[Etiological agents in bacterial meningitis and cerebrospinal fluid shunt infections and their antibiotic susceptibilities].
Akut bakteriyel menenjit ve santral sinir sistemi sant enfeksiyonlarinda etkenler ve antibiyotik duyarliliklari
Adolescent↗
Biomedical subjects
Ulkü Altoparlak
Publications and source records attributed to Ulkü Altoparlak.
[A transfusion-transmitted malaria case].
Malaria is a rare but potentially serious complication of blood transfusion. In this report a transfusion-transmitted malaria case has been presented. A 47-years-old woman admitted to our clinic with the complaints of striking fever with chills, diarrhea and vomiting. She had history of an operation and transfusion before 10 days of admission. On physical examination jaundice, splenomegaly and abdominal tenderness were detected. Laboratory results revealed anemia, and elevated LDH and bilirubin levels. Examination of thin blood films yielded Plasmodium vivax trophozoites. Chloroquine was initiated for therapy and the patient was successfully treated. On the other hand, informations about her blood donor indicated that he had been in the military service in Southeast Anatolia of Turkey where malaria is endemic. All the efforts to reach the donor, for his diagnosis and treatment, were failed. Since our region (Northeast Anatolia) is not an endemic area for malaria and the patient had no travel history to an endemic area, it has been considered that the transmission route of malaria in this case was blood transfusion. In conclusion, as there are no available approved tests for malaria screening of donations, the transfusion-transmitted malaria can only be prevented by careful questioning of the donors.
Animals↗
[The pathogens and their antibiotic sensitivities in hospital-acquired pneumonia cases].
Dynamic precautions in the early diagnosis and treatment of hospital acquired pneumonias are necessary because of their high mortality. In these patients, invasive diagnostic approaches may be needed since clinical and radiological findings and other non-invasive approaches frequently fail to establish the diagnosis. Thirty eight patients were prospectively included in the study. Average age of patients was 45.5 +/- 16.4 years; 31 were males (81.6%) and 7 (18.4%) were females. Pneumonia was detected in 9 (23.7%) cases during the first five days and in 29 (76.3%) cases after the fifth day of admission to the hospital. Bronchoscopic interventions diagnostic purpose were carried out in 25 (65.8%) patients. The culture results were negative in 7 (18.4%) cases. While more than one pathogen was determined on the cultures of 16 (42.1%) patients only one pathogen was isolated in the cultures of 15 (39.4%) cases. The frequently isolated pathogen on cultures was Staphylococci (45.4%). Other pathogens were Enterobacter spp., Pseudomonas spp., Escherichia coli, Serratia and Streptococcus pneumoniae according to their frequency on cultures. High resistance rates to the third generation cephalosporins were determined. Eleven of 17 deaths in 38 pneumonia cases were attributable to pneumonia. As a conclusion, isolation of pathogen and antibiotic resistance should be determined in the cases with hospital acquired pneumonia. Invasive diagnostic interventions were not avoided when necessary. Although pro-BAL and PSB methods were expensive, their use in selected cases may prevent unnecessary antibiotic use and contribute to a decrease in mortality rate.
Anti-Bacterial Agents↗
[Correlation of urinary tract infections with the vaginal colonization in postmenopausal women].
Estrogen deficiency is a major contributor to the pathogenesis of urinary tract infections (UTI) in postmenopausal women. After menopause, the vaginal pH increases, lactobacilli disappear from the vaginal flora, and the vagina is predominantly colonized by Enterobacteriaceae, especially Escherichia coli. To better understand the associations between post-menopausal vaginal flora and the development of UTI, we conducted a prospective study among 87 postmenopausal women ages between 50-65 years. Vaginal samples were collected from lateral vaginal wall of women to perform a smear on a glass slide and placed on appropriate media. The smear was then stained with Gram stain. Urine samples were collected and cultured by standard bacteriologic techniques. Vaginal lactobacilli were present in 55.2%, and vaginal Enterobacteriaceae were present in 40.2% of the subjects. Heavy growth of lactobacilli was associated with a lower frequency of vaginal colonization with Enterobacteriaceae members (p<0.001), Streptococcus sp. (p<0.05) and Pseudomonas sp. (p<0.05). The most commonly isolated microorganism was E. coli. The frequency of asymptomatic bacteriuria and symptomatic UTI among postmenopausal women were found 17.5% (15/87) and 11.5% (10/87), respectively. As a result, Enterobacteriaceae colonization of the vagina in postmenopausal women increases the prevalence of asymptomatic bacteriuria and symptomatic UTI (p<0.01 and p<0.05, respectively).
Aged↗
[Streptococcal toxic shock syndrome: a case report].
Streptococcal toxic shock syndrome (STSS) is the most severe form of invasive infections caused by group A streptococci. In this report, a 36-years-old man who was admitted to our clinic with the complaints of fever, rash, skin lesions, abdominal pain, weakness and anuria for 2 days, has been presented. His body temperature was 39.5 degrees C and blood pressure was 50/20 mmHg. In physical examination, diffuse erythematous rash on the body, cellulitis on left leg and foot, fungal lesions on the toes, and abdominal tenderness were noted. Laboratory results revealed a dramatic increase in leukocyte count, increased sedimentation rate, elevated blood urea nitrogen, cretinine, liver enzymes and bilirubin levels. Group A streptococci were isolated from the blood culture of the patient. Despite supportive (intravenous saline, dopamine) and antibiotic (clindamycin-ceftriaxone combination) therapies, adult respiratory distress syndrome has developed in two days, and he died on the third day. This case was presented to draw attention to STSS, which was a rare clinical entity with rapid progression to mortality despite aggressive medical therapy.
Adult↗
[Activity of frequently used disinfectants and antiseptics against nosocomial bacterial types].
In this study, bactericidal activity of widely used disinfectants and antiseptics (glutaraldehyde, laurylbispropylidentriamin 5 g and benzalkoniumchlorid 20 g, polyvinylpyrolidon iodine, benzalkonium chloride and sodium hypochloride) against some nosocomial bacterial isolates were investigated by qualitative and quantitative suspension test methods. One methicillin-resistant Staphylococcus aureus (MRSA), 6 multi drug-resistant Gram-negative hospital isolates (Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloaca, Klebsiella pneumoniae, Citrobacter diversus, Serratia marcescens) and 3 standard strains of American Type Culture Collection (ATCC) bacteria (S. aureus, P. aeruginosa, E. coli) were tested against three different concentrations of disinfectants of which, manufacturer's recommended use-dilution, 1/2 and 1/4 of those recommended dilutions. All tested disinfectants were found effective in all three concentrations against nosocomial isolates in five minutes, by using both qualitative and quantitative suspension methods. When the test was repeated with albumine, bactericidal activities of disinfectants were found the same. Our findings showed that these disinfectants can be still used in safe for the sterilization in hospital, and routine disinfection protocols do not need to be alerted.
Anti-Infective Agents, Local↗