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Öğe Antimicrobial susceptibility and serotype distribution of pneumococci strains isolated from meningitis patients(2006) Firat M.; Ersoy Y.; Eşel D.; Bayraktar M.; Çaylan R.; Durmaz R.Treatment of life threatening pneumococcal infections such as meningitis has recently become problematic due to the emergence of antibiotic resistant strains. Antimicrobial susceptibility data usually derived from the studies that included all clinical pneumococcal isolates. However, resistance patterns of this microorganism isolated from meningitis cases in our country are not exactly known. The aim of this study was to determine the antimicrobial susceptibility and serotypes of Streptococcus pneumoniae strains isolated from meningitis cases. This retrospective study was designed in three university hospitals in Turkey and 72 pneumococci isolated from patients with meningitis were evaluated. In this study disk diffusion test and E-test methods were used to determine the susceptibility of pneumococci to some antibiotics. All S.pneumoniae isolates were serotyped using Quellung reaction. Although resistance for oxacillin was found by disc diffusion method in 11 isolates, only six of them were found to be resistant by E-test. By the latter procedure, no resistance was recorded against ceftriaxone and meropenem, while chloramphenicol resistance was found as 1.4%. In our study, erythromycin, ciprofloxacin and levofloxacin resistance were 2.8%, TMP-SMX resistance was 26.4%, while no vancomycin resistance was detected by disk diffusion. In evaluation of 72 pneumococci, we found 16 different serotypes and four isolates could not be serotyped. The serogroup 23 (n: 19) was the most common one followed by serotype 19 (n: 9) and serotype 14 (n: 7). Of six resistant isolates, three pneumococci were serogroup 23 and the remaining were from three different serotype/ serogroups 11, 14 and 19. As a result penicillin resistance in pneumococci isolated from meningitis was low and there was no resistance to ceftriaxone. It seems that ceftriaxone is an appropriate choice for empirical treatment of meningitis in our patients. These findings also revealed that pneumococcal polysaccharide capsule vaccines in use cover most of the invasive pneumococcal serotypes.Öğe Evaluation of serum levels of immunoglobulins (IgA, IgE, IgG, IgM) complements (C3, C4) and C-reactive protein in bladder cancer: A controlled prospective clinical trial(2005) Kiliç S.; Bayraktar M.; Bayraktar N.; Ergin H.; Beytur A.; E?ri M.Introduction: During the management of a patient with bladder cancer, the aim of a clinician is to diagnose the tumor with a most sensitive and least invasive method. Cystoscopy and urine cytology are standard practice in following these patients; however, cystoscopy is invasive, and urine cytology has low sensitivity. Therefore, this study aims to evaluate the diagnostic and prognostic value of the humoral immunity in the bladder cancer patients by means of measuring serum levels of immunoglobulins, complements and C-reactive protein pre and postoperatively compared with controls. Materials and methods: Blood and urine samples were taken from both tumor and control patients preoperatively and from only tumor patients at postoperative 1 and 3 months. Urine samples were examined immediately for microscopic examination and culturing. Serum samples were stored at -80°C in a deep freeze till processing and assessed blindly by same person at the end of the study. Patients who preoperatively received intravesical BCG instillation therapy, radiotherapy or chemotherapy for their bladder carcinoma diseases were not included in tumor group. Patients who underwent a transurethral procedure for a non-neoplastic genitourinary disease and did not have any documented cancer, served as controls. Results: Mean ages of tumor (20 pts; 1 female, 19 males) and control (41 pts; 3 females, 38 males) patients were 64.2±9.9 and 63.7±8.9, respectively (p=0.846). All tumor patients completed 3 months of follow-up. There was no statistical difference in urinary infection incidences between tumor and control groups. Serum IgA, IgE, IgG, C3 and CRP levels were statistically significantly higher in tumor group than in control group, while lower C4 and indifferent IgM levels were present in tumor group compared to control. However following tumor resection, all of them decreased very significantly. All serum levels, except C4, of 6 patients with visible tumor in their bladders at postoperative 3rd month were similar to those of tumor-negative patients. Although preoperative high levels of IgA, IgE, IgG, C3 and CRP appeared as sensitive, specific and predictive in primary bladder tumor diagnosis, post-treatment levels of any of those above were not found as useful in follow-up, suggesting that these were not diagnostic and prognostic parameters for bladder tumor. No correlation was established between infection and serum levels in both groups since there were not statistically significant differences in serum immunoglobulins, complements and CRP levels between the patients with and without urinary infection in each group. Pathologic stage and grade of the tumor did not correlate with immunoglobulin and C4 levels. However, there was a significant positive correlation between stage and C3 or CRP. There were no differences between the 3rd month serum levels of patients who took no therapy (6 pts) or chemotherapy (5 pts) or intravesical BCG (9 pts) after resections, except C4 which was higher in patients who took chemotherapy than in those who took BCG. Conclusion: Although serum immunoglobulins, complements and CRP appear to be nondiagnostic for primary bladder carcinoma, wider studies with longer follow-up and higher patient population are necessary for more definitive conclusions.Öğe Haemophilus aphrophilus brain abscess in the first decade(Medknow Publications and Media Pvt. Ltd, 2005) Bayraktar M.; Onal C.; Durmaz B.; Yakinci C.; Sonmezgoz E.This report presents a case of brain abscess due to Haemophilus aphrophilus in a six-year old boy. He was admitted to our hospital suffering from left-sided weakness. The initial radiological diagnosis was an intracranial abscess. Purulent material was obtained by puncturing the subcortical lesion and the sample was cultured on conventional media. H. aphrophilus was isolated in pure culture, identified according to conventional methods and confirmed by Becton Dickinson Laboratory (BBL) crystal system. After surgical drainage and eight weeks of antibiotic therapy, the neurological findings improved. The presented case is an example of H. aphriphilus causing brain abscess in the first decade without cardiac predisposition and with good outcome.Öğe Investigation of the blood biochemical status of gas station workers(2006) Bayraktar N.M.; Karagözler A.A.; Bayraktar M.; Titretir S.; Gözükara E.M.The aim of this study was to examine occupation-associated effects on blood cytokine and immunoglobulin g (IgG) levels, antioxidant enzyme activities (SOD, GSHPx, and catalase), nitrite and nitrate levels, and malondialdehyde (MDA) concentrations in gas station workers (GSWs). Trace elements (Cu, Zn, and Pb) in serum, and the amount of hemoglobin in erythrocytes were also determined. Forty male GSWs and 30 male controls were included in the study. No significant difference was observed between the hemoglobin levels of GSWs and those in controls. Proinflammatory cytokine levels, such as tumor necrosis factor-? and interleukin-8 were significantly increased in GSWs' sera. Interleukin-1? and interleukin-6 were below the detection limit of the assay in both the groups. Cytokine receptor interleukin 2R concentration and IgG levels were also significantly increased. Approximately, two-fold increase in nitrite and nitrate concentrations was found in GSWs' sera. Erythrocyte antioxidant enzyme levels were significantly lower in GSWs' blood. MDA concentration, a measure of lipid peroxidation, was found to be significantly elevated. Zn levels were significantly decreased, whereas Cu and Pb levels were increased in GSWs' sera. Smoking was not found to be a major confounder for the association between exposure and blood parameters. © 2006 Taylor & Francis.
