BackgroundBacterial resistance to antibiotics is increasing worldwide. Antibiotic-resistant strains can lead to serious problems regarding treatment of infection. Carbapenem antibiotics are the final treatment option for infections caused by serious and life-threatening multidrug-resistant gram-negative bacteria. Therefore, an understanding of carbapenem resistance is important for infection control. In the study described herein, the phenotypic and genotypic features of carbapenem-resistant Enterobacteriaceae strains isolated in our hospital were evaluated.MethodsIn total, 43 carbapenem-resistant strains were included in this study. Sensitivity to antibiotics was determined using the VITEK®2 system. The modified Hodge test (MHT) and metallo-β-lactamase (MBL) antimicrobial gradient test were performed for phenotypic identification. Resistance genes IMP, VIM, KPC, NDM-1, and OXA-48 were amplified by multiplex PCR.ResultsThe OXA-48 gene was detected in seven strains, and the NDM-1 gene in one strain. No resistance genes were detected in the remainder of strains. A significant correlation was observed between the MHT test and OXA-48 positivity, and between the MBL antimicrobial gradient test and positivity for resistance genes (p < 0.05).ConclusionThe finding of one NDM-1-positive isolate in this study indicates that carbapenem resistance is spreading in Turkey. Carbapenem resistance spreads rapidly and causes challenges in treatment, and results in high mortality/morbidity rates. Therefore, is necessary to determine carbapenem resistance in Enterobacteriaceae isolates and to take essential infection control precautions to avoid spread of this resistance.

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The efficacy and tolerability of three different combination treatment regimens in human brucellosis were compared in 118 uncomplicated patients enrolled in a prospective study between May 1997 and December 2002. Brucellosis was diagnosed using standard clinical and microbiological findings. Patients with central nervous system involvement, spondylitis, endocarditis or children under 16 years of age were excluded from the study. Patients were randomly assigned to receive 400 mg of ofloxacin plus 600 mg of rifampicin (OR, n = 41), 200 mg of doxycycline plus 600 mg of rifampicin (DR, n = 45) or 1g intramuscularly streptomycin (administered for three weeks) plus 200 mg doxycycline (DS, n = 32) daily for 6 weeks. All patients were followed up at least 6 months after cessation of therapy. There was no statistical difference between the groups on relapse rates and clinical response to the treatment (P>0.05). Five patients in OR (12.8%), six patients in DR (14.3%) and three patients in DS groups (9.7%) suffered relapse. The side-effects were seen in eight (19.5%), 21 (46.7%) and eight (25.0%) patients of OR, DR and DS groups, respectively. The use of combination therapy of ofloxacin plus rifampicin for 6 weeks was found to be as effective as DR and DS. The side-effects of therapy in OR and DS groups was less severe than in the DR group.

IntroductionCoastal zones, considered to be a valuable economic and environmental resource for human and marine habitats, are the most dynamic natural environment of any region on earth. Changes in the ocean-climate system and increasing human activities in these regions make the coastal areas more susceptible to natural hazards and more costly to live in. One of the most serious problems is the accelerated sea level rise and its resulting physical impacts on the coastal zones. Any rise in the mean sea level may result in the retreat of unprotected coastlines due to coastal inundation, erosion, and increased storm flooding (Nicholls et al. 1995). As emphasized in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC AR4), the global sea level rose by 1.8 to 3.1 mm/year during the last century and present estimates of future rise range from 18 cm to 59 cm by the year 2100 (Solomon et al. 2007). Low lying areas such as beach ridges, coastal plains, deltas, estuaries, lagoons, and bays would be the areas that would suffer the most as a result of the enhanced sea level rise. Thus, it is essential to quantify the response of coastal systems to sea level change, as well as to assess the potential threats posed to human and marine biodiversity.A near global comparative analysis by Dasgupta et al. (2007) regarding the impact of permanent inundation due to sea level rise on 84 developing countries revealed that hundreds of millions of people in the developing world are likely to be displaced by a sea level rise of 1 to 5 m within this century. Accompanying economic and ecological damage will be severe for many. Approximately 0.3% (194,000 km 2 ) of the territory of the 84 developing countries would be impacted by a 1-m rise. This would increase to 1.2% in areas where the sea level rose 5 m. Nearly 56 million people (approximately 1.28% of the population) in these countries would be impacted under a 1-m rise scenario. This would increase to 89 million people for 2 m and 245 million people (approximately 5.57%) for a 5-m rise. The impact of sea level rise on gross domestic product (GDP) is slightly greater than the impact on population, because GDP per capita is generally above average for coastal populations and cities. Wetlands would experience significant impact even with a 1-m rise. Up to 7.3% of wetlands in the 84 countries would be impacted Abstract: With the rising sea level becoming a more pressing issue to coastal areas, a comprehensive analysis has been conducted to assess the vulnerability of the Çukurova Delta under the projected inundation by the end of the century. The level of inundation was estimated from a multimission satellite altimetry sea level anomaly and significant wave height data between September 1992 and February 2012. Superposed to the clear annual oscillation with 6.2 cm amplitude peaking around the beginning of October, the mean sea level signal exhibits a positive trend of 3.4 ± 0.1 mm/year over the altimetric data period. The extreme wave height with a 100-year ...