Selda Sayin Kutlu

Community-acquired Streptococcus mitis meningitis: a case report

BACKGROUND Streptococcus mitis is prevalent in the normal flora of the oropharynx, the female genital tract, gastrointestinal tract, and skin. Although it is usually considered to have low virulence and pathogenicity, Streptococcus mitis may cause life-threatening infections, particularly endocarditis. Meningitis with S. mitis is rare, but has been described in individuals with previous spinal anesthesia, neurosurgical procedure, malignancy, or neurological complications of endocarditis. CASE REPORT A 58-year-old, alcoholic male patient with a high fever, headache, and changes in mental status was admitted to hospital with the diagnosis of meningitis. S. mitis, isolated from cerebrospinal fluid, was sensitive to penicillin. He was given a 14-day course of ampicillin and made a full clinical recovery. CONCLUSIONS The purpose of this report is to emphasize the importance of the occurrence of S. mitis meningitis in patients with concomitant factors such as older age (>50 years), alcoholism, poor oral hygiene, and maxillary sinusitis.

Prevalence and risk factors for methicillin-resistant Staphylococcus aureus colonization in a diabetic outpatient population: A prospective cohort study

BACKGROUND Diabetes mellitus is a risk factor for methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection. We attempted to determine the prevalence and risk factors for MRSA colonization in a population of outpatients with diabetes. METHODS This prospective cohort study enrolled patients with diabetes. Anterior nares cultures were obtained from patients with diabetes admitted to outpatient endocrinology and metabolism clinics, and risk factors for MRSA colonization were analyzed. RESULTS Out of the 304 patients evaluated, 127 (41.9%) were colonized with S aureus and 30 (9.9%) were colonized with MRSA. Overall, 23.6% of all S aureus isolates were MRSA. In multivariate analysis, factors independently associated with an increased risk of MRSA colonization included the presence of connective tissue disease (odds ratio, 7.075; 95% confidence interval, 2.157-23.209; P = .001) and insulin therapy (odds ratio, 3.910; 95% confidence interval, 1.652-9.251; P = .002). CONCLUSIONS The prevalence of MRSA colonization in our sample of diabetic outpatients was 9.9%. Independent risk factors for MRSA colonization were the presence of connective tissue disease and insulin use. A better understanding of the epidemiology and risk factors for nasal MRSA colonization in the persons with diabetes may have significant implications for the treatment and prevention of MRSA infections.

Seroprevalence of human cystic echinococcosis and risk factors in animal breeders in rural communities in Denizli, Turkey

INTRODUCTION Cystic echinococcosis (CE) is a serious public health problem in sheep-raising regions of Turkey. The aim of this study was to determine the prevalence and associated risk factors of echinococcosis in rural regions of Denizli in Turkey. METHODOLOGY This study was undertaken in four townships in Denizli County between May 2009 and July 2009. Family members were interviewed to assess possible risk factors for infection and tested for anti-E. granulosus antibodies by enzyme-linked immunosorbent assay (ELISA). RESULTS Of the 1,133 individuals included in the study, 78 (6.9%) were found to be anti-EG seropositive. Multivariate analysis showed that the 30-39 year age group (odds ratio [OR]: 3.29; 95% confidence interval [CI]: 1.30 ± 8.33; p = 0.01), the ≥ 60 year group (OR: 4.08; 95% CI: 1.57 ± 10.61; p = 0.004), and the group that reported sometimes or never getting veterinary care for their animals (OR: 1.75; 95% CI: 1.05 ± 2.93; p = 0.032) had higher rates of seropositivity. Multivariate analysis showed that education was not significantly associated with seropositivity. Furthermore, no significant correlation with location, occupation, dog ownership or contact with dogs, or with cattle and/or sheep/goat ownership was found. Regular veterinary care and education had significant effects on lowering the prevalence of CE. CONCLUSIONS Our results suggest that preventive measures, such as regular veterinary care for animals and educative and supportive activities oriented to the people working in farming and animal husbandry should be taken to decrease the prevalence of human CE in Turkey.

Evaluation of Device Associated Infection Rates in Intensive Care Units of Pamukkale University Hospital

Intensive care units (ICUs) are unfortunately the epicenters of nosocomial infections. The aim of the study was to investigate device associated infection rates in a small Turkish hospital. Device utilization ratios and device associated infection rates were calculated according to definitions of the Centers for Disease Control (CDC). During a period of 24 months 1,387 patients were surveyed in our ICUs. A total of 287 device associated infections were detected. In our study ventilator associated pneumonia was the most frequent nosocomial infection with a rate of 59.7 per 1,000 ventilator days. The most frequent pathogen of device associated infection was Candida spp. High rates of device associated infections in a small Turkish hospital clearly indicate the urgent need of the implementation of infection control guidelines.

Hepatocellular Carcinoma in a Chronic Hepatitis B Patient With Suppressed Viral Replication

Yazışma Adresi / Address for Correspondence: Murat Kutlu, Pamukkale Üniversitesi, Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Denizli, Türkiye E-posta/E-mail: muratkutlu72@yahoo.com (Geliş / Received: 20 Ekim / October 2015; Kabul / Accepted: 28 Temmuz / July 2016) DOI: 10.5152/kd.2016.31 Viral Baskılanma Sağlanan Kronik Hepatit B Hastasında Hepatoselüler Kanser Gelişimi

Prophylaxis Against Human Immunodeficiency Virus

Giriş İnsan immün yetmezlik virusu (HIV), cinsel ilişki, perinatal yol, ortak injektör paylaşımı, perkütan yaralanma, mukoza teması, kan transfüzyonu ve organ transplantasyonuyla bulaşmaktadır (1). Kan, semen, vagina salgısı, plevra, perikard, periton, sinovya, beyin-omurilik ve amniyon sıvıları, HIV için bulaştırıcı olarak kabul edilirken; gözle görülür kan içermeyen dışkı, burun salgısı, tükürük, balgam, ter, gözyaşı, idrar ve kusmuk, bulaştırıcı olarak kabul edilmemektedir (2). Nadiren bulaşma bildirilmiş olmakla birlikte insan ısırıkları da, ağızda gözle görünür kanaması olan infekte kişi tarafından ısırılma söz konusuysa, riskli temas olarak değerlendirilmelidir (3,4). HIV bulaşmasını azaltmak için infekte kişilerin erken tanı ve tedavisi, güvenli cinsel ilişki, sünnet ve ortak injektör paylaşımının önlenmesinin yanı sıra antiretroviral ajanlarla temas öncesi profilaksi (TÖP) ve temas sonrası profilaksi (TSP) uygulamaları da önemlidir.