Search

Background: Stenotrophomonas maltophilia is an important cause of life-threatening nosocomial infection. Aim: To evaluate the clinical features, antibiotic treatment and prognosis of S. maltophilia bacteraemia. Methods: Patients with blood cultures positive for S. maltophilia at the Children's Hospital, Ankara University Medical School between 1995 and 2005 were evaluated retrospectively. The results were compared with those of a case–control group of patients with Pseudomonas aeruginosa bacteraemia (n=33). Antibiotic susceptibilities of S. maltophilia strains were determined by disc diffusion. Susceptibility to ciprofloxacin was also determined by broth dilution. Results: Thirty-six (2.2%) blood cultures were positive for S. maltophilia. Neutropenia was more common in the P. aeruginosa group (p=0.001). Breakthrough bacteraemia developed more commonly during carbapenem treatment in the S. maltophilia group (p=0.02). Ciprofloxacin and trimethoprim–sulfamethoxazole in combination with/without an aminoglycoside were the antibiotics most commonly selected to treat S. maltophilia bacteraemia. Mortality was more common in the P. aeruginosa (13/33) than in the S. maltophilia (2/33) group (p=0.001). According to susceptibility, determination by the disk diffusion method, beta-lactam antibiotics, aminoglycosides and chloramphenicol had little or no effect, whereas trimethoprim–sulfamethoxazole, doxycycline and fluoroquinolones were more active against S. maltophilia strains. However, ciprofloxacin susceptibility results were quite different when determined by disk diffusion (97% isolates susceptible) and broth dilution (49% isolates susceptible). Conclusions: Although S. maltophilia bacteraemia is rare in children, antibiotic resistance to these strains is an important problem. Tetracyclines, trimethoprim–sulfamethoxazole and fluoroquinolones are the most active agents against S. maltophilia strains. [ABSTRACT FROM AUTHOR]

Candida lipolytica has infrequently been identified as a cause of infection and is associated mostly with vascular catheter-related fungaemia. Patients reported in the literature have been successfully treated with catheter removal or amphotericin B treatment. We report 2 infants with C. lipolytica fungaemia unresponsive to catheter removal and amphotericin B therapy and treated successfully with the addition of caspofungin to amphotericin B. [ABSTRACT FROM AUTHOR]

Mechanical ventilation increases the frequency of nosocomial infections. This study describes the frequency of multi-resistant viridans streptococcal colonisation, the clinical course of nosocomial sepsis and ventilator-associated pneumonia in mechanically ventilated neonates in the neonatal intensive care unit of Ankara University Hospital. Seventy-nine ventilated newborns were enrolled. Broncho-alveolar lavage culture and blood cultures were positive in 44 (56%) and 17 (22%) patients, respectively. The most predominant micro-organisms in broncho-alveolar lavage cultures were multi-resistant viridans streptococci (29, 66%). Viridans streptococci were also one of the predominant organisms in blood cultures (5/17, 29%). In 29 patients with broncho-alveolar lavage positive for viridans streptococci, nine (31%) had colonisation, 15 (52%) had ventilator-associated pneumonia and five (17%) had sepsis owing to viridans streptococcus. Ventilator-associated pneumonia was encountered in 52/1000 ventilation days. Mortality was caused by infection in three (10%) of them. Mechanically ventilated neonates in our neonatal intensive care unit had a high rate of both multi-resistant viridans streptococcus airway colonisation and subsequent ventilator-associated pneumonia and sepsis. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the clinical pattern of Salmonella bacteraemia in Turkish children. From 1993 to 2002, all children with a blood culture positive for Salmonella were retrospectively evaluated in the Division of Paediatric Infectious Diseases in Ankara University School of Medicine. All Salmonella isolates were serotyped and investigated for antimicrobial susceptibility. During the 10-year study period, 40 patients with Salmonella bacteraemia were identified. Of 37 eligible children, eight had enteric fever and 29 had non-typhoidal salmonellosis. Salmonella typhimurium was the most common serotype in the group with non-typhoidal salmonellosis. No significant differences were found between the enteric fever and non-typhoidal salmonellosis groups with regard to clinical features, laboratory findings and outcome, except in mean platelet counts and mean serum alanine aminotransferase (ALT) levels. In vitro resistance rates of Salmonella strains were low. Outcome was excellent in all but one child with hydrocephalus and gross neurological sequelae owing to meningitis. Salmonella bacteraemia is relatively uncommon in Turkish children. Differentiating between enteric fever and non-typhoidal Salmonella bacteraemia on clinical grounds is difficult. [ABSTRACT FROM AUTHOR]