Yücel Duman

Intravesical hyaluronic acid and chondroitin sulfate alone and in combination for urinary tract infection: Assessment of protective effects in a rat model

Objective:  To determine the protective effects of hyaluronic acid and chondroitin sulfate in treating urinary tract infections in a rat model.

Laboratory-acquired skin infections in a clinical microbiologist: Is wearing only gloves really safe?

Laboratory-acquired infection is one of the leading occupational health hazards. On a laboratory workers hands, carbuncles occurred. Staphylococcus aureus was isolated from pus samples of the carbuncles, with the same pulsed field gel electrophoresis band pattern with one of the recently studied strains in the laboratory. Incorrect or inadequate application of infection control measures may result in pathogen acquisition from the clinical samples, and wearing only gloves is not sufficient for the biosafety of laboratory workers in clinical diagnostic laboratories.

Clinical features and follow-up results of the patients with methicillin-resistant Staphylococcus aureus (MRSA) in orthopedic practice -

Treatment of the infections caused by methicillin-resistant Staphylococcus aureus (MRSA) strains in orthopedic patients is a difficult and laborious process for both the patient and physician. Staphylococcus aureus(S. aureus) is one of the leading causes of community-acquired and nosocomial infections. In this study, we aimed to investigate the susceptibilityof the MRSA strainsisolated in orthopedic patients cultured for different reasons in our clinic to various antibiotics, and to evaluate clinical characteristics of the patients and factors affecting the prognosis. A total of 40 patients with MRSAisolated in our orthopedics clinic between December 2012 and November 2016 were retrospectively analyzed. Data including age, sex, comorbidities, previous surgeries, and previous antibiotic treatments were obtained from patients’ files and electronic information system. Of 40 patients, 60% were male, and 56% were over 60 years old. While 80% of the patients underwent an orthopedic surgery, 20% of them received no surgical intervention before the diagnosis. A total of 90% were in-patients, and the mean length of hospital stay was 22 days. The mean time from the date of hospitalization to the isolation of MRSA was 12 days. According to the consultation findings, in the clinical recovery process of the patients and in the treatment algorithm given to those patients, vancomycin and teicoplanin were found to be among the most important treatment options, in addition to significant debridement to be done, for MRSA strains. Our study results suggestthat, in addition to the surgical debridement, timely antibiotherapy is of utmost importance to reduce mortality and morbidity in MRSA-positive orthopedic patients.

Changing trends of carbapenem resistance of escherichia coli and klebsiella pneumoniae strains isolated from intensive care units, inpatient services and outpatient's clinics: a five years retrospective analysis

Background: Carbapenem resistance (CR) was rarely reported in Klebsiella pneumoniae and Escherichia coli strains until ten years ago. In recent years, increasing carbapenem resistance in gram negative bacteria is a substantial concern. Objectives: In this study; we aimed to evaluate the changing frequency of CR in K.pneumoniae and E.coli strains that were isolated from the patients from intensive care units, inpatient services and outpatientsÂ’ clinics in the last five years. Methods: Data of antimicrobial susceptibility belonging to clinical isolates of K.pneumoniae and E.coli strains determined between 2013 and 2017 were retrospectively collected from Laboratory Information System. Results were statistically analyzed. Results: A total 4002 K.pneumoniae and 13462 E.coli strains were included. The CR of K.pneumoniae strains were found as 11.6%; while of E.coliÂ’s were found as 0.6%. The highest CR frequency was detected among intensive care unitsÂ’ isolates of K. pneumoniae as 20.1%. We determined that CR significantly increased in intensive care unit isolates of E.coli and K.pneumoniae about 5-10 folds throughout the study period; however, there was no remarkable change in the CR of E.coli strains from the outpatientsÂ’ clinics. Conclusion: We determined that the resistances of K.pneumoniae and E.coli strains to carbapenems were progressively increasing by years, especially in intensive care units and inpatient services. Therefore, appropriate antimicrobial use policies sought to be considered against to this growing problem.

Investigation of HBV DNA in HBsAg positive patients

Hepatitis B virus is an important health problem which about 400 million people are infected chronically and 500,000 to 1,200,000 people die every year due to HBV-related diseases. In the study we aimed to investigate the HBV DNA results in HBsAg positive patients. HBsAg positivity was detected by ELISA method in patients who were admitted to our hospital with suspicion of hepatitis. HBV DNA was performed by real time PCR. In this context, the presence of HBV DNA in serum sample results of 2437 HBsAg-positive patients which were sent to our Microbiology laboratory between August 2014 and August 2015 was retrospectively examined. HBV DNA was positive in 1037 (42.5%) and 1400 (57.5%) of the HBsAg positive cases. 42.2% of male patients’ and 43% of female patients’ HBV DNA was positive. HBV DNA positivity was detected in 42% of adult patients and 55% of children in child age group. As a result; we suggest that viral replication should be demonstrated in HBsAg-positive cases and HBV DNA level should be determined for follow-up the antiviral therapy.