Sadik Akgun

Bilateral parotitis in a patient under continuous positive airway pressure treatment

BACKGROUND AND OBJECTIVES Many conditions such as bacterial and viral infectious diseases, mechanical obstruction due to air and calculi and drugs can cause parotitis. We present a case of unusual bilateral parotitis in a patient under non-invasive continuous positive airway pressure (CPAP) therapy for chronic obstructive pulmonary disease exacerbation in intensive care unit. CASE REPORT A 36-year-old patient was admitted to intensive care unit with the diagnosis of chronic obstructive pulmonary disease exacerbation. Antibiotherapy, bronchodilator therapy and non-invasive positive pressure ventilation were applied as treatment regimen. Painless swellings developed on the 3rd day of admission on the right and a day after this on the left parotid glands. Amylase levels were increased and ultrasonographic evaluation revealed bilateral parotitis. No intervention was made and the therapy was continued. The patient was discharged on the 6th day with clinical improvement and regression of parotid swellings without any complications. CONCLUSIONS Parotitis may have occurred after retrograde air flow in the Stensen duct during CPAP application. After the exclusion of possible viral and bacteriological etiologies and possible drug reactions we can focus on this diagnosis.

An Overview of Antibacterial Resistance Patterns of Pediatric Community-Acquired Urinary Infections.

Urinary tract infection (UTI) is common in children. The aim of this study was therefor to construct a guide for the empirical antibiotic treatment of community‐acquired UTI by investigating the etiology and antimicrobial resistance patterns of uropathogens and analyzing the epidemiological and clinical patient characteristics.

The importance of culture-antibiogram and evaluation of the empirical antibiotic treatment in peritonitis due to perforated appendicitis acquired intra-abdominal infection

Prudent use of antibiotics gains more importance as increased antibiotic resistance along with a gradual recession in newly developed antibiotics is seen. It is aimed to show the importance of cultureantibiogram for detecting causative bacteria and antibiotic resistance profile for prudent antibiotic usage and empirical antibiotic coverage in pediatric and adult cases with peritonitis secondary to perforated appendicitis. This study includes a total of 58 patients who underwent surgery for perforated appendicitis and secondary peritonitis. Cultures-antibiogram obtained by suctioning of the peritoneal fluid or swabbing during the surgery of the patients having proliferation was evaluated. Out of total 35 pediatric cases, E. coli in 27 cases, E. coli and P. aeruginosa in 5 cases. In the 32 cases with E. coli cultured, antibiotic resistance was seen for Ampisilin-sulbactam (SAM) in 13 (36.1%) cases, ceftriaxone in 12 (33.3%) cases and Extended Spectrum Beta Lactamase (ESBL) in 10 (31.2%) cases. Out of total 23 adult cases, E. coli was cultured in 18 cases. Of the 18 cases with E. coli cultured, antibiotic resistance was seen for SAM in 10 (43.4%) cases, ceftriaxone in 9 (39.1%) cases and ESBL in 6 (33.3%) cases. It is believe that the evaluation of peritoneal culture results obtained during surgery will lead to a decrease in mortality and morbidity rates.

In-vitro comparison of tigecycline as an alternative to the classical therapy in brucellosis treatment

&NA; Brucellosis is an important zoonosis because of its difficult and prolonged treatment regimen; at the same time, it sometimes involves serious complications. The aim of the study was to determine the antibiotic susceptibility profiles of ciprofloxacin, clarithromycin, doxycycline, rifampicin, streptomycin, and tigecycline using the E-test method on brucellosis, and the distribution of Brucella species. Forty-four patients (24 men, 20 women) who were admitted to our laboratory between 2014 and 2016 and for whom Brucella bacteria were found to be grown in their blood cultures were included in the study. Blood samples from patients were incubated on BD Bactec Fx. Positive signaling samples were plated on sheep blood agar and eosin methylene blue agar media. The bacteria were then allowed to grow for 48 h in an incubator at 37 °C. Gram-negative cocobacillus as a result of Gram staining was identified with the Vitek 2 Compact instrument and the gram negative identification kit. Antibiotic susceptibility tests against ciprofloxacin, clarithromycin, doxycycline, rifampicin, streptomycin, and tigecycline were also evaluated. Twenty four (54.5%) of 44 patients were men, 20 (45.5%) were women and the mean age was 42.5. The youngest patient was 14 and the oldest patient was 86 years old. All of the isolated bacteria (100%) were detected as Brucella melitensis with the fully automated culture antibiogram device (Vitek 2 Compact, Biomerieux). In the evaluation realized by E-test method, the minimum and maximum minimum inhibitory concentration values for each antibiotic taken for study were obtained as follows: for ciprofloxacin, 0.125–0.50 &mgr;g/ml; for clarithromycin, 0.32–1 &mgr;g/ml; for doxycycline, 0.032–0.64 &mgr;g/ml; for rifampicin, 0.016–0.32 &mgr;g/ml; for streptomycin, 0.10–0.25 &mgr;g/ml; and for tigecycline, 0.125–0.38 &mgr;g/ml. B. melitensis was detected as the causative factor in the majority of cases of brucellosis in the world. Furthermore, according to the E-test method, lower minimum inhibitory concentration values for doxycycline, rifampicin, streptomycin, and tigecycline indicate that they are important antimicrobials in the treatment.