Background: The effectiveness of microscopy of Gram-stained smear (GSS) for the detection of male urethral infection is debatable, especially in cases with low inflammation and no visible urethral discharge. This clinical study compared GSS samples collected with the conventional swab method and our new technique, the kissing slide method, together with polymerase chain reaction results to demonstrate the effectiveness of this new method in men with acute urethritis. Methods: The study included 64 men who presented to the urology outpatient clinic with complaints of acute urethritis between October 2019 and January 2020. Two GSS samples were collected from each patient, first using the kissing slide method (applying the slide directly to the urethral mucosa), followed by the conventional method. The results were compared with polymerase chain reaction findings. Results: The patients' mean age was 37.4 ± 7.8 years, and 68.7% had no visible urethral discharge on physical examination. At a GSS threshold of ≥5 polymorphonuclear leukocytes/high-power field, sensitivity values were 60% (95% confidence interval [CI], 42.32%–75.41%) for the kissing slide method and 23.33% (95% CI, 11.79%–40.93%) for the conventional method. At a threshold of ≥2 polymorphonuclear leukocytes/high-power field, sensitivity values with the kissing slide and conventional methods were 80% (95% CI, 62.69%–90.5%) and 50% (95% CI, 33.15%–66.85%) in all patients, and 66.67% (95% CI, 41.71%–84.82%) and 20% (95% CI, 7.047%–45.19%) in cases without visible urethral discharge, respectively. Conclusion: The new kissing slide method is a noninvasive alternative method that may have better sensitivity than the conventional GSS sampling method in the diagnosis of male acute urethritis. Randomized studies are needed to verify these findings.
30 January 2023 in Journal of Infection and Chemotherapy
Aims: Carbapenem-resistant Gram-negative microorganisms are gradually increasing in hospitalized patients in intensive care units and causes increased morbidity, mortality, and cost. This study aims to investigate the susceptibility of ceftazidime-avibactam (caz-avi), which has recently started to be used for the treatment of infections caused by carbapenem-resistant (CR) Gram-negative bacteria isolated from various samples received from the intensive care unit (ICU) of our hospital. Methods: Carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) strains isolated from various clinical specimens that were sent to our laboratory between January 1st, 2021, and October 30th, 2022, were retrospectively evaluated in the study. The culture and antibiogram results of the samples were received over the laboratory information system (LIS) and evaluated using statistical analyses. Ceftazidime-avibactam susceptibility was studied using the disc diffusion method. Results: Ceftazidime-avibactam antibiotic susceptibility test results of 352 (69.4%) CRKP and 155 (30.6%) CRPA strains isolated from various clinical samples from the ICU of our hospital were analyzed. Of the CRKP strains, 313 (88.9%) were found to be susceptible and 39 (11.1%) were found to be resistant to ceftazidime-avibactam. Of the CRPA strains, 131 (84.5%) were found to be susceptible and 24 (15.5%) were found to be resistant. Conclusion: Determining the regional susceptibility of carbapenem-resistant strains isolated in our hospital to a new antimicrobial combination such as caz-avi will allow a better understanding of the spread of resistance.