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 ventilator-associated 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.

Could thrombocyte parameters be an inflammatory marker in the brucellosis?

AIM: To investigate links between platelet parameters mean platelet volume (MPV), platelet count (PC), platelet distribution width (PDW), platelet mass (PM) and brucella tube agglutination titers (BSTAT) in patients with brucellosis. Initially, PC, MPV, PM and PDW calculations were compared between periods before and after treatment. The correlation between inflammation markers (erythrocyte sedimentation rate, ESR, white blood cell count, WBC, and C reactive protein, CRP) and platelet parameters was subsequently investigated. METHODS: This self-controlled study included 40 patients who had positive BSTAT at least at a titer of 1/160. Platelet parameters and inflammation values (CRP, ESR) at the time of positive BSTAT at least at a titer of 1/160 (pre-treatment) were compared with control of the same parameters at the time when BSTAT became negative or when the titers reduced 4 folds (post-treatment). RESULTS: Mean platelet volume values (7.90+1.96) were significantly elevated in post treatment period when compared to pre treatment (7.58+1.96), (p= 0.023). Post treatment CRP, ESR and PC were significantly reduced when compared to pretreatment values (p=0.000, p=0.000 and p=0.025, respectively). In the pretreatment period, a direct correlation between ESR and PC values (r=0.036, p=0.025), and inverse correlations between ESR with MPV (r=-0.337, p=0.038) was found. A dependent predictive factor in multivariate logistic regression analysis for BSTAT was not found. CONCLUSION: We suggest that PC and MPV may be inflammatory markers in brucellosis.

Microbial colonization of the external auditory canal and nose in hemodialysis patients.

AIM: The aim of our study is to determine the microbiology of the external auditory canal and nose in uremic patients on chronic dialysis. METHODS: All patients undergoing regular hemodialysis for at least 3 months were included in this study. The nasal and external auditory canal swabs were collected from 83 haemodialysed patients. RESULTS: From 83 patients (37 females, 46 males) nasal and external auditory canal cultures were obtained. Mean duration on dialysis was 41.75 ± 45 months and mean age of patients was 61 ± 13 years. Microflora in the nasal cavities (70/80, 87.5%) and external auditory canal (48/59, 81.3%) were similar in all culture positive patients (coagulase-negative staphylococci). Coexistence of coagulase- negative staphylococci and diphteroids was detected in 20 patients' (25.0%) nasal vestibule and in eight patients' (13.5%) external auditory canal. CONCLUSION: Microflora in the nasal cavities and external auditory canal were similar in chronic renal patients. External auditory canal microflora was not associated with history of diabetes mellitus, hepatitis status and starting date of hemodialysis in our study.