Serdar Gül

Antimicrobial susceptibilities of Francisella tularensis subsp. holarctica strains isolated from humans in the Central Anatolia region of Turkey

OBJECTIVES To assess the in vitro susceptibility of Francisella tularensis subsp. holarctica biovar II strains to 24 antimicrobial agents. METHODS Thirty-nine F. tularensis strains isolated from humans in the Central Anatolia region of Turkey were examined. Each isolate was identified by conventional and molecular techniques. MICs of aminoglycosides, tetracyclines, fluoroquinolones, macrolides, penicillins, cephalosporins, imipenem, clindamycin, linezolid, chloramphenicol and rifampicin were determined using the Etest method on glucose/cysteine blood agar plates. Interpretation of results was made according to CLSI clinical breakpoints. RESULTS All strains were susceptible to aminoglycosides, tetracyclines, chloramphenicol, rifampicin and three fluoroquinolones. In contrast, resistance to penicillins, cephalosporins, carbapenems, macrolides and clindamycin was observed for all isolates. Fluoroquinolones had the lowest MIC(50) and MIC(90). CONCLUSIONS All strains were susceptible to the antibiotics traditionally used to treat tularaemia, such as streptomycin (MIC(90) 1.5 mg/L), gentamicin (MIC(90) 0.25 mg/L), tetracycline (MIC(90) 0.38 mg/L) and chloramphenicol (MIC(90) 0.25 mg/L). Since fluoroquinolones showed the lowest MIC values, and have important advantages over aminoglycosides, including ease of oral administration and lower toxicities, quinolones have the potential for being effective first-line therapy for tularaemia.

Tularemia during pregnancy: Report of four cases

Abstract Tularemia during pregnancy is exceedingly rare and has been reported infrequently in Europe. A review of the literature identified only 3 documented cases. Herein we report 4 tularemia cases occurring early in the second and third trimesters, which were successfully managed without any adverse pregnancy outcomes.

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.

The epidemiology of malaria in Adana between 2002 and 2012

OBJECTIVE We aimed to evaluate the epidemiological data of malaria cases in Adana province of Turkey, between 2002 and 2012. METHODS Active and passive surveillance results collected by the Malaria and Tropical Diseases Education and Research Center of the Adana Public Health Directorship were evaluated retrospectively. The patients were evaluated according to age group, gender, months, malaria species, and whether imported cases or not. RESULTS Two hundred fifty-two patients were diagnosed with malaria during a period of 11 years. Among these patients, 148 (58.7%) were male and 104 (41.3%) were female. Plasmodium vivax was detected in 229 (90.9%) patients, and P. falciparum was detected in 23 (8.1%) patients. All P. falciparum cases and six of the P. vivax cases were of foreign origin. When the patients were evaluated according to age group, 203 (80.5%) were over 15 years of age, and it was statistically significant (p<0.05). CONCLUSION Çukurova is an endemic region for malaria, and Adana is the largest city in the region. We believe that surveillance studies conducted without any interruption may prevent malaria from becoming a reemerging problem in this region.

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

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.