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    Effect of the warm and wet environment of the swimming-pool on the bacterial flora of the external ear canal and development of otitis externa in children who attend to swimming course
    (Galenos Yayincilik, 2006) Akoglu, E.; Cetin, M.; Onlen, Y.; Duran, N.; Sangun, O.; Savas, L.; Ocak, S.
    Objective: Especially in the summer season, there is an increased incidence of ear infections in the children who attend to the swimming pools. The most frequent ear infection in this group is otitis externa. This study was planned in order to examine whether the microbiologic flora of the normal external auditory canal (EAC) is changed by the pool environment in the presence or absence of cerumen; and to evaluate the relationship of these changes with the external otitis. Methods: Ear swab samples of EAC from 197 children were taken before and 1 month after the swimming course. These samples were evaluated at the microbiology laboratory after the otoscopic examination of each student. Results: The most frequently isolated microorganisms from the samples which were taken before the course were; Staphylococcus epidermidis (76.7%), Diphteroid spp. (47.3%) and alpha-hemolytic streptococci (29.9%) respectively. After the course period, it was determined that the percentage of isolated microorganisms changed, although the order of the frequency of the first three microorganism remained the same (Staphylococcus epidermidis 75.9%, Diphteroid spp. 56.3% and alpha-hemolytic streptococci 41.1%). Only one case of external otitis due to Pseudomonas aeruginosa was seen in the course period. Conclusions: It was concluded that an alteration in the microbiologic flora of the EAC and the presence or absence of cerumen do not play a role in the development of EAC infections provided that the hygienic conditions are constituted and EAC skin is not traumatized.
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    Nosocomial urinary tract infections: Micro-organisms, antibiotic sensitivities and risk factors
    (Univ West Indies Faculty Medical Sciences, 2006) Savas, L.; Guvel, S.; Onlen, Y.; Savas, N.; Duran, N.
    Objective. Although urinary tract infections (UTIs) are the most common hospital-acquired infections, the epidemiology of these UTIs is not well defined in Turkey. The aim of this surveillance study was to determine micro-organisms responsible for UTI, their antibiotic sensitivities and to describe the incidence and risk factors of nosocomial urinary tract infections (NUTI). Subjects and Methods: This was a prospective surveillance study including cases of NUTI in intensive care units and various inpatient clinics. This study was carried out between November 2000 and January 2002. The following information was recorded: patients' age, gender type of infection (hospital-acquired), presence of urinary catheter, intensive care unit admission, duration of hospital stay, type of organisms isolated and their antimicrobial susceptibility. The diagnosis of NUTI was based on criteria established by the Centers for Disease Control, Atlanta. Mini Api and conventional culture methods were used to determine the causative agents. The agents were isolated on eosin methylene blue agar and 5% sheep blood agar Statistical analyses of data were by chi-square test and logistic regression. Results: In this study, 618 (2.1%) nosocomial infections (NIs) were determined in 29778 patients, and 178 of these infections were NUTI (28.8%, 178/618). The mean age of NUTI patients was 61.0 +/- 19.4 years (0-91 years) and 82 NUTI patients (46.1%) were male and 96 (53.9%) were female. The most frequently isolated micro-organism was Escherichia coli (31.4%) followed by Candida spp (21.3%), Klebsiella spp (10.6%) and Enterococcus spp (6.9%). Compared to the rate of other NIs, the rate of NUTI increased by 1.011 times per year of age, by 2.052 times in females and by 3.83 times in patients with urinary catheters (p < 0.05). The most effective antibiotics against Gram-negative bacteria were found to be imipenem and meropenem. Conclusions: Important factors to prevent NUTI are to avoid unnecessary urethral catheterization, to choose narrow spectrum antibiotics according to antibiotic sensitivities, to investigate regularly the causative micro-organisms and their resistance patterns and to update the treatment protocols.