Ugur Arslan

Serratia marcescens sepsis outbreak in a neonatal intensive care unit.

Background:u2002 Contaminated parenteral nutrition (PN) is an important source of infection in neonates. Many organisms have been reported to cause contamination resulting in outbreaks in intensive care units. The aim of the present study was to investigate an outbreak caused by Serratia marcescens in a neonatal intensive care unit (NICU).

Transient bacteremia after removal of a bonded maxillary expansion appliance.

INTRODUCTIONnThe aim of this study was to investigate the presence of transient bacteremia after the removal of a modified bonded rapid maxillary expansion appliance.nnnMETHODSnThe sample consisted of 25 subjects (15 girls, 10 boys; mean age, 14.4 years; range, 12.2-16.6 years). All subjects underwent rapid maxillary expansion at the start of the orthodontic treatment with the same type of appliance. Two 10-mL blood samples were taken, the first as a baseline and the second 3 minutes after removal of the appliance. All blood samples were incubated in an automated blood culture system, and bacteria were identified by using conventional biochemical methods and API kits (bioMérieux, Marcy lEtoile, France).nnnRESULTSnOvert soft-tissue bleeding was observed in 11 of the 25 patients during appliance removal, and 8 of 25 patients showed bacteremia after appliance removal. The data were analyzed with the Fisher exact test. No statistically significant relationship was found between overt bleeding and bacteremia incidence (P = 0.054).nnnCONCLUSIONSnBecause transient bacteremia is caused by trauma from the removal of the modified bonded rapid maxillary expansion appliance, orthodontists should consider the possibility of bacterial endocarditis in at-risk patients when using splint-type tooth-and-tissue-borne rapid maxillary expansion appliances.

Chemotherapy-induced Hepatitis B virus reactivation in HbsAg positive cancer patients: a single center experience

Hepatitis B reactivation due to chemotherapy is a cause of serious morbidity and mortality in some of the patients with cancer. In this study, we retrospectively assessed the prevalence of hepatitis B reactivation among the patients undergoing cytotoxic chemotherapy. We investigated efficacy of lamivudine prophylaxis against hepatitis B reactivation as well.

Effects of 2 bracket and ligation types on plaque retention: a quantitative microbiologic analysis with real-time polymerase chain reaction.

INTRODUCTIONnThe aim of this study was to evaluate the effects of self-ligating brackets and conventional brackets ligated with stainless steel ligatures on dental plaque retention and microbial flora.nnnMETHODSnTwenty boys (mean age, 14.2 ± 1.5 years) underwent bonding with self-ligating bracket systems and conventional standard edgewise bracket systems ligated with stainless steel ligatures with a split-mouth design. Clinical measurements, including plaque index, probing pocket depth, and bleeding on probing, were obtained before bonding, 1 week after bonding, and 3 months after bonding. Supragingival plaque samples were obtained at baseline and 3 months after bonding for the detection of bacteria. A quantitative analysis for Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, and Lactobacillus acidophilus was performed using real-time polymerase chain reaction. The Mann-Whitney U test and the Hotelling T(2) multivariate test were used for statistical comparisons of the groups.nnnRESULTSnThe numbers of S mutans, S sobrinus, L casei, and L acidophilus were not statistically different between self-ligating brackets and conventional brackets ligated with stainless steel ligatures (Pxa0>0.05). The 2 archwire ligation techniques showed no statistically significant differences in plaque index, bleeding on probing, and probing pocket depth values of the bonded teeth (Pxa0>0.05). All clinical parameters and the numbers of all microorganisms showed statistically significant increases from baseline to 3 months after bonding in both groups (Pxa0<0.001).nnnCONCLUSIONSnSelf-ligating brackets and conventional brackets ligated with stainless steel ligatures do not differ with regard to dental plaque retention.

Two outbreaks of ESBL‐producing Klebsiella pneumoniae in a neonatal intensive care unit

In the present study, two epidemic episodes of extended spectrum beta‐lactamase (ESBL)‐producing Klebsiella pneumoniae in the neonatal intensive care unit (NICU) were evaluated.

Antimicrobial susceptibility and resistance mechanisms of methicillin resistant Staphylococcus aureus isolated from 12 Hospitals in Turkey

IntroductionMethicillin-resistant Staphylococcus aureus (MRSA) is one of the most important nosocomial pathogens and is also emerging in Turkish hospitals. The aim of this study was to determine the antimicrobial susceptibility profiles of MRSA isolated from Turkish hospitals.Materials and methodsA total of 397 MRSA strains isolated from 12 hospitals in Turkey were included to present study. Antimicrobial susceptibilities were tested using agar dilution method. Presence of ermA, ermB, ermC, msrA, tetM, tetK, linA and aac-aph genes were studied by PCR.ResultsAll strains were susceptible to vancomycin and linezolid. The susceptibility rates for fusidic acid, lincomycin, erythromycin, tetracyclin, gentamycin, kanamycin, and, ciprofloxacin were 91.9%, 41.1%, 27.2%, 11.8%, 8.5%, 8.3% and 6.8%, respectively. Lincomycin inactivation was positive for 3 isolates. Of 225 erythromycin resistant isolates 48 had ermA, 20 had ermC, and 128 had ermA-C. PCR was negative for 15 strains. Of 3 isolates with lincomycin inactivation one had linA and msrA. Of 358 gentamycin resistant isolates 334 had aac-aph and 24 were negatives. Among 350 tetracyclin resistant isolates 314 had tetM. Of 36 tetM negative isolates 10 had tetK.ConclusionMRSA isolates from Turkish hospitals were multiresistant to antimicrobials. Quinolone and gentamycin resistance levels were high and macrolide and lincosamide resistance were relatively low. Susceptibility rates for fusidic asid were high. Linezolide and vancomycin resistance are not emerged. The most common resistance genes were ermA, tetM and aac-aph. Evolution of antimicrobial susceptibilities and resistance genes profiles of MRSA isolates should be surveyed at regional and national level for accurate treatment of patients and to control dissemination of resistance genes.

Molecular epidemiology of vancomycin-resistant Enterococcus faecium strains isolated from haematological malignancy patients in a research hospital in Turkey

Infections and outbreaks of vancomycin-resistant enterococci (VRE) still appear to be rare in Turkey. In the present study, VRE strains isolated during an outbreak in a haematology unit of a training and research hospital in Turkey were typed and their antimicrobial-resistance patterns were characterized by molecular methods. Twelve vancomycin-resistant Enterococcus faecium strains isolated from patients with haematological malignancies were investigated by PCR for the presence of genes encoding resistance to vancomycin, tetracycline, chloramphenicol, gentamicin and erythromycin. Their clonal relationship was evaluated by PFGE and multilocus sequence typing. All strains were resistant to vancomycin and erythromycin, and had the vanA and ermB genes, respectively. PFGE was used to determine the presence of two pulsotypes and determine their subtypes. Pulsotype A belonged to sequence type (ST) 17 and pulsotype B belonged to ST 78. All strains with the vanA gene were not the same clone, indicating multiple acquisitions of resistant isolates, even over such a short time period.

Serum C-reactive protein and procalcitonin levels in non-small cell lung cancer patients

Aim of the study The basic uses of C-reactive protein (CRP) and procalcitonin (PCT) in clinical practice are in the diagnosis and follow-up of infectious disease. The fact that CRP already achieves high levels in cases with lung cancer, however, limits its diagnostic specificity. Procalcitonin may be an important marker in the differential diagnosis of lung cancer patients who have fever and high CRP levels. Our objective in this study was to determine the levels of CRP and PCT in patients with newly diagnosed non-infectious non-small cell lung cancer (NSCLC) and to relate these results to patient and disease characteristics. Material and methods Serum CRP and PCT levels were measured in 79 histopathologically proven NSCLC patients and 20 healthy controls. Results were compared with demographic and clinical variables in patients with NSCLC. Results Serum CRP concentrations were significantly higher in NSCLC patients compared to the control group [38.30 (7.79–185) mg/dl vs. 7.79 (3.36–26.10) mg/dl; p < 0.001]. There was no significant difference between the two groups in PCT levels (p > 0.05). A mild, positive correlation was found between CRP level and tumor diameter. When comparing CRP levels in the lung cancer patients grouped according to age, sex, smoking status, clinical TNM staging and performance status (PS), the only significant difference found was that for PS score. Conclusions High serum CRP levels in non-infectious NSCLC patients are mainly related to PS status and weakly to tumor size. Adding serum PCT measurement may contribute to exclusion of infections in patients with NSCLC.

Identification and antifungal susceptibility of Candida species isolated from bloodstream infections in Konya, Turkey

BackgroundIn this study, our aim was to identify Candida species isolated from bloodstream infections and to determine their susceptibilities to various antifungal agents to demonstrate the local resistance profiles and to guide empirical treatment for clinicians.MethodsTwo hundred Candida isolates (95 Candida albicans, 105 non-albicans Candida strains) were included in the study. Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, voriconazole, posaconazole, caspofungin and anidulafungin were performed with broth microdilution method according to the Clinical and Laboratory Standards Institute M27-A3 document.ResultsOf the 200 Candida strains, the most prevalent species were C. albicans (47.5xa0%), Candida glabrata (18.0xa0%) and Candida parapsilosis complex (14.0xa0%). All Candida species except for three (1.5xa0%) Candida kefyr strains were susceptible to amphotericin B. Only one (2.8xa0%) C. glabrata was resistant to fluconazole (MICxa0≥xa064xa0μg/ml), and the others (97.2xa0%) exhibited dose-dependent susceptibility. All species, but C. glabrata strains, were susceptible to fluconazole. Resistance to voriconazole, posaconazole, caspofungin and anidulafungin was not detected in any strain.ConclusionCandida albicans were susceptible to all antifungal drugs. Three C. kefyr strains were resistant to amphotericin B. Only one C. glabrata was resistant to fluconazole. All the strains were susceptible to voriconazole, posaconazole, caspofungin and anidulafungin. In vitro antifungal susceptibility tests should be performed to select of appropriate and effective antifungal therapy, and monitor the development of resistance.

Spontaneous pneumomediastinum as a complication in human bocavirus infection

The most common causes of spontaneous pneumomediastinum (SPM) in children are asthma attack and respiratory tract infection. Here, we describe a case of SPM in a human bocavirus‐infected 2‐year‐old boy with bronchiolitis.