The antimicrobial susceptibility of Stenotrophomonas maltophilia isolates using three different methods and their genetic relatedness

BACKGROUND: Stenotrophomonas maltophilia is inherently resistant to many antimicrobials. So far, antimicrobial susceptibility tests for S. maltophilia have not been fully standardized. The purpose of the study was to compare the susceptibility of S. maltophilia isolates against seven different antimicrobials using three different methods and to investigate their genetic relatedness. RESULTS: Although trimethoprim/sulfamethoxazole (SXT) and ciprofloxacin have the lowest MIC values, SXT (98.1%) and ticarcillin/clavulanate (TLc) (73.1%) were found to be the most effective antimicrobials by agar dilution method, which was in accordance with the breakpoints established by NCCLS. Disc diffusion and E-test was in agreement with agar dilution method for SXT. When the isolation dates, clinics, antibiotyping, and AP-PCR data were investigated, two small outbreaks consisting of five and three cases were determined. CONCLUSION: By using the NCCLS criteria, disc diffusion and E-test were unreliable alternative methods for S. maltophilia, except for SXT. However, the significance of these data should be confirmed by further experimental and clinical studies

The prevalence of pediculus humanus capitis and tinea capitis among elementary school students in Edirne

Amaç: Bu çalışmada Edirne Merkez İlköğretim Okulları öğrencilerinde pedikulus humanus kapitis ve tinea kapitisin görülme sıklığı ve tinea kapitis yapan etkenlerin saptanması amaçlandı. Olgular ve Yöntemler: 2003 yılı Nisan ve Mayıs aylarında Edirne merkezindeki 34 ilköğretim okulunda 12.868 öğrenci tarandı. Saç ve saçlı deride lezyon görülenlerin lezyonlu bölgelerinden, saç teli ve saçlı derilerinden kazıntı örneği alındı. Alınan örneklerden KOH ile direkt mikroskobik inceleme ve sikloheksimidli Sabouraud dekstroz agarda mantar kültürü yapıldı. Bulgular: Toplam 698 (%5.4) öğrencinin başında pedikulusun sirke, nimf veya olgun şekli saptandı. Kız öğrencilerdeki pozitiflik (%10.3) erkek öğrencilerdekinden (%0.9) daha yüksekti (p<0.001). Enfestasyon oranı en az yedi yaş altında (%3.4) bulundu (p<0.001). Sosyo-ekonomik düzeyi düşük ailelerin bulunduğu bölgelerde bitlenme oranı daha yüksekti (p<0.001). Hiçbir öğrencide tinea kapitise rastlanmadı. Sonuç: Pedikulus humanus kapitisin Edirne’de bir halk sağlığı sorunu olmaya devam ettiği görüldü. Eradikasyon için aileler, öğretmenler ve sağlık çalışanları tarafından öğrencilerin periyodik kontrollerinin yapılması, hasta kişilerin tedavi edilmesi, alt yapı hizmetlerinin iyileştirilmesi, etkenden nasıl korunulması gerektiği üzerine sürekli eğitim verilmesinin yerinde olacağı sonucuna varıldı.Objectives: In this study, we aimed to determine the prevalences of pediculus humanis capitis and tinea capitis and the causative agents of tinea capitis in elementary school children in Edirne. Materials and Methods: A total of 12,868 students from 34 elementary schools were scanned in April and May 2003. Samples of skin scrapings and hair roots were collected from students with hair and scalp lesions. Specimens were evaluated microscopically by KOH, and were inoculated into agar slants of Sabouraud dextrose agar with cycloheximide. Results: Eggs, nits or adult forms of head lice were detected in 698 (5.4%) students. The prevalence of head lice was significantly higher in girls (10.3%) than in boys (0.9%) (p&lt;0.001). The infestation rate was the lowest below seven years of age (3.4%, p&lt;0.001). Infestation rate was also high in families with low socioeconomic conditions (p&lt;0.001). Tinea capitis was not detected in any of the students. Conclusion: Pediculus humanis capitis was found to continue to be a public health problem in Edirne. The following conclusions were drawn for its eradication: periodic scanning of the students by families, teachers, and health professionals should be implemented; affected children should be properly treated; health facilities should be improved; and continuous education should be given to prevent its spread

Investigation of Colistin Heteroresistance and Some Factors Affecting Heteroresistance in Carbapenem-Resistant A. baumannii Strains

Introduction: Colistin can be used in patients infected with carbapenem-resistant Acinetobacter baumannii complex (CR-ABC), but recently resistance to colistin and heteroresistance have been reported. In this study we aimed to investigate the colistin heteroresistance rates and the effects of colistin and its combinations on colistin heteroresistance/resistance development in CR-ABC strains in our hospital. Materials and Methods: Heteroresistance analysis was performed on CR-ABC isolates and standard ABC strain [American Type Culture Collection (ATCC) 19606)] strain. To investigate hidden heteroresistance, the isolates were exposed to colistin at sub-inhibitory concentrations. ‘Time-kill’ study was performed on the standard strain and a clinical strain for colistin. Serial passage test was performed to investigate the effects of drug combinations on heteroresistance/resistance development. Results: In the first heteroresistance analysis test, all strains were found to be non-heteroresistant. However, after sub-inhibitory exposure to colistin, colistin heteroresistance/resistance developed in all isolates. In serial passages, colistin-rifampicin and colistin-tigecycline (Col+Tig) combinations were found to be effective and prevented growth of colistin-resistant sub-populations even at sub-inhibitory doses. Colistin-gentamicin (Col+Gen) combination was not found to be effective against the clinical isolate while it was effective on ATCC strain. Colistin-fluconazole combination was found to be ineffective at all concentrations. Conclusion: In our study, it was shown that the strains which were detected to be non-heteroresistant could easily transform to heteroresistant/resistant forms after exposure to colistin. Colistin-rifampicin and Col+Tig combinations were found to be effective and prevented the emergence of heteroresistance/resistance to colistin even at low concentrations. At low concentrations, Col+Gen combination was ineffective against the clinical ABC isolate. Colistin-fluconazole combination failed to inhibit the emergence of resistant bacteria. Heteroresistance or resistance to colistin may easily develop because of inappropriate use of this antibiotic. To prevent this condition, colistin should be administrated at appropriate doses and in combination with the suggested antibiotics

The nosocomial infections, microorganısms and their antimicrobial susceptibilities and antibiotic consumption in intensive care unit

Trakya Üniversitesi Hastanesi (TÜH) Merkez Yoğun Bakım Ünitesi (MYBÜ)'nde kullanılan antibiyotiklerin hastane infeksiyon (Hİ) etkeni mikro-organizmalara etkinliği ve antibiyotik kullanımı ile hastane infeksiyonu gelişimi arasındaki ilişkinin belirlenmesi amaçlandı. Hastalar prospektif olarak laboratuvara ve hastaya dayalı, aktif sürveyans yöntemiyle değerlendirildi. Mikro-organizmaların tanımlanması ve antibiyotik duyarlılıklarının belirlenmesi TÜH Mikrobiyoloji Laboratuvarı'nda yapıldı. Merkez Yoğun Bakım Ünitesi'ne dokuz ayda yatırılan 135 hastadan 36 Acinetobacter cinsi bakteri, 25 Pseudomonas aeruginosa, bir Stenotrophomonas maltophilia, 20 Candida cinsi maya, sekiz Enterobacteriaceae üyesi, 25 Staphylococcus kökeni, beş Enterococcus kökeni olmak üzere 120 mikro-organizma izole edildi. Acinetobacter türlerine karşı sefaperazon/sulbaktam, P. aeruginosa kökenlerine karşı piperasilin/tazobaktam ve meropenem en etkili antibiyotikler olarak belirlendi. Gram-pozitif bakterilerde vankomisin direnci saptanmadı, ancak Staphylococcus aureus kökenlerinin %85'i metisiline dirençli idi. Hastane infeksiyonu gelişimi ile antibiyotik kullanılması arasında anlamlı ilişki bulunmadı. Uygun dozda ve sürede, YBÜ'nün florasına uygun antibiyotik kombinasyonları ampirik tedavide kullanılmalı, hastaların kültür sonucuna göre tedavi tekrar düzenlenmeli ve antibiyotik kullanımına infeksiyon uzmanına danışılarak karar verilmelidir.The aim of this study was to determine the antibiotics used in the Intensive Care Unit (ICU) of Trakya University Hospital, their effect on the microorganisms isolated as nosocomial infection agents and the relation between the antibiotic consumption and hospital infections. The patients hospitalized in ICU were evaluated prospectively with the active surveillance method based on the labor-atory and patients. The identification of microorganisms and antimicrobial susceptibilities tests were made the in Microbiology Laboratory of Trakya University Hospital. Thirty six Acinetobacter spp, 25 Pseudomonas aeruginosa, one Stenotrophomonas maltophilia, 20 Candida spp, eight bacteria belonging to Enterobectericeae, 25 Staphylococcus spp, five Enterococcus spp, in total 120 microorganisms were isolated. The most effective antibiotic against Acinetobacter spp. was cefoperasone/sulbactam, and to P. aeruginosa piperacillin/tazobactam and meropenem. The vancomycin resistance was not detected in gram positive bacteria, but 85% of Staphylococcus aureus strains were resistant to meticilline. No relation between the antibiotic usage and nosocomial infections was found. The antibiotics should be used in appropriate dosage and for appropriate periods, the combination of appropriate antibiotics according to the ICUs' flora should be used in empiric treatment and the treatment should be rearranged according to the reports of cultures. The antibiotics should be given following consultation with infectious disease specialists

Phytochemical Investigation of the Bulbs of Ornithogalum Umbellatum L. and Antimicrobial Activity of Its Raw Extract

DergiPark: 242139trakyafbdBu çalışmada Edirne civanndan toplanan Ornithogalum umbellatum L. soğanlanndaki kimyasal bileşikler izole edilmiştir. Soğanlann kloroform (CHCl) ve CHCl3:C2H5OH (2:1) ekstrelerine, kromatografik yöntemler uygulanarak ayırma ve safiaştırma işlemleri yapılmıştır. Bitkiden izole edilen maddelerin UV, lR, NMR ve FAB-Mass spektrumlan alınarak kimyasal yapılan belirlenmiştir. Kimyasal yapısı belirlenen bileşiklerden 1-(2-metil-undekanil)-2-(3-metil-heptil)-benzen dikarboksilli asit diesterinin spektroskopik yapı analizi burada sunulmaktadır. Ayrıca, soğanlann kloroform ve metanol ile ekstraksiyonu sonucu ele geçen ham ekstreler birleştirilerek bunun antimikrobiyal aktivitesi araştınlmıştır. Ham ekstrelerin denenen konsantrasyonlarda Bacillus subtilis'in üremesini inhibe etmediği, Enterococcus faecalis ve Candida albicans için daha zayıf etkili olduğu saptanmıştır. Gram-negatif basillere karşı etkilerinin ise değişken olduğu bulunmuştur.In this study, Ornithogalum umbellatum L. growning around Edirne has been phytochemically investigated. Choloroform (CHCl) and CHCl3:C2H5OH (2:1) extracts of the plant bulbs were seperated and purificated by using clıromatographic methods. The chemical structures of the isolated fo ur compounds from plant were elucidated by using UV, IR, NMR and FAB-Mass spectroscopies. One of them, 1-(2-methyl-undecanyl)-2-(3-methyl-heptyl)-beıızenedicarboxlic acid diester, was shown below. In addition , CHCl3 and CH3OH raw extract of the bulbs were combined and the n was investigated for its antimicrobial activity. The raw extract at test concentrations did not inhibit growth of Bacillus subtilis, it was more effective relatively to gram-positive coccus excluding Enterococcus faecalis. For Enterococcus faecalis and Can d i da albicans, it was detemıinated to be the least effective. For gram-egative bacils, it showed that extract was variable effective

The Synthesis of Cyclohexane Carboxylic Acid, Its Cobalt and Sodium Salts and Antimicrobial Activity of Sodium Salt

DergiPark: 246175trakyafbdSon yıllarda geçiş metal naftenatlarının (karboksilatlarının) sentezi çok fazla uygulama alanına sahip olduğundan büyük öneme sahiptir. Bu tip anorganik sentezler yeni koordinasyon bileş iklerinin elde edilmesine ve incelenmesine neden olmuştur. Burada halkaya sahip karbon asitlerinin kompleks meydana getirmesini ve bunların basit karboksilatlardan farkını belirlemek için çalışmalar yapıldı. Naftenik asit (siklohekzan karboksilikas it) ile NaOH'in karşılıklı etkisiyle sodyum karboksilat elde edildi. Daha sonra yer değiştinne reaksiyonu ile kobalt naftenat sentezlendi. Kobalt karboksilatın optimal sentezi, iki basamaklı yer değiştirme reaksiyonu ile gerçekleşmiştir. Elde edilen asit ve naftenatların IR, NMR spektrumları ve kobalt naftenatın termegravimetrik analizi alınarak fiziksel, kimyasal özellikleri ve kristal yapısı incelenmiştir. Sodyum karboksilatın antimikrobiyal aktivitesi Gram-pozitif kok (Staphylococcus aureus), Gram-negatif basit (Escheric!ıia coli) ve maya mantarında (Candida albicans) araştırılmıştır.In the recent years, the synıhesis of transition metals naphtenates beauce very imporıant because of large application possibilities. Those types of inorganic synthesis become a reason for discovery and the study of new coordination compounds. The experiments are designeel to make complex compounds of eyetic carbon acid and to study their differences from simple carboxylates. By using of naphtlıanic acid (cycloheksanccarboxylic acid) and sodium hydroxide, sodium naphthenate is produced. Then applying substation reaction, cobalt naphthenate is synthesized. The optimal yields for cobalt naphtlhenate is obtained by a two step reaction. The physical and chemical properties and structural characteristics for acid and naphthenate are obtained by applying IR, NMR and termogravimetric analysis. In this study antimicrobial activity of sodium naphthenate was also in vestigated on Gram-positive cocci (Staphylococcus aureus), Gram-negative bacilli (Escherichia coli) and yeast (Candida albicans)

Relationship between Helicobacter pylori Adenotonsillar Colonization and Frequency of Adenotonsillitis in Children

Background: There are insufficient data in the literature on the presence of Helicobacter pylori in tonsil and adenoid tissue of patients with only airway obstruction. This study examined the presence of H. pylori in surgical cases with airway obstruction or recurrent infection. Aims: To investigate the relationship between H. pylori adenotonsillar colonisation and the frequency of adenotonsillitis and to compare paediatric and adult patients according to H. pylori tonsillar colonisation. Study Design: Prospective clinical trial. Methods: Patients scheduled for adenoidectomy or tonsillectomy were classified into three groups based on indications: paediatric infection (n=29), paediatric obstruction (n=29) and adult infection (n=12). Tissue samples obtained from patients were examined for the presence of H. pylori by culture, rapid urease test and polymerase chain reaction. Results: Forty-nine tonsil tissues were examined. Positive results were found in two specimens with the rapid urease test (4.1%) and three with polymerase chain reaction examination (6.1%). Only three positive polymerase chain reaction results (5.8%) were identified in 52 adenoid tissue samples. There were no statistically significant differences in the presence of H. pylori between paediatric infection and obstruction groups or between paediatric infection and adult infection groups. Conclusion: In our study, there was a low incidence of H. pylori colonisation in tonsil and adenoid tissues. Regarding H. pylori colonisation, there was no significant difference between paediatric infection and obstruction groups. Also, no significant difference was found between adult and paediatric cases

Antimicrobial resistance patterns and serotype distribution among Salmonella enterica strains in Turkey, 2000-2002

Since Turkey currently lacks a national reference center for Salmonella infections, the present study was conducted to document the distribution of serotypes and antimicrobial resistance patterns among Salmonella enterica isolates recovered from clinical samples in ten Turkish provinces over a 2-year period. Among the 620 Salmonella enterica isolates recovered between 1 July 2000 and 30 June 2002, strains belonging to the serotypes Enteritidis (47.7%), Typhimurium (34.7%), Paratyphi B (6.0%), Typhi (2.9%), Paratyphi A (0.2%) and serogroup C (8.5%) were found. Resistance to multiple antimicrobial agents was particularly high among Salmonella Typhimurium isolates (76.7%), and resistance or decreased susceptibility to ciprofloxacin (MIC >= 0.125 mg/l) was demonstrated in Salmonella Paratyphi B, Salmonella Typhimurium and Salmonella Enteritidis strains. All of the Salmonella Typhi isolates were susceptible to ciprofloxacin. The results indicate that decreased susceptibility to ciprofloxacin is an emerging problem in Salmonella enterica in Turkey, particularly in multiresistant strains

Clinical importance of extended-spectrum beta-lactamase (PER-1-type)-producing Acinetobacter spp. and Pseudomonas aeruginosa strains

Recently, an extended-spectrum beta -lactamase (PER-I) was found to be disseminated among Acinetobacter spp, and Pseudomonas aeruginosa isolates in Turkey. A population-based cohort study was conducted to elucidate predictive mortality factors in patients with nosocomial infections caused by Acinetobacter spp. and P. aeruginosa, with particular reference to PER-1-type extended-spectrum beta -lactamase (ESBL) production. The study group comprised 16 and 21 non-survivors and 82 and 126 survivors in cohorts infected with Acinetobacter and E. aeruginosa, respectively. In the Acinetobacter-infected cohort, nosocomial pneumonia, hypotension and infection with a PER-positive isolate were independent predictors of mortality. In the P. aeruginosa-infected cohort, impaired consciousness, a PER-positive isolate, male sex and (with a negative relative risk) urinary tract infection were independent predictors of death. This study demonstrated the relationship of PER-1-type ESBL-producing Acinetobacter spp. and P. aeruginosa with poor clinical outcome