Detection of Entamoeba histolytica in stool specimens with the ELISA method [Dişki Orneklerinde ELISA Yöntemi ile Entamoeba histolytica'nin Saptanmasi.]

In this study, carried out between November 2006 and September 2007, amebic cysts were observed in 44 (0.37%) out of a total of 1720 stool specimens which were examined by direct microscopy. Entamoeba histolytica specific antigen was investigated with ELISA in the specimens in which cysts were observed. Specific antigen was detected in 26 (59.1%) of these specimens. The diagnosis of amoebiasis for the patients whose ELISA tests were positive was confirmed and the appropriate therapy was immediately begun. This prediagnosis was abandoned for patients whose test results were "negative". Because of the low sensitivity of direct microscopy in confirming the prediagnosis of amoebiasis, it is necessary to perform ELISA on the specimens in order to determine whether the patient should be treated or to prevent patients from being given an unnecessary treatment

Hepatitis C virus genotypes in A province of western black-sea region, Turkey [Zonguldak bölgesinde hepatit c virusu genotipleri]

Hepatitis C virus (HCV) is one of the significant causes of hepatitis, cirrhosis and hepatocellular carcinoma all throughout the world. There are six genotypes and more than 50 subtypes of HCV. HCV genotyping is of crucial importance in the determination of the treatment protocols and the follow-up of the clinical course since treatment success is low and the duration of treatment is longer in HCV genotype 1 infected cases. The aim of the present study was to evaluate the HCV genotype profiles of the pa tients with chronic hepatitis C in Zonguldak, providing the first data about HCV genotypes from western Black-Sea region, Turkey. The HCV genotypes of 44 patients (26 female, 18 male; age range: 29-89 years, mean age: 60.05 ± 10.81 years) with positive anti-HCV antibody and HCV-RNA results, admitted to the hospital between May 2007 and July 2009, were retrospectively evaluated and included in the study. Alanine aminotransferase (ALT) levels of the patients were between 8-160 IU/L (mean 63.99 ± 37.15 IU/L) and the aspartate aminotransferase (AST) levels were between 17-160 IU/L (mean 62.77 ± 36.75 IU/L). HCV antibody was determined by ELISA method (Abbott Laboratories, USA), and HCV-RNA was determined by two commercial real-time polymerase chain reaction systems [Cobas Taqman (Roche Diagnostic, USA) and Rotor-Gene 6000 (Corbett Research, USA)]. The genotyping was performed by a reverse hybridization based method, Versant®HCV Genotype Assay (LiPA) 2.0 (Bayer Health Care, Belgium). HCV genotypes could not be determined for 5 (11.4%) patients since HCV-RNA levels were low. Genotyping could be performed for 39 (88.6%) patients and 38 (97.4%) had genotype 1b and one (2.6%) patient had genotype 1a. In conclusion, in concordance with the other studies conducted in our country, genotype 1b was found to be the most prevalent genotype in patients from our region

Evaluation of reduced susceptibility to vancomycin among mrsa strains isolated from clinical specimens [Kli·ni·k örneklerden i·zole edi·len mrsa suşlarinda vankomi·si·ne karşi azalmiş duyarliligin araştirilmasi]

In this study, a total of 390 methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from clinical specimens between April 2004 and June 2008, in a university hospital in Zonguldak (located at Black Sea region), Turkey, were evaluated retrospectively for reduced susceptibility to vancomycin. Brain heart infusion (BHI) plates containing 4 and 6 µg/ml of vancomycin were used to screen for vancomycin intermediate S.aureus (VISA) strains. Additionally, vancomycin minimal inhibitory concentrations (MIC) of the isolates were determined by agar dilution method. No growth was observed on the screen plates after 24 and 48 hours of incubation. None of the isolates revealed MIC values equal to or higher than 2 µg/ml; MIC90 and MIC50 values were 1 µg/ml. Although VISA isolates were not detected in this study, no data was obtained for heterogeneous VISA isolates since macro-E test or population analysis were not performed. It was concluded that systematic surveillance of MRSA isolates is of particular importance to investigate the presence of VISA/hVISA isolates which may lead to treatment failures and hospital epidemics

A first insight into the genetic diversity and population structure of Mycobacterium tuberculosis in Zonguldak, Turkey

This study evaluated the molecular epidemiology and biodiversity of Mycobacterium tuberculosis isolates in Zonguldak, Turkey, and investigated the presence and significance of the LAM7-TUR clone by spoligotyping and mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) analysis. In total, 128 isolates were tested by spoligotyping; 25 selected isolates representative of the LAM7-TUR clone and similar types were also tested by MIRU-VNTR analysis. In total, 47 distinct patterns were revealed by spoligotyping, represented by 13 clusters containing between two and 28 isolates (94 isolates in total), and 34 unique patterns (a clustering rate of 73%). Using MIRU-VNTR analysis, the clustering relationships revealed by spoligotyping were confirmed. The most common spoligotyping profile was SIT53, followed by SIT41 (LAM7-TUR) and SIT50. The SIT284 clone was another phylogeographically specific clonal complex whose presence in Turkey may be endemic. The LAM7-TUR genotype was highly prevalent in Zonguldak. © 2007 The Authors Journal Compilation © 2007 European Society of Clinical Microbiology and Infectious Diseases.European Commission Federation of European Microbiological SocietiesE. Aktas was supported by a short-term fellowship of the Federation of European Microbiological Societies (FEMS) during her stay at the Pasteur Institute of Guadeloupe. Ö. Anğ and J.-L. Guesdon are acknowledged for their help in obtaining the fellowship. T. Zozio was supported through a PhD fellowship awarded by the European Union, the Regional Council of Guadeloupe and the International Network of the Pasteur Institutes. J. W. Dale is thanked for his kind help in improving the English language style of this manuscript. No information has been provided by the authors concerning the existence or absence of conflicting or dual interests

First isolation and detection of multiple clones of vancomycin- resistant enterococci in the pediatric unit of Van Yuzuncu Yil University, Turkey [Van Yüzüncü Yil Üniversitesi pediatri servisinde vankomislne direnç li enterokoklarin ilk izolasyonu ve çogul klonlarin tespiti]

Upon isolation of the first vancomycin resistant enterococcus (VRE) from the urine sample of a nine months old patient in pediatric unit of Van Yuzuncu Yil University Hospital (located in eastern part of Turkey), we aimed to search for the presence of VRE isolates in the unit, to determine the resistance genotypes and to evaluate the clonal relationships among isolates. A total of 28 rectal swabs and 28 skin swabs from the patients, 12 skin swabs from the staff giving care to the patients, 15 skin swabs from the mothers of the patients and 96 environmental samples from the pediatric unit were screened. Antibiotic susceptibilities were tested and the resistance genotypes were determined. Molecular typing of the isolates was performed using pulsed-field gel electrophoresis (PFGE). Apart from the first case, 13 more VRE isolates, one being a clinical isolate from the urine of a patient and 12 isolates from the screening samples (8 rectal swabs, one skin swab and three swabs from patients' beds) were obtained. All of the isolates were identified as Enterococcus faecium with similar antibiotic susceptibility patterns. VanA gene was present in all of the isolates. PFGE demonstrated two major clones and five clones closely related with the major ones. This was the first VRE isolation and colonization reported in our region. The isolates belonged to more than one clone. Currently, VRE did not seem to be a significant pathogen in Turkey, however, there may be an underestimation of the problem and continuous surveillance studies should be undertaken in every region