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Öğe Akut kolesistit akut pyelonefritin bir komplikasyonu olabilir mi?(2009) Küçükbayrak, Abdulkadir; Demirli, Keziban; Özdemir, Davut; Yazıcı, Burhan; Kayıkçı, Ali; Özaydın, İsmetÜriner sistem enfeksiyonları toplumda en sık görülen enfeksiyonlardandır. Akut pyelonefrit bir üst üriner sistem enfeksiyonudur. Akut pyelonefrit (APN) yan ağrısı veya hassasiyeti veya her ikiside, ateş, idrar yaparken yanma-sızı, idrar kaçırma ve sık idrara çıkma şikâyetleri ile karakterize bir hastalıktır. Bu semptomlar enfeksiyon olmadan da bulunabilir (Ör: Renal enfakt, renal kalkül). En sık etken Escherichia coli’dir. Akut pyelonefrit geçiren hastalarda; renal abse, perirenal abse, karın içi abseler ve sepsis gibi komplikasyonlar gelişebilir (1). Akut kolesistit (AK); safra kesesi iltihabıdır. En sık nedeni safra yolları tıkanıklığıdır. Hastalar sıklıkla sağ üst kadran ağrısıyla başvururlar fakat bazı hastalarda lokalize bulgular bulunmayabilir. Hastalarda ateş, taşikardi sık görülen bulgulardandır. AK tanısı için ilk olarak ve en sık yapılması gereken görüntüleme metodu ultrasonografidir (US). Komplikasyondan şüphelenilen durumlarda bilgisayarlı tomografi (BT) çekilebilir (2).Öğe Andiscriminated aseptic meningitis case between rickettsia and leptospiral meningitis(2008) Özdemir, Davut; Şencan, İrfan; Yıldırım, Mustafa; Güçlü, Ertuğrul; Yavuz, Tevfik; Karabay, OğuzRickettsial meningitis and leptospiral meningitis should be included in the differential diagnosis of aseptic meningitis in patients exposed to endemic areas. In this report we describe a case of aseptic meningitis in which neither a rickettsial nor leptospiral etiology could be established.Öğe Antimicrobial Susceptibility and Uropathogens Isolated From Children and Adults with Community-Acquired Urinary Tract Infections(Ortadogu Ad Pres & Publ Co, 2010) Yıldırım, Mustafa; Şahin, İdris; Gülcan, Aynur; Özdemir, Davut; Küçükbayrak, Abdülkadir; Uzun, Hakan; Kaya, DemetObjective: The aim of this study was to determine the distribution of uropathogens causing community-acquired urinary tract infections in Duzce, and their antimicrobial susceptibility patterns. Material and Methods: The study was conducted prospectively in the Duzce University Medical Faculty between July 2004-June 2006 and included outpatients. Identification of microbial growth and determination of antimicrobial susceptibility by the Kirby-Bauer disk diffusion technique were performed according to the Clinical and Laboratory Standards Institute. Results: In total, 702 bacterial isolates were examined in the study. E. coli (64.1%) was the most common urinary pathogen identified. Klebsiella spp. (9.0%), Proteus spp. (5.8%), Staphylococcus aureus (4.7%), Enterococcus spp. (4.3%), coagulase-negative Staphylococci (2.6%), S. agalactiae (2.1%) and P. aeruginosa (1.9%) were the next most common species isolated. Community acquired uropathogens isolated in our region were highly resistant to trimethoprim/sulfamethoxazole, amoxicillin and amoxicillin clavulanate. However, ciprofloxacin was active against pathogens examined in this study with susceptibilities between 64.7% and 88.8% for the most prevalent pathogens (E. coli, 81.0% susceptible). The susceptibility of gram-negative pathogens to the parenterall antibiotics seemed to be higher than the oral agents. Conclusion: Many oral antimicrobial agents do not seem to be appropriate for the empirical treatment of community-acquired urinary tract infections in our region due to very high rates of resistance. Some oral antibiotics such as ciprofloxacin and cefaclor should be used cautiously in adults.Öğe Brusellozise bağlı subakut tiroidit olgu sunumu ve literatür değerlendirmesi(2007) Küçükbayrak, Abdulkadir; Yıldırım, Mustafa; Özdemir, Davut; Gergin, Rezan; Güçlü, ErtuğrulBrusellozis dünyada yaygın olarak görülen zoonotik bir hastalıktır. Hastalık birçok sistemi tutmakla birlikte tiroid bezi tutulumu nadirdir. Tanı; brusellozise ait klinik bulguları olanlar kişilerde standart tüp aglütinasyon testiyle (endemik olmayan yerlerde 1/1160, endemik yerlerde 1/320 veya l/640) ve/veya kan, diğer doku veya vücut sıvılarından Brucella spp.'nin izole edilmesiyle konulur. Standart tüp aglütinasyon testinin negatif olması durumunda; uygun klinik bulguların varlığında Brusella Ig M antikorlarının pozitif olmasıyla da tanı konulabilir. Bu yazıda, subakut tiroidit tanısıyla takip edilen 19 yaşında bir bayan hasta sunulmuştur. Brusellozise bağlı subakut tiroidit tanısı; klinik bulgular, tiroid fonksiyon testlerinin, tiroglobülin ve tiroglobülin antikorlarının yüksekliği, Brusella Ig M antikorlarının pozitif bulunması ve tiroid sintigrafisi ile konulmuştur.Öğe Comparison of the 2000 and 2005 outbreaks of tularemia in the Duzce region of Turkey(Natl Inst Infectious Diseases, 2007) Özdemir, Davut; Şencan, İrfan; Annakkaya, Ali Nihat; Karadenizli, Aynur; Güçlü, Ertuğrul; Sert, Erhan; Kafalı, AliTularemia caused by Francisella tularensis, which is considered a biological warfare agent, is a widely distributed zoonosis. In this study, we aimed to compare a 2005 outbreak of tularemia that was confirmed as waterborne by PCR to outbreak of tularemia that was reported as waterborne in 2000 and to investigate the changes of epidemiological characteristics between these two outbreaks occurring in the same region. In the present study, a total of 11 patients were diagnosed with tularemia. In the 2000 outbreak, oropharyngeal type was observed in 19 patients, and ulceroglandular type in 3 patients. In the 2005 outbreak, oropharyngeal type was observed in 8 patients, and oculoglandular type in 3 patients. However, our cases are not sufficient to make a conclusion that the characteristics of tularemia seem to be changing.Öğe Comparison of the tuberculin skin test and the quantiferon test for latent Mycobacterium tuberculosis infections in health care workers in Turkey(Natl Inst Infectious Diseases, 2007) Özdemir, Davut; Annakkaya, Ali Nihat; Tarhan, Gülnur; Şencan, İrfan; Cesur, Salih; Balbay, Öner Abidin; Güçlü, ErtuğrulThe aim of this study was to compare the efficacy of the tuberculin skin test (TST) and the quantiferon test (QFT) for detecting latent tuberculosis infection (LTBI) in health care workers (HCWs). Seventy-six participants who were working in Duzce University Hospital, where tuberculosis patients were being treated, were included in the study. TST was performed according to the Mantoux technique. QFT was performed in accordance with the manufacturer's instructions. A positive TST result was defined as an induration diameter of >= 15 mm. TSTs were positive in 41 of 76 participants (53.9%) and QFT was positive in 65 of 76 participants (85.5%). There was a significant difference between the numbers of QFT-positive and TST-positive cases (P = 0.02). When the induration diameter of TST was >= 20 min, QFT positivity was 100%. Multivariate analysis revealed that there was a significant correlation between the percentage of patients with QFT positivity and the induration diameter of TST (P = 0.009). QFT thus seems to be more effective for LTBI diagnosis than TST. However, large-scale trials including quantitative measurement of QFT in subgroups taking into account the division where HCWs are employed and the different results of TST might clarify the usefulness of QFT in LTBI diagnosis.Öğe Decreasing risk of Staphylococcus aureus infections(W B Saunders Co-Elsevier Inc, 2007) Karabay, Oğuz; Yıldırım, Mustafa; Özdemir, Davut…Öğe Disseminated Tuberculosis During the Course of Behçet's Disease: A Case Report(2012) Gönen, İbak; Özşahin, Mustafa; Yıldırım, Mustafa; Özdemir, Davut; Aydın, Leyla Yılmaz; Kutlucan, Ali; Büyükkaya, RamazanBu yazıda, ateş, baş ağrısı ve yorgunluk şikayetiyle başvuran, Behçet hastalığı seyrinde dissemine tüberküloz olan, 22 yaşında bir erkek hasta sunuldu. Başlangıç tanısı nöro-Behçet sendromuydu. Romatizmal hastalıkların seyrinde görülen tüberküloz, genellikle TNF-alfa blokerlerinin kullanımıyla ilişkilendirilmektedir. Olgumuzda, hasta TNF-alfa blokeri kullanmamış olmasına rağmen, dissemine tüberküloz gelişti. Mevcut bilgilerimiz doğrultusunda, bu olgu, konvansiyonel immünosüpresif tedavi alan bir Behçet hastasında gelişen bu denli yaygın seyreden ilk tüberküloz olgusudurÖğe Disseminated Tuberculosis During the Course of Behcet's Disease: A Case Report(Turkish League Against Rheumatism, 2012) Gönen, İbak; Özşahin, Mustafa; Yıldırım, Mustafa; Özdemir, Davut; Aydın, Leyla Yılmaz; Kutlucan, Ali; Büyükkaya, RamazanIn this article, a 22 year-old male with disseminated tuberculosis during the course of Behcet's disease who was admitted with the complaints of fever, headache and fatigue was presented. The initial diagnosis was neuro-Behcet's syndrome. Tuberculosis during the course of rheumatic diseases are often associated with the use of TNF-alpha blockers. In our case, the patient experienced severe disseminated tuberculosis, despite being TNF-alpha blocker-naive. To the best of our knowledge, this is the first case of tuberculosis with such a disseminated course developed in a patient with Behcet's disease who received conventional immunosuppressive treatment.Öğe Evaluation of Anti-Body Response of Anti-Hbc Only-Positive Patients to Hepatitis-B Vaccine(Düzce Üniversitesi, 2008) Özdemir, Davut; Yılmaz, Zeynep; Şencan, İrfan; Yıldırım, Mustafa; Küçükbayrak, AbdülkadirWe sometimes meet some patients with HBsAg and anti-HBs negativity, and anti-HBc total positivity only. These patients are called as isolated anti-HBc positive. Thirty nine (5.80%) of total 767 patients applied to our outpatient clinic showed isolated anti-HBc positivity between November 2000-June 2004. Thirty nine patients were taken into study (14 female and 25 male). The mean age was 49,8±10.33. Patients were vaccinated with recombinant HBV vaccine at months 0, 1 and 6. Anti-HBs titers were performed after one month for each vaccination. Hepatitis markers were detected by third generation ELISA method. Among these subjects HBeAg, anti-HBe, and anti-HCV positivity were found in 1 (2,6%), 10 (25,6%) and 3 (7,7%) cases, respectively. The patient’s numbers whose Anti-HBs titers were detected ? 10 IU/L after first, second and third vaccination were 20 (51,2%) , 31 (86,1%) and 32 (91,4%) patients, respectively. Four of 39 patients were lost on second and third vaccination whereas one of them on third only. Immunity was insufficient (Öğe First case of continuous ambulatory peritoneal dialysis peritonitis due to Candida sake(Wiley-Blackwell Publishing, Inc, 2009) Güçlü, Ertuğrul; Soypaçacı, Zeki; Yıldırım, Mustafa; Küçükbayrak, Abdülkadir; Özdemir, DavutFungal peritonitis is a relatively uncommon complication of peritoneal dialysis that contributes significantly to morbidity, drop out from the continuous ambulatory peritoneal dialysis (CAPD) program, and mortality. Candida sake infections were rarely published in literature. We present the first case of peritonitis due to C. sake. A 41-year-old man was admitted to our hospital with abdominal pain, nausea, vomiting, fever, weakness. Abdominal ultrasonography demonstrated a fistula tract, which has an opening at inferolateral of the umbilicus extending 5 cm from the skin into the abdominal cavity with a foreign body (11 x 10 mm length) inside the fistula. The foreign body was removed by surgery being apparently a part of a previously inserted peritoneal catheter. Postoperative specimens revealed polymorph leucocytes and yeast cells in Gram stain, and culture on Sabouraud dextrose agar (SDA) yielded a growth of a fungus, subsequently identified as C. sake with Api ID 32C. Fluconazole (200 mg/day) therapy was started. He recovered after two weeks of therapy. In conclusion, C. sake, a rare type of Candida species, should be considered as a probable peritoneal pathogen in patients with multiple episodes of bacterial peritonitis, previous broad-spectrum antibiotic therapy and diabetes mellitus.Öğe Frequency of nasal helicobacter pylori carriage among cooks(Pakistan Medical Assoc, 2013) Karabay, Oğuz; Güçlü, Ertuğrul; Kocoğlu, Esra; Özdemir, Davut; Şencan, İrfan; Karabay, Meltem; Gözdaş, Hasan TahsinObjective: To investigate the frequency of nasal helicobacter pylori carriage among cooks living in Bolu, Ardahan and Sakarya province of Turkey. Methods: A total of 54 cooks (10 from Bolu, 29 from Ardahan and 15 from Sakarya) were enrolled. Nasal helicobacter was tested using polymerase chain reaction. Results: Helicobacter pylori was detected in only one cook. Conclusion: Nasal Helicobacter pylori colonisation ratio in cooks in Turkey was found to be very low. Presumably hand hygiene compliance lowered the frequency.Öğe Gezici süperfisiyel tromboflebit ile başvuran akut lenfoblastik lösemi olgusu(2007) Küçükbayrak, Abdulkadir; Gergin, Rezan; Yıldırım, Mustafa; Özdemir, Davut; Kavak, AyşeVenöz tromboemboHzm ve maliyn hastalıklar arasında bir ilişki olduğu yapılan çalışmalarda gösterilmiştir. Maliyniteli olguların %5-10'unda; derin ven trombozu, arteriyel tromboz, gezici tromboflebit, pulmoner emboli ve non-bakteriyel trombotik endokardit gibi tromboembolik olaylar gelişmektedir. Genellikle ileri evre kanserlerde görülen tromboz bazen kansere ait bulgular ortaya çıkmadan ilk bulgu olarak da saptanabilir. Sağ ayak bileği travması sonrası başvuran, ateş ve hiperlökositoz görülerek yatırılan olguda sağ bacak diz üstü iç yan bölgede yüzeyel tromboflebit olduğu saptandı. Hastanın yapılan periferik yaymasında %90 blast formunda lenfositler görüldü. Periferik kandan yapılan immünfenotipleme sonucu Pre B hücreli ALL ile uyumlu bulundu (CD-19 %93.74, CDL5 %98.73,CD-34 %87.58, CD-22 %63.59, CD-10 negatif). Yapılan kemik iliği biyopsisinde pre B hücreli ALL tanısı teyit edildi. Pre B hücreli lösemi tanısı alan hastanın ikinci günde sol bacakta da tromboflebit gelişti. Antitrombin III (%95) ve fibrinojen (3.7g/dL) düzeyleri normal olan, derin ven trombozu saptanmayan olgu nadir görülmesi ve gezici süperfisiyel tromboflebit ile akut lenfoblastik lösemi arasındaki ilişkiyi düşündürmesi açısından sunulmaya uygun bulunmuştur.Öğe Hand carriage of Candida species and risk factors in hospital personnel(Wiley, 2007) Yıldırım, Mustafa; Şahin, İdris; Küçükbayrak, Abdülkadir; Özdemir, Davut; Yavuz, M. Tevfik; Öksüz, Şükrü; Çakır, SelmaThe hands of healthcare workers (HCWs) are considered to be important for colonisation and infection of Candida spp. The objective of this study was to evaluate the rate of Candida carriage on the hands of the hospital personnel the potential risk factors. Samples were collected from the hands of 214 (139 female and 75 male) hospital personnel working at Duzce Medical Faculty Hospital, Duzce, Turkey. Of these, 88 were nurses, 62 resident doctors, 21 laboratory workers, 30 officers and 13 dining room personnel. The hands of all participants were tested by culture with the broth wash technique. Overall, 34.1% of the people analysed were found to harbour Candida spp. on their hands: 30.7% were nurses, 25.8% resident doctors, 28.6% laboratory workers, 84.6% dining room personnel and 43.3% officers. Candida carriage rates of the dining room personnel were higher than found in the other groups (P = 0.001). Isolated Candida species were C. parapsilosis (38.4%), C. tropicalis (26.0%), C. albicans (23.3%), C. kefyr (11.0%) and C. globosa (1.4%). Candida carriage rate was higher in the glove-using group (35.1%) than the non-glove using group (7.1%, P = 0.031). We concluded that carriage of Candida species on the hands of personnel was common especially in non-medical staff. Wearing gloves was found to be related to increased rates of Candida carriage in the nurse group. Candida parapsilosis was the most frequently colonising species that may be a predisposing condition for nosocomial infections transmitted with the hands of HCWs. Hospital personnel should be educated for regular hand washing practice for preventing Candida colonisation.Öğe Hastane İnfeksiyonu Etkeni Olan Pseudomonas Aerugınosa Suşlarının Yıllara Göre Antibiyotik Duyarlılıklarının Karşılaştırılması(2014) İnce, Nevin; Öksüz, Şükrü; Danış, Ayşe; Geyik, Mehmet Faruk; Özdemir, DavutHastane inf eksiyonları günümüzde morbidite, mortalite ve maliyetteki artış nedeniyle önlem alınması ve gerekli poli- tikaların düzenlenmesi gereken önemli bir sağlık sorunudur. Bu inf eksiyonların % 10-25inden Pseudomonas aeruginosa etken olarak izole edilmektedir. Bu çalışmada 2011 ve 2013 yılları arasında hastane inf eksiyonu olarak izole edilen P.aeruginosa suşlarının çeşitli anti- biyotiklere duyarlılık oranları ve yıllar içindeki değişimleri değerlendirilmiştir. Suşlar en f azla solunum yolu örneklerinden (n152), en az sayıda ise kateter örneklerinden yapılan kültürlerden (n9) üretilmiştir. Örneklerin klinik bölümlere göre dağılımlarına bakıldığında en f azla sayıda suş dahiliye yoğun bakım ünitesindeki hasta örneklerinden yapılan kültürlerden izole edilmiştir. Yıllara göre P.aeruginosanın antibiyotik direnç durumuna bakıldığında 2011 yılında, 2012 ve 2013e göre direnç oranlarının daha düşük olduğu görülmüştür. İmipenem, piperasilin-tazobaktam, siprof loksasin ve sef operazon- sulbaktam antibiyotiklerine karşı direnç oranlarında yıllar içinde istatistiksel olarak anlamlı bir artış saptanmıştır. Amikasin, gentamisin, meropenem, kolistin, piperasilin, sef epim, levof loksasin ve sef tazidim için ise yıllar arasındaki f arklılık istatistiksel olarak anlamlı bulunmamıştır. P.aeruginosa suşlarına genel olarak bakıldığında en düşük direnç oranı % 9.8 ile kolistine, en yüksek direnç oranı ise % 55.9 ile meropeneme karşı saptanmıştır. Sonuç olarak elde edilen veriler ışığında, hastanemizde P.aeruginosa ile oluşan inf eksiyonların ampirik tedavisinde imipenem, piperasilin-tazobaktam, siprof loksasin ve sef operazon-sulbaktam antibiyotiklerinin yıllar içerisindeki direncinde anlamlı artış nedeniyle kullanımında dikkatli olunmalıdır. Antibiyotik direnç prof illerinin güncellenmesi antipsödomonal tedavi politikalarında düzenleme yapılmasına olanak sağlaması açısından önem taşımaktadır.Öğe High rate of hepatitis B virus DNA positivity in anti-HBc only-positive patients(Ankara Microbiology Soc, 2008) Yıldırım, Mustafa; Yavuz, M. Tevfik; Özdemir, Davut; Behçet, Mustafa; Şencan, İrfanIn hepatitis B virus (HBV) infections, detection of only anti-HBc in the absence of HBsAg and anti-HBs is known as 'anti-HBc only' situation. In this study we investigated the rate of HBV-DNA positivity in anti-HBc only-positive 45 patients (29 male, 16 female; mean age: 39.2 +/- 12.3 years) who were followed in the outpatient clinics of a University Hospital in Duzce (located at northern west part of Turkey). HBV markers were investigated by 3rd generation ELISA (MEIA Axsym-Abbott), and HBV-DNA were searched by real-time PCR [extraction: Minielute (Qiagen, Germany); PCR kits: Florion HBV (Iontek, Turkey); detection: i-cycler IQ5 (BioRad, USA)] methods. As a result, 24.4% (11/45) of the patients were found HBV-DNA Positive (> 10(3) copies/ml). There was no statistically significant difference of HBV-DNA positivity rates between males (9/29; 31%) and females (2116; 12.5%), (p = 0.15). It was concluded that there may be a serious risk of HBV transmission from anti-HBc only-positive patients since the rate of HBV-DNA positivity was found high in our study. Thus HBV-DNA screening should be performed in 'anti-HBc only' patient groups.Öğe High rate of hepatitis B virus DNA positivity in anti-HBc only-positive patients [?zole anti-HBc pozitif hastalarda saptanan yüksek hepatit B virusu DNA oran?](2008) Yıldırım, Mustafa; Yavuz, M. Tevfik; Özdemir, Davut; Behçet, Mustafa; Şencan, İrfanIn hepatitis B virus (HBV) infections, detection of only anti-HBc in the absence of HBsAg and anti-HBs is known as 'anti-HBc only' situation. In this study we investigated the rate of HBV-DNA positivity in anti-HBc only-positive 45 patients (29 male, 16 female; mean age: 39.2 ± 12.3 years) who were followed in the outpatient clinics of a University Hospital in Düzce (located at northern west part of Turkey). HBV markers were investigated by 3rd generation ELISA (ME-IA Axsym-Abbott), and HBV-DNA were searched by real-time PCR [extraction: Minielute (Qiagen, Germany); PCR kits: Florion HBV (Iontek, Turkey); detection: i-cycler IQ5 (BioRad, USA)] methods. As a result, 24.4% (11/45) of the patients were found HBV-DNA positive (> 103 copies/ml). There was no statistically significant difference of HBV-DNA positivity rates between males (9/29; 31%) and females (2/16; 12.5%), (p=0.15). It was concluded that there may be a serious risk of HBV transmission from anti-HBc only-positive patients since the rate of HBV-DNA positivity was found high in our study. Thus HBV-DNA screening should be performed in 'anti-HBc only' patient groups.Öğe Impact of a multidimensional infection control approach on central line-associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)(Biomed Central Ltd, 2013) Leblebicioğlu, Hakan; Öztürk, Recep; Rosenthal, Victor Daniel; Akan, Özay Arıkan; Sırmatel, Fatma; Özdemir, Davut; İnan, AsumanBackground: Central line-associated bloodstream infections (CLABs) have long been associated with excess lengths of stay, increased hospital costs and mortality attributable to them. Different studies from developed countries have shown that practice bundles reduce the incidence of CLAB in intensive care units. However, the impact of the bundle strategy has not been systematically analyzed in the adult intensive care unit (ICU) setting in developing countries, such as Turkey. The aim of this study is to analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce the rates of CLAB in 13 ICUs of 13 INICC member hospitals from 8 cities of Turkey. Methods: We conducted active, prospective surveillance before-after study to determine CLAB rates in a cohort of 4,017 adults hospitalized in ICUs. We applied the definitions of the CDC/NHSN and INICC surveillance methods. The study was divided into baseline and intervention periods. During baseline, active outcome surveillance of CLAB rates was performed. During intervention, the INICC multidimensional approach for CLAB reduction was implemented and included the following measures: 1-bundle of infection control interventions, 2-education, 3-outcome surveillance, 4-process surveillance, 5-feedback of CLAB rates, and 6-performance feedback on infection control practices. CLAB rates obtained in baseline were compared with CLAB rates obtained during intervention. Results: During baseline, 3,129 central line (CL) days were recorded, and during intervention, we recorded 23,463 CL-days. We used random effects Poisson regression to account for clustering of CLAB rates within hospital across time periods. The baseline CLAB rate was 22.7 per 1000 CL days, which was decreased during the intervention period to 12.0 CLABs per 1000 CL days (IRR 0.613; 95% CI 0.43 - 0.87; P 0.007). This amounted to a 39% reduction in the incidence rate of CLAB. Conclusions: The implementation of multidimensional infection control approach was associated with a significant reduction in the CLAB rates in adult ICUs of Turkey, and thus should be widely implemented.Öğe In vitro bacterial adherence to teicoplanin and calcium sulfate-soaked bone cement(E I F T Srl, 2005) Şencan, İrfan; Şahin, İdris; Tüzüner, Tolga; Özdemir, Davut; Yıldırım, Mustafa; Leblebicioğlu, HakanThe aim of this study was to assess in vitro the improvement in release kinetics for teicoplanin and the inhibition of bacterial adhesion on calcium sulfate-soaked PMMA discs. Calcium sulfate has been used in vivo and shown to be biocompatible, and prevention of bacterial adhesion may be expected with calcium sulfate-soaked polymethylmethacrylate (PMMA). Discs were made by adding teicoplanin and calcium sulfate in powder form to PMMA powder. The antibiotic concentration eluted from PMMA discs was assayed by agar diffusion assay. Nonadherent bacteria were removed by washing and adherent bacteria were detached by sonication. The suspension including nonadherent bacteria was seeded on sheep blood agar plate and incubated for 24 h at 37 degrees C for the growth of microorganisms. The teicoplanin released from discs containing calcium sulfate was higher than that released from discs which had not been soaked with calcium sulfate. The count of bacteria adhering to the calcium sulfate-soaked discs was lower than that from the discs without calcium sulfate. In conclusion, the addition of calcium sulfate to teicoplanin-loaded PMMA bone cement may provide local antibiotic concentrations higher than MIC values due to increased antibiotic release. Furthermore, calcium sulfate was found to be effective in reducing bacterial adherence to treated discs.Öğe In vivo evaluation of teicoplanin- and calcium sulfate-loaded PMMA bone cement in preventing implant-related osteomyelitis in rats(Esift Srl, 2006) Tüzüner, Tolga; Şencan, İrfan; Özdemir, Davut; Alper, Murat; Duman, S.; Yavuz, Tevfik; Yıldırım, MustafaThe objective of this study was to evaluate the efficacy of teicoplanin- and calcium sulphate-loaded polymethylmethacrylate (PMMA) bone cements in preventing experimental implant-related osteomyelitis in rats. Four groups of antibiotic-loaded rods were prepared and were implanted into the lateral condylus of the rat femur after inoculation of Staphylococcus aureus. The effectiveness of these were assessed microbiologically, radiographically, and histopathologically. Radiographic evaluation revealed a significant reduction of periostal reaction and osteolysis in rats that received calcium sulphate- and teicoplanin-loaded rods. Histopathological evaluation confirmed these results. Acute infection and bone necrosis were found to be significantly lower in rats that had received calcium sulphate- and teicoplanin-loaded rods. The addition of calcium sulfate to teicoplanin-loaded PMMA bone cement appeared satisfactory as an antibiotic-carrying system for prophylaxis of experimental implant-related osteomyelitis, but further investigations are needed to reach definitive statements for clinical applications.
