Search

Objective: Urinary tract infections (UTIs) are common in the community. The prevalence of UTIs rises in the elderly as a result of age-related changes and comorbidities. In treating the elderly, it is important to choose antibiotics carefully and avoid unnecessary ones. The goal of this study was to analyze the bacteria isolated from geriatric urine samples and their resistance patterns. Materials and Methods: Urine culture results in geriatric patients (>65 years old) were analyzed between January 1, 2016 and February 1, 2020. Antibiotic resistance was evaluated in frequently isolated bacteria. In terms of antibiotic resistance, antibiotics that can be used in outpatient therapy and do not require the approval of an infectious disease specialist were investigated. Results: The records of 37735 urinary samples were screened. In 31.3% (11840/37735) of the urine culture microorganisms were isolated. Escherichia coli was the most common microorganism with a rate of 40.1% (4758/11840), followed by Klebsiella spp. with 15.5% (1844/11840), Enterococcus spp. with 10.3% (1222/11840), and Pseudomonas aeruginosa with 3.4% (406/11840). Ceftriaxone resistance of 37.6% was found in Escherichia coli; ciprofloxacin resistance was 41.5%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance was 43.4%, and nitrofurantoin resistance was 1%. There was no resistance to fosfomycin. The antibiotic resistance of Klebsiella spp. gave a result of 41.6% ceftriaxone resistance, while ciprofloxacin resistance was 32.6%, and TMP-SMX resistance was 39.6%. The antibiotic resistance of Pseudomonas aeruginosa was 19.04% ciprofloxacin resistance, and 5.1% amikacin resistance. In Enterococcus spp. ampicillin resistance was found to be 42.9%. Conclusion: Infections in geriatric patients can quickly prove fatal. Antibiotic selection is critical in regard to elderly patients, and knowing regional antimicrobial resistance patterns is important. But balancing efficacy, safety, and tolerability with the development of antimicrobial resistance in this patient population is difficult. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI 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 Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Background and Aim: Tigecycline is a semi-synthetic tetracycline with activity against most multidrug-resistant (MDR) bacteria. Methods: We studied in vitro activity of tigecycline by agar dilution (AD) and Etest methods to evaluate their correlation. The study included 206 isolates of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, Klebsiella pneumoniae and MDR Acinetobacter baumannii recovered from blood cultures of patients of Baskent University between 2008 and 2010. Results: ESBL-producing E. coli had MIC50/MIC90 values of 0.5/0.5 µg/ml by AD and 0.25/0.5 µg/ml by Etest. ESBL-producing K. pneumoniae had MIC50/MIC90 values of 1/2 µg/ml by AD and 0.75/2 µg/ml by Etest, whereas MDR A. baumannii had MIC50/MIC90 values of 4/4 µg/ml by AD and 2/4 µg/ml by Etest. The correlation between AD and Etest was weak for ESBL-producing E. coli and strong for ESBL-producing K. pneumoniae and MDR A. baumannii. Tigecycline MIC values for ESBL-producing E. coli were lower than the tigecycline concentration, while they were higher than the concentrations attainable by treatment doses for A. baumannii. Conclusion: Tigecycline is an appropriate agent in the treatment of E. coli bacteremia, but it is not for treating A. baumannii bacteremia. Tigecycline could be used for K. pneumoniae bacteremia treatment after determining its MIC value. Determining the MIC value by gold-standard methods is more appropriate due to the correlation between Etest and AD at high MIC values. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Bloodstream infections (BSI) are frequently seen after solid organ transplantation. The incidence of bloodstream infections differs among the types of transplantation. The microbiological features and antimicrobial resistance patterns change from centre to centre. Aims: To evaluate the incidence and spectrum of aetiological agents of bloodstream infections among solid organ transplantation recipients. Study Design: Retrospective descriptive study. Methods: Medical records of solid organ transplant recipients in the period between January 1st 2004 and August 15th 2012 were assessed retrospectively. The study population comprised 927 (64 heart, 556 kidney, 307 liver) consecutive recipients. Bloodstream infections were divided into three groups according to the onset time of bloodstream infections after transplantation: early, mid-term and late. The incidence and microbiological features of bloodstream infections were evaluated. Results: The number of bloodstream infection episodes was 317 in 191 recipients which was distributed as 228 (72%) in liver, 70 (22%) in kidney and 19 (6%) in heart transplantation. Ninety-eight 98 (30.9%) of the episodes were diagnosed within the early period, 134 (42.3%) within the mid-term and 85 (26.8%) in the late period. Early and mid-term bloodstream infections were seen statistically more often in liver than in kidney or heart transplantation (p=0.01 and p=0.031, respectively). Late bloodstream infections were also common in liver transplant recipients which was not statistically significant (p=0.229). Conclusion: Liver transplant recipients are at the highest risk for developing BSI after transplantation in early, mid-term and late periods. [ABSTRACT FROM AUTHOR]

Aim: Community-acquired infections caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria are an emerging problem. Digestive tract colonization is a prerequisite for infections by ESBL-producing microorganisms. The aim of this study was to determine the prevalence of and risk factors for fecal carriage of ESBL-producing Escherichia coli ( E. coli) or Klebsiella spp. in the community. Materials and Methods: A total of 928 stool samples admitted to the laboratory during a four-month period were included in the study. Samples were diluted in saline and cultured in two EMB agar plates supplemented with either 1 μg/ml cefotaxime or 1 μg/ml ceftazidime. All isolates that grew were identified to the species level. E. coli and Klebsiella spp. strains were tested for ESBL production with ceftazidime and ceftazidimeclavulanate discs according to the Clinical and Laboratory Standards Institute (CLSI) Guideline. Results: Of the 928 stool samples included, 133 (14%) were isolated from inpatients and 795 (86%) from outpatients. Sixty-three (47.3%) of 133 hospitalized and 121 (15.2%) of 795 outpatients harbored ESBL-producing E. coliand Klebsiellaspp. (P = 0.000). Chronic hepatic failure (OR: 8.7, CI: 1.65–46.12; P = 0.011) and recent antibiotic use (OR: 4.4, CI: 1.76–11.16; P = 0.002) were found to be associated with ESBL positivity for the hospitalized patients. Recent antibiotic use (OR: 2.8, CI: 1.61-5.12; P = 0.000) was found to be the only independent variable associated with ESBL positivity for the outpatients. Conclusions: The high prevalence (15.2%) of fecal carriage of ESBL-producing bacteria in the community warrants further study in this field including the consequences of this colonization in the hospital setting. [ABSTRACT FROM AUTHOR]

Introduction: Necrotizing fasciitis is a serious infection of the subcutaneous tissue and fascia. Despite being rare, it may have a high mortality rate because it usually leads to rapidly progressing fascial necrosis. The purpose of this study was to report a case of early stage necrotizing fasciitis that developed after cryotherapy for a penile condyloma, 19 days before the index emergency department admission. Case Report: A 32-year-old man without any history of systemic disorder was admitted to our emergency department for groin swelling and burning sensation that developed 12 hours before his hospital admission. Edema and hyperemia starting from the left inguinal region and extending to the penis and scrotum were noted on physical examination. While initially being considered a case of early stage necrotizing fasciitis and tested for it, the patient rapidly developed a bulla and entered intermediate stage. We hospitalized the patient with an initial diagnosis of necrotizing fasciitis and initiated dual antibiotic therapy. Furthermore, we debrided the wound and excised the necrotic tissue debris. We discharged the patient on the 12th day. Conclusion: Clinical suspicion should be high for necrotizing fasciitis in emergency. Initiating the most appropriate medical and surgical therapy as soon as the diagnosis is made is the key for preventing mortality and morbidity. [ABSTRACT FROM AUTHOR]

ABSTRACT: Although group A ?-hemolytic streptococcus is an uncommon cause of infective endocarditis, an increase in the incidence of invasive group A strepto coccusinfections including bacteremia has been reported in the last two decades. Herein we report Streptococcus pyogenes endocarditis in a previously healthy adult patient who was hospitalized to investigate the etiology of fever. Because of a suspicion of a new vegetation appeared in the second (aortic) valve in the 14th day of high dose penicillin G treatment, the mitral and aortic valves were replaced by mechanical prosthesis on the 22nd day of treatment. He was discharged from hospital after the 6 week course of antibiotic treatment [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which is concerned with mirtazapine-induced thrombocytopenia and neutropenia.