Evaluation of the relationship between procalcitonin level and the causative pathogen in intensive care patients with sepsis.

Aim: This study was designed to investigate how procalcitonin (PCT) levels are affected by different pathogens in patients with sepsis. Materials & methods: A total of 110 Gram-positive sepsis, 62 Gram-negative sepsis and 27 fungal sepsis patients were included in the study. Kaplan-Meier and ROC curve analysis was performed to assess PCT levels. Results: PCT levels were 2.36 ng/ml in Gram-negative patients, 0.79 ng/ml in Gram-positive patients and 0.89 ng/ml in fungal patients. The area under the curve for PCT was 0.608, the cutoff value was 1.34, sensitivity was 56.50% the specificity was 56.50%. Conclusion: PCT survival levels of 7.71 ng/ml in Gram-negative patients, 2.65 ng/ml in Gram-positive patients and 1.16 ng/ml in fungal patients can be evaluated to predict survival.

Darkness hormone or daylight hormone in women with systemic lupus erythematosus?

INTRODUCTION: In this study, it was aimed to compare the effects of both melatonin and 25-hydroxyvitamin D3, defined as an immune modulator, on laboratory diagnostic criteria parameters and disease activity in patients with systemic lupus erythematosus (SLE). METHODS: The study included 56 women with SLE and 40 healthy women (control group). Melatonin and 25-hydroxyvitamin D3 levels of patients and healthy individuals included in the study were examined. In addition, leukocytes, lymphocytes, platelets, C3, C4, anti-double-stranded DNA (Anti-dsDNA), antinuclear antibody, and SLE disease activity index (SLEDAI) were analyzed in women with SLE. Patients were divided into four subgroups according to SLEDAI. RESULTS: Melatonin and 25-hydroxyvitamin D3 levels of women with SLE were lower than healthy women (p < 0.001). Both melatonin and 25-hydroxyvitamin D3 levels were not correlated with laboratory diagnostic criteria parameters. Only 25-hydroxyvitamin D3 levels were correlated with leukocyte levels (p < 0.01). There was no significant difference between the melatonin levels of the subgroups. The 25-hydroxyvitamin D3 levels of the subgroup without disease activity were higher than levels of the subgroups with disease activity (p < 0.05). There was a negative correlation between SLEDAI score and 25-hydroxyvitamin D3 levels (p < 0.05). CONCLUSION: Women with SLE had lower melatonin and 25-hydroxyvitamin D3 levels than healthy women. On the other hand, parameters of laboratory diagnostic criteria of SLE disease were not related. Only 25-hydroxyvitamin D3 levels were inversely related leukocyte levels. SLE disease activity was not correlated with melatonin levels but negatively correlated with 25-hydroxyvitamin D3 levels. Key Points • Women with SLE have low levels of melatonin and 25-hydroxyvitamin D3. • Melatonin and 25-hydroxyvitamin D3 levels are not related to the laboratory diagnostic criteria parameters for SLE disease. • Low levels of melatonin and 25-hydroxyvitamin D3 may be a factor in the unbalanced immune system of SLE. • Supplementation of melatonin and 25-hydroxyvitamin D3 may be recommended for women patients with SLE.

Distribution and antifungal susceptibility of candida species isolated from blood cultures.

OBJECTIVE: To determine the distribution of samples exhibiting candida growth among the blood cultures, and the antifungal susceptibility. METHODS: The retrospective study was conducted at Samsun Training and Research Hospital, Samsun, Turkey, and comprised data of immunosuppressed patients with sepsis from January to December 2018. Yeast growth was typed by means of colony morphology, germ tube formation and the VITEK 2 system. The susceptibility was determined using the same automated system. Resistant strains were also tested using the dilution method. Data was analysed using SPSS 25. RESULTS: Of the 50 patients, 31(62%) were males and 19(38%) were females. The overall mean age was 60.84±22.05 years. Of the total samples, 31(62%) were received from intensive care units, 14(28%) from the palliative care unit, and 5(10%) from inpatients. The most common isolate was candida albicans 26(52%), while candida parapsiosis was the most common among non-albicans species 13(26%). Resistance to antifungals was observed in 13(26%) isolates; 5(10) to fluconazole, 4(8%) to voriconazole, 2(4%) each to flucytosine and amphotericin B. The findings obtained through both the dilution method and the automated system were consistent. CONCLUSIONS: The resistance to antifungal drugs varied among different candida species.

Relationship between antibiotic resistance, efflux pumps, and biofilm formation in extended-spectrum ß-lactamase producing Klebsiella pneumoniae.

Klebsiella pneumoniae is an important pathogen both in community and hospital environment. In this study, we aimed to determine the antibiotic susceptibilities, expression levels of AcrA, ketM, kdeA, kpnEF, and kexD genes related to efflux pump and biofilm formation in 100 extended-spectrum ß-lactamase producing Klebsiella pneumoniae. The relative expression levels of AcrA, ketM, kdeA, kpnEF, and kexD were determined by quantitative real-time PCR and biofilm formation was screened by microtiter plate assay. Based on CLSI breakpoints, zone diameters showed that 72% of isolates were resistant to ceftazidime, 79% to aztreonam, 54% to ciprofloxacin, 32% to ertapenem, 74% to tobramycin, 65% to tetracycline and all isolates were resistant to ampicillin, ceftriaxone, and cefotaxime. The relative expression of AcrA was upregulated in ciprofloxacin susceptible isolates and also upregulation of newly described efflux pump, kexD, was correlated with tobramycin and aztreonam resistance. A significant correlation was observed between resistance-nodulation-division and single-type efflux pumps. On the other hand, ciprofloxacin susceptible isolates formed stronger biofilms than resistant isolates. The up or down regulation of efflux pumps didn't enhance biofilm formation capacity.

In Vitro Effects of Ivermectin and Sulphadiazine on Toxoplasma gondii.

OBJECTIVE: Ivermectin and sulphadiazine were tested individually to determine their in vitro effects on Toxoplasma gondii grown in human epidermoid larynx carcinoma (Hep-2) cell culture. STUDY DESIGN: In-vitro study. MATERIAL AND METHODS: Toxoplasma growth was quantities by an enzyme immunoassay performed directly on the fixed cultures, using a rabbit anti-T. gondii immunoglobulin G as the first antibody and a phosphatase-labeled anti-rabbit immunoglobulin G as the second antibody. For each drug, regression models were used to quantify the relationship between optical density values and antimicrobial agent concentrations in the cultures. RESULTS: The 50% inhibitory concentrations (IC50) of ivermectin and sulphadiazine were found to be 0.2 µg/mL and 7.3 µg/mL after 48 h of exposure, respectively. None of the concentrations tested for each drugs demonstrated toxicity to Hep-2 cells after 72 h of incubation. CONCLUSION: These results indicate that ivermectin significantly inhibited replication of the tachyzoites of T. gondii RH strain.