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In this study, the clinical and laboratory features of 26 infectious mononucleosis (IMN) cases who have been diagnosed between the years of 1984-2005 were evaluated retrospectively. The mean age of the patients was 26+/-11 years, the rate of being hospitalized was 65%, and mean hospitalization period was 9.2+/-6 days. Fever (81%), weakness (50%), sore throat (50%), headache (50%) and swollen neck (35%) were the most common symptoms, while in the physical examination cervical lymphadenopathy (81%), splenomegaly (69%), hyperemic pharynx (65%), hepatomegaly (54%) and tonsillitis (50%) were observed. Laboratory results yielded leukocytosis in 21%, leucopenia in 12%, anemia in 44%, thrombocytopenia in 5% and elevated transaminase levels in 84% of the patients. Of the patients 15 (57.7%) had the history of using antibiotics before the diagnosis. Serological diagnosis was performed by Paul-Bunnel test and/or IgM positivity against Epstein-Barr virus (EBV) viral capsid antigen (VCA). Tonsillo-pharyngitis secondary to edema and respiratory distress due to lymphadenopathy pressure were detected in four patients, whereas pancytopenia was established only in one patient, as complications. This study emphasized that, although IMN is a self-limited infection, the diagnostic difficulties may arise when the clinical course is atypical, and rarely seen life-threatening complications may also develop during IMN course.

Oerskovia species are Nocardia-like bacteria that have been only and rarely associated with human infections. In this report, a meningitis case caused by Oerskovia xanthineolytica was presented. A 44 years old male patient who had experienced ventriculo-peritoneal shunt (V-P shunt) due to hydrocephaly, developed meningitis. O. xanthineolytica was isolated from three of the cerebrospinal fluid (CSF) samples and V-P shunt cultures. Identification of the isolate was performed by Phoenix SystemTM (NMIC/ID-5 panel, Becton Dickson, Sparks, MD, USA). Empirical vancomycin (2x1 g/day iv) plus rifampin (1x600 mg/day po) therapy has failured. Since CSF cultures were still positive in the 22nd day of therapy, the shunt was removed and continuation of the same antimicrobial treatment for 42 days resulted in complete cure.

In this study, 21 HIV/AIDS cases (18 male, 3 female; age range 17-64 years), followed up in the Department of Infectious Diseases of Uludag University Medical Faculty between 1997-2003 have been analyzed retrospectively, by means of epidemiological, clinical and laboratory aspects. Nineteen (90%) of them were heterosexual, and in 9 cases the diagnosis was coincidental during the blood donations or routine testing. The non-compliance rate of patients to antiretroviral treatment was found as 76%, and the most important factor for non-compliance was the difficulty in providing antiretroviral drugs. The most frequently encountered opportunistic infections were oropharyngeal candidiasis (n:5), herpes zoster (n:4) and community acquired pneumonia (n:4).

In this study a total of 87 Streptococcus pneumoniae strains were tested for their susceptibility to penicillin with disk diffusion method by using 5 micrograms methicillin disks. In 68 strains susceptibility to penicillin was also determined by using agar dilution method performed in Mueller-Hinton agar supplemented with 5% sheep blood. Of 63 adult isolates tested with disk-diffusion method 35 strains (55.6%) were susceptible to penicillin, 24 strains (38.1%) had low level resistance and 4 strains (6.3%) had high-level resistance to penicillin. Of 24 S. pneumoniae isolates recovered from children 5 (20.8%) were penicillin susceptible, while 11 (45.8%) had low level resistance and 8 (33.4%) had high level resistance to penicillin. These values were 40 (45.9%), 35 (40.3%) and 12 (13.8%) in total isolates respectively. Of 44 isolates in which MIC values of penicillin were determined by agar dilution method, 34 strains (77.3%) were penicillin susceptible and 10 strains (22.7%) had low level resistance while none of these strains had high level resistance to penicillin. Of 24 children isolates tested with agar dilution method 11 strains (45.8%) were susceptible to penicillin, 8 strains (33.4%) showed low level resistance and 5 strains (20.8%) showed high level resistance to penicillin. For total of 68 isolates these values were 45 (66.1%), 18 (26.4%) and 5 (7.3%) respectively. These findings indicate the need to perform antibiotic susceptibility testing of all pneumococcal isolates to avoid therapeutic failure.

Empiric therapy is essential in Gram-negative nosocomial bacteremia. Therapy is initiated according to the most frequently isolated organisms and their susceptibility profiles. In order to determine the appropriate antibiotics for this purpose, a study was conducted in 176 blood isolates in Hacettepe University Hospitals. Antibiotic susceptibilities were determined by microbroth dilution tests. The results showed amikacin, ofloxacin and ciprofloxacin to be the most effective antibiotics in-vitro. It is suggested that these agents should be employed in empirical therapy until the causative agent is defined.

Resistance to new generation beta-lactam antibiotics in Gram-negative bacteria is increasing worldwide. This resistance is due to EBS enzymes in Klebsiella spp., and Type-I chromosomal enzymes in Enterobacter spp., Citrobacter, P. aeruginosa, Providencia, M. morganii and S. marcescens. In this study, the types of beta-lactamases in 16 Klebsiella spp. and 15 Enterobacter spp. which are resistant to newer beta-lactam antibiotics was investigated by isoelectric focusing. The results of the study showed that TEM-1 enzymes are prevalent in these isolates. pI (isoelectric point) values and antibiotic susceptibility test results suggest that there are EBS enzymes in Klebsiella spp., and Type-I enzymes in Enterobacter spp. These results have to be supported by further investigations.

Drug fever is an uncommon manifestation of isoniazid intolerance. A patient with tuberculous peritonitis is presented with a diagnostic problem, because of continuous and spiking fever, while she was on isoniazid. The fever disappeared after discontinuation of the drug. For confirmation of the drug fever, isoniazid was given on two occasions. Fever respond was demonstrated on rechallenge. This case calls attention to uncommon adverse reaction of isoniazid in patients who are treated with isoniazid.

In this study in vitro activities of different antimicrobial drugs against 1000 staphylococci were evaluated. Tested staphylococci were isolated from the clinical material of out patient and in patient sections. Susceptibility tests were done according to NCCLS Disk Diffusion Technic. The antimicrobial drugs evaluated in this study were; Vancomycin, ofloxacin, sulbactam-ampicillin, co-trimoxazole, tetracycline, erythromycin, tobramycin, methicillin, first and third generation cephalosporins and penicillin. Vancomycin was the drug of choice against resistant staphylococci. Ofloxacin, sulbactam-ampicillin, first generation cephalosporins and some aminoglycosides were more effective than others.

A total of 7898 non-fermentative Gram-negative bacilli were isolated from various clinical materials. Pseudomonas (7526) was the most common among them. Alcaligenes faecalis (273), Acinetobacter sp. (93) and Flavobacterium (6) were the other non-fermentative Gram-negative bacilli. Most of them were found in urine and pus cultures, however they were also isolated from sputum, blood, and cerebrospinal fluid. Gentamicin was the most effective antibiotic in vitro. Fifty four per cent of Pseudomonas, 100% of Acinetobacter, and 70% of Alcaligenes faecalis were inhibited by tobramycin.

In this study, in vitro susceptibilities of 24 campylobacter strains isolated from fecal samples were tested for quinolone antibiotics. 13 of the strains were identified as C. jejuni and 11 of them were C. coli. Antibiotics which were included in this study were ciprofloxacin, ofloxacin, pefloxacin and fleroxacin. Antibiotic susceptibility tests were performed on Mueller-Hinton agar (supplemented with 5% sheep blood) using the agar dilution method. Results showed that quinolone antibiotics are very active against Campylobacter species. There was not any marked difference between the susceptibility patterns of C. jejuni and C. coli.

In this study, by using the microbroth dilution method, in vitro susceptibilities of gram negative bacteria to new generation cephalosporins were examined, and among these, 40 bacteria which showed resistance against at least two antibiotics were tested for beta-lactamase production. Beta-lactamase production was positive in all of them. However, this type of resistance could not be transferred to susceptible recipients by conjugation experiments. Our results suggest that the resistance to beta-lactam antibiotics in these strains are related with chromosomally mediated beta-lactamases.