Acinetobacter türlerine bağlı kan dolaşımı infeksiyonlarında risk faktörleri: İleriye dönük bir olgu-kontrol çalışması

Objective: The aim of this prospective case control study was to describe the risk factors for bacteremia due to Acinetobacter species among hospitalized patients. Methods: The study was conducted prospectively from July 2012 to January 2014, and one case group and two control groups were created. Case group comprising patients with Acinetobacter bacteremia and control group 1 comprising patients with bacteremia due to other agents and control group 2 comprising non-bacteremic patients were compared in terms of demographic characteristics, underlying diseases, invasive procedures, and antibiotic use. Results: The study group (n=23) and control groups (n=46) were compared with univariate analysis and significant risk factors for Acinetobacter bacteremia were as follows: total parenteral nutrition, chemotherapy, use of broad spectrum antibiotics including β-lactam and β-lactamase inhibitors, carbapenems, teicoplanin, and antifungals (p<0.05). The duration of hospitalization was longer in case group (p=0.005). In multivariate analysis, factors independently associated with an increased risk of Acinetobacter spp. bacteremia included total parenteral nutrition (odds ratio, OR 5.13; confidence interval 95%, CI 95%, 1.41-18.57; p=0.013), use of a β-lactam/β-lactamase inhibitor (OR 7.67; CI 95% 1.67- 35.25; p=0.009), and use of teicoplanin (OR 4.11; CI 95% 1.09- 15.46; p=0.036). Conclusions: The definition of risk factors for Acinetobacter spp. bacteremia may help with the management of patients and infection control precautions by early prediction of the infection. © 2015, AVES Ibrahim Kara. All rights reserved

Successful treatment of multidrug resistant Acinetobacter baumannii meningitis.

Acinetobacter baumannii is a major cause of nosocomial infections in many hospitals and appears to have a propensity for developing multiple antimicrobial resistance rapidly. We report two cases with post-surgical meningitis due to multidrug resistant A. baumannii which were successfully treated with high-dose intravenous meropenem therapy. Multidrug resistant Acinetobacter spp. in intensive care units are a growing concern. High-dose meropenem is used in the treatment of these infections

H pylori iceA alleles are disease-specific virulence factors

Aim: To characterize and compare genotype profiles of H pylori strains isolated from patients with chronic gastritis and duodenal ulcer in western part of Turkey. Methods: A total of 46 patients [30 chronic gastritis (CG) and 16 duodenal ulcer (DU)] who had undergone endoscopy because of dyspeptic complaints were studied. The antral biopsy specimens were evaluated for the presence of H pylori by rapid urease test and culture, and the genotype profiles were determined by real-time PCR. Results: The cagA gene was observed in 43 (93.5%) isolates. The vacA s1m2 genotype was the predominant subtype, found in 63.3% and 68.7% of isolates in patients with CG and DU, respectively. Twenty (66.6%) isolates from patients with CG were iceA2 positive while the iceA1 was predominant in those with DU (68.8%). In terms of the association of the iceA alleles to other genes, both alleles were significantly associated with the cagA vacA s1m2 genotype. Conclusion: The prevalent circulating genotypes in CG and DU were cagA vacA s1m2 iceA2 and cagA vacA s1m2 iceA1 genotype, respectively. It was found that cagA vacA s1m2 genotype seems to be common virulence factors in both CG and DU while iceA alleles show specificity for gastroduodenal pathologies in this study. © 2007 The WJG Press. All rights reserved

Seroprevalence of hepatitis E virus among primary school children

Objectives: To investigate the seroprevalence of anti-hepatitis E virus antibody among primary school children in the two different areas of Denizli, Turkey. Methodology: Anti-HEV antibodies were investigated in 185 primary school children (91 from rural areas and 94 from urban areas of Denizli). The children were divided into two age groups as seven-year old group and fourteen-year old group. Samples were tested for anti-HEV Ab by an enzyme-linked immunoassay. Results: A total of 23 primary school children were anti-HEV Ab positive, giving a prevalence of 12.4%. The seroprevalence rate was 13.1% in rural areas and 11.7% in urban areas. The difference in the seropositive rates was not statistically significant (p > 0.05). Among 185 primary school children, Anti-HEV antibodies were positive 17 (18.1%) in seven-year old group, and 6 (6.6%) in fourteen-year old group. The difference in the seropositive rates was statistically significant (p < 0.05). Conclusions: There was no association between the anti-HEV Ab and gender, socioeconomic level, parental educational level, rural or urban areas. Anti-HEV Ab seroprevalence was higher in seven-year old children than fourteen-year old children

Systemic and local antibiotic prophylaxis in the prevention of Staphylococcus epidermidis graft infection

BACKGROUND: The aim of the study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of Staphylococcus (S.) epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials. METHODS: Graft infections were established in the subcutaneous tissue of 120 male Wistar rats by implantation of Dacron/ePTFE grafts followed by topical inoculation with 2 × 10(7 )CFUs of clinical isolate of methicillin-resistant S. epidermidis. Each of the graft series included a control group, one contaminated group that did not receive any antibiotic prophylaxis, two contaminated groups that received systemic prophylaxis with teicoplanin or levofloxacin and two contaminated groups that received teicoplanin-soaked or levofloxacin-soaked grafts. The grafts were removed 7 days after implantation and evaluated by quantitative culture. RESULTS: There was significant bacterial growth inhibition in the groups given systemic or local prophylaxis (P < 0.05). Methicillin-resistant S. epidermidis had greater affinity to Dacron graft when compared with ePTFE graft in the untreated contaminated groups (P < 0.05). CONCLUSION: The study demonstrated that the usage of systemic or local prophylaxis and preference of ePTFE graft can be useful in reducing the risk of vascular graft infections caused by staphylococcal strains with high levels of resistance

Evaluation of direct microscopic examination, acridine orange staining and culture methods for the detection of Trichomonas vaginalis in vaginal discharge specimens

Trichomonas vaginalis is the causative agent of human trichomoniasis which is a sexually transmitted disease mainly in women. The infection may be asymptomatic or symptomatic such as severe vaginitis and cervicitis. The aim of this study was to compare direct microscopic examination, acridine orange stained examination and culture in Modified Diamond medium, for the detection of T.vaginalis from the vaginal swab samples of 310 patients (age ranges: 17-45 years old) who were complaining from vaginal discharge. Of them 40 (12.9%) samples were found positive with culture, 20 (6.5%) were positive with direct microscopy and 19 (6.1%) were positive with acridine orange staining method. The positive results were obtained in 17 cases by each of the three methods, in 3 cases by direct microscopy and culture, in 2 cases by acridine orange staining and culture, and in 18 cases by culture only. T.vaginalis has been detected in 19.5% of 41 patients with itching, 15.7% of 190 patient with groin pain and 23.2% of 43 patients with cervical erosion, in addition to vaginal discharge, by at least one of the methods. In conditional evaluation, there were no statistically significant differences between T.vaginalis positivity with age groups and the contraceptive methods used. As a result, it was concluded that for the laboratory diagnosis of T.vaginalis, acridine orange staining technique does not have any superiority over direct microscopy. Although direct microscopy is a practical and economical method, it has low sensitivity, so all of the suspected samples which are found negative by this method, should be cultivated for a definite diagnosis

Comparison of genotypic and phenotypic characteristics in biofilm production of staphylococcus aureus isolates

Staphylococcus aureus which is an important pathogen, is known to have several virulence factors. The pathogenicity of S.aureus isolates are related with features like adherence, various toxins, enzymes, structural and extracellular factors. Slime factor and biofilm formation are also the pathogenicity factors of the bacteria. Biofilm formation is usually associated with chronic infections and has become a subject of interest in a wide area of research. Biofilm is an adherent structure formed by bacteria encased within a matrix produced on natural body surfaces or medical devices. As the biofilm producing S.aureus isolates are more resistant to antibiotics and and their biofilms prevent phagocytosis, the treatment of infections caused by biofilm positive S.aureus isolates become difficult. The icaADBC locus and some proteins have provento be responsible for the formation of S.aureus type biofilm. The aim of this study was to investigate the relationship between the genotypic and phenotypic detection methods of biofilm formation with icaA, icaD and bap genes and phenotype expressions which are responsible for the formation of biofilm in S.aureus isolates. One hundred seventy five S.aureus isolates from various clinical specimens were included in the study. For the phenotypic detection of biofilm producing isolates Congo red agar (CRA) medium and microplate method were used. The biofilm-producing strain Staphylococcus epidermidis ATCC 35984 and S. epidermidis ATCC 12228 were used as positive and negative controls, respectively. One hundred fifty two S.aureus biofilm producing isolates were detected at Least by either Congo Red agar or microplate method and all isolates were screened for icaA, icaD and bap genes by PCR. The production of polysaccharide intracellular adhesins/poly-N-acetyl-beta-1-6–glucosamine (PIA/PNAG) was also investigated in S.aureus isolates. For the detection of PIA/PNAG chemiluminescence dot-blot method was used. According to the phenotypic evaluations based on colony morphologies in CRA medium, biofilm formation were found as negative in 101 of 175 isolates (57.7%), while biofilm formation were positive in 74 (42.3%) of the isolates. As a result of quantitative evaluation by microplate method based on absorbance measurement, biofilm production was determined as negative in 34 (19.4%) specimens, moderate in 112 (64.0%) specimens and strong in 29 (16.6%) specimens. Microplate and CRA methods were incompatible with each other when compared for their biofilm production determination (p< 0.001). Among the 152 clinical isolates used to determine the presence of icaA and icaD genes responsible for the formation of biofilms, the genes were detected in 136 (89.5%) of the isolates and in the S.epidermidis ATCC 35984 strain used as a positive control. icaA and icaD genes were not detected in sixteen of the 152 (10.5%) clinical isolates and in the S.epidermidis ATCC 12228 strain used as a negative control. A weak-moderate correlation was found between icaA and icaD genes and biofilm production determined in CRA medium. A good correlation was found between icaA and icaD genes and biofilm production detected in microplate method. bap gene was determined in only one of the 152 clinical S.aureus isolates studied and in S.aureus V329 strain used as positive control. For the detection of PIA/PNAG which was synthesized by icaADBC genes, 50 clinical S.aureus isolates were used. PNAG production was determined in 42 isolates with positive icaA and icaD genes by the chemiluminescence dot-blot method, and no PNAG production was determined among eight isolates with negative ica genes. As a result, it was found that the microplate method was more sensitive and reliable for the phenotypic determination of biofilm formation in S.aureus isolates, high level of biofilm formation among clinical S.aureus isolates (about 80%), the role of icaA and icaD genes and products (PIA/PNAG) in biofilm production was determined. © 2018 Ankara Microbiology Society. All rights reserved

Deni̇zli̇ şehi̇r merkezi̇nde kovuklu agaç gövdeleri̇nden Cryptococcus neoformans i̇zolasyonu

Cryptococcus neoformons is a basidiomycetous yeast leading to life-threatening infections in human and animals. It has been isolated from decaying hollows and fissures from various tree species in different parts of the world. The isolation of the yeast from the environment is less in the eastern part of Mediterranean area. Only one C.neoformans strain from debris of Eucalyptus comolduleosis in the blossoming period, has been reported by consecutive studies done in suspected areas since the last 10 years. In this study, 300 tree including trunk hollows and fissures have been screened for colonization of Cneoformans in Denizli city (located on Aegean part of Turkey) center during July 2008. All samples has been collected by swabbing technique and cultured on minimal Staib agar ME,dium (without creatinine and potassium clihydroden phosphate). Two (0.6%) strains of Cneoformons have been isolated from the total of 300 screened trees. One of these isolates was from Platonus orientolis (plane tree; n= 92) and one from Punica gronatum (pomegranate tree; n= 2). Six and three colonies per plate have been isolated from Porientolis and Pyronatum samples, respectively. Cneoformans has not been isolated in the repeat cultures done in the following two months. Although Cneoformons was isolated from previously unaccomplished niches in this study, our results suggested that Cneoformons colonization of trees trunk hollows and fissures was not common in Denizli city center