Although the commonest manifestation of Salmonella infection is acute gastroenteritis, infection ... more Although the commonest manifestation of Salmonella infection is acute gastroenteritis, infection may spread to the blood-stream may and the illness can present with focal lesions in almost any organ with or without septicemia. We describe here a case of Salmonella typhi infection of a sacroiliac joint that was cured with ciprofloxacin therapy for six weeks. The patient was immunologically normal. Salmonella etiology was not suspected in this case, and the diagnosis was made only after bacterial isolation. Physicians should be aware of this rare manifestation of Salmonella infection, especially in endemic areas.
is described.A previously healthy 28-year-old man was admitted to our clinic with a two weeks his... more is described.A previously healthy 28-year-old man was admitted to our clinic with a two weeks history of pain in the right upper abdomen, followed by fever, chills, and vomiting. On admission day, physical examination revealed that he was in pain and feverish (38.6° C), and had hepatomegaly. Laboratory fi ndings included total white blood cell (WBC) count of 14,800/mm
Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study rep... more Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients' initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 ± 9.4 years. The initial mean value of ALT was 79 ± 39.9 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 ± 0.7. Two of the patients (5.9%) achieved HBV DNA less than 300 copi...
To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial... more To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial meningitis in our region. One hundred and forty-four patients were randomized prospectively and evaluated to determine the efficacy of dexamethasone treatment in adult patients with acute bacterial meningitis at Dicle University Hospital, Diyarbakir, Turkey between January 2000 and December 2004. While the first group received ceftriaxone 4 gr/day plus dexamethasone, the second group received ceftriaxone 4 gr/day only. Dexamethasone was given 10-15 minutes before the first 8 mg dose of antibiotic treatment. It was continued at 16 mg/day for 3 days. The study included 144 patients with the diagnosis of acute bacterial meningitis. Cerebrospinal fluid (CSF) was analyzed at the time of admission, after 24-48 hours (Table 1), and at the end of treatment. Accordingly, CSF leukocyte level was found to be 1710+/-2140/mm3 in group 1 receiving dexamethasone treatment compared to 1950+/-2244/mm3 i...
HBeAg-positive patients with normal ALT levels are unlikely to respond to current therapy. In add... more HBeAg-positive patients with normal ALT levels are unlikely to respond to current therapy. In addition, there is a high risk of hepatocellular carcinoma in HBeAg-positive patients in the natural course of HBV infection. For this purpose, we aimed to investigate the clinical efficacy and safety of a three-month course of lamivudine therapy in HBeAg-positive hepatitis B patients with normal aminotransferase levels for assessing a more practical and economical approach to these patients. Forty-six patients were prospectively randomized into two groups. Group A consisted of 13 patients treated with lamivudine 100 mg/day, for 12 weeks [7 males, mean age 23.30+/-5.82 years, median ALT of 27 IU/L (21-40), median HBV DNA of 4116 pg/ml (2885-6628)]. Group B consisted of 33 patients without treatment [18 males, mean age 24.75+/-6.92 years, median ALT of 30 IU/L (19-39), median HBV DNA of 4094 pg/ml (782-7387)]. Main outcome measure was sustained virologic response, which was defined as loss o...
In recent years, high resistance to antibiotics used for staphylococci infections causes problems... more In recent years, high resistance to antibiotics used for staphylococci infections causes problems in the treatment. The aim of this study was to investigate the susceptibilities of staphylococcus strains which were isolated in bone tissue and sinus-tract specimens of chronic osteomyelitis (COM) that were seen in our hospital against fusidic acid, vancomycin and teicoplanin that were also recommended as treatment of staphylococci infections. Disk diffusion method was used for in vitro susceptibility testing. In this study, 41 Staphylococcu s aureus and 12 coagulase-neg ative staphylococci strains isolated from bone tissue and sinus-tract were investigated. The rates of resistance to fusidic acid were 4.3% in methicillin-s ensitive S. aureus, 16.7% in methicillin-r esistant S. aureus, 0% in methicillin-sensitive coagulase-negative staphylococci and 36% in methicillin-r esistant coagulase-negative staphylococci . There were no resistance to vancomycin and teicoplanin in none of the str...
Delta virus infeksiyonu tum dunyada oldugu gibi ulkemizde de gorulen onemli bir karaciger hastali... more Delta virus infeksiyonu tum dunyada oldugu gibi ulkemizde de gorulen onemli bir karaciger hastaligidir. Viral hepatitin az rastlanilan bir formudur. Klinik olarak ciddi bir seyir gosterir. Buna ragmen tedavi secenekleri cok az veya yetersizdir. Diger viral hepatit turlerine gore fulminan hepatit, erken siroz gelisimi, terminal karaciger yetmezligine ilerleyis ve yuksek hepatoseluler karsinom gelisim riski ile karakterize siddetli bir hastalik formuna neden olabilmektedir. Kronik delta hepatiti tedavisinde interferonlar disinda yarari kanitlanmis bir tedavi secenegi yoktur. Calismaya kronik delta hepatiti tanisi konulan ve daha once hic tedavi almamis toplam 21 hasta alindi. Hastalar iki gruba ayrildi. Birinci grupta 11 hastaya bir yil sureyle, ikinci grupta 10 hastaya ise iki yil sureyle PEG IFN-α-2a tedavisi verildi. Bu tedavi seceneklerinin karaciger fonksiyon testleri, virolojik gostergeler ve karaciger histopatolojisi uzerine etkileri arastirildi. Tedavinin sonunda birinci grupt...
Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year... more Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naïve HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4 +/- 41.5 IU/L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA < 300 copies; at month 48, 90% of patients had HBV DNA < 50 IU/mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.
Bu çalflman›n amac›; Dicle Üniversitesi Hastanesi ‹nfeksiyon Hastal›klar› ve Klinik Mikrobiyoloji... more Bu çalflman›n amac›; Dicle Üniversitesi Hastanesi ‹nfeksiyon Hastal›klar› ve Klinik Mikrobiyoloji Laboratuvar› ve Merkez Laboratuvar›’nda bir y›ll›k sürede de¤iflik klinik örneklerden soyutlanan, Centers for Disease Control (CDC) kriterlerine göre hastane infeksiyonu etkeni kabul edilen 124 Gram-negatif bakteride genifllemifl spektrumlu beta-laktamazlar› (GSBL) E-test yöntemiyle araflt›rmakt›. En s›k GSBL üreten sufllar Klebsiella spp. %45 (15/33), Escherichia coli’de %32 (10/31), Pseudomonas spp.’de %13 (3/24), Enterobacter spp.’de %27 (3/11), Acinetobacter spp.’de %22 (2/9) ve Proteus spp.’de %14 (1/7) olarak bulunmufltur. ‹zole edilen 124 sufltan 38’inin (%31) GSBL üretti¤i belirlenmifltir. Hastane kaynakl› infeksiyonlardan izole edilen Gram-negatif bakterilerde, özellikle Klebsiella spp. ve Escherichia coli sufllar›nda GSBL üretimi araflt›r›lmal›d›r. Bu infeksiyonlarda kullan›lacak uygun antibiyotik seçiminde bakterilerin GSBL pozitifli¤inin de dikkate al›nmas› gerekir.
To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial... more To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial meningitis in our region. One hundred and forty-four patients were randomized prospectively and evaluated to determine the efficacy of dexamethasone treatment in adult patients with acute bacterial meningitis at Dicle University Hospital, Diyarbakir, Turkey between January 2000 and December 2004. While the first group received ceftriaxone 4 gr/day plus dexamethasone, the second group received ceftriaxone 4 gr/day only. Dexamethasone was given 10-15 minutes before the first 8 mg dose of antibiotic treatment. It was continued at 16 mg/day for 3 days. The study included 144 patients with the diagnosis of acute bacterial meningitis. Cerebrospinal fluid (CSF) was analyzed at the time of admission, after 24-48 hours (Table 1), and at the end of treatment. Accordingly, CSF leukocyte level was found to be 1710+/-2140/mm3 in group 1 receiving dexamethasone treatment compared to 1950+/-2244/mm3 in group 2 (p=0.001). The consciousness in the group receiving dexamethasone improved significantly more rapidly than the control group (p=0.001). While mortality was 9.7% in the patient group receiving dexamethasone it was 16.7% in the control group, however, it was not significant (p=0.093). The use of dexamethasone in adult patients is still under debate, and the administration of dexamethasone 10-15 minutes before antibiotherapy to unconscious patients in a poor state of health, is effective in the clinical improvement of the patient.
Although the commonest manifestation of Salmonella infection is acute gastroenteritis, infection ... more Although the commonest manifestation of Salmonella infection is acute gastroenteritis, infection may spread to the blood-stream may and the illness can present with focal lesions in almost any organ with or without septicemia. We describe here a case of Salmonella typhi infection of a sacroiliac joint that was cured with ciprofloxacin therapy for six weeks. The patient was immunologically normal. Salmonella etiology was not suspected in this case, and the diagnosis was made only after bacterial isolation. Physicians should be aware of this rare manifestation of Salmonella infection, especially in endemic areas.
is described.A previously healthy 28-year-old man was admitted to our clinic with a two weeks his... more is described.A previously healthy 28-year-old man was admitted to our clinic with a two weeks history of pain in the right upper abdomen, followed by fever, chills, and vomiting. On admission day, physical examination revealed that he was in pain and feverish (38.6° C), and had hepatomegaly. Laboratory fi ndings included total white blood cell (WBC) count of 14,800/mm
Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study rep... more Tenofovir disoproxil fumarate (Tenofovir DF) is a nucleotide analogue. This multicentre study reports retrospectively the long-term efficacy and safety data with tenofovir DF treatment in nucleosid(t)e-naive, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. Thirty-one patients (11 females, 20 males) received 245 mg tenofovir DF per diem. All patients' initial serum hepatitis B virus (HBV) DNA levels were over 2,000 IU/ml. Serum alanine aminotransferase (ALT) levels, HBeAg, hepatitis B e antibodies (anti-HBe), hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (Anti-HBs), HBV DNA, creatinine and urea levels were evaluated at baseline, and at weeks 12, 24, 48 and 96 during therapy. Thirty-one patients completed 96 weeks of treatment. Mean age was 37.6 ± 9.4 years. The initial mean value of ALT was 79 ± 39.9 IU/L. At baseline, mean of fibrosis (Ishak) of liver biopsies was 2.3 ± 0.7. Two of the patients (5.9%) achieved HBV DNA less than 300 copi...
To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial... more To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial meningitis in our region. One hundred and forty-four patients were randomized prospectively and evaluated to determine the efficacy of dexamethasone treatment in adult patients with acute bacterial meningitis at Dicle University Hospital, Diyarbakir, Turkey between January 2000 and December 2004. While the first group received ceftriaxone 4 gr/day plus dexamethasone, the second group received ceftriaxone 4 gr/day only. Dexamethasone was given 10-15 minutes before the first 8 mg dose of antibiotic treatment. It was continued at 16 mg/day for 3 days. The study included 144 patients with the diagnosis of acute bacterial meningitis. Cerebrospinal fluid (CSF) was analyzed at the time of admission, after 24-48 hours (Table 1), and at the end of treatment. Accordingly, CSF leukocyte level was found to be 1710+/-2140/mm3 in group 1 receiving dexamethasone treatment compared to 1950+/-2244/mm3 i...
HBeAg-positive patients with normal ALT levels are unlikely to respond to current therapy. In add... more HBeAg-positive patients with normal ALT levels are unlikely to respond to current therapy. In addition, there is a high risk of hepatocellular carcinoma in HBeAg-positive patients in the natural course of HBV infection. For this purpose, we aimed to investigate the clinical efficacy and safety of a three-month course of lamivudine therapy in HBeAg-positive hepatitis B patients with normal aminotransferase levels for assessing a more practical and economical approach to these patients. Forty-six patients were prospectively randomized into two groups. Group A consisted of 13 patients treated with lamivudine 100 mg/day, for 12 weeks [7 males, mean age 23.30+/-5.82 years, median ALT of 27 IU/L (21-40), median HBV DNA of 4116 pg/ml (2885-6628)]. Group B consisted of 33 patients without treatment [18 males, mean age 24.75+/-6.92 years, median ALT of 30 IU/L (19-39), median HBV DNA of 4094 pg/ml (782-7387)]. Main outcome measure was sustained virologic response, which was defined as loss o...
In recent years, high resistance to antibiotics used for staphylococci infections causes problems... more In recent years, high resistance to antibiotics used for staphylococci infections causes problems in the treatment. The aim of this study was to investigate the susceptibilities of staphylococcus strains which were isolated in bone tissue and sinus-tract specimens of chronic osteomyelitis (COM) that were seen in our hospital against fusidic acid, vancomycin and teicoplanin that were also recommended as treatment of staphylococci infections. Disk diffusion method was used for in vitro susceptibility testing. In this study, 41 Staphylococcu s aureus and 12 coagulase-neg ative staphylococci strains isolated from bone tissue and sinus-tract were investigated. The rates of resistance to fusidic acid were 4.3% in methicillin-s ensitive S. aureus, 16.7% in methicillin-r esistant S. aureus, 0% in methicillin-sensitive coagulase-negative staphylococci and 36% in methicillin-r esistant coagulase-negative staphylococci . There were no resistance to vancomycin and teicoplanin in none of the str...
Delta virus infeksiyonu tum dunyada oldugu gibi ulkemizde de gorulen onemli bir karaciger hastali... more Delta virus infeksiyonu tum dunyada oldugu gibi ulkemizde de gorulen onemli bir karaciger hastaligidir. Viral hepatitin az rastlanilan bir formudur. Klinik olarak ciddi bir seyir gosterir. Buna ragmen tedavi secenekleri cok az veya yetersizdir. Diger viral hepatit turlerine gore fulminan hepatit, erken siroz gelisimi, terminal karaciger yetmezligine ilerleyis ve yuksek hepatoseluler karsinom gelisim riski ile karakterize siddetli bir hastalik formuna neden olabilmektedir. Kronik delta hepatiti tedavisinde interferonlar disinda yarari kanitlanmis bir tedavi secenegi yoktur. Calismaya kronik delta hepatiti tanisi konulan ve daha once hic tedavi almamis toplam 21 hasta alindi. Hastalar iki gruba ayrildi. Birinci grupta 11 hastaya bir yil sureyle, ikinci grupta 10 hastaya ise iki yil sureyle PEG IFN-α-2a tedavisi verildi. Bu tedavi seceneklerinin karaciger fonksiyon testleri, virolojik gostergeler ve karaciger histopatolojisi uzerine etkileri arastirildi. Tedavinin sonunda birinci grupt...
Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year... more Entecavir is a guanosine analogue with activity against hepatitis B virus. The aim of this 4-year trial was to evaluate entecavir treatment in nucleos(t)ide-naïve HBeAg-positive chronic hepatitis B patients. Forty-nine patients received entecavir and nine of them withdrew from the trial at the end of week 96. The initial mean value of alanine aminotransferase was 79.4 +/- 41.5 IU/L, and at the end of the 4-year study period, 90% of patients had alanine aminotransferase values within the normal range. At week 96, 91.7% of patients had HBV DNA < 300 copies; at month 48, 90% of patients had HBV DNA < 50 IU/mL. HBeAg loss was recorded in 7.1% of patients at week 96 and in 12.5% at month 48. The rate of HBeAg seroconversion was 4.8% at week 96 and 7.5% at month 48. The rate of HBsAg seroconversion was 2.1% at week 96 and 2.5% at month 48. Entecavir as a potent and safe agent leading to continuous viral suppression proved to be safe and well tolerated therapy.
Bu çalflman›n amac›; Dicle Üniversitesi Hastanesi ‹nfeksiyon Hastal›klar› ve Klinik Mikrobiyoloji... more Bu çalflman›n amac›; Dicle Üniversitesi Hastanesi ‹nfeksiyon Hastal›klar› ve Klinik Mikrobiyoloji Laboratuvar› ve Merkez Laboratuvar›’nda bir y›ll›k sürede de¤iflik klinik örneklerden soyutlanan, Centers for Disease Control (CDC) kriterlerine göre hastane infeksiyonu etkeni kabul edilen 124 Gram-negatif bakteride genifllemifl spektrumlu beta-laktamazlar› (GSBL) E-test yöntemiyle araflt›rmakt›. En s›k GSBL üreten sufllar Klebsiella spp. %45 (15/33), Escherichia coli’de %32 (10/31), Pseudomonas spp.’de %13 (3/24), Enterobacter spp.’de %27 (3/11), Acinetobacter spp.’de %22 (2/9) ve Proteus spp.’de %14 (1/7) olarak bulunmufltur. ‹zole edilen 124 sufltan 38’inin (%31) GSBL üretti¤i belirlenmifltir. Hastane kaynakl› infeksiyonlardan izole edilen Gram-negatif bakterilerde, özellikle Klebsiella spp. ve Escherichia coli sufllar›nda GSBL üretimi araflt›r›lmal›d›r. Bu infeksiyonlarda kullan›lacak uygun antibiyotik seçiminde bakterilerin GSBL pozitifli¤inin de dikkate al›nmas› gerekir.
To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial... more To evaluate the efficacy of dexamethasone added to the treatment of adult patients with bacterial meningitis in our region. One hundred and forty-four patients were randomized prospectively and evaluated to determine the efficacy of dexamethasone treatment in adult patients with acute bacterial meningitis at Dicle University Hospital, Diyarbakir, Turkey between January 2000 and December 2004. While the first group received ceftriaxone 4 gr/day plus dexamethasone, the second group received ceftriaxone 4 gr/day only. Dexamethasone was given 10-15 minutes before the first 8 mg dose of antibiotic treatment. It was continued at 16 mg/day for 3 days. The study included 144 patients with the diagnosis of acute bacterial meningitis. Cerebrospinal fluid (CSF) was analyzed at the time of admission, after 24-48 hours (Table 1), and at the end of treatment. Accordingly, CSF leukocyte level was found to be 1710+/-2140/mm3 in group 1 receiving dexamethasone treatment compared to 1950+/-2244/mm3 in group 2 (p=0.001). The consciousness in the group receiving dexamethasone improved significantly more rapidly than the control group (p=0.001). While mortality was 9.7% in the patient group receiving dexamethasone it was 16.7% in the control group, however, it was not significant (p=0.093). The use of dexamethasone in adult patients is still under debate, and the administration of dexamethasone 10-15 minutes before antibiotherapy to unconscious patients in a poor state of health, is effective in the clinical improvement of the patient.
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