Ureaplasma urealyticum: Presence among Sexually Transmitted Diseases.

The aim of this study was to detect the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Trichomonas vaginalis, and Ureaplasma urealyticum in genital specimens of symptomatic patients. This study also examined the role of U. urealyticum in infections of the lower genital tract. Cervical and urethral samples from 96 patients (46 males, 50 females) were tested using the Seeplex(®) STD6 ACE kit. Consent forms were received and a questionnaire was applied. All statistical analyses were performed using the SPSS statistical software program (version 17.0). Among the samples tested, at least 1 pathogen was detected in 49% of the samples; specifically, the rate of detection of U. urealyticum, M. hominis, C. trachomatis, N. gonorrhoeae, M. genitalium, and T. vaginalis was 29.1%, 10.4%, 8.3%, 7.3%, 6.3%, and 4.2%, respectively. U. urealyticum was detected as the sole pathogen in samples from 10% of female patients and 28.3% of male patients (p = 0.035). U. urealyticum was present in 54.5% (18/33) of samples in which a single pathogen was detected and 71.4% (10/14) of samples in which multiple pathogens were detected. Among men, significant differences in discharge, dysuria, and pruritus were not noted among those with negative results (84.6%, 69.2%, and 38.5%, respectively), among those positive for only U. urealyticum (100%, 66.7%, and 26.7%, respectively), and those positive for N. gonorrhoeae, C. trachomatis, M. genitalium, and T. vaginalis (100%, 93.3%, and 26.7%, respectively). Detection of U. urealyticum, either alone or together with other pathogens, in a symptomatic group of patients is an important finding, particularly in men.

Growing OXA-23 type strains among carbapenem-resistant Acinetobacter baumannii and tigecycline as an alternate combination therapy.

BACKGROUND/AIM: The increasing prevalence and global spread of difficult-to-treat carbapenem-resistant Acinetobacter baumannii has become a serious problem. The aim of this study is to investigate the resistance patterns and tigecycline sensitivity of carbapenem-resistant A. baumannii strains. MATERIALS AND METHODS: Acinetobacter strains that were carbapenem-resistant and collected mainly from intensive care units were included into this study. The antibiotic sensitivity/resistance of the strains to other antibiotics and tigecycline were noted. Presence of blaOXA-23, blaOXA-48, blaOXA-58, and NDM-1 was investigated by PCR. RESULTS: In total, 44 carbapenem-resistant A. baumannii strains were detected. In addition, 57% (25/44) showed resistance to netilmicin and 2% (1/43) to tigecycline. All of the strains were susceptible to colistin. blaOXA-58 was found only in one (2%) strain while blaOXA-23 was found in 14 (32%) strains. All strains were negative for blaOXA-48 and NDM-1. CONCLUSION: blaOXA-23 was the main resistance pattern in carbapenem-resistant A. baumannii strains. blaOXA-58 was present only in one strain and no blaOXA-48 was found. Tigecycline susceptibility is high and it can be a treatment option for a possible combination therapy of carbapenem-resistant A. baumannii, especially for those for whom colistin is contraindicated because of its toxicity.

[Assessment of diagnostic methods for the catheter-related bloodstream infections in intensive care units]. / Yogun Bakim Ünitelerinde Gelisen Kateter ile Iliskili Kan Dolasimi Enfeksiyonlarinin Tanisinda Kullanilan Yöntemlerin Degerlendirilmesi.

The majority of catheter-related bloodstream infections (CR-BSI) are associated with central venous catheters (CVCs) and most of them develop in patients staying at intensive care units (ICUs). The aim of this study was to assess the performance of different methods for the diagnosis of CR-BSI in neurology and neurosurgery ICUs of our hospital. This prospective study was carried out between January 2007 and January 2008 and all of the patients were followed daily for CR-BSI after the insertion of CVCs. Blood cultures were taken simultaneously from the catheter lumen and from at least one peripheral vein when there was a suspicion of CR-BSI. Additionally, from patients whose CVCs were removed, catheter tip cultures were taken and from patients with exit site infection, cultures of the skin surrounding the catheter entrance were taken. Catheter tip cultures were done by using quantitative and semiquantitative culture methods. Blood cultures taken from the catheter lumen and peripheral vein were incubated in the BACTEC 9050 (Becton Dickinson, USA) automated blood culture system. Gram and acridine orange (AO) staining were used for the smears prepared from the catheter tips and blood cultures. To evaluate the value of culture and staining methods in the diagnosis of CR-BSI; sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) of each method were determined. A total of 148 patients (66 male, 82 female; age range: 1-94 years, mean age: 58.7 ± 21.8 years) were included in the study, of whom 67 (45.3%) were from neurology and 81 (54.7%) were from neurosurgery ICUs. One hundred ninety-nine CVC application performed in 148 patients were evaluated. Mean duration of catheterization was 8.5 ± 5.2 days. Thirty-two episodes of CR-BSI among 199 catheterizations (16%) in 29 patients among a total of 148 patients (19.6%) were determined. The most frequently isolated microorganisms were methicillin-resistant coagulase-negative staphylococci (8/32; 25%), penicillin-resistant Enterococcus spp. (8/32; 25%) and Candida albicans (4/32; 12.5%). Sensitivity, specificity, PPV and NPVs of the quantitative and semiquantitative culture methods of the catheter tip and the differential time to positivity (positive result obtained at least two hours earlier in blood cultures drawn through the catheter than the peripheral blood cultures which were taken simultaneously) between blood cultures drawn through the catheter and those drawn from the peripheral vein were 100% for the diagnosis of CR-BSI. Sensitivity and NPV of the isolation method of the same microorganism from blood culture drawn through the catheter and drawn from the peripheral vein were 100%, specificity was 85% and PPV was 88% for the diagnosis of CR-BSI. Sensitivity, specificity, PPV and NPVs of Gram and drawn simultaneously from the peripheral vein and quantitative and semiquantitative cultures of the catheter tip in patients with removed catheter, were important factors in terms of diagnosis of CR-BSI. It was also concluded that AO staining could provide additional benefit in the diagnosis of CR-BSI since it has higher sensitivity, specificity, PPV and NPVs for peripheral blood cultures and catheter tip cultures compared to Gram staining.

Are interleukin-6, body mass index and atopy crucial in infantile intussusception?

OBJECTIVE: To determine the role of inflammation related to body mass index (BMI) and atopy in the etiology of idiopathic intussusception (IS) which is seen more frequently in obese children and which is considered to increase in the allergy season. METHODS: The study comprised a study group consisting of 22 infants with IS and a control group consisting of 20 healthy infants with age and BMI matched. In both groups, gender, weight, height, month of birth, month of admittance (allergy season) of each infant were recorded. Information regarding whether or not the child had any skin rash, atopy, oral allergy syndrome, and whether or not the patient had been fed cow's milk and breast milk was recorded. Hemoglobin (Hb) levels, white blood cell (WBC) and eosinophil counts, interleukin-6 (IL-6) levels and allergy panel were studied in all patients. Additionally, cross reactive protein (CRP) and blood urea nitrogen (BUN) levels were determined in the study group. During statistical comparison p < 0.05 was considered statistically significant. RESULTS: Mean IL-6 levels in the control and study groups were 1.59 ± 0.15 pg/ml and 4.12 ± 5.04 pg/ml, respectively. IL-6 levels were statistically different between each groups and between cases with barium reduction and cases reduced manually by laparotomy within the study group. Both groups were similar statistically with regard to the others parameters. No atopy was detected by allergy panel. When binary logistic regression analysis with the cut-off value of IL-6 set as 1.6 pg/ml was applied to all data, statistically significant values were obtained only when the case was in the study group and when CRP levels were increased (p = 0.05 and p = 0.001, respectively). CONCLUSIONS: We demonstrated that IL-6 levels are increased in the study group, especially in the operated patients, however, that high BMI and atopy have no effects on this fact and that atopy is not associated with IS in the clinical study.

[Varicella-zoster virus seroprevalence in children between 0-15 years old]. / 0-15 yas arasi çocuklarda varicella-zoster virus seroprevalansi.

The incidence of chicken pox infections in our country is not clear since it is not an obligatory reported disease, and there is not enough seroepidemiologic studies on this subject. The aim of the study was to determine the seroprevalence of infections caused by Varicella-Zoster virus (VZV), and to determine the relation of prevalence with some factors. For this purpose, 885 children ages between 0-15 years old, were investigated for the presence of VZV-IgG antibodies. Specific IgG antibodies were screened qualitatively by enzyme immunoassay (ELISA). As a result, it was found that after the declination of maternal antibodies, seropositivity rates were low up to the end of the first year, and then showed a gradual increase. The seropositivity rates were found 41.2% for 4-5 years old group, whereas it was 80% for 10-11 years old group and 85% for 13-15 years old group. There was no statistically important difference between seropositivity and sexes of children (p>0.05), but the seropositivity rates showed statistically important differences between increasing age and the number of siblings. In conclusion, as the majority of varicella infections occur in early childhood, the best way to prevent the circulation of wild type VZV, is the vaccination of children against chicken pox.

Plasma soluble intercellular adhesion molecule 1 levels are increased in type 2 diabetic patients with nephropathy.

BACKGROUND/AIM: Intercellular adhesion molecule 1 (ICAM-1) is a mediator in the recruitment of leukocytes in the glomerular cells. The role of ICAM-1 in diabetic complications is still a matter of debate. This study was performed to investigate the relation of plasma soluble ICAM-1 (sICAM-1) to nephropathy in patients with type 2 diabetes mellitus. METHODS: Ninety-three patients (24 males and 69 females) with type 2 diabetes mellitus were included into the study. Fifty patients had nephropathy, and 43 were free from nephropathy. Fifty healthy subjects (14 males and 36 females) served as the control group (group 1). Twenty-five of the diabetic patients had microalbuminuria (group 2), 25 had macroalbuminuria (group 3), and 43 had neither micro- nor macroalbuminuria (group 4). The plasma sICAM-1 levels were measured in blood samples drawn after fasting. RESULTS: The mean plasma sICAM-1 levels were not different in the 93 diabetic patients as compared with the healthy controls (392.7 +/- 119.5 vs. 350.1 +/- 90.2 ng/ml, p > 0.05). The mean sICAM-1 level was significantly higher in the diabetic patients with nephropathy than in those without nephropathy (430.3 +/- 78.2 vs. 368.2 +/- 122.5 ng/ml, p = 0.03) and in the controls (430.3 +/- 78.2 vs. 350.1 +/- 90.2 ng/ml, p = 0.016). The difference in sICAM-1 levels between groups 2 and 3 was not significant (p > 0.05). The plasma sICAM-1 levels were significantly higher in both groups 2 and 3 than in both groups 1 and 4 (434.5 +/- 129.2 vs. 427.2 +/- 113.7 ng/ml and 368.2 +/- 122.5 vs. 350.1 +/- 90.2 ng/ml, respectively). CONCLUSIONS: The plasma sICAM-1 levels in patients with type 2 diabetes mellitus are not significantly different from those in nondiabetic subjects. High levels of sICAM-1 suggest that sICAM-1 may play a role in the development of nephropathy in patients with type 2 diabetes mellitus.