Microorganisms and Antibiotic Resistance Patterns of Pneumonia in Patients on Mechanical Ventilation

To determine the causative microorganisms, their antibiotic resistance and empirical treatment in ventilator associated pneumonia (VAP), 101 patients on mechanical ventilation were studied. The material extracted by bronchoscopic techniques (protected specimen brush, bronchoalveolar lavage) was tested by classic microbiological and quantitative culture methods. VAP was detected at 45 (44.5%) of our patients. We isolated P. aeruginosa (35%), S. aureus (22.8%) and K. pneumoniae (17.5%) as the causative agents of VAP. P. aeruginosa isolates were found to be sensitive to ciprofloxacine (82%), amikacin (70%) imipenem (64%) and ceftazidime (60%), but were resistant to cefoperazone (88%), mezlocillin (85%) and gentamicin (80%) by standart disk diffusion method according to National Committee for Clinical Laboratory Standards (NCCLS) criteria. Staphylococcus aureus isolates were sensitive to cotrimoxazole (65%), ciprofloxacine (63%); methicillin resistance were found as 26%, all isolates were sensitive to vancomycin and teicoplanin. K. pneumoniae isolates were sensitive to ciprofloxacine (83%), amikacin (79%), imipenem (74%), ceftazidime (70%), but were resistant to ampicillin/sulbactam and cefazoline (80%), and tobramycin (69%). In conclusion, the causative microorganisms of VAP and their resistance patterns for each hospital should be taken into consideration for planning the empirical therapy

Assessment of the antibody response in 110 healthy individuals who have been subject to Vi capsular polysaccharide vaccine.

Typhoid fever is a disease predominant in underdeveloped and developing countries. Typhoid fever is more prevalent, in fact endemic, in countries where fecal contamination of water and food sources are very common. The majority of the reported cases are in the adult age group. There are three different vaccines which can be used to prevent typhoid fever. In this study, we have used the parenteral Vi vaccine which was developed using the polysaccharide Vi antigen that covers the bacterial surface, thus, concealing the O antigen protecting the bacteria against Anti-O antibodies and regarded as virulence factor. A total of 110 individuals whose sera were negative for seroconversion prior to vaccination were included in this study in which we have assessed Anti-Vi antibodies by tube agglutination. Serum and stool samples of 110 individuals were assessed 1 month after the vaccination. A total of 105 (95.5%) of the vaccinated people were considered to have positive (1/40 and higher) response and this result was regarded as prophylactic seroconversion. None of the people in the study group had Salmonella typhi, S. paratyphi A,B,C isolated from their stool cultures

Antibody Seroprevalence of Diphtheria in Young Adults

Our study has been planned to search for the susceptibility of the young adult population to diphtheria. For this purpose, 410 soldiers in 20-25 age group have been tested for their antibodies against diphteriae. We have also recorded their ages, education status and geographic regions. Blood samples were taken from a research group of mean age 20.89 ± 0.095 and then 0.5 mL adult type diphtheria-tetanus vaccine (Imogam dT, Pasteur-Merieux, France) was applied. Of 410, the second blood samples of 316 subjects were taken for searching the diphtheria antibodies. Diphtheriae antibody levels were tested by using of Gen-enzyme Virotech GmbH (Löwenplatz 5, Rüsselsheim, Germany) test kit in the first and the second blood samples of these 316 subjects. 24.5% (50/204) of the 20 years age group, 29.4% (30/102) of the 21-24 years age group and 30% (3/10) of the 25 years age group had antibodies under the protective level of 0.01 IU/mL. Prior to vaccination period a statistically insignificant difference between the groups was determined with respect to age, educational status and geographic area (p> 0.05 for all groups). After the vaccination, in all age groups the antibody levels were found as above the protective level. According to these results, it can be concluded that dT vaccination should be considered for the 20 years age group

The effect of the doxycycline-rifampicin and levamisole combination on lymphocyte subgroups and functions of phagocytic cells in patients with chronic brucellosis.

Background: Brucellosis is one of the important health problems for both humans and animals in Turkey since agriculture and stock raising appears to be the most important means of subsistence. Investigations on the pathogenesis of brucellosis reveal that the etiologic agent can survive in phagocytic cells, and cell-mediated immunity plays an important role in immunity against bacteria. Methods: In this study, we investigated whether supplementation of levamisole, a well-known antihelminthic agent with immune-stimulating activity to conventional antibiotic therapy, would improve the anergy against Brucella . Results: The results of our study reveal that a 6-week course of levamisole as a supplement to conventional antibiotic therapy in chronic brucellosis is not superior to conventional antibiotic treatment alone with respect to lymphocyte subgroup ratios and phagocytic function. Conclusion: In chronic brucellosis, levamisole administered as a supplement concomitantly with conventional antibiotic therapy has no immunostimulating effect on the basis of the lymphocyte subgroups ratios measured and the ability of phagocytosis in the present study. Further large clinical and laboratory trials are necessary to investigate the immunological and physiological effects of levamisole on T H1 subtypes and cytokine secretion

Investigation into the efficacy of diagnostic tests ın brucellosis

Çalışmamızda, Haziran 2000-Mayıs 2003 tarihleri arasında anamnez ve fizik muayene bulgularıyla bruselloz olduğu düşünülen, Rose Bengal lam aglütinasyon testi (RBT) ve Wright tüp aglütinasyon testi (TAT) pozitif bulunarak tanısı kesinleşen 24’ü erkek, 8’i kadın hastada bruselloz tanı yöntemlerinin etkinliği araştırılmıştır. Olgularımızın %100’ünde RBT ve TAT, 12 (%37.5) hastada Brucella IgM pozitif bulundu. ELISA yöntemiyle bakteriye karşı oluşan antikorların tespitinin, hastalığın tanı ve tedavisinin takibinde anlamlı olduğu görüldü. Hastalarımızın %18.7’sinde kanda, %28.1’inde kemik iliğinde üreme saptandı. Kültür sonuçlarının düşük kalmasının nedeni, hastalara tanı konmadan önce başka sağlık kuruluşları tarafından verilen çeşitli antibiyotikler olarak düşünüldü. Çalışmamızda, 3 (%9) olguda PCR tekniği ile serumda Brucella bakterisi saptandı. Hasta serumunun PCR tekniği için uygun örnek olmadığı düşünüldü.In our study, 24 male and 8 female patients with brucellosis whose diagnosis were confirmed by positive slide agglutination (Rose Bengal) and standard tube agglutination (Wright) tests were enrolled between the dates of June 2000 and May 2003. Both agglutination tests were positive in all patients. In the serological diagnosis of brucellosis, Brucella IgM antibodies detected by using ELISA were positive in 12 (37.5%) patients respectively. Detection of the antibodies by using ELISA method was found to be effective in the diagnosis and follow-up to response to the treatment of Brucella. Blood and bone marrow cultures were positive in 18.75% and 28.1% of patients, respectively. Non-specific antibiotic use before specific diagnosis and treatment was thought as a cause of low positivity rate in culture results. Because polymerase chain reaction (PCR) assay was positive only in 3 (%9) patients, the serum was considered not to be the appropriate material for the analysi