Emine Sönmez

Nosocomial infections in a new medical center, Turkey.

Nosocomial infection was found in 255 (2.5%) of 10,164 inpatients in a new medical center with a 310-bed capacity. The infection rate was 12.5% in the intensive care unit, 9.5% in neurology, 5.5% in general surgery, and 4.0% in orthopedics. Rates in the other services were lower. Hospital-acquired infections in our medical center frequently involved multiply resistant Enterobacteriaceae and staphylococci.

Antihepatitis B response to hepatitis B vaccine administered simultaneously with tetanus toxoid in nonresponder individuals.

In this prospective study, our aim was to test the effect of simultaneous administration of preS2 and S containing recombinant hepatitis B vaccine (S2SRHB) with tetanus toxoid (TT) to the individuals who did not respond after three doses of hepatitis B vaccine previously. There were three groups (healthy individuals, pregnant women, hemodialysis patients), each was divided into two subgroups as groups A and B. Group A received S2SRHB+TT and group B received only S2SRHB. We found that in groups receiving both vaccines, both seroconversion rate and antibody titer level were significantly higher (P<0.05). In conclusion, simultaneous administration of S2SRHB+TT is more effective than administration of S2SRHB alone.

Effect of the treatment of brucellosis on leukocyte superoxide dismutase activity and plasma nitric oxide level.

Background: The mechanisms by which brucellae evade intracellular killing by polymorphonuclear leukocytes are incompletely understood. In this study, we evaluated changes of leukocyte superoxide dismutase (SOD) activity and plasma total nitrite as an indicator of nitric oxide (NO) levels during brucellosis therapy. Methods: Thirty-two patients with acute brucellosis, 27 patients with chronic brucellosis and 30 healthy controls were included in the study. Patients with acute brucellosis were tested for leukocyte SOD activity and plasma total nitrite levels before, during (21st day), and at the end (45th day) of the combined therapy of rifampicin and doxycycline. The same parameters were also investigated in chronic cases and controls. Results: The SOD activities were lower in patients with acute brucellosis before therapy compared with those 21 and 45 days after starting therapy (P< 0.001). In contrast, total nitrite levels did not change significantly (P>0.05). Conclusions: In the present study, leukocyte SOD activity was found to be decreased in patients with acute brucellosis. Enzyme activity was increased by treatment, finally reaching the activity of healthy controls. Using an antioxidant agent in addition to classical antimicrobial therapy for acute brucellosis might be a therapeutic approach.

Diagnosis of Tuberculosis: PPD or BCG Test

In recent years, several articles have been published about BCG tests in the diagnosis of tuberculosis, particularly in children. The test is reportedly more sensitive and more specific than tuberculin test (PPD). We evaluated the results of simultaneous application of PPD and BCG test in order to assess its efficacy in adults and adolescents with tuberculosis (tbc). We applied BCG test and PPD concurrently in 35 healthy controls and 41 tuberculosis cases presented to Research Hospital, Inönü University and Malatya Tuberculosis Dispensary with clinical and radiological findings. The subjects also had sputum examined for presence of acid-fast bacilli (AFB) by direct microscopy, culture on Lowenstein Jensen medium and by polymerase chain reaction (PCR). We conclude that BCG test is more sensitive and more specific than PPD in diagnosis of tuberculosis in adults and adolescents.