26 research outputs found

    Indoor and outdoor airborne bacteria in child day-care centers in Edirne City (Turkey), seasonal distribution and influence of meteorological factors

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    This paper presents information about airborne mesophilic bacteria in the indoor and outdoor air of child day-care centers (CDCCs) in the city of Edirne, Turkey. Air samples were collected using the Petri plate gravitational settling method from the indoor and outdoor air of CDCCs. Counts of airborne bacteria were measured as colony forming units (CFU) collected by gravity onto Brain Heart Infusion Agar plates (with 5% sheep blood). Samples were taken monthly over a period of 12 months between January and December 2004. A total of 3,120 bacteria colonies were counted on 192 Petri plates. Four groups of culturable bacteria were identified: Gram-positive cocci, Gram-positive bacilli, endospore-forming Gram-positive bacilli, and Gram-negative bacteria. Airborne Gram-positive bacteria were the most abundant at more than 95% of the measured population. While Gram-positive cocci were more common in indoor environments, Gram-positive bacilli were more dominant in outdoor air. Bacteria commonly isolated from CDCCs were identified at a genus level. Staphylococcus (39.16%), Bacillus (18.46%), Corynebacterium (16.25%), and Micrococcus (7.21%) were dominant among the genera identified in the present study. The dominant genera identified in the day-care centers were Staphylococcus, Micrococcus, and Corynebacterium for indoor air and Bacillus, Corynebacterium, and Staphylococcus for outdoor air. Staphylococcus, Streptococcus, Bacillus, and Corynebacterium genera were found in samples from every month. Bacterial colony counts were compared by sampling location (indoors and outdoors), seasons, and meteorological factors. We found negative correlations between the monthly total outdoor bacterial counts and the sampling day's average relative humidity and average rainfall, and the monthly average rainfall. Fluctuations in bacterial counts in different seasons were observed.Scientific and Technical Research Council of Turkey (TUBITAK)Scientific and Technical Research Council of Turkey (TUBITAK) supported first author Halide Aydogdu during her PhD education as a scholar student. We would like to thank TUBITAK for financial support. We would also like to thank Ebru Yavuz for statistical analyses. In addition, the present study is a part of the PhD thesis of Halide Aydogdu, the first author. The first part (about airborne fungi) of the PhD thesis of Halide Aydogdu was published in Environmental Monitoring and Assessment, 147: 423-444, 2008

    Nosocomial infections and risk factors in intensive care unit of a university hospital in Turkey

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    The aim of this study was to determine the types nosocomial infections (NIs) and the risk factors for NIs in the central intensive care unit (ICU) of Trakya University Hospital. The patients admitted to the ICU were observed prospectively by the unit-directed active surveillance method based on patient and the laboratory over a 9-month-period. The samples of urine, blood, sputum or tracheal aspirate were taken from the patients on the first and the third days of their hospitalization in ICU; the patients were cultured routinely. Other samples were taken and cultured if there was suspicion of an infection. Infections were considered as ICU-associated if they developed after 48 hours of hospitalization in the unit and 5 days after discharge from the unit if the patients had been sent to a different ward in the hospital. The rate of NIs in 135 patients assigned was found to be 68%. The most common infection sites were lower respiratory tract, urinary tract, bloodstream, catheter site and surgical wound. Hospitalization in ICU for more than 6 days and colonization was found to be the main risk factor for NIs. Prolonged mechanical ventilation and tracheostomy, as well as frequently changed nasogastric catheterization, were found to be risk factors for lower respiratory tract infections. For bloodstream infections, both prolonged insertion of and frequent change of arterial catheters, and for urinary tract infections, female gender, period and repeating of urinary catheterization were risk factors. A high prevalence rate of nosocomial infections was found in this study. Invasive device use and duration of use continue to greatly influence the development of nosocomial infection in ICU. Important factors to prevent nosocomial infections are to avoid long hospitalization and unnecessary device application. Control and prevention strategies based on continuing education of healthcare workers will decrease the nosocomial infections in the intensive care unit.Trakya University [TUBAP-544]This study was granted by Trakya University Scientific Research Projects (TUBAP-544). The statistical analyses were performed by Burcu Tokuc MD, PhD. We would like to thank her for her contribution

    Characteristics of Pseudomonas aeruginosa isolates from intensive care unit

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    The study looked at the antimicrobial resistance patterns, serotypes, molecular types, metallo beta-lactamase, and chromosomal betalactamase enzymes of P. aeruginosa strains isolated from the patients and the staffs of the intensive care unit. P. aeruginosa isolates from the patients as nosocomial pathogens and from the staffs were evaluated for their susceptibilities to the antimicrobials by the disk diffusion and E-test methods. Metallo beta-lactamase enzymes were investigated by E-test, the inducibility of beta - lactamase enzymes were detected by the disk antagonism test. Serotyping was performed by slide agglutination method. The P. aeruginosa isolates were typed by pulsed field gel electrophoresis. Twenty-five P. aeruginosa strains from the patients and three from the staffs were isolated. Fifteen P. aeruginosa, eleven of which composed of MDR bacteria, were found in serogroup E, 7 strains in G, 4 strains in B, and 1 strain in serogroup A. In all 12 bacteria in the MDR and serogroup E, metallo beta-lactamase enzyme was found to be positive. And in other 15 strains, except the bacterium which could not be serotyped, chromosomal beta-lactamase was found to be positive. The result of the molecular typing showed PFGE A pattern. In conclusion, a pattern in PFGE which included bacteria from MDR and serogroup E, G which was observed in the P. aeruginosa strains which was isolated from the staff's hands and from the 5 patients, and PFGE F pattern were found to be observed the most. Finally, the two different clonal strains were found to be established in the intensive care.Trakya University Scientific Research Project [TUBAP 544]This study was granted by Trakya University Scientific Research Projects (TUBAP 544)

    Investigation of Colistin Heteroresistance and Some Factors Affecting Heteroresistance in Carbapenem-Resistant A. baumannii Strains

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    Introduction: Colistin can be used in patients infected with carbapenem-resistant Acinetobacter baumannii complex (CR-ABC), but recently resistance to colistin and heteroresistance have been reported. In this study we aimed to investigate the colistin heteroresistance rates and the effects of colistin and its combinations on colistin heteroresistance/resistance development in CR-ABC strains in our hospital. Materials and Methods: Heteroresistance analysis was performed on CR-ABC isolates and standard ABC strain [American Type Culture Collection (ATCC) 19606)] strain. To investigate hidden heteroresistance, the isolates were exposed to colistin at sub-inhibitory concentrations. ‘Time-kill’ study was performed on the standard strain and a clinical strain for colistin. Serial passage test was performed to investigate the effects of drug combinations on heteroresistance/resistance development. Results: In the first heteroresistance analysis test, all strains were found to be non-heteroresistant. However, after sub-inhibitory exposure to colistin, colistin heteroresistance/resistance developed in all isolates. In serial passages, colistin-rifampicin and colistin-tigecycline (Col+Tig) combinations were found to be effective and prevented growth of colistin-resistant sub-populations even at sub-inhibitory doses. Colistin-gentamicin (Col+Gen) combination was not found to be effective against the clinical isolate while it was effective on ATCC strain. Colistin-fluconazole combination was found to be ineffective at all concentrations. Conclusion: In our study, it was shown that the strains which were detected to be non-heteroresistant could easily transform to heteroresistant/resistant forms after exposure to colistin. Colistin-rifampicin and Col+Tig combinations were found to be effective and prevented the emergence of heteroresistance/resistance to colistin even at low concentrations. At low concentrations, Col+Gen combination was ineffective against the clinical ABC isolate. Colistin-fluconazole combination failed to inhibit the emergence of resistant bacteria. Heteroresistance or resistance to colistin may easily develop because of inappropriate use of this antibiotic. To prevent this condition, colistin should be administrated at appropriate doses and in combination with the suggested antibiotics

    Comparison of dichloran rose bengal chloramphenicol and Sabouraud dextrose agar with cycloheximide and chloramphenicol for airborne mold sampling

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    The more the mold species isolated on a culture medium, the more the sampling environment is represented accurately. According to the sampling purpose, it is crucial to use the best culture medium for mold. However, no study is available regarding the comparison of dichloran rose bengal chloramphenicol (DRBC) and Sabouraud dextrose agar with cycloheximide and chloramphenicol (SDA-CHX-CHL) culture media in terms of their application for airborne sampling, isolation, and identification of fungi. Airborne mold samples were impacted onto both DRBC and SDA-CHX-CHL, simultaneously using single-stage Andersen sampler. The limit of detection (LOD) value for airborne mold count was 7 CFU m(-3) (1 colony growth on the Petri dish). The total mold counts (TMC) ranged between < 7 and 504 CFU m(-3) (med 56 CFU m(-3)) and < 7 and 1218 CFU m(-3) (med 259 CFU m(-3)), collected on SDA-CHX-CHL and DRBC, respectively. Significantly higher TMC were observed on DRBC than on SDA regardless of the sampling environment (i.e, indoor or outdoor) (p < 0.05). Among the most predominant mold genera, observation frequencies of Penicillium spp. and Aspergillus spp. on both culture media were found to be more than 70%. Observation frequencies of Cladosporium spp., Alternaria spp., and yeast were found to be higher in samples collected on DRBC than those on SDA-CHX-CHL. Finally, DRBC was found to be superior to SDA in terms of both number of colonies and number of genera isolated from the air.Scientific and Technological Council of Turkey (TUBITAK) [112Y059]This study was supported financially by The Scientific and Technological Council of Turkey (TUBITAK). Project No: 112Y059. Authors also thank to Osman Cotuker and Deniz Tasdibi for field studies and to Catherine Yigit for English proofreading

    Çanakkale Onsekiz Mart Üniversitesi Saglik Uygulama ve Arastirma Merkezi 2009-2011 yili Tüberküloz Laboratuvar verilerinin degerlendirilmesi

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    Objective: Tuberculosis microbiological laboratory diagnosis was firstly started in year 2009, in Microbiology Laboratory of Onsekiz Mart University Research and Education Hospital in Çanakkale. We aimed at this study to present our laboratory data and to evaluate the methods which were used for the diagnosis of micobacteria. Method: Samples sent to our laboratory for tuberculosis culture were stained by Ehrlich-Ziehl-Neelsen (EZN) method and evaluated microscopically. After processing of samples, each sample was inoculated to Löwenstein-Jensen medium (LJ) and BACTEC MGIT 960 (Mycobacteria Growth Indicator Tube, Becton Dickinson, USA) liquid based medium. If suspected growth was detected, Mycobacterium tuberculosis complex (MTBC) typing was made and if requested antituberculosis drug susceptibility for streptomycin (STR), isoniazid (INH), rifampicin (RF) and ethambutol (ETM) tested. Samples from normally sterile body sites cultured directly, others were firstly decontaminated and concentrated. Results: During the study period 1.048 samples from 667 patient has been processed. Seventy eight samples (7.44%) from 54 patients were found positive by BACTEC MGIT system: 71 of them MTBC and seven of them were mycobacteria other than tuberculosis (MOTT). By LJ medium 64 MTBC and 4 MOTT strain, totally 68 mycobacterium were isolated. Mean time for detecting positive culture by MGIT 960 was 11.8 days (± 7.45 SD). With EZN stain, 49 samples were detected as acido resistant bacilli and only 42 (86%) of them were positive by culture. Antituberculosis drug susceptibilty was evaluated at isolates of 25 from 54 patients. A resistance to at least one of the drugs were detected in six isolates. It is found that five isolates were resistant to STR, three were resistant to INH and one was resistant to ETM. Three isolates were resistant to both STR and INH. Rifampicin resistance was not detected in MTBC. Conclusion: With this study we presented first tuberculosis laboratory findings from our province, Çanakkale. Tuberculosis microbiological culture and antituberculosis susceptibility tests can be made using Bactec MGIT 960 system which is easier and faster than solid media culture. In tuberculosis diagnosis sensitivity of culture is higher than microscopical evaluation. It was concluded that although microscopic examination has low sensitivity, for early detection of tuberculosis both culture and staining should be used together for routine detection of tuberculosis

    In vitro activity of methylene blue and eosin methylene blue agar on colistin-resistant A. baumannii: an experimental study

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    Introduction. Colistin is a last-resort antibiotic used against carbapenem-resistant Acinetobacter baumannii (AB); however, colistin resistance has been reported recently. Methylene blue (MB) is used in microbiology for staining, and in medicine as an antidote drug. Aim. We aimed to investigate the antimicrobial effects of MB and eosin methylene blue (EMB) agar against colistin-resistant AB strains. Methodology. Firstly, a standard strain and AB clinical isolate were included in the study. After determining MICs, two strains were transformed into colistin-resistant forms, using Li's method. At each step, new MICs were determined and subcultures were inoculated onto EMB and sheep blood agar (SBA). Colistin MICs of the subcultures were also determined using Mueller-Hinton agar (MHA) containing MB. Secondly, colistin-resistant clones from 31 multidrug-resistant AB clinical isolates were screened to investigate their susceptibilities to EMB agar. Results. In the first round, MICs of both strains had risen to 64 mu g ml(-1). Subpopulations with high colistin resistance were inhibited by MB and EMB agar, but could grow well on SBA. In MHA plates containing MB, the MICs decreased to 0.5 mu g ml(-1) for colistin-susceptible or moderately resistant clones. Additionally, clones with high colistin resistance showed atypical colony morphology on SBA. In the second round, 35% of the clinical isolates, which had gained resistance to colistin, were inhibited by EMB agar. Conclusion. MB may have inhibitory effects against colistin-resistant AB. Secondly, using only EMB agar for subculturing may cause missing of colistin-resistant strains

    Conjunctivitis due to Neisseria sicca: A case report

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    We report the first case, in Medline-based literature, of conjunctivitis caused by gram negative diplococcus, Neisseria sicca. Although it is not widely accepted as such, isolation from cultures of repeated eye swab samples suggests that N. sicca may be a pathogen in conjunctival infections. Positive culture for this organism should not be readily dismissed. Such conjunctivitis responded favorably to treatment with netilmicin eye drops

    Hepatitis B Seroprevalance Among Health care Workers in a Tertiary Hospital

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    Objective: In this study it is aimed, to determine the seroprevalence of HBV in health care workers in our hospital and to determine the factors that affect the epidemiology of transmission. Materials and Methods: Serum samples were taken from those of the hospital employees between June 2009-June 2010 and a questionnaire was held. Samples were tested for HBsAg, antiHBs and antiHBc total with MEIA method with an autoanalyser. Results: The mean age of the study group was 30.9 (+/- 6.9) and 100 men, 156 women participated on a voluntary basis. Professions were grouped as, 95 doctors, 60 nurses, midwives, 26 technicians, 16 laboratory technicians, biologists, 13 nurses, 19 cleaners, 27 administrative and technical staff. 188 people under 10 years, and 68 people over ten years worked in the field of health care. In this study, 22 people found contacted with HBV (8.6%), 234 persons (91.4%) were not contacted with HBV, 166 of them (64.8%) were vaccinated. One person (0.4%) were positive for HBsAg. None of the nursing aides was vaccianted, 26.3% of cleaning workers were found to be vaccinated. According to the results of laboratory tests, among needle injured person in the last year, being vaccinated (25 persons, 89.3%) and to have prior infection (27 people, 96.4%) rates were significantly higher (p = 0.003). By multivariate multinomial logistic regression analysis to determine the factors that affect transmission of hepatitis B, none of the variables was observed as a significant factor (p> 0.05). Conclusion: HBsAg seroprevalence is very low compared to other studies in our hospital. Vaccination rate is high. However, nurses and cleaning personnel vaccination rate found particularly low. Considering that these services are carried out in health care settings by frequently changing personnel, training and vaccination of these individuals should be planned before starting the work. While needlestick and sharp injuries were seen mostly by people those previously infected or vaccinated, this suggest that these people must be trained and informed again about bloodborne infectious agents like HBV and others

    Ocular aspergillosis: Obtaining a specimen is crucial for diagnosis. A report of three cases

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    Aspergillus species have been implicated in a wide variety of primary ocular conditions, characterized by either slow and asymptomatic infection, or rapid, uncontrollable progression and sometimes death. The study design is a case series including chronic asymptomatic dacryocystitis, dacryocystitis with dacryoliths and endogenous endophthalmitis. Due to this variable clinical presentation of aspergillosis a high level of suspicion must be maintained as fulminant aspergillosis may lead to a rapidly progressive infection which may result in death. (C) 2012 International Society for Human and Animal Mycology. Published by Elsevier B.V
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