Distribution of anti-HAV IgM positivity according to age and months of a year in Van region,Turkey

Objectives: In this study we investigated the anti-HAVIgM positivity rates and their distribution according to ageand season of a year in Van region of Turkey.Materials and methods: During five-year period between2006-2010, the presence of anti-HAV IgM weredetermined in the serum samples sent to our laboratorythat have prediagnosis of hepatitis A by ELISA test, usingAxSYM (Abbott Diagnostics, Germany) and i2000SR Architect(Abbott Diagnostics, Germany) analyzers. For statisticalanalyze of Anti-HAV IgM positivity rates, patients’age and gender and time of year when specimen wasobtain were compared.Results: The presence of anti-HAV IgM was investigatedin a total of 8851 patients, including 5303 (60%) childrenand 3548 (40%) adults. Anti-HAV IgM in children and adultpatients were determined as 9.8% and 2.6%, respectively,and this difference was found statistically significant (p<0.01). Anti-HAV IgM positivity rate began to rise in August,reached the highest level in November-Decemberand decreased to the initial level in January. The highestfrequency detected during the November-December periodwas statistically significantly higher than rates foundduring other months.Conclusions: The prevalence of Hepatitis A was found tobe similar with previous studies performed in our country.The prevalence of disease was significantly increased especiallybetween November and December.Key words: Anti-HAV IgM, seasonal distribution, seroprevalence,ag

Antibiotics resistance of Stenotrophomonas maltophilia strains isolated from various clinical specimens

Background: A limited number of antibiotics are recommended for the therapy of Stenotrophomonas maltophilia infections due to therapy difficulties caused by its numerous mechanisms of resistance.Objectives: In this study conducted over a period of approximately 5 years we aimed to determine resistance rates of S. maltophilia based on drug classification recommended by Clinical and Laboratory Standards Institute.Methods: A total of 118 S. maltophilia strains isolated from various clinical specimens between January 2006 and June 2012 were included in the study. BD Phoenixautomated microbiology system (Becton Dickinson, USA) was utilized for species level identification and antibiotic susceptibility testing.Results: Sixty seven of S. maltophilia strains were isolated from tracheal aspirate isolates, 17 from blood, 10 from sputum, 10 from wound and 14 from other clinical specimens. Levofloxacin was found to be the most effective antibiotic against S. maltophilia strains with resistance rate of 7.6%. The resistance rates to other antibiotics were as follows: chloramphenicol 18.2%, trimethoprim-sulfamethoxazole 20.3% and ceftazidime 72%.Conclusion: The study revealed that S. maltophilia is resistant to many antibiotics. The treatment of infections caused by S. maltophilia should be preferred primarily as levofloxacin, chloramphenicol, and TMP-SXT, respectively.Keywords: Stenotrophomonas maltophilia, antibiotic, resistanc

The evaluation of vancomycin-resistant enterococci and carbapenamase producing Klebsiella colonization among ICU-Hospitalized Patients

Background: Multi-drug resistant organisms, especially Vancomycin-Resistant Enterococcus (VRE) and Carbapenam Resistant Klebsiella pneumoniae (KPC), are serious health threat. Early detection of resistant bacteria colonization amongpatients in intensive care units (ICUs) not only enables effective treatment but more importantly prevents disease and limits transmission. Therefore, we aimed to to assess the frequency of VRE and KPC colonization via rectal swab sampling. Methods: The study was carried out in ICUs of a tertiary hospital. Two rectal swab samples were collected within the first 24 hours of admission and another one was taken every subsequent 15 days to test for for VRE and KPC carriage. Results: A total 316 rectal swab samples taken from 230 patients. Forty-seven patients were screened at least 2 times. 183 patients were not further screened due to discharge, exitus or transfer to other wards. Thirty-six patients (16%) were determinedto be VRE (+). The most frequently isolated strain was E. faecium (80.5%) and its most common genotype was VanA (87.5%). Seven patients (3%) were identified as KPC (+). OXA-48 type crbapenamase was confirmed in all KPC isolates. Conclusion: This study shows that VRE and KPC colonization continues to be a serious threat in ICUs. Keywords: Carbapenam resistant klebsiella pneumoniae; vancomycin-resistant enterococci; intensive care units

Can We Trust a Compact Bacteriological Screening Test to Identify the Common Vaginal Pathogens?

Objectives: The objective of this study was to evaluate the performance of the A.F. Genital System® in the detection of vaginal pathogens in patients with obstetrical and gynecological pathologies. Materials and Methods: A total of 197 vaginal swab samples were collected from patients presenting with various obstetrical and gynecological pathologies. The A.F. Genital System® and vaginal culture/traditional methods were used for pathogen detection. Results: The A.F. Genital System® demonstrated a detection rate of 68% for single vaginal infectious agents, outperforming the vaginal culture/traditional methods (52.8%). However, differences in detection rates were observed for specific pathogens, such as E. coli, Gardnerella vaginalis, Staphylococcus aureus, and Pseudomonas spp. Conclusions: Despite lower sensitivity for specific pathogens, the A.F. Genital System® showed a high correlation with reference tests, suggesting its potential utility as a diagnostic tool for identifying common vaginal pathogens in clinical settings

Van İli Sınırları İçerisinde Van ve Erçek Gölü’nün Mikrobiyolojik Kirlilik Seviyesinin Belirlenmesi

Amaç: Van Gölü, bölgenin en önemli rekreasyon alanlarından biridir. Göl’ün mikrobiyolojik kirlilik açısından araştırılması halk sağlığı için çok önemlidir. Bu çalışmada, Van ilinin sınırları içinde bulunan Van ve Erçek Gölü’nün mikrobiyolojik kirlilik varlığının ve oranının saptanması, insan sağlığını ve çevreyi korumak üzere, yüzme ve rekreasyon amaçlı kullanılan bu suların kalitesinin belirlenmesi amaçlanmıştır. Bu amaçla 29 farklı noktadan alınan örneklerde fekal koliform, toplam koliform ve enterokok varlığı araştırılmıştır.Yöntem: Haziran-Eylül 2015 tarihleri arasında, önceden belirlenen 29 noktadan iki haftada bir olmak üzere 232 adet su örneği, Yüzme Suyu Kalitesi Yönetmeliği (76/160/AB) ek: 5 maddesine uygun olarak, 300-500 ml’lik steril plastik şişelere alınarak Van İl Halk Sağlığı Laboratuvarı’na iletildi. Örneklerin koliform ve enterokok yönünden analizi için membran filtrasyon yöntemi kullanıldı. Yüzme suyu kalitesi yönetmeliğine göre zorunlu değerler fekal koliform, toplam koliform ve enterokok için sırasıyla 2000 kob/100 ml, 10.000 kob/100 ml ve 1000 kob/100 ml olarak alındı. Alınan su örneklerinde fekal koliform, toplam koliform ve enterokok türlerinden herhangi birinin zorunlu değerlerin üzerinde saptanması durumunda, söz konusu su örneği kötü kalite olarak değerlendirildi.Bulgular: Alınan toplam 232 su örneğinin 196’sında (%84) herhangi bir bakteriyel kirlilik bulunmazken, 36 örneğin (%16) fekal koliform, toplam koliform ve enterokok türleri ile kontamine olduğu belirlendi. Örnek alınan 29 sahilden 17’sinde (%71) en az bir veya daha fazla örnekte kötü kaliteli su belirlendi.Sonuç: Mikrobiyolojik kirlilik saptanan yerlerin kullanımının kısıtlanarak önlem alınması öngörüldü. Ayrıca belirtmek gerekir ki, analizlerin düzenli olarak yapılması halk sağlığı açısından önemlidir.Objective: Lake Van is one of the most important recreation areas of the region. Investigation of microbiological pollution of Lake Van is very important for public health. The aim of this study is to assess the microbiological pollution and determine water quality of the lakes Van and Erçek situated within Van Province, which are used for swimming and recreation to protect both human and environmental health. For this purpose, the presence of fecal coliform, total coliform and enterococci were investigated in samples taken from 29 different points of the lakes.Method: Between June and September 2015, 232 water samples were taken from predefined 29 points, every two weeks, and sent to the Public Health Laboratory of Van Province in 300-500 mL sterile plastic bottles in accordance with Bathing Water Quality Regulation (76/160 / EU: add-on clause 5. Membrane filtration method was used to analyze the samples for coliform bacilli and enterococci. Mandatory values according to bathing water quality regulation were taken as 2000 cfu/100 ml,10000 cfu/100 ml and 1000 cfu/100 ml for fecal coliform, total coliform and enterococcus, respectively.Results: In 196 (84%) of 232 water samples collected, no bacterial contamination was found, while 36 (16%) samples were found contaminated with fecal coliform, total coliform and Enterococcus species. At least one or more specimens of poor quality water were detected in 17 of 29 sampled beaches.Conclusion: It was envisaged to take precautions by restricting the use of the places where microbiological pollution was detected. In addition, regular analyzes are important for public health.</p

Change in Serum Concentrations of Interleukin-2 and Interferon-γ during Treatment of Tuberculosis

We aimed to investigate changes in serum concentrations of the cytokines interleukin (IL)-2 and interferon (IFN)-gamma during the clinical course of active tuberculosis, to establish the presence of cellular immunity before and after treatment. Blood samples were taken from 18 patients with active tuberculosis before and 2 months after therapy; IL-2 and IFN-gamma concentrations were evaluated. The mean serum IL-2 concentration before therapy was 164.5 pg/ml (range 12 - 980 pg/ml) and the concentration 2 months after therapy was 92.11 pg/ml (range 1 - 490 pg/ml). The mean serum IFN-gamma concentrations were 10.83 pg/ml (range 1 - 22.2 pg/ml) and 4.64 pg/ml (range 1 - 28.5 pg/ml), respectively. The decrease in concentrations of both cytokines after therapy was statistically significant. Further studies investigating the benefits of adding cytokines to drug treatment for tuberculosis are needed

Change in serum concentrations of interleukin-2 and interferon-gamma during treatment of tuberculosis

We aimed to investigate changes in serum concentrations of the cytokines interleukin (IL)-2 and interferon (IFN)-gamma during the clinical course of active tuberculosis, to establish the presence of cellular immunity before and after treatment. Blood samples were taken from 18 patients with active tuberculosis before and 2 months after therapy; IL-2 and IFN-gamma concentrations were evaluated. The mean serum IL-2 concentration before therapy was 164.5 pg/ml (range 12 - 980 pg/ml) and the concentration 2 months after therapy was 92.11 pg/ml (range 1 - 490 pg/ml). The mean serum IFN-gamma concentrations were 10.83 pg/ml (range 1 - 22.2 pg/ml) and 4.64 pg/ml (range 1 - 28.5 pg/ml), respectively. The decrease in concentrations of both cytokines after therapy was statistically significant. Further studies investigating the benefits of adding cytokines to drug treatment for tuberculosis are needed

First isolation and detection of multiple clones of vancomycin-resistant enterococci in the pediatric unit of Van Yuzuncu Yil University, Turkey

Bu çalışmada, Van Yüzüncü Yıl Üniversitesi, Tıp Fakültesi Hastanesi pediatri servisinde dokuz aylık bir hastanın idrarından, bu hastane ve bölgedeki ilk vankomisine dirençli enterokok (VRE) susunun izole edilmesi üzerine, bu serviste başka VRE izolatlarının varlığının araştırılması, direnç genotiplerinin tespiti ve izolatlar arasındaki klonal ilişkinin değerlendirilmesi planlanmıştır. Bu amaçla hastalardan 28 rektal sürün-tü, 28 cilt sürüntüsü, hastaların bakımından sorumlu personelden 12 cilt sürüntüsü, hastaların annelerinden 15 cilt sürüntüsü ve servisten 96 çevre örneği alınmıştır. İzole edilen suşlann antibiyotik duyarlılıkları ve direnç genotipleri tespit edilmiş; izolatların moleküler tiplendirmesi "pulsed-field" jel elektroforezi (PFCE) ile yapılmıştır. Birinci olgu dışında; biri başka bir hastanın idrarından, 12'si tarama örneklerinden (8 olgunun rektal sürüntü, bir olgunun cilt örneği ve üç hasta yatağı örneği) olmak üzere 13 izolat daha elde edilmiştir. Bütün izolatlar Enterococcus faecium olarak tanımlanmış ve benzer antibiyotik duyarlılık profillerine sahip oldukları gözlenmiştir, izolatların hepsinde vanA geni tespit edilmiştir. PFGE sonuçları, iki majör klon ve bu klonlarla yakın ilişkili beş klonun varlığını ortaya koymuştur. Sonuç olarak; Van bölgesinden ilk VRE izolasyonunun ve birden fazla klonun yayılımının bildirildiği bu çalışma, ülkemizde çok yaygın gibi görünmese de, giderek artan izolasyon oranları ile VRE'lerin potansiyel önemini vurgulamaktadır.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. PFCE 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

Investigation of Extended Spectrum Beta-Lactamase (ESBL) Genes in ESBL-Producing Escherichia coli and Klebsiella pneumoniae Strains

Introduction: Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is an important health problem all over the world. In this study, it was aimed to determine the ESBL genes in Escherichia coli and Klebsiella pneumoniae strains isolated for approximately four-year period. Materials and Methods: A total 100 ESBL-producing E. coli and 100 ESBL-producing K. pneumoniae strains which were isolated between January 2008 and October 2012 were included into this study. The strains were identified using classical bacteriologic methods and BD Phoenix (Becton Dickinson, US) automatized bacterial identification device. CTX-M, TEM, SHV, VEB, GES, PER and OXA beta-lactamase genes were analyzed with the PCR method. Results: The beta-lactamase genes detected in ESBL-positive K. pneumoniae strains were as follows: 99% for CTX-M, 91% for SHV, 71% for TEM, 10% for OXA-10 group, and 5% for OXA-2 group. In E. coli strains, the prevalence of CTX-M was 92%; TEM was 70%, SHV was 21%, and OXA-2 group was 3%. CTX-M alone was found to be positive in 25 of the 98 (25.5%) in E. coli strains; TEM alone was found to be positive in 2 of 98 (2%) and SHV alone was found in 2 of 98 (2%). CTX-M alone was found positive in 3 of 100 (3%) K. pneumoniae strains. No other resistance genes alone were found in the strains. No GES, VEB and PER-producing strains were determined in this study. Conclusion: In the study, high prevalence of CTX-M beta-lactamase was found in ESBL-producing strains. It was thought that the high potential of mobility with CTX-M genes was the most possible reason for this result. Determination of ESBL genes will be useful to understand resistance epidemiology, develop effective therapeutic strategies, and plan the appropriate preventive measurements