Peritoneal Fluid Analysis of the Newborn Calves with Intestinal Atresia - a Clinical Approach

Background: Anomalies and fetal problems are encountered in all animals. Intestinal atresia is a congenital anomaly of both humans and animals. Intestinal atresia has four morphological types, and they can be observed in jejunum, ileum, cecum, colon, rectum and anus (type I: mucosal atresia, type II: atretic ends separated by fibrous cord, type III: atretic ends separated by a “V” shaped mesenteric gap or atretic end coil like an “apple peel”, type IV: multiple atresia). In calves, it is also commonly encountered; it is still a question to be replied about the exact prognosis of the patients with intestinal atresia. Thus, the main objective of the present study was to evaluate peritoneal fluid analysis results of calves with intestinal atresia.Materials, Methods & Results: Twenty-two calves were presented with abdominal distension and lack of defecation. Clinical and radiological findings pointed out the intestinal atresia. Blood samples were collected for routine hematological and serum total protein (TP) analysis. Peritoneal fluids were aspirated with sterile technique from the caudal abdomen, and biochemical features, cell contents and microbiological cultures of the peritoneal fluids were analyzed. Following to preoperative, surgical and necropsy findings, intestinal atresia were diagnosed as type II, III and IV in calves. Neutrophilic leukocytosis was observed in calves with type IV intestinal atresia. Red blood cells and platelet counts were determined in the peritoneal fluids. TP and density values of the peritoneal fluid were high in all cases. These results pointed the presence of the acute infection and peritonitis. Statistical comparison of each parameter showed that there was no significant difference between the types of intestinal atresia. Microbiologically, fecal origin bacteria were cultured in 12 calves.Discussion: In general, four types of intestinal atresia are encountered in calves, and all types are fatal pathologies; thus, surgery should urgently be planned as soon as diagnostic work-ups are completed after birth. Peritoneal fluid analysis is a useful diagnostic choice because changes in the peritoneal fluid parameters help to diagnosis of the intra-abdominal pathology. Intestinal atresia as more common anomaly in Holstein, Jersey and Montafon breed calves. In animals with intestinal atresia, surgical treatment is not usually recommended due to economic reasons and small chance of postoperative success. Long-term survival rate of surgically treated animals depends on the type of intestinal atresia and applied surgical technique. Atresia recti and ani may occur simultaneously with atresia coli, and all atresias (atresia coli, ani, recti or ani et recti) can be successfully treated by surgery. Continuous distention of the large intestinal segments leads to ischemia, necrosis, peritonitis and bowel perforation. Peritoneal fluid analysis should include the classic parameters for diagnosis, but these analyses are often insufficient to identify the etiology or pathogenesis of the disease. An increase in total WBC count and percentage of the neutrophil cells in the peritoneal fluid indicate the acute infectious origin inflammation. Additional parameters in the peritoneal fluid analysis have been established to improve diagnostic precision and specific information. Presence or absence of the bacteria in the peritoneal fluid samples is important to characterize the transudate and exudate. Changings in the peritoneal fluid values does not related to type of the intestinal atresia in calves

Evaluation of serum indirect hemagglutination test results of suspected cystic echinococcosis cases from 2009-2017

Objective: To evaluate the serological, radiological and epidemiological analysis of suspected cystic echinococcosis patients, and to assess the positivity rate in the region. Method: The retrospective study was conducted at Bursa Uludag University Hospital, Bursa, Turkey, and comprised data from January 2009 to December 2017 related to patients of either gender with suspected cystic echinococcosis who underwent indirect haemagglutination testing. Demographic and clinical data of patients who tested positive were analysed. Statistical analysis was done using SPSS 23. Results: Of the 3910 patients with a mean age of 41.6±19.35 years (range: 0-93 years) who underwent indirect haemagglutination testing, 692(17.7%) tested positive; 390(56.4%) females, and 302(43.6%) males. The highest seropositivity rate 107(15.5%) was observed in 2011, followed by 104(15%) in 2016. Seropositive cases were predominantly seen in those aged 40-49 years 131 (18.9%), followed by those aged 50-59 years 124 (17.9%). Conclusion: Cystic echinococcosis was found to be a public health problem South Marmara region of Turkey. Key Words: Echinococcus granulosus, Cystic echinococcosis, Indirect haemagglutination, Seroprevalence

Investigation of methicillin resistant Staphylococcus aureus in neonatal intensive care unit

Methicillin resistant Staphylococcus aureus (MRSA) strains lead to severe infections in immunosupressive patients, geriatric population and premature infants. 27 MRSA strains isolated in the Neonatal Intensive Care Unit was considered as an outbreak and it was aimed to investigate the genetic and epidemiologic relation of the MRSA outbreak. MecA gene was investigated in the S. aureus strains and pulsed field gel electrophoresis (PFGE) was used to investigate the genetic relation between outbreak strains. MecA gene was showed in all isolates. PFGE revealed that there were two different strains and most of the isolates (25/27) were owing to same clone. One of the samples were found closely related with the common strain and the other sample was found genetically unrelated. To terminate the outbreak; liquid baby food was gained to the baby food kitchen, no more new patient was imported to the neonatal unit and none of the patients were exported from neonatal unit to other clinics during outbreak, education about infection control precautions was given to all the staff and nursing bottle dishwasher was obtained. To manage and terminate the outbreak, besides the infection control precautions, tests to determine the genetic relation between outbreak strains which are done in the microbiology laboratory are needed. Molecular analysis of outbreak strains will contribute to prove the epidemiologic and evolution of outbreaks

Serotype distribution of Streptococcus pneumoniae and pneumococcal vaccine coverage in adults in Turkey between 2015 and 2018

AbstractObjective To evaluate the serotype distribution and antibiotic resistance in pneumococcal infections in adults and to provide a perspective regarding serotype coverage of both current and future pneumococcal vaccines.Patients and methods This passive surveillance study was conducted with the Streptococcus pneumoniae strains isolated from the specimens of patients with pneumonia (materials isolated from bronchoalveolar lavage), bacteraemia, meningitis, pleuritis and peritonitis between 2015 and 2018. Serogrouping and serotyping were performed by latex particle agglutination and by conventional Quellung reaction using commercial type-specific antisera, respectively. The strains were analysed for penicillin, cefotaxime, erythromycin and moxifloxacin susceptibilities by E-test.Results In the whole study group (410 samples from adults aged ≥18 years), the most frequent serotypes were 3 (14.1%), 19 F (12%) and 1 (9.3%). The vaccine coverage for PCV13, PCV15, PCV20 and PPV23 was 63.9%, 66.6%, 74.1% and 75.9%, respectively, in all isolates. Penicillin non-susceptibility in invasive pneumococcal disease (IPD) was 70.8% and 57.1% in the patients aged <65 and ≥65 years, respectively. About 21.1% and 4.3% of the patients with and without IPD had cefotaxime resistance. Non-susceptibility to erythromycin and moxifloxacin was 38.2% and 1.2%, respectively.Conclusions The results revealed that novel PCV vaccines may provide improved coverage as compared with the currently available vaccine, PCV13. The significant antibiotic resistance rates imply the need to extend the serotype coverage of the vaccines. Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution and incidence changes of IPD cases in the population and to inform policy makers to make necessary improvements in the national immunization programmes.Key messagesThis multicentre study demonstrated the most recent serotype distribution and antibiotic resistance in adult population in Turkey.Shifting from PCV13 to novel conjugated vaccines will significantly increase the coverage.Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution changes and the incidence of cases with invasive pneumococcal disease in the population

Serotype distribution of Streptococcus pneumoniae in children with invasive diseases in Turkey: 2008-2014

WOS: 000371745700019PubMed ID: 26325175Successful vaccination policies for protection from invasive pneumococcal diseases (IPD) dependent on determination of the exact serotype distribution in each country. We aimed to identify serotypes of pneumococcal strains causing IPD in children in Turkey and emphasize the change in the serotypes before and after vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) was included and PCV-13 was newly changed in Turkish National Immunization Program. Streptococcus pneumoniae strains were isolated at 22 different hospitals of Turkey, which provide healthcare services to approximately 65% of the Turkish population. Of the 335 diagnosed cases with S. pneumoniae over the whole period of 2008-2014, the most common vaccine serotypes were 19F (15.8%), 6B (5.9%), 14 (5.9%), and 3 (5.9%). During the first 5y of age, which is the target population for vaccination, the potential serotype coverage ranged from 57.5 % to 36.8%, from 65.0% to 44.7%, and from 77.4% to 60.5% for PCV-7, PCV-10, and PCV-13 in 2008-2014, respectively. The ratio of non-vaccine serotypes was 27.2% in 2008-2010 whereas was 37.6% in 2011-2014 (p=0.045). S. penumoniae serotypes was less non-susceptible to penicillin as compared to our previous results (33.7vs 16.5 %, p=0.001). The reduction of those serotype coverage in years may be attributed to increasing vaccinated children in Turkey and the increasing non-vaccine serotype may be explained by serotype replacement. Our ongoing IPD surveillance is a significant source of information for the decision-making processes on pneumococcal vaccination.PfizerPfizerThis study was supported by Pfizer

Serotype distribution ofStreptococcus pneumoniain children with invasive disease in Turkey: 2015-2018

Objectives To determine the serotype distribution of pneumococcus causing invasive pneumococcal disease (meningitidis, bacteremia and empyema) in children in Turkey, and to observe potential changes in this distribution in time to guide effective vaccine strategies. Methods We surveyedS. pneumoniaewith conventional bacteriological techniques and with real-time polymerase chain reaction (RT-PCR) in samples of cerebrospinal fluid (CSF), blood and pleural fluid.S. pneumoniaestrains were isolated from 33 different hospitals in Turkey, which are giving health services to approximately 60% of the Turkish population. Results A total of 167 cases were diagnosed with invasive pneumococcal disease between 2015 and 2018. We diagnosed 52 (31.1%) patients with meningitis, 104 (62.2%) patients with bacteremia, and 11 (6.6%) patients with empyema. Thirty-three percent of them were less than 2 years old and 56% less than 5 years old. Overall PCV13 serotypes accounted for 56.2% (94/167). The most common serotypes were 19 F (11.9%), 1 (10.7%) and 3 (10.1%). Conclusions Besides the increasing frequency of non-vaccine serotypes, vaccine serotypes continue to be a problem for Turkey despite routine and high-rate vaccination with PCV13 and significant reduction reported for the incidence of IPD in young children. Since new candidate pneumococcal conjugate vaccines with more serotype antigens are being developed, continuing IPD surveillance is a significant source of information for decision-making processes on pneumococcal vaccination