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Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Urinary tract infection (UTI) is among the common bacterial infections in pediatric patients. These infections are more common in girls over one year old. This study aimed to investigate the bacterial distribution and drug resistance status in urine cultures of pediatric patients in our center. Materials and Methods: Urine culture results of patients who were presented to the outpatient clinics or were admitted to the Sivas Cumhuriyet University hospital between January 2017 and December 2022 were included in the study. The hospital automation system, patient files, and laboratory information management system were examined retrospectively. Statistical analysis was performed using the SPSS 22.0 software. A P-value of <0.05 was deemed significant. Results: Significant growth was observed in the urine cultures of a total of 1287 pediatric patients, 889 (69.1%) girls and 398 boys (30.9%). The patients included in the study were between the ages of 0-17, and children aged 1-6 (37.6%) were diagnosed with UTI more frequently than other ages. The most common UTI agent in the pediatric age group was Escherichia coli (56.6%). The first agent isolated in girls and boys is E.coli. Additionally, the prevalence of K. pneumoniae, P. mirabilis and K. oxytoca bacteria was higher in boys (p < 0.05). E. coli isolates showed minimal resistance to such as amikacin (0.6%), fosfomycin (1.0%), nitrofurantoin (1.4%), ertapenem (2.4%), imipenem (0.7%) and meropenem (0.9%). Conclusion: In this study, low resistance levels were detected for amikacin, fosfomycin, nitrofurantoin and carbapenem group antibiotics, which are important alternatives in the empirical treatment of UTI. On the other hand, due to the high resistance levels detected, it is thought that more caution should be exercised in the empirical use of amoxicillin-clavulanate, trimethoprimsulfamethoxazole and cefixime. If these antibiotics are to be preferred, waiting for the antibiogram results is an appropriate approach. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the prevalence and phenotypes of macrolide, lincosamide, and streptogramın B (MLSB) resistance in Staphylococcus aureus strains isolated from clinical samples and to assess the efficacy of mupirocin and fusidic acid against these isolates. Methods: Between January 2021 and December 2022, S. aureus strains isolated from clinical samples were identified by VITEK® MS (bioMérieux, France), and their antibiotic susceptibilities were determined using VITEK® 2 (bioMérieux, France). The disk approximation method was used to determine the MLSB resistance phenotypes using erythromycin (15 μg) and clindamycin (2 μg). For fusidic acid, a MIC of ≤1 mg/L was considered susceptible, and a MIC of >1 mg/L was considered resistant. The European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2020 guidelines were followed, with a MIC of ≤1 mg/L considered sensitive, a MIC of 2-256 mg/L indicating low-level resistance, and a MIC of >256 mg/L indicating high-level resistance for mupirocin. Results: The MLSB resistance phenotypes of the strains were as follows: 8.9% inducible (iMLSB), 4.6% chromosomal (cMLSB), 12.8% MS type, 0.8% L type, and 72.92% erythromycin and clindamycin sensitive were detected. Mupirocin resistance was detected 7.2% in 250 S. aureus strains, 14.3% in MRSA, and 2.1% in MSSA. Fusidic acid resistance was seen at 10.7% in 711 S. aureus strains, 20.1% in MRSA, and 5.5% in MSSA. Conclusion: When erythromycin resistance is detected in MRSA isolates, it is essential to determine macrolide resistance phenotypes with a simple and easy method such as the D-test and investigate clindamycin resistance for choosing appropriate antibiotics. Mupirocin resistance in S. aureus strains was higher in MRSA isolates than in MSSA isolates. It is noteworthy that fusidic acid resistance is frequently seen in both MRSA and MSSA isolates that are susceptible to erythromycin and clindamycin. In infections where fusidic acid is commonly used, it is necessary to monitor antibiotic susceptibilities closely. [ABSTRACT FROM AUTHOR]

Copyright of Mersin Üniversitesi sağlık Bilimleri Dergisi is the property of Mersin University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Neonatal sepsis is a clinical syndrome characterized by non-specific signs and symptoms caused by various pathogens. The diagnosis is based on a combination of clinical and laboratory findings. Gram-positive and Gram-negative bacteria are the predominant etiologic agents. In our study,we aimed to evaluate the types of microorganisms grown in neonatal blood cultures and antimicrobial susceptibilities of Gram-negative agents. Materials and Methods: We retrospectively analyzed 2566 blood culture results. Samples from blood culture bottles with growth were passaged on blood agar. The growing colonies were identified by MALDİ-TOF MS. Antibiotic susceptibility tests were performed on a fully automated device. The results were evaluated according to EUCAST standards. Results: Growth was detected in 12.1% of the samples. 59.5% of the patients with growth were male. 66% of the patients were at term and 53.7% had early-onset sepsis. 74.6% of the cases were cesarean section and 59.5% were above 2500 grams. Coagulase-negative staphylococci (CNS) were the most common organisms grown in early and late-onset sepsis. 73.9% CNS, 9% Gram-negative enteric and nonfermentary bacilli, 2.9% Gram-positive bacilli and 0.1% fungi were grown. 40% of S.aureus were methicillin resistant. The most antimicrobial-resistant Gram-negative agent was Klebsiella spp. Klebsiella spp. isolates were resistant to amikacin 9%, ampicillin 100%, cefepime 72.7%, ceftazidime 81.8%, gentamicin 81.8%, meropenem 9.1%. Extended spectrum beta lactamase was positive in 90.9%. Acinetobacter spp. isolates were resistant to amikacin 42.8%, ampicillin 42.8%, gentamicin 42.8%, meropenem 42.8%. Conclusion: Microorganism species and antibiotic susceptibilities in intensive care units vary over time and between clinics. Broad-spectrum antimicrobials started early with suspicion of sepsis without culture confirmation can be replaced with agentspecific narrow-spectrum antimicrobials when growth is detected in culture,monotherapy can be switched or treatment can be terminated early. This may contribute to the prevention of resistance development. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective:Leishmaniasis is the second deadliest parasitic disease in the World Health Organisation’s list of neglected diseases, following malaria. Cutaneous leishmaniasis (CL) is the most common form of the disease and it is one of the few communicable diseases with increasing incidence rates owing to factors like armed conflicts and climate change. CL can be divided into two major groups: Acute CL (ACL) and chronic CL (CCL). The aim of this study was to compare the in vitro efficacy of miltefosine and pentavalent antimony compounds in the CCL patient samples.Methods:Five isolates previously isolated from 5 CCL patients were included in this study. Genotyping is performed using internal transcribed spacer 1 (ITS 1) gene region real-time PCR. In vitro drug efficacy tests were applied to determine their activity against meglumine antimoniate (MA) and miltefosine. Serial dilutions (512, 256, 128, 64, 32, 16, 8 and 4 µg/mL) prepared from MA and miltefosine were prepared in 96-well flat-bottom cell culture plates and incubated at 24 °C for 48 hours. The efficacy of the drug on Leishmania spp. promastigotes after 24 and 48 hours was evaluated by hemocytometer slide and XTT cell viability test.Results:All of the samples were genotyped as L. tropica. Evaluation of 24 and 48 hours showed, 128 µg/mL and 256 µg/mL and 32 µg/mL and 64 µg/mL concentrations of miltefosine and MA were enough to kill all the promastigotes respectively. The results of the hemocytometer slide and XTT were consistent.Conclusion:There are no studies investigating the in vitro efficacy of miltefosine with the CCL patient group. To overcome the treatment challenges experienced in this special patient group, more studies are needed. According to our results, it is concluded that miltefosine is efficient for the treatment of CCL and further clinical studies with miltefosine will reveal valuable data.

Copyright of Etlik Veteriner Mikrobiyoloji Dergisi is the property of Veteriner Kontrol Merkez Arastirma Enstitusu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Tepecik Education & Research Hospital / İzmir Tepecik Eğitim ve Araştırma Hastanesi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective:The relationship between drug resistance and the expression of hexokinase (HK) has been indicated in leishmaniasis. According to the prolonged treatment period in cutaneous leishmaniasis (CL) patients co-infected with Crithidia in Iran, this study aims to investigate the expression of HK in the proteome of Leishmania major and Crithidia using a proteomic approach.Methods:A total of 205 samples were removed from the lesions of patients in Fars province, Iran, for the characterization of L. major and Crithidia using polymerase chain reaction (PCR). After protein extraction, two-dimensional gel electrophoresis was employed for protein separation. Several spots were isolated for HK determination in the proteomes of L. major and Crithidia using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF/TOF MS).Results:The PCR results showed 5 positive cases for Crithidia and 96 positive cases for L. major. MALDI TOF/TOF MS indicated HK as a common protein in the proteome of L. major and Crithidia. HK was up-regulated in the Crithidia proteome in comparison with the L. major proteome.Conclusion:Since a relationship between HK expression and drug resistance has been indicated in leishmaniasis, the overexpression of HK in Crithidia might be related to the increased duration of the treatment period in CL patients co-infected with Crithidia.

Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In the study, 419 Mycobacterium tuberculosis complex strains (MTC), which were isolated from samples sent to the Regional Tuberculosis Laboratory in our city between 2015 and 2019 with suspected tuberculosis from Erzurum and surrounding cities were investigated. Methods: Our research is a retrospective cross-sectional study and clinical samples sent to the Regional Public Health Laboratory with suspicion of Tuberculosis within a five-year period from January 2015 to December 2019 were first evaluated by using Ehrlich-Ziehl-Neelsen staining technique. The samples were then simultaneously inoculated into the automated culture system (BACTEC MGIT 960) with Löwenstein-Jensen medium. Sensitivity research was conducted for isoniazide, rifampicin, streptomycin and ethambutol antibiotics with BACTEC MGIT 960 system to samples defined by MTC identification test (TBc ID) from reproduction positive tubes. Results: In our study, 337 (80.4%) of the 419 MTC strains investigated in our study were susceptible to all major anti-TB drugs, while 82 (19.6%) were found to be resistant to at least one major anti-TB drug. The distribution of resistance ratios was isoniazid (11.9%), streptomycin (11.7%), rifampicin (4.1%), ethambutol (3.6%). Multi-drug resistant (MDR)–TB ratio (isoniazid+ rifampicin) was found to be (3.6%). Conclusions: In our study, in the strains in which resistance to anti-TB drugs was investigated, the highest drug resistance was determined for isoniazid. The lowest drug resistance was determined for ethambutol.

Cancer is a disease that occurs in tissues and organs as a result of uncontrolled cell divisions. There are numerous types of cancer related with different frequencies and mortality rate. Ovarian cancer is the seventh common type of cancer worldwide and is the fifth cause of cancer-related death. Although there are standard treatment methods for cancer types, people give different responses to these treatment methods. In spite of all the treatment strategy developed, ovarian cancer still has a high mortality rate. For this reason, it is very important to better understand the drug resistance mechanisms that prevent the effecttiveness of today's treatment methods, to develop new treatment methods and the determination of molecular characterization. In recent years, research has focused on methods containing pathway analysis within the scope of developing targeted therapy strategies for ovarian cancer. In this context, the activity status of onco-proteins in pathways such as WNT, Hedgehog and NOTCH signaling pathways were evaluated. In addition, the innovative treatment efficiency of Nanog protein and photodynamic therapy options on ovarian cancer has been detailed in recent years. It will be possible to increase the quality of the healing process of patients suffering from this disease by enlightening the molecular characterizations of the treatment methods that are available and still being developed in the treatment of ovarian cancer. [ABSTRACT FROM AUTHOR]

Bipolar disorder is a disabling psychiatric disorder which causes premature death and loss of quality of life. Despite the developments, novel treatments are partially effective and insufficient responses to treatment may cause loss of quality of life. Contemporary approaches to treatment planning is done by taking current symptoms and personal treatment history of the patient into account and tailoring them to treatment for each patient, i.e. individualized treatment. In this article, effects and side effects of antipsychotics, mood stabilizers and sedative hypnotic medications are reviewed and presented briefly for clinicians. Although novel developments have been observed in the literature about mixed states and psychotic symptoms, evidence based options are still limited. Efficacy of mood stabilizers may be prolonged and additional medications may also be needed frequently in patients, treated with mood stabilizers. Antipsychotics may cause several side effects and cannot be maintained for a long time in some of those patients. These factors may limit the use of mood stabilizers or antipsychotics. Therefore, the experience of the clinician and personal history of the patient still have importance in the procedure. [ABSTRACT FROM AUTHOR]

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Health Sciences / Sağlık Bilimleri Dergisi is the property of Erciyes Universitesi Saglik Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Bacterial bloodstream diseases cause important public health problems and are considered as significant issues in morbidity and mortality in patients who are hospitalized. This study aimed to investigate the frequency of bacterial isolates from suspected septicemia and subsequent drug resistance patterns in affiliated patients to the Amir Al-Momenin Hospital of Gerash, Fars, Iran. Materials and Methods: In this hospital-based cross-sectional study, 2485 blood samples were examined in the Bacteriology Laboratory of Amir Al-Momenin Hospital of Gerash, during 2018-2019. Then, drug susceptibility tests were done for positive blood cultures. All specimens were cultivated in MacConkey agar, Blood Agar, and chocolate agar mediums. A total of 120 positive samples were obtained, and biochemical tests were used to classify bacteria to species levels. After identification, a drug susceptibility test was carried out on the Mueller-Hinton agar via 16 antibiotics based on the Clinical and Laboratory Standards Institute guidelines. Results: Of the 2485 blood culture results, 120 (4.82%) were determined as positive. The blood culture examination revealed the most common isolated as Staphylococcus epidermidis (45%, n=54 cases), Acinetobacter baumannii (10.83%, n=13 cases), Escherichia coli (10%, n=12 cases), Klebsiella pneumoniae (5.83%, n=7 cases), respectively. Additionally, among all the antibiotics tested, the highest percentage of resistance was related to cefoxitin in 48 cases (40%), cephalexin in 47 (39.1%), clindamycin in 47 (39.1%), and erythromycin in 42 (35%). Conclusions: Results revealed that most of the bacterial isolates had a high rate of resistance to the most commonly used antibiotics. Therefore, continuous antibiotic resistance pattern evaluation in different areas is necessary.

E. coli is one of the most important food borne pathogen, which could be transmitted by milk and milk products. To assess the role of dairy milk as the source of drug resistant E. coli, we examined 50 raw dairy milk samples (25-farm milk + 25-market milk) from some selected areas of Bangladesh by cultural, morphological, biochemical and antimicrobial sensitivity tests. In the preliminary observation, the mean total aerobic mesophilic count of market and farm raw milk samples were 8.98 and 8.68 log CFU/ml, while mean coliform count were 4.20 and 3.03 log CFU/ml respectively. Thirty-three E. coli isolates were recovered from collected samples (66% 33 of 50) and this pathogen was more prevalent in market milk (76%, 19 of 25) than farm milk (56%, 14 of 25). In addition, most of the isolated E. coli exhibited resistance against ampicillin and cefotaxime. This result shows that, the raw dairy milk and its products could be a source of human drug resistant E. coli.

The increase in methicillin and multidrug resistance (MDR) of Staphylococcus species, which are frequently isolated from cats and dogs, formed the basis of our study. For this purpose, a total of 142 clinical samples (wound, ear, eye, nasal, skin swabs, etc.) belonging to 100 dogs and 42 cats brought to the Near East University Animal Hospital were studied in our investigation. Species-level identification of Staphylococcus spp. isolated from the samples examined was performed with the VITEK-2 microbial ID/AST test system and API Staph identification system. Antimicrobial susceptibility analyzes of Staphylococcus isolates were carried out through the VITEK-2 automated system. From the samples, 78 (54.92%) Staphylococcus spp. were isolated. 52 (66.67%) of the isolates were identified as Coagulase positive Staphylococcus (CoPS) and 16 (20.51%) as Coagulase negative Staphylococcus (CoNS). Among CoPS, the most frequently identified species were S. pseudintermedius (38.46%) and S. aureus (25.64%); whereas among CoNS, S. chromogenes (10.26%) was determined as the most predominant. According to the results of antimicrobial susceptibility analyzes, 11 (28.2%) isolates were determined as methicillin resistant S. aureus (MRSA), 10 (25.64%) as methicillin resistant S. pseudintermedius (MRSP) and 10 (25.64%) isolate methicillin resistant Coagulase negative Staphylococcus (MRCoNS). Besides, 6 (40.00%) MDR-MRSP and 4 (26.66%) MDRMRSA positivity were determined among the species with multiple drug resistance. Of the 23 MDR Staphylococcus spp. isolates in total, 21 were isolated from dogs and 2 from cats. By analyzing the current approaches of the increased drug resistance with the data obtained in this study in Staphylococcus species isolated from animals, necessary contributions have been implemented to the treatment protocols within this framework. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Faculty of Pharmacy of Ankara University / Ankara Üniversitesi Eczacilik Fakültesi Dergisi is the property of Ankara University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Lacosamide is a third-generation antiepileptic agent that selectively enhances slow inactivation of sodium channels that take part in generation and propagation of action potentials and results in the diminution of neuronal excitability. Because of this new mechanism of action, it is expected to be efficacious in patients with drug-resistant epilepsy. In this study, we aimed to assess the efficacy and tolerability of lacosamide add-on treatment in refractory epilepsy patients by presenting our experience in a tertiary referral center. Methods: Medical records of refractory focal epilepsy patients who were followed in epilepsy outpatient clinic between October 2014 and May 2017 were retrospectively reviewed in this study. Patients who were treated with add-on lacosamide and completed minimum of six months follow-up period were included. ≥50% reduction in seizure frequency was defined as treatment response. Results: In this study, 88 patients were included. The percentage of seizure-free patients after six months follow-up was 4.6% and the treatment response rate was 55.6%. We also evaluated the effect of concomitant use of sodium channel blockers, the presence of abnormal findings on magnetic resonance imaging and the introduction stage of lacosamide. No significant difference was observed in the response rate regarding the mentioned parameters. 19% of the patients reported side effects, the majority of which were dizziness, vertigo and somnolence. None of them discontinued treatment because of side effects. Conclusion: Our findings suggest that lacosamide add-on therapy is effective in refractory focal epilepsy and has an appropriate tolerability and safety profile since none of the patients stopped treatment due to side effects. [ABSTRACT FROM AUTHOR]

Objective: Patients with drug-resistant focal or generalized epilepsy are important in terms of treatment and polytherapy necessity, adverse effect profiles of drugs, and seizure control difficulties. Clobazam (CLB), which has a lesser sedative effect than other benzodiazepines, is frequently used in different countries. In this study, we aimed to present the results related to the demographic characteristics, adverse effects, and treatment efficacy of patients under CLB treatment. Materials and Methods: Patients who were followed up in the outpatient clinic of Cerrahpaşa Medical Faculty were screened retrospectively. Sex, age of seizure onset, duration of epilepsy, seizure type, duration of drug use, frequency of seizures before and after CLB, and drug adverse effects were investigated. The decrease in seizure frequency could not be quantitatively evaluated in some patients because the study was retrospective. For this reason, two groups were identified as having a significant reduction in seizure frequency and being seizure-free according to the information provided by the parents and the recorded data. Results: Forty-one patients with CLB who were followed in the epilepsy clinic were examined. The mean age of 26 male and 15 female patients was 30.30 years. The mean duration of epilepsy was 20.4 years. It was determined that 16 patients were either seizure-free or had intervening rare, mild seizures. There was a significant decrease in seizure frequency in nine patients. Headache was observed in one patient, and sedation and dizziness in two patients. Conclusion: CLB is especially recommended for add-on therapy in Lennox-Gastaut syndrome. In this study, it was observed that in focal/generalized, idiopathic/ cryptogenic different groups, 39% of the patients were seizure-free. However, this effect was not lost during the mean follow-up period of 12.2 months. Although the value of this data decreases due to its retrospective nature, the place of CLB in the treatment of focal/generalized epilepsy is important. [ABSTRACT FROM AUTHOR]

Objective: In order to manage the antimicrobial treatment of patients with cholangitis/cholecystitis properly, it is very important to predict the potential causative pathogens and their antimicrobial resistance patterns. The aim of this study is to provide data for empirical treatment approaches by identifying the causative agents of biliary tract infections and their antimicrobial susceptibilities, and the risk factors in patients infected with drug-resistant microorganism. Methods: Hospitalized patients with cholangitis/cholecystitis developed primarily or secondary to a biliary tract intervention, and whose bile samples for culture could be obtained, were included in the study during a 9-month period. Bile cultures were incubated in an aerobic environment, and antimicrobial susceptibilities were tested by disk diffusion method. Isolated strains that were resistant to at least two major antimicrobial groups were regarded as "drug-resistant". Risk factors for development of infection with a drug-resistant pathogen were evaluated by univariate analysis. Results: A total of 76 bacteria were isolated from 58 bile samples obtained from patients with biliary tract infections. While 30 (39.5%) bacteria were in the drug-resistant group, patients infected with these agents were found to be 26 (44.8%). All drugresistant strains of Escherichia coli were producing extendedspectrum β-lactamases, and carbapenem resistance was seen among Pseudomonas aeruginosa strains only. Antimicrobial usage during last 3 months before diagnosis (p=0.01) and duration of hospital stay before the infective episode (p=0.03) were found to be risk factors for cholangitis due to drug-resistant agents. Conclusions: In order to guide the empirical treatment of patients with cholangitis/cholecystitis properly, antimicrobial susceptibility patterns of causative agents should be monitored closely and drug-resistant pathogens should be considered in patients with a history of antimicrobial usage during the last 3 months or who have been hospitalized for a long time before the infective episode. closely and drug-resistant pathogens should be considered in patients with a history of antimicrobial usage during the last 3 months or who have been hospitalized for a long time before the infective episode. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate the predictive factors related to pharmacotherapy resistance in patients with obsessive-compulsive disorder (OCD). Methods: Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Structured Clinical Interview for DSM-III-R Axis II Disorders (SCID-II), Yale-Brown Obsessive Compulsive Scale-Symptoms Checklist (YBOCS), Hamilton Depression Rating Scale (HDRS), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale, Level of Expressed Emotion were applied to 30 treatment resistant patient with OCD and 30 treatment responder patients with OCD. Expressed Emotion Scale (EES) were applied to the relatives of patients. Results: When the groups were compared, living out of city center, age of onset in disease, total disease duration and presence of psychiatric disease in the family, YBOCS, HDRS, OVIS, EES, CTQ sexual abuse scale scores and major depression comorbidity were significantly higher in treatment resistant group. High YBOCS total score and presence of mental illness in the family were found to be effective for predicting resistance to drug treatment. Conclusion: The high severity of the disease and the presence of psychiatric diseases in the family increase the risk of treatment resistance. [ABSTRACT FROM AUTHOR]

Riga-Fede disease (RFD) is a traumatic, reactive benign disorder characterized by persistent ulceration on the tip or ventral surface of the tongue, seen mainly in infants and children. Lesions tend to develop after the eruption of natal or primary incisors, resulting from repetitive traumatic damage due to backward and forward movements of the tongue over the lower incisors. A literature survey has revealed a very limited number of reported cases of RFD in adults. Herein we reported a 70-year-old female patient who developed RFD-like ulcers on the tongue and buccal mucosa during the previous two months, while under treatment of dental implants. Histopathological examination and direct immunofluorescence of the ulcers and periulcer area did not yield a specific diagnosis. The lesions were resistant to systemic steroid treatment, however, after applying for a soft dental plate nightly for protection of the tongue and buccal mucosa, all ulcers completely healed in two months. With regard to the presented patient, we have reviewed the cases of RFD or RFD-like ulcers reported in adults and discussed the factors contributing to ulcer formation in our patient. [ABSTRACT FROM AUTHOR]

Background and Design: Symptomatic dermographism (SD) is the most common form of the inducible urticaria that impairs quality of life significantly and requires further treatment. Guidelines recommend a stepwise approach starting with second-generation (sg) H1 antihistamines (AHs), and it has been advised that the same algorithm that is available for chronic spontaneous urticaria might be implemented in chronic inducible urticarias. However, there is a lack of clinical trials assessing the efficacy of AHs and omalizumab in patients with SD. In this study, we aimed to evaluate treatment responses in SD patients by using patient-reported outcomes and physician's assessment tools. Materials and Methods: This prospective observational study included 58 patients with SD. Treatment responses were evaluated with urticaria control test (UCT), patient's global assessment of disease severity (PatGA-VAS), physician's global assessment of disease control (PhyGA-VAS), and dermatology quality of life index (DLQI) at 0, 4, 8, 12 and 24th weeks of the treatment. Results: Fifty-eight patients (40 women and 18 men) with a mean age of 36.9±12.38 years (range: 17-72) were included in the study. The mean disease duration of the patients was 31.8±46.22 months. Fifteen patients (43.1%) responded to single-dose sg-AHs, while 25 (43.1%) responded to updosing or combination of sg-AHs. The response was confirmed by increased UCT scores, PhyGA-VAS (p<0.001), and decreased DLQI scores and PatGA-VAS (p<0.001). Eighteen patients were diagnosed as AH-resistant, and omalizumab was implemented. Total response rates increased to 86.2% at week 24 supplementation with omalizumab treatment. Conclusion: One-third of SD patients is resistant to AHs and might require third-line treatment such as omalizumab. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the susceptibility of Mycobacterium tuberculosis complex (MTBC) strains produced in non-pulmonary samples against major tuberculosis (TBc) drugs, including isoniazid (INH), rifampin (RIF), streptomycin (SM), and ethambutol (EMB), using the Mycobacterium Growth Indicator Tube (MGIT) method. Methods: In this retrospective, cross-sectional study, samples taken from non-pulmonary organs between January 2008 and September 2013 were cultivated in the MGIT, on Lowenstein- Jensen (LJ) media and MTBC isolates identified by Becton Dickinson (BD) MGIT TBc Identification test (TBc ID) were investigated in terms of susceptibility against TBc drugs including INH, RIF, SM and EMB by BACTEC MGIT 960 (Becton Dickinson, USA). Results: In our study, MTBC was isolated in 275 (4.6%) of 6018 samples that were incubated in MGIT and LJ media. Of 275 MTBC isolates, 160 (58%) belonged to non-pulmonary organs and 115 (42%) to the lung. While a resistance to those anti-tuberculosis drugs was not detected in 41 (67.2%), the resistance rates were 27.8% for INH, 3.2% for RIF, 14.7% for EMB, and 11.5% for SM. Conclusions: The rate of resistance to INH + RIF detected in the MTBC isolates cultured from extrapulmonary samples was found to be similar to those reported in other studies from Turkey. The high rate of resistance to INH should be taken into consideration in the treatment and management of TBc. [ABSTRACT FROM AUTHOR]

Aim: In this study, it was aimed to determine the epidemology, agents and antibiotical sensitivity of urinary tract infections in the Kars region. Material and Method: Between January 2015 and January 2016, (438 patients) in the policlinics and services of Kafkas University Medical Faculty Health Research Hospital with positive urine culture from the were evaluated. Patients were questioned in terms of age, gender, underlying diseases and complicating factors (pregnancy, urethral catheter etc.). Results: The most isolated agent from the urine cultures was Escherichia Coli(E.coli) with the rate of 66,4%.It is identified that policlinic patients, who E.coli has been found in their urine have high resistance to ciprofloxacin(22,1%), and cephalosporins(cefepime 23,5%, ceftazidime 22,5% ceftriaxone 26,3%), however they have lowest resistance to nitrofurantoin (4,7%) or amoxicillin clavunat (16,4%). In hospitalized patients, it is detected that there is a hight resistance to ceftriaxone (48,7%) and ciprofloxacin (48,7%) on the other hand there is low resistance againts the s antibiotics such as amikacin (7,7%), gentamicin (10,3%) or carbapenem (imipenem 2,6%, meropenem 1,3%). Conclusion: Local resistance rates should be known when ampirical treatment is given in the community acqurired urinary tract infection patients. Besides, differences in the rates of antibiotic resistance between hospitalized patients and outpatients should be taken into consideration. Antibiotic treatment should not be initiated without indications, especially if there is no indication, asymptomatic bacteriuria should not be treated. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Epilepsy is one of the most common chronic neurological disorders. Currently, a variety of older and newer AEDs are used in the treatment of epilepsy. Despite the use of these AEDs, about 20-30% of patients are not succesfully treated. This group of patients is called pharmacoresistant epilepsy patients. The frequency of seizures in patients with refractory epilepsy, adversely affects the quality of life and cognitive functions. Today, successful results are obtained from the epilepsy surgery. The purpose of this study was to evaluate the efficacy of epilepsy surgery (resective/VNS) in children with pharmacoresistant epilepsy. METHODS: This study was conducted among 62 children that were followed in Gazi University department of neurology long-term video EEG monitorization unit, with the diagnosis of epilepsy. They underwent the epilepsy surgery with the decision of the epilepsy surgery council. RESULTS: The study included 48 patients that underwent VNS treatment and 14 patients that underwent resective surgery. 31 patient were girls, 31 patients were boys, age at onset of seizures (range) was 35,2 ± 37,0 months, age at epilepsy surgery was 11,9 ± 3,8 years, time before epilepsy surgery was 8,7 ± 4,1 years. 12 patients that underwent resective surgery were seizure free, 3 patients with VNS implantation were seizure free after surgery. Seizure reduction > %90 was achieved in 1 patient, > % 75 in 7 patients and > % 50 in 19 patients. DISCUSSION and CONCLUSION: In conclusion resective surgery and VNS are effective treatment methods in children with pharmacoresistant epilepsy. VNS is relatively safe. In early period, resective epilepsy surgery for appropriate patients reduces the mortality. With appropriate patient and appropriate surgical method selection in patients with epilepsy, seizure control can be achieved largely. Until more effective therapies are developed, VNS and resective surgery will remain attractive alternatives for pharmacoresistant epilepsy. [ABSTRACT FROM AUTHOR]

Objectixe: The problem oj anti-tuberculosis (anti-TB) drug resistance continually threatens the success of TB control programs all over the world since the beginning of the 1990s. This problem which tends to increase continuously has now reached a global dimension. In this study, 252 Mycobacterium tuberculosis complex (MTC) isolates obtained between January 2010 and December 2016 were analyzed retrospectively and primary and secondary resistance status against first-line anti-TB drugs (isoniazid [INH], rifampicin [RIF], streptomycin [SM], ethambutol [EMB] has been evaluated. Material and Method: Sterile body fluids from clinical specimens accepted and examined directly in the mycobacteriology laboratory; the contaminant clinical samples were firstly subjected to homogenization and decontaminationbytheN-acetyl-L-cysteine-sodiumhydroxidc method, followed by culture and antibiotic susceptibility status with the BACTEC MG1Tfully automated system Results: Seventy (27.8%) of isolates were found to be resistant to at least one of the four anti-TB drugs. Isolates showing single or combined drug resistance for INH, SM, RIF and EMB were 20.6% (n=52), 12.3% (n=31), 7.5% (n=l9) and 6.7% (n=17) respectively. Single drug resistance was detected in 42 (16.7%) isolates. INH, EMB, SM and RIF resistance rates were 9.5% (n-24), 4.0% (n=10), 2.8% (n-7) and 0.4% (n=l) respectively. Eighteen (7.1%) isolates were found to be multidrug resistant (MDR) TB strains. We have more than one resistant strain isolate except MDR-TB strain, 4% (n=10). The rate of resistance to all drugs was 1.6% (n-4). Conclusion: In our study, it is striking that INH resistance is found entirely in at least two drug resistant isolates (n=28) and also in 20.6% of isolates, INH resistance is detected. This result shows that one of every five isolates is resistant to INH. Therefore, maximum protection of the RIF is necessary to prevent further MDR-TB problems in our hospital. Although our MDR- TB rates tend to decrease by percentage through previous years, increasing and facilitating travel from countries with high MDR-TB rales to our country and recent increase in immigration numbers from countries in civil war seem to be again growing problem for drug resistant TB and MDR-TB. [ABSTRACT FROM AUTHOR]

Objective: In this study, it was aimed to investigate the infecting agents and their resistance rates and to determine the risk factors with regard to growth of multidrug resistant (MDR) organisms in patients with diabetic foot infections. Methods: Follow-up forms of 114 diabetic foot patients who had completed their treatments at the care unit for chronic wounds, and their infections between September 2016 and August 2017 were evaluated retrospectively. According to the antimicrobial susceptibility testing, Gram-negative organisms resistant to at least two antimicrobial category, enterococci resistant to penicillin group, or staphylococci resistant to methicillin were accepted as MDR. One MDR isolate was assumed sufficient for evaluation in case more than two organisms were isolated in the same culture. Results: Of 114 patients who were included in this study, 73 (64%) were male. Ninety one (79.8%) of the patients had stage 3 and 4 foot infections according to the PEDIS classification. Microorganisms were isolated in 85 (74.6%) cultures taken from wound sites, and 11 (12.9%) of them were dual growth. A total of 96 organisms, 35 (36.4%) Gram-positives and 61 (63.6%) Gram-negatives, were isolated. The most frequent isolates were 24 (25%) coagulase-negative staphylococci, 19 (19.8%) Pseudomonas aeruginosa and 12 (12.5%) Escherichia coli. Among all isolates, 46 (47.9%) were MDR in the initial wound site cultures. MDR rates of the most frequently-isolated bacteria were 66.7% for coagulase-negative staphylococci, 89.5% for P. aeruginosa and 41.7% for E. coli. Growth of an MDR pathogen was significantly associated with peripheral arterial disease (p≤0.001), hypertension (p≤0.001), polymicrobial growth (p=0.023) and history değişof hospitalization (p=0.026). However, its association with osteomyelitis was not found to reach a significant level statistically (p=0.052). Conclusions: Out of every four patients, three yielded an organism in their initial deep tissue cultures. Of the most frequently-isolated infections, MDR rates were among the highest rates in similar studies. Resistance to antibiotics is a major problem that threatens human life throughout the world, and as we have seen in our study, this threat is also apparent for diabetic foot infections. [ABSTRACT FROM AUTHOR]

Objective: Optimizing colistin susceptibility testing has difficulties because of its high molecular weight and high binding capacity to polystyrene which is frequently used in antibiotic susceptibility testing. We aimed to compare the results of isolates, which were detected as colistin-resistant in the automated system, obtained by using broth microdilution (BMD) method which is the gold standard, with gradient diffusion method (GDM). Methods: We investigated 36 Klebsiella pneumoniae, 9 Acinetobacter baumannii and 5 Pseudomonas aeruginosa isolates, identified by the Phoenix™ 100 (Becton Dickinson, Sparks, MD, USA) automated system, isolated from various clinical specimens sent to the Central Microbiology Laboratory between August 2016 and April 2017. The susceptibility of the isolates was also tested by GDM and BMD method. Results: When the colistin resistance rates obtained from the gold standard BMD method were compared with the automated method, the categorical agreement (CA) rate of the automated system was 92% for all isolates, 100% for K. pneumoniae, 77.8% for A. baumannii, and 60% for P. aeruginosa. The very major error (VME) rate was 0%, and the major error (ME) rate was 8% for all isolates. When GDM was used for all isolates, CA was found to be 20% for all isolates, 16.7% for K. pneumoniae, 22.2% for P. aeruginosa and 40% for A. baumannii. VME was found to be 80%, and ME was %0 for all isolates. Conclusions: CA, VME and ME rates of Phoenix™ 100 for detecting colistin resistance is within acceptable limits according to ISO 20776 standard, but the rates of GDM is not suitable for this purpose. [ABSTRACT FROM AUTHOR]

Objective: Mycoplasma hominis and Ureaplasma urealyticum are opportunistic pathogens which can frequently be isolated from genitourinary tracts in humans. The aim of this study was to evaluate the presence, epidemiologic features and antibiotic susceptibility of M. hominis and U. urealyticum agents in urine specimens which were sent from various clinics of Uludağ University, Hospital of Health Application and Research Center for diagnosis of genitourinary system infection. Methods: Urinary specimen results of M. hominis and U. urealyticum were retrospectively reviewed between January 2015 and December 2016 in our hospital. Urinary specimens were examined using Mycoplasma IES (Autobio Diagnostics, Zhengzhou, People's Republic of China) in 2015 and Biosynex® Mycoplasmatest (Biosynex, Illkirch-Graffenstaden, France) in 2016 for the identification of M. hominis and U. urealyticum. Simultaneous urine culture and complete urinalysis results were compared with results of M. hominis and U. urealyticum. Results: In our study, we evaluated 5852 samples of 2926 patients comprising 67.43% females and 32.57% males for detection of M. hominis and U. urealyticum in urine. While U. urealyticum, and M. hominis were detected in 22.25% (651/2926) and 1.23% (36/2926) of the samples, respectively; coinfection was detected in 3.79% (111/2926). M. hominis and/or U. urealyticum positivity (n=798/2926) were found to be 32.12% in women and 11.02% in men. Resistance rates of M. hominis according to sex were found to be higher in women for ciprofloxacin and a statistically significant difference was found (χ ²=4.336, p=0.037). Conclusions: As there was no growth in routine urine cultures of about half of the M. hominis and/or U. urealyticum-positive patients, it is recommended to consider the presence of urogenital M. hominis and U. urealyticum infections for treatment and to use laboratory tests for the diagnosis of these agents especially in the presence of risky conditions such as pregnancy. [ABSTRACT FROM AUTHOR]

Objective: Antiplatelet therapy is an indispensable part of current coronary artery disease and resistance to ADP inhibitors leads to adverse cardiovascular events on patients. In current study, it was aimed to detect clopidogrel resistance markers in patients undergoing percutaneous coronary intervention. Methods: Eighty consecutive patients (38 clopidogrel resistance individuals, 42 healthy individuals) who underwent percutan intervention procedure due to coronary artery disease and who had tested positive for clopidogrel resistance at the end of the first week were included in study. In the VerifyNow test,> 208 platelet reactivity unit clopidogrel resistance and> 550 aspirin reaction unit were accepted as aspirin resistance. 28 patients were treated with ST elevation MI, 18 patients without ST elevation MI, and the other patients were treated for stable coronary disease. Demographic findings, CV, family background variables, body mass index, injection fraction, aspirin resistance and biochemical parameters were compared between groups. Results: The mean age of the patients were 59 ± 12 and 15 were female. Subjects with clopidogrel resistance was significantly lower in Hemoglobin values. Resistance was more frequent in hypertension, while female sex and smokers were more frequent. Logistic regression analysis showed that hemoglobin (odds ratio = 0.8; 95 % safety interval (0.678- 0.945), p = 0.008] significantly predicted clopidogrel resistance. Conclusion: Low hemoglobin level predicts clopidogrel resistance independently of other clinical variables. [ABSTRACT FROM AUTHOR]

Although rapid responses or long disease free intervals can be retained in advanced stage cancer either by conventional treatment strategies or targeted therapies; cure is seldom if ever is obtained. Recent advances in tumor biology have succeeded in identifying a minor tumor cell subpopulation which have extraordinary capabilities for treatment resistance against various treatment strategies utilizing chemotherapeutic agents and radiotherapy. These cells carry stem cell like properties such as ability to initiate tumor by themselves, self renewal and ability to differentiate into heterogeneous cancer cell lines. In this review , survival and metastatic capabilities of cancer stem cells (CSCs), resistance mechanisms against chemotherapeutic agents are summarized . Novel therapeutic strategies developing against these resilient cell group such as agents specifically designed for targeting survival pathways and intracellular metabolism of CSCs are also discussed.

Salmonella is considered as a global problem ranking first among food borne diseases. All motile Salmonella of poultry origin are zoonotic and readily transmit to human via meat and eggs but reports on non - typhoidal Salmonella serovars circulating in layer chickens is very limited in South-East Asian countries including Bangladesh. Salmonella serovars isolated from apparently healthy chickens were characterized in the present study. Of 170 samples (cloacal swab 150 and feed 20) collected from commercial layer farms, motile Salmonella was isolated 4% (6/150) and 50% (10/20) respectively by cultural, biochemical, motility test and by detection of hisJ gene. About 5% (8/170) samples possessed serovar-specific gene fimA, suggesting that isolates were Salmonella enterica serovar Typhimurium. Antimicrobial susceptibility testing demonstrated that the isolated serovars were multidrug resistant. Therefore apparently healthy layer chickens harbour and transmit S. Typhimurium to the environment, although little is alarming since it has zoonotic significance and the isolates were resistant to commonly used first line of antibiotic in Salmonella infection.

Heterotopia, referred to as a limited or common neuronal migration disorder, may manifest clinically with mild mental retardation, epileptic seizures, psychiatric symptoms, or systemic disorders. Approximately 90% of cases have drug-resistant epileptic seizures. Lennox-Gastaut syndrome (LGS) is an epileptic encephalopathy with cognitive impairment; it is treatment-resistant and has a poor prognosis, with multiple patterns of seizures and specific electroencephalographic (EEG) patterns. In this case, the brain imaging showed band heterotopy, an EEG 2-2.5 Hz spike wave, and multiple spike and fast rhythms. This case of a 17-year-old male patient with drug-resistant tonic, atonic, myoclonic, atypical absence seizures, and behavioral abnormalities who was diagnosed with LGS was presented to highlight the difficulty in treatment management. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to determine the resistance mechanisms of carbapenem-resistant Enterobacteriaceae (CRE), and evaluate the prospective alternative treatment options. Methods: Between October 2014 and July 2015, rectal swabs routinely obtained from hospitalized patients were included in the study. The isolated Gram-negative enteric bacteria were identified to the species level by using standard conventional microbiological methods. Determined carbapenem resistance in enteric bacteria was confirmed by using meropenem Etest® (bioMérieux, Marcy l'Etoile, France), and the resistance mechanisms were investigated with MAST-ID™ Discs (Mast Diagnostics Ltd, Bootle, Merseyside, UK). Antibiotic susceptibilities of the CRE were determined by disk diffusion method using isepamicin, chloramphenicol, and minocycline disks (Oxoid, Basingstoke, Hampshire, UK). Results: Of the 3,323 rectal swabs sent to the laboratory during the study period, totally 84 (2.5%) CRE were isolated with one strain from each patient. Of the 84 CRE, 74 (88%) were Klebsiella pneumoniae and 10 (12%) were Escherichia coli. Among the 84 CRE, 66 (78.5%) with OXA-48, 11 (13.1%) with OXA-48 + metallo-β-lactamase (MBL), 1 (1.2%) with only MBL and 1 (1.2%) with AmpC + porin loss were detected, none of the strains were positive for KPC. In 5 (6%) strains, none of the resistance mechanisms were found. Of the 84 CRE, 80 (95.2%), 77 (91.6%) and 14 (16.6%) were found to be susceptible to isepamicin, chloramphenicol and minocycline, respectively. Conclusions: The OXA-48 type, endemic in Turkey, was also the most commonly detected carbapenemase in the study. It has been observed that isepamicin and chloramphenicol can be the potential antibiotics in the treatment of KDE-related infections. [ABSTRACT FROM AUTHOR]

Herein, oxipropanolamine derivatives from α-naphthol compound were synthesized and the activities against MDR (multi-drug resistant) bacteria were evaluated. Strains of S. aureus which is one of Gram-positive bacteria and A. baumannii, P. aeruginosa, E. coli which are of Gram-negative bacteria were used.The tested bacteria are Grampozitif stain of S. aureus and Gram-negatif stains of A. baumannii, P. aeruginosa, E. coli. For the synthesis of compounds 2a-d which were used in the study, firstly 2-((naphthalen-1-yloxy)methyl) oxirane was obtained with the reaction of α-naphthol with epichlorohydrin and then reacted with four diffrent amine groups to obtain 2a-d derivatives. While the obtained compounds 2a, 2b and 2c have more antibacterial activity than other tested antibacterials, the compound 2d has shown moderate or blow antibacterial activity against Gram-negative bacteria, but has a high activity against gram-positive bacteria S. aureus. [ABSTRACT FROM AUTHOR]

Objective: Bacteremia is the leading cause of morbidity and mortality among immunocompromised patients. The aim of this study is to evaluate the etiology of bacteremia and the antibiotic susceptibilities of etiologic agents among immunocompromised patients followed up from January 1, 2012 to July 30, 2013. Methods: Immunocompromised patients, both inpatient and outpatient treated in our hospital, were followed prospectively. The definition of "immunocompromised patients" consisted of solid organ (kidney, liver) transplantation recipients and hemato-oncologic malignancy patients with a history of chemotherapy in the previous month before bacteremia. Results: This prospective study comprised of 167 bacteremia episodes of 130 consecutive immunocompromised patients. The most isolated group of bacteria was Gram-negative bacteria. Escherichia coli was the most commonly (30.8%) isolated bacteria and the second was coagulase-negative staphylococci (15.1%). Fifty one percent of the E. coli isolates were extended-spectrum p-lactamase-positive. Acinetobacter baumannii was the second most common bacteria of Gram-negative agents and the ratio of multiple drug-resistant (MDR) isolates among Acinetobacter isolates was 73%. Conclusions: Gram-negative bacteria are the most common causative agents of bacteremia in immunocompromised patients in our hospital. The rising ratio of MDR A. baumannii is a striking problem which causes difficult-to-treat infections. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the susceptibility of enterococcal strains isolated from both nosocomial and community-acquired urinary tract infections between January 2011 and December 2014, and also to compare the resistance rates between January 2011-December 2012 and January 2013-December 2014 periods. Methods: The identification of the strains and antimicrobial susceptibility rates were determined by BD Phoenix (Becton, Dickinson and Company., Sparks, Maryland, USA) and VITEK® 2 (bio-Mérieux, Marcy l'Etoile, Fransa) automatized systems. Results: All isolates (n=156) were found to be susceptible to vancomycin, teicoplanin, linezolid and tigecycline. Penicillin, ampicillin, ciprofloxacin, nitrofurantoin, tetracycline, fosfomycin, gentamicin (high-level) and streptomycin (high-level) resistance rates were 60.9, 8.7, 15.2, 4.3, 73.9, 6.5, 15.2 and 26.1% in nosocomial Enterococcus faecalis isolates (n=46), respectively; and 100, 100, 28.6, 65.7, 42.9, 8.6, 17.1 and 31.4% in nosocomial E. faecium isolates (n=35), respectively. Comparison of data between January 2011-December 2012 and January 2013-December 2014 periods revealed significant increases in resistance rates to penicillin, ciprofloxacin, and streptomycin (high-level) in nosocomial E. faecalis isolates and to ciprofloxacin and streptomycin (high-level) in nosocomial E. faecium isolates. In community-acquired E. faecalis isolates, the resistance rates for penicillin and ciprofloxacin were found to be increased in the second period of the study. Conclusions: High-level aminoglycoside and quinolone resistance rates in enterococci were significantly increased in our hospital. Results of antimicrobial susceptibility testing are important for choosing appropriate treatment. [ABSTRACT FROM AUTHOR]

Objectives: It has been proposed that human platelet antigen- 1 (HPA-1) gene polymorphism is associated with coronary artery disease (CAD) and affects platelet function. We aimed to investigate the distribution of HPA gene polymorphism between angiographic CAD and a control group and the relation between HPA gene polymorphism and platelet aggregation. Study design: The study population consisted of 94 patients with angiographic CAD and 115 patients without angiographic CAD. Platelet aggregation was measured with impedance aggregometry on the fifth day of percutaneous coronary intervention (PCI). Platelet aggregation >480 AU*min was defined as the clopidogrel resistance group. Blood samples were obtained from all participants at discharge for investigating HPA- 1 gene polymorphism. Results: There was no significant difference in the distribution of HPA-1 gene polymorphism between the control and CAD groups (78.7% vs. 78.1% for A allele and 21.3% vs. 21.9% for B allele, p=NS). The analysis between groups with and without clopidogrel resistance revealed no significant difference in the distribution of HPA-1A and HPA-1B alleles between the groups (A allele 78.7% vs. 78.9% and B allele 21.3% vs. 21.1%, p=NS). In the CAD group, there were no significant differences in platelet aggregation between HPA-1A and HPA- 1B alleles (294+-240 vs. 259+-261 AU*min, p=NS). Conclusion: The distribution of HPA-1 gene polymorphism was not different in CAD patients compared to the control group. HPA-1 gene polymorphism was not associated with platelet aggregation or clopidogrel resistance assessed by impedance aggregometry in the CAD group.

Neisseria gonorrhoeae is one of the most important pathogenic microorganisms in sexually-transmitted diseases in the world. N. gonorrhoeae is an important problem for the community health due to the emerging resistance to antibiotics which has been used in the treatment in recent years, as well as the infections caused by it. When the antibiotic groups which were preferred in the past such as penicillins, tetracyclines, macrolides, trimethoprim-sulphametoxazole and quinolones are evaluated together, N. gonorrhoeae has been reported to become a multidrug- resistant organism with reduced susceptibility to thirdgeneration cephalosporins, which has been recommended in the last few years and started to be used widely. We herein present the first cefuroxime-resistant N. gonorrhoeae strain in Turkey, which was isolated from urethral swab culture taken from a patient presenting with complaint of urethral discharge. [ABSTRACT FROM AUTHOR]

Objective: Infections caused by Candida species are becoming important causes of morbidity and mortality in intensive care patients. The aim of this study was to determine species distribution and antifungal susceptibility of 121 Candida species isolated from various clinical samples of intensive care unit patients in our center. Material and Methods: Species distribution and antifungal susceptibility of the isolates were determinated with VITEK 2 Compact System (BioMérieux, France). Results: The 121 Candida strains were identified as follows: 60 C.albicans (49.6%), 21 C. tropicalis (17.3%), 17 C. parapsilosis (14%), 15 C. glabrata (12.4%), 3 C. keyfr (2.5%), 2 C. krusei (1.7%), 1 C. lusitaniae, 1 C. famata and 1 C. lipolytica. All of the Candida strains were found to be susceptible to flucytosine, fluconazole, voricon-azole and caspofungin except C.krusei strains which are intrinsically resistant to fluconazole. Intermediate susceptibility to amphotericin B was determinated in four (3.4%) Candida strains and four (3.4%) strains were found to be resistant to amphotericin B. Minimum inhibitory concentration (MIC) values of the isolates with intermediate susceptibility and resistanceto amphotericin B were2 µg/mL and 8 µg/ mL respectively. Conclusion: Identification and susceptibility tests for Candida species should be performed for the proper management and treatment of patients with Candida infections. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa strains may develop the resistance to antibiotics via different mechanisms such as, alteration of protein binders of penicillin, porin mutations, DNA-gyrase mutation and active expulsion pumps. Especially, multi-drug resistant P.aeruginosa strains, are known to be most important cause of mortality in the intensive care units. Special antibiotic therapy is required, because of having the multiple antibiotic resistances. The case reports a 67-year-old male patient who had a history of 6 years paraplegia. He admitted to the emergency department with impaired general condition, including a week ongoing nausea,chest pain, cough, phlegm, wheezing and fatigue. Widespread crepitant rales were detected up to the middle and lower zones of both lungs. Besides, there was CRP elevation, hyperuricemia, a consolidated infiltration compatible with increased opacity at lower zone of right lung and reticulonodular style increased opacity at upper zone of right lung on chest .On disk diffusion, there was resistance to all antibiotics except colistin. Although colistin treatment was initiated, the patient was lost due to cardiac arrest at the 3rd day of treatment. This case is reported to be observed for the first time of P. aeruginosa infection that was extensively drug-resistant to antibiotics except colistin in our hospital, and to highlight importance of true treatment arrangements according to antibiotic susceptibility. [ABSTRACT FROM AUTHOR]