Listeria monocytogenes has been often leads to infection in pregnant women, newborns and patients with impaired immune response. Serotypes 1/2a, 1/2b and 4b are responsible on majority of human infections and outbreaks of food. The girl baby was born from twenty years old, primiparous mothers at term with normal birth weight in our hospital. She was brought with to the pediatric emergency department with fever, groaning, sucking, bruising and complaints on the second day of the birth. Ampicillin and cefotaxime was started to patient with diagnosis of early-onset neonatal sepsis. First blood culture sample of the patient were positive on the second day of incubation. Then, Gram-positive bacilli were seen in gram stain. It was made identification of bacteria in two different automated systems (Phoenix and VITEK).We believed that this case is important in the way of case of neonatal sepsis with Listeria monocytogenes serotype 4b that firstly ever reported in Turkey.

Rothia mucilaginosa, orofarenks ve üst solunum yollarının mikrobiyotasında yer almaktadır. Alt solunum yolu infeksiyonlarında ve bağışıklık sistemi normal kişilerde nadiren görülmekte ve genellikle bağışıklık sistemi baskılanmış hastalarda ortaya çıkmaktadır. Kronik obstrüktif akciğer hastalığı (KOAH) tanısıyla takip edilen 75 yaşındaki erkek hasta, KOAH tanısıyla göğüs hastalıkları servisinde takibe alınmıştır. Moksifloksasin tedavisi altındayken semptomları gerilemeyen hastadan alınan tekrarlayan balgam kültüründe kanlı agarda hemoliz yapmayan, yuvarlak grimsi konveks koloniler VITEK 2 (bioMerieux, France) otomatize sistemi ve izolat matriks-aracılı lazer dezorbsiyon iyonizasyon uçuş zamanı kütle spektrometresi (MALDI-TOF MS) sistemi kullanılarak R. mucilaginosa olarak tanımlanmıştır. Kirby-Bauer disk difüzyon yöntemi kullanılarak yapılan antibiyotik duyarlılık testinde, linezolid, klaritromisin, meropenem, sefoperazon + sulbaktam, piperasilin + tazobaktam, vankomisin, sefotaksim, eritromisin, klindamisin, ampisilin + sulbaktam, amoksisilin + klavulanik asit, penisilin, sefoksitin ve teikoplanine duyarlı, sefazolin, moksifloksasin ve oksasiline dirençli olduğu görülmüştür. Kültür sonucu ile hastaya ampisilin + sulbaktam ve klaritromisin kombinasyon tedavisi başlanmış, klinik olarak düzelen hasta kontrole gelmek üzere taburcu edilmiştir. Bu yazıda bilinen immün sistem problemi olmayan KOAH'lı bir hastada R. mucilaginosa'nın neden olduğu bir pnömoni olgusu sunulmuştur.

No abstract

The aim of the present study was to evaluate the phenotypic characteristics of the macrolidelincosamide-streptogramin B (MLS B) resistance in Staphylococcus aureus and coagulase-negative staphylococci (CNS) strains isolated from various clinical samples in our hospital. The study was conducted on 516 Staphylococcus isolates isolated from various clinical samples in Microbiology Laboratory of Diyarbakir State Hospital between January, 2009 and December, 2009. After the identification of microorganisms via conventional methods and the evaluation of their methicillin resistance profile, disk approximation test was performed using erythromycin (15 µg) and clindamycin (2 µg) disks in order to determine MLS B resistance phenotypes. Of 516 Staphylococcus isolates, 208 were determined to be S. aureus and 308 were CNS. The MLS B resistance of isolates was 56.2%, whereas the resistance due to the efflux pump was determined to be 3.5%. The MLS B resistance phenotype was determined in 38% of S. aureus strains and 68.5% of CNS strains. The presence of MLS B resistance was determined to be higher in methicillin-resistant group (74.7%) compared to the methicillin-susceptible group (23.9%). While constitutive MLS B resistance (cMLS B) and inducible MLS B resistance (iMLS B) were determined in 48.9 and 19.1% of methicillin-resistant S. aureus strains, respectively, these rates were 2.6 and 10.5% for methicillin-susceptible strains, respectively. The rate of constitutive resistance was determined to be 41.5% in methicillin resistant CNS, whereas the rate of inducible resistance was determined to be 35.9%. In methicillin-susceptible CNS group, cMLS B and iMLS B resistances were determined to be 17.6 and 23%, respectively. The cMLS B phenotype was more common among methicillin-resistant S. aureus and CNS group, whereas iMLS B phenotype was more common among methicillin-susceptible S. aureus strains. In conclusion, we suggest that the determination and reporting of the presence of inducible resistance is of great importance regarding the success of therapy; therefore, it would be beneficial to use D test in routine antibiogram studies.