Nosocomial Acinetobacter baumannii infections and changing antibiotic resistance

Objectives: In the intensive care setting, Acinetobacter baumannii causes ventilator-associated pneumonia and other nosocomial infections that are difficult to treat. Objective of this study was to investigate nosocomial A. baumannii infections and its changing antibiotic resistance

Methods: A total of 56 patients diagnosed with A.baumannii infections between January 2009 and December 2011 were included in the study. Diagnosis for nosocomial infections was established according to the CDC [Centers for Disease Control and Prevention] criteria. Identification of the agents isolated was carried out using conventional methods and VITEK 2 automated system, while antibiotic sensitivity testing was performed through VITEK 2 AST-N090 automated system

Results: The most common infection was nosocomial pneumonia by 43%, among which 46% were ventilatorassociated pneumonia. Considering all years, the most effective antibiotics on the isolated strains were found as colistin, tigecycline, imipenem and meropenem. However resistance to imipenem and meropenem was observed to increase over years

Conclusion: The issue of increased resistance to antibiotics poses difficulty in treatment of A. baumannii infections which in turn increases the rate of mortality and cost. In order to prevent development of resistance, antibiotics must be used in an appropriate way in accompanied with proper guidance

Bone marrow biopsy findings in brucellosis patients with hematologic abnormalities / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Brucellosis can mimic various multisytem diseases, showing wide clinical polymorphism that frequently leads to misdiagnosis and treatment delay, further increasing the complication rates. In this study, we aimed to examine bone marrow biopsy findings in brucellosis cases presenting with hematologic abnormalities.</p><p><b>METHODS</b>Forty-eight brucellosis cases were prospectively investigated. Complaints and physical examination findings of patients were recorded. Patients' complete blood count, routine biochemical tests, erythrocyte sedimentation rate, C-reactive protein and serological screenings were performed. Bone marrow biopsy and aspiration was performed in patients with cytopenia, for bone marrow examination and brucella culture, in accordance with the standard procedures from spina iliaca posterior superior region of pelvic bone.</p><p><b>RESULTS</b>Of the 48 patients, 35 (73%) were female and 13 (27%) were male. Mean age was (34.8 ± 15.4) years (age range: 15 - 70 years). Anemia, leukopenia, thrombocytopenia and pancytopenia were found in 39 (81%), 28 (58%), 22 (46%) and 10 patients (21%), respectively. In the examination of bone marrow, hypercellularity was found in 35 (73%) patients. Increased megacariocytic, erythroid and granulocytic series were found in 28 (58%), 15 (31%) and 5 (10%) patients, respectively. In addition, hemophagocytosis was observed in 15 (31%) patients, granuloma observed in 12 (25%) and increased eosinophil and plasma cells observed in 9 (19%) patients.</p><p><b>CONCLUSION</b>According to the results of our series, hemophagocytosis, microgranuloma formation and hypersplenism may be responsible for hematologic complications of brucellosis.</p>

Peripheral blood monocytes in multiple sclerosis exacerbations

Monocytes [MO], macrophages, and microglia have a central role in the central nervous system inflammation of multiple sclerosis [MS]. During clinical activity in MS, MO activation markers increase and some interleukins and tumor necrosis factor-alpha levels are elevated. Our aim was to determine levels of absolute MO count and percentage in peripheral blood of MS patients during the attacks. We assessed the percentage of MO by examining the blood smears in 28 patients with definite MS, in 20 patients with acute cerebrovascular disease [CVD] and in 20 healthy control subjects. The mean value of absolute MO count in MS patients, CVD and control groups were as 606.67 +/- 170.52, 746.50 +/- 414.76 and 360.00 +/- 109.54 respectively. The mean values of MO percentage in MS patients, CVD and control group were 8.34 +/- 2.61%, 5.56 +/- 2.48% and 5.36 +/- 1.50% respectively. The mean percentage of MO was significantly elevated in MS patients compared with the both groups of CVD and control [P<0.001]. Our results suggest a possible role of an increase in MO activation in the acute exacerbations of Multiple Sclerosis