Successful vaccination policies for protection from invasive pneumococcal diseases (IPD) dependent on determination of the exact serotype distribution in each country. We aimed to identify serotypes of pneumococcal strains causing IPD in children in Turkey and emphasize the change in the serotypes before and after vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) was included and PCV-13 was newly changed in Turkish National Immunization Program. Streptococcus pneumoniae strains were isolated at 22 different hospitals of Turkey, which provide healthcare services to approximately 65% of the Turkish population. Of the 335 diagnosed cases with S. pneumoniae over the whole period of 2008-2014, the most common vaccine serotypes were 19F (15.8%), 6B (5.9%), 14 (5.9%), and 3 (5.9%). During the first 5 y of age, which is the target population for vaccination, the potential serotype coverage ranged from 57.5 % to 36.8%, from 65.0% to 44.7%, and from 77.4% to 60.5% for PCV-7, PCV-10, and PCV-13 in 2008-2014, respectively. The ratio of non-vaccine serotypes was 27.2% in 2008-2010 whereas was 37.6% in 2011-2014 (p=0.045). S. penumoniae serotypes was less non-susceptible to penicillin as compared to our previous results (33.7 vs 16.5 %, p=0.001). The reduction of those serotype coverage in years may be attributed to increasing vaccinated children in Turkey and the increasing non-vaccine serotype may be explained by serotype replacement. Our ongoing IPD surveillance is a significant source of information for the decision-making processes on pneumococcal vaccination.
Bu çalışmada Ankara ilinde dört eğitim ve araştırma hastanesinin yoğun bakım ünitesinde çalışan sağlık personelinin enfeksiyon kontrol önlemleri hakkındaki bilgi düzeyinin eğitim öncesi ve eğitim sonrasında değerlendirilmesi ve bilgi düzeylerini etkileyebilecek faktörlerin belirlenmesi amaçlanmıştır.
Achromobacter xylosoxidans formerly named as Alcaligenes xylosoxidans is an aerobic, non-fermenting, oxidase positive, catalase positive gram negative bacillus. It is seen especially in immunosuppressed patients, patients with tumors, hypogamaglobulinemia or transplant patients. A. xylosoxidans infection in urinary system is very rare. 56 year old male patient was presented to our clinic with bilateral flank pain. He had not immunodeficiency and tumor history. He had diabetes mellitus. He had shock wave lithotripsy history for bilateral kidney stone. He had previous open surgery for right kidney stone and retrograde intrarenal surgery for left kidney stone. In the urine culture, Achromobacter xylosoxidans infection was detected. Ciprofloxacin, ceftriaxone and methenamine hippurate treatment were firstly applied to the patient. Patient was followed and 15 days later he admitted our clinic. 38 white blood cells and 8 red blood cells were present in urinalysis and the control urine culture was sterile. In conclusion, A. xylosoxidans infection is rarely seen and it has high resistance to antibiotics. Clinicians must be careful about the infection and treatment of A. xylosoxidans infection.
Bu çalışmada Ankara ilinde dört eğitim ve araştırma hastanesinin yoğun bakım ünitesinde çalışan sağlık personelinin enfeksiyon kontrol önlemleri hakkındaki bilgi düzeyinin eğitim öncesi ve eğitim sonrasında değerlendirilmesi ve bilgi düzeylerini etkileyebilecek faktörlerin belirlenmesi amaçlanmıştır.
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a leading pathogen of serious infectious diseases in intensive care units. Novel antibiotic combination therapies are needed to treat serious infectious diseases caused by MRSA. Objectives: Our objective was to evaluate the minimum inhibitory concentrations (MICs) of ceftaroline (CPT), telavancin (TLV), daptomycin (DPC), and vancomycin (VA) alone and in vitro synergistic activity of CPT-TLV, CPT-DPC, and CPT-VA combinations against MRSA isolates. Methods: Fifty MRSA strains isolated from blood (90%) and tracheal aspirate (10%) of patients in intensive care units (ICUs) between 2013 and 2016 were included in the study. The Epsilometer test was used for determining the synergistic activities of antibiotic combinations. We evaluated the synergistic, additive, indifferent, and antagonist effects of MRSA strains by the fractional inhibitory concentration (FIC) index.
Results:Of the 50 MRSA strains tested, 100% were susceptible to TLV, DPC, and VA. CPT was detected as resistant in 3 (6%) of the isolates. CPT-TLV, CPT-DPC, and CPT-VA combinations were found to have synergistic effects in 14%, 38%, 10% and additive effects in 40%, 32%, and 22% of the isolates, respectively. No antagonism was detected in any of the combinations. Conclusions: The combination of CPT with DPC showed the best synergy profile among all antibiotic combinations tested against MRSA isolates obtained from patients in ICUs.
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