Aslihan Candevir

Pseudomonas aeruginosa infections due to electronic faucets in a neonatal intensive care unit.

Aim:u2003 To evaluate the role of electronic faucets in a newborn intensive care unit during a Pseudomonas aeruginosa outbreak.

Withdrawal of Staphylococcus aureus from intensive care units in Turkey

BACKGROUNDnIn the past, Staphylococcus aureus infections have displayed various patterns of epidemiologic curves in hospitals, particularly in intensive care units (ICUs). This study aimed to characterize the current trend in a nationwide survey of ICUs in Turkey.nnnMETHODSnA total of 88 ICUs from 36 Turkish tertiary hospitals were included in this retrospective study, which was performed during the first 3 months of both 2008 (period [P] 1) and 2011 (P2). A P value ≤.01 was considered significant.nnnRESULTSnAlthough overall rates of hospital-acquired infection (HAI) and device-associated infection densities were similar in P1 and P2, the densities of HAIs due to S aureus and methicillin-resistant Sxa0aureus (MRSA) were significantly lower in P2 (P < .0001). However, the proportion of HAIs due to Acinetobacter was significantly higher in P2 (P < .0001).nnnCONCLUSIONSnThe incidence of S aureus infections is declining rapidly in Turkish ICUs, with potential impacts on empirical treatment strategies in these ICUs.

A significant interaction between moxifloxacin and warfarin in a patient with a mitral bioprosthetic valve

Moxifloxacin is an advanced-generation fluoroquinolone with a broad spectrum of antimicrobial activity that is not metabolized by cytochrome P450 system. Therefore, the drug interaction of moxifloxacin is rarely seen. It has been reported that moxifloxacin is safe and well tolerable. We aimed to report a drug interaction between moxifloxacin and warfarin in a 74-year-old patient with a prosthetic mitral valve.

Hepatitis B, Hepatitis C, Human immunodeficiency virus and syphilis frequency among blood donors: A single center study

We aimed to provide updated results for seroprevalence of hepatitis B, hepatitis C viruses while presenting first data for human immunodeficiency virus and syphilis seropositivity amongst blood donors in Adana, Turkey. Screening and confirmatory test results of 62,461 donors were evaluated. HBsAg, anti-HCV, anti-HIV1/2 and syphilis seropositivity was 1.92%, 0.48%, 0.20%, 0.18% respectively, based on screening tests, and 1.66%, 0.05%, 0.003%, 0.10% respectively, according to confirmatory tests. Transfusion-transmitted infections (TTI) was more prevalent in low-educated donors. HBsAg and syphilis seropositivity rates were higher in married subjects. We found that the prevalence of HBV and HCV was significantly decreased in the last two decades in Adana. Importantly, this study provides first data in HIV and syphilis seropositivity rates among blood donors in our region and both HIV and syphilis seroprevalences were found to be low compared to many regions of Turkey. However, considering the fact that increasing number of immigrants may change prevalences and trends of TTI both in Adana and in Turkey, strict monitorization and yearly reporting of TTI rates seem necessary to be able to take proactive measures.

A Case of HIV Infection with Thrombocytopenia: Assosiation of HIV, Thrombotic Thrombocytopenic Purpura and Brucellosis

To report a case of HIV infection presenting with thrombotic thrombocytopenic purpura (TTP) and brucellosis that responded well to plasmapheresis and anti-infective therapy. A 64-year-old woman with moderate confusion, fever and pancytopenia was admitted. HIV infection history was taken from her family and she was not receiving antiretroviral therapy last one year. She had generalized purpuric skin lesions. Wright tube agglutination test was found positive with a 1:160 dilution and the patient was diagnosed as brucellosis. Detailed literature search showed brucellosis as a possible cause of TTP. Patient was treated by plasma exchange/fresh frozen plasma and antimicrobials and the response was excellent. Although brucellosis seems to explain the clinical picture of this patient, it is revealed that broad differential diagnosis is needed to reach uncommon diagnosis like TTP particularly in HIV infected patients.

Colonization and Resistance Patterns of Gram-Positive and Gram-Negative Bacteria in Patients Had No Recent History of Hospitalization

Objectives:The aims of this study were to evaluate colonization with resistant gram-positive and gram-negative microorganisms and the results of antibiotic susceptibility of patients who had no history of hospitalization at least within the last 3 months and also to evaluate the risk factors of antibiotic resistance in bacterial isolates. Methods:A cross-sectional study was designed in a university hospital. Patients admitted to hospital between January 1, and December 31, 2008, was included in the study. A total of 653 isolates of nasal and rectal swab cultures were obtained from 248 patients. Risk factors and demographic data were determined with a prospective surveillance. Logistic regression models were performed to evaluate the independent risk factors for resistance. Results:Methicillin resistant Staphylococcus aureus rate in Staphylococcus aureus was 3.9%, and methicillin resistance rate in coagulase-negative staphylococci was 60.6%. Extended-spectrum &bgr;-lactamase (ESBL) production rate of Escherichia coli and Klebsiella pneumoniae isolates was 15%, quinolone resistance rate in Enterobactericeae was 20.7%, and vancomycin resistance rate in Enterococcus species was 10.8%. Univariate analyses were shown that antibiotic use was found to be risk factors associated with the recovery of a resistant organism for ESBL production (odds ratio [OR], 6.2; 95% confidence interval [CI], 2.8-13.8), quinolone (OR, 3.5; 95% CI, 1.9-6.6), and methicillin resistance (OR, 3.3; 95% CI, 1.7-6.2). In multivariate analysis, independent risk factors associated with the recovery of a resistant organism were found to be use of antibiotics. Previous hospitalization was also found to be an independent risk factor for methicillin resistance (OR, 2.4; 95% CI, 1.2-4.6). Conclusions:Resistance rates of isolates were found to be high. An especially high rate of quinolone resistance and production of ESBL in colonized Enterobacteriacea species and vancomycin resistance in colonized Enterococcus species in community are starting to attract attention.