Salmonella enterica kökenlerinde azalmış siprofloksasin duyarlılığı ve nalidiksik asit tarama testi

Although the fluoroquinolones are the drugs of choice for invasive Salmonella infections, recently reduced ciprofloxacin susceptibility and therapeutic failures have been reported from many countries. The purpose of this study was to determine reduced ciprofloxacin susceptibity among Salmonella enterica strains isolated in the routine laboratory. A total of 133 Salmonella enterica isolates collected between 1997-2005 were studied retrospectively. Nalidixic acid and ciprofloxacin susceptibilities were investigated by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines, also ciprofloxacin MIC values were determined by E-test. Reduced ciprofloxacin susceptibility was described as MIC values ? 1 ;micro;g/ml - ? 0.125 ;micro;g/ml. Ciprofloxacin MIC values of all 133 isolates were between 0.004-0.25 ;micro;g/ml. Twenty two isolates were classified as nalidixic acid resistant while the rest 111 were evaluated as sensitive. Ciprofloxacin MIC values of these 111 strains were ? 0.064 ;micro;g/ml and 22 isolates had MIC's between 0.125-0.25 ;micro;g/ml. Isolates for which the ciprofloxacin MICs were ? 0.064 ;micro;g/ml had inhibition zone diameters ? 33 mm for nalidixic acid whereas isolates showing decreased ciprofloxacin susceptibility had zone diameters of 25-32 mm. Among the S. enterica strains isolated in the laboratory 16.5% reduced ciprofloxacin susceptibility and nalidixic acid resistance were detected. To determine the reduced ciprofloxacin susceptibility, screening nalidixic acid resistance by disk diffusion was observed to be helpful.İnvazif Salmonella infeksiyonlarında florokinolonların ilk seçilecek ilaçlar olmasına karşın son zamanlarda bir çok ülkeden azalmış duyarlılık ve buna bağlı tedavi başarısızlıkları bildirilmektedir. Bu çalışmanın amacı, Salmonella enterica kökenlerinde azalmış siprofloksasin duyarlılığını araştırmaktır. Çalışmada 1997-2005 yılları arasında soyutlanan 133 S. enterica kökeni retrospektif olarak incelendi. Nalidiksik asit ve siprofloksa-sin duyarlılıkları Clinical and Laboratory Standards Institute (CLSI) önerileri doğrultusunda disk difüzyon, siprofloksasin MİK değerleri ise E-test yöntemi ile belirlendi. Azalmış siprofloksasin duyarlılığı, siprofloksasin MİK ? 1 µg/ml - ? 0.125 µg/ml olması olarak tanımlandı. İncelenen kökenlerin siprofloksasin MİK değerleri 0.004-0.25 µg/ml. arasında bulundu. Kökenlerin 22'si nalidiksik aside dirençli, 111'i duyarlı idi. Duyarlı 111 kökenin siprofloksasin MİK'leri ? 0.064 µg/ml, dirençli 22 kökenin ise 0.125-0.25 µg/ml arasındaydı. Siprofloksasin MİK'leri ? 0.064 µg/ml olan kökenlerin disk difüzyon yöntemindeki nalidiksik asit inhibisyon zon çapları ? 33 mm bulundu. Siprofloksasine azalmış duyarlılık görülen kökenlerin zon çapları ise 25-32 mm arasında idi. Soyutlanan S. enterica kökenleri arasında %16.5 oranında azalmış siprofloksasasin duyarlılılığı belirlendi. Disk difüzyon yöntemi ile nalidiksik asit direnci araştırmanın azalmış siprofloksasin duyarlılığı olan kökenleri belirlemede yararlı olduğu görüldü

The Utility of Colistin in Multiple Drug-Resistant Pseudomonas aeruginosa Bacterial Keratitis in a Kaposi's Sarcoma Patient

WOS: 000484381700009PubMed ID: 31486610A 71-year-old male patient presented with decreased visual acuity, redness, and discharge in his right eye for 5 days. He had undergone evisceration of his left eye several years earlier. Before presentation, he had received chemotherapeutic agents for Kaposi's sarcoma of the scalp. Slit-lamp examination revealed severe hypopyon and an extensive corneal ulcer with surrounding infiltrate, which extended to the deep stroma. Microbiological evaluation identified the causative agent to be multiple drug-resistant Pseudomonas aeruginosa. Based on culture and susceptibility results, the patient was started on topical colistin 0.19% instilled hourly. Complete resolution of keratitis with residual corneal scarring was observed. In recent years, there has been an increase in drug resistance in P. aeruginosa keratitis. The lack of new antimicrobial agents against these resistant strains has led clinicians to reconsider colistin, which is an old drug. In this report, we aimed to stress the utility of colistin in multiple drug-resistant P. aeruginosa bacterial keratitis in a Kaposi's sarcoma patient

Secondary bacterial infections and antimicrobial resistance in COVID-19: comparative evaluation of pre-pandemic and pandemic-era, a retrospective single center study

Purpose In this study, we aimed to evaluate the epidemiology and antimicrobial resistance (AMR) patterns of bacterial pathogens in COVID-19 patients and to compare the results with control groups from the pre-pandemic and pandemic era. Methods Microbiological database records of all the COVID-19 diagnosed patients in the Ege University Hospital between March 15, 2020, and June 15, 2020, evaluated retrospectively. Patients who acquired secondary bacterial infections (SBIs) and bacterial co-infections were analyzed. Etiology and AMR data of the bacterial infections were collected. Results were also compared to control groups from pre-pandemic and pandemic era data. Results In total, 4859 positive culture results from 3532 patients were analyzed. Fifty-two (3.59%) patients had 78 SBIs and 38 (2.62%) patients had 45 bacterial co-infections among 1447 COVID-19 patients. 22/85 (25.88%) patients died who had bacterial infections. The respiratory culture-positive sample rate was 39.02% among all culture-positive samples in the COVID-19 group. There was a significant decrease in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (8.94%) compared to samples from the pre-pandemic (20.76%) and pandemic era (20.74%) (p = 0.001 for both comparisons). Interestingly, Acinetobacter baumannii was the main pathogen in the respiratory infections of COVID-19 patients (9.76%) and the rate was significantly higher than pre-pandemic (3.49%, p < 0.002) and pandemic era control groups (3.11%, p < 0.001). Conclusion Due to the low frequency of SBIs reported during the ongoing pandemic, a more careful and targeted antimicrobial prescription should be taken. While patients with COVID-19 had lower levels of ESBL-producing Enterobacterales, the frequency of multidrug-resistant (MDR) A. baumannii is higher.Karolinska InstituteOpen access funding provided by Karolinska Institute. The author(s) received no specific funding for this work

EVALUATION OF CHILDHOOD URINARY TRACT INFECTION AND ANTIBIOTIC SUSCEPTIBILITY IN A TURKISH CENTER

WOS: 000541963200991[No abstract available

Nosocomial Infections in a Neurological Intensive Care Unit

WOS: 000270682900006Background: Nosocomial infections in intensive care units are common and associated with high morbidity, mortality. This study was planned to evaluate the occurance and causes of site specific nosocomial infections in a neurological intensive care unit (NICU) and their relevance to underlying diseases. Methods: Patients treated for more than 24 hours in Ege University Medical School Hospital NICU were evaluated by prospective daily surveillance for overall and site specific infections during the 12 months of the year 2005. Nosocomial infections incidence and their relation with underlying disease were investigated. Results: Three hundred and fifty six patients were included. A hundred and ten nosocomial infections were seen. The rate of infection per 100 patients was 30.8. Site-specific infections were; urinary tract infection (49.1%), pneumonia (30.9%), catheter related blood stream infections (18.1%) and primary bacteremia (1.8%). In univariate analysis, no differences were found between the patients with stroke and other NICU disorders in terms of risk factors for NICU-AI such as; age, gender, type of nosocomial infections, length of stay, and mortality. But the length of stay was significantly prolonged and mortality was significantly higher in patients with NICU-AI when compared with patients without NICU-AIs. Conclusion: The incidence of nosocomial infections in our NICU was found to be as high as in other critical care units and causes higher mortality. This was supposed to be associated with prolonged hospital stay and insufficient compliance to infection control measures instead of the underlying disease of the patients