ÖZ Amaç: Yara yatağı bakterilerin üremesi için ideal bir yüzeydir ve mikrobiyal enfeksiyonun yara iyileşmesi üze-

Objective: We aimed to show the alteration of distribution of causative microorganisms in diabetic foot infections quinquennially by evaluating studies of Turkish origin published in national or international journals or presented in national or international meetings between January 1, 2000 and December 31, 2014. Methods: We used "diabetic foot" as a key word in search engines of National Thesis Center, Turkish Council of Higher Education, and National Academic Network and Information Center, the Scientific and Technological Research Council of Turkey. Furthermore, "diabetic foot" and "Turkey" were used as key words in two search engines, PubMed ® accessing MEDLINE database of the United States National Library of Medicine, and Google Scholar. We also searched for the books of related scientific meetings. Finally, a total of 28 studies were analyzed. Results: Among the microorganisms, Gram-positives were 45.8% while the rate of Gram-negatives were 53.7% and the rate of Candida spp. were 0.05%. The most common microorganisms were Staphylococcus aureus (22.8%), Pseudomonas aeruginosa (16.7%) and Escherichia coli (12.9%) Comparison of the second and the third 5-year revealed that the increase in rate of Gram-positives and the decrease in rate of Gram-negatives were both statistically significant. The decrease in the frequency of methicillin-resistant S. aureus (MRSA) was statistically significant particularly in the last 5-year period. Conclusions: Empirical antibiotherapy has to cover Gram-negatives particularly P. aeruginosa together with S. aureus while there is no need to consider covering MRSA for antimicrobial choices in majority of cases.

A 49-year-old man with a medical history of polycystic kidney disease was presented to the emergency department with fever and left flank pain. Abdominal examination revealed an enlarged and painful left kidney. The C-reactive protein level was significantly high and the magnetic resonance imaging revealed areas of abnormal intensity and fluid-fluid levels in renal cysts. Brucella abortus was yielded from both blood and cyst fluid culture. Standard therapy (rifampicin plus doxycycline) of brucellosis was started, but the clinical and laboratory signs subsided after the addition of ciprofloxacin. There was no need for aspiration of infected cyst fluid. Hereby, according to the medical database search, we report that the first renal cyst infection caused by B. abortus was successfully treated with triple antibiotic therapy.

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