Fusidic acid resistance among staphylococci strains isolated from clinical specimens

Objectives: The aim of this study was to investigate in vitrosusceptibility of fusidic acid to clinic isolates of staphylococci.Materials and methods: The forty-one coagulase negativestaphylococci (CNS) and 18 Staphylococcus aureusstrains isolated from various clinical specimens were includedin this study. Staphylococci isolates were identifiedby conventional methods such as colony morphologyonto medium, gram staining, catalase and coagulasetests. According to “Clinical and Laboratory Standards Institute(CLSI)” criteria, antimicrobial susceptibility testingof isolates was performed by Kirby-Bauer’s disk diffusionmethod.Results: The seventy-two percent of the isolated S.aureuswere defined as methicillin sensitive-S.aureus (MSSA),28% of the isolated S.aureus were defined as methicillinresistant-S.aureus (MRSA). The difference among fusidicacid susceptibility rates of MSSA and MRSA strains wasnot statistically significant (p=0.305). The twenty-nine percentof the isolated CNS were defined as methicillin sensitive-CNS (MS-CNS), 71% of the isolated CNS were definedas methicillin resistant-CNS (MR-CNS). There wasno statistically significant difference between MS-CNSand MR-CNS strains for fusidic acid susceptibility rates(p=0.490). But the difference among fusidic acid susceptibilityrates of CNS and S.aureus strains was statisticallysignificant (p<0.001). CNS strains were found more resistancethan S.aureus strains for fusidic acid.Conclusion: In this study, the resistance rates weredetected to increase for fusidic acid along with methicillinresistance. Among CNS isolates, fusidic acid resistancerates were significantly more elevated than that forS.aureus. Fusidic acid remains as an alternative in thetreatment of infections due to staphylococci

Morganella morganii in sinonasal region: A rare case report

Morganella morganii is a gram negative pathogen andmay cause potentially lethal disease especially in patientswith underlying or immunosuppressive disease. It is commonlyfound in long-term urinary catheter used and immunesystem deficiency patients as nosocomial disease.Involving other systems such as skin, skeletal systemand central nervous system can be seen too. Sporadicoccurrence is rare and can be seen in any system by variouscauses like AIDS, snake bites and poisoning. In thiscase we present sporadic Morganella morganii infectionon sinonasal region with the presence of sinusitis, sinocutaneousfistula, preseptal cellulitis and hard palate defecton 58 year old male diabetic patient. Microbiologicalassessment from open wound and sinuses were reportedas Morganella morganii. To our knowledge, this is the firstcase of sino-nasal Morganella morganii infection with sino-cutaneous fistula, preseptal cellulitis and maxillofacialbone destruction. J Clin Exp Invest 2013; 4 (3): 383-386Key words: Morganella Morganii, sino-nasal fistula, preseptalcellulitis, bone destructio

Investigation of Entamoeba histolytica in stool specimens by direct microscopic examination and ELISA in a hospital

Objectives: Stool antigen assay has been shown to be as sensitive and specific as culture with isoenzyme analysis and to outperform microscopy for the detection of E.histolytica in endemic area. The aim of the present study is to investigate the presence of E.histolytica by direct microscopic examination and ELISA in stool samples, comparatively.Materials and methods: Between September 2010 and May 2011, a total of 975 stool samples of patients in different age groups were sent to microbiology laboratory of Kızıltepe General Hospital. Native-Lugol method and E.histolytica-specific antigen test (Adhesin Ag, Entamoeba CELISA Path) was applied to all stool samples.Results: E.histolytica/dispar cysts and/or trophozoites were observed in 21 out of 975 (2.2%) stool samples examined by native-Lugol method. In addition, E.histolytica-specific antigen in 975 stool specimens was investigated by ELISA. E.histolytica-specific antigen was determined in 4 patients which had E.histolytica/dispar cysts and/or trophozoites at direct microscopic examination. Although at direct microscopy of 3 patients E.histolytica/dispar cysts and/or trophozoites not observed, E.histolytica-specific antigen was found favorable. A total of 7 (0.7%) E.histolytica specific antigen was found in the patient’s stool samples. Patients with E.histolytica-specific antigen were treated.Conclusion: E.histolytica specific antigen in stool samples should be investigated to avoid unnecessary treatment

Bir devlet hastanesindeki klinik örneklerden izole edilen stafilokok suşlarında fusidik asit direnci

Amaç: Bu çalışmanın amacı, klinik örneklerden izole edilen stafilokok suşlarında fusidik asidin in vitro etkinliğinin araştırılmasıdır. Gereç ve yöntem: Çalışmaya çeşitli klinik örneklerden izole edilen 41 koagülaz negatif stafilokok (KNS) izolatı ile 18 Staphylococcus aureus suşu dahil edildi. Stafilokok izolatları besiyeri yüzeyindeki koloni morfolojisi, gram boyama, katalaz ve koagülaz testleri gibi konvansiyonel yöntemlerle identifiye edildi. İzolatların antimikrobiyal duyarlılıkları “Clinical and Laboratory Standards Institute (CLSI)” önerileri doğrultusunda Kirby-Bauer disk difüzyon yöntemi kullanılarak çalışıldı. Bulgular: İzole edilen S.aureus suşlarının % 72’si metisiline duyarlı (MSSA), % 28’i metisiline dirençli (MRSA) olarak tanımlandı. MSSA ve MRSA suşlarının fusidik asit duyarlılık oranları arasındaki fark istatistiksel olarak anlamlı bulunmadı (p=0.305). İzole edilen KNS’lerin % 29’u metisiline duyarlı (MS-KNS), % 71’i metisiline dirençli (MRKNS) olarak tanımlandı. MR-KNS ve MS-KNS suşlarının fusidik asit duyarlılık oranları arasında istatistiksel olarak anlamlı fark yoktu (p=0.490). Ancak, KNS ve S.aureus suşlarının fusidik asit duyarlılık oranları arasındaki fark istatistiksel olarak anlamlıydı (p<0.001). KNS suşları fusidik aside S.aureus suşlarından daha fazla dirençli bulundu. Sonuç: Bu çalışmada, metisilin direnci ile birlikte fusidik aside karşı da direnç gelişiminde artış olduğu gözlendi. KNS izolatları arasındaki fusidik aside direnç oranları S.aureus suşlarına göre önemli ölçüde artmıştır. Sonuç olarak, fusidik asit stafilokoklara bağlı enfeksiyonların tedavisinde hala bir alternatif olarak durmaktadır.Objectives: The aim of this study was to investigate in vitro susceptibility of fusidic acid to clinic isolates of staphylococci. Materials and methods: The forty-one coagulase negative staphylococci (CNS) and 18 Staphylococcus aureus strains isolated from various clinical specimens were included in this study. Staphylococci isolates were identified by conventional methods such as colony morphology onto medium, gram staining, catalase and coagulase tests. According to “Clinical and Laboratory Standards Institute (CLSI)” criteria, antimicrobial susceptibility testing of isolates was performed by Kirby-Bauer’s disk diffusion method. Results: The seventy-two percent of the isolated S.aureus were defined as methicillin sensitive-S.aureus (MSSA), 28% of the isolated S.aureus were defined as methicillin resistant-S.aureus (MRSA). The difference among fusidic acid susceptibility rates of MSSA and MRSA strains was not statistically significant (p=0.305). The twenty-nine percent of the isolated CNS were defined as methicillin sensitive- CNS (MS-CNS), 71% of the isolated CNS were defined as methicillin resistant-CNS (MR-CNS). There was no statistically significant difference between MS-CNS and MR-CNS strains for fusidic acid susceptibility rates (p=0.490). But the difference among fusidic acid susceptibility rates of CNS and S.aureus strains was statistically significant (p&lt;0.001). CNS strains were found more resistance than S.aureus strains for fusidic acid. Conclusion: In this study, the resistance rates were detected to increase for fusidic acid along with methicillin resistance. Among CNS isolates, fusidic acid resistance rates were significantly more elevated than that for S.aureus. Fusidic acid remains as an alternative in the treatment of infections due to staphylococci

Helicobacter pylori antigen prevalence in dyspeptic patients in Kırşehir region

Helicobacter pylori is a microorganism found as related to gastritis, peptic ulcus and gastric cancer. In developed countries H. pylori antigen prevalence was low, but relatively high rates were reported in developing countries. In this study, H. pylori antigen was investigated in the stool samples of the outpatients with dyspeptic complaints.Materials and Methods: H. pylori antigen prevalence in stool samples of 592 outpatients with dyspeptic complaints were evaluated by Helicobacter pylori stool antigen test in the study period November 2009 - June 2010.Results: The stool samples of 149 patients [41 (27.5%) male and 108 (72.5%) female] were found to be positive for H. pylori stool antigen test and overall prevalence was 25.2%. The highest prevalence for antigen test was detected in patient group over 70 years. No significant relationship was found between antigen positivity and gender.Conclusion: H. pylori antigen prevalence in our study group was lower than the studies published before in our country. Antigen positivity ratio was detected to be increased with age

Klinik örneklerden izole edilen staphylococcus suşlarına karşı kinupristin- dalfopristin, metisilin ve vankomisinin in vitro etkinliği

Bu çalışmada, çeşitli klinik örneklerden izole edilen stafilokok suşlarında kinupristin-dalfopristin duyarlılık oranlarının araştırılması amaçlanmıştır. Çalışmaya, mikrobiyoloji laboratuvarına gönderilen çeşitli klinik örneklerden izole edilen 98 stafilokok suşu [74'ü koagülaz negatif stafilokok (KNS) ve 24'ü S. aureus] dahil edildi. Stafilokok suşları konvansiyonel yöntemler ile tanımlandı. Stafilokok suşlarının metisilin ve kinupristin-dalfopristin duyarlılığı Clinical and Laboratory Standards Institute (CLSI) önerileri doğrultusunda Kirby-Bauer disk difüzyon yöntemiyle çalışıldı. Ayrıca suşların vankomisin duyarlılığı E-test yöntemi ile araştırıldı. Çalışmada kalite kontrol suşu olarak S. aureus ATCC 25923 kullanıldı. İzole edilen KNS’lerin 53(% 72)’ü metisiline dirençli KNS (MR-KNS) ve S. aureus’ların ise 3(%13)’ü metisiline dirençli (MRSA) olarak tanımlandı. MRKNS’lerin 8(% 15)’i kinupristin-dalfopristine dirençli iken, metisiline duyarlı KNS'lerde (MS-KNS) kinupristindalfopristin direnci 1(%5) suşta tespit edildi. MSSA ve MRSA suşlarının hiçbirinde kinupristin-dalfopristin direnci tespit edilmedi. Suşların tamamının vankomisine duyarlı olduğu bulundu. Stafilokok suşlarının kinupristindalfopristine yüksek oranda duyarlı oldukları bulundu. Sonuç olarak vankomisin gibi kinupristin-dalfopristin kombinasyonun da özellikle dirençli Gram-pozitif kok enfeksiyonlarının tedavisinde alternatif olabileceğini düşünmekteyiz.The aim of the study is to investigate susceptibility of staphylococci strains isolated from various clinical samples to quinupristin-dalfopristin. The ninety-eight strains of staphylococci [74 coagulase-negative staphylococci (CNSs) and 24 S. aureus] isolated from various clinical samples were included the study which had been sent to microbiology laboratory. Staphylococci strains were identified by using conventional methods. Methicillin and quinupristin-dalfopristin susceptibility of staphylococci strains were performed by Kirby-Bauer&amp;#8217;s disc diffusion method according to the Clinical and Laboratory Standards Institute criteria. Also, vancomycin susceptibility of strains was investigated by E-test method. Strain of S. aureus ATCC 25923 was used as the quality control strain. The fifty-three (72%) strains of the CNSs were defined as methicillinresistant CNS (MR-CNS), three (13%) strains of S. aureus was defined as methicillin-resistant S. aureus (MRSA). The eight (15%) strains of MR-CNS were found resistant to quinupristin-dalfopristin, one (5%) strain of MS-CNS were found resistant to quinupristin-dalfopristin. None of MSSA or MRSA strains were resistant to quinupristin-dalfopristin. All of the strains were found as susceptible to vancomycin. Strains of staphylococci were found susceptible to quinupristin-dalfopristin at high rates. Consequently we think that quinupristin-dalfopristin combination may be an alternative option for treatment of resistant Gram-positive cocci infections like vancomycin

In-vitro activity of fosfomycin trometamol and some other antibiotics against Escherichia coli strains isolated from urinary tract infections

Objectives: In recent years, in our country and the world, susceptibility of uropathogenic E.coli strains to commonly used antibiotics in the treatment of urinary tract infections has decreased. That decreased susceptibility has been caused to treatment failure, need to change the empirical treatment, increase in prescription costs, prolongation of hospital stay, increased social costs, increased morbidity and mortality. In this study, determination of susceptibility to different variety of antibiotics and fosfomycin in urinary tract infection isolate E.coli were aimed.Materials and methods: The study included E.coli positive urine samples which had been sent to State Hospital Central Laboratory in Kızıltepe between August 2010 and December 2010. These isolates were obtained from patients who have microscopically 10/mm3 leukocyte in urine. In this study, we tested susceptibility of isolated E.coli to FOT (Fosfomycin), CIP(ciprofloxacin), IP (İmipenem), TZP (Piperasilin-Tazobactam), CAZ (Ceftazidim). According to CLSI criteria, susceptibility testing was performed by Kirby-Bauer disc diffusion method.Results: E.coli strains isolated from urine samples examined between August 2010 and December 2010, all were susceptible to fosfomisine. The resistance rates of E.coli strains to Ceftazidim, Ciprofloxacin, İmipenem, Piperacillin-Tazobactam were found respectively 33.3%, 49.1%, 36.8%, 45.6% (Table 1).Conclusions: Because of the high susceptibility rates of fosfomycin at community-acquired urinary tract infection, it can be preferred to the non-complicated urinary tract infections as an antimicrobial agent

Intestinal parasites and report of etiological analysis in a state hospital

Amaç: İntestinal parazitler, özellikle gelişmekte olan ülkeler başta olmak üzere küresel olarak yaklaşık dört milyar insanı etkileyen önemli bir halk sağlığı sorunudur. Bu çalışma; çoklu (mikst) intestinal parazit prevalansını ve potansiyel infeksiyon kaynağını belirlemek amacıyla yapılmıştır. Gereç ve yöntem: Çalışmaya 4 aylık periyotta, Kızıltepe Devlet Hastanesi Mikrobiyoloji Laboratuvarına paraziter etken varlığının araştırılması amacıyla gönderilen 1620 dışkı örneği prospektif olarak dahil edildi. Makroskobik inceleme sonrası dışkı örnekleri, dışkı konsantratör tüpü ile çöktürülüp kopro-parazitolojik yöntemlerden nativ-lugol yöntemi uygulanarak intestinal parazitler yönünden incelendi. Dışkı örneklerinin tamamı Entamoeba histolytica/dispar taraması için ticari test kiti kullanılarak Mikro-ELISA yöntemi ile adhezin antijen varlığı yönünden araştırıldı. Bulgular: Çalışmada, toplam 1620 insan dışkı örneği incelendi ve 447’si (% 27.6) intestinal parazitler yönünden olumlu bulundu. Enfekte dışkı örnekleri arasında; 63’ünün (% 14.1) iki parazit ve 18’inin (% 4.0) üç parazit ile çoklu infekte olduğu görüldü. Giardia intestinalis (% 43.3), Taenia spp. (% 36.4) ve Trichomonas hominis (% 5.4) en sık tespit edilen parazitlerdi. Çoklu parazitle (G. intestinalis & Taenia spp.) infekte dışkı örneklerinde kadın ve erkekler arasında cinsiyet açısından istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Sonuç: Bulgularımız bölgemizde parazitik infeksiyonların endemik kalmaya devam ettiğini göstermektedir.Objectives: Intestinal parasitosis is a major public health problem particularly in the developing countries and affects approximately 4 billion people globally. The presented study aimed to determine the prevalence of multiple (mixt) intestinal parasites and potential source of infection in our region. Materials and methods: A total of 1,620 stool specimen that sent to Kızıltepe State Hospital Microbiology Laboratory throughout a 4 months period to investigate for parasitic agents were included. Following macroscopic examination, stool specimens were precipitated and examined for intestinal parasites by copro-parasitological methods including native-lugol method. All of stool specimens were investigated for Entamoeba histolytica/dispar screening by Micro-ELISA method using commercial kits regarding with the existence of adhesin antigens. Results: In this study, a total of 1,620 human stool samples were examined and 447 (27.6%) were found to be favorable for intestinal parasites. Among infected stool samples, 63 (14.1%) were infected with two parasites and 18 (4.0%) with three parasites. The first three most common parasites were Giardia intestinalis (43.3%), Taenia spp. (36.4%) and Trichomonas hominis (5.4%). There was no significant difference between males and females in multiple infected (G. intestinalis &amp; Taenia spp.) stool samples (p&gt;0.05). Conclusion: Our findings suggested that intestinal parasitic infections remain endemic in our region