Birgül Kaçmaz

Procalcitonin Level and Its Predictive Effect on Mortality in Crimean-Congo Hemorrhagic Fever Patients.

Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal disease which is endemic to Turkey. We aimed to investigate the procalcitonin levels and their prognostic value over fatality in CCHF patients. The sera were harvested from patients who were diagnosed with CCHF within the first 2 days of the onset of their symptoms. The patients were divided into 2 groups according to their survival status: fatal or non-fatal. The biochemical and hematological parameters were studied in the Biochemistry Laboratory of Sorgun City Hospital. The sera were stored at -80℃ until testing for procalcitonin, and the procalcitonin levels were assayed by ELISA at the Biochemistry Laboratory of Kirikkale University. Forty- eight patients were included in the study, with 8 and 40 patients in the fatal and non-fatal groups, respectively. While the procalcitonin level was high in all patients in the fatal group, the same was observed in 30 patients in the non-fatal group (75%). The mean value of procalcitonin was 1.12 ng/ml in the fatal group and was 0.21 ng/ml in the non-fatal group (P = 0.003). According to the results of our study, the procalcitonin levels in the first 2 days of the onset of the symptoms might be helpful for predicting fatality in CCHF patients.

Risk factors for colistin-associated acute kidney injury: a multicenter study from Turkey

The aim of this study was to investigate the incidence of acute kidney injury (AKI) and risk factors due to colistin use in patients infected with multidrug-resistant pathogens. This multicenter, retrospective, observational study was conducted in Turkey, at 5 different research and university hospitals. Cox regression analyses were performed, to determine independent predictors of AKI. From April 2012 to July 2014, a total of 216 patients aged between 18-94 years, treated with colistimethate sodium (CMS) were included in the study. The mean age of the patients was 60.3 ± 20.1 years. The overall incidence of AKI was 34.3% (74/216) at any time during treatment. Concomitant use of loop diuretics, baseline creatinine level, and CMS dosage were independently associated with AKI. According to our results, patients with higher baseline creatinine levels, or patients who had to use concomitant loop diuretics may need to be monitored more closely, and dose adjustment should be done promptly. More comprehensive studies are, however, still needed to evaluate the efficacy of low-dose colistin since higher doses tend to increase the risk of AKI.

Reliability of VITEK® 2 System for Identification of Yeasts: An Isolate of Candida parapsilosis Incorrectly Identified as Cryptococcus neoformans

Yazışma Adresi / Address for Correspondence: Serdar Gül, Kırıkkale Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Kırıkkale, Türkiye E-posta/E-mail: serdarguul@yahoo.com (Geliş / Received: 26 Ocak / January 2017; Kabul / Accepted: 21 Temmuz / July 2017) DOI: 10.5152/kd.2017.24 VITEK® 2 Cihazının Mayaların Tanımlanmasındaki Güvenilirliği: Cryptococcus neoformans Olarak Tanımlanan Candida parapsilosis İzolatı

Does penile tourniquet application alter bacterial adhesion to rat urethral cells: an in vitro study

PURPOSE To investigate the effects of penile tourniquet (PT) application on bacterial adhesion to urothelium. METHODS Fifty-six rats were allocated into control group (CG), sham group (SG), PT group (PTG). No intervention was applied in CG. A 5mm-length urethral repair was performed in SG and PTG. In PTG, a 10-min duration of PT was applied during the procedure and the tissue oxygenation monitor was used to adjust the same degree of ischemia in all subjects. Samples were examined for wound healing parameters and tissue levels of inflammatory markers, eNOS, e-selectin, and ICAM-1antibodies. The adhesion of Escherichia coli to urothelium was investigated with in vitro adhesion assay. RESULTS Inflammation was higher and wound healing was worse in SG than CG and in PTG in comparison to CG and SG (p<0.05). The endothelial damage, as shown by eNOS expression, was significantly higher in PTG compared to CG and SG (p<0.05). The staining with ICAM-1 and e-selectin antibodies, showing increased inflammatory response to bacterial adhesion, was significantly higher in PTG compared to CG and SG (p<0.05). In vitro urethral cell proliferation was achieved only in CG and SG revealing significantly increased adhesion in SG compared to CG (p<0.05). The PT application caused endothelial corruption and prevented cell proliferation in cell culture. CONCLUSION The PT application does not improve wound healing and increases bacterial adhesion molecules in penile tissue. The in vitro assays showed that PT causes severe endothelial damage and inhibits endothelial cell proliferation.

İdrar Kültürlerinden İzole Edilen Bakteriler ve Antibiyotik Duyarlılıkları

Uriner sistem enfeksiyonlari, toplum kokenli ve saglik bakimi ile iliskili enfeksiyonlar arasinda en sik gorulen enfeksiyondur. Uriner enfeksiyonlarda tedavi genellikle ampirik olarak baslandigi icin etkenlerin ve antibiyotik duyarlilik paternlerinin bilinmesi tedavi basarisi icin onemlidir. Bu calismada Kirikkale Universitesi Tip Fakultesi Hastanesi Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Laboratuarinda Şubat 2013 –Şubat 2014 tarihleri arasinda idrar kulturlerinden izole edilen bakteriler ve bu bakterilerin antibiyotik duyarliliklari degerlendirilmistir. Idrar kulturunde ureme saptanan hastalar antibiyotik kullanimi ve/veya hastanede yatis oykusune gore iki gruba ayrilmistir. Grup 1, antibiyotik kullanimi olmayan ve/veya hastanede yatis oykusu bulunmayan; grup 2, antibiyotik kullanimi olan ve/veya hastanede yatis oykusu bulunan hastalardan olusturulmustur. Bakteri tanimlanmasinda ve antibiyotik duyarliliklarinin saptanmasinda Vitek 2 otomatize sistem kullanilmistir. Toplam 118 bakteri calismaya alinmistir. Birinci grup 45 ve ikinci grup 73 bakteri mevcuttu. Sonuc olarak; her iki grupta da en sik izole edilen bakteri Escherichia coli olmakla birlikte iki grup arasinda etken ve duyarlilik sonuclari bakimindan anlamli farkliliklar saptanmistir.

İDRARDA PİYÜRİ VE KÜLTÜR SONUÇLARININ KARŞILAŞTIRILMASI

Giris : Uriner sistem enfeksiyonunun tanisinda ilk adim idrarin piyuri varligi icin mikroskobik incelemesidir. Piyuri genellikle enfeksiyon ile iliskilendirilir. Gerec ve Yontem : Bu arastirmada idrar kulturu icin laboratuarimiza gelen idrar orneklerinde piyuri varligi arastirilmis, piyuri saptanan ornekler kultur uremesi ile karsilastirilmistir. Bulgular : Retrospektif olarak yapilan calismada laboratuvarimiza Ocak 2015 - Temmuz 2015 tarihleri arasinda kultur amaciyla gonderilen toplam 3787 idrar ornegi degerlendirilmistir. 927 (%24) hastada piyuri saptanmis, bu orneklerin 336’sinda (%36) anlamli ureme gorulmustur. Sonuc : Calismanin sonucunda uriner sistem enfeksiyonu dusunulen hastalarda piyurinin tek basina tani koydurucu bir test olmadigi ve bu hastalarda idrar kulturunde uremenin her zaman saptanamayabilecegi bilinmelidir.

A comparison of the recoverable proportion of methicillin-resistant Staphylococcus aureus from two different types of papers

Aim: Paper is used for various purposes in hospitals. Generally, there are two different types of paper, which are commonly used in our facility: wood-free paper, and paper containing wood. We compared the recoverable proportion of methicillin-resistant Staphylococcus aureus (MRSA; ATCC 43300) from the surface of such papers. Method: The papers were divided into two groups: Group 1: wood-free paper; Group 2: paper containing wood. The papers were contaminated in a standardized procedure with 0.1 mL of a 5×107 CFU MRSA/mL stock solution. Results: The recoverable proportion of MRSA was higher in the wood-containing papers than in the papers without wood (P=0.043). Conclusion: This study indicates that if paper is purchased for healthcare facilities it should not contain wood, but rather wood-free paper types should be considered.