A case of urinary tract infection caused by Raoultella planticola after a urodynamic study

AbstractHere we report the case of a patient who developed urinary tract infection after a urodynamic study. The causative agent was Raoultella planticola, a rare opportunistic pathogen that usually invades immunocompromised patients. While a urinary tract infection with R. planticola has been previously described, this is the first report in which an R. planticola infection developed after a urodynamic study. We postulate that the mechanism of infection was direct invasion of the urinary tract from contaminated urodynamic study equipment. Here, we discuss the role played by isotonic solutions in facilitating bacterial reproduction

Bartonella henselae IgM seropositivity in both adult and pediatric patients with diverse clinical conditions in Turkey

Bartonella henselae is the causative agent of cat scratch disease (CSD). In this study, we aimed to investigate the clinical data of patients with suspicion of CSD and delineate current epidemiological features. A total of 785 patients with suspected CSD were included in the study. B. henselae IgM antibody was determined by indirect fluorescent antibody (IFA) test using a commercial kit (Euroimmun, Germany). Sex, age, clinical pre-diagnosis and animal contact information of the patients were obtained from hospital electronic database records. Seventy-eight (9.9%) of 785 samples were seropositive. Out of 78 patients, 46 with animal contact data were further analyzed. Of these patients, 56% were male, and 41% were under 18 years of age. Seropositivity was more commonly observed in fall and winter. The most common finding was lymphadenitis (63%). Thirty-five patients (76%) had a previous history of animal contact (cat/dog). Of the 46 seropositive patients, 78.3, 15.2, 4.4, and 2.1% had titers of 1:80, 1:160, 1:320, and 1:640, respectively. Our study confirms that CSD is not rare in Turkey. Thus, it should always be considered in the differential diagnosis of patients presenting with lymphadenopathy in all age groups, particularly children. Questioning of cat exposure should never be neglected, especially in areas with intense population of stray cats, such as Istanbul

Comparison of Broth Microdilution and Colistin Disk Elution Methods for the Determination of Colistin Susceptibility in Multidrug Resistant Pseudomonas aeruginosa Isolates

Introduction: Colistin is increasingly used as a last-choice antimicrobial in the treatment of infections caused by multidrug-resistant Pseudomonas aeruginosa isolates. Due to the recent increase in colistin resistance around the world, the need for reliable methods for susceptibility testing has become more important. In this study, it was aimed to determine the performance of the broth disc elution (BDE) test, which was developed as an alternative to the reference broth microdilution (BMD) method. Materials and Methods: Fourty eight multidrug resistant Pseudomonas aeruginosa strains isolated from various clinical specimens were included in the study. The BMD method was performed according to the recommendations of the ISO-standard (20776-1), and the BDE test was done according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. The categorical agreement, major error, and very major error (VME) rates of the BDE test were determined by comparing with the BMD method. Results: By using the reference BMD method, 47 of 48 isolates were found to be susceptible (98%), and one was found to be resistant (2%). According to BMD test, the minimum inhibitory concentration distribution of the isolates was between 0.25-64 mg/l. The BDE test also correctly detected 47 susceptible and 1 resistant isolates. When the BDE test was compared with the BMD, the rate of categorical agreement was found to be 100%. No major or VMEs were detected. Conclusion: The BDE test performed very well in determining colistin susceptibility in multidrug resistant P. aeruginosa isolates. Therefore, we think that the BDE test can be used as a practical and reliable method in laboratories with limited resources where it is not possible to perform the reference BMD method

Evaluation of the Seroprevalence of Hepatit A and Vaccination Status in Children Aged Two and Sixteen Years

Objective: In this study; the aim was to evaluate the seroprevalence of hepatitis A virus (HAV) in 2-16 year age group, and the rate of hepatitis A vaccination.\ud Materials and Methods: This study was conducted on 400 children aged between 2 and 16 years with no chronic diseases who attended the pediatrics outpatient clinic in Health Sciences University, Haydarpaşa Numune Training and Research Hospital. After obtaining informed consent from the parents, blood samples were taken for investigating serological markers for hepatitis A in the microbiology laboratory using the ELISA method. The parents were asked whether or not their children had been vaccinated against hepatitis A. \ud Results: In this study 44.3% of the participants included were girls and 55.8% were boys. The mean age of the children was 10.8±4.18 years. 27.3% of patients were anti-HAV IgG-positive, and 11% had been vaccinated against hepatitis A. When we compared preschool and school age patients, anti-HAV IgG positivity was detected in all children who were vaccinated in the preschool group; while 5.9% of unvaccinated children were anti-HAV IgG-positive and 94.1% were negative. It was found that school age children were unvaccinated, and anti-HAV IgG was positive in 19.6% of the children and negative in 80.4% of the children.\ud Conclusion: In our study, although the prevalence of hepatitis A was found to be low compared to the eastern and southeastern cities of our country, it is still higher than in the developed countries. In order to prevent hepatitis A infection, it is necessary to improve the socio-economic conditions of the country, to create better sanitary conditions and hygienic practices, and raise awareness of the infection

Comparison of performance of LIAISON SARS- CoV-2 antigen assay with RT-PCR during the Omicron wave

Due to the newly emerging Omicron variant, there is a need to re-evaluate the performance of auto-mated antigen tests. Our study aim was to evaluate the performance of the automated Liaison SARS-CoV-2 antigen assay against reverse transcriptase polymerase chain reaction (RT-PCR) in samples with Omicron variant. A prospective study was performed on 373 combined oro-nasopharyngeal samples (NPS) randomly collected from symptomatic patients. NPS were tested with Liaison SARS-CoV-2 Ag test (DiaSorin, Italy) and DS Coronex COVID-19 Multiplex RT-PCR Diagnosis Kit (DS BioTechnology, Ankara, Turkey). Of 373 samples, 124 (33.2%) were found to be RT-PCR positive and 249 (66.8%) RT-PCR negative. Taking RT-PCR as a reference, the sensitivity and specificity of the Liaison SARS-CoV-2 Ag assay were found as 84.6% (95%CI 77.3%-90%) and 100% (95%CI 98.5%-100%), respectively. For samples with a cycle threshold (Ct) value <25 (high viral load), the sensitivity increased to 100%. When antigen concentration and Ct values were compared, a strong negative correlation between antigen and Ct values was determined (P < 0.001). The Liaison antigen test met the performance criteria recommended by the WHO for samples with the Omicron variant. In addition, it showed excellent sensitivity and specificity in patients with high viral load. Therefore, Liaison antigen test can be a reliable and useful alternative in the diagnosis of SARS-CoV-2 infection, particularly in resource-constrained laboratories

Detection of colistin resistance among multidrug-resistant Klebsiella pneumoniae and Escherichia coli clinical isolates in Turkey

In this study investigation of plasmid-mediated mcr 1-5 resistance genes was performed among multidrug-resistant (MDR) colistin sensitive and resistant Klebsiella pneumoniae and Escherichia coli strains isolated in our laboratory. We aimed to evaluate automated system (Vitek-2), broth microdilution (BMD) reference method and chromogenic media performance. Totally 94 MDR K. pneumoniae and six E. coli isolates were included in the study. CHROMID (R) Colistin R agar (COLR) (bioMerieux, France) was used to determine the colistin resistance by chromogenic method. Standard PCR amplification was performed using specific primers to screen the plasmid-mediated mcr 1-5 genes. Sixty-one isolates were resistant to colistin and 39 were susceptible with reference BMD. The essential and categorical agreement of Vitek-2 was determined as 100 and 99%. The sensitivity of COLR medium was 100%, the specificity was 97.5%. In our study mcr-1 was detected in eight isolates, while other mcr genes were not detected. Due to the high sensitivity and specificity of the COLR medium, it can be used in routine diagnostics for the detection of colistin resistance. In our study we detected 8% prevalence of mcr-1 among MDR strains however, two mcr-1 positive isolates were found sensitive to colistin by BMD

Investigation of vancomycin resistance in staphylococcus strains isolated from various clinical samples

Introduction: Besides the few investigation demonstrating the vancomycin resistance towards Staphylococcus aureus in recent years, it has been also reported a decreased sensitivity of these bacteria to vancomycin. In the present study, it was aimed to evaluate sensitivity test in staphylococcus strains isolated from various clinical samples.Methods: A total of 164 staphylococcus strains consisting of Methicillin Resistant Staphylococcus aureus (n=93), and Methicillin Resistant Coagulase Negative Staphylococcus (n=71) were included in this study. The vancomycin agar screening and E-test methods were used to assess vancomycin sensitivity, and results were interpreted to Clinical and Laboratory Standard Institute and European Committee on Antimicrobial Susceptibility Testing criteria.Results: After assessing the strains by using E-Test, neither decreased sensitivity, nor resistance to vancomycin was determined according to Clinical and Laboratory Standard Institute. However, 3 of 6 Methicillin Resistant Staphylococcus aureus, and 1 of 7 Methicillin Resistant Coagulase Negative Staphylococcus reproduced in Brain Heart Infusion Agar were found to be resistant to vancomycin according to European Committee on Antimicrobial Susceptibility Testing.Conclusion: Because even small changes can be clinically significant, Minimum İnhibition Concentration value of vancomycin should be correctly determined

Investigation of Antifungal Susceptibility of Trichosporon Asahii Isolated From Urine Samples

Objective: As part of the normal human flora of the skin and gastrointestinal tract, Trichosporon species may lead to opportunistic infections through underlying facilitating factors. Urinary tract infections (UTIs) are the most common infections occurring in intensive care units (ICUs), where catheterization procedures are performed extensively. The aim of the study investigates the antifungal susceptibility of T. asahii strains isolated from urine samples

Evaluation of Broth Disk Elution Method to Determine Colistin Resistance in Klebsiella pneumoniae and Escherichia coli Strains

© Copyright.Background: The reference broth microdilution (rBMD) method for the determination of colistin resistance is very laborious and time consuming, and many manual errors can occur. There are also limitations in detection of colistin heteroresistance. Therefore, alternative methods with satisfactory performance are required for routine laboratory work. In our study, the colistin broth disk elution (CBDE) method recommended by the Clinical and Laboratory Standards Institute (CLSI) for the detection of colistin resistance in routine applications was compared with rBMD. The compatibility and error rates of the method were evaluated and its usability in routine laboratory studies was examined. Methods: Eighty-nine multidrug resistant Klebsiella pneumoniae and five Echerichia coli strains isolated from various clinical specimens were included in the study. Identification of strains and antibiotic susceptibility tests were performed with MALDI-TOF MS (bioMerieux, France) and Vitek-2 (bioMerieux) system. Minimum inhibitory concentration (MIC) was studied in 0.125 - 128 mg/L dilution range by using polystyrene microplate and colistin sulfate salt according to ISO-standard (20776-1) recommendations for the reference BMD test. The CBDE method was performed according to the CLSI recommendations. Isolates with MIC ≤ 2 mg/L were considered susceptible, while isolates with MIC > 2 mg/L were considered resistant according to EUCAST recommendations. The performance of the CBDE method was evaluated according to ISO criteria (Categorical agreement > 90%; major error and very major error rates 4 µg/mL values could not be determined with the CBDE method, essential agreement (EA) could not be calculated. No major or very major errors were detected. Conclusions: Our results showed that the performance of the CBDE test is good when compared to the rBMD method. According to our data, we believe that the CBDE method can be used in routine laboratories for the detection of colistin resistance