The mortality in patients who developed meningitis was high. The high percentage of concurrent nosocomial infections was associated with a high mortality rate which was a serious problem.

The prevalence of multidrug-resistant Pseudomonas aeruginosa strains has been increasing every year, and treatment with various antimicrobial combinations has been offered alternatively in the clinical practice. The aim of this study was to evaluate the in vitro effects of combinations of meropenem, cefepime, or piperacillin-tazobactam with ciprofloxacin against multidrug-resistant P. aeruginosa strains by the time-kill method. The results show that both the combination of two beta lactams with ciprofloxacin and three beta lactams with ciprofloxacin against 4 of 5 multidrug-resistant P. aeruginosa strains has no effect in vitro. The combination of one beta lactam (meropenem, cefepime, piperacillin-tazobactam) with ciprofloxacin has a synergistic effect against one strain of multidrug-resistant P. aeruginosa that is ciprofloxacin susceptible and resistant to meropenem, cefepime, and piperacillin-tazobactam. None of the combinations had an antagonistic effect against these multidrug-resistant strains.

Objective: This study aimed to identify antibiotic susceptibility rates of enterococcal strains, and to compare the high-level resistance to aminoglycosides (HLAR) in vancomycin-sensitive enterococcal species (VSE) and vancomycin-resistant enterococcal species (VRE). Methods: The study included 100 VRE and 100 VSE strains recovered from the samples sent to laboratory from various departments of Haydarpaşa Numune Training and Research Hospital. Results: All VRE strains were defined as Enterococcus faecium, although of the VSE strains, 53% were identified to be as Enterococcus faecalis, 42% E. faecium, 3% Enterococcus durans, and 2% Enterococcus avium. High-level resistance to vancomycin (MIC, >256 µg/ml) was determined in all VRE strains and when analyzing MIC values for teicoplanin, five strains were found to be moderately susceptible (MIC, 16 µg/ml) and 95 strains were resistant (MIC, >32 µg/ml). Of the VRE strains, one was linezolid-resistant (MIC, 12 µg/ml) and the other was intermediately susceptible (MIC, 4 µg/ml) and remainders were evaluated to be susceptible (MIC, <2 µg/ml). In VRE strains, high-level gentamicin resistance (HLGR) was found to be 83% and high-level streptomycin resistance (HLSR) 89%, association of HLSR with HLGR was 78%. In VSE strains, HLGR was found to be 42% and, HLSR 48%, the association of HLSR with HLGR was found to be 36%. HLAR in VRE strains was found to be higher as compared with VSE strains (p <0.005). Conclusion: Antimicrobial resistance is increasing in enterococci strains. Therefore a follow-up is required resistance pattern including both vancomycin resistance and HLAR. J Microbiol Infect Dis 2013; 3(3): 100-103 Enterokoklarda yüksek düzey aminoglikozid, vankomisin ve linezolid direnci ÖZET Amaç: Bu çalışmada, enterokok suşlarının antibiyotik duyarlılık oranlarının saptanması, vankomisin duyarlı enterokok (VSE) ve vankomisin dirençli enterokok (VRE) suşlarındaki yüksek düzey aminoglikozid direncinin karşılaştırılması amaç-landı. Yöntemler: Haydarpaşa Numune Eğitim ve Araştırma Hastanesi kliniklerinden gönderilen örneklerden, laboratuvarımız-da izole edilen 100 adet VRE, 100 adet VSE suşu çalışma kapsamına alındı. Bulgular: VRE suşlarının tümü Enterococcus faecium olarak tanımlanmış olup, VSE suşlarının ise %53'ü Enterococcus fae-calis, %42'si E. faecium, %3'ü Enterococcus durans, %2'si Enterococcus avium olarak tespit edildi. VRE suşlarının tümünde yüksek düzey vankomisin direnci (MİK, >256 µg/ml) belirlendi, teikoplanin MİK değerleri incelendiğinde beş suş orta duyarlı (MİK, 16µg/ml), 95 suş dirençli (MİK, >32 µg/ml) olarak saptandı. VRE suşlarından biri linezolid dirençli (MİK, 12 µg/ml), biri ise orta duyarlı (MİK, 4 µg/ml) olarak saptandı, diğer suşlar duyarlı (MİK, <2 µg/ml) olarak değerlendirildi. VRE suşlarında yüksek düzey gentamisin direnci (YDGD) %83, yüksek düzey streptomisin direnci (YDSD) %89, YDSD ve YDGD birlikteliği %78 olarak bulundu. VSE suşlarında YDGD %42, YDSD %48, YDSD ve YDGD birlikteliği %36 olarak tespit edilmiştir. VRE'lerde YDAD'nin VSE suşlarına ...