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    The characteristics of nasopharyngeal Streptococcus pneumoniae in children attending a daycare unit
    (Edizioni Int Srl, 2008) Abut, Latife Iseri; Apan, Teoman; Otlu, Baris; Caliskan, Ahmet; Durmaz, Riza
    S. pneumoniae is a component of normal nasopharyngeal flora in children. Nasopharyngeal colonization in children attending daycare units has an important effect on the spread of S. pneumoniae. In this study, we aimed to investigate colonization status, antimicrobial susceptibility, and clonal relatedness of the S. pneumoniae strains in children attending a daycare unit. One hundred and six nasopharyngeal swabs were collected from 25 children attending a daycare unit in an 8-month period. S. pneumoniae was identified by a conventional method. Antibacterial sensitivities of the strains were tested by disc diffusion method. Pulsed field gel electrophoresis (PFGE) was used to analyze the clonal relationship of the strains. A total of 25 (23.5 %) S. pneumoniae strains were identified from 106 nasopharyngeal swaps. S. pneumoniae growth was detected in at least one culture of the 19 children (colonization rate; 76%). Seven of the 25 strains (28%) showed resistance to penicillin, 5 (20%) were resistant to trimethoprim-sulfomethoxsazole. The other tested antibiotics were almost effective. The clonal relationship among strains was found as 54.5%. The highest rate of strain entry was in the winter months with strains of opaque colonies, which are known to be more pathogenic. However, the spreading rate among the children was the highest in the summer months and the strains detected in these months had transparent colonies with more transmitting characteristics. Therefore, to prevent S. pneumoniae infection in closed crowded areas, the summer months should not be overlooked.
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    Epidemiologic characterization of nosocomial Acinetobacter baumannii infections in a Turkish university hospital by pulsed-field gel electrophoresis
    (Mosby-Elsevier, 2009) Cetin, Emel Sesli; Durmaz, Riza; Tetik, Tulay; Otlu, Baris; Kaya, Selcuk; Caliskan, Ahmet
    Background: Although members of the Acinetobacter genus are not commonly part of the human flora, their relatively high prevalence in hospital environment frequently results in colonization of the skin and respiratory tract. Objectives: The present investigation was carried out to elucidate epidemiologic characteristics of nosocomial Acinetobacter baumannii infections in a teaching hospital. Methods: Epidemiologic, clinical, and demographic features of the 66 patients with A baumannii infection during a 14-month period were recorded. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method, and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis (PFGE). Results: The incidence of A baumannii infection was especially high in January, April, May and June 2006. The isolates were most frequently obtained from blood and tracheal aspirates sent from the intensive care unit and neurosurgery ward. Although the most frequently identified predisposing factors were cerebrovascular disease and surgical operation, the main risk factors identified in these patients were catheterization and mechanical ventilation. Genotype analysis of the 66 A baumannii strains by PFGE revealed the circulation of 36 different PFGE types. of which type A (12) and K (17) accounted for 44% of the isolates. We found high clonal relationship (80.3%) among the typed strains. Thirteen antibiotypes were observed. Most of the isolates were multidrug resistant. Resistance to imipenem, meropenem, gentamicin, amikacin, tobramycin, netilmicin, ampicillin-sulbactam, trimethoprim-sulfamethoxazole, piperacillin-tazobactam, cefoperazone-sulbactam, ciprofloxacin, and levofloxacin were found in 44%, 47%, 47%, 84.8%, 21.2%, 3%, 62.1%, 57.6%, 94%, 62.1%, 95.5%, and 95.5% of the isolates, respectively. Conclusion: The epidemiologic data obtained suggested that the increase in the number of A baumannii infections in our hospital was caused by the interhospital spread of especially 2 epidemic clones. We determined that clonally related strains can survive for a long time in our hospital and cause nosocomial infections in the predisposed patients. (Am J Infect Control 2009;37:56-64.)
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    A PNEUMONIA CASE CAUSED BY CEDECEA LAPAGEI
    (Ankara Microbiology Soc, 2008) Yetkin, Guelay; Ay, Selma; Kayabas, Uener; Gedik, Ender; Gucluer, Nilay; Caliskan, Ahmet
    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 12(th) 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.