IntroductionMethicillin-resistant Staphylococcus aureus (MRSA) is one of the most important nosocomial pathogens and is also emerging in Turkish hospitals. The aim of this study was to determine the antimicrobial susceptibility profiles of MRSA isolated from Turkish hospitals.Materials and methodsA total of 397 MRSA strains isolated from 12 hospitals in Turkey were included to present study. Antimicrobial susceptibilities were tested using agar dilution method. Presence of ermA, ermB, ermC, msrA, tetM, tetK, linA and aac-aph genes were studied by PCR.ResultsAll strains were susceptible to vancomycin and linezolid. The susceptibility rates for fusidic acid, lincomycin, erythromycin, tetracyclin, gentamycin, kanamycin, and, ciprofloxacin were 91.9%, 41.1%, 27.2%, 11.8%, 8.5%, 8.3% and 6.8%, respectively. Lincomycin inactivation was positive for 3 isolates. Of 225 erythromycin resistant isolates 48 had ermA, 20 had ermC, and 128 had ermA-C. PCR was negative for 15 strains. Of 3 isolates with lincomycin inactivation one had linA and msrA. Of 358 gentamycin resistant isolates 334 had aac-aph and 24 were negatives. Among 350 tetracyclin resistant isolates 314 had tetM. Of 36 tetM negative isolates 10 had tetK.ConclusionMRSA isolates from Turkish hospitals were multiresistant to antimicrobials. Quinolone and gentamycin resistance levels were high and macrolide and lincosamide resistance were relatively low. Susceptibility rates for fusidic asid were high. Linezolide and vancomycin resistance are not emerged. The most common resistance genes were ermA, tetM and aac-aph. Evolution of antimicrobial susceptibilities and resistance genes profiles of MRSA isolates should be surveyed at regional and national level for accurate treatment of patients and to control dissemination of resistance genes.

The reusability of disposable plastic trocars after high-level disinfection by alkalinized 2% glutaraldehyde solution was examined in a prospective study from the point of view of infection risk in order to determine the safety and economic benefits. For this purpose, 45 laparoscopic cholecystectomy cases were analyzed microbiologically and clinically. In 30 cases, trocars subjected to 15 min of disinfection by glutaraldehyde were used. In the remaining 15 cases, new trocars were used and a control group was established. In total, eight culture samples were taken from trocars, laparoscope (as it is disinfected by the same method), glutaraldehyde solution and umbilicus of the patients preoperatively; and from the bile in the gallbladder, peritoneal lavage fluid, and epigastric and umbilical incisions postoperatively. Only one of the disinfected trocars yielded a culture-positive result. No culture-positive results were found in the samples taken from laparoscope, glutaraldehyde, and epigastric incisions. Culture-positive results were obtained in 11 cases at the umbilicus, in one case at the peritoneal lavage and in one case at the umbilical incision. None of the patients had infection at the wound site or intra-abdominally. In conclusion, we have shown that disposable plastic trocars subjected to high-level disinfection can be reused safely without infection risk and that cost can be reduced.

Surgical source control along with effective antibiotics is essential in the treatment of mediastinitis. Tigecycline has the potential to be an option for pan-resistant A. baumannii mediastinitis.

Staphylococcus aureus is one of the most frequent agents causing hospital infections. S.aureus has a great ability to adapt itself to variety of conditions and successful clones can be epidemic and even pandemic by its ability spread from one continent to another. The aims of this study were to detect spa types of 397 methicillin-resistant S.aureus (MRSA) strains isolated from 12 centers in different geographical regions of Turkey from 2006 to 2008, and to investigate their clonality by PFGE and MLST typing. Additionally, 91 MRSA from four of those 12 centers isolated during 2011 were also studied for their spa types. PFGE profiles indicated the presence of a major pulsotype, namely pulsotype A with a rate of 91.4% (363/397), followed by pulsotype B (n= 18, 4.5%) and pulsotype C (n= 11, 2.8%). Among isolates tested 363 (91.4%) were SCCmec type III, 30 (7.6%) were SCCmec type IV. Sequence analysis of representative isolates revealed that ST239 (85.1%) was the most common MLST type followed by two MLST types ST737 (4%), and ST97 (2.8%), both SCCmec type IV. Two isolates were ST80 with SCCmec type IV. Of 397 isolates, 338 (85.1%) were t030, followed by t005 (2.5%) and t632 (2%). Among MRSA isolated during 2011, 64 (70.3%) of 91 were t030, 4 (4.4%) were t005, 2 (2.2%) were t015, and 2 (2.2%) were t1094. Among centers the t030 prevalence of 2006-2008 isolates ranged from 59-100%. The highest t030 prevalence was found in Ankara (100%) and lowest in Trabzon (59%) provinces which are located at central and northestern Anatolia, respectively. In Istanbul province, the prevalence of t030 was 94.5% among 2006-2008 isolates which decreased to 55.5% among 2011 isolates. Also a decrease in t030 rates was observed among samples from Konya and Trabzon but not from Aydin. Our results showed that the most common MRSA clone in Turkey is ST 239-SCCmec type III, t030 which persisted during the six years of the study period. Presence of PVL toxin gene was tested by PCR and 5 (3%) isolates found to be positive, of them two were SCCmec Type IV-ST80 and three were SCCmec Type III-ST239. This study is the largest epidemiological survey ever done in Turkey which showed presence of a hospital Turkish clone TR09 (ST239-SCCmecIII-t030) and a community clone TR10 (ST737-SCCmecIV-t005) largely disseminated in Turkey.

Four hundred children between the ages of 1 month and 14 years with the complaint of diarrhea were studied to assess Campylobacter jejuni isolation rates in childhood acute gastroenteritis in Turkey and to clarify clinical presentations of C. jejuni enteritis. C. jejuni was found to be the second most common isolate with a rate of 8.3%, the first being Shigella strains. The highest isolation rate was in the 6 to 14-year age range at 12%. The most frequent symptoms in patients with C. jejuni enteritis were abdominal pain (51.5%), vomiting (36.4%) and fever (30.3%). Stool examination revealed bloody mucous stool in 51.5% of the patients, and erythrocytes and/or leucocytes were detected in 42.4%. Only 12.1% of the patients with C. jejuni enteritis were hospitalized in this study.