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Stenotrophomonas maltophilia infection is of concern in patients with cancer. Antibiotics active against S. maltophilia are rarely used in the treatment of febrile neutropenia, making it important to identify the factors influencing mortality in cancer patients with S. maltophilia infection. The objective of this study was to analyze the clinical characteristics and outcomes of cancer and hemopathic patients with S. maltophilia infection and assess the factors influencing the mortality. The microbiology laboratory records of Erciyes University, Faculty of Medicine Hospital were reviewed to retrospectively identify patients with S. maltophilia infection between January 2007 and June 2011. A total of 38 patients (25 male, 13 female) were eligible for the study. The median age of the patients was 53 years. The underlying disease was hematological malignancy and disorders in 76.3 % (29 cases), solid tumors in 15.8 % (six cases), aplastic anemia in 7.9 % (three cases), while 18.4 % (seven cases) were hematopoietic stem cell transplantation (HSCT) recipients. An indwelling central venous catheter was used in 32 cases (84.2 %). Twenty-seven patients (71.1 %) were neutropenic at the onset of infection. Nine patients (23.7 %) were receiving corticosteroid therapy. The overall 14-day mortality rate was 50 %. Three of the patients received empirical antibacterial treatment, and three HSCT recipients received trimethoprim-sulfamethoxazole prophylaxis, which is active against S. maltophilia. Severe sepsis (OR 13.24, 95 % confidence interval (CI) 1.62-108.57) and the duration of the treatment (OR 0.73, 95 % CI 0.60-0.90) were related to death based on logistic regression analysis findings. In immunocompromised hematology-oncology patients with severe sepsis, S. maltophilia should be considered as a possible cause of infection, and should be given effective empirical antibiotic treatment immediately; the antimicrobial spectrum may be narrowed according to results of antibiotic susceptibility test.

Objective: Tunneled cuffed dual-lumen catheters (TCCs) are commonly used for vascular access in hemodialysis (HD) patients. Catheter-related bloodstream infection (CRBSI) is the major problem leading to morbidity and mortality. We investigated whether 26% NaCl solution has any favorable effect on the infections and thrombosis caused by HD catheters. Methods: TCCs were locked with either 26% NaCl and heparin or standard heparin. The primer end point of the study was the CRBSI or thrombosis of the TCC. We compared the antimicrobial activity of the NaCl solutions (6.5%, 13%, 26%) with 0.9% NaCl solution by time-kill kinetic assay. All tests were performed in triplicate by incubation of test fluids with Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis. Results: The mean catheter survival was significantly higher in the 26% NaCl and heparin group (129.5 ± 50.1 catheter days to 103.3 ± 59.8, p = 0.008). CRBSI rates (10-15.4%) did not differ significantly between the two groups (p = 0.54). The hypertonic 13% NaCl solution had bactericidal effects on E. coli and P. aeruginosa, but had bacteriostatic effect on S. aureus and S. epidermidis. Conclusion: In this study we demonstrated that the 13% NaCl solution and more hypertonic NaCl solutions revealed potent in vitro antimicrobial properties against all checked Gram-negative microorganisms.

Objective: The antibacterial effectiveness of four different sealers AH Plus, EndoRez, mineral trioxide aggregate (MTA) Fillapex, iRoot SP against Enterococcus faecalis was evaluated by time kill assay method in vitro . Materials and Methods: Four sealers are used in this study: An epoxy resin-based sealer, AH Plus (Dentsply, Maillefer, Switzerland), a polymethacrylate resin-based sealer, EndoRez (Ultradent, South Jordan, UT) and two calcium silicate-based sealers, MTA Fillapex (Angelus Solucxoes Odontologicas, Londrina, Brazil), iRoot SP (Innovative BioCreamix Inc., Vancouver, Canada). Each sealer was mixed according to manufacturer′s instructions. Five mg of each sealer was added to sterile tubes separately and evaluated at 20 min, 24 h, 7 days, and 30 days. Two tubes were used as positive and negative. Results: At the 20 th min AH Plus and iRoot SP were bactericidal, MTA Fillapex, and EndoRez were ineffective at the 20 th min. At the 1 st day MTA Fillapex was ineffective and rest of the sealers was bacteriostatic. At the 7 th day, only MTA Fillapex showed bactericidal effect, AH Plus, iRoot SP and EndoRez were bacteriostatic. At the 30 th day, MTA Fillapex was still bactericidal, AH Plus, iRoot SP, and EndoRez were still bacteriostatic. Conclusion: All root canal sealers tested were effective against E. faecalis . Fresh iRoot SP and fresh AH Plus had bactericidal action against E. faecalis . EndoRez has bacteriostatic behavior against E. faecalis . MTA Fillapex was the only sealer that could be bacteriocidal at 7 th and 30 th day.

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