological response was higher in vancomycin versus linezolid-10 (p: 0.01), but not vancomycin versus linezolid-20 or linezolid-10 versus-linezolid-20 groups. Conclusions: Our results suggest that linezolid is not statistically inferior to vancomycin in the treatment of MRSA meningitis in an experimental rabbit model in 20 mg/kg q12 h dosage; however, it is inferior in 10 mg/kg q12 h dosage. Additional data should gathered to confirm these findings in advance of clinical trials to assess efficacy in humans.Ege UniversityEge UniversityEge Universit

Genetic Relationships Among Some Hawthorn (Crataegus spp.) Species and Genotypes

The genus Crataegus is well distributed in Turkey as a wild plant, with numerous, inherently variable species and genotypes. RAPD markers were used to study 17 hawthorn genotypes belonging to Crataegus monogyna ssp. monogyna Jacq (2 genotypes), C. monogyna ssp. azarella Jacq (1), Crataegus pontica K.Koch (3), Crataegus orientalis var. orientalis Pallas Ex Bieb (3), Crataegus pseudoheterophylla Pojark (1), Crataegus aronia var. dentata Browicz (1), C. aronia var. aronia Browicz (4), and Crateagus x bornmuelleri Zabel (2). The 10 RAPD primers produced 72 polymorphic bands (88% polymorphism). A dendrogram based on Jaccard's index included four major groups and one outgroup according to taxa. The lowest genetic variability was observed within C. aronia var. aronia genotypes. The study demonstrated that RAPD analysis is efficient for genotyping wild-grown hawthorns

PHYSICO-CHEMICAL AND BIOLOGICAL ACTIVITY OF HAWTHORN (Crataegus spp. L.) FRUITS IN TURKEY

Hawthorn (Crataegus spp. L.) is a native fruit of great economic importance in Turkey and has been widely using in folk medicine particularly for the treatment of mild heart diseases for a long time. In the study, 18 previously selected hawthorn genotypes belong to several Crataegus species grown in the hawthorn repository collection in Malatya province in Turkey were evaluated. Fruit mass and soluble solid content of selected genotypes ranged from 0.76 to 4.27 g and 6.71 to 15.83%, respectively. The genotype 44MA12 belongs to C. monogyna subsp. azarella had distinct and the highest anthocyanin (516 mg per 100 g fresh fruit) content and the strongest 1,1-diphenyl-2-picrylhydrazyl radical scavenging capacity (2.91 mu g.g(-1)). The genotype 44MA11 belongs to C. meyeri had the highest phenolic content (3460 mg per 100 g gallic acid equivalent in fresh fruits). All hawthorn genotypes displayed high antioxidant activity. The results suggest that hawthorn fruits including significant human health benefit substances and may be used for developing functional foods because of its high phenolic, anthocyanin content and antioxidant properties

Optimization of long-term investments of electric distribution systems considering planning metrics

This paper presents a dynamic planning algorithm methodology which optimizes long-term primary electric distribution network investments considering planning metrics. An algorithm which calculates a representative primary network model of distribution grids, whose primary and secondary networks are intricate, is developed. It is aimed to facilitate assessment of primary distribution network investment requirements and thereby defining grid investment candidates effectively. A planning algorithm, which considers representative primary network model and candidate planning investments as inputs, is developed based on a mixed integer programming (MIP) technique. Some planning metrics are defined in order to technically and economically assess optimum investments along the planning horizon. DIgSILENT PowerFactory (PF) software is utilized in technical analysis to assess impacts of candidate grid investments on technical constraints. The algorithms and planning metrics developed in the study are tested satisfactorily on pilot regions of Akdeniz Electric Distribution Company in Turkey

Vancomycin versus Linezolid in the Treatment of Methicillin-Resistant Staphylococcus aureus Meningitis

WOS: 000323419000004PubMed ID: 23672240Background: Vancomycin is the mainstay of treatment for methicillin-resistant Staphylococcus aureus (MRSA) meningitis. However, successful outcomes with linezolid have not been reported in a large series of patients. We conducted a single-center retrospective cohort study to compare vancomycin with linezolid in the treatment of MRSA meningitis. Methods: We extracted data and outcomes for all adult patients (age > 18 years) with culture-proved MRSA meningitis who received vancomycin or linezolid between January 2006 and June 2011. A definite diagnosis of meningitis was based on the isolation of MRSA in at least one cerebrospinal fluid (CSF) culture and findings in CSF that are typical of the infection. Linezolid was given intravenously (IV) at a dosage of 600mg q12h and vancomycin IV at 500mg q6h. Results: A total of 8 patients with MRSA meningitis (5 male, 3 female; age [mean +/- SD] 61.6 +/- 13.2 years) received vancomycin and 9 patients (7 male, 2 female; age 59.1 +/- 15.6 years) received linezolid. All isolated strains of MRSA were susceptible to both vancomycin and linezolid. The rates of microbiologic success with linezolid or vancomycin, in terms of clearance of MRSA from CSF on day 5, were 7/9 and 2/8 (p = 0.044, Fisher exact test). No severe adverse events occurred in either treatment arm of the study. One-month survival of the patients in whom treatment was successful microbiologically was 2/2 in the vancomycin-treated group and 4/7 in the linezolid-treated group. Minimum inhibitory concentration (MIC) data for vancomycin were available for 5/6 treatment failures with vancomycin, and vancomycin MIC values of these five strains were 2 mg/L. Conclusion: Analysis of the findings in the limited cohorts in our study suggests that linezolid is superior to vancomycin for treating MRSA meningitis, especially in cases in which there is a high MIC (2mg/L) for vancomycin. A clinical study involving larger cohorts may increase the evidence available in relation to this question

Neuromyelitis Optica and Neuromyelitis Optica Spectrum Disorder Patients in Turkish Cohort Demographic, Clinical, and Laboratory Features

Background: Neuromyelitis optica (NMO) is an immune-mediated, chronic relapsing, inflammatory disease characterized by severe attacks of optic neuritis and myelitis