We tracked and documented the time of positivity of blood cultures by using the BACTEC 9120 (Becton Dickinson Diagnostic Instrument Systems) blood culture system over a 5-year study period. A 7-day protocol of the incubation period was selected, and a total of 11,156 blood cultures were evaluated. The clinically significant microorganisms (32.95%) were isolated in 3,676 specimens. Gram-positive and -negative bacterial isolation rates were found to be 41.07 and 44.88%, respectively. Yeasts were found in 14.03% of all pathogens. Both the false-positivity and -negativity rates were very low (0.1 and 0.3%, respectively). The mean detection times for all of the pathogens were determined to be 19.45 h. Yeasts, nonfermentative gram-negative bacteria, and Brucella melitensis strains were isolated within 5 days. By taking these data into account, we decided to establish a 5-day-incubation protocol in our laboratory instead of the 7 days that are commonly used.Bloodstream infection is one of the most serious problems in all infectious diseases. Despite recent developments, like nucleic acid probes, PCR, and other molecular techniques for microbiological diagnosis, blood cultures still remain the most practical and reliable method in the diagnosis of bloodstream infections. Blood culture is one of the most important tools in the clinical microbiology laboratory. Rapid isolation and identification of the microorganisms in blood samples and directing of the treatment accordingly are critically important in order to reduce the mortality rate (2). The fact that conventional methods are not sufficient for a low mortality rate has resulted in the extensive usage of various continually monitored blood culture systems in many clinical microbiology laboratories over the past 25 years. In the end, these systems were proven to be highly reliable. One of these, BACTEC 9120, is based on the monitoring of the CO 2 concentration produced by growing microorganisms with a fluorescent sensor located at the bottom of each bottle (8). The aim of this study was to determine the detection times and the distribution of the bacteria and yeasts isolated from the blood samples by using BACTEC 9120 (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md.) over a 5-year period. We also had it in mind to analyze the data to decide which incubation protocol would be more suitable for practical purposes.This study was conducted in the Clinical Microbiology Laboratory of Osmangazi University Medical Faculty Hospital from August 1996 to December 2001. Most of the patients were adults from intensive care and hematology units. Two bottles were used in the culturing for every patient. All of the phlebotomies were performed with peripheral sticks, and the blood samples were drawn by a clinician by the bedside after cleansing the skin with 70% isopropyl alcohol and applying 10% povidone-iodine for 1 min. The blood samples were inoculated at a volume of 1 to 5 ml into BACTEC Peds Plus/F and a volume of 10 ml into PlusϩAerobic/F blood culture bottles and wer...

No abstract

No abstract

Corynebacterium jeikeium has been recognized as an important cause of infection, particularly among neutropenic patients who have central venous catheter (CVC). Routine use of tigecycline in children is not yet approved. Here in we present a child with relapsed-refractory lymphoblastic leukemia who was successfully treated with tigecyline due to multi-drug-resistant C. jeikeium sepsis without removal of CVC. Our case highlights the use of tigecycline where there are no alternatives. Further studies regarding the efficacy and safety of tigecycline in pediatric patients are needed.

No abstract

ceftobiprole exhibits in vitro activity against a wide range of Gram-positive and Gram-negative pathogens, including multidrug-resistant strains. No changes in its known susceptibility profile were identified.

The accurate diagnosis of Epstein-Barr virus (EBV) infections is important, as many other infectious agents or diseases can cause similar symptoms. In this study, sera of pediatric patients who were suspected to have an EBV infection, were sent to Eskisehir Osmangazi University Faculty of Medicine, Department of Clinical Microbiology, and investigated by IFA, ELISA, immunoblotting and Real-time PCR. The performances of these tests were compared with IFA. The rates of agreement between ELISA and IFA were found as 100% for seronegative, 100% for acute primary infection, 22.2% for late primary infection, 92.1% for past infection. The rates of agreement between immunoblotting and IFA were found as 80.8% for seronegative, 68.8% for acute primary infection, 55.6% for late primary infection, 86.6% for past infection. The sensitivity of immunoblotting for anti-VCA IgM was identical with ELISA, and higher for anti-VCA IgG, anti-EBNA IgG, anti-EA antibodies, while the specificity of immunoblotting for these antibodies were found to be lower. The sensitivity and specificity of Real-time PCR for detection of viremia in acute primary infection were found as 56.25% (9/16) and 97.89% (139/142), respectively. The diagnostic methods should be chosen by evaluating the demographic characteristics of patients and laboratory conditions together.

Amaç: Tüm dünyada genişletilmiş spektrumlu beta laktamaz (GSBL) üreten mikroorganizmalar ile oluşan enfeksiyonlarda artış gözlenmektedir. GSBL üreten mikroorganizmaların taşıyıcılığı, ciddi enfeksiyon için zemin hazırlamaktadır. Gereç ve Yöntemler: Bu çalışmada 3. basamak sağlık hizmeti veren bir hastanede salgın olmayan bir dönemde hastanede yatan ve ya polikliniğe başvuran çocuklarda gayta örneklerinde (464 gayta örneği; 270 hastanede yatan, 194 polikliniklere başvuran çocukta) GSBL üreten E. coli ve Klebsiella spp. sıklığının ve risk faktörlerinin prospektif olarak değerlendirilmesi planlandı. Tüm gayta örnekleri, GSBL üretimi yönünden disk yöntemi ile değerlendirildi ve imipenem duyarlılığı agar dilüsyon metodu ile CLSI kılavuzuna göre değerlendirildi. Bulgular: Hastanede yatan çocukların 66'sında (%24; 25 Escherichia coli, 39 Klebsiella pneumoniae, 2 Klebsiella oxytoca), ayaktan başvuran çocukların ise 14'ünde (%7.2; 10 E. coli, 3 K. pneumoniae, 1 K. oxytoca) gayta örneklerinde GSBL üreten mikroorganizma gösterildi. Elde edilen tüm izolatlar imipenem duyarlı idi. Hastanede yatan hastalardan elde edilen izolatlarda saptanan imipenem MIC değerlerinin, poliklinik hastalarından elde edilenlere göre 3-4 dilüsyon daha yüksek olduğu görüldü. Hastanede yatan hastalarda GSBL üreten mikroorganizmaların fekal taşıyıcılığı ile yoğun bakım ünitesinde kalış, mekanik ventilasyon gereksinimi, idrar sondası, santral kateter takılması, cerrahi girişim uygulanması ve öncesinde tedavide 3. kuşak defalosporinlerin kullanılmasının ilişkili olduğu görüldü. Ayaktan poliklinikle- AbstractObjective: The isolation of extended-spectrum β-lactamase (ESBL) -producing bacteria has increased worldwide. Fecal colonization with ESBLproducing isolates is considered a prerequisite for infection. Material and Methods:We prospectively evaluated the prevalence and risk factors for fecal carriage of ESBL-producing E. coli and Klebsiella spp. in hospitalized and ambulatory children. A total of 464 fecal samples from pediatric patients (270 hospitalized and 194 ambulatory) were collected from a tertiary care center in Turkey during a non-outbreak period. All stool samples were evaluated for ESBL production by the combination disc test and for imipenem susceptibility by the CLSI agar dilution method. Results: Sixty-six (24% of total) hospitalized children (25 with Escherichia coli, 39 with Klebsiella pneumoniae and 2 with Klebsiella oxytoca) and 14 (7.2% of total) ambulatory children (10 with E. coli, 3 with K. pneumoniae and 1 with K. oxytoca) had a positive fecal sample for ESBL-producing microorganisms. All isolates were susceptible to imipenem; however, the MIC values of strains isolated from hospitalized patients were 3-4 fold higher in dilution than were those of strains isolated from ambulatory children. Univariate analyses showed that intensive care unit stay, urinary catheterization, indwelling catheterization, surgical interventions and prior 3 rd -generation cephalosporin usage were associated with ESBL positivity for the hospitalized pati...