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    Clinical importance of extended-spectrum ?-lactamase (PER-1-type)-producing Acinetobacter spp. and Pseudomonas aeruginosa strains
    (Lippincott Williams & Wilkins, 2001) Vahaboglu, H; Coskunkan, F; Tansel, O; Ozturk, R; Sahin, N; Koksal, I; Kocazeybek, B
    Recently, an extended-spectrum beta -lactamase (PER-I) was found to be disseminated among Acinetobacter spp, and Pseudomonas aeruginosa isolates in Turkey. A population-based cohort study was conducted to elucidate predictive mortality factors in patients with nosocomial infections caused by Acinetobacter spp. and P. aeruginosa, with particular reference to PER-1-type extended-spectrum beta -lactamase (ESBL) production. The study group comprised 16 and 21 non-survivors and 82 and 126 survivors in cohorts infected with Acinetobacter and E. aeruginosa, respectively. In the Acinetobacter-infected cohort, nosocomial pneumonia, hypotension and infection with a PER-positive isolate were independent predictors of mortality. In the P. aeruginosa-infected cohort, impaired consciousness, a PER-positive isolate, male sex and (with a negative relative risk) urinary tract infection were independent predictors of death. This study demonstrated the relationship of PER-1-type ESBL-producing Acinetobacter spp. and P. aeruginosa with poor clinical outcome.
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    A methicillin-resistant Staphylococcus aureus outbreak in a new university hospital due to a strain transferred with an infected patient from another city six months previously
    (Luigi Ponzio E Figlio, 2003) Tansel, O; Kuloglu, F; Mutlu, B; Anthony, RM; Uyar, A; Vahaboglu, H; French, GL
    Kocaeli University Medical School was established in 1995. The first methicillin resistant Staphylococcus aureus isolate was detected two years later in a patient transferred from a different city. Six months after this, we detected a small MRSA outbreak in the intensive care unit involving four patients, two of whom had bacteremia, and a staff nasal carrier. All isolates, including the first, appeared to be a single outbreak strain, demonstrated by pulsed field gel electrophoresis profiles which different by at most two bands, identical randomly amplified polymorphic DNA profiles, and identical coagulase gene types by PCR. Antibiogram were identical except that one isolate was additionally resistant to cotrimoxazole. These results show that MRSA isolates can spread between hospitals with infected or colonized patients and can apparently persist in the hospital for six months without causing infection. Screening of asymptomatic patients on wards affected by MRSA or transferred from other hospitals may be helpful in controlling these infections.