Prevalence and antibiotic susceptibility of Mycoplasma hominis and Ureaplasma urealyticum in pregnant women.

BACKGROUND: Mycoplasma hominis and Ureaplasma urealyticum are important opportunistic pathogens implicated in urogenital infections and complicated pregnancy. We aimed to study the role of these pathogens in symptomatic and asymptomatic pregnant women and determine their clinical significance and antibiotic susceptibility. METHODS: One hundred pregnant women were included in the study, 50 symptomatic patients and 50 asymptomatic controls. Duplicate endocervical samples were taken from each individual and analyzed using the Mycoplasma IST-2 kit and A7 agar medium. Antimicrobial susceptibility was tested against doxycycline, josamycin, ofloxacin, erythromycin, tetracycline, ciprofloxacin, azithromycin, clarithromycin, and pristinamycin using the Mycoplasma IST-2 kit. RESULTS: Twelve symptomatic pregnant women had spontaneous abortions. Of these, eight (66.7%) cases had been colonized with M. hominis and/or U. urealyticum. Of the pregnant women infected with M. hominis and/or U. urealyticum, 40.7% delivered a low birth weight infant. M. hominis was successfully cultured in five women (5%) and U. urealyticum in 27 (27%). Among positive cultures, 15.6% and 84.4% of isolates were M. hominis and U. urealyticum, respectively. M. hominis and U. urealyticum were uniformly susceptible to doxycycline, tetracycline, and pristinamycin, which may be successfully used in the empirical therapy of infected individuals. CONCLUSIONS: It can be concluded that genital colonization with M. hominis and U. urealyticum may predispose to spontaneous abortion and low birth weight.

[A pneumonia case caused by Cedecea lapagei]. / Cedecea lapagei'nin neden oldugu bir pnömoni olgusu.

Cedecea spp. which are the members of Enterobacteriaceae family, are mostly isolated from sputum and their clinical importance is not yet demonstrated. This report presents a pneumonia case caused by Cedecea lapagei. A 38-years-old male patient admitted to Inonu University Faculty of Medicine Emergency department with prediagnosis of subarachnoid haemorrhage was operated and transferred to Intensive Care Unit of Reanimation where he underwent artificial ventilation. On the third day of hospitalization his temperature was 39 degrees C, white blood cell count was 27.000/ml and he was still unconscious. He had a history of chronic obstructive pulmonary disease. Chest X-ray revealed opacities in the right lower lobe and mucoid tracheal secretion ensued following tracheal entubation performed after operation. Direct microscopic examination of bronchoalveolar lavage (BAL) fluid yielded abundant number of leukocytes and gram-negative bacilli. Bacteria isolated from BAL specimen were identified as C. lapagei by Phoenix 100 (Becton Dickinson, USA) automated system and also by API 20E kit (Biomerieux, France). Upon the initiation of intravenous amikacin (1 x 1 g) and meropenem (3 x 1 g), the signs of infection decreased in intensity, however, the patient was lost due to subarachnoid hemorrhage on the 12th day of hospitalization. In this case it was estimated that C. lapagei pneumonia originated from the aspiration of upper airway secretion owing to unconsciousness of the patient. Although there were reports of Cedecea infections in the literature, this was the first documented case of C. lapagei pneumonia when the accessible related literature was concerned.

[Distribution of bacteria isolated from urine cultures in Malatya University Hospital laboratory (letter)]. / Malatya Universite hastanesi Laboratuvarinda Idrar kültürlerinden izole edilen bakterilerin dagillmi.

The aim of this letter was to report the distribution of bacterial species isolated from the urine samples of patients in Malatya, which is located in Estern Anatolia part of Turkey. A total of 3.774 urine cultures were performed in the period of April-June 2006, and 792 (21%) of them yielded bacterial growth. The isolates have been identified by conventional methods and confirmed by Phoenix 100 (Becton-Dickinson) system. As a result, 702 (89%) Gram negative and 90 (11%) Gram positive bacteria were isolated from the samples. The most frequently isolated bacteria were Escherichia coli (58%), followed by Klebsiella spp. (14%), Pseudomonas spp. (6.4%), Enterococcus spp. (5%), Staphylococcus spp. (3.8%) and Streptococcus spp. (1.7%). The species distribution was found as follows; K. pneumoniae ssp pneumoniae (95/110), P. aeruginosa (48/51), E.faecalis (27/40), E. cloacae (19/29), P.mirabilis (19/22), C.freundii (8/12), coagulase negative staphylococci (19/30) and S. aureus (11/30). The first three array were shared by E. coli, Klebsiella spp. and Pseudomonas spp. for the samples of both outpatients and inpatients, while Pseudomonas spp. and E. coli were the most frequently isolated bacteria from the urine samples of intensive care unit patients. Our data was found parallel to the results of other national and international studies.