Detection of methylase genes in P. aeruginosa isolates from burn patients

Abstract

Background: The aim of this study is to evaluate the patients with intracranial suppurative infection (ISI) in contextwith clinical, radiological and laboratoryfindings, andprognosis, retrospectively. Methods & Materials: All patients with ISI, who were treated and followed up at the infectious diseases and clinical microbiologydepartment between1998and2013,were evaluated in context with data of the cases including anamnesis, physical examination, laboratory and radiological findings were evaluated, retrospectively. Results: Of all 23 patients, mean age was 38.21±12.61 (range: 19-67 years, median: 34) and mean duration of symptoms was 22.25±20.22 days. Headache was the most common symptom. Frontal lobewas themost common localization of ISI andmastoiditis due to chronic suppurative otitis media was the most common source of infection causing to ISI. Invasive procedure was undergone to 16 (69.5%) cases as open craniotomy, burrhole aspiration and stereotactic biopsy to due to severity of signs and symptoms at admission, deteriorating clinical findings and convulsion. P. mirabilis, Pseudomonas spp., Peptostreptococcus spp., Enterococcus avium, M. tuberculosis complex and Toxoplasma gondii were isolated from specimens of six cases (37,5%) among 16 cases that have undergone to open craniotomy (n:2), burrhole aspiration (n:12) and stereotactic biopsy (n:2). Leukocytosis was observed in 13 patients (11,527±4,552). Ceftriaxone (2 gr IV every 12hours) combined with metronidazole (500mg IV every 8hours) were given to patients between 21 and 120 days until clinical signs and resolution of radiological findings recovered. Initial standard treatment was switched to combination therapy including vancomycin and meropenem in five patients and to meropenem therapy in two cases for two weeks due to severity of symptoms at admission and deterioration of signs and symptoms under standard combination therapy. Sequelae and case fatality rates were observed as 8.6%. Relapse did not occur. Conclusion: Patients should be examined in cases with headache,male genderwith neurological signs and symptomswith or without fever in terms of ISI on admission for early diagnosis, timely adequate therapy and surgical intervention to reduce mortality and sequelae rates.