In-vitro activity of fusidic acid against methicillin-resistant Staphylococcus aureus.
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Biomedical subjects
Publications and source records attributed to N Yulug.
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Evaluating the adherence factor of uropathogenic Escherichia coli is important for assessing the relative efficiency of antimicrobials when used at sub-minimal inhibitory concentration (sub-MICs). The microdilution method was used to determine the MICs of gentamicin, trimethoprim-sulfamethaxozole and penicillin. Then the efficacy of antimicrobial sub-MICs was determined by hemagglutination and adherence assays. Instead of showing nearly the same MICs, gentamicin had nearly twice the activity of trimethoprim-sulfamethaxozole. Gentamicin, as a "long acting" agent, can be accepted as being more effective than trimethoprim-sulfamethaxozole or penicillin, especially at sub-MICs, against adherence factors of uropathogenic E. coli, and can be used as monotherapy for urinary tract infections.
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Fecal-oral transmission of vancomycin-resistant strains of Enterococci (VRE), which colonize the human gastrointestinal tract, has led to nosocomial epidemics in recent years. The aim of this study was to establish the incidence and associated factors of fecal colonization with VRE in neonates. In our hospital 110 rectal swab specimens collected in the neonatal intensive care unit (NICU) were examined for VRE. For comparison, rectal swabs collected from 42 healthy neonates on the obstetrics ward were also analyzed. Of the NICU patients, 8 had VRE MICs of 8-64 microg/ml for vancomycin and 2-32 microg/ml for teicoplanin, whereas none of the healthy newborns, had VRE (p < 0.05). All patients positive for VRE had factors known to be associated with VRE carriage, such as low birth weight or long-term antibiotic therapy.
PURPOSE: To present two immunocompetent patients with Aspergillus niger infection of the exenterated orbit. METHODS: Case reports. RESULTS: The patients were treated with oral itraconazole and socket irrigation with amphotericin B. The sockets cleared completely; no growth was observed on reculturing. CONCLUSIONS: A niger infection of an exenterated socket can be effectively treated with oral itraconazole and topical amphotericin B in immunocompetent patients.
OBJECTIVE: To determine the resistance among Escherichia coli isolates causing urinary tract infections in hospitalized patients and outpatients. METHODS: This study was carried out in the Department of Microbiology, Dokuz Eylul University, Medical Faculty Hospital, Inciralti, Ismir, Turkey, from February 1997 through to June 1998. A total of 300 Escherichia coli strains were isolated from urine specimens of 111 hospitalized and 189 elderly outpatients (more than 20 years of age). We determined the minimum inhibitory concentrations of the test drugs nalidixic acid, pefloxacin, ofloxacin, norfloxacin and ciprofloxacin by the microdilution method, recommended by the National Committee for Clinical Laboratory Standards. RESULTS: Minimum inhibitory concentrations(50) and minimum inhibitory concentrations(90) values of strains tested against fluoroquinolones, pefloxacin and nalidixic acid were the same for strains isolated from hospitalized and outpatients (0.125 microg/ml outpatients (0.03 microg/ml). Twenty-six (9%) of 300 Escherichia coli strains were resistant to all drugs used. Twenty (77%) of these 26 strains were isolated from hospitalized patients. We found that the resistance to nalidixic acid is much higher than other fluoroquinolones. At the same time, the resistance in the strains that were isolated from hospitalized patients is again higher than outpatient strains (46%). CONCLUSION: Resistance among Escherichia coli isolates from patients to quinolones used in the treatment of urinary tract infections was rare during this period. Our study, like many other reports showed the increased resistance to fluoroquinolones for clinical isolates. However the appearance of multi resistant clones and the elevated prevalence of quinolones resistance in the hospital studied are warning signals for an increase in resistant strains as seen in many other countries. Therefore, it is important for physicians to use fluoroquinolones carefully so as to prevent, or delay, the emergence of resistant strains.
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Beta-lactam susceptibility and beta-lactamase patterns of a random sample of 44 Klebsiella pneumoniae strains that had been isolated from nosocomial infections at Dokuz Eylül University Hospital in Izmir, were investigated. All strains were amoxycillin resistant but in the presence of clavulanic acid 26 became sensitive. Similarly 39 of the strains were resistant to ceftazidime and cefotaxime; clavulanic acid restored sensitivity to ceftazidime in 28 and to cefotaxime in 25 of these resistant strains. Extended spectrum beta-lactamase (ESBL) production was positive in 84% of the isolates as determined by the double disk synergy test. Isoelectric focusing revealed that each strain produced one to four beta-lactamases, pI 7.6 enzymes being the most prevalent. Other enzymes with pIs of 8.4, 8.2, 5.4, 7.8 were also detected. Resistance to ceftazidime was transferred from 18 of the 44 isolates to the recipient Escherichia coli K-12 at 37 degrees C. The transconjugants were examined for their plasmid content and the plasmids were characterized by their size and resistance profile. Fourteen different restriction pattern groups were identified with Eco R1. The results indicate a high prevalence of ESBL production in nosocomial K. pneumoniae isolates in Izmir and have major implications concerning the clinical use of later generation cephalosporins.
Fecal specimens from 50 healthy volunteers living in Izmir, Turkey, were examined for the presence of beta-lactamase producing Escherichia coli by selection on agar plates containing ampicillin (10 mg/L). Thirty-nine (78%) of the strains were ampicillin-resistant and ampicillin MIC50 values for these isolates were > or =1024 microg/ml (range 32- > or =1024 microg/ml). Ampicillin MIC values remained above 64 microg/ml in 16 (41%) strains despite addition of clavulanic acid (2 mg/L). Beta-lactamase production of the clavulanate-resistant strains was further investigated by analytical isoelectric focusing (pI). Enzymes with pIs of 5.4, 5.6, 7.4, 7.6 and >8.5 were detected. Sixty-nine percent of the isolates produced a pI 5.4 enzyme that cofocused with TEM-1. Beta-lactamase assays revealed that hyperproduction of these enzymes was the predominant mechanism for clavulanate resistance. Twelve (75%) of the isolates were able to transfer their ampicillin resistance. The ampicillin and ampicillin plus clavulanic acid MIC values of all transconjugants were above 256 microg/ml. Transferable ampicillin resistance was associated with resistance to other antibacterials at the following frequencies: tetracycline 92%, trimethoprim 83%, streptomycin 50%, gentamicin 25%, and chloramphenicol 8%. In conclusion, it has been suggested that commensal bacteria in normal populations make up the largest reservoir of antibiotic-resistant genes. Although the exact molecular mechanisms could not be determined, the current study shows that the incidence of ampicillin and clavulanic acid resistance is also high in commensal fecal flora.
Methylene blue (MB) alone, MB metabolites in the urine and the effect of MB plus alkalization on Candida species were determined. MB was used for the treatment of childhood renal candidiasis (CRC) in 3 patients as an irrigating solution. Besides irrigation, fluconazole 3 mg/kg/day intravenously and MB 0.2 mg/kg/day were administered perorally. Urine cultures were cleared of Candida. DMSA scans obtained after 6 months showed no evidence of scarring. MB can be used for irrigation of the urinary tract, with fewer side effects than amphotericin B (AB). Additionally we advocate the use of ureteral catheters instead of nephrostomy in the treatment of CRC.
The susceptibility patterns of 35 Shigella isolates (16 S. flexneri, 14 S. dysenteriae and 5 S. sonnei) to trimethoprim (Tp) and various antibiotics including amoxycillin, amoxycillin-clavulanic acid, nalidixic acid, ciprofloxacin, ceftazidime and ceftriaxone, were investigated. Twenty-two (62.8%) strains were resistant to Tp with a minimal inhibitory concentration (MIC50) value of 512 mg/L. Only six isolates were amoxycillin resistant, to which clavulanic acid restored sensitivity in all of them. None of the isolates were resistant either to extended spectrum cephalosporins or to quinolones. Resistance to Tp was transferred from 7 of the 22 isolates (31.8%) to the recipient Escherichia coli K12. Tp MIC values of the transconjugants were 512 mg/L. In no strain could amoxycillin resistance be transferred. Our results indicate that as the prevalence of transferable Tp resistance in Shigella isolates in Izmir is substantially high, alternative antimicrobial agents should be considered for empirical antibiotic therapy.
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The distribution of hepatitis C virus (HCV) genotypes was investigated in 89 HCV-infected Turkish patients. Blood samples were collected from haemodialysis patients (n = 45), chronic liver disease (CLD) patients (n = 38), acute non-A, non-B (NANB) hepatitis patients (n = 2) and blood donors (n = 4). HCV RNA sequences were amplified in the 5' non-coding region and were typed by restriction fragment length polymorphism analysis. The predominant genotype was 1b (75.3%), followed by 1a (19.1%), 2 (3.4%) and 4 (2.2%). While there was no significant difference in the distribution of HCV genotypes with respect to age, sex, transfusion history, alanine aminotransferase levels or liver histology (in the CLD group), type 1a-infected patients were younger than type 1b-infected patients (P < 0.05) in the haemodialysis group. Serological reactivity to recombinant HCV proteins was assessed in 58 samples using the Chiron RIBA-2 assay. The reactivity of samples from patients infected with type 1b with 5-1-1 and c100 antigens was significantly lower (P < 0.05) than the reactivity of samples from those infected with type 1a. These results, together with the results of two previous studies, indicate that HCV genotypes 1, 2, 3 and 4 are prevalent in different frequencies in the Turkish population. Determination of the genotype distribution of HCV in a geographical area may provide important clues for studying the epidemiology, transmission and pathogenesis of HCV-related diseases and may also aid in improving serological assays to detect HCV infection.
In this study some alpha-(1,2,4-triazolyl)acetophenone derivatives were synthesized by the condensation of various triazole and alpha-bromoacetophenone rings. The structures of the compounds have been elucidated by UV, IR, 1H-NMR, mass spectra and elementary analysis. The in vitro antifungal activity of the compounds were investigated against some yeast-like fungi (Candida albicans, C. parapsilosis, C. stellatoidea and C. pseudotropicalis) and moulds such as Trichophyton rubrum and T. mentagrophytes by the tube dilution method and MIC (minimal inhibitory concentration), MFC (minimal fungicidal concentration) values were determined. Compound A16 was significantly more effective than the other compounds. The results obtained for antifungal activity against moulds were not significant.
Minimum inhibitory concentrations and the effective period for cidal concentrations of an amphoteric surfactant mixture (C31G) were determined on 13 microorganisms (common bacteria, strains ATCC, and fungi) by microtiter dilution procedure. Also the antimicrobial efficiency of this composition (C31G) was evaluated on 105 culture samples which were obtained from (Turkish) patients having vaginal infections. E. coli was found to be the most frequently observed microorganism (45.45%) in these samples and C31G was determined to be active on microorganisms obtained from vagina at low concentrations in a short time.
Ten new 3-(2-phenethyl)-5-substituted-tetrahydro-2H-1,3,5-thiadiazine-2- thiones were synthesized by the reaction of phenylethylamine with carbon disulfide and potassium hydroxide, followed by formaldehyde and appropriate amino acids. The structures of these compounds have been confirmed by UV, IR, 1H-NMR and elementary analysis. The antifungal activities of the compounds were tested by tube dilution method against yeast-like fungi (Candida albicans, C. parapsilosis, C. stellatoidea and C. pseudotropicalis) and minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) values were determined. All compounds proved to be highly effective against yeast-like fungi (MFC range: 1.56-12.5 micrograms/ml).
Synthesis and antifungal evaluation of 5-ethoxycarbonyl-2-(substituted-benzyl or phenoxymethyl)benzimidazoles are reported. Structures of the compounds were elucidated with IR-, 1H-NMR-, 13C-NMR-, mass-spectra and elemental analysis. Preliminary results show that none of the synthesized benzimidazole derivatives has antifungal activity at the concentration of 100 micrograms/ml against Candida parapsilosis, Candida stellatoidea, and Candida pseudotropicalis.